In a February 24, 2026 Townhall.com column, Elizabeth Hicks, U.S. Policy Analyst at the Consumer Choice Center, delivers a pointed critique of America's escalating healthcare costs, identifying Certificate of Need (CON) laws as the primary culprit behind what she terms a "quiet monopoly" inflating medical bills nationwide.
Hicks opens with striking statistics: since 2000, hospital prices have surged by 220%, substantially outpacing inflation, wage growth, and overall economic expansion. Healthcare now consumes nearly one out of every five dollars in the American economy. However, Hicks argues this isn't due to a fundamental shortage of medical facilities. "There is no hospital shortage in America," she asserts. "Only competition shortages."
The core thesis of the article is that America's healthcare crisis is fundamentally "a spending problem disguised as a healthcare problem"—one where patients bear the cost of government-sanctioned monopolies rather than market failures.
The article identifies Certificate of Need laws as the primary driver of healthcare consolidation and price inflation. Currently active in 35 states, these regulations require new hospitals, surgical centers, and imaging facilities to obtain state approval before establishing operations. Most controversially, they grant existing hospitals de facto "veto power" over potential competitors entering their geographic vicinity.
CON laws were originally conceived in the 1970s as cost-containment measures, premised on the theory that preventing unnecessary facility duplication would reduce healthcare spending. Hicks argues the opposite has occurred: regions with CON laws experience approximately 11% higher healthcare costs and 30% fewer hospitals per capita compared to areas without such restrictions.
The regulatory framework has facilitated aggressive consolidation into regional monopolies, with dominant hospital systems using CON statutes to block new entrants. This artificial scarcity eliminates competitive pressure that would otherwise drive efficiency improvements and price reductions. Patients consequently face higher premiums, inflated deductibles, and reduced choice—all resulting from regulatory barriers rather than genuine resource constraints.
Hicks advocates for the complete repeal of CON laws at the state level, arguing that "the fight for your health starts with the freedom to compete." She contends that eliminating these barriers would allow market entry by innovative healthcare providers, surgical centers, and diagnostic facilities, creating genuine competition that benefits consumers through lower prices and improved service quality.
The article appears within a broader conservative policy push for hospital price transparency and deregulation, coinciding with renewed executive branch attention to healthcare affordability under the Trump administration. Hicks' analysis aligns with free-market healthcare reform proposals that emphasize regulatory rollback over increased government intervention.
The Consumer Choice Center, which published the article simultaneously on its own platform, characterizes itself as a global grassroots consumer advocacy organization supporting market-based solutions to policy challenges.
Hicks presents a compelling case that America's healthcare affordability crisis stems less from medical complexity than from entrenched regulatory structures protecting incumbents from competition. Whether state legislators will embrace this deregulatory approach remains an open question, given the political influence of established hospital systems invested in maintaining the status quo.
Editorial comments expressed in this column are the sole opinion of the writer
