A healthier and more affordable Vermont without CON laws

By David Flemming

After the federal government began urging states to repeal their certificate of need (CON) programs in 1986, 12 states have done so. New Hampshire repealed theirs as recently as 2016. Now, thanks to a new study, we now know much money Vermont has been hemorrhaging with CON requirements for the past couple of decades. Even more importantly, we now know how much healthier we would be without CON laws.

A certificate of need is a government-granted authorization that new or existing healthcare providers and facilities must apply for and receive before opening up shop or expanding services.

According to a 2016 study from the Mercatus Center, if Vermont had not adopted CON laws in 1986, the rate of deaths in Vermont hospitals resulting from post-surgery complications would be 5 percent lower due to several factors. Vermont hospitals would have 36 percent more MRI machines and 37 percent more CT machines. Without CON laws, 5 percent more Vermonters would be able to stay within their home counties to receive medical scans. Better equipment would have reduced the number of patients readmitted to the hospital for surgery complications by 0.3 percent.

Without CON, each Vermonter would have consumed $228 less healthcare annually, resulting in over $141 million in annual savings for our state. Additionally, 5 percent more patients would have rated their Vermont hospital experience higher when surveyed.

Repealing CON laws can relieve doctors and administrators from unnecessary regulatory paperwork, allowing them to focus on improving patient outcomes, while charging patients less. In essence, a full repeal of Vermont’s CON laws will make Vermonters healthier and with more money in their pockets.


Image courtesy of U.S. Navy

One thought on “A healthier and more affordable Vermont without CON laws

  1. Since practicing medicine in Brooklyn in the early 1980’s certificates of need (CON) have interfered with my ability to diagnose and treat my patients on an outpatient basis. The greatest advantage to patients is to be worked up and treated as an outpatient, provided their degree of illness is applicable. Inpatients incur costs which are multiples of the same outpatient diagnostics and treatments plus they are subject to exposure to pathological organisms not jeopardizing their health at home. The greatest effect then was on availability of CT scanners, then MRI machines. Private imaging centers tried to open but for years were severely restricted by CONs. Patients had to wait weeks for scans. Instead, they’d be hospitalized. What they needed was a work up, they didn’t necessarily need to be in the hospital.

    The deciding factor, other than degree of illness, is often the speed of the workup. CONs slow down workups, slow down treatment and benefit no one except for medical institutions which have a monopoly hold over a community, region or state.
    For the monopoly, CONs restrict competition. In Vemont, the State government has been in league with monopolistic medical centers, such as UVM, to continue this anti competitive, anti patient practice.

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