TIME TO DROP HOSPITAL REVIEW

Apparently feeling its oats for the few times since it was formed to review requests for major capital expenditures at Missouri hospitals, the state's Health Services Review Committee recently denied three requests for resonance imaging systems.

St. Francis Medical Center in Cape Girardeau was one of the three hospitals requesting a new MRI unit. Hospital officials are appealing the committee's denial.

Missouri's hospitals and other health care providers must obtain a certificate of need from the committee before they can make large capital expenditures. The philosophy behind the regulation is that unneeded capital spending means higher medical bills for the consumer.

St. Francis was leasing its existing MRI unit and was set to dismantle and hoist its leased MRI through the roof if the $1.65 million replacement was approved.

The committee apparently rejected St. Francis' MRI request because the state now requires 4,000 scans annually to justify a new scanner. St. Francis only provides 2,700 such procedures each year.

But no one opposed the request, not even Southeast Missouri Hospital officials. So why was it rejected? The ruling that St. Francis wasn't able to document a need in their service area seems arbitrary.

The Health Facilities Review Committee repeatedly has approved debatable projects that not only showed insufficient need but created an unnecessary duplication of services in Cape Girardeau and other cities.

The problem here is that for committee members -- politicians and political appointments -- the decisions are no-win. The very nature of the regulatory body, which aims to keep a lid on health-care costs, is to drive up costs. An application fee runs into the thousands of dollars, amounting to 1 or 2 percent of the total project cost. Applicants also spend thousands of dollars on lobbyists. Those costs, no less than capital improvements costs, end up being borne by patients.

Too often, political influence plays a greater role in the panel's decisions that does more noble factors like duplication of services and patient costs. Some state officials already have called for dismantling or at least reducing the committee's scope.

The Missouri General Assembly should again consider legislation to eliminate or reduce the role of the regulatory agency. Many states have disposed of their certificate-of-need programs, which were established by federal law in 1979 -- a law that since has been repealed.

Missouri should give serious consideration to joining the 16 states that have erased their certificate-of-need laws or no longer review hospital additions or new medical equipment purchases. Based like many government regulations on good intentions, their usefulness seems to have faded.