Specialized Medical Centers Will Benefit New Hampshire

Throughout this legislative session, House leadership has made clear that our first priority was to maintain the New Hampshire Advantage by fostering a job growth environment, not raising taxes, and eliminating unnecessary and burdensome regulations.

New Hampshire is fortunate. We enjoy the fourth lowest unemployment rate nationally and unemployment has dropped since the last election with the creation of 10,000 new jobs. However, we cannot get complacent. Within New Hampshire, Salem and Pelham have among the top 25 highest unemployment rates of 8.6 percent and 7.9 percent respectively, according to state figures. We owe the 38,000 of our friends and neighbors who are currently unemployed every opportunity to find work.

One initiative we are working on encompasses all of what we are trying to accomplish: it creates jobs, develops the economy, and improves the quality of health care statewide.

House Bill 1642, which I cosponsored with my colleagues Reps. Marilinda Garcia and Gary Azarian, would make New Hampshire a magnet for highly-specialized medical centers. Already Cancer Treatment Centers of America has expressed a great interest in expanding here. The legislation encourages and enables such development in health care by exempting for-profit specialty hospitals with 50 or fewer beds from the burdensome and anti-free market certificate of need (CON) process. Additionally, it also requires the state to submit a waiver of the Medicaid enhancement tax for such hospitals.

Specialized acute care hospitals fill the gap in services between short-term acute care hospitals and skilled nursing homes or subacute facilities. Destination specialty hospitals focus on specific medical issues - such as oncology, cardiology, spinal injury, etc - and meet the needs of patients who no longer require the ICU, yet whose medical conditions are too complex for transfer to a lesser facility. Treatment programs center around providing the highest level of comprehensive care needed to improve patient outcomes. In short, these hospitals offer higher quality care, more amenities and an alternative to general hospitals. These benefits also include the related economic benefits such as new revenue toward the business profits and business enterprise taxes, the rooms and means tax, and the boost to local property taxes which should reduce the overall tax burden to the host community.

From a health care perspective, specialty hospitals benefit patients who require an extended hospitalization because they are able to deliver a complete continuum of care at costs that are typically lower than a traditional hospital. From an economic perspective, any organization that is seeking to invest millions of dollars into our economy while improving care is one that we should welcome.

Surprisingly, despite the health and economic benefits this legislation provides there are critics who contend specialty hospitals draw less-complicated, more-profitable patients with Medicare and private insurance away from general hospitals, which threatens other hospitals’ existence. However, it’s critically important to understand that this criticism is based almost entirely from a fear of competition and come from beneficiaries of the current monopolistic CON system. Specialty hospitals aren’t seeking to capture our market; they instead consider New Hampshire a strategic geographic location to attract customers from the greater Northeast region.

Debunking claims of unfairness begins by looking at New Hampshire’s CON process. It requires permission from a board of competitors prior to building or modifying health care facilities, acquiring new medical equipment, or offering new inpatient care beds and services.  The CON process is controlled in such a way as protects the established hospitals and serves as a barrier to a competitive health care system.  We need more competition, not less.

Specialty hospitals are very different from the general acute care hospitals that the CON process was put in place to control and generally do not meet the CON requirements.  Additionally, private, for-profit organizations that make investment and acquisition decisions based on the needs and demands of their patients and the fast-paced developments in technology and medicine, have no interest in locating in a state where such purchases could take months to apply for approval or be denied outright. Specialty hospitals also prefer flexibility to meet their client needs, not necessarily according to the dictates of individual CON laws.

New Hampshire is incredibly fortunate to have hospitals that deliver great care. This legislation in no way should be seen as a lack of appreciation for what they do. However, New Hampshire must be welcoming to any organization that wishes to come to our state to offer more health care options and grow our economy, especially when they show a willingness to expand to the greater Salem area.

It is time to see less government and special interest intrusion into the development of innovative health care treatment systems while at the same time creating jobs. New Hampshire needs House Bill 1642.