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North Carolina ophthalmologist Jay Singleton has a state-of-the-art vision center in New Bern east of Fayetteville, where he can treat patients at a fraction of big hospital costs. Unfortunately, the state won’t let him use his space for most of the surgeries he performs. Instead, Singleton must drive two miles down the road to a
Carolina Journal is the source for daily news and commentary on state and local government, in digital & print, covering politics and public policy.
Carolina Journal is the source for daily news and commentary on state and local government, in digital & print, covering politics and public policy.
Carolina Journal reports: A coal miners’ son. A powerful attorney. A defeated surgeon. Two college sweethearts. All of them became caught up in a powerful system known as Certificate of Need. Certificate of Need laws give the state control of medical resources. Twenty-five people, an advisory board appointed by the governor, oversee the supply of hospital beds, medical equipment, and a host of other resources. In theory, the system is supposed to guard patients’ access to health care. But the system offers a wealth of opportunities to crush unwanted competition and hamstring...
effects of Certificate of Need laws: 1970s: Health insurers have a dilemma, and Uncle Sam is about to get involved. At the time, insurers pay hospitals for their costs. Hospitals go on buying sprees, and everyone else foots the bill. 1971: North Carolina decides hospitals have a spending problem, and they need a budget. Lawmakers require providers to get state permission before making any big purchases — and Certificate of Need laws are born. 1973: Not so fast. The N.C. Supreme Court axes the first version of CON laws for “establishing a monopoly.” 1974: Congress p...