It is difficult to say what exactly spurred the inane idea to kill CON, though it could easily be attributed to backroom maneuvers through politics. It has certainly been fueled by uninformed opinions rather than facts and furthered by the same old bureaucratic controllers who preserve tax-paid positions over good policy.
Michigan’s Certificate of Need policy is and has been very nearly the only manner of controlling rising costs by preventing an oversupply of services in regional markets, and the only measurable method of assuring all areas of the state have adequate access to services and medical technologies.
Just ask the individuals paying the health care bills. Michigan House members heard from them during a flurry of fast-track public hearings last week and received an earful from the business owners who are being pounded by the fifth consecutive year of double-digit premium increases. Ford Motor Company, the largest of the companies testifying, noted that CON does keep costs lower in states where the company has more than 10,000 employees. Even Spectrum Health and Saint Mary’s, which both have had their problems with CON procedures, support its continuance. Further, documented proof of CON support comes from study by the Florida Hospital Association
By the end of last week, members of the state House backed off trying to kill the process, indicating they now want only to “fix” it. The initiative in the State Senate, however, is an outright death sentence for CON.
By all accounts the state Department of Community Health executives responsible for the process have woefully administered their responsibilities, causing predictable backlogs in the review process and demonstrated inadequacies in staffing. Who should be going to the woodshed here is becoming clear. Despite the facts presented during the hearings by companies and hospital groups, the deputy director of the Michigan Department of Community Health wanted the committee to focus instead on a single survey by a Duke University professor purporting CON does not work. It is curious that Deputy Director Carol Isaacs, who is married to a physician, used a study which does reflect the actual experience of individuals fully involved in the best and worst of the process, and even more curious that academic experts at the University of Michigan, Michigan State University or Grand Valley State University, each with health care management program expertise, were not called upon. The director’s one-sided perception of CON value perhaps suggests why program administration is stymied. If the executives in this department do not have the interest or ability to manage this program, it should be given a new parent, and it certainly must make staffing a priority.
Business has run into such bureaubrats before, but there is reason to hope that legislators looking for real solutions will use the facts given by Ford, Lacks Enterprises and many other business owners — who are footing the bill. State leaders will have an incredible problem if business can no longer afford to provide health care benefits, and most people know that already has become a dominant discussion.