Last week, Florida State Senator Rob Bradley, State Senator Rob Bradley introduced legislation (SB 676) which seeks
to repeal the Certificate of Need program here in Florida. Despite the
potential for an increase in cost and decrease in quality, that would come with
deregulation, Governor Rick Scott has expressed his support
of the legislation.
As
I have explained in my previous posts, the Certificate of Need program is a
regulatory process that requires certain health care providers to obtain state
approval before offering new or expanded services. The CON program in Florida
regulates the construction of new hospitals, hospices, skilled nursing
facilities, and care facilities for the developmentally disabled, as well as
certain hospital services.
As you also know, I oppose
the deregulation of CON, in particular as it relates to the creation and
expansion of inpatient care. I have outlined in significant detail the negative
effects deregulation of CON would have in previous
posts but in short, I believe it
will have a negative impact on cost, quality and access to health care in our
state. However, Senator Bradley, Governor Scott, and those who support the
elimination of CON believe that free market forces will improve quality while
lowering costs.
And while I staunchly
believe in free market economics, the reality is that health care does not
operate in a free market space. In a free
market economy, prices, quality and quantity of goods and services are
determined by the open market and consumers. In addition, the government imposes very
little - if any - restrictions
and regulations on the forces of supply and demand that drive the costs of
goods and services.
Hospital pricing cannot be
determined by a free market system because a hospital cannot set their own
pricing for services. Hospitals are reimbursed for services based on rates
established by the Centers for Medicare and Medicaid and thus, must work with insurance
providers and government agencies to negotiate wholesale pricing. In addition,
hospitals cannot provide or deny services based on a patient’s ability to pay, making
the system of supply and demand irrelevant. For example, if a patient comes to
the ER requiring stiches, federal law requires that they be treated even if
they do not have insurance or the money to cover the cost of the treatment they
received.
Additionally, hospital and health care pricing is also
incredibly complicated and there is a scarcity of price information out there
for consumers. This makes shopping for certain types of health care services
incredibly difficult and many times, consumers won’t know exactly what they owe
for a procedure until they get the bill. There also tends to be significant
variety in pricing from provider to provider and cost does not always directly
correlate to quality. This is yet another complication when it comes to health care in a free
market space.
When new hospitals come
into the region due to deregulation, they will look to compete for patients
with insurance coverage or the financial means to pay for their own care. And
so, while I am a big believer in free market economics and know the positive
effects it has on many sectors of our economy, free market economics and
deregulation simply don’t work when it comes to health care. Despite the belief
of those who support the legislation, it will drive up costs and decrease
quality. Take it from someone who has been working to provide quality health
care to the consumer for the past 20 years.
And so what, now? As I have
said before, I think here in Florida we can buck the trend, put party politics and
ideology aside and come together in the spirit of doing the right thing for our
State when it comes to access to high quality and affordable health care. I
don’t think we need to rush bills into the legislature but instead, we can sit
down at the same table and thoughtfully and engage with each other to work
towards a positive outcome that puts consumers and our neighbors first.
It is in this spirit that I
want to challenge our legislators to put together a statewide “blue ribbon” working
group comprised of legislators, health care leaders, physicians, medical
professionals and patient advocates. This mission of this group will be simple:
to come together, roll up its collective sleeves and work toward providing the
highest quality and most affordable health care for this State’s most precious
resource—Floridians.
Finally, if you are concerned about how the
deregulation of CON and specifically, Senate Bill (SB 676) will affect your
access to high quality and affordable health care, I encourage to reach out to
your legislators
and make your voice heard.
Like what you read? Want to
keep in touch? Please connect with me on LinkedIn.
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