By BOBBY HARRISON / Daily Journal
The chairmen of the House and Senate public health committees would not say whether they would support efforts to repeal the process where certain health care facilities must obtain a certificate of need to operate in the state.
But Rep. Sam Mims, R-McComb, chairman of the House committee, and Sen. Dean Kirby, R-Pearl, chairman of the Senate panel, and members of their committees held a three-hour hearing on the issue Monday.
“We are just interested in getting the best health care we can get for the dollars we are allotted,” Kriby said after the meeting.
Mims simply said “it is a big issue” that deserved the attention of his committee.
Both said they would continue to study the issue.
Russ Latino, the state director for Americans for Prosperity, told legislators they should repeal the certificate of need (CON) process and allow “market driven forces” to determine the number of hospitals and other health care facilities in the state. That, he said, would lead to lower costs and better care.
“More competition tends to lead to higher quality,” agreed Matthew Mitchell, an economist at George Mason University, who has studied the issue and said most economists view CON laws as “anti competition.”
But others disagreed.
“The free market forces are not working in health care,” said physician John Fitzpatrick, chairman of the board of the Hattiesburg Clinic.
For instance, a person suffering a heart attack does not shop for the lowest-priced hospital.
Mississippi, like all states with the exception of Louisiana, adopted CON laws in the 1970s at the insistence of the federal government. The thought was to develop health care facilities with a plan to ensure that all hospitals, for instance, did not try to locate in more populous and more affluent areas and to ensure medical providers did not overbuild, forcing prices to be increased to help pay for the new equipment or buildings.
But in the 1980s, the federal law was repealed and about 15 states have scraped their CON requirements.
Efforts have been underway for years to ease the restrictions of the Mississippi law or to fully repeal it as some at Monday’s meeting supported. As is often the case, the meeting dealing with health care issues attracted scores of lobbyists whose medical clients are dependent on state and federal dollars to support their operations.
Ashley Noble, policy specialist with the National Conference of State Legislatures, testified that Mississippi has one of the nation’s more restrictive CON laws.
A medical provider must obtain a CON from the state health office:
- For the installation of major medical equipment costing more than $1.5 million.
- For clinical health services costing more than $5 million.
- For non-clinical health services costing more than $10 million.
It would take a CON to build a new hospital, to add beds to an existing hospital or to install a magnetic resonance imaging machine. An office for a new doctor would not require a CON.
The decisions on whether to grant a CON is supposed to be based on the state health plan developed by the Board of Health. The plan determines the medial needs of the areas of the state. For instance, the state health plan would determine whether there are regions of the state in need of more hospital beds.
Asked if he thought eliminating the CON process in Mississippi would hold down costs, Kirby said “no,” but by the same token he said all laws need to be tweaked on occasion.
Whether the CON law will be tweaked in the 2018 legislative session or completely eliminated as some at Monday’s meeting advocated will likely be debated more in the coming months.