Iowa has one of the highest quality, lowest cost health care systems in the United States. And at the heart of that system are 118 community hospitals that stand ready, every day and every night, to serve everyone, regardless of their ability to pay. A move is underway in Des Moines to change an Iowa law, the Certificate Of Need legislation, that we think might threaten rural health care. The law, enacted in 1977, was designed to avoid duplication of medical services to keep costs down for patients. In Iowa this law, requiring approval of new facilities costing $1.5 Million or more, has worked very well.
Critics of the law are now saying it “stifles competition” and eliminating the law would lead to private investment in new medical facilities providing more choices, and therefore, lower costs. We think those critics fail to understand the realities of living in rural Iowa.
What’s most important for rural communities isn’t the opportunity to go shopping for doctors or surgeries like critics imagine, it is an emergency department close-by and staffed to respond when needed. What’s important is a relationship with a primary care provider and access to the technology needed to provide for your health. What’s at stake is the future of rural Iowa and the health of rural Iowans.
The new facilities built without oversight won’t be located in small towns. They will be in urban communities and using their services will require rural patients to travel, which is especially difficult for the elderly and those of lesser means. What we fear is what has already happened in states where Certificate Of Need requirements have been repealed; the small number of patients hospitals in rural communities lose will spell the difference between keeping the doors open or closing them for good.
This might be an acceptable economic or medical outcome if our small hospitals provided services at inflated costs, or if patient outcomes failed to be at the same level of quality as larger hospitals. The data says, and our patients agree; we provide high quality services at comparable or lower costs.
There is one additional factor to consider. Community hospitals are an engine of economic growth. Virginia Gay Hospital provides employment for more than 200 people and has a total economic impact to the communities we serve estimated at $37 Million, and generates retail sales of $4 Million. Those retail sales in turn generate $240,000 in sales tax revenue to help support our state, our communities and our schools.
Requiring a Certificate Of Need before constructing new medical facilities is a proven, fair, and reasoned process of approving medical expansions based on patient need rather than on marketing hype. If you are concerned that repealing the Certificate Of Need requirement might jeopardize your access to health care, let your state legislators know how you feel.
Mike Riege, Administrator, Virginia Gay Hospital and Clinics