In researching "After the ACA" about supply-side restrictions in medicine and health insurance, I became aware of CON ("certificate of need") laws. Yes, to expand or build a new hospital, in many states, you need state approval, and those proceedings are predictably hijacked politically. For once, they came up with an unintentionally appropriate acronym.
I was interested in this story that not just competing hospitals, but also local activists who want U of C to lose a bundle of money on a trauma center stopped the expansion.
Protesters who want trauma center services at the university testified at the hearing in Bolingbrook and claimed credit for the decision.Also interesting,
According to the report, the proposed 40 private intensive care unit rooms were too large to comply with the state’s standards.
Each room was planned to have a shower and an alcove for nurses to fill out reports out of view of the patient, making the rooms 36 square feet larger than the maximum the state recommends.Sounds nice. I didn't know the state of Illinois had a standard for the maximum permissible size of a hospital room.
The report also says the expansion of surgical beds is not necessary because the university isn’t using its existing beds.
The state requires the beds must be occupied a minimum of 88 percent of the time to meet efficiency standards and justify an expansion. In 2013, the university had patients in surgical beds 79 percent of the time,Let's take this more generally. No restaurant should be allowed to refurbish and put in nicer tables it's at 88 percent of capacity now.
It sounds like the U of C wants to go after, as one doctor put it to me once, "Saudi Princes with interesting cancers." The model of all hospitals these days is to cross-subsidize care that doesn't pay for itself with patients like these. Except the golden-egg hunters want the egg before raising the goose.
As usual, the issue is not what should be done but who gets to decide. Should the U of C build bigger nicer hospital beds? Should it run a trauma center? Good questions -- but why is this anyone but the U of C's business?
Hilariously, this all started as a "cost control" measure, forgetting that in economics, costs go down when you let supply curves move to the right.