The Health Care CON Game

The clash of has spilled over into Dorchester County. Roper St. Francis v. Trident Health Systems is no longer contained to Berkeley County for the right to build a hospital, but now they’re fighting over Trident’s expansion of Summerville Medical Center, the only hospital in Dorchester County. The stakes in this game are huge – not just for the health care providers – but also for Summerville residents. The pot in this game of Hospital Hold ‘Em is no just access to adequate health care, but the economic vitality of thousands of residents in both Dorchester and Berkeley counties.

The root cause is not who provides quality health care, but it’s an antiquated regulatory structure that is more akin to gang turf than the aim of efficient service delivery. South Carolina requires hospitals complete a Certificate of Need process (CON) justifying the “need” for the construction or expansion of hospital facilities. The regulatory process operates under the guise of keeping health care affordable, but in reality does nothing but limit consumer choice in their health care decisions. Our process makes hospitals more like electric utility monopolies doling out where you can provide service, rather than free-market based decisions based on competency, affordability and convenience based consumer spending decisions we consumers use in everyday life.

Imagine if other industries were forced to operate in this manner. Can you envision the lack of choices, and increased prices if this were applied to neighborhood grocery stores? If Publix had to get permission to open down the street from Piggly Wiggly, what would be the motivation for these stores to compete for your business? The incentives disappear not only to compete on price, but on service as well. Long lines and high prices will surely follow in this kind of environment. Why should healthcare be any different?

Dorchester County is merely the latest battlefield in this fight. Hospitals throughout the state continuously engage in regulatory warfare through CON challenges. The casualties of the hospital wars are always the citizens of the communities that these providers allegedly serve. In reality, the only casualties of this war are the collateral damage suffered by the citizens losing out on expanded employment opportunities, economic investment, competition in healthcare delivery, and greater consumer choice.

So, call your legislators and ask them to support the elimination of the CON process. Ask them why they overrode the veto that would have starved DHEC of the funds to continue this flawed process. Let’s put our citizens back to work and ensure a healthy future for all of our neighbors. Just imagine there would have never been a war between the Corleones and Tattalgias had there been a certificate of need process in The Godfather.