by David Williams
Americans are still recovering from COVID lockdowns – by far one of the worst examples of chaos created by government intrusion. Career bureaucrats wreaked havoc on the economy and education system from their offices in Washington, D.C. Americans were left to fend for themselves while their businesses and savings accounts were depleted. Despite all these measures taken to safeguard the healthcare system, hospitals across the country were still overrun during the height of the pandemic.
The deregulation that occurred at the federal and state level to spur the economy and ensure the healthcare system was able to quickly respond to the ever-changing environment showed the power of regulatory reform without forcing taxpayers to foot the bill. Tennessee’s deregulation of some of the provisions of Certificate of Need (CON) during the pandemic was a shining example.
Most Tennesseans don’t know CON laws still exist. These regulations are a prime example of senseless and harmful bureaucratic red tape that continues to impact all Tennesseans. They reduce access to lifesaving care across Tennessee, harming big cities and rural communities.
In short, CON laws require new medical providers in the state – commonly hospitals –demonstrate that there is a “need” for their services in the community where they want to invest in health care infrastructure and operate. A little known fact is that twelve unelected bureaucrats oversee this burdensome, arbitrary approval process on the behemoth Tennessee Health Facilities Commission that was newly created from the merger of two separate state health departments. Additionally, competing health systems operating in the region can be a powerful voice preventing a competitor’s application from receiving approval.
The red tape built into CON laws significantly hinders the necessary expansion of Tennessee’s healthcare system to meet the need of growing communities across the state. It’s also objectionable to anyone who believes in the power of the free market to address gaps in the marketplace. CON regulation essentially allows the government to pick winners and losers in healthcare.
In fact, 12 states have repealed their CON laws because of their harmful consequences. Limiting the number of healthcare providers directly results in increased costs for consumers and decreased access to essential care.
Governor Bill Lee and the legislature should be applauded for taking the first steps to address the negative impacts of CON laws while COVID continued to create stress on the healthcare system last year. The state implemented CON reform to lessen some of the red tape hospitals contend with to manage their beds for overnight stay, and especially for the rural neighbors that desperately need access to medical services now.
As healthcare providers across the country and in Tennessee struggled to manage the volume of patients needing emergency care during the peak of the public health emergency, East Tennessee hospitals reported “crisis” levels of COVID-19 patients. Emergency departments and hospitals functioned at or over capacity for weeks, leaving many patients with nowhere to turn.
CON requirements prevent healthcare systems that are already at capacity from expanding to adequately meet the needs of their communities. The next public health crisis like COVID-19 could devastate the Volunteer State if changes aren’t made.
While there has been some progress, there are 29 remaining CON regulations that continue to limit access to critical care for Tennesseans. The legislature must fully repeal the state’s CON laws to ensure adequate access to care, as well as the ability to address ongoing and future healthcare challenges. By limiting access to care, Tennessee’s CON law will continue to impact all Tennesseans. This will affect new mothers and their newborns who have to be transferred due to their hospital’s lack of a neonatal intensive care unit (NICU), patients needing open heart surgery or stroke care, and often-overlooked rural communities where the lack of care is worsening health care outcomes, to name a few.
Only half of the hospitals in Tennessee with a maternity ward have a NICU to provide critical care to newborns. Babies delivered in hospitals without a NICU spend their first hours being transferred to a hospital with a NICU instead of receiving the care they need – sometimes separated from their mothers.
Rural Communities are suffering the most from a lack of access to care. Tennessee has experienced the second most rural hospital closures in the country over the last 17 years, with 55 percent of the remaining still “at-risk.” Hospital closures have left a significant gap in healthcare that is compounded by the devastating effects of the opioid epidemic. CON repeal will help open the door to healthcare providers who can deliver much needed emergency care for rural Tennesseans.
Tennessee is growing. The state – home to three of the ten fastest growing cities in the south – is expected to grow by nearly 10 percent across the next decade. With a population reaching 7.5 million, repealing CON immediately will allow Tennessee’s health care infrastructure to keep up with this growth.
Fully repealing CON laws during the 2023 legislative session will remove bureaucratic red tape and unaccountable government officials from the healthcare system, freeing hospitals to focus on improving access to affordable, high-quality health care instead of wasting resources and time on this onerous approval process.
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David Williams is the president of the Taxpayers Protection Alliance.
Photo “Surgeon” by Jonathan Borba.
