Healthcare's legal monopoly - WALB.com, Albany News, Weather, Sports

Healthcare's legal monopoly

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November 9, 2006

Albany -- A fight is looming for the Georgia Legislature in 2007, and it will have a major impact on the way you receive your health care, and how much you will have to pay for it.

For the last year and a half, s state commission has studied Certificate of Need-- or CON--  laws in Georgia, and next month their recommendations go to Legislators. Hospitals say changes in current law could ruin them, while doctors and industry says it has to change to control health care costs.      

South Georgia Doctors and industry leaders say a fair market system for health care would cut your medical costs. Albany surgeon Dr. John Bagnato said, "People ought to have choice. You'll get better health care at a lower cost."

But Georgia 'CON' or Certificate of Need laws say surgeons like Bagnato can't just set up private ambulatory surgical centers. Those surgeries and other certain medical practices can only be done in approved facilities.

Hospital consultants say it protects the fragile financial condition of the health care system in Georgia. Hospital consultant and one-time state legislator Tommy Chambless said, "There are so many rural hospitals that are operating in the red, that if it were not for CON, many of those would collapse."

Bagnato said hospital administrators are playing the fear game. "Hospitals in Georgia last year made over $900 million in profit, in profit."

Georgia enacted CON in 1979, to control competition in health care and protect hospitals. Community hospitals like Phoebe Putney are licensed as the only providers of profitable medical services like general surgery, in order to offset the cost of medical necessities.

"Like emergency care, trauma care, intensive care units," Chambless said.  And indigent care. Community hospitals in Georgia provided abut $880 million in uncompensated care, and say without CON protection, doctors and surgeons would take all the money they need to operate.

Phoebe Putney CEO Joel Wernick said, "Those who pay, often times pay for those who don't pay. It's not a question if it's right or wrong, it's currently the way it is."

Albany's large industry say it's wrong. Their studies found their workers in South Georgia were paying the highest health care costs in the nation, because of the lack of competition. CACH President Vince Falcione said, "We think CON needs to be changed here in Georgia."

A data analyses study done for the Georgia CON Committee agrees, finding that CON regulation is associated with higher private inpatient costs. And there was no significant correlation between the number of hospitals lost and the presence or rigor of CON regulation.

But Phoebe officials say high poverty and disease levels in South Georgia make CON essential to keep their doors open. "To assure that the weakest among us has access to quality health care services," Wernick said. 

Bagnato says community hospitals get millions of dollars for Medicare, Medicaid, and tax exemptions to cover those costs. "The only people who benefit from CON are the hospital administrators, their lawyers and their lobbyists."

Hospital administrators say the doctors just want to expand their business and make more money, which Bagnato proudly says is true. He just wants you to be able to choose where you spend your health care dollar.  "If you give consumers choice, they will reward those who provide a better service. And the better service will be a better product and a better price."

He says state hospital groups fear competition, and that's why they spend so much money lobbying state lawmakers to keep their CON mandated monopolies.  "Hospitals don't want it done, and they control things through all their money they spend on lobbyists," Bagnato said.

Consultant Chambless said, "I think jobs and futures are certainly in jeopardy, as a result of how this fight goes."

Both sides agree the Georgia legislature can improve CON laws by streamlining parts of it, without totally gutting the program.

Next year Georgia lawmakers will tackle this complex issue, which impacts your job, money, and the medical care for everyone in the state.  

Phoebe officials also say CON laws have helped keep them from being a burden to county tax payers. In Atlanta, Grady Hospital receives more than $100 million from Fulton and Dekalb County tax rolls.

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