In blatant disregard of the free market, Georgia’s Certificate of Need requirement (coincidentally abbreviated as CON) allows the state Department of Community Health to imperiously decide where certain medical facilities can be built, no matter where private or public funding otherwise would build them in response to consumer demand.
That includes hospitals, and back in January the DCH decreed that neither Doctors Hospital nor University Hospital, headquartered in Richmond County, could step into hospital-less Columbia County to build free-standing emergency rooms.
That’s despite the fact not only that Columbia County is the largest county in Georgia without a hospital, but it flies in the face of free-market economics for there to be an arbitrary restriction on the number of any enterprises that investors can undertake.
But here’s the irony: Columbia County officials believe they’ve found a way to bypass the DCH and its market-restricting regulations – but it involves using public money.
Here’s how it works. The CON law includes a provision
allowing a county to apply for an exception “if the facility is an existing teaching hospital,” or if “the facility is a sole community provider” – and the county itself provides more than 20 percent of the capital for the project.
So, it seems, Columbia County hopes to circumvent the DCH restrictions on the medical free market by priming the pump with public funding – thereby also finagling with free enterprise. A request for proposals to that effect is drawing significant interest from the major medical players in the market, each of whom want a bigger footprint in the lucrative Columbia County market. Taxpayer funding would be the icing on the cake.
Indeed, University Hospital’s board voted last week to pursue a proposal to build a $150 million hospital in Columbia County.
The good news is that the ends seems to justify the means, for a couple of reasons. The most obvious, of course, is that Columbia County can make an excellent argument for needing its own hospital.
With one of the state’s fastest-growing populations – more than 135,000 people now call the county home – it makes as much sense for the county to have more major medical facilities as it does for it to have more stores and restaurants to service that population, as dictated by the free market.
In addition, that proposed government funding toward a new hospital, roughly one-fifth of the total cost or an estimated $30 million or so, would come from the sales tax. That means Columbia County voters next year would have the opportunity to approve or reject the proposal based on whether they agree or disagree with the request for the use of their money.
County officials, then, have a two-fold obligation: first, to look out for the best interest of the county by pursuing top-notch services for their citizens; and then, to spell out why taxpayers should invest their money in vital community services that, if not for a monopoly-protecting bureaucracy in Atlanta, would attract funding for those services without their help.
Any irony aside, that’s a debate worth having.