[Restrain]

There is a state board that has to approve all new hospitals and existing hospital expansions. Fort Myers hospitals last flu season had people in hallways. I was in a Port Charlotte hospital a couple of weeks ago, it was full and the snowbirds hadn't arrived. Yet every time the area asks Tallahassee for more hospital space some bureaucrat says NO.

It is time to get rid of this board and let the locals decide if the want another hospital,if a hospital needs expansion. Something like this might work in Rhode Island, but it sure doesn't work here.

[d4g4m]

They can't expand because of racism and global warming.

[beachmouse]

There is a certain logic to this- repeated studies show that the more of a given procedure a hospital does, the better the patient outcomes. So one hospital doing, say, 1000 appendectomies per year will have better outcomes for that patient population than four hospitals each doing 250 appendectomies a year.

So limiting the number of hospitals and hospital specialization areas within a geographic area can actually be good for public health. But like many things, the problem is in the execution where it's often too hard to get a new certificate of need both because of general bureaucracy and because established hospitals try to block newer medical centers from encroaching on what they see as the veteran's territory, even when the need is actually there to the point where a second hospital would hit critical mass for excellence in what they want to do and the competition would help keep hospitalization costs down for all consumers.

[Happiness-is-close]

The state needs to be involved in this decision because hospitals receive funding from the state for a wide variety of reasons. If there are enough hospitals to serve the population then we shouldn't be building more hospitals that would drain taxpayer money to keep their lights on.

[kyle19125]

Originally Posted by beachmouse

There is a certain logic to this- repeated studies show that the more of a given procedure a hospital does, the better the patient outcomes. So one hospital doing, say, 1000 appendectomies per year will have better outcomes for that patient population than four hospitals each doing 250 appendectomies a year.

So limiting the number of hospitals and hospital specialization areas within a geographic area can actually be good for public health. But like many things, the problem is in the execution where it's often too hard to get a new certificate of need both because of general bureaucracy and because established hospitals try to block newer medical centers from encroaching on what they see as the veteran's territory, even when the need is actually there to the point where a second hospital would hit critical mass for excellence in what they want to do and the competition would help keep hospitalization costs down for all consumers.

The issues however with maintaining a monopoly are many. If existing Hospital "A" for example is part of a for-profit corporation that's just maintaining standards (which aren't terribly high) and is guaranteed exclusive territory until the population growth no longer allows it, preventing not-for-profit Hospital "B" (that's part of a highly-rated system) from serving the population...who is best being served? That answer would seem to be the bureaucracy, perhaps under the table? We are a free market economy the last I checked and allowing the consumer (or this case patient) to determine the better fit is part of that process, and not that of government.

[Restrain]

Texas had this system, the local hospitals and local governments that made money off the community hospital would fight any expansion by competitors. Finally threw it out. Now it has competing hospitals where there was no competition, as well as specialized hospitals for short terms (day, overnight care from outpatient surgery, cancer hospitals, etc). All of which has made mainline hospitals compete for your business.

[kyle19125]

Originally Posted by Restrain

Texas had this system, the local hospitals and local governments that made money off the community hospital would fight any expansion by competitors. Finally threw it out. Now it has competing hospitals where there was no competition, as well as specialized hospitals for short terms (day, overnight care from outpatient surgery, cancer hospitals, etc). All of which has made mainline hospitals compete for your business.

Which raises the quality of care and services provided, as it should be.

[flyboytampabay]

They are called certificate of need laws. The agency is the Agency for Healthcare Administration. Many states have done away with CON laws as they inhibit competition and drive up costs. I think about 16 states have done away with CON laws. Texas and Arizona are perfect examples of how healthcare services improve without government intervention. If the states reasoning were correct why don't they regulate drug stores. Where there is a CVS a wallgreens is around the corner.