Havighurst Clark C
Duke University School of Law, Durham, North Carolina, USA.
Health Aff (Millwood). 2005 Jul-Dec;Suppl Web Exclusives:W5-373-5. doi: 10.1377/hlthaff.w5.373.
Certificate-of-need (CON) regulation was originally intended to correct market failures that no longer afflict health care markets. It is ironic that Sujit Choudhry and colleagues now invoke it to deal with situations where, in their view, competition is working altogether too well. Protectionist regulation, long discredited in other areas, is particularly misguided in health care, where health insurance greatly increases the profitability of monopoly and imposes the resulting higher costs on unwilling premium payers. To use cross-subsidies to finance even worthy (let alone unworthy) health care projects is to put public burdens unfairly (regressively) on the backs of working Americans.
需求证明书（CON）监管最初旨在纠正那些不再困扰医疗保健市场的市场失灵问题。具有讽刺意味的是，苏吉特·乔杜里及其同事现在援引该监管措施来处理他们认为竞争过于有效的情况。保护主义监管在其他领域早已声名狼藉，在医疗保健领域尤其具有误导性，因为医疗保险极大地提高了垄断的盈利能力，并将由此产生的更高成本强加给不情愿的投保人。利用交叉补贴来资助即使是有价值的（更不用说无价值的）医疗保健项目，是将公共负担不公平地（累退地）加在在职美国人身上。
