Certificate of Need (CON) is among the legal documents in the US. It is a requirement in various federal jurisdictions and states with the aim of expansions, proposed acquisitions, or enable people to establish healthcare facilities (Ho, Ku‐Goto & Jollis, 2009). The certificate is provided by the regulatory agency with authority on a given jurisdiction. The need for the certificate was identified first in the healthcare sector. In a state with a CON program, the planning agency must approve major expenditures for some health care facilities. The primary purpose of a CON program is to control healthcare costs by restricting duplicate services and identifying if new capital expenditures meet the needs of a community. When discussion the issue of giving certification for new hospitals, it is CON, which makes the decision.
There are often two sides to an issue, making up the pros and cons. In terms of pros, CON restricts healthcare spending. CON was began with an objective of containing healthcare cost inflation by reducing overbuilding in a healthcare facility. Besides, CON can bring new healthcare facilities to an area that is often overlooked, such as rural areas (Ho, Ku‐Goto & Jollis, 2009). CON considers opinions from both the public and stakeholders. The key benefit of CON is that it moves healthcare from being an economic product. However, some argue that CON stifles competition that could force existing providers to work more effectively, which might lower patient costs. Thus, CON often keeps the price of care high.
The legal requirement for CON in Oregon, Wisconsin, and Minnesota
|New healthcare facility except some religious institutions shall get a certificate of need from health services before any development (Heiman, 2018)||It is among the states that do not enforce certificate of need (CON)||The individual applying must describe the proposed facility as well as its location, provide the basis for alleged needs, address possible options and offer environmental information (Heiman, 2018)|
|Licensing is provided by the Oregon Health Authority||Licensing is provided by Wisconsin Department of health services||Licensing is provided by Minnesota Department Healthcare Facilities program|
|There are no moratoria||There are no moratoria||Hospitals and bed expansions are covered under moratoria|
|The facilities that are under CON are hospitals, specialty inpatient care, and long term care facilities||CON is not applied in relevant statutes, but the state keeps an approval process for nursing homes (Heiman, 2018)||The state keeps various approval processes|
In regards to the above comparative analysis, it is worth noting that Wisconsin has the least onerous law because there is no enforcement of the law. In Wisconsin, approval is only required for nursing homes. On the other hand, Minnesota is the most difficult because of the degree of scrutiny as well as legal burden that new facilities must comply with (Heiman, 2018). I do not think CON laws are controversial because every state has varying rules and regulations to get the same need. For example, if healthcare is to be equal across the board, why should the process be different from one state to another? These laws cannot be controversial because, based on the legal framework used in the US, every state has the responsibility of defining the legal aspects with which hospitals and healthcare centers operate. While Oregon’s laws may appear simple and direct, Minnesota majors on details may be framed based on its perception of fair treatment.
Heiman, C. A. (2018). Shifting Purpose: Why Iowa’s Certificate of Need Law is a Form of Economic Protectionism for Certain Iowa Health Care Providers and Should Be Repealed. Iowa L. Rev., 104, 385.
Ho, V., Ku‐Goto, M. H., & Jollis, J. G. (2009). Certificate of Need (CON) for cardiac care: the controversy over the contributions of CON. Health services research, 44(2p1), 483-500.