State House

South Carolina’s Certificate Of Need Repeal ‘Con’ Job

A curious carveout benefits a government-run hospital in Charleston …

I have no issue with the recent passage of S. 164 – a bill which will phase out South Carolina’s unduly burdensome “Certificate of Need” (CON) program.

In fact, I strongly support this legislation.

CON is a restrictive “regulatory regime” – administered by the S.C. Department of Health and Environmental Control (SCDHEC) – which forces hospitals to seek state approval if they wish to build new facilities, open new practices or purchase certain types of new equipment.

Eliminating it should facilitate a flood of new health care investment, new facilities, expanded options for consumers and – ideally – lower costs for patients.

Lawmakers failed to pass a clean repeal of CON, though. In addition to “sunsetting” this program – a nice way of saying they are leaving its onerous provisions in place for another three-and-a-half years – the final version of this bill contained a curious carveout.



According to a last-minute amendment adopted by lawmakers, CON is repealed effective immediately in the event of “the relocation of a licensed hospital in the same county in which the hospital is currently located.”

In other words, if an existing facility is changing locations within the same county it is “exempt from Certificate of Need review,” according to the amendment.

As you might expect, this carveout is all about serving a specific special interest – in this case, a government-run interest: The Medical University of South Carolina (MUSC). For those of you unfamiliar with the Palmetto State’s command economic approach to, well … everything, MUSC is a state-run hospital which spares no expense (of yours) as it seeks to expand its domineering, anti-competitive reach across the state’s health care industry.

MUSC is also the tip of the spear when it comes to advancing the woke mutilation and drugging of our children – a.k.a. “gender-affirming therapy.” Shockingly, South Carolina’s “Republican” supermajorities continue giving MUSC whatever it wants – including this latest CON carveout.

So … how is this “hospital relocation” amendment tied to MUSC?

Last fall, Charleston S.C.-based Roper St. Francis hospital announced it was “moving Roper Hospital from the Charleston peninsula” to a gleaming new $1 billion facility in North Charleston.

(Click to View)

New Roper Hospital in North Charleston (Roper St. Francis)

Roper’s move is significant because it would free up the hospital’s current location on the Charleston peninsula – a 332-bed facility which includes comprehensive intensive care units, heart and vascular capabilities, inpatient and outpatient surgery facilities and rehabilitation centers – for MUSC to acquire.

MUSC has long coveted Roper’s downtown Charleston location – which is surrounded by MUSC facilities including its college campus to the north, the Shawn Jenkins’ Children’s Hospital to the west and its main university hospital to the east.

Just take a look at the current MUSC campus map …

(Click to View)

(Via: MUSC)

For the deal to go through though, it has to be exempted from CON review.

How did MUSC receive such preferential treatment from state government (again)? As previously noted, its governing board is loaded with influential political appointments – including the father of powerful S.C. House speaker Murrell Smith and the brother of veteran Democratic lawmaker Leon Stavrinakis. Former state representative James Battle is also on the board – as is the father of former House majority leader (and well-connected lobbyist) Kenny Bingham.

In fairness to Bingham, though, he did consistently support eliminating CON during his tenure in the S.C. House.

Sources close to the CON debate told us the speaker’s office leaned on members to support the last-minute “carveout” – which is a glaring conflict of interest given the fact Smith’s father is a board member at the government-run hospital system.

Again, I support the CON bill passed by the legislature – and hope the governor signs it – but it’s still important to note its passage wasn’t on the level.

Bigger picture? South Carolina is never going to have a functioning market-based health care system so long as powerful politicians keep putting their thumbs on the scales in favor of the government-run system (which just so happens to be loaded to the gills with their family members and former colleagues).

I have no problem with government subsidizing certain health care expenditures as a core function of government – if it is done the right way.

“I believe government should make allowances for essential health care services as part of a limited social safety net – while at the same time performing essential regulatory functions of the health care industry (including the protection of patient privacy rights),” I noted in a recent column. “However, it is my view government should never compete directly in either the health care delivery or health insurance industries.”

Sadly, MUSC continues to do that … and continues receiving special treatment from “Republican” and Democratic legislative leaders as it does.



Will Folks on phone
Will Folks (Brett Flashnick)

Will Folks is the founding editor of the news outlet you are currently reading. Prior to founding FITSNews, he served as press secretary to the governor of South Carolina. He lives in the Midlands region of the state with his wife and seven children.



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Anonymous May 12, 2023 at 8:01 pm

great story.

jbl1a May 15, 2023 at 8:12 am

Deep corruption in this state…..


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