Ask Virginia's Republican lawmakers about Obamacare, and you can see the veins in their foreheads start to throb. The law's an excrescence, they will tell you. It's the big hand of government smashing a framing hammer down on the invisible hand of Adam Smith. It's socialist social policy married to misguided industrial policy.
So why hasn't the GOP led an assault on the state's certificate of public need law? As A. Barton Hinkle explains, the COPN law is supply-side Obamacare: top-down, command-and-control restrictions on which providers can offer which services. A certificate of public need is, essentially, a government permission slip. Without one, a Virginia doctor can't put an MRI machine in his clinic. A hospital can't build a new wing. A hospital company can't add a satellite campus. And so on. The process strangles free enterprise and squashes the idea of economic competition.