Lawmakers Debate What Ails CON
LANSING - Lawmakers and concerned citizens are stepping up debate on a Michigan program that requires hospitals to obtain state approval before making major expenditures for equipment or expanded facilities.
The Certificate of Need program - originally developed to promote the availability and accessibility of health care services at a reasonable cost and within reasonable proximity for all people in the state - is believed by some to be producing the opposite.
Lansing dermatologist Dr. Greg Messenger, while testifying before a House subcommittee on health care costs, said CON has been used to monopolize health care in the Lansing area.
"We have health care systems that own the physicians and the insurance companies and the hospitals; and all three are ganging up on the patient," Messenger said. "The patient is no longer the center focus of health care, and that's wrong."
Rep. Stephen F. Adamini, D-Marquette, said much of the testimony presented thus far before the subcommittee suggests that CON is inadequately staffed, but Rep. Jerry Kooiman, R-Grand Rapids, said the problems are far more basic.
"The system for cost containment that we have for CON is a 1970s process for the 21st century technology that we now enjoy," Kooiman said. "Not only can this technology in the long run save lives and improve health care access in Michigan, but I believe it will save costs."
Those who work for and manage the CON commission agree that the program needs reform and structural change.
CON Commission Chair James Maitland said, "The CON process and program really work, but certainly can benefit from improvement."
At the Feb.12 subcommittee meeting, Maitland explained the commission's process for acting on CON standards. Maitland's documentation suggested that a top priority request for a revision of standards takes at least nine months.
For example, Sen. William Van Regenmorter, R-Georgetown Township, submitted a letter to the CON commission last May, urging the commission to classify the revision of Positron Emission Topography standards as its top priority, so that a PET scanner could be immediately approved for West Michigan.
PET scanners dramatically increase doctors' ability to detect cancers and brain and heart problems at early stages.
If the Legislature and Gov. John Engler approve PET standard revisions submitted by the commission Jan. 9, changes will take effect on Feb. 25, permitting West Michigan to purchase the requested PET scanner.
All three of the state's licensed PET scanners are in southeast Michigan.
Kooiman expressed his frustrations with the CON process concerning Metropolitan Hospital's request to relocate to Metro Health Corp.'s planned health care village in Wyoming.
Although the move will place the Grand Rapids area hospital outside of Kooiman's district, he feels the move is necessary to serve West Michigan's health care needs.
"I have been extremely frustrated with the CON process in terms of the delays in allowing Metro to move more than two miles to get out of a residential area and better serve the health care needs of West Michigan," Kooiman said.
Messenger urged the subcommittee to listen to patients and let health care modernize. He said repealing CON would nurture competition between hospitals and thus drive down health care costs throughout Michigan.
"The real world wants new facilities; they want to repeal CON," he said. "They want high technology, so I urge you to listen to the patients."
The next meeting of the CON commission is scheduled for March 12, when the commission will take final action on the first phase of MRI standard revisions. The commission expects the procedures to be completed by August, and if both changes are approved, MRI units will be increased by 60 percent in Michigan.