On the 5th of September, 2018, The New York Times published an article lamenting the difficulties a doctor and his rural patients encountered when they tried to create their own local hospital. The villain of the piece — there must always be a villain — was the regional hospital in a nearby (but not conveniently so) small city that blocked the new venture by attacking, for a variety of pious-sounding reasons, issuance of the legally-required “certificate of need”.
Online comments on the story were generally what one might expect: expressing outrage at the callousness of the regional hospital for putting its business needs above the needs of patients, critical generally of the shortcomings of the American health care system, and quick to assign blame for all of that to “Republicans”, the “free market”, and other assorted deplorables.
I posted my own comment to point out that it was not, in fact, the free market that prevented creation of this local project but government; and that the government authority exercised to do so was not the product of right-wing ideology but, rather, of the left-wing penchant for central planning. It is reproduced here.
Note: One person replied to my comment to point out that the state had originally approved the new project but that the regional hospital had sued to stop it. I assert that doesn’t negate my point: the basis of the lawsuit was a claim that the state should have rejected it based on its own rules for determining whether or not there was a “need” and on its assessment of viability — that is, they accused the state of erring in its judgement when exercising its authority. But it was still precisely the authority of the state to forbid such projects in the first place that they were relying on; and it was still the power of the state they were wielding on their own behalf to stop the project from moving forward.
5 September 2018
Yes, the Naples Community Hospital plays the part of villain, putting their own profits ahead of the needs of rural patients. Shame on them.
But keep in mind: the weapon they used to kill this vision of private sector cooperation was government.
It was not the Naples Community Hospital that stopped people from creating their own local alternative, but the state of Florida acting on its own technocratic vision about how medical services should be “optimized” by central planning.
One might legitimately ask why the state should have that authority in the first place.
Without access to the coercive power of the state to wield on its behalf, the only means the Naples Community Hospital would have had to counter this threat to its profits would have been to provide better service to the people who needed it.
© Copyright 2018, Augustus P. Lowell