{"id":20713,"date":"2023-11-19T19:57:08","date_gmt":"2023-11-20T05:57:08","guid":{"rendered":"http:\/\/thefilipinochronicle.com\/backup\/?p=20713"},"modified":"2023-11-19T19:57:10","modified_gmt":"2023-11-20T05:57:10","slug":"reform-con-laws-to-increase-hawaii-healthcare-access","status":"publish","type":"post","link":"https:\/\/thefilipinochronicle.com\/backup\/2023\/11\/19\/reform-con-laws-to-increase-hawaii-healthcare-access\/","title":{"rendered":"Reform CON Laws To Increase Hawaii Healthcare Access"},"content":{"rendered":"\n
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by Keli\u2018i Akina<\/em>

<\/strong>Who do you think decides whether Maui needs a new cancer center, Kauai needs a new hospice, or the North Shore needs a new drug treatment facility?

Well, you might be surprised to find out it\u2019s not the investors who want to build the facilities nor the doctors or nurses who would provide the services there or even public demand. Instead, it\u2019s state government bureaucrats who call the shots.

Yes, strangely enough, if officials at the Hawaii Health Planning and Development Agency say there is no need for a new healthcare facility or service, then it doesn\u2019t matter who disagrees with them. Healthcare providers cannot build a new hospital, MRI machine, or dialysis center without state government permission.

Why? Because of an obscure series of Hawaii regulations called \u201ccertificate of need\u201d or CON laws. CON laws are a relic of a different time when states worried about the potential negative impacts of duplicating healthcare services in an area. But what is \u201cduplication\u201d when it comes to healthcare services?

According to Matthew Mitchell, a guest on a recent episode of my \u201cHawaii Together\u201d<\/a> program on ThinkTech Hawaii, duplication \u201cis what economists \u2014 and, frankly, what normal people, I think, everywhere \u2014 call competition. So [CON laws are] essentially mandating that there not be any sort of competitive provision of healthcare.\u201dThat being the case, should we be surprised that some of the biggest supporters of CON laws are existing healthcare providers who want to avoid competition?

Mitchell, who is a senior research fellow at the Knee Center for the Study of Occupational Regulation at West Virginia University, said in some states \u2014 including Hawaii \u2014 existing providers are even allowed to participate in the CON approval process, to give their opinion on whether a potential competitor is needed or not.

It\u2019s a lot like letting Starbucks vote on whether a different coffee shop can open in the neighborhood.

Mitchell said researchers have examined whether the justifications for CON laws hold up, and the answer is a resounding \u201cno.\u201d Despite the claims of their supporters, CON laws actually make healthcare more expensive and less accessible. Mitchell said more than 400 tests have assessed how CON laws affect access, cost and quality of care, “and it’s really extraordinary in terms of how overwhelming the evidence is” that CON laws reduce healthcare access and quality.

In recent years, many states have been reforming or repealing their CON laws in response to these findings. But not Hawaii. In fact, our state requires certificates of need for more healthcare services than any other \u2014 even for burn units.

\u201cWhenever I see that one, I scratch my head because one of the original rationales for a CON is to discourage providers from offering care that\u2019s not needed,\u201d said Mitchell. \u201cI don\u2019t think there\u2019s any evidence, anywhere, that has ever been accumulated to suggest that doctors are offering burn care when burn care is not needed.\u201d

It\u2019s so obvious that leaving it up to the government to decide whether we \u201cneed\u201d another burn unit, MRI machine or new hospital only results in delays, added expenses and fewer options for patients.

Other states have successfully reformed their CON laws without any negative effects on patient care. In fact, most of them have seen improvements in healthcare access and quality.

It seems to me that what we really \u201cneed\u201d is to reconsider Hawaii\u2019s overly restrictive certificate-of-need laws and let entrepreneurs, investors, doctors and the public in general make their own healthcare investment decisions.

KELI\u2018I AKINA<\/strong> is president and CEO of the Grassroot Institute of Hawaii<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

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