North Carolinians are Being Conned by Certificate of Need Laws | Citizens Against Government Waste

North Carolinians are Being Conned by Certificate of Need Laws

The WasteWatcher

North Carolina is among 35 states and the District of Columbia that currently have certificate of need (CON) laws, which are intended to be used in approving major healthcare facility capital expenditures and projects in an effort to protect patients and control costs. 

Instead, these laws are anticompetitive and limit supply and access to quality care for patients.  They also hinder innovation and create barriers to entry into the health care industry.  

One example of the restrictions on competition occurred in North Carolina, when Dr. Jay Singleton, an eye surgeon who owns an ophthalmology practice in New Bern, challenged the state’s CON law.  It prevented Dr. Singleton from performing eye surgeries at his own surgery center. 

Dr. Singleton took the state to court in 2020 and appealed his case in 2021 and again in 2022 when his case was dismissed.  His latest appeal will be heard by the North Carolina Supreme Court.  According to his legal filing, Dr. Singleton could perform cataract surgeries for $1,800, far less than the $6,000 in charges for the same eye surgery performed at CarolinaEast hospital in New Bern, which holds the CON for eye surgeries in the state.

This was not the first and will not be the last CON application North Carolina officials reject in the name of “patients.”  In 2020, North Carolina denied a CON application to construct a 30-bed acute care hospital in north Mecklenburg County.  The $147 million facility would have included two operating rooms and created hundreds of jobs, while helping to fill the medical needs of the more than or 1.2 million residents of Mecklenburg County.

If North Carolina eliminated the current CON laws, the state could help patients save money and doctors save lives.  CON states, like North Carolina, have mortality rates of about 5.5 percent higher than states operating without CON laws.  North Carolina's healthcare costs could drop by $213 per person if lawmakers repealed the state’s CON laws permanently.  That would also lead to as many as 55 more hospitals and 14 more ambulatory surgical centers being constructed.

Like the other states with CON laws, North Carolina’s law continues to harm patients, limit access to quality care, and keep healthcare costs high.  State legislators should consider the constituents they represent and repeal these burdensome laws.