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 3^rd 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 2^nd 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 In fact, by 1987, the federal government’s own long-term study data was so damning that it repealed the law.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.

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