If you’ve recently tried to schedule a medical appointment in Delaware, you’ve probably heard a familiar response: “The next available appointment is in six months.”
For many Delawareans, this is no longer an occasional inconvenience. It has become routine.
Delaware ranks near the bottom nationally for health care access and cost. A recent West Health-Gallup survey placed the state 46th out of 51 in overall health care experience and 48th in cost and access. Many families feel the effects when they struggle to find timely appointments with specialists, imaging services or outpatient procedures.
One possible contributor to this shortage receives little public attention: Delaware’s certificate of public review law. As explained in a recent article published by the Caesar Rodney Institute — “Delaware Health Care Supply Needs Competition” — CPR regulations require health care providers to prove to the state that additional medical facilities, equipment or services are “needed” before they can expand or open new services.
Supporters originally believed that this system would control costs by preventing “excess capacity.” But decades of research have raised serious questions about whether these laws actually work as intended.
Federal agencies — including the Federal Trade Commission and the U.S. Department of Justice — have repeatedly warned that certificate of need laws can limit competition and discourage new physicians from entering a state. When supply is restricted, patients may face higher prices, fewer choices and longer wait times.
In Delaware, the CPR process can require extensive financial disclosures and months of review before medical facility projects are approved. Even when applications are ultimately granted, delays and uncertainty can discourage investment by medical practices and clinics that are considering whether to come into the state.
Delaware residents want both high-quality care and timely access to it. If our current Delaware laws discourage new medical practices and clinics from expanding services here, it may be worth asking whether reforms, or even complete repeal, of Delaware’s CPR laws could help improve access, cost and outcomes.
Health care policy is complicated, but the question facing patients is simple: Why is it so difficult to get an appointment when we need one?
Michelle Parsons
Fenwick Island
Reader reactions, pro or con, are welcomed at civiltalk@iniusa.org.
