Long before Gov. Nikki Haley vetoed the nearly $2 million needed to run the Certificate of Need program last year—and long before the state Supreme Court ruled in April the Department of Health and Environmental Control would have to find another way to fund it, the free market was born.
As one of 35 states with a CON program, according to the South Carolina Hospital Association, the state requires medical institutions to get permission before expanding services.
So when House members debated a proposal by Rep. Bakari Sellers, D-Denmark, to suspend the CON on Wednesday, it came as no surprise that the debate expanded to include the free market. The proposal failed.
But it sparked a debate worth having. Rep. Eric Bedingfield boiled it down to one question. “You are either for a free market-minded individual, or you are not,” said the Belton Republican.
A doctor, Rep. Kris Crawford, R-Florence, cautioned against abandoning the program, saying only cream of the crop would succeed. Rep. Jim Merrill agreed. That’s what the free market is about, said the Charleston Republican. “For free market people, CON is an absolute travesty.”
Lawmakers representing more rural areas bristled against the idea of suspending government regulation of health care location and expansion. Free standing emergency rooms in rural areas of the state won’t stand without the CON, said Rep. Murrell Smith, R-Sumter. “You lose the soul of a community when you lose your hospital,” he said.
And maybe he’s right. After all, what will become of people who face emergencies in areas not within 45 minutes of a hospital? My guess is that they will have judged the risk ahead of time. Or they will have moved. And if economic conditions are ever right for the area, it will attract industry—including health care.
But government can’t build a free market. It can—and should—only get out of the way.
There’s a reason technology in health care defies the technological model for growing cheaper as technology advances—it’s because health care flouts the free market under the guise of protecting the consumer’s wallet. And because there are consequences—big, expensive ones—when an industry becomes a quasi-governmental institution. Expensive tests requiring such technology as MRI are basically unaffordable—at least without insurance, which is also basically unaffordable still. But perhaps that’s another editorial.
What do I know, anyway? I live within 20 minutes of four large hospitals.