The CON board: The beast that won’t die

Grant D. Bosse

July 9, 2013

As originally published in the New Hampshire Union Leader

The state’s Certificate of Need board, an outdated government panel that oversees hospital construction spending, was slated to go away in 2015, but supporters of government rationing slipped a provision into the state budget deal that pushes the day of reckoning back to June 30, 2016.

Officially known as the Health Services Planning and Review Board, the CON board has been around since 1979 and requires New Hampshire hospitals and clinics to get permission before building or expanding their facilities or purchasing expensive equipment. The theory is that a panel of well-intentioned bureaucrats could hold down health-care costs by preventing hospitals from reckless and wasteful expansion. It hasn’t worked.

CON Boards have been around for nearly 50 years and have never been shown to keep costs down. But they have slowed the spread of MRI machines and other miraculous medical devices in the name of cost controls. They have also forced hospitals to navigate a lengthy and expensive maze of regulations and reports. Former Illinois governor and current federal inmate Rob Blagojevich used his state’s CON Board to shake down applicants for bribes.

The deal snuck into the budget shuffles some deck chairs at the CON Board and gives supporters an extra year to keep it alive. New Hampshire would be wise to let the sun set on this costly and counterproductive bureaucracy.

1 reply
  1. Gary Gahan says:

    What ever happened to consumers driving the wagon instead of the other way around? The tail is wagging the dog instead! Health care is virtually the only consumer good that I am aware of that has no cost up front disclosure that would help consumers “shop” for the best health care for any specific need at prices that they are willing to have paid whether is was completely out of pocket or through some insurance arrangement. Insurance companies have no incentives to offer to their insureds to look for any cost effective approaches to treatment or for people to take more control over conditions such as hypertension, obesity, diabetics, etc. that can help contain increasing needs and costs
    for expensive treatment moving forward in their lives. Perhaps a combination of these
    concepts might help make health care a truly consumer driven agenda.

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