Archive for March, 2021

By John Toedtman, Executive Director of the Caesar Rodney Institute

March 24, 2021

The recently issued 58 page-report and recommendation penned by Amanda McAtee, who leads the internal research for the Joint Legislative Oversight and Sunset Committee, aptly described the multiple shortcomings of the current Health Resources Board (HRB) process and recommended a new Advisory Board and a Director.

The new Advisory Board would include five dedicated members to conduct the research to present to a Director that would be the final decision-maker, all of whom would report to the Governor. All this does is make administering a terrible law more efficient.

The stated purpose of the Sunset Committeeis to determine whether a given agency meets the goals of its original purpose and, if not, change it or eliminate it.

In the 43 years of its existence, the “Certificate of Need” law (CON) renamed the “Certificate of Public Review” in Delaware has never once met its declared goals.  The stated goals were to lower health care costs by better utilization of existing facilities and expand access to quality health care. In fact, it has failed.

Over the years, the HRB has been hijacked by the influences of Christiana Care (the monopoly health care provider) in New Castle County and Bayhealth (the monopoly health care provider in Kent County). Their control of the HRB has kept new competition out of Delaware and acted as a protection racquet for the incumbents.  

Consider the following:

  • According to the Kaiser Health Foundation report Delaware has the third-highest per capita healthcare spending in the U.S.
  • The Medicaid panel of doctors in Delaware is so limited that Medicaid patients have difficulty finding healthcare.
  • Christiana Care Emergency Room wait time is approximately 4 hours, 53 minutes. One of the longest in the U.S. due to no competition.
  • The widely acclaimed Mercatus Center Study comparing 35 states with CON laws vs. 15 states without CON laws concluded that the states without CON laws (open competition) had better quality and widely available health care at a lower cost.
  • The JLOSC has the Mercatus Center Study that estimated that Delaware would save $248 million in healthcare costs annually by repealing the CON Law and eliminating the Health Resources Board. Still, the study was NOT taken into consideration in the “McAtee Report.”
  • The Federal Government created the original law in 1974, and after review, actually repealed the law in 1987 because it did not meet the goal of lower cost and increased health access. The Feds advised all states that the law is anti-competition and should be repealed at the state level….15 did, and 35, including Delaware, still have the law.
  • The JLOSC was provided a list of 13 non-partisan government and academic studies over the past 30 years of the effects of the CON laws, all of which concluded that the CON laws are anti-competitive and failed to deliver the desired results of lower health care costs and increased health care access.
  • The “McAtee Report” also did NOT consider the 13 non-partisan government and academic studies and stated that the research team had only spoken to some of the 35 states that still have the CON laws. The Caesar Rodney Institute found no studies that supported the CON laws.
  • According to public IRS Form 990 reports and Wall street Bond Rating firms, the pre-tax profitability of Christiana Care and BayHealth are higher than comparable size hospital systems elsewhere in the U.S., and in the case of Christiana Care, often three or four times as high.

This terrible CON law cannot be fixed by streamlining it. The JLOSC committee’s recommendation of creating an Advisory Health Resources Board with a Director to replace the existing Health Resources Board which puts the Governor directly in charge of Delaware’s entire healthcare industry.

The “Sunset Committee” must do the right thing for all Delawareans and ELIMINATE the Health Resources Board.

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