Washington state Senate Bill 5017 is a timely debate on the utility of the Certificate of Need program. This program profoundly affects access to medical care. Anyone wanting to build a health care facility must apply to Washington state for a Certificate of Need. This applies to hospitals, nursing homes, ambulatory surgical centers, hospice centers, dialysis units, etc. The state will only grant a certificate if it determines a community needs a new facility — regardless of the market research that an organization may have already done in deciding to expand.
Existing facilities also typically appeal a newcomer's application. The result? Limited competition and regional monopolies. Worse, this program does a crummy job of assessing need; ask any dialysis patient who has to go to dialysis at midnight.
This ongoing crisis in Clark County is the result of a two-year certificate battle between dialysis providers. How did we forget that at the other end of this legal red tape are real live patients? It appears this certificate program has little to do with "need" as you or I might understand it.
If we are serious about expanding access to affordable health care, then we need a flexible health care market — one that is accountable to patients, not politics.