Quote:1) You assume the state government is the only barrier to entry. It may simply not make financial sense to build a hospital. There may be no demand for one. 

 

2) Not sure why you wouldn't want the oversight of a physician. They are your primary healthcare provider. 

 

3) There is a good reason they don't sell across state lines. Insurers would cherry pick where they provided business, potentially to the states with the healthiest populations. This would create a race to the bottom as insurers would get to choose both their regulator and their risk pool. 

 

1. Here in Jacksonville 3 health care systems have been fighting over who gets to build a hospital in the Southwest area of the region. St. Vincent's, Baptist and HCA all applied for a CON to build but St Vs was approved and the other two told they couldn't build. Demand is irrelevant, the government decides who does and doesn't get to build their facilities in that neighborhood. Here's an article about the Baptist denial and the reasons outlined for telling them no.

 

http://jacksonville.com/community/clay/2...y-hospital

 

2. There are dozens of minor health care issues that we currently use physicians for that could be accomplished without their oversight. The cost of becoming a physician and the salary and benefits of being one means that they as a whole are ragingly protective of their market share and territory. As a result we now have a severe shortage of providers at every level because doctors do work that doesn't require them and we strangle the supply from medical schools.

 

3. Insurers already do that by how they contract with health systems and physicians and by choosing to leave states entirely. As always happens when government is involved, we have a huge bureaucracy full of redundancy and red tape that drives prices upward with a crippling effect on the service.

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