Best and Worst from the 2015 General Assembly

by James A. Bacon

thumbs_upThe best: crowdfunding. A bill submitted by Del. Scott Taylor, R-Virginia Beach, will make it easier for entrepreneurs to raise money for start-up businesses through crowdfunding. The bill creates an exemption from the state Securities Act applying to the first $2 million raised per year. A business still could not raise more than $10,000 from any single purchaser unless the purchaser is an accredited investor.

States Taylor: “The greatest challenge that start-ups with good ideas face is finding the capital to grow. ‘Crowdfunding’ has grown to a multi-billion dollar industry that lets entrepreneurs make their case to small investors and get their ideas off the ground. This legislation will make it easier for Virginians to invest in promising Virginia start-ups, creating a culture of entrepreneurship and more good-paying jobs.”

The bill passed the House of Delegates on a 99 to 0 vote.

pukeworthyThe worst: Selective COPN rollback: The Certificate of Public Need (COPN) law, which regulates investment in new medical facilities and expensive equipment, protects hospitals from competition — justifiable only as a way to offset hospitals’ significant obligation to provide indigent care. A bill submitted by Bobby Orrock, R-Thornburg, would roll back the law in certain instances.

The bill would provide exemptions for existing general hospitals and psychiatric hospitals when adding non-nursing home beds, exemptions for certain hospitals adding open heart surgery, and exemptions for certain hospitals adding neonatal care facilities.

Less regulation is a good thing, right? Yes, when applied to everyone equally. COPN review adds unnecessary cost and makes hospitals less responsive to market conditions. But less regulation is NOT a good thing when it serves to advantage certain players over others. Please note: The exemptions apply only to existing hospitals — not to anyone trying to enter the market. In effect, it lifts the burden of regulation for established providers while maintaining it for anyone who wants to compete.

Second, the bill provides arbitrary conditions on who qualifies for the exemption. Hospitals adding open heart surgery must have “at least 1,100 adult inpatient or outpatient cardiac catheterizations, including at least 400 therapeutic catheterizations, or discharged at least 800 patients with the principal diagnosis of ischemic heart disease during the 12 months immediately preceding such registration.” What? Is there any medical justification for such a restriction, or has it been inserted into the bill to apply to one particular hospital only? Who is that hospital? People should demand to know.

The bill also exempts “intermediate- or specialty-level neonatal special care services at an existing medical care facility that registers the new service and delivered more than 1,000 infants in the 12 months immediately preceding such registration.” Really? What’s the justification for that exemption? Who’s the beneficiary here? How about a little transparency?

Orrock’s bill was passed unanimously by the House Health, Welfare and Institutions Committee.

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One response to “Best and Worst from the 2015 General Assembly

  1. Nice pumpkin!

    Orrock hails from the Fredericksburg Area where Mary Washington Hospital up until recently was the sole regional hospital until HCA was allowed to put up a competing Hospital called Spotsylvania Regional.

    I don’t profess to know what Mr. Orrock is up to – but clearly it’s something!

    but I also don’t buy the “competition” argument and here’s why.

    Many doctors in the area are credentialed at both hospitals.

    Take gastroenterologists who perform colonoscopies – who will tell you that on Tuesday and Wed they do them at MWH and Thur and Frid they do them at Spotsy REgional Medical – and there is no difference in price.

    If there was/is a real difference between CON states and non-CON states – why doesn’t it show up in costs like Colonoscopies and others?

    It seems like that could become such convincing evidence that it would end the debate.

    I think the average person visits their doctor – he/she recommends a procedure – schedules the appointment – and .000001% of patients ask if there are choices that save money.

    THis is one of the most maddening things about the right – on these issues.

    They make it an issue. They claim it could make a difference and that we should make changes in legislation based on the premise – and then there is no evidence.. It becomes little more than a fervent belief…

    I would be fine getting rid of CON in Va – but I do not see any real evidence that it changes health care costs – in states that don’t have it.

    or perhaps I’m just being ignorant and there IS evidence?

    Let’s put it this way. if there is no evidence, then why is this such a deal? Its sort of like the Tort argument.. lots of belief – almost no evidence…

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