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Repealing the Certificate of Need Program is up for debate in South Carolina

Some lawmakers are looking to repeal the state law in hopes of improving access to healthcare, while others worry of the possible consequences for hospitals.

COLUMBIA, S.C. — Some South Carolina lawmakers are looking to make the state's healthcare system more competitive. 

Now that senators are back in the State House for regular session, one of the first things they're tackling is a bill that aims to repeal the Certificate of Need (CON) Program. 

The program allows state government to regulate healthcare providers. It requires healthcare providers to get approval from SCDHEC before making changes to their facilities; including expanding or changing the number of beds available. 

According to SCDHEC, it also prevents duplication of healthcare services and regulates what providers can open where. Some lawmakers, like Senator Wes Climer (R, York), are against these regulations. "The Certificate of Need does nothing but deny access and increase the cost of health care,” Climer said during a press conference Wednesday.

Climer is sponsor of Senate Bill 290, which aims to repeal most of CON. A few physicians joined Climer and other lawmakers during the press conference to explain why they are against CON.

Dr. Rob Brown with the South Carolina Medical Association said the law squanders competition and promotes big business in healthcare.

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"The majority of physicians are now employed by hospital systems. As a result of this consolidation, overall competition has decreased with near monopoly conditions, patients have fewer options and costs have grown out of control,” said Brown.

Under CON, Brown said that large hospital systems are able to veto small business's requests to expand or open a facility in their area.

Brown offered the following comparison when explaining why he thinks CON disadvantages other providers: "Imagine if we had a CON in the grocery industry and 'Farmer Smith' decided he wanted to sell produce. What if Publix or Harris Teeter could raise their hand and say 'I object!'"

Opponents of CON say it drives up costs for patients, but the South Carolina Hospital Association told News19 it actually funds free and discounted care for low-income families.

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Executive Vice President of SCHA, Christian Soura said, “In the last year, South Carolina hospitals spent more than $1.8 billion providing free or discounted care." Soura explained that they're happy to provide free care, but they can't, "if other providers can swoop in, just provide the profitable services and leave us to take care of everything else.”

Soura supports CON but said he would like to see it reformed.

"We all agree it takes too long to get a final decision, that there are too many appeals, and appeals take too long," Soura said when talking about the process for a healthcare provider to get permission from SCDHEC.

However, SCHA does not want to see the program repealed.

Debate on the Certificate of Need law began Wednesday in the South Carolina Senate and is expected to go for several days. 

According to the National Conference of State Legislatures, 15 states have gotten rid of the program, but it still exists in 35 other states and Washington D.C.