NANNY STATISM RUN AMOK …
By FITSNews || A South Carolina hospital has been told it cannot perform open heart surgeries or heart catheterizations at its new lab without first receiving the approval of state government.
And no, we’re not talking about an inspection to ensure compliance with health or safety standards … the hospital must prove to the government there’s a market for its new services.
Crazy? Absolutely … but such is life in “Republican-controlled” South Carolina.
According to administrative judge Ralph King Anderson III, Lexington Medical Center must shut down its new heart facility pending the issuance of a “certificate of need” by the S.C. Department of Health and Environmental Control (SCDHEC). The hospital operates one other open heart operating room and a pair of heart catheterization labs – facilities the hospital says are “very busy” – but it’s now been ordered to shut down its second heart operating room and a third cath lab.
That’s right … in South Carolina, a government bureaucracy decides whether a new hospital (or hospital program) is viable in the marketplace. As opposed to, you know … the marketplace .
According to the hospital, patients will be moved around so that no one misses a scheduled procedure … but such logistical juggling strikes us as highly disruptive.
To her credit, S.C. Gov. Nikki Haley has fought to block this arrangement (although the issue is a sore spot for her politically). SCDHEC director Catherine Templeton has also tried to cut this nanny statism from her agency – although the state’s Supreme Court has blocked her efforts.
Insane … and of course Lexington Medical is being sued by a rival hospital, Providence, which claims to support this insidious “certificate of need” program because it “protects consumers from high health care costs and preserves the quality of health care services available to all community members.”
Really?
They clearly aren’t opening the mail at our house … or the homes of hundreds of thousands of Palmetto State residents who have seen their health care premiums skyrocket in recent years.
Also, our guess is Providence Hospital – which wants to keep the market cornered when it comes to heart-related procedures – would be singing a much different tune if the government were arbitrarily shutting down one of its facilities (and potentially putting its patients in danger).
Can’t wait to see its commitment to “affordable, quality care” then …
We reject the “certificate of need” program on principle as yet another example of government meddling in the private sector. We also sternly rebuke the judges upholding this nonsense – as well as Providence Hospital for cloaking its naked self-interest under the guise of its regulations.
72 comments
I’m pretty sure certificates of need are pretty much standard practice in every state.
So that makes the concept valid?
If CON works so well with hospitals, why not drugstores or convenience stores? There’s two intersections near me. One has three drugstores and a convenience store. The next one down the road has three convenience stores and a drugstore.
How many of those drug stores were paid for with your tax dollars?
Was that the case with both of these hospitals specific units?
CON is required by state, county or private health facilities for licensing to operate by DHEC. SC CODE: Section 44-7-160. It has nothing to do with state funding or state insurance eligibility.
SCHA – “Without CON, entrepreneurs could build and offer any type of service to those willing to pay.” They would only be required to meat health requirements.
It has everything to do with funding:
“…CON Laws, 2009
Resources & reports
Certificate of Need (C.O.N.) programs are aimed at restraining health care facility costs and allowing coordinated planning of new services and construction. Laws authorizing such programs are one mechanism by which state governments seek to reduce overall health and medical costs. Many “CON” laws initially were put into effect across the nation as part of the federal “Health Planning Resources Development Act” of 1974. Despite numerous changes in the past 30 years, about 36 states retain some type of CON program, law or agency as of December 2013.
HISTORY
In 1964, New York became the first state to enact a statute granting the state government power to determine whether there was a need for any new hospital or nursing home before it was approved for construction. Four years later the American Hospital Association expressed an interest in Certificate of Need laws. The AHA started a national campaign for states to generate their own CON laws. By 1975, 20 states had enacted CON laws; by 1978, 36 states had enacted them.
The 1974 federal Act required all 50 states to have a structures involving the submission of proposals and obtaining approval from a state health planning agency before beginning any major capital projects such as building expansions or ordering new high-tech devices. Many states implemented CON programs in part because of the incentive of receiving CON federal funds.
http://www.ncsl.org/research/health/con-certificate-of-need-state-laws.aspx
The Colonel —- Absolutely are required in almost every state for public hospitals.
SC requires CON in order to build or expand publicly owned, private or non profit health facilities. Even if every dollar comes from a private source. Only research, training and non health expenditures are exempted. Federal facilities are also exempted.
The Colonel —- How many of those drug stores were paid for with your tax dollars?—-
DHEC must refuse to license any new or expanded health facilities that hasn’t had an approved CON, no matter who owns it or
I thought you liked capitalism. This is the invisible hand of the free market at work.
I was editing as you responded. The government should only regulate for safety, not cost or demand. This Federal requirement to regulate was a failure. The law was amended and now states are not required to issue a CON, but many states still have there laws on the books.
Grasshopper, you have failed your business class. You have not properly identified the product being sold in the free market. Here is how this works.
Company A, makes gobs of money as the only supplier of a product that people must have to live. Company B, says, I want some of that action. I want to supply that product and make gobs of money as well. Company B, calls up its dark money people and they get dark money to certain legislators. In response, Company A calls its dark money people an they get dark money to another group of legislators or even the same legislators. The company that hires the best legislators prevails . Thus the invisible hand of the free market in legislative services works its magic and the best capitalist wins.
What you describe above is exactly what happens with the CON program. It is influenced by the Gov and legislature. That may be business reality, but it’s not free market. That is exactly what Haley was accused of, but at least she vetoed funding for the program. The courts said the program must continue even without funding appropriated because it it still in the statutes.
“That may be business reality, but it’s not free market.”
Precisely.
Government control assumes that if there are too many suppliers then they have to charge fewer customers more to make profit.
Free markets don’t guarantee a profit. If there are too many suppliers they must lower prices to get as many customers as possible to reduce losses or get rid of excess supply. Free markets self correct. It is always to the consumers advantage if there is an oversupply, because prices drop.
David Koch, Charles Koch, and Howard Rich are on a plane. The engine goes out. The pilot comes out of the cockpit with a parachute on and a key in his hand. The key is to the parachute locker. He offers the key to the highest bidder. What price will the free market place on the key?.
If it weren’t for the damn Certificate of Need there would be three parachutes.
There may be 20 parachutes, But you have to get into the locker.
Three lockers, three keys. It’s all the same. CON only restricts the amount available and protects from competition the one approved for a CON.
Look this is the point. Health care is not a “free market.” People have to have the product or die. Further, there is actually plenty of supply, its just that if you make the supply freely available, the huge benefit of having a product where the demand is not price elastic goes away. So the real value in the product is the ability to restrict access to the product until you have sucked out the last dime you can get for it..
Business understands that. The product on the market here is the legislators. They are the pilot. They have the key. Neither they nor the Businesses want the parachutes to be freely available for everyone, So they sell the key to someone and then that someone sells the product again to the highest bidder.
This is a horrible system, but the truth is pure capitalism would likely be no better in this instance. Unless they were compelled to do otherwise, the unregulated capitalist would hord the product and sell it to the dying rich. If you want to see an example of that, add a few poor people to the plane and and three parachutes.
I am not saying there is a great answer with no problems. I think government should assure there are parachutes for everyone on the plane, but I am sure you will disagree.
I am however hoping everyone will start to see the evil of allowing dark money to flow into the hands of politicians. All money contributed to politicians should be disclosed, and politicians should not be allowed to vote on any matter if someone with an interest in that matter has given them money.
Ask George Soros.
Well I doubt he would be on the plane with the other three, but if he is all the better for the pilot.
I can’t believe you are so daft as to not understand what a “free market” is….
Let me start with one simple axiom for you Tom:
If any private company(meaning both owned and funded) can run to gov’t and get them to run any kind of interference directed at competitors, IT’S NOT A FREE MARKET!
Its not a free market in what?
CON is “interference directed at competitors”. A hospital wants its competitors denied a CON. That is why the program should be ended.
We’re arguing in circles. The whole point to CON was to ensure money was spent wisely and that hospitals didn’t get into “arms races”. I never said anything about insurance or fees. This is about costs and tax dollars. “Costs” drive fees, particularly in private facilities, taxes pay for the facilities at public hospitals.
That benefits hospitals that already provide a service from competition. That enables them to raise prices because competition is suppressed. We don’t worry if CVS or Rite-Aid get into an arms race. Where in the private sector is an arms race ever been the problem?
WHY DID THE FEDERAL GOVERNMENT END THE PROGRAM? IT DIDN’T REDUCE COST. WHY DO STATES CONTINUE IT? BECAUSE IT ENCOURAGES BRIBERY AND DRIVE CAMPAIGN CONTRIBUTIONS, LIKE HALEY AND LEXINGTON MEDICAL..
I will grant that CONs have invited corruption – name a law that hasn’t.
Colonel, these are quotes from your link.
—- The federal mandate was repealed in 1987, along with its federal funding. In the decade that followed, 14 states discontinued their CON programs. —–
—– Once need was established, the applicant organization (corporation, not-for-profit, partnership or public entity) was granted permission to begin a project. These approvals generally are known as “Certificates of Need.”—-
NOTE THE WORKS CORPORATE, NOT-FOR-PROFIT.
Absolutely are required in every state for public hospitals. They are supposed to be procured before the facility is built, not after.
And, for any expansion of services.
Nikki defunded the office responsible for processing CONs, therein lays (or laid, it’s been reopened) the loophole.
I love government telling us what market demand should be. Makes total sense.
To the dumbass liberal socialists it certainly does.
Sandy you ignorant slut. Its not socialism, its crony capitalism. Capitalist paid off government to restrict competition, so they could make more money.
Tell Nikki, to not forget we love that. Government goes to the highest bidder. That is the Republican way. If Lexington wants this so badley they need to pay a few more Legislators, to help out.
This is an example of your money being spent where it probably wasn’t needed Three facilities with 10 miles perform the same services.
There is always the possibilities that: 1) some are not doing a good job, 2) some are dirty with the super-bugs, 3) some are just plain corrupted by “party favors” …
Providence, Baptist and Richland all do cardiac services. Providence is nationally ranks/rated and is one of the best cardiac centers in the SE US. Richland performs the full range of cardiac services and is also a nationally recognized stoke treatment center. Baptist also has the full range of services.
And what does any of that have to do with government deciding how much competition to allow?
You either believe in the free market, or you don’t.
It’s ok if you don’t, just state it up front. “Sometimes” is a contradictory position for a variety of reasons.
Arms races among public entities are a bad thing. Private hospitals should not have been included and that is one reason that the rule was overturned. If my tax dollars are being spent “free market” doesn’t apply. The public hospital is one of those rare exceptions to the idea that private industry always does it better.
“The public hospital is one of those rare exceptions to the idea that private industry always does it better.”
And your proof of this?
If it were not for public hospitals, many SC counties would have no hospital. Is the quality of care better? Well, that’s a different debate – I’m talking existence here.
Well, I could argue on your admission in regard to quality alone that a local doctor & medical table was probably better than a public hospital….
Agreed, public hospitals, even here in Taxifornia, do an excellent job, generally.
But, the private health care sector is being driven into spiraling costs and inefficiencies by ACA/BummerCare and the Taxifornia equivalent.
You folks in South Carolina should consider yourselves blessed that any private sector entity would wish to build new facilities in your state. … And in my opinion, you should stamp out any g’ment agencies that may try to slow or stop that private sector effort In Any Sector, healthcare or otherwise.
Private sector competition is Always a Good Thing, even if it shines a better light on the public sector … and even if the public sector Might Suffer. Please see: The Wealth Of nations by Adam Smith – “http://en.wikipedia.org/wiki/The_Wealth_of_Nations
They are not telling you what market demand is or should be. They are telling you where they want what market demand there is to go.
Oh. That way they can earn bribe money.
Exactly. Which is why we need all money flowing to politicians to be exposed to the public.
“They are not telling you what market demand is or should be.”
That is incorrect. You have a hospital clearly seeing an increased demand for said services and investing accordingly. The government has decided that the services in play are enough for the demand, obviously not taking into account price, at the prodding of one of the hospitals competitors.
I’m surprised you favor crony capitalism Tom.
Crony capitalism is when the private entity is given a special privilege (CON) that is denied to its competitors.
I don’t. I also don’t favor CONs, I am just trying to make it clear that this is all about big money in politics. Nothing more. The cure is to expose all money flowing to politicians to the sunlight and not allow politicians to vote on issues if they have received money from a party involved.
I hear that the SC Supreme Court is shaking in their collective boots as a result of the stern rebuke from Sic Willie. Did Will learn narcissism at the knee of his former boss Sanfraud?
I’m dangerous lol … https://www.fitsnews.com/2014/09/25/big-data/
People want a choice, but Providence Hospital does not want people to have a choice. Lexington Medical Center is one of dozens of hospitals statewide that capitalized on the CON loophole, they just happen to in an area with some pretty heavy competition for patients. This sounds like a crybaby hospital with a case of butthurt because a piece of their pie is being snatched by a rival healthcare provider.
Yep!
This is an explanation of why limiting the number of facilities where certain procedures can be done makes hospitals safer for patients.
“Smaller Military Hospitals Said to Put Patients at Risk”:
http://www.nytimes.com/2014/09/02/us/smaller-military-hospitals-said-to-put-patients-at-risk.html?module=Search&mabReward=relbias%3Aw%2C%7B%221%22%3A%22RI%3A8%22%7D&_r=0
Doctors who do the most procedures get the best outcomes/results for their patients. Every hospital wants to get a doctor to come in and do their heart surgeries. They make money from it. But, if the doctor doesn’t do a minimum number of procedures per year, he/she generally cannot keep their skills at the optimal level. This has been documented for decades.
So, it’s not just about hospitals getting to do what they want to make money. It’s about hospitals providing safe surgeries to patients.
Regardless of whatever law SC has made, constitutional law made by the US Supreme Ct supersedes. Lexington’s rights are being violated.
Certificates of need are driven by money and politics, and I was on a five-person county-wide CON committee years ago. I’m a businessman and know something about marginal costs and revenues, and the others were a housewife, a dentist, a retired navy man and a lawyer. When MUSC wanted a new CAT scan costing millions, we reviewed the application — a three-inch notebook — and I asked the question, “How many procedures are expected each week?” Answer: Five. My reply, “That’s very few. Where’s the nearest CAT scan machine with this resolution quality?” Answer: Greenville. Question: “Why not send patients to Greenville and absorb the travel cost, since this is insane and loses four million dollars annually in operating cost?” Answer / Reply: “Are you crazy? We don’t want lowcountry people going upstate. We want to keep the money here.” Vote: four to one in favor of the CAT machine. The local doctors and medical establishment (and General Electric, the CAT machine maker) won.
As a businessman, you understand if you lose the Cats scan business you lose other services as well. Often patients show up for several procedures. You’ve heard of a “lose leader”. Also it could effect your ability to attract the best staff. It also has promotional value to the institution.
The magic finger of private enterprise, against all logic, surpasses all the state planning, even of committees with businessman.
Hey Shifty – we need a “CAT scan joke” right about now.
“Void WhereProhibited” ….. hmmm,
>>>>>>>>>
They try to humiliate you in the hospital. They make you pee in a bottle and I hate that. I was in the hospital and the nurse said, “You have to pee in this bottle.”
She left and I filled it with Mountain Dew. She came back and I chugged it. She was puking for days. It’s a sick world and I’m a happy guy!
>>>>>>>>>>
I had general anesthesia. That’s so weird. because you go to sleep in one room and then you wake up four hours later in a totally different room. Just like college.
>>>>>>>>>>
JEWISH WORLD RECORDS
>>>>>>>>>>>>>>>>>>>>>>
Dr. Louis Pranksy, a 56-year old respiratory specialist, is known to ask the highest fees in the world for his
professional services. As an example of his price structure, his patients with walking pneumonia are charged by the mile.
———-
Dr. Leon Klaubstein, today at the age of 102, still goes to his office every day to care for his one remaining patient — himself.
Of course! We all know that competition lowers quality and raises medical costs!
Providence is bad news. I went to an appointment at one of their clinics. I had been led to believe they would see me without insurance, but they refused to see me, even though I offered to pay the entire actual amount of the bill up front with my debit card. Apparently insurance would pay more. I would never send one of my friends (or future clients) to such a place. I will not be returning.
Don’t be so simplistic. Obamacare’s rules making and mandates are still being published. Since 2010, healthcare as we knew it is gone forever. If you are retired or disabled, you must have Medicare Part B or be refused treatment from your caregiver regardless if you have healthcare coverage better than Medicare.
I am neither. Where does this leave me?
If you want your heart surgery in the marketplace,go to Piggly Wiggly.
Yeah.Good heart surgeons are a dime a dozen.
LMC first opened in 1971. Leader in performing BBQ and beer stomach pumps, LMC opened xray, physical therapy units by the 1980’s. In the 1990’s, the were allowed to operate surgically! Being able to read a newspaper, LMC officials began to see a pattern. Catholic Providence NE was making a ton of money by actually keeping heart attack patients alive. No money in letting them die. So in defiance of the federal mandate to prevent over capacity (Certificate of Need Program 1971) which always translates into healthcare cost inflation (higher costs for patients) LMC, decided, “What the hell do they know”. DHEC, the program’s arbitrator, turned down their request for a Cardiac Unit. Columbia already had enough capacity. In fact, many Bob Jones University grads and Masons began grumbling, “why should I have to go to a Catholic hospital”? So they went to their lobbyist Rep Haley and she cobbled a bill, going over the heads of DHEC and the CON Program, to allow more cardiac capacity we did not need. You see, SC was one state that kept the CON Program and funded it with our tax dollars. Gov Sanford vetoed the bill which was sustained despite the annual rite of overturning Governor vetoes by the General Assembly. The kicker? The Feds stopped funding the CON Program in 1987 and repealed the mandate. So LMC sued P-NE when they wanted to add more bed space and what not. They settled. LMC paid damages of 15 million, broke up P-NE’s world class Cardiac Unit by pilfering their top surgeon and agreed to allow P-NE to expand. Well that was not enough. LMC defied the agreement and opened up another unit. Haley responded in cutting the funding for DHEC’s CON Program. Haley’s DHEC Chief then dropped the CON Program setting up any expansion by anyone after 40 some years with the CON Program resulting in lower costs for patients by careful expansions based on real needs, not petty religious bigotry. Well, our State Supreme Court overruled Haley’s dirty politics and ordered the CON Program back up. Even an Administration Court agreed by rebuking the underhanded expansions while the court fights raged! Thank you Gov Haley for your bigotry, dirty politics, and screwing up SC’s healthcare delivery system…NOT
CON was/is a good idea and 75% of the states still have the program in place.
Yes it is. Haley’s dirty politics shut down SC’s state taxpayer funded CON Program (state taxpayers paid to keep it open preventing over capacity down since the Feds stopped their program in 1987) for one hospital in Lexington County. Many healthcare corporations began building as soon as Haley vetoed funding. Now the courts ruled that was mean spirited, dirty, and illegal. However, many over capacity projects are finished or partially built giving taxpayers more hits against the General Fund and higher healthcare costs across the state. State and local governments healthcare policies will increase passing the costs to the taxpayer’s revenue in the General Fund. This is politics for the few at the expense from the many. Disgusting no matter how you dissect it. Haley is the reason for all of this, too.
So if you have an acute MI in Lexington, better pray that your ambulance driver is a NASCAR vet, because your corrupt state gubmint credentialing body refuses to offer you the expeditious access to the life – saving resources as Richland County residents…
Reading the post and the comments, it’s amazing that so many people seem to think that the medical business has ever operated in a true free market manner.
The idea was created in new York and spread from there, that’s enough for me, it’s corrupt law created to give the existing ones power to prevent new comers into the market. Truth be told, we would probably be better off with a lot of smaller specialized facilities spread around than these huge behemoths that take up multiple city blocks, like the utilities have become, the monster now exists to maintain its existence, whether it’s electricity or medical services, the primary mission is to keep feeding itself and prevent anyone else from eating. The product/service is irrelevant.
Repeal the law and let the waters of the free market flow.
In the mid 1980s I served on the Central Regional Planning Commission for the Midlands areas as the sole business community representative. The Commission had the same authority as the agency Haley tried to kill. All Hospital operations were under our guideline approval authority. As the only business representative, I was shocked at the amount of corruption in the Hospital System. Every where I looked I found a complete lack of common business practices such as: bidding out lab work, doing business cost analysis, avoiding single source suppliers, and watching out for employee kick back schemes. I caused so much fuss that the other appointees were glad to seem me leave, and go back to my bigger corporate duties. So they could continue the status quo.
There was absolutely no need for many of the proposed hospital services other than to put money into the hands of hospital doctors and officials at the taxpayers expense such as: duplicating numerous treatments that were already available at multiple other hospitals. Lexington Hospital was the worse one of the bunch. There is completely no need for another Heart Hospital in the Columbia area. Not only do we have Providence Hospital, a well respected Hospital with a history of professional success. We also have the Heart Hospital at Richland Memorial, and services at Baptist Hospital. With all the Hospitals located within a 10 mile radius of each other.
Hospitals like the new Partridge Hospital do nothing to help the medical care of the Midland’s citizens. All they do is run up the costs without providing any more care than is already available. Just get out your check book if you ever have to go into any of these duplicating hospitals. That’s not my opinion it’s also the results of resent cost surveys in the area.
The real crime in Haley’s taking bribes to keep this rip off going, is that people are actually dying due to lack of real emergency care. Most people do not realize that there is really only one Trauma Center in the entire Midlands area. It’s at Richland Memorial Hospital. All the other Hospital’s emergency rooms can’t really provide the critical care. Instead, they will provide limited stop gap care, then send you to Richland. Along with a giant bill, rotten service, and the probability that the move can kill the patient.
Expansion of Hospital facilities at any hospital that waste money on beautiful buildings, fountains, and other crap that does not go directly to patient care, should not be allowed. Instead, they should be forced to spend those moneys on the critical Trauma Centers our area so desperately needs.
Just thank God that we have the Hero’s at Richland Memorial Hospital Trauma Unit who work long hours in desperate care of our critically injured and sick citizens every day. Without them, we would be in a hell of a mess from Haley’s Hospital Kick Back Schemes.