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Hospital extensions still need government oversight

Johnson City Press • Feb 26, 2019 at 7:15 AM

Legislators should not pull the plug on the Certificate of Need process for expanding health care facilities, at least not entirely.

State Sen. Mike Bell, R-Riceville, and Rep. Mark Hall, R-Cleveland, have filed legislation that would remove the requirement that hospitals obtain a certificate of need to build satellite emergency departments or offer cardiac catheterization services.

The bill — one of a number filed this session regarding certificates of need — was prompted by the state’s denials last year of applications from Chattanooga-based Erlanger Health System and Tennova Healthcare in Cleveland to build freestanding emergency departments in Bradley County. Bell told the Chattanooga Times Free Press dozens of outraged constituents contacted him afterward — all wanting the state to allow the hospitals to build the satellites without “government interference.”

Furthermore, Hall told the newspaper that certificates of need are no more than state governments overstepping boundaries and creating monopolies.

While we won’t weigh into whether Bradley County emergency satellites were needed, we will disagree with Hall’s assessment of state oversight.

As we have seen in Northeast Tennessee and Southwest Virginia, duplication of services drives up costs in many instances. Regardless of whether you agree with Ballad Health’s post-merger strategies, clearly the two systems that formed it — Mountain States Health Alliance and Wellmont Health System — had overbuilt in certain areas to compete for patients even within the bounds of the state’s regulations.

Maintaining hospital services, particularly emergency care, is expensive. An overabundance of beds, duplication of technology and the personnel to match in any service area mean the increased costs are passed onto the health care consumer and Tennessee’s TennCare system for low-income families.

That’s why the state must maintain a degree of control over health care expansions.

Perhaps a review of the certificate-of-need criteria is in order, especially if the Bradley County applications indeed represented a case of unmet needs, but to cut off an important government function of oversight would put more burden on patients and the state.

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