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Hospitals Need Permission To Expand, But Florida Bill Would Change That

Liz West
Flickr Creative Commons

Close to 100 million people visited Florida last year, and state officials are hoping to keep that number growing.

A way to do that, according to one Northeast Florida lawmaker, is to entice patients from around the country to seek treatment in the state.

Proponents of so-called “medical tourism” may now have the data they need to convince skeptics.

The Florida Chamber of Commerce estimates hundreds of thousands of visitors receive some type of medical care during their trip, and that translates to some major cash.

Sen. Aaron Bean (R-Fernandina Beach) is sponsoring a bill increasing international promotion of Florida doctors and hospitals. Bean says Florida is a perfect medical tourism destination, and George Mason University researcher Chris Koopman says according to a recent study, Bean may be onto something.

“Folks are leaving states that regulate MRI machines, CT scans and PET scans and getting those services in states that do not regulate it,” like Florida, he says.

Koopman says deregulation happens when states do away with something called certificates of need: essentially, state permission slips for hospitals to expand equipment or services.

George Mason’s certificates-of-need study shows Florida has benefited from giving hospitals more independence.

“Florida's not regulating any of these is in some ways a beneficiary of the bad policies of other states,” Koopman says.

But there are opponents of repealing the law. Sen. Arthenia Joyner (D-Tampa) has fought Republican attempts to get rid of certificates of need. Joyner says taking away that permission process could further disadvantage low-income residents because for-profit hospitals would have more of an incentive to expand services near people with higher incomes and good insurance.

Certificates of need were first instituted by New York in 1964. The rationale was threefold. First, the law was aimed at lowering health-care prices by eliminating redundancy. Officials worried that if hospital construction went unabated, providers would then seek to recoup costs by raising prices on patients. Second, the state theorized that if hospitals had the freedom to build facilities where they pleased, they’d only choose to serve richer areas, where they’d rake in more dollars. Last, certificates of need could ensure quality of care by allowing only thoroughly vetted, established companies to set up shop in a community.

George Mason University researchers say the process has failed to lower costs and instead has actually opened the door to ballooning prices by limiting competition. However, researcher Chris Koopman admits recent research into that theory has had conflicting results.

Though some services have been removed from Florida's certificate-of-need list, the state still requires them for more than 10 types of equipment and procedures, as well as for building new hospitals, ambulatory surgical centers and other medical facilities.  

But a bill now before the Legislature would repeal certificates of need altogether, allowing hospitals to expand however they choose.

Thirty-seven states, including Florida, have some kind of health care certificate-of-need process.

Ryan Benk is a former WJCT News reporter who joined the station in 2015 after working as a news researcher and reporter for NPR affiliate WFSU in Tallahassee.