Hospitals Shouldn’t Need State Permission Slips

In 2006, a Norwich neurology practice with a new $1.5 million MRI scanner had a simple request. It asked the state for permission to use the scanner for all of its patients. The state said, “No.”

For four years the practice had to fight state regulators before it finally got permission to use the scanner the way it wanted to in the first place. If the state had granted permission four years earlier, what would have happened? Would any patients have been injured or harmed? No. In fact, the quality of care could have been higher.

The state regulates the use of MRI scanners – and a host of other health care related devices and practices – through the use of “certificates of need.” These certificates are basically permission slips issued by the state, and they are used to limit the supply of healthcare.

In a new Yankee Institute policy brief, “Does Connecticut Have Enough Healthcare?” released March 26, we say it is time to end the use of certificates of need in Connecticut.

Last year, state regulators used the certificate of need to kill a $500 million investment by Tenet Healthcare in Connecticut hospitals.

Certificates of need were dreamed up decades ago as a way to reduce healthcare spending by reducing the amount of healthcare available. While the policy has reduced the amount of healthcare available, it has caused prices to rise.

Connecticut has more services covered by certificate of need than 32 other states, including 14 states that don’t have any permission slip requirements.

To be clear these certificates have nothing to do with the quality of healthcare, instead they limit the quantity of health care. For example, Connecticut has a third fewer hospital beds per capita than the national average. The certificate of need process is at least partly to blame.

It’s time for the state to stop using certificates of need to regulate the supply of healthcare.

Does Connecticut Have Enough Healthcare?


Less Choice, Higher Costs for Health Care

Maine’s Experience Should Give Connecticut Pause in Pursuing Politicized Health Insurance Rate Approval Process

Maine Heritage Policy Center and the Yankee Institute for Public PolicySB 194 – An Act Concerning Rate Approvals For Individual Health Insurance Policies purports to be responding to real concerns about the impact of health insurance premium increases. However, it is a flawed response, as best illustrated by Maine’s experience, which has a similar politicized process.

The Maine Heritage Policy Center’s Tarren Bragdon has teamed up with the Yankee Institute’s Fergus Cullen to author a white paper on Connecticut’s competitive individual market for health care and warn against politicizing the rate approval process.

Download the White Paper now!


Obamacare for CT to Bust Budget

HARTFORD – The Connecticut version of Obamacare called SustiNet could add more than $2 billion in new annual spending to the state budget with no means to pay for it, a new study by the Yankee Institute finds.

Dr. SustiNet’s Prescription for Big Government Healthcare” rings the alarm about how much the ambitious government-driven heath care plan passed over Gov. M. Jodi Rell’s veto in 2009 is likely to cost Connecticut taxpayers. The report finds SustiNet’s backers significantly overstated the number of uninsured in Connecticut, dramatically understated the likely costs of SustiNet, and ignored many of the effort’s likely negative side effects.

Highlights of the report:

• Connecticut spends $4.1 billion a year on its existing taxpayer-funded state health care
programs, including Medicaid and three state health insurance programs
• SustiNet will cost Connecticut taxpayers at least $2 billion more in new, annual government
• 90 percent of Connecticut residents have insurance coverage.
• Of the 343,000 people who do not have health insurance, most are either eligible for existing
government-sponsored health insurance programs, can afford some form of health insurance and choose to forego it, or are only temporarily without coverage.
• SustiNet underestimates the cost of expanding the HUSKY program; understates the cost of subsidizing insurance; ignores the tendency of taxpayer-subsidized insurance plans to cause those with existing private insurance to switch to government plans; and ignores “adverse selection,” by which new enrollees have higher medical expenses than current enrollees.
• SustiNet’s unpleasant side effects will include higher taxes, reduced employment, longer waits, higher costs, fewer choices, and rationing.

“Connecticut residents who are worried about the big government health care bills being debated in Washington should be just as concerned about SustiNet,” said Fergus Cullen, executive director of the Yankee Institute. “SustiNet is to the Connecticut health care system what Obamacare is to the national health care system. Given Connecticut’s existing budget deficit, it is not realistic to believe the state can afford SustiNet as envisioned by its backers. State officials should revisit the whole idea of SustiNet before it’s too late,” Cullen said.

Cullen emphasizes that the Yankee Institute supports SustiNet’s stated goals of increasing coverage and lowering costs, but the report argues that there are market-based alternatives to SustiNet’s big government approach to health insurance change that can achieve some of SustiNet’s stated goals at a fraction of its likely costs. These include:

• Allowing Connecticut residents to purchase health insurance across state lines
• Relaxing Scope of Practice and Certificate of Need laws that artificially limit supply and drive
up costs
• Reforming existing state health insurance programs

Download the full report now.


Poll: CT Residents Oppose Health Care Overhaul

HARTFORD – A new poll conducted by the Yankee Institute for Public Policy shows that Connecticut residents oppose the national health care overhaul  being debated in Congress.

  • Connecticut residents oppose the current bills in Congress by a margin of 51-34 percent
  • By a margin of 62-29 percent, Connecticut residents believe Congress has rushed the process and should take more time to get it right
  • More than three-quarters of voters, 77 percent, say they are very concerned or somewhat concerned that changes in health care will result in more government spending, higher taxes, and a bigger budget deficit.  61% described theselves as “very concerned” about these possibilities
  • Half of state residents say the changes to health care being considered will do more harm than good
  • By a nearly 2:1 margin, Connecticut residents say Congress in being too ambitious.  They favor smaller, more incremental reforms to a major overhaul
  • Residents are also concerned about proposed expansions to Medicaid to be paid for by state taxpayers.  Residents oppose expanding Medicaid by a margin of 49-26%. 

In terms of how to pay for health care changes:

  • A large majority of residents oppose taxing health insurance, 77 to 9 percent.  We didn’t distinguish between so-called “Cadillac” plans and other insurance plans, but voters seem to recognize that taxing insurance policies just drives up premiums and costs
  • A large majority also oppose taxing people who don’t have insurance, by 59-27 percent.  This is the so-called “individual mandate”.
  • Residents also oppose taxing businesses that don’t offer health care, 44-31 percent.  This is another mandate.

Methodology: This poll was conducted on January 12th and 13th using automated phone dial technology.  A total of 1,526 residents completed the survey, resulting in a margin of error of 2.5 percent. 

  • released a poll today showing that Connecticut residents are very skeptical of the health care reform efforts currently under consideration by the U.S. Congress.

Download the full results of the poll here!