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State House

South Carolina Politicos Take Victory Lap On ‘Certificate Of Need’ Repeal

“More choices … lower costs”

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An assemblage of South Carolina lawmakers and lobbyists gathered in the rotunda of the S.C. State House this week to watch governor Henry McMaster ceremonially sign a long-overdue phaseout of the state’s “Certificate of Need” (CON) legislation.

CON laws were passed in numerous state legislatures by large healthcare providers – ostensibly because hospitals could not make a profit in unregulated markets due to excessive competition. In reality, CON laws – which require the construction of new medical facilities to first be approved by bureaucrats – allowed for the complete stifling of competition by firms already dominating the market.

Originating in New York in the 1970’s and becoming federal law shortly thereafter, the measures were by all accounts a collective failure. Less competition predictably led to the chronic under-service of patients in areas where it was less profitable to operate, as hospitals were content to prevent the construction of competing medical centers which might detrimentally impact the bottom line of their flagship facilities.

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Federal legislators recognized the experiment’s failure, and removed CON from the U.S. Code in 1986. Unfortunately, this didn’t stop state legislators from holding on to the power CON afforded them for many more decades. Thirty-five states still had CON laws on the books at the beginning of this year, South Carolina included.

If you follow FITSNews’ coverage of the Palmetto State’s corrupt, results-challenged government, it shouldn’t surprise you this arrangement – which put elected officials and bureaucrats at the center of a multi-million dollar industry – was something that lawmakers were reluctant to abdicate.

State senator Wes Climer of Rock Hill, S.C. led the multi-year battle to wrest this power away from state actors. South Carolina’s program, administered by the S.C. Department of Health and Environmental Control (SCDHEC), forced hospitals to seek DHEC approval if they sought to build new facilities, open new practices or purchase certain types of new equipment. This arrangement allowed for the state’s entrenched healthcare providers to muscle out newcomers looking to open practices, and to prevent competitors from installing vital instruments like MRI machines.

Climer described the repeal as a win for patients at today’s ceremony.

“They will have more choices, they will have lower costs … not by spending more money, not by creating new programs, but by getting government out of the way to unleash the private sector to invest and compete,” he said.

As South Carolina’s population continues to grow, our medical infrastructure must also scale up. Removing the ability of entrenched industry powers – and blundering bureaucrats – to stifle competition was a necessary step in facilitating this much needed growth.



(Via: Travis Bell)

Dylan Nolan is the director of special projects at FITSNews. He graduated from the Darla Moore school of business in 2021 with an accounting degree. Got a tip or story idea for Dylan? Email him here. You can also engage him socially @DNolan2000.



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Red Uprising October 4, 2023 at 8:07 am

Don’t worry, the certificates of greed are still 100% legal.

CongareeCatfish Top fan October 4, 2023 at 10:37 am

One more step in the long march to dismantle the unholy bastard of the modern Clinton- Obama camp marxists and the old-school FDR/Truman/Johnson/Nixon fascists that is our modern healthcare bureaucracy.

Bill October 4, 2023 at 11:07 am

A massive mistake. Just gives Hospital Corporations a “Blank Check,” to charge citizens for duplicate facilities, duplicate fees, duplicate treatments, duplicate un-needed hospital beds, etc. Turns loose the bribery and ripoffs so clearly shown by “Tricky Nick,” Haley Ethics Investigations & Violations. With her “No Show Job,” at Lexington Hospital. Citizens just lost control even more of their Health Care Costs and quality treatments. GOP in SC is out of control.

Ben Barnes Top fan October 5, 2023 at 7:22 am

Healthcare costs won’t go down until PBM’s and insurance companies are reigned in. If they would manage themselves, there might not be a drive to government oversight, but, alas, greed always overcomes the public good.


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