AL study questions need for CON process

Kind of a stretch to call this a "study" or a "report" ... it chides pro-CON thinking as not being based on empircal data, but about the only quantitative data presented here is that 13 states have recently repealed CON regs.

It's a theoretical opinion piece, pure and simple.

Not that there's anything wrong with that. Other than a little truth-in-advertising. (The author also critizes CON regs as being being a secret tax to support indigent and otherwise unfunded care ... it is "ironical" that two of the strongest arguments against CON the author makes are pitfalls he himself trips into ... lack of empirical data and truth-in-advertising.)

But well-reasoned opinion can be helpful.

My real biggest problem with this after a quiick read is that nowhere does it mention any of the Wennberg et al studies that very conclusively demonstrate ... in large, well designed empircal studies that encompass 300+ natural health care "markets" in this country, and have seemingly irrefutable statistical results ... that BED SUPPLY is positively related to utilization and total (societal) hospitalization costs, after adjusting for age, race, income level, etc.

So this is very selective in what parts of the story to present ... a couple of worse-case snapshots of CON wrangles, none of any safety-net hospitals jeoparized by the emergence of a nearby free-market specialty hospital that "competes on price" by 15% because it's eliminated the hospital's 25% cross-subsidy of unfunded patients. (And maybe that's an urban myth ... would be nice to have DATA to frame this kind of discussion, rather than a few carefully selected Reagan-esque anecdotes.)

There are legitimate pro and con arguments about CON, theoretical and presumably empirical ... it would nice to see both sides.

As Rohrer* concluded in 1988, "The incentive systems so often touted as alternatives to regulation actually engender more regulatory interence than does overt regulation of bed supply." That still seems very true today, IMO.

* James E. Rohrer, Efficiency and the Supply of Hospital Beds in Metropolitan Areas, Journal of Public Health Policy, Vol. 9, No. 3. (Autumn, 1988), pp. 393-402.