Center For Health Policy



(Pictured: Dr. Christopher Casscells, CRI Policy Director)

Center For Health Policy

 
For three years, CRI has advocated for advancing healthcare services in Delaware on a more free-market basis, thus reducing costs by hundreds of millions of dollars a year to taxpayers, medical centers and hospitals, third-party payers/insurers, and individual patients.  The catalyst to that goal – and the top priority of the Center for Health Policy - is the repeal or “sunsetting” of Delaware’s Certificate of Need (CON) program.
 
With the establishment in the mid-70s of the CON program, the goal of the Delaware Health Resources Board was to control healthcare costs by regulating the approval of new healthcare facilities, the expansion of existing facilities, and even the purchase of new high-tech medical equipment.  That original intent has failed:
 
  • Delaware now ranks 3rd nationally in per capita medical costs. 
 
  • As has been unfortunately evident throughout the Covid-19 pandemic, the state has a chronic shortage of hospital beds, ICU capacity, and emergency room capacity, resulting in the 2nd longest emergency room wait time in the nation.
 
Today, in great measure because of the CON program, the healthcare market is replete with counterproductive incentives and disincentives, resulting in hundreds of millions of dollars a year of waste, compounded by an inequality of access to and quality of patient care.  A 2017 study by the Mercatus Center of George Mason University documented that the state’s healthcare expenditures could be reduced by $270,000,000 a year if the CON program was eliminated.  Nationwide, similar studies have eventuated in 15 states repealing their CON laws.  In fact, by 1987, the federal government’s own long-term study data was so damning that it repealed the law. 
 
That the CON program has become an impediment to the financially responsible investment of the state’s healthcare funds and has not gone unnoticed by Delaware legislators and its Sunset Committee.  CRI has developed a plan to advocate for eliminating the CON law. In 2021, we will be working with several other state-wide health-related organizations to push for the legislature’s elimination of the state’s CON program and the DHRB.
 
The Center will also continue to publish documentation on the crushing impact of Delaware’s swelling Medicaid costs on the state’s budget.  In short, unless the Medicaid cost factor alone is somehow controlled, Delaware’s budget cannot be balanced without impacting harshly on other vital services and programs.  To that end, CRI intends to collaborate with other influential organization such as the Medical Society of Delaware and the Delaware Public Health Association to develop options – perhaps on a trial basis – that would guarantee quality care for underserved communities while saving tens of millions of dollars every year in the state budget.
 
Center Director Christopher D. Casscells received his BS and Public Health training at Yale University, his MD from the University of Virginia, and post-graduate surgical training at Yale New Haven Hospital. He is a recently retired Orthopaedic Surgeon who founded the Health Policy Sector at CRI over a decade ago while President of the Delaware Academy of Medicine.
 
 

Soon in this country there will be two types of medical providers: those who demand fee-forservice, and those who will see as many patients as possible to make as much money as possible. In one case those with affluence will still see medical providers quickly, while everyone else will have t...

Read More

The news is that the rollout of Obamacare is a disaster, and by any measure widely known it is just that, a screw-up. Do you remember Ali getting destroyed by Frasier in the first few rounds? The strategy became known as Rope-a-Dope. Ali won. We can learn from Ali and history. This "...

Read More

As the "train wreck" of ACA unfolds, at every level we are facing disappointment.  We were promised that 700,000 Americans with pre-existing conditions would become insurable five years ago.  Approximately 1/10 of those actually became insured.  The predictable cost to the h...

Read More

This article was originally published as a "Delaware Voice" article in the News Journal on October 13, 2014. Delaware and the Christiana Care Health Systems feted Dr. Donald Berwick, former head of Medicare and Medicaid Services and a major author of the Affordable Care Act, last year and...

Read More

There is a lot of misunderstanding around the recent Ebola outbreak. There is reason to feel safe from the disease based upon its prevalence or density in our population. There is also good reason to be concerned about the disease and act proactively, due to the extremely high death rate associat...

Read More

This is the full 2013 Medicare report from the CMS Medicare Board of Trustees. This document outlines the current state of Medicare and the future of Medicare/Medicaid, as studied by insurance actuaries working with or for CMS. http://go.cms.gov/18S2l5Y

If you were paying attention to the news this week you know a video of MIT professor Jonathan Gruber, one of the most important authors of tha Affordable Care Act openly admitted in a video recorded in 2013 that the passage of ACA was dependent upon fooling both the CBO and Congress and the inh...

Read More

In 2012 the Supreme Court ruled on a series of cases, cumulatively decided as Florida, et al., v. Department of Health and Social Services and concluded that the ACA was a tax and thus was constitutional. At that time Obamacare supporters were very happy and Obamacare opponents were furious with the...

Read More

This article first appeared in The News Journal print edition January 14, 2015 and at Delawareonline.com January 13, 2015. Read the original HERE When I read Delaware’s proposed Health Care Innovation Plan, I can’t help but think of the German economy under the top-down control implem...

Read More

The state is moving forward on a Delaware Health Care Innovation Plan that to implement will involve a one time outlay of $160 million and $190 million annually for 10 years. The major components of the plan will include a health information exchange, a "holistic" approach to work force de...

Read More