Perhaps the biggest health care battle of our lifetime exploded almost a decade ago when Congress rammed through Obamacare. As a result, patient choices... This is the year to finally reform Certificate of Need

Perhaps the biggest health care battle of our lifetime exploded almost a decade ago when Congress rammed through Obamacare. As a result, patient choices have been limited while the cost of health care skyrocketed.

What consumers have cried for since then is not only some sanity in the cost of health care, but fewer restrictions on where patients can be treated for their illnesses.

In Georgia, we have our own contribution to that problem. It’s a 40-year-old law called Certificate of Need (CON), which says the state must give its blessing before a provider can offer new services, expand a facility or even construct a new hospital to serve patients.

In many cases, competing hospitals use this process to object to a new service in the community – whether it be an open-heart surgery unit, a maternity ward or new imaging equipment.

If patients truly are the focus of everything we do in health care, then Georgia lawmakers need to allow providers to create more health care options.

That is why I commend one large hospital system for not battling to keep the status quo on CON but providing leadership in presenting a sensible middle ground to the CON battles and an alternative to House Bill 198 and Senate Bills 74 and 114.

Piedmont Healthcare, which operates 11 hospitals in our state, has shown the Legislature a path forward with its recommendation for CON reform that would bring additional choices for patients while meeting the concerns of the large and small hospitals.

Their proposal outlines four changes that I could support as lieutenant governor, and which I believe the Legislature should endorse, so we can show Georgians we are serious about addressing their health care needs.

The plan says:

**  Remove any restrictions on the Cancer Treatment Centers of America hospital in Newnan so it can convert to an acute care hospital and treat Georgia patients at its specialized cancer facility. Currently it has an annual cap so only 35 percent of its patients can be Georgia residents.


**  Remove the requirement for a CON process for capital expenditures and equipment thresholds to make it easier for hospitals to purchase new equipment. The plan says this would apply as long as new services or stand-alone emergency departments cannot be added through one of these processes.

** Permit Legacy Sports Institute, a free-standing sports medicine and orthopedic center, to open in Alpharetta as planned. This facility would offer services to athletes and others in need.

** Allow acute care providers who want to offer inpatient psychiatric beds to be exempt from the CON process when adding new psychiatric beds at an existing facility or converting acute care beds to inpatient psychiatric beds.

Like many others, I want to protect our state’s rural hospitals and expand health care options for patients in these parts of the state. I proposed growing the Rural Hospital Tax Credit to $100 million so these small hospitals can purchase additional equipment to treat patients locally.

However, at the State Capitol, the need to reform CON has a greater urgency. In December, the Trump Administration called for the elimination of CON regulations in the states, saying such laws represent “one of the worst” of states’ anti-competitive regulations.

In addition, the federal government has become more receptive to Medicaid waiver plans for states that have no CON laws. I am committed to pursuing such a waiver to provide a more cost-efficient and free-market approach to providing Medicaid coverage to low-income Georgians. That makes embracing CON reform even more critical this year.

Gov. Kemp with Lt. Gov. Duncan

As we approach Crossover Day for the 2019 session, I urge the lawmakers to consider this roadmap from one of the states largest health care providers.

It’s time to put patients first and finish our work on CON.

Duncan, a Republican from Cumming, is Georgia’s lieutenant governor. He is also the former CEO of Wellview Health, and was active on health care issues while a member of the Georgia House.

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Geoff Duncan

  • Avery Jackson

    February 27, 2019 #1 Author

    Duncan is just another pro-business, right wing politician who is only looking out for investors who support for profit health care facilities. Without the certificate of need process there would be “fly by night” health care providers on every corner putting out poor health care services because they put profit first. These health care providers that want to get rid of the certificate of need probably funded Duncan’s campaign for lieutenant governor and now they want to get what they paid for.


  • Randy

    February 27, 2019 #2 Author

    Sorry, but no. Go ahead and give CTCA and Legacy Sports their handouts. But know that “more health care options” does not equal BETTER health care options. Over saturation of market will destabilize the backbone of our health care delivery system — our safety net hospitals.


    • Albert

      March 1, 2019 #3 Author

      Actually, costs for certain procedures are MUCH lower at independent surgery centers. My recent hernia surgery costs would have been 300-400% higher had I gone to one of the 4 major hospital systems in Atlanta. They would argue that it’s because they have to care for uninsured population and seriously ill patients. I could rationalize this argument to accept perhaps a 50% or even a 100% increase in cost of care for routine surgeries in relatively healthy patients, but not 300-400%!! I did extensive research prior to my surgery. The independent surgeon I used operates both at the surgery center and the major system, so his separate costs were the same. These “non for profit” hospitals are basically fleecing the patients and insurance companies. All of this consolidation was encouraged by ObamaCare with the creation of these giant monopolies with these ACO’s. Back in the day when patients had much lower out of pocket costs, the patients didn’t care. Now that deductibles are reaching $10K, it matters. Amazing what happens when patients have some skin in the game. Monopolies do NOT lower costs, like any other industries.


  • Albert

    February 28, 2019 #4 Author

    If you are relatively healthy and have a high deductible health insurance plan, it literally costs 3 to 4 times the amount to have a hernia fixed by a surgeon at a stand alone surgery center compared to one of the four major health systems in Atlanta. I’ve researched this and made many phone calls. I understand that these health systems do care for uninsured and complex patients, and I could see a 50% or even a 100% surcharge for that, however 3-4 times the cost is ridiculous. The independent surgeons operate surgeon I used operate at both major system and at the independent surgery center, so they get paid the same. This is just a pure money grab by these giant monopolies. It used to be that when the health insurance plans paid most of the costs, the consumers didn’t really care. But now that my deductible is $10K, it matters. Amazing how behavior changes when we have skin in the game. Equally amazing how these legacy hospital systems were fleecing the insurance companies and the patients by their new created monopolies, all of which was encouraged by Obamacare and the creation of these Accountable Care Organizations. My care was great at the ASC, service was quick, and I was only required to check in 1 hour before surgery rather than 3 hours! I am fully aware that this is not an option if you have complex health history, but if you are healthy, independent surgery centers are the way to go.


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