Why We Can’t Have Nice Things: Permission Slips for Innovation
Dr. Jay Singleton remembers the moment when he realized that Certificate of Need laws were serious business.
“He stood up and stared at me and hit his hands on the table,” Singleton recalls. “And he said, ‘well, we’re going to fight you on this.'”
As we explained in last week’s episode of Why We Can’t Have Nice Things, Singleton has been trying to open a new cataract surgical center in New Bern, North Carolina. He’d met with the CEO of the local hospital as a friendly gesture. What he got was the promise of a protracted legal fight.
Earlier this year, Singleton’s case made it to the North Carolina Supreme Court—though he is still likely a long way away from having a final resolution. Meanwhile, his patients continue to face higher costs: Singleton says that a surgery that would cost $1,800 at his clinic instead costs about $6,000 at the hospital up the road.
Joshua Windham, the Institute for Justice attorney who is litigating Singleton’s case, says the problem lies with North Carolina’s Certificate of Need (CON) law, which gives government regulators—rather than patients or consumers—the power to decide what services are needed.
“They’re really permission slip requirements for innovators,” says Windham. “The government can’t possibly know these things in advance, in part because people’s perceptions of their own needs will change, but also because the facts of reality will change.”
In some places, those roadblocks to innovation in health care are starting to fall. Als
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