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Webinar highlights need to get rid of medical ‘certificate of need’ laws

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Three experts explained Monday how CON laws have throttled Hawaii’s ability to cope with its healthcare needs

Hawaii anachronistic medical “certificate of need” laws have percolated to the top of local discussion in recent months, especially as more people have realized their connection to Hawaii’s lack of healthcare capacity in the wake of the coronavirus crisis.

Hawaii’s CON laws, in fact, are the strictest in the nation, covering 28 different medical services and leading to the fewest hospital beds per capita in the nation. Since 2006, state officials have rejected over $200 million of private healthcare investments, which would have added more than 200 hospital beds to meet Hawaii’s medical needs.

On Monday, the institute sponsored a webinar on the topic, “How CON laws have limited healthcare in Hawaii” (see video below). The event drew extensive news coverage on Maui, likely due to the participation of Joe Pluta, president of the West Maui Taxpayers Association, who has long campaigned for a second hospital on the island.

“For West Maui,” reported Dakota Grossman of The Maui News, the commute to Maui Memorial Medical Center in Wailuku “is lengthy and often too far away in emergency situations,” and “this second hospital is critical.”

He quoted Pluta as saying it’s a “life or death issue,” but obtaining a certificate of need has been “a tremendous challenge,” and it will take “convincing the legislatures who have the power” to move the project forward.

Sal Nuzzo, director of the Florida-based James Madison Institute’s Center for Economic Prosperity, explained during the webinar that medical CON laws came into being at the insistence of the federal government. In a rare move, the federal government later said it had made a mistake and urged their repeal. However, since they are state laws, repeal — or even reform — hasn’t been so easy, especially since they benefit special interests.

Grossman also quoted Naomi Lopez-Bauman, healthcare policy director for the Arizona-based Goldwater Institute:

“It really is time for Hawaii lawmakers and policymakers to take a hard look at what they want for the state in terms of health care access and affordability,” Lopez-Bauman said. “If they want patients to have better services at a lower cost, and to be in more abundance, they really need to eliminate these laws.”

Institute President Keli’i Akina moderated the discussion; Josh Mason, institute marketing director, fielded questions from the audience.

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