Goodbye Incrementalism?

May 12, 2023
Wendy Damron's Photo - President and CEO

Wendy Damron

President & CEO

The photo you see adjacent to this post is of a group of true believers who assembled on January 21, 2020 on the first floor of the Statehouse to call for a total repeal of the state Certificate of Need program.

Earlier this week, Senator Tom Davis referred to this event humorously as “a few of us standing beside cardboard cut-outs [about Certificate of Need].” Davis recalled that no one gave repeal of Certificate of Need a snowball’s chance. Folks laughed at the idea of full repeal of a law clearly set in concrete.

Then came Governor McMaster’s COVID Executive Order later that year, Senator Wes Climer’s bold stand on the floor of the Senate in 2021, and the leadership of Medical Affairs Committee Chairman Danny Verdin and Senate Majority Leader Shane Massey in 2022. We also published our study in March, 2022.

Then the phones started to ring and the emails flowed…from you

In 2023, the Senate doubled down, and on the House side, new committee and subcommittee chairs Rep. Sylleste Davis and Rep. Mark Smith roared. They never gave up when the sledding got tough. Speaker Murrell Smith brought it all home. 

In the end, a monumental piece of legislation passed the General Assembly without a dissenting vote. Who would have “thunk” it on that cold day in January of 2020? Not me.

The fact and the deeper meaning of South Carolina’s total repeal of Certificate of Need cannot be overestimated. The leading scholar of CON in America is Dr. Matthew Mitchell of West Virginia University (formerly of The Mercatus Center) said: 

Two years ago, Montana enacted a similar reform, eliminating every CON but that for nursing homes. The difference is that Montana only regulated 9 services and technologies at the time of its reform, whereas South Carolina has one of the most extensive programs in the country, requiring a CON for 18 different services and technologies. Only New Hampshire and Florida have come close since 2015.

The reason we are so encouraged about the General Assembly’s bold move on Certificate of Need is what it could mean for the future. If the South Carolina legislature is willing to listen to citizens and patients first and foremost, the sky is the limit for reforms across the board.