NC Legislation to Make Healthcare More Accessible and Affordable by Ending the CON Scheme

RALEIGH – Everyone is talking about rising prices. Gas. Lumber. Dogecoin. But these trending spikes join the perennial champion in cost inflation — healthcare prices — that Americans have come to know all too well. Notably, some of the leading reasons for the inflation in medical bills can be attributed to the same factor driving cryptos to the moon: artificial scarcity.

And it’s government regulations and overly empowered crony bureaucracies that enforce that artificial scarcity, and thus the resulting price inflation, here in North Carolina through a legal regime known as Certificate of Need legislation. A basic, relatable example: cronies and bureaucrats decide how many MRI machines ought to be in your county and who can have them. The stakeholders with control over MRI permission slips via the power of pull are essentially crowned gatekeepers of the market, naturally blocking out competition by refusing approval of new MRI resources. THAT is why your bill for an MRI scan is as expensive as it is, upwards of $1200-$1500 in some cases.

This problem spreads through the healthcare industry, and certain lawmakers are waging a battle to tear down this antiquated regime, break up the state enforced monopolies on healthcare resources, and let those resources grow and prices come down. The Carolina Journal highlights bills seeking to do just that in the N.C. General Assembly, but the fighting the lobbyists won’t be easy:

“[…] Jordan Roberts, government affairs associate at the John Locke Foundation, told Carolina Journal that Senate Bill 462 looks the most promising. That legislation would increase the dollar amount threshold health facilities must spend on various equipment and capital expenses before they are subject to a CON review. The bill ties that amount to inflation. 

That bill also creates a deadline for CON holders to complete construction projects. Projects that cost more than $50 million must be started within four years, and facilities that cost less than $50 million must be started within two years.

Roberts said some companies obtain the CON licenses and then “squat” on them to keep competition out. 

“I think [SB 462] is a welcome reform and has the best chance of passing,” he said. 

On the other end of the spectrum, Senate Bill 309 and companion legislation House Bill 410 look to repeal CON laws completely in North Carolina. Roberts said those types of bills have been filed before and are met with great resistance.

“That is very unlikely to get passed,” he said. “The hospital lobbying group would fight tooth and nail from it ever getting a hearing.” […]”

The language of the bills reforming CON laws demonstrate just how complicated and arbitrary this regime is. In essence, medical providers need a permission slip to provide YOU healthcare, and there are only a limited number.

Think of the absurd costs involved in securing an official taxi medallion in New York City; now apply that to your healthcare. That is what CON represents, and exactly why it should be repealed. The reason why it has not been repealed already, after years of futile attempts by select lawmakers and stakeholders, falls entirely within the realm of crony lobbies protecting market share. It comes at the expense of you and me, and the doctor trying to offer lower cost MRIs to help patients, but can’t because the cabal doesn’t want the competition.

Learn more about the history of CON laws, and how other states have learned their lesson and repealed them, here.