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Certificate of Need CON: A tangled web of bureaucracy, clout, and backroom deals

Carolina Journal reports: A coal miners’ son. A powerful attorney. A defeated surgeon. Two college sweethearts.   All of them became caught up in a powerful system known as Certificate of Need. Certificate of Need laws give the state control of medical resources. Twenty-five people, an advisory board appointed by the governor, oversee the supply of hospital beds, medical equipment, and a host of other resources.   In theory, the system is supposed to guard patients’ access to health care.   But the system offers a wealth of opportunities to crush unwanted competition and hamstring smaller doctors’ practices. Under CON laws, incumbent providers can take their competitors to court and force them to bleed money for months, years, or even decades.  

Certificate of Need CON: A tangled web of bureaucracy, clout, and backroom deals - Carolina Journal

speak on the record.   “It’s human nature, so I shouldn’t be surprised, but I have clients who think it’s unconstitutional, it’s terrible, it’s an unfair restraint on trade,” said a CON attorney. “But once they get it, CON is great, it’s saving money, it’s good for the people. It’s incredible the metamorphosis they undergo.”  THE FIGHTER  Dr. Jay Singleton sometimes says he’s not the right man for the job.  Singleton is the son of coal miners. He spent his childhood crisscrossing Appalachia in a trailer, always in search of another dying non-union mine. The good old days of mining were just a memory, and, more and more, the only thing left was strip mining, tearing the tops off mountains.  

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