Towards a Better, Freer, Less Expensive and More Accessible Healthcare System in Virginia
by James C. Sherlock
COVID-19 exposed weaknesses in Virginia’s healthcare delivery system in both readiness and equity of access.
Even before COVID, we have been dealing for decades with the costs of all kinds imposed by Virginia’s unregulated regional healthcare monopolies. The General Assembly has an opportunity, even in this upcoming non-budget year, to deal with them in ways that also save money in Medicaid.
The Certificate of Public Need (COPN) law passed in 1973 gave the Virginia Department of Health (VDH) control over the construction and expansion of new hospitals, ambulatory care and diagnostic imagery centers and of the equipment necessary to operate them. Every effort to break the monopolies it has created or repeal the law has failed.
We see the results of nearly 50 years of this law in the extraordinarily high costs of healthcare in Virginia, the profound unreadiness of the Virginia healthcare system for COVID and the disproportionate impact of COVID on Virginia’s poor.
It is time to stop pursuing COPN repeal and move forward with reform.
I will offer here a broad program to update Virginia law to control costs and improve access without repeal of COPN. Each of the reforms start with the assumptions that we have regional healthcare monopolies and they are not going away and that COPN is not going to be repealed. Reform will have to work around those facts. Continue reading