Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

As cancer patients wait, states play favorites

Jaimie Cavanaugh, JD and Daryl James
Policy
July 5, 2022
Share
Tweet
Share

Cancer patients soon will have new treatment options in Connecticut. Health care providers recently received regulatory approval for a joint venture that will allow them to open the state’s first proton therapy center.

The lifesaving technology, which uses laser beams as a safer and more effective alternative to chemotherapy, is urgently needed. So the announcement was a big deal. But what the partners failed to mention in their news release is that a competitor could beat them to market with a similar facility 45 miles away—except the state is running interference.

The rival project already has the necessary medical expertise, financing, zoning permits, and community support lined up. The only thing missing is a “certificate of need” (CON), a government permission slip to launch, expand or terminate any health care venture in the state.

The rival project, led by a group of independent doctors and investors, has tried to get a CON for two years. But the oversight agency with veto power recently issued a preliminary denial. Two weeks later, the same agency approved the joint venture.

The protectionism was not lost on the losing side, which has warned about higher health care costs due to a potential monopoly. An appeal is pending, but if the state sticks with its preliminary decision, Connecticut cancer patients will find themselves with less choice and less access to proton therapy.

The case shows a clear example of the government picking winners and losers. Two applicants submitted viable proposals. But rather than letting them compete on a level playing field—or coexist in separate cities—state regulators tipped the scales in favor of only one bid.

To make matters worse, Connecticut allowed the winning side to testify against its potential rival at a CON hearing, despite a clear conflict of interest. Something similar would happen if Connecticut allowed The Home Depot to participate in decisions about new hardware stores—or if the state allowed McDonald’s to say who could sell burgers.

Our public interest law firm, the Institute for Justice, has no connection to either proton therapy project, but supports the rights of all health care providers to invest their own money without unreasonable or excessive government interference.

Unfortunately, the Connecticut case is not unusual. “Conning the Competition,” a nationwide analysis of state laws from the Institute for Justice, identifies 38 states—plus Washington, D.C.—with some form of CON legislation. Overall, 34 of these jurisdictions allow competitors to intervene in the application process and object to applications that could reduce their revenue.

CON laws purport to lower health care costs, increase patient access and ensure quality by managing the distribution of private resources, but none of these gains has materialized. A joint report from two federal agencies—the Federal Trade Commission and the Antitrust Division of the Justice Department—finds no evidence that CON laws achieve any public benefit.

A supermajority of studies agrees. More importantly, decades of real-world experience show that CON laws do not work as advertised. Recognizing the policy error, Congress reversed itself in 1986 and repealed CON mandates it had imposed just 12 years earlier.

Since then, California, Texas, and 10 other states, which contain nearly 40 percent of the U.S. population, have canceled their CON laws entirely. Most recently, New Hampshire joined the list in 2016. Each time, the American Hospital Association and local affiliates predicted disaster, but negative effects never materialized.

The opposite happened instead. At the start of the COVID-19 pandemic, states without CON laws had more hospitals and surgery centers per capita, along with more hospital beds, dialysis clinics, and hospice care facilities.

ADVERTISEMENT

Recognizing its disadvantage, Connecticut scrambled to suspend CON requirements for mental health care facilities through June 2026 in response to a bed shortage. The legislation, which Gov. Ned Lamont signed on May 23, 2022, represents a step in the right direction. But additional psychiatric hospitals already could be open without CON constraints.

Proton therapy also could be available today if providers did not have to spend years begging for permission to serve patients. Lifesaving technology should not have to wait. Rather than playing favorites, states should repeal their CON laws and let doctors work.

Jaimie Cavanaugh is an attorney. Daryl James is a writer.

Image credit: Shutterstock.com

Prev

The forgotten crisis: a shortage of geriatric doctors in the U.S.

July 4, 2022 Kevin 2
…
Next

A hospice doctor's advice on getting your finances in order

July 5, 2022 Kevin 0
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
The forgotten crisis: a shortage of geriatric doctors in the U.S.
Next Post >
A hospice doctor's advice on getting your finances in order

ADVERTISEMENT

More by Jaimie Cavanaugh, JD and Daryl James

  • The impact of certificate of need laws on rural health care

    Jaimie Cavanaugh, JD and Daryl James
  • Patients lose when states block independent doctors

    Jaimie Cavanaugh, JD and Daryl James

Related Posts

  • Cancer patients who want to take unproven supplements

    Marc Braunstein, MD, PhD
  • Obstruction of medical justice: How health care fails patients with cancer

    Miriam A. Knoll, MD
  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • You are abandoning your patients if you are not active on social media

    Pat Rich
  • We must help patients recognize how important their opinions are

    Karen Sepucha, PhD
  • Physicians who don’t play the social media game may be left behind

    Xrayvsn, MD

More in Policy

  • Why your health care dashboard isn’t working and how to fix it

    Dave Cummings, RN
  • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

    Robert E. White, Jr. & The Doctors Company
  • How new loan caps could destroy diversity in medical education

    Caleb Andrus-Gazyeva
  • Why transplant equity requires more than access

    Zamra Amjid, DHSc, MHA
  • Ideology, not evidence, fuels the anti-trans agenda

    Andie Riffer, PhD and Shawn E. Parra, LCSW, MSW
  • Health equity in Inland Southern California requires urgent action

    Vishruth Nagam
  • Most Popular

  • Past Week

    • Why your clinic waiting room may affect patient outcomes

      Ziya Altug, PT, DPT and Shirish Sachdeva, PT, DPT | Conditions
    • The backbone of health care is breaking

      Grace Yu, MD | Physician
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • Why transplant equity requires more than access

      Zamra Amjid, DHSc, MHA | Policy
    • The ethical crossroads of medicine and legislation

      M. Bennet Broner, PhD | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • How your family system secretly shapes your health

      Su Yeong Kim, PhD | Conditions
    • Women physicians: How can they survive and thrive in academic medicine?

      Elina Maymind, MD | Physician
    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Why AI in health care needs stronger testing before clinical use [PODCAST]

      The Podcast by KevinMD | Podcast
    • How AI is reshaping preventive medicine

      Jalene Jacob, MD, MBA | Tech
    • How transplant recipients can pay it forward through organ donation

      Deepak Gupta, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why your clinic waiting room may affect patient outcomes

      Ziya Altug, PT, DPT and Shirish Sachdeva, PT, DPT | Conditions
    • The backbone of health care is breaking

      Grace Yu, MD | Physician
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • Why transplant equity requires more than access

      Zamra Amjid, DHSc, MHA | Policy
    • The ethical crossroads of medicine and legislation

      M. Bennet Broner, PhD | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • How your family system secretly shapes your health

      Su Yeong Kim, PhD | Conditions
    • Women physicians: How can they survive and thrive in academic medicine?

      Elina Maymind, MD | Physician
    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Why AI in health care needs stronger testing before clinical use [PODCAST]

      The Podcast by KevinMD | Podcast
    • How AI is reshaping preventive medicine

      Jalene Jacob, MD, MBA | Tech
    • How transplant recipients can pay it forward through organ donation

      Deepak Gupta, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

As cancer patients wait, states play favorites
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...