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7 responses to “The Virginia Way”

1. 

   LarrytheG

   October 28, 2015

   Yeah, I read the same article.

   I have a thought.

   theory is fine for talking but it’s not a good thing to just do instead of what you’re doing right now.

   theory works pretty good when you hold all the variables but one or two constant but it totally sucks in the real world where there are multiple varying influences and that’s especially true with libertarian type supply/demand thinking.

   so, here’s the thought.

   completely deregulate on a pilot basis in an urban area, a rural area like SW Va and an in-between area like Lynchburg, Charlottesville, Harrisonburg, etc.

   “instrument” the things that there are worries about – like charity care so that we know when they change and we also can compare back to the areas that still are under COPN.

   do that process.. find out what tweaks needs to be done – and address the charity care issues – up front – keeping charity care – whole – and not thrown to the wolves while claiming getting rid of COPN was a success.

   In other words, make the hospitals and other players – i.e. real participating partners in the effort – “stakeholders” I think they call them… on paper…

   I’m in FAVOR of more efficient markets that work more like free markets are supposed to work – but I’m loath to the out-of-the-frying-pan-into-the-fire approach of the libertarian zealot types.

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2. 

   Acbar

   October 28, 2015

   A certificate of convenience and necessity is merely a certification that all necessary political tribute has been paid.

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3. 

   CrazyJD

   October 28, 2015

   Here’s another of Larry G’s completely unsupported claims:
   “theory works pretty good when you hold all the variables but one or two constant but it totally sucks in the real world where there are multiple varying influences and that’s especially true with libertarian type supply/demand thinking.”
   In the context of Jim’s post, what exactly does this drivel mean?

   You would control for the many things you are concerned about, but you only mention one: charity care.
   Enlighten me. What does charity care have to do with COPN, which is just another way of perpetuating a monopoly or near monopoly? I’ve never heard “charity care” mentioned as a concern. Ordinarily, if you have more supply because you have free entry to the world of providing health care, then prices come down and more of the less affluent can afford health care.
   Ordinary supply and demand. But then that would be the approach of those nasty “libertarian zealot types”

   Give it up Larry.

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   1. 

      LarrytheG

      October 28, 2015

      Crazy – Jim can tell you or you can read for yourself .. I mentioned Charity because the hospitals are concerned about that.

      further – I do not buy the basic supply/demand theory applied to real world circumstance without insuring we know what the various impacts are before we go screwing things up by believing theory works in practice.

      Go look at what happened to Kansas on supply-side – it blew up – in no small part because the true believers were wrong.

      for the record – I’m opposed to COPN – with caveats. I do not believe it “works” with health care without adverse impacts. I do not believe we go break something then try to fix it. I think we should seek ahead of time to see what is going to get broke and have a plan to fix it.

      I don’t have much confidence in the theory folks.. left or right – I think we have to have metrics and we have to take responsibility for not breaking the status quo without a replacement plan.

      I don’t have much patience for those who’d tear things apart becaus the disagree with the way it’s currently done.

      we very probably have a wrong, back-door way to fund charity care.

      we need to fix it. I’m not in favor of breaking it and saying “oh well”.

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4. 

   TooManyTaxes

   October 28, 2015

   This is a typical public utility (natural monopoly) statute. The purpose to prevent the construction of unnecessary facilities that will cause overspending on health care. Such statutes are incompatible with competition. Assuming there is competition in health care, the statute should not be applied.

   In response to GOP Delegate Kathy Byron, the US DoJ and FTC filed comments generally critical of the Virginia statute. https://www.ftc.gov/news-events/press-releases/2015/10/agencies-submit-joint-statement-regarding-virginia-certificate

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   1. 

      TooManyTaxes

      October 29, 2015

      If one goes to the FTC’s website and search for “certificate of need,” the records show Agency comments on this issue going back to the 1980s.

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5. 

   LarrytheG

   October 28, 2015

   Indeed as TMT says – none other than the Federal Govt itself is on record against COPN.

   If we are currently paying for charity care with lucrative services and those services are going to get more competitive and the result is that some hospitals that treat large populations of indigent are going to go broke and close up… I’d wonder if that will end up costing Virginians even more for charity care.

   I think we want to know if that will be the case – and we may well need to find a cost-effective answer.. rather than essentially degrading even more – health care for the indigent.

   If Crazy finds that to be a “liberal” issue – I guess I’d defer to Jim Bacon for his thoughts.

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