There are lots of obvious ways in which conservative ideologues are rolling back decades of progress in North Carolina. From taxes to guns, clean water to abortion rights, school privatization to voting rights, Medicaid expansion to predatory loans, the list of high-profile issues is a long one.
What’s more, it is not exhaustive. A lot of the damage is taking place largely under the radar as free market fundamentalists work in scores of unsexy nooks and crannies to lift up the god of unfettered casino capitalism and eradicate common good rules and regulations that curb greed and serve the public interest.
A very helpful op-ed in this morning’s edition of Raleigh’s News & Observer shines a light on a classic example of how right-wing nerds of ruining our state in an obscure but important area. The subject is so-called “Certificate of Need” laws or “CON.” For decades, CON laws have helped assure that major health care resources like hospitals and surgery centers are at least somewhat fairly distributed throughout the state and not just clustered in high wealth and highly populated communities.
Unfortunately, repeal of CON laws has been something close to an obsession amongst the groups in the Art Pope empire for many years. The drumbeat to repeal has now gotten so loud that lawmakers are seriously considering action in this area.
As the op-ed in the N&O this morning by Roanoke Rapids hospital CEO William Mahone (“Why Certificate of Need laws are important to NC health care”) makes clear, however, repeal of CON laws would be a disaster for most folks not living amongst the state’s “haves.”
As Mahone, notes, the notion of “deregulating” an industry in which federal government reimbursements already account for two-thirds of hospital patients is just silly. All the repeal of CON laws will do is to effect a shift of resources away from community-based hospitals to free-standing specialty centers located in or on the fringes of affluent urban communities. This is from the op-ed:
“A provision in the proposed legislation sets a goal for the amount of charity care a single-specialty center should provide. But that hardly equates to the overall community benefit from a hospital. State and federal standards recognize that community benefit includes not just charity care but losses sustained from Medicare, Medicaid, bad debt, teaching programs, research and donations to the community. Last year, N.C. hospitals provided more than $1.8 billion in uncompensated care, including charity care as well as unpaid co-pays and deductibles and services not covered by insurance. Many N.C. hospitals already operate in the red, and one-third have margins between zero and 5 percent.
Hospitals are trusted providers in our communities, with long-term commitments to infrastructure, employment and, most importantly, to the patients we serve. We are working every day to control costs and improve patient outcomes for all who depend on us. State lawmakers must not surrender to entrepreneurs working to take profitable services away from hospitals, leaving them to care for the emergencies and the uninsured.
North Carolinians can have freestanding specialty centers or they can have hospitals, but they can’t have both.”
The bottom line: Hospitals are far from perfect and many have much to do to improve their services. But eliminating them is not something that is in the best interest of most North Carolinians — regardless of what the market fundamentalist nerds contend.