That’s what it looks like from here. Republican majority leader Mike Hager had Lindsey, his girl Friday, send out invites this week to a “Certificate of Need working group” to be convened on Tuesday, February 16th. The group’s purpose, according to Ms. Dowling, is “[…] to discuss the plans moving forward to either repeal or reform the CON laws.”
Certificates of Need (CON) are the state’s way of keeping health care under its thumb, and are a great vehicle for politicians to use as leverage for shaking down health care interests for cash. Basically, if you are a health care provider seeking to introduce a new service in a community, you have to plead your case with state regulators. You have to make the powers-that-be in Raleigh believe that your new service is truly needed in that community. *Never mind that you know your communities better than some bureaucrat sitting in Raleigh.*
For instance, it is a heck of a lot more expensive to do most procedures in a hospital than in an outpatient, or ambulatory, surgery center. If a group of doctors gets together and decides they want to set up an outpatient surgery center in a community, that could threaten the bottom line of the community’s hospital.
As a free marketeer, I am all for giving people as many choices as possible. I am all for competition. Competition typically results in lower prices for consumers. (I am seeing that right now — just down the road from Haymaker HQ. We had a new gas station open up next to an existing one. It seems — by the hour — the stations are changing their pricing to stay at least a few cents below the other.) And these politicians are always talking about how they favor controlling health care costs. *But we all know it’s sooooo much more fun to control people and their destinies and shake them down for cash so they can actually pursue said destinies.*
What’s wrong with allowing people to take risks — free of bureaucratic interference — with their own money to provide a service in a market where they believe there is a need?
Now, here comes the hitch. The troika that calls the shots in the state House — Nelson Dollar, David Lewis, and speaker Tim Moore are well-subsidized by hospital and other health care interests that like the CON process the way it is. There is a good chance Hager’s working group will decide to move forward in the upcoming short session with some plan to reform or repeal CON laws. Dollar-Lewis-Moore have made it clear they don’t want anything like that showing its face in the short session.
This could really could evolve into an out-and-out challenge to the troika, whose foundations are already quite shaky. Dollar and Lewis are both facing stiff primary challenges. Insiders tell me those two are the keys to keeping Moore in power. If either — or both — should go down, it would likely spell the end of Moore’s tenure in the chamber’s Big Chair.