Yaffee: The Alabama Certificate of Need laws are just a huge disadvantage

In 2023, my daughter Evangeline was born at the Huntsville Hospital site in Madison, Alabama. I have to say it was a great experience. I’m also glad I didn’t have to drive much further from Athens to Huntsville during my labor. I’m definitely grateful for the local area in Madison.

When the hospital was first planned, there were some who tried to block construction. They made this argument to the Alabama Certificate of Need (CON) Board. That’s right. In Alabama, a so-called conservative state where leaders value the power of the free market, anyone who wants to build a medical facility must turn to technocrats on a governing body that picks winners and losers.

Currently, this useless government bureaucracy is delaying approval of a new outpatient surgery center in Montgomery proposed by the Southern Orthopedic Surgery Center. Baptist Medical Center South and Jackson Hospital oppose the project.

While there are some legitimate arguments for opposing such a project, it seems to me that the best thing for Alabamians is more options and more competition in healthcare. Instead, we have a government organization whose job is primarily to limit competition. This is not how a market should work in a free state like Alabama.

But don’t just take my word for it. Just look at a 2024 report published by the Commonwealth Fund. The report highlighted that Alabama consistently ranks in the bottom quartile for health care quality and outcomes.

The problems with CON laws have also become more apparent during the COVID-19 pandemic. Death rates for COVID-19 patients and others also increased in states where these laws were in effect, according to research by economists at the University of Cincinnati, Auburn University and Southern Illinois University.

Aside from worse health outcomes, it also encourages corruption. Alabama State Comptroller Andrew Sorrell explained how this can happen in an interview on my radio show several years ago.

“Richard Scrushy was the CEO of HealthSouth and he figured out that if he could be appointed to that board, he could vote no against all of his competitors building a new hospital,” Sorrell said. “So he donated $500,000 to Don Siegelman’s lottery campaign in exchange for a seat on the Certificate of Needs Board. Of course, both later ended up in prison, but we have done absolutely nothing to resolve the issue with the Certificate of Needs Board since then. We have learned nothing from this mistake and I think this is a real tragedy.”

RELATED: AFP: Alabama’s certificate of need laws hinder Hoover’s health care expansion

When I first heard about the CON laws, it sounded like something straight out of the former Soviet Union. Imagine if we had something similar for every other part of our economy. Should new grocery stores have to go through a state review board? Should new restaurants have to go through a state review board? We wouldn’t put up with that, and we shouldn’t tolerate that in our health system either.

The good news is that it doesn’t have to be this way. We can follow the example of several other states that have already adopted reforms. In recent years, Georgia, Tennessee, and Florida have modified their CON programs to encourage health care innovation in their states. South Carolina has completely repealed its CON law.

If leaders in the Yellowhammer State are serious about promoting the free market, limited government, and conservative politics, then it’s time for them to prove it to the people: abolish the big CON.

Yaffee is a writer for Yellowhammer News and hosts “The Yaffee Program” weekdays from 9 to 11 a.m. on WVNN. You can follow him on X @Yaffee