North Carolina’s highest court is set to deliberate on whether a New Bern eye surgeon can proceed with his legal challenge against the state’s certificate-of-need (CON) regulations. Lawyers representing Dr. Jay Singleton and state regulators engaged in a rigorous debate before the state Supreme Court justices on Wednesday, spanning over an hour.
Dr. Singleton contests certain provisions of the state’s CON law, which prevent him from conducting most eye surgeries at his personal operating room. Instead, he is compelled to perform these procedures at CarolinaEast, the only facility in the region holding a CON, effectively serving as a state-endorsed permission slip for medical services.
Teaming up with attorneys from the Institute for Justice (IJ), Dr. Singleton argues that the CON law infringes upon his constitutional rights. Josh Windham from IJ emphasized that the law grants CarolinaEast a monopoly over operating rooms in the area, significantly restricting competition and patient choice.
Despite previous rulings against Singleton by lower courts, including a unanimous decision by the state Court of Appeals in June 2022, the battle continues in the state’s highest court. State Deputy Solicitor General Nicholas Brod defended the legislature’s authority to enact and amend the CON law over the years, emphasizing the General Assembly’s prerogative in economic policy matters.
The heart of the issue lies in whether the CON law, as applied to Singleton, violates fundamental constitutional principles. Justice Anita Earls probed into the scope of relief sought by Singleton, questioning which medical providers would still be subject to CON requirements even if relief were granted.
Moreover, the debate extended to whether the state’s offer of a CON to Singleton could resolve the case. Justice Trey Allen highlighted the core injury inflicted on Singleton, irrespective of the outcome of the CON application process.
Singleton’s lawyers argued against the notion that he should have pursued a CON before resorting to legal action, drawing parallels with hypothetical First Amendment cases. They stressed that Singleton is challenging the CON law’s constitutionality in his specific circumstances, not seeking a broad repeal of the law.
The case underscores broader questions about economic liberty, the role of state regulation in healthcare, and the balance between competition and consumer welfare. The outcome of this legal battle could have far-reaching implications for healthcare policy in North Carolina, with potential ramifications for providers, patients, and the broader healthcare landscape.
