Certificate Of Need Repeal Will Have Serious Consequences

July 16, 2019

 By Marilyn Ralat-Albernas

Marilyn Ralat Albernas, 2018.jpgThe Florida Legislature passed a staggering array of bad bills earlier this year from arming teachers while attacking public school funds; cynically restricting voting rights and citizen initiatives; allowing the separation of immigrant families; and many others that captured attention for being so brazen and outrageously against the will and well-being of Florida voters.

However, another piece of short-sighted legislation with a longer, less headline-friendly name – Florida’s Certificate Of Need (CON) repeal – also will have dangerous and costly consequences for Floridians and their families.

This repeal was largely ushered through Tallahassee by GOP House Speaker Jose Oliva from Miami.

CON rules ensure that a community must need additional medical facilities – such as specialized treatment centers – before others can be built.  My fellow healthcare workers know that these prudent requirements ensure that health service providers expand in ways that provide services our communities truly need – not just those that bring in the most profits.

Yet Oliva and free-market opportunists have made “disruption” or “competition” their priorities for the healthcare system because they seem to believe deregulation is the solution to almost every imaginable issue.

What they really want in this case is to give hospital companies unhindered ability to build boutique specialty care units offering only the most lucrative medical services, even if those resources already exist in a community.

No doubt, these companies will cherry-pick the most affluent neighborhoods, leaving working-class communities neglected (as always). 

These factors will result in the non-profit community facilities – and ultimately taxpayers – responsible for the massive cost of all the other money-losing services. 

This increases the cost of healthcare to the vast majority of us, while a select wealthy and connected few benefit richly.  Doesn’t this sound familiar on so many issues from our so-called representatives in Tallahassee today and the past 20 years?  The politicians allow profiteers to take advantage of the public trust time and time again.

Especially when it comes to medicine, free market ideology is clearly misplaced when it comes to medicine.  Healthcare is not a random service or commodity to be sold at the newest strip plaza to pop up in your neighborhood.

Quality care requires important standards, performance and practice. However, many of these assurances are now lost with Oliva’s repeal bill, because a variety of critical quality measures were incorporated in CON rules and language.

In addition, when limiting the number of facilities allowed to perform very specialized, complex procedures – pediatric heart surgery, for example – statistics show that proficiency and successful outcomes improve. CON repeal disregards these benefits.

Yes, the free market might shake out the underperforming, money-losing facilities, but it is little condolence for a grieving parent to know their center eventually went out of business.

There’s no doubt these consequences of CON repeal will be tragically revealed. This is especially distressing for my fellow frontline medical workers who are committed to the highest standards.  My colleagues consider ourselves “guardians of quality” when it comes to care, and our union visited lawmakers to voice our deep knowledge and grave concerns about the bill. Sadly, our pleas were ignored. 

Our members will continue to stand together and speak up for patients and our communities, but Speaker Oliva, Gov. DeSantis, the GOP legislature must be held accountable when Floridians suffer from their misplaced ideological decisions and dogma.  


Marilyn Ralat-Albernas is a registered nurse in Miami and a member of 1199SEIU Florida, the union representing more than 25,000 healthcare workers throughout the state.