Resisting the CON: Senators Launch Effort to Repeal “Competitor’s Veto” of Healthcare Services

April 22, 2021

Oran P. Smith, Ph.D

Senior Fellow

“There are many of us that would support this bill, this year, now.” – Sen. Dick Harpootlian (D-Richland), on a bill to repeal Certificate of Need (CON) in its entirety

When the South Carolina Senate took up S.717 this week, there was little passion on the floor of the “deliberative body.” Frankly, the bill looked like a snoozer.

The proposal introduced by Senator Danny Verdin (R-Laurens) and Senator Darrell Jackson (D-Richland) to remove restrictions on new diabetic service providers was innocuous enough. The text of the legislation was not more than a sentence long.

Jackson’s S.717 sought to carve out diabetic services from requiring what are called Certificates of Need (CON). Under CON laws, rather than market demand determining the supply of a medical service, clinicians and medical facilities must seek approval from a state agency (in this case DHEC), and their competitors before expanding facilities or services for patients. South Carolina is one of the most prolific “CONners” in the entire country with more than 18 different healthcare services requiring a CON.

Immediately seeing the larger principle in play, Senator Wes Climer (R-York) proposed an amendment that would repeal all Certificate of Need regulations in the state, instead of just those pertaining to screening for diabetic amputations.

And then, the rumble was on.

An unlikely ally, Democrat Sen. Dick Harpootlian (Richland) jumped in quickly in support of the Republican Climer: “[with CON], it appears that the behemoths of the healthcare industry are competing for monopolies in certain areas… If in fact you amended that bill to do what Senator Climer said, there are many of us that would support that in this bill, this year, now.”

Now is good!

Palmetto Promise has long been an advocate of full repeal, particularly following the COVID-19 pandemic which saw many states, including South Carolina, temporarily repeal CON to increase hospital capacity during the pandemic. As PPI Visiting Fellow Dr. Marcelo Hochman put it, “A law that’s good enough to be lifted during an emergency is probably a law that should be lifted permanently.”

Although the bill was “carried over,” support for full repeal of Certificate of Need was well-represented across political parties and regions of the state in the Senate chamber.

Time will tell if a majority of South Carolina Senators will answer the call to eliminate the competitor’s veto to healthcare. But the fight is worth having. It is urgent that South Carolina addresses this anti-competitive, regulatory “wall” surrounding hospitals and allows the free market to work. As Senator Jackson said during the debate, “we could literally save lives.”

To get a quick glimpse at the top line facts surround CON, download our new Fast Facts publication.