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State regulations determine who can buy medical imaging machines

During Susan Chester’s mammogram, her doctor saw something suspicious and referred her for second round of diagnostic imaging including an ultrasound. Thankfully, that testing showed Chester no problems. Her health scare was over, but Chester says that’s when the money trouble began.

“It was $700 more or less out of pocket after insurance that I had to pay and I know other women who are having a similar experience and feel like it discourages women from having their mammograms," Chester said.

That’s what Dr. Gajendra Singh sees happening too. He’s a surgeon in Winston-Salem who opened Forsyth Imaging.

“We have multiple patients who put off their imaging for a long time because they could not afford thousands of dollars. They had the pain here and there. Once we scanned them, because we made it affordable, we saw they had cancer because it was not diagnosed and we see it spread everywhere,” Singh said.

Singh says he has a better way. His diagnostic office provides upfront pricing and he says his business charges less than hospitals and other medical facilities.

“When you go to hospital or somewhere we don’t know how much it’s going to cost and the bill keeps coming. There are fees and that doesn’t make sense. We are a completely transparent service. Our prices are online so when you come here you know how much it’s going to cost,” Singh said.

Forsyth Imaging has the equipment to offer CT scans, ultrasounds, echocardiograms and X-rays, but North Carolina has restrictions in place to keep Singh from buying the machine for MRI imaging.

The state regulates the health care industry through certificate of need laws. Basically, CON prohibits doctors and hospitals from adding to their facilities or equipment without the state’s approval.

With the help of Renee Flaherty, with the Institute of Justice, Singh sued the state, arguing it’s impossible for a small business owner to get that approval.

“The North Carolina constitution flatly forbids the government from creating monopolies and creating winners and losers in the marketplace and providing privileges to private businesses. It gives patients fewer options and that means everyone loses except those hospitals’ bottom line,” Flaherty said.

Hospital administrators tell FOX8 it’s not that simple.

Steve Lawler is the president of the North Carolina Healthcare Association.

“This is a shocking statistic but only about 40 percent of what hospitals do is actually profitable. 60 percent is mission-based work,” Lawler said.

He argues the certificate of need program protects the money hospitals make in areas like diagnostic imaging so they can provide care for everyone including those who can’t pay.

“CON creates a level of protection especially in rural communities such as this one that organizations are not competing for those essential services that are used to underwrite all of this other work,” Lawler said.

It’s the idea of a cross subsidy. Those who can pay may pay more to cover those who can’t.

Singh’s lawsuit was filed in Wake County Superior Court. His attorney expects an update later this fall.

If you are interested in learning more about Forsyth Imaging, visit their website.