Save veterans, end certificates of need
There is no denying that the Oregon Health Authority is at a crossroads. A recent Portland Tribune editorial was correct to offer the agency's new Director an opportunity to restore the agency, with a new approach to transparency and accountability for Oregonians. Unfortunately, the Editorial Board failed to acknowledge the systemic issues of inappropriate relationships between OHA and the industries it regulates.
As reported in the Wilsonville Spokesman, OHA recently denied a certificate of need to an applicant health care provider on grounds that there is no community need for additional inpatient psychiatric services. This is absurd given the state is ranked last in the nation when comparing rates of mental illness with access to services. OHA's rationale? That it would potentially hurt revenues from existing hospital monopolies — they would have to "compete" with a new provider.
For each newly proposed health care facility, OHA requires the facility applies for a certificate of need (CON). This requirement dates back to a 1971 law that intended to compel health care providers to prove there was a need for their services. However, over the past 10 years the federal government and 16 states have acknowledged that these laws have not only failed to achieve their goals, they have instead hurt the health care system by promoting collusion, increasing consumer cost and limiting patient choice.
We speak as two women who lost loved ones, one a brother, another a nephew — both veterans — to suicide because of inaqueate resources. Through our advocacy efforts to improve mental health care for veterans, we have discovered that one of the biggest hurdles to expanding treatment options is the controversial bureaucratic CON requirement.
During the last legislative session, we actively worked to pass SB 1054, also known as Will's Bill, which would have waived CON laws for new mental health hospitals serving veterans. Early on, we were stunned by the false information that began circulating around the Capitol about Will's Bill and our group of veterans and advocates. We were surprised to learn that the Brown Administration and OHA were actively lobbying to protect the certificate of need process that has come under fire from the U.S. Department of Justice and the Federal Trade Commission during both the Obama and Bush administrations.
OHA is an agency revealed to be far too comfortable with deceptive messaging, inappropriate actions and opaque relationships with monied interests in the health care indus-
We see hubris in its claim that there are enough inpatient beds when data shows there aren't. We see ignorance in its willingness to discredit years of research from the FTC, DOJ and Mercatus Institute on the failure of CON laws. And we see questionable priorities when an agency makes decisions to restrict
a new provider to protect the
profits of an existing hospital monopoly.
Oregonians deserve better. As we both know all too well, Oregon's inept mental health system is literally a crisis of life or death. To move forward, OHA needs to reject the status quo and embrace a culture change to accept new providers, new ideas and a new way of engaging with legislators and the public. Changing course on the CON process would be a good place for the agency's new director to start.
Julie Terry and Debbie Brown both lost loved ones to suicide. Julie's brother, Will Naugle, ended his life in January 2017 and Debbie's nephew, Tanner Volkers, ended his life in December 2013