The issues that appear the most complicated are those requiring our attention because they are the most important. Legislation in the Virginia General Assembly regarding our Certificate of Public Need (COPN) law falls in this category. With so much happening around us — in Washington and in Richmond — it is easy to put aside complicated policy deliberations for someone else to sort through. On an issue as important as COPN, we cannot afford to lose focus and allow others to make these decisions – we must also seek to influence the decisions. Legislation now pending in the Virginia Senate quietly has the potential to negatively impact each and every one of us here in the Virginia Piedmont.
To cut to the primary issue: COPN serves the public need in health care in efficient and cost-effective means. It supports access to care, prevents unnecessary over-expansion, helps control costs, and offsets charity care the hospitals provide. Federal law requires hospitals to provide medical care to individuals, even those not able to afford treatment. Serving these individuals is part of hospitals’ core community service missions.
This also comes at significant expense. These costs put immense financial pressure on our local hospitals which stand as economic drivers and major employers throughout the Commonwealth, and especially in rural communities. COPN helps bring stability to a system that is already imbalanced due to unfunded government mandates. In essence, Virginia’s public need law helps ensure that medical care is available in every community, no matter the area’s financial circumstances. Hospitals provide a range of needed services to communities. Some services have positive revenues. Even though services such as obstetrics, burn care, trauma care, psychiatric services, and skilled nursing are costly to offer and lose money, the hospitals continue to provide these needed services. COPN supports the availability of such services. Without it, there could be a rush to provide care in the most lucrative regions of the state, leaving many without the health care each of us needs and deserves.
I had the honor of being on the Northwestern Health Planning District Board in the 1990s when COPN review was a focal point. Then as now, I appreciate the value of COPN in prudent management of health care resources. The outcome of ‘too much’ duplication in health care services is poor quality. Diluting the system with redundant services is not good for patients or clinicians. This can lead to less development and retention of expertise and skilled practitioners and over-prescribing of services for reasons that may not be patient-centric.
Virginia has high quality and value in health care outcomes and costs. Many states without COPN actually have higher healthcare costs than Virginia. There is a comparable precedent in the airline industry, which “deregulated” and now is trying to re-establish its quality and reputation in a climate of cost-cutting that could lead to fewer airlines.
If you care about our health care services, please let our state senator know the Certificate of Public Need law is important. Every Virginian deserves access to quality health care.