Jackson Jambalaya

This column is reprinted from State Representative Robert Foster's Facebook page with his permission.

Everyone hears about how corrupt Mississippi is and how low we are ranked in healthcare, but most do not know just how corrupt or why our healthcare is so bad. Healthcare corporations are some of the most powerful lobbyists in this state, who also have very deep pockets. They will not like what I am about to share- and will provide manipulated statistics and false information in an attempt to discredit me. None of that matters because the truth is the truth and I answer to the people of Mississippi, not to them.


I am about to try and explain to you just how corrupt our healthcare system is and how we can make healthcare better for every Mississippian. This is a rather long post, but there is a lot to explain. I need this message to get out and I need your support.

First, an example: What if Mississippi had a law that only allowed one car dealership in a region of our state and that particular dealership also owned most of the repair and maintenance shops in that region? Most of the mechanics in that region have no choice but to work for that one dealership and accept their terms, or be put out of business because even though they are qualified to do the work they are not allowed by the government to operate unless they work for the profit of the dealership holding the certificate of monopoly.

How expensive would a car be?

How expensive would parts and labor be for repairs and maintenance, and how terrible would the service be if you did not have any other dealerships you could take your business to without driving a very long way? Even if you drove a long way within the state to another dealer they also have a monopoly in their region of the state, so it is not any better there either. You could go out of state for better service, but your insurance probably wouldn't pay for that. Thankfully we do not have this type of law on car dealerships but unfortunately this is the reality of our healthcare system in Mississippi - the "Good Ole Boy" system.

Mississippi has a set of healthcare laws called Certificate of Need laws, or CON laws. I call them Certificates of Monopoly because this is what they are. We have some of the most restrictive CON laws in the entire country. Many states have very minimal CON LAWS, if any. For the most part they have many competing healthcare providers with high access to care, more competitive pricing and better service. They also have healthier people in their state - imagine that.

These CON laws give large corporate healthcare providers regional monopolies on healthcare in our state. These laws prevent doctors and other healthcare professionals from being able to open competing healthcare services against healthcare giants. You may be professionally trained to provide a service, licensed to provide that service, and have a facility which meets all of the requirements to do the service- but, a monopoly board gets to decide if there is a “need” for your service before you are allowed to provide it. Not only that, but the large corporate healthcare company that you want to compete against can sue you into oblivion in a “hearing” carried out by the monopoly board where they will claim there is no “need” for any additional healthcare services in that region. These large healthcare companies claim that without these laws to restrict competition all of our rural hospitals will go out of business, which is ludicrous. Without these laws, yes, some badly run hospitals or healthcare facilities may go out of business. However, since there is no shortage of sick people or people in bad health in Mississippi many more will open up in their place and compete for your business like in every other state. The competition will make them offer better service, higher wages to their workers, and will drive prices down.

These monopoly holders falsely claim that free market principles do not work in healthcare because they need to be able to make large profits off of the services they provide to the insured/cash patients in order to pay for all of the charity/un-insured patients they care for. To that point, we have Medicaid and a trauma care fund to reimburse them for those services. If those payments are not enough to cover those costs then we should have a debate about the amount of those payments. This, however, is a separate issue from whether or not we should allow competition in healthcare in our state, like in most every other state.

I have seen evidence of how CON laws restrict access to healthcare, suppress the wages of healthcare workers and how they hinder the quality of healthcare in Mississippi. I’m not saying we don’t have some great hospitals and healthcare facilities in our state that are providing top notch service, but everyone has room for improvement and competition is the best way to bring about innovation. CON laws suppress the wages of healthcare workers in our state because those workers have no choice but to work for the one big monopoly company in many regions of our state. I have spoken to many Doctors and other healthcare providers about this. Many are scared to speak out because they may lose their “privileges” to work at the hospital, or get fired for speaking out against these large healthcare monopoly giants.

The Federal Department of Justice and the Federal Trade Commission have stated that CON laws go against the Federal Anti-Trust Act, are monopolistic and should be repealed. If I had millions of dollars to take this to Federal Court - I would - but since I don’t, I am going to need your help to change these corrupt laws.

Do your own research, find out the truth, spread the truth. Call, message and email the Governor, the Lt. Governor, the Speaker of the House, your state Senator and your State Representative and tell them to support the Mississippi Access to Care Act. Share this post with your family, your friends, media contacts and especially your medical providers. I need doctors, nurses and medical technicians who have experienced the ill effects of these laws firsthand to reach out and contact their elected officials in support of this bill. You don’t have to make a public stand, although I welcome it, but you can make some phone calls to your elected officials and tell them to support this common sense piece of legislation.

This Mississippi Access to Care Act does three things:

1. It removes the requirement for a healthcare professional from having to get a CON to provide any service that they are already qualified and licensed to perform. Yes, our CON laws are so restrictive that they even restrict trained healthcare professionals from providing their services across our state. Some of their services (which varies on the region) can only be provided under the umbrella of a CON holder and for their profit alone.

2. It removes the requirement for a healthcare provider to get a CON to purchase a piece of healthcare equipment that they already have a qualified and licensed professional ready and waiting to operate.

3. It removes the requirement for a multi-specialty Ambulatory Surgery Center (better known as a same day surgery center) and for dialysis centers from having to get a CON in order to compete against a major medical facility. Stand alone medical facilities run with less overhead, reach further out into rural communities, have less wait times, and offer a wide range of specialty services at very competitive prices.

In other words, if a highly trained healthcare professional wants to open a privately owned center to provide healthcare and provide access to care in small towns across Mississippi, or compete and offer better pricing and service across the street from a major medical facility then they can without being denied by a board of monopoly, just like they do in most every other state but ours.

There are many other issues in healthcare that need to be addressed, but the reform of our CON Laws is one of the major hurdles before us. We need to break up these state mandated monopolies, and after doing this many other things will start to fall into place.

I have spoken to countless individuals all across our state and improving healthcare in Mississippi seems to be a top priority for all - from the young to the elderly, from the poor to the middle class. With us ranking last in health out of all 50 states it should also be a top priory for every elected official in this state. I have dropped a CON repeal bill the last two years. This is my third year to push this piece of legislation. Demand that your elected officials get this bill to the floor for a debate and a vote - and then hold us all accountable for our votes on this very important issue.

Session starts Jan. 2nd this year. The time to act is now.

Robert Foster
MS State Representative, Distrcit 28