> If only. CON laws and their analogues form monopolies in the true sense - businesses who are protected from competition by law. But hey, what's wrong with that?
CONs are a tool - and they can be used for good, or used for bad. Obviously cases where they're misused will attract media attention and no-one thinks about why CONs exist in the first place:
I understand that CONs exist to prevent over-supply of medical services in one area to the detriment of another, or to prevent the inefficient - or inhumane - distribution of medical resources given the US' healthcare system and hospital builder's and operators motives.
In an economic sense: in poorer and rural areas you'll find higher rates of people being uninsured, which means the hospital will have to deal with more indigent patients which can be very expensive - without having enough wealthy patients effectively subsidizing the poorer patients. In the case of emergency care, federal law requires ER departments to treat everyone regardless of ability to pay or insurance which will be hugely expensive - and in non-emergency care you'll simply have fewer paying patients overall - meaning less revenue for a hospital - this means that even the most altruistically run non-profit hospital would rather set-up shop in a wealthier area than a poorer area. This then leads to poorer areas being under-served, which then leads to greater disparities in socioeconomic and quality-of-life outcomes. This is not good for a well-functioning society.
The other reason concerns the negative consequences of having hospitals competing with each other. I assume we all know that (and why) having two hospitals in the area will not result in lower sticker-prices for services or will necessarily improve the quality of the patient-experience (besides bigger marketing budgets...) - competing for patients is one thing, but when they start competing for staff, doctors, specialists - and competing for limited resources (e.g. Covid-19 test kits, medical supplies, etc) that pushes expenses up sharply. This is also not good.
So yes - just like the New York Taxi Cab Medallion system, the Certificate-of-Need system can also be used to artificially restrict supply for the worst reasons - but it has its place, and provided it's well-administered it will be essential to ensure certain efficiencies until the US gets its act together on healthcare like most of the developed world already has.
(If my understanding of the nature of CONs is incorrect, please let me know in a reply - I understand there's an increasing general consensus in academia and public-policy against CONs lately, but I'm also suspicious that people may conflate CON systems in some states that so-far appear to be working well with CON systems in states with a history of regulatory-capture and legislative abuse. Obviously I'd prefer non-CON to a poorly-run CON system, but from what I can tell a well-run CON system is better than non-CON).