Op-Ed: Mississippi leaders need action to improve health care.



Mississippi saw some spectacular inauguration events over the past couple of weeks. Gov. Tate Reeves was sworn in for a second term, the House got a new speaker, Jason White and our lawmakers came together to start the new legislative session.

Amid the celebratory atmosphere, much talk was about the need to work together to improve our state. It was great hearing leaders talk seriously about the need to improve the health of our state.

According to various indexes, the Magnolia state has some of the worst health outcomes in the country. But what can state leaders do about it?

Often in politics, it is easier to define a problem than to solve it. State leaders might have plenty of powers, but the reality is that they cannot always solve some of society’s most intractable problems.

There is, however, one thing that our state leaders could do this legislative session which would significantly improve health care in Mississippi: they could abolish the anticompetitive laws in the health sector that intentionally limit the number of health care providers in our state.

According to a new report published by the Mississippi Center for Public Policy, removing these outdated restrictions would boost health care in Mississippi, cutting costs and improving access to treatment.

For several decades, if a health care provider wants to offer new services or expand existing services in 19 key areas of health care, they have been required to get a permit. These Soviet-style permits, known as Certificates of Need, are also required for a provider wanting to spend more than $1.5 million on new medical equipment, relocate services from one part of the state to another, or change ownership.

Unlike other sensible licensing requirements, CON requirements are not designed primarily to assess a provider’s qualifications, safety record, or fitness. They are about central planning to decide if each new applicant’s services are “needed” by the community. I believe it should be up to patients and practioners to decide what is needed, not government bureaucrats.

In many parts of our state, there is no medical care where it is most needed. CON laws should take much of the blame for this since they have intentionally restricted what is available. What started a generation ago as a misguided attempt to restrict increases in health costs has become a legally sanctioned protectionist scheme.

CON laws in Mississippi limit the provision of long-term care, despite demographic change that has seen the number of elderly people needing care increase dramatically. Ambulatory services, key diagnostic services, psychiatric services and many other services are all limited by CON laws.

Mississippi’s leaders could remove the red tape restricting these services right away. Our report provides lawmakers with a list of options for reform.

If the case for change is so overwhelming, why has it not already been done?

In any market, when there are restrictions imposed to keep out the competition, there will be various vested interests that lobby for their retention. So, too, with CON laws.

Defenders of CON restrictions suggest that CON repeal would be risky and dangerous. They like to imply that any reform would reduce access and quality would suffer.

Such concerns are unfounded. Over 100 million Americans—nearly a third of the population—live in states without CON laws in health care. Four in ten Americans live in states with limited CON regimes that apply to only one or two services, such as ambulance or nursing homes.

If our lawmakers are serious about improving health care in Mississippi, I hope they read our report, which sets out not only what needs to be done, but provides a roadmap explaining how to do it. Let’s get down to work.

Douglas Carswell is the President & CEO of the Mississippi Center for Public Policy. The report, Mississippi’s Certificate of Need Laws: Options for Reform, can be accessed at

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