Health care playing field must be level

Some doctors want it eliminated, hospitals want it to stay, and on Friday the Bush administration voiced its opinion, siding with doctors in saying that Georgia should do away with its certificate-of-need (CON) law.

The law exists to make sure that adequate health care services are available to meet the needs of all people in the state while protecting against unnecessary duplication of services that can raise the cost of that care.

Gov. Sonny Perdue has taken the middle ground on the issue, with legislation presented on his behalf that would not scrap CON but also would not require it for doctors opening free-standing outpatient and radiology centers.

That plan would make for an uneven playing field, allowing those facilities to cherry pick the most lucrative procedures and best-insured patients. That is not fair to the hospitals, which rely on some services to help fund others that don't generate as much revenue, like the emergency room.

The playing field should be leveled. Clinics and physician groups that are competing against hospitals for patients should play by the same rules the hospitals must obey. If there is CON for one, there should be CON for all.

The idea of CON is to prove a community has a need for proposed new facilities or services they wish to provide. That is not the case if CON isn't required for free-standing outpatient and radiology centers. The siphoning off effect that would happen if CON is not required for those facilities would leave hospitals treating the least lucrative patients and procedures.

Perdue's plan calls for physician entrepreneurs to pay "civic rent" by serving uninsured patients as well as those covered by Medicaid or PeachCare for Kids in return for not having to provide CON. But the Georgia Hospital Association said that coverage will not be enough to prevent the damage that would be caused by the migration of patients from hospitals to the free-standing centers.

Not all states require CON, but Georgia does. And as long as it does, clinics, physicians groups and the hospitals they compete with should all play by the same rules. Have any thoughts about this editorial? Share them with us at letters@gwinnettdailypost.com. Letters should be no more than 200 words and are subject to approval by the publisher. Letters may be edited for style and space requirements. Please sign your name and provide an address and a daytime telephone number. Address letters for publication to: Letters to the Editor, Gwinnett Daily Post, P.O. Box 603, Lawrenceville, GA 30046-0603. The fax number is 770-339-8081.