I recently was part of a group that traveled to Raleigh, North Carolina, to hear a legislative committee meeting about the Certificate of Need that is required to open a medical facility in North Carolina.
The Certificate of Need (CON) hearing was on HB200, a bill sponsored by Representative Marilyn Avila that would remove several types of operating rooms (including those for ophthalmology procedures and colonoscopy) from the list of medical facilities which are required to apply for (a lengthy, expensive, difficult process) and get a CON before they can be set up.
It is our Legislative Action Committee’s position that hospitals have managed to have a monopoly on CON’s for years, have used them to shut individual physicians out of competition, and have used them to drive the cost of procedures up (people who pay for their own health care, and people who are experiencing higher and higher co-pays see this very clearly). This has resulted in higher salaries for some members of hospital staffs and very high retained earnings for some hospitals including the one here in New Bern.
The hearing was fast paced, enormously interesting, and did nothing to dispel our view.
Representative Avila introduced the bill, said a few words about it, and then explained that the group would hear from one person who was in favor of passage of the bill and a second person who was against it.
Connie Wilson, a lobbyist for a group of physicians, spoke first. She was followed by a lobbyist for a group of hospitals. They each spoke for about ten minutes.
Connie speaks fluidly. She’s very clear, concise, and straightforward. She builds her case with facts. She uses charm and humor. (Can you tell I was REALLY impressed?) She made the bill seem like the best thing to come along since sliced bread.
The fellow who spoke for hospitals used platitudes, veiled warnings about what “might” happen if some CON requirements were lifted, and tried to create fear. He did a respectable job for someone who had to defend an indefensible position, but I found myself constantly annoyed by things he said.
Then the questions began.
We’d been given to understand that 5 Representatives were of particular concern to folks who want the bill to pass, and every one of them was at the hearing, and each of them asked one or more questions that seemed to be from a negative perspective.
I’m going to tell you who each of the 5 is, what district he serves, what his contact information is, and then ask you a favor. Here they are…
Representative John Szoka is a Republican serving NC House District 45. His home is in Fayetteville. His office is in Room 2223 of the Legislative Building. His phone is 919-733-9892. His email is firstname.lastname@example.org.
Representative Josh Dobson is a Republican serving NC House District 85. His home is in Nebo. His office is in Room 1006 of the Legislative Building. His phone is 919-733-5862. His email is email@example.com.
Representative Brian Brown is a Republican serving NC House District 9. His home is in Greenville. His office is in Room 604 of the Legislative Office Building. His phone is 919-733-5757. His email is firstname.lastname@example.org.
Representative Kelly Hastings is a Republican serving NC House District 110. His home is in Cherryville. His office is in Room 1206 of the Legislative Building. His phone is 919-715-2002. His email is email@example.com.
Representative Nelson Dollar is a Republican serving NC House District 36. His home is in Cary. His office is in Room 307-B of the Legislative Office Building. His phone is 919-715-0795. His email is firstname.lastname@example.org.
If you live in the district of one of these folks, please go to see them, give them a call, or email them (expressed in the order of preference), and ask them to support HB200. Do this as quickly as you can. This bill needs to be reported out of the Health Committee, be heard by 2 other committees, and be voted on on the House floor by “crossover” on April 30 in order to remain viable.
Jay Singleton, DO, FACS, spoke at a recent CCTA meeting in Stanly Hall in New Bern, North Carolina. He is an eye surgeon who is supporting repeal of the Certificate of Need (CON). He sums up the issue as follows, “The CON law is one of the few existing laws that has been ruled unconstitutional by the Supreme Court. Hospitals have used this law for nearly forty years to become too big to fail in our state. Many members of the general assembly have been duped by the hospital association and its lobbyists into believing healthcare would collapse and the sky would fall without this dubious law. Do not fall for the chicken little argument.”
As a resident of Massachusetts, I had cataract surgery on each eye. The first surgery was done in the hospital at Boston Eye and Ear. That is an outstanding hospital, although it has limited available parking and is in the middle of city traffic. The second surgery was done at Surgisite in Waltham, Massachusetts. It was easier to get to, parking was available, and the experience was much easier and less stressful (aside from being much cheaper). Based on my personal experience, I would strongly suggest that the North Carolina legislature repeal the CON law and allow the free market to lower the cost of medical care in the State of North Carolina and to give people the option of receiving quality medical care in small local facilities that specialize in specific areas rather than exclusively in large hospitals.