{"id":41522,"date":"2021-03-08T16:09:21","date_gmt":"2021-03-08T21:09:21","guid":{"rendered":"https:\/\/www.rightwinggranny.com\/?p=41522"},"modified":"2021-03-08T16:09:21","modified_gmt":"2021-03-08T21:09:21","slug":"when-medical-facilities-have-monopolies","status":"publish","type":"post","link":"https:\/\/www.rightwinggranny.com\/?p=41522","title":{"rendered":"When Medical Facilities Have Monopolies"},"content":{"rendered":"

The Carolina Journal<\/a> posted an article today about the Certificate of Need (CON) laws in North Carolina.<\/p>\n

The article notes:<\/p>\n

In theory, the system is supposed to guard patients\u2019 access to health care.\u00a0\u00a0<\/strong><\/p>\n

But the system offers a wealth of opportunities to crush unwanted competition and hamstring smaller doctors\u2019 practices. Under CON laws, incumbent providers can take their competitors to court and force them to bleed money for months, years, or even decades.\u00a0\u00a0<\/strong><\/p>\n

It may be easy to\u00a0praise the system on the record.\u00a0But those who criticize it do so quietly, and they fear retribution. Many\u00a0declined\u00a0to publish their names\u00a0in this story\u00a0or\u00a0to\u00a0speak on the record.\u00a0\u00a0<\/strong><\/p>\n

\u201cIt\u2019s human nature, so I shouldn\u2019t be surprised, but I have clients who think it\u2019s unconstitutional, it\u2019s terrible, it\u2019s an unfair restraint on trade,\u201d said a CON attorney. \u201cBut once they get it, CON is great, it\u2019s saving money, it\u2019s good for the people. It\u2019s incredible the metamorphosis they undergo.\u201d\u00a0<\/strong><\/p>\n

According to the article, the fight against the CON laws began with Dr. Gajendra Singh, a surgeon who tried to treat poor patients. He watched patients put off medical tests only to find that they had terminal cancer that might have been checked if detected earlier.<\/p>\n

The article reports:<\/p>\n

Singh\u00a0began the fight<\/a> Singleton (Dr. Jay Singleton) carries on.\u00a0<\/strong><\/p>\n

Singh watched his patients being crushed by medical bills or catching cancer too late. One man put off getting an MRI for more than a year. What he found was worse than any medical bill.\u00a0<\/strong><\/p>\n

\u201cSo, I saw it,\u201d Singh told\u00a0WFDD<\/a>. \u201cHe had a cancer spread everywhere. And that was a Stage 4 cancer. And I felt guilty. Like you know, that as a society we had failed him.\u201d\u00a0<\/strong><\/p>\n

Singh founded his own imaging center in Forsyth County a year later, and sued to overthrow the CON regime. He is something of a legend now, at least in pockets of the medical community.\u00a0<\/strong><\/p>\n

Singh saved his patients\u00a0thousands of dollars<\/a>. Some drove for hours; some came from other states. Some came because of mysterious pain, and others because these were the only scans they could afford.\u00a0<\/strong><\/p>\n

\u201cSingh, man,\u00a0gotta\u00a0hand it to him. But he bit off a lot,\u201d Singleton said. \u201cHe went after the MRIs, the \u2018Shangri La,\u2019 the temple.\u201d\u00a0<\/strong><\/p>\n

But Singh\u2019s practice\u00a0collapsed under<\/a>\u00a0the stress inflicted by CON laws and the COVID-19 pandemic. His patients have lost their access to affordable medical scans, and Singh has stopped talking to the press.\u00a0\u00a0<\/strong><\/p>\n

\u201cTrailblazers are usually found dead on the trail,\u201d Singleton said. \u201cYou want to be the second guy, the third guy. Not the first guy.\u201d\u00a0<\/strong><\/p>\n

Please follow the link to read the entire article. The article cites other examples of doctors who tried to treat patients in need and were blocked by CON laws. Thirty-five states currently have CON laws.<\/p>\n

The article concludes:<\/p>\n

Even former council members can\u2019t agree on whether the CON process is driven by data or swayed by politics. \u00a0<\/strong><\/p>\n

The\u00a025-member<\/a>\u00a0State Health Coordinating Council is dominated by hospital systems, which\u00a0control at least 10 seats. Two business advocates, two elected lawmakers, and one insurer are tasked with representing small and large businesses.\u00a0\u00a0<\/strong><\/p>\n

The critics accuse the state of playing politics with patients\u2019 access to health care. They point to\u00a0studies<\/a>\u00a0showing that CON states have fewer rural hospitals.\u00a0<\/strong><\/p>\n

\u201cIt\u2019s very political. You can look at the council, see who\u2019s there, and whose interests they\u2019re protecting,\u201d said a former council member who feared retribution. \u201cReality is, there\u2019s an oligopoly. There\u2019s a few big medical centers. They have all the money and all the clout.\u201d\u00a0<\/strong><\/p>\n

CON\u2019s supporters say the council protects the state from a destructive medical arms race. They warn that rural hospitals will close if exposed to uncontrolled competition.\u00a0<\/strong><\/p>\n

\u201cWhen hospitals had to shut down electives, rural hospitals really struggled,\u201d said Cody Hand, lobbyist for the N.C. Healthcare Association. \u201cWithout the CON laws, those hospitals couldn\u2019t make it financially. \u2026. Our fear is that,\u00a0without CON, someone could come in and easily pick those profitable services off.\u201d\u00a0<\/strong><\/p>\n

Another former council member believes CON laws have created monopolies. He supports parts of CON, but its process forced him to spend hundreds of thousands of dollars on CON\u2019s legal battles.\u00a0<\/strong><\/p>\n

\u201cIf they keep filing lawsuits, they can delay that competitor from coming in, and they\u2019ll make up the legal fees,\u201d the former council member said. \u201cThat\u2019s been a nasty battle, there\u2019s still bad blood between the two parties. The scars are still there.\u201d\u00a0<\/strong><\/p>\n

He believes there has to be a legal recourse for providers. But he also acknowledged the dangers of the current system.\u00a0<\/strong><\/p>\n

\u201cIt\u2019s crazy, crazy stuff,\u201d he said. \u201cThe small guys, the hospital can beat them down.\u201d\u00a0<\/strong><\/p>\n

CON reform is notoriously difficult to move in the legislature. But the N.C. Healthcare Association does support reforming the litigation that dogs the CON process, Hand said.\u00a0\u00a0<\/strong><\/p>\n

Hand said he wouldn\u2019t oppose raising the bond \u2014 or the $50,000 competitors must stake to sue over CONs \u2014 to create a \u201cgood faith scenario.\u201d But he rejected any repeal efforts.\u00a0\u00a0<\/strong><\/p>\n

\u201cIt\u2019s a burden on my members as well,\u201d Hand said. \u201cBut [repeal] for us is a baby with the bathwater issue.\u201d\u00a0<\/strong><\/p>\n

Singleton is less charmed. If he heard Hand\u2019s comment, he would likely accuse him of drowning the baby.\u00a0<\/strong><\/p>\n

\u201cIn the face of CON, you find out who the true predators are,\u201d Singleton said. \u201cSmall hospitals have to fear our larger hospitals, kind of like fish.\u201d\u00a0<\/strong><\/p>\n

Long before I moved to North Carolina, I had cataract surgery. Because there was a time lag between when each eye needed the surgery, the first surgery was done at Massachusetts Eye and Ear Hospital in Boston, the second at Surgisite Boston, a modern ambulatory surgery center that is used by 70 ophthalmologists from throughout the region, located in Waltham, Massachusetts. Aside from the ease of getting to the site and the available parking, the Surgisite had the most up-to-date equipment and was amazingly efficient (as well as cheaper for my insurance company). There are some medical procedures that can be done very safely outside of a hospital at a much lower cost. Unfortunately CON laws prevent that from happening. CON laws create a very unproductive monopoly.<\/p>\n","protected":false},"excerpt":{"rendered":"

The Carolina Journal posted an article today about the Certificate of Need (CON) laws in North Carolina. The article notes: In theory, the system is supposed to guard patients\u2019 access to health care.\u00a0\u00a0 But the system offers a wealth of … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[13542,8817,13539,13540,13541,12860],"class_list":["post-41522","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-cateract-surgery","tag-certificate-of-need","tag-con","tag-dr-gajendra-singh","tag-dr-jay-singleton","tag-the-carolina-journal"],"_links":{"self":[{"href":"https:\/\/www.rightwinggranny.com\/index.php?rest_route=\/wp\/v2\/posts\/41522","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.rightwinggranny.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.rightwinggranny.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.rightwinggranny.com\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.rightwinggranny.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=41522"}],"version-history":[{"count":1,"href":"https:\/\/www.rightwinggranny.com\/index.php?rest_route=\/wp\/v2\/posts\/41522\/revisions"}],"predecessor-version":[{"id":41524,"href":"https:\/\/www.rightwinggranny.com\/index.php?rest_route=\/wp\/v2\/posts\/41522\/revisions\/41524"}],"wp:attachment":[{"href":"https:\/\/www.rightwinggranny.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=41522"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.rightwinggranny.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=41522"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.rightwinggranny.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=41522"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}