COPN — or Certificate of Public Need — is a complicated acronym used to describe something very simple: a patch or turf where only one hospital can offer services determined to be a “public need” such as radiology, MRIs, and the like.
At at time where the new Republican Congress is getting ready to strip away $340 million in federal taxpayer funding from America’s #1 abortion chain, Virginia lawmakers are dangerously flirting with a policy that would not only play right into the hands of Planned Parenthood and other abortion providers by providing them access to the most lucrative parts of the health care industry.
Recently, there has been an effort to devolve certain part of the health care to the private sector, allowing smaller firms (or out-of-state firms) to peel away the more profitable parts of the health care industry, ostensibly with the idea that greater competition will induce lower prices for the consumer.
The problem is threefold. First, there is a general acceptance by civil society that health care is a public need. If one walks into a hospital and drops to the floor, that hospital is legally required to treat you regardless of your ability to pay (you can talk to Medicaid later). This is why COPN exists — so that health care in a region is provided with the full spectrum of available tools to every citizen.
Second, there is a distinction between universal health care (which we by and large have) and universal health coverage. Of the 30 million uninsured prior to the passage of Obamacare, 15 million of them were the working poor. What Obamacare did effectively was push 15 million into a health care system designed to handle less than those 15 million… and given the 80/20 rule where 80% of the resources are consumed by 20% of the people, and given further that we already have universal health care (but not universal health coverage), the reason why costs are skyrocketing is because the 20% of the pie got bigger… and the 80% they consume became exponentially larger as a result.
What this has effectively accomplished is a third and salient point: for those who can afford excellent quality care, there are one set of rules. For the rest? There are pills… gobs and gobs of pills that sedate and anesthetize.
For instance, West Virginia’s Office of the Attorney General recently received a report from the U.S. Drug Enforcement Administration (DEA) outlining how over the last six years, West Virginians have been dispensed 780 million hydrocodone and oxycodone pills over the last six years — 433 pain pills for every man, woman, and child.
This is what happens when health care is removed as a public need, and instead treated as a profit margin.
The real concern, of course, is that health care in and of itself becomes a business focused on profitable people. More alarmingly, when the business consists of dispensing with the most defenseless of human beings, organizations such as Planned Parenthood are eager to welcome COPN with open arms, as they (among others) will be able to provide a comfortable profit margin to the struggling abortion industry — even providing the ability for Planned Parenthood to expand its locations to provide “health care” alongside their abortion services — an angle Planned Parenthood is increasingly taking even as the abortion industry refuses to rise to the basic safety standards of modern dentistry.
Of course, it boils down to something quite fundamental. Where markets cannot innovate, they legislate. Removing COPN and disguising it as “reform” permits outside markets to expand to their maximum territorial extent.
If 2016 taught anyone anything, this is the lesson behind unlocking the secret of the anger behind the Trump voter — those watching the halls of power and seeing the rules rigged so that the common weal is pillaged for private gain. Creating a system of profitable health care for profitable people surely is not a goal we aspire to in the Commonwealth.
Moreover, if COPN reform means giving organizations like Planned Parenthood a new lease on life their deadly business of carving up babies and placing their body parts on the open market, pro-lifers and conservatives of every stripe should be wary at best. As the “baby body parts” scandal demonstrates, not everything cloaked in “market forces” are to the benefit of the taxpaying public, especially when we carve out items of public need for private gain.
The goal of any sort of reform should not be to make health care more profitable for a few, but instead to make health care affordable for the many — and especially for the working poor.
Rather than addressing the symptoms of a broken health care system by addressing COPN reform, broad and sweeping market reforms should be introduced that give individuals greater control over their health care decisions while insuring against catastrophic loss — namely, Health Savings Accounts (HSAs) backed up by High Deductible Insurance Plans (HDIPs). Drive down the 80/20 principle by turning consumers into savers, by changing the equation of spending “our money” to spending their savings account… and not only do you elegantly resolve the problem of universal health care vs. universal health coverage, but you teach the working poor how to manage savings.
For the 400,000 underinsured in Virginia, this is surely more of a fighting chance than privatizing health care for profitable people, much less steering them into the arms of Planned Parenthood.