An example from healthcare
The university in which I practice ophthalmology is in an expansion phase. As the local population has grown the lines between local communities have blurred and communities merged. Our university is trying to build a hospital in such a community just west of the larger Augusta.
As you may suspect building a hospital is not like building a shed or even a house. One of the legal documents Georgia requires is a certificate of need (CON). The CON came to the fore back in the 1960s when its point was to prevent the building of unnecessary health care facilities. It was presumed that doing so would increase cost through unnecessary patient admissions.
At this point, Medicare, Medicaid, and private insurance companies effectively limit hospitalizations through reimbursement rates. The CON, though, has not gone by the wayside, and since possessing one is a limiting factor on health care corporations their acquisition becomes a legal battleground from the courts to the state legislatures.
Since at least as early as 2014 the three major hospitals in Augusta, Georgia have been vying for the CON to build a hospital in the growing community to our west known as Grovetown. It has been long tied up in courts as each participant along the way touts their ability to provide the best care to the people of this community. I think only one holdout remains, and I do not know its current status. I do know that many roadblocks have been placed before Augusta University’s (AU) path. Almost assuredly AU will be given the CON, but it has been long delayed.
Much of the delay over the CON has been court related, but that is not the only venue. The state legislature has players on the bigger, statewide level which have large local implications. As reported by the Atlanta Journal and Constitution Dublin Republican, Matt Hatchet, filed House Bill 198 which aims to remove Georgia’s requirement for most CONs. One can expect all manner of good pretexts to be laid down as shields to deeper motives on both sides of this bill. It is not credible to believe that all motives will be altruistic. Health care is a major, major industry. Taking care of patients is big business. With big business comes big money. With big money comes all manner of cunning and craft.
Who is tossed to and fro in the waves of the courts and the legislatures? Communities, patients, employees. Good will come and bad will come. Both will be delayed by the jockeying.
Franklin Graham, the son of Billy Graham, was given the helm of Samaritan’s Purse in 1980. One of the men who mentored Franklin in his pre-Samaritan’s Purse years used the saying, “Wrong is wrong. Right is right. Wrong is never right.” That is a rare principle in finances, but it is a principle that if adhered to will ground one in the midst of cunning and crafty schemes.
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