As the new legislative session begins here in Florida, politicians from across the state once again consider whether the Certificate of Need (CON) program—the regulatory process designed to limit health care costs and promote planning for new health care services and facilities—is best kept on the books here in the Sunshine State.
Those who know me, have followed me on social media or read my blog posts over the past several years, are familiar with my belief that repealing CON is not good for our consumers, our community or our state. They have read my detailed arguments outlining that the elimination of CON could trigger a chain reaction that would cause three problems for residents: an increase in health care costs, a decline in the quality of care and a decrease in access to care.
They also know that my position on CON is deeply informed by my extensive research on quality, clinical outcomes, safety, access, and cost. Based on this research, I believe there is no clear indication or definitive proof that a deregulated state drives lower costs, higher quality and greater access to care. While there is research to substantiate both sides of the argument, the most compelling and the preponderance of evidence points to the idea that the more of a certain procedure a hospital or clinician does, the more proficient they become. And as they become more proficient, it leads to better quality outcomes for the consumer and ideally, lower costs.
I have made this argument about CON for the past several years and will continue to do so to those who want to hear it, but I want to start to think about the impact of CON in a new way. I want poise this question: what would you do, where would you turn, if you, your family or your friends were faced with a life-threatening health care emergency? What if, god forbid, you, your spouse or your oldest friend were diagnosed with a complicated, highly specialized or rare medical condition?
I would assume that if you are like me, you would do everything in your power to access the best care and treatment available. You would look to the most world-renowned and highly-rated medical centers and doctors across the country in New York City, Boston, Philadelphia, Chicago, Baltimore, Cleveland or even the Mayo Clinic in Minnesota as soon as possible. You may also look to Florida hospitals, like Tampa General Hospital, which is consistently rated one of the best in the country.
While there is fantastic health care in cities, towns and rural communities here in Florida and across the country, there are particular situations, I would think, where you would look beyond your community to ensure that you have access to the most innovative and aggressive medical treatment and care available.
When you think about the leading medical institutions across the country, you should know that a significant majority of them are located in states that have CON laws in place. In fact, 14 of the top 20 hospitals in the country as ranked by US News and World Report are in states with CON on the books and two more, the Mayo Clinics in Arizona and Minnesota, are located in states that operate a regulatory process that functions similar to CON.
Doesn’t this tell you something? Isn’t there something to be made of the fact that the best hospitals in the country (and frankly the world) are in states that have a regulated environment on the acute care side of the business? I hypothesize that there is, and that CON contributes to their ability to deliver the best and most innovative care. I can’t help but think, if we want to be the best in the health care space, shouldn’t we emulate the best?
And so, if you are in Florida or in another state that is considering deregulating health care where it should not be deregulated, I encourage you to reach out your legislators – call their offices, write them, do what you can to make your voice heard and say “no!” Let them know that you want access to the highest quality out there and most affordable care available and CON makes that possible. And if given the opportunity, ask them where they would go for treatment or where they would send their family or friends when faced with a serious medical crisis…