I bet Santa would agree about CON laws

by Keli'i Akina, Ph.D., President / CEO, Grassroot Institute of Hawaii

I’ve had a funny old Christmas song running through my head lately — “Grandma Got Run Over By A Reindeer.”

But I’ve changed the lyrics a bit after reading the Grassroot Institute of Hawaii’s newest white paper about how to improve healthcare in Hawaii by reforming the state's rules concerning medical certificates of need.

Referred to as CONs for short, medical certificates of need are a regulatory tool used to control the number of healthcare resources in an area. In Hawaii, they are required for 87 out of 109 possible medical services and facilities, which means our state has one of the strictest CON laws in the nation.

Anyway, about the song. I think you’ll probably remember the tune well enough to hum along, and maybe even sing along with these new lyrics I came up with.

Tutu got run over by a reindeer,

just as she stepped off Tita’s lanai.

We tried to rush her to the doctor,

but there were no specialists we could find.

She'd had one too many mai tais

and we begged her to lie down.

Now we have nowhere close to take her

'cause we have few healthcare options in our town

CON rules slow healthcare expansion

and make services cost more

'cause too many regulations

make it hard for new clinics to open doors

Tutu got run over by a reindeer.

Santa’s sleigh had worked up too much speed.

We couldn’t get her to a doctor

‘cause we’ve got certificates of need.

So there aren’t enough health options.

Sometimes we have to fly to get support.

But that’s what you get with strict CON laws.

Fewer options but you pay more.

We sure miss our lovely Tutu.

She was always such a beaut.

Grandpa says we have to change our CON laws.

That’s why we’re all now working with Grassroot.

The original song is quite a bit longer, but you get the idea.

According to my Grassroot colleague Malia Hill, who wrote the new white paper, “Even changing the number of beds or reclassifying their usage within a facility requires a certificate of need.”

Hill further points out that studies have linked CON laws to higher medical costs and fewer healthcare facilities and services, especially in rural areas and for vulnerable populations such as our kupuna.

This is a situation that our state lawmakers really should be taking a closer look at.

I bet Santa would approve.