Public Health

Certificate-of-Need Laws Prevent Access to Lifesaving Medical Technology


Colorectal cancer is the second leading cause of cancer death in the United States. In large part, that's because less than half of the population that should be getting screened isn't getting screened.

It doesn't have to be this way. Medical science has found a way to use CT scanners to do screenings non-invasively, negating the need to insert a colonoscope into the rectum and large intestine. But for regulatory hurdles, people could just go to a clinic, pay for a quick photo & analysis session and be on their way.

However, as of 2010, 13 states require medical institutions to get permission, in the form of a "certificate of need," before purchasing new CT scanners. Other states require doctors to obtain a certificate of need before offering new medical procedures like virtual colonoscopies, which are still relatively cutting edge.

From Darpana Sheth of the Institute for Justice, writing in the Daily Caller:

In a lengthy and expensive process, verging on full-blown litigation, medical providers must demonstrate a "need" for the proposed services. Worse, existing healthcare facilities are invited to oppose and defeat a would-be competitor's application. This process results in a de-facto "certificate of monopoly" for favored established businesses.

Consider entrepreneur and physician Dr. Mark Baumel. He wanted to open several "one-stop shops" for colon health in Virginia that would provide virtual colonoscopies along with same-day polyp removal, just as he does at his flagship facility in Delaware. Unlike Delaware, Virginia prohibits purchasing a CT scanner without first obtaining a certificate of need. And yet, Virginia's Department of Health has denied Dr. Baumel a certificate of need.

None of Dr. Baumel's potential competitors even offer the service that he wants to provide. But they could. And state health planners apparently think protecting existing businesses from even the possibility of competition is more important than patient access to potentially lifesaving screenings.

Baumel is suing Virginia, with the help of the Institute for Justice. See more Reason coverage of certificate-of-need laws here and here.

Disclosure: I am a former employee of the Institute for Justice.

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  1. Nothing illustrates the absolute economic illiteracy, stupidity, and uncaring nature of central planning better than certificate-of-need laws.

    1. I was about to say essentially the same thing. The fact that they exist at all is an abomination.

      I can easily see myself replying to someone who has told me that I need one by saying ” How about a certificate of FUCK YOU instead? I will be the judge of what I need.”

    2. Who needs a third dimension of X-ray data?

      1. Who needs a bazooka? None of your damn business.
        Oh, and fuck Feinstein with Shreek’s dick.

  2. It’s a conspiracy. These CT scanners would reveal the existence and location of the State’s giant cock.

  3. You can’t have equal access to all medical technologies and have cutting edge technology at the same time. ObamaCare has made it very clear which is more important. This is only a small taste of what’s to come!

  4. Who gives a shit about the little things in the matter, like the people who die because the government imposes these restrictions? That shit’s small potatoes. No, what’s truly important is that a better-qualified, better-intentioned, popularly mandated cuntstain signs a piece of paper — then, and only then, can we allow lives to be saved.

    What a disgusting state of affairs.

  5. Interference in the market interferes with supply and demand?


    1. No, that’s just a libertard conspiracy theory. They concoct them at their annual Minority Baby Sacrifice Convention under the Confederate Battle Flag at the South Carolina State House grounds.

  6. Does anyone even pretend that there is a reason for this other than further fellating the cock of authority?

  7. “In a lengthy and expensive process, verging on full-blown litigation, medical providers must demonstrate a “need” for the proposed services. ”

    This is how government heals.

  8. You can’t always get what you want
    You can’t always get what you want
    You can’t always get what you want
    But if you try sometimes well you might find
    You get what you need

    1. And then she blew my mind!

      1. Mother’s little helper.

    2. Churchill?

    3. And I know what you need!

  9. That’s the doctors’ labor union in action. Thanks again, AMA.

    1. Not just the AMA. The existing hospitals/medical facilities, their trade group, the staff’s union (nurses and non-medical personnel), the state’s beauracracy to administer the CoN program, the public employees union, the insurance companies (CoN prevents costly duplication and wasteful spending, doncha know?), their trade group, medical equipment suppliers that can sell higher priced equipment and services, their trade group and the politicians in the pockets of the above. And specialist attorneys, lobbyists, and other “facilitators” to “help” the new entrant.

      Basically everyone except the patient.

      1. “Basically everyone except the patient.”

        Harry Truman refused to loosen wage/price controls post-WWII; he was SURE he could ‘control’ the economy better than any market signals.
        So the companies saw if you can’t offer a higher pay to attract talent, you offer benes.
        And so, the story starts. It’s been downhill ever since.

    2. I really doubt the AMA had anything to do with this. They are a pathetic organization that far less than 10% of docs belong to.

      No, the docs are usually just as fucked by things like this as the patients. These are crony capitalists, perhaps some of them big-money docs with a major corporate practice, but the vast majority of your regular front-line docs have absolutely no voice or influence.

      Over 85% of docs in the USA opposed Obamacare. That should give you an idea from the get-go.

  10. Metazoan| 3.30.13 @ 6:01PM |#
    “Does anyone even pretend that there is a reason for this other than further fellating the cock of authority?

    There’s no doubt this is one of the motives, but this is the leading edge of ‘death panels’.
    Once gov’t is paying medical costs, gov’t gets to choose who gets paid for what; “He who pays the piper calls the tune”.
    So now, it’s “certificate of need” for a specific service. Who judges whether that “need” is sufficient?
    Guess what happens if you’re 65 and ‘need’ an organ transplant; the (non-existent) death panel decides whether you ‘need’ it.

    1. This is clearly the trend.

      I just wonder, if or when, this trend will be reversed. It will require people to have foresight, and realize this is the trend before it happens to them personally. I’m not optimistic.

    2. I should be hitting retirement age just as socialized medicine hits full stride and bottoms everything out. “I’m sorry sir, we’d love to give you life sustaining care, but we’ve blown our annual budget on Star Trek-themed training videos and nominally-related tropical conferences. Please enjoy what’s left of your life.”

      I’m going to die a spectacular death. Worthy of song.

  11. Baumel is suing Virginia, with the help of the Institute for Justice.

    I only wish that in addition to a judgement in his favor, that he’s granted the rite to bloody and brutal vengeance against his enemies, as well.

    A few more cases ending like that and we might see no more.

    1. JW| 3.30.13 @ 8:11PM |#
      “Baumel is suing Virginia, with the help of the Institute for Justice.”

      This is good news. IJ picks their fights and wins on a regular basis. I am a donor to them and they seem to deliver.

    2. I only wish that in addition to a judgement in his favor, that he’s granted the rite to bloody and brutal vengeance against his enemies, as well.

      heh, HL Mencken proposed something like act. After all, people are punished.. but who punishes the state?

  12. Halftime:

    Wichita St 35
    tOSU 22

    Have sloopy put on suicide watch.

    1. 43 to 19!
      60 to 48!
      In a close one, 38 t0 36!
      An upset: 53 to 44!
      We have a winner in every game!

      1. you seem extra bitter this evening. not enough brandy in your easter basket?

    2. Alabama got flat out beat by the Shockers in the NIT final two years ago. Is there some reason why Wichita State isn’t considered a Cinderella team this year?

    3. I’m more worried about the safety of Baby Reason.

      1. Now I’m really worried.

        I guess the worst will happen when Michigan win tomorrow. 😐

    4. The Shockers play in Koch arena. So, there are two Cinderella tournament universities that have received funding from Koch Industries (Florida Gulf Coast’s economic department be the other)?.

        1. SHOCKING

          1. SHOCKTOPUS

  13. Shit like this almost, -almost-. makes me want to cheer for Obama leading the libtards down the full throttle Cloward-Piven strategy to absolutely obliterate the ‘health care system’ as we’ve come to know it in this country. Looked at from that perspective, it almost makes the cocksucker a goddamned hero.

  14. Star Trek: The Man Trap is on TV. One of the best episodes in the series.

    1. My mom got me that episode on VHS as a consolation prize for not getting elected to student council. I guess in the long run, I was the real winner.

    2. Lemme know if Mirror, Mirror is on next

      1. Nope. Watching free broadcast TV. The Invisible Man Returns w/ Vincent Price is on now. I strongly suspect the guinea pigs were harmed in the making of this motion picture

    3. AFAIK, all the Star Trek episodes are on Netflix

  15. Where’s Sloopy? I want some tasty Buckeye tears.

    1. poking the bear. I like it.

    2. Embarrassment usually doesn’t cause tears. That was more pathetic than anything.

    1. A classic meme. Made all the better by the slight hint of smirk on Stewart’s face, indicating that he is in on the joke, hence Trek wins.

    2. The creator of that photo was just scared of twihards.

  16. more auto reviews from middle earth

    1. Kinda silly looking but I like the color all right.

  17. The US war on drugs has cost one trillion dollars and resulted in 45m arrests. And yet nothing has changed, argues film-maker Eugene Jarecki, a polemical campaigner to reform America’s drugs laws.


    Occasionally, I’m reminded that Bill Maher doesn’t quite come from the same level of stupid as the rest of the Left. Here is serving up an lovely order of snark for Bloomberg’s nanny state agenda.

  19. Too bad Epi’s not here. I just wanted to tell him he can catch the end of “Con Air” if he’s quick. My friendly cable calls it “MNV” channel – what the fuck. But it’s on. HURRY, EPI!!!

    1. It’s that guy!

    2. in order to satisfy homosexual aliens


  20. The Eiffel Tower in Paris has been evacuated after an anonymous phone-call threatening an attack.

    An estimated 1,400 people were visiting the site when France’s anti-terrorism police made the decision to clear it.

    /I like how it identifies it as the one in Paris. But is it Paris Texas, Paris Ontario, or Paris France?

    1. May I have this dance?

    2. What the hell was that, APF?

      You’re not even trying anymore, are you?

      1. I can’t help it if your life is a meaningless void.

  21. Thank goodness it’s less than half.

  22. state health planners

    There’s your problem.

  23. OT:…..s_carousel

    Lots of anthropomorphizing of a goddamn freeway, treating it like the soul of America.

    1. Maryland and Virginia just passed tax increases to address transportation needs, high among them deteriorating highways such as the Beltway.


      That’s fucking hilarious. That money will be used for everything *except* roads.

  24. Sometimes man you just have to roll with it. Wow.

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