This past Friday, the conservative Daily Progress editorial board totally ripped into “free-market advocates in the General Assembly” for having “undermined their own argument by advancing legislation that does the opposite of promoting competition.” Why? Because, as the Daily Progress explained:
…pieces of the legislation are clearly aimed at protecting specific projects — without the possibility of competition. How else would you interpret a bill ordering the state health commissioner to exempt proposed projects from the normal [Certificate of Public Need – COPN] process, when the proposals are so narrowly defined that they can only refer to a single, favored provider? That’s not competition; that’s cronyism.
For more on COPN and why it’s so important, click here. In short, COPN “protects health care access, controls costs, and offsets unfunded charity care mandates on hospitals.” Also consider: “Health care is not a free market. Federal law requires hospitals to provide emergency care regardless of a patient’s ability to pay. Also, many patients who need hospital care are uninsured, underinsured, or are covered by federal or state health programs that do not cover hospitals’ full costs for delivering care.” Of course, for-profit actors would love to come in and cherry pick the profitable stuff from hospitals, leaving them with everything that loses money, sending the hospitals into a financial death spiral. The question is, why on earth would our General Assembly enable that disastrous outcome?!?
Which brings us back to the specific bill the Daily Progress slammed — SB 266, patroned by Sen. David Suetterlein (R-SD19) and co-patroned by Senators John Cosgrove (R-SD14), Bill DeSteph (R-SD8), Siobhan Dunnavant (R-SD12), Jennifer McClellan (D-SD9), Chap Petersen (D-SD34) and Lionell Spruill (D-SD5). SB 266 is an “omnibus” piece of legislation that “incorporates SB 235, SB 354, SB 365, SB 806, SB 848, and SB 923” — each drawn as a special exemption to COPN seemingly to benefit one specific provider. The “omnibus” passed the State Senate on February 13 by a vote of 20-19 (overwhelmingly along party lines, with the vast majority of Democrats, other than the two co-patrons mentioned above, voting NAY).
Among other problems, this legislation shows the inconsistency and hypocrisy of claims by Republicans who like to wax rhapsodic about the wonders of competition. Except, that is, when they choose to provide massive, taxpayer-funded corporate welfare to any number of their favored industries, whether we’re talking about the fossil fuel industry or, in this case, health care (which, of course, is NOT a true free market). What SB 266 demonstrates is that those voting for it don’t really want a level playing field, but instead want preferential treatment for specific providers — and are asking the legislature to provide that preferential treatment to them.
In addition to being poor public policy and a violation of professed “market principles,” the approach to this legislation raises serious questions about whether it conflicts with language in the Virginia Constitution that prohibits special legislation to benefit a particular entity.
- The General Assembly shall not enact any local, special, or private law in the following cases:
- (18) Granting to any private corporation, association, or individual any special or exclusive right, privilege, or immunity.
Yet that’s exactly what this legislation appears to do (bolding added by me to show that there are clearly specific providers the patrons had in mind in writing the bill).
- The establishment of a new ambulatory surgery center located in Planning District 23 that will provide health care services related to the practice of gastroenterology primarily to patients in the Cities of Norfolk, Portsmouth, and Virginia Beach, provided that the applicant is a physician certified by the American Board of Internal Medicine in gastroenterology who has practiced in Planning District 23 for over 30 years and who provides health care services related to the practice of gastroenterology and currently performs at least 95 percent of his procedures for Medicare patients in his current facility.
- The establishment of a new ambulatory surgery center located in Planning District 15 that will provide ophthalmic services, provided that the applicant is a physician certified by the American Osteopathic Board of Ophthalmology and Otorhinolaryngology who has owned an ophthalmology practice in the Town of Ashland for at least 20 years and currently provides ophthalmic services primarily to patients from the Counties of Hanover, King and Queen, King William, Louisa, and Spotsylvania, the City of Fredericksburg, and the Towns of Ashland and Tappahannock.
- The establishment of a new ambulatory surgery center located in Planning District 23 that will provide orthopedic services and the acquisition of medical equipment necessary for the provision of magnetic resonance imaging (MRI) services, provided that the applicant has been in business for at least 15 years, employs at least 20 physicians, and operates at least five locations in Planning District 23 that specialize in the provision of orthopedic services.
- The acquisition of the medical equipment necessary for the provision of magnetic resonance imaging (MRI) services in Planning District 8, provided that the applicant provides orthopedic and therapy care services and operates at least 20 locations in the Commonwealth.
- The establishment of a new ambulatory surgery center located in Planning District 23 that will provide orthopedic services,provided that the applicant has held a certificate for magnetic resonance imaging (MRI) services for at least 12 years and exceeded its charity care requirements on such certificate by at least $70,000 in calendar year 2016.
Note how specific these descriptions are? Thus: “at least $70,000” (not $80,000 or $200,000 or whatever); “at least 12 years” (not 15 or 20 years or whatever); “at least 20 locations” (not 30 or 50 or 100 or whatever); etc.
So yeah, as the Daily Progress stated in its editorial, these bills are “clearly aimed at protecting specific projects – without the possibility of competition,” not to mention a classic case of “cronyism” run amok, and possibly (probably?) unconstitutional ot boot. Again, the fact that the vast majority of those voting for this bill were Republicans, the same folks who claim to love competition and the “free market,” is even more galling. One thing it isn’t is surprising, as hypocrisy when it comes to so many things – from caring about deficits/debt, national security, family values, etc. – is basically inherent to being a Republican nowadays…