Alabama’s Dumb Health Care Regulations Helped Create a Shortage of ICU Beds
With COVID infections serious enough to require hospitalization surging, Alabama’s Department of Health delivered grim news last week: There are no more available beds in the state’s intensive care units (ICUs).
An insufficient supply of ICU beds is one of the acute crisis points of the pandemic. When hospitals run out of room to treat patients who need the most help, doctors and hospital administrators must make difficult triage decisions. This affects not just COVID patients but anyone else who might be in urgent need of medical care—car crash victims or those who’ve had heart attacks—and it almost certainly means that some people will die who otherwise may have survived.
It’s a crisis that has been made worse by outdated and ineffective government regulations—known as “Certificate of Need” (CON) laws—that actually reduce the number of available hospital beds by requiring that hospitals get permission from the state before adding capacity.
In Alabama, which is one of 27 states that subjects the supply of hospital beds to CON oversight by the state, we’re now seeing some of the consequences of these rarely thought-of policies. While the surging number of serious COVID cases there and elsewhere across the country is largely the result of unvaccinated Americans being hit by the highly contagious delta variant, a restricted supply of hospital beds is not helping.
Since March 2020, states that use CON laws to regulate the supply of hospital beds have seen an average of 14.99 days per month where ICU capacity has exceeded 70 percent, according to Matthew Mitchell, a senior research fellow at the Mercatus Center who crunched Department of Health and Human Services (HHS) data and shared his findings with Reason. Meanwhile, states that do not have CON laws governing the supply of hospital beds have seen an average of just 8.65 days per month with ICU capacity exceeding 70 percent, according to Mitchell.
Mitchell’s findings suggest that either the virus is specifically targeting states with CON laws—highly unlikely—or else those laws might be worsening the crisis.
In Alabama, specifically, there have been 29 days for which bed utilization was above 70 percent in the past month. Over that same period, the average non-CON state experienced just 6.9 days above 70 percent.
The United States has only 2.8 hospital beds per 1,000 people, according to data from the Organization for Economic C
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