Written by Mark Schroer, MD
I think we can all agree that medicine in America and in our state is in need of reform. We all know the statistics. We spend more money than any nation in the world but our quality and access to healthcare is less than optimal. We can do better. We need reform from top to bottom. Medical education, training, administration, innovation and cost all need to improve if we are to care for our citizens. These reforms are many. Repealing the Certificate of Need (CON) is only one of the hundreds of reforms that need to be implemented to improve healthcare in our state. Why repeal the CON? It does not work. KRS 216B.010 clearly states, “the Cabinet for Health and Family Services to perform any certificate-of-need function and other statutory functions necessary to improve the quality and increase access to health-care facilities, services and providers, and to create a cost-efficient health-care delivery system for the citizens of the Commonwealth.” Quality. Access. Cost-efficiency. The CON has failed in all three.
I find it increasingly difficult to deliver health care to my patients. Simply put, my patients cannot get the tests, medicines, and specialty care that they need. The CON is one of many barriers that prevent me from delivering care.
Simply ask your constituents how they feel about health care in our state. Are they pleased with it? Do they feel there is room for improvement? We know the answers already. Many are not pleased with health care in our state. And yes, there is tremendous opportunity for improvement.
Some are concerned about the rural hospitals in our state. Rightly so. I believe there are many ways to fund and deliver health care to rural Kentuckians. One way is the concept of “hospital-at-home” which is an initiative put forth by the American Hospital Association and Mass General Brigham Hospital in Boston.
Some argue that we need the CON because American medicine is not practiced in a free-market system. I think it is clear to everyone that American medicine is not practiced in a free market. There are too many rules and regulations for it to be a free market. However, there are still large sums of money involved and who has access to that money is restricted by the CON.
We all agree then that American medicine is not practiced in a free-market system. But that is not the issue regarding the CON. Let us keep our eye on the ball. In this game the ball is patient care. The real issue is how can we deliver health care with improved quality, access and lower cost to the patient. We need to do a better job taking care of the patient. The hospital, the doctor, the nurse, and all other providers, need to be cared for, but only on the premise that they deliver care. We are all secondary. The patient is our primary concern. Our survival is necessary to the serve the patient. And it is incumbent upon the hospital, the doctor, the nurse, and all other providers, to deliver that care in the highest quality manor to all who seek our help. Anything less is a failure of our mission as health care providers.
Please repeal the Certificate of Need.
Mark Schroer is a Northern Kentucky based doctor