Tuesday, April 24, 2012

The choice facing New Hampshire

The saga to give preferred treatment to private specialty hospitals in New Hampshire continues this week.  You will recall that the House of Representatives approved a series of measures that would grease the skids for entry of Cancer Treatment Centers of America® and other such facilities.  Now things move to the Senate Health and Human Services Committee, which is holding hearing on bills this Thursday at 1:00 pm in Room 100 of the State House.

There are two bills.  One, HB 1617, would eliminate the state's certificate of need process.  The other, HB 1642, would give preference to to specialty hospitals under the existing CON process, plus offer other financial advantages.

My regular readers know that I am no fan of protectionist policies designed to secure the market position of incumbent health care providers, but this debate seems to me to be quite different from that.  These bills are designed to take existing regulatory structures -- which were adopted to protect against "supply push" expansion of health care utilization and costs -- and throw them aside for a special interest group.  In addition, there can be little doubt that passage of the bills would allow these specialty facilities to direct their marketing to patients who have private insurance.  This kind of cream-skimming would have an adverse affect on the state's community hospitals.

As an aside, I notice that the Boston media has completely ignored this story even though the legislation would have spill-over effects.  The House bill, for example, provides that these specialty hospitals must target patients from out of state.  Clearly, they would look for patients from the Massachusetts-New Hampshire border region.  That might not be of great concern to the Boston-based academic centers, but it surely should be a concern for those community hospitals in northern Massachusetts that offer local service to cancer patients.

1 comment:

Andrew Eills said...


Thank you for your comments. Yes, the current CON law in New Hampshire may not be perfect, but HB 1742 as proposed not only would allow a "destination specialty hosptial" to avoid any state regulatory oversight or review on need that community hosptials have to go through,the bill also would expemt CTCA and other "destination hospitals" [sounds like a resort, doesn't it] from the state tax that all other hosptials in NH must pay.