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The study goes on to say that were states to significantly relax their regulatory thresholds, "total hospital costs would not increase, but rather would decline by 1.4 percent."

Turns out that the FTC (then and now) may have missed something -- a 1998 Duke University study found "Mature CON programs are associated with a modest (5 percent) long-term reduction in acute care spending per capita, [emphasis added] but not with a significant reduction in total per capita spending." And this is supported by more recent research, which clearly indicates the supply of health care facilities drives demand, not the other way 'round.

Ohio eliminated their CON program in 1995. Over the next four years, there were 19 new hospitals built, a five-fold increase in the number of freestanding MRIs, and the number of ambulatory surgical centers grew by 600%. These weren't being built to reduce costs.

Manufacturers have also seen benefits from CON regulations. The big three automakers all compared costs in CON v non-CON states, and found that states with substantial CON programs had significantly lower health care costs. In fact, when considering locating plants and facilities, the big three consider CON "as a positive factor." Chrysler found that their per-employee health care costs were substantially lower in CON states than in non-CON jurisdictions, with costs as much as 164% lower in CON states. GM found its health care costs were nearly a third less in CON states in a similar analysis. Their report states "Some argue that deregulating health facility expansion will trigger free-market forces of supply and demand, and lead to lower costs. On the contrary, General Motors has not found that to be true based on our vast experience in states that have varying degrees of CON regulation."

And an analysis by Ford found that inpatient and outpatient hospital costs were 20% lower in CON states.

Specific procedure prices were also lower in CON states, refuting Palin's contention that freeing up the market to more competition will reduce costs. MRIs were at least 11% more expensive, and coronary bypass operations were at least 20% more expensive. Ambulatory surgery center charges were also 25% lower.

Quality is also higher in CON states.

A study published in JAMA found that the quality of outcomes in coronary artery bypass surgery was directly linked to the CON process. Those who had CABG in non-CON states were significantly more likely to die (5.1% chance v 4.4% in CON states) due primarily to the higher volume per facility in CON states. Notably, in states that repealed CON laws, the percentage of patients undergoing CABG in low-volume hospitals tripled.

p>The CON legislation Palin supported has yet to be approved by Alaska's legislature, and continues to face strong opposition from within the state. Palin's doctrinaire position on health care is in lock-step with the GOP -- it relies on an unfounded and unsupported faith in the free market's ability to somehow reduce health care costs and increase quality, despite all evidence that there is no such linkage. br> -- Joseph Paduda br> Principal br> Health Strategy Associates, LLC /p> p>

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