Fellow citizens of Wake County, as you may be aware three competing hospital systems have submitted applications to develop 101 new beds. These competing applications were submitted by Rex Healthcare, Novant Health and WakeMed.
- Rex proposes to add 11 new beds and a cardiovascular-focused heart tower to its Raleigh Campus as well as build community hospitals in Wake Forest and Holly Springs.
- Novant Health has proposed building a 50 bed hospital in Holly Springs.
- WakeMed is proposing to add 79 new beds to Raleigh Campus and 22 beds to Cary Hospital
Who gets to add these beds is ultimately decided by the state. The state, through Certificate of Need, manages which hospital systems get to build and what they build. The process is meant to control healthcare costs and ensure that hospitals do not just add money-making services without doing their fair share of community indigent care.
CON makes sense because healthcare is not a free-market good. In the United States, most health care providers participate in Medicare and as such are obligated by federal law to provide lifesaving care. Converting health care to free-market status would mean that a 2 year old with pneumonia would have difficulty receiving care in an emergency department unless they could demonstrate the ability to pay – similar to how a hungry person would have difficulty getting free groceries from a grocery store. A true free market system would neither subsidize nor provide care unless cash were in hand.
Regulations like Certificate of Need ensure that healthcare organizations provide access to care and build facilities in poor as well as rich neighborhoods to ensure access to care for all. Certificate of Need also gives a helping hand those healthcare organizations that provide the vast majority of charity care. Certificate of Need works – it ensures equal access to health care services and places beds when and where they are needed.
It would be great for every community to have a hospital, including Wake Forest and Holly Springs, but unfortunately it is simply not an efficient way to provide healthcare services.
Additionally, we have to be careful not to duplicate services that already exist. A new cardiovascular-focused patient tower at Rex would be the fourth heart center in the Triangle and the second in Wake County. We ultimately pay the price for these expenditures – isn’t a $278 million price tag to vacate one heart program and move it across town to a new program, as Rex proposes, a bit of a waste?
The fact is WakeMed provides 80 percent of the charity care in Wake County, operates the most successful heart program in North Carolina, and is driving the need for more beds due to Raleigh Campus’ high occupancy. Our proposals are also less expensive and can be implemented more quickly. Isn’t it time we stopped unnecessary health care expenses and focused on cost-effective, efficient, and affordable care?
Stan Taylor is WakeMed vice president of corporate planning.