N.C. Doctor Sues to Break Up State-enforced Medical Monopoly

Dr. Gajendra Singh knows first hand how frustrating it can be to find quality, affordable and transparently priced health care. As a surgeon practicing in Winston-Salem, North Carolina, he’s seen countless patients find themselves deep in medical debt after having to pay thousands of dollars in out-of-pocket expenses for medical imaging. Dr. Singh knew he could do better.

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In 2017, he founded Forsyth Imaging Center to provide medical imaging services at a fraction of the prices charged by hospitals and other competitors.

In addition to X-rays, ultrasounds and other diagnostic imaging services, Forsyth provides MRI scans. On average, an MRI at a North Carolina hospital costs upwards of $2,000. At Forsyth, Dr. Singh charges $500 to $700. But keeping prices affordable is difficult. That’s because North Carolina’s outdated laws prevent Dr. Singh from owning an MRI scanner.

Instead, in order to provide MRI scans, Forsyth must spend thousands of dollars each day to rent a mobile MRI scanner. Dr. Singh would like to purchase a fixed MRI scanner to keep costs low, but he cannot because North Carolina prohibits doctors from offering new services or buying new equipment without first obtaining a government permit called a “certificate of need” (CON).

Unfortunately, Dr. Singh cannot even start the costly and cumbersome permit process because a board dominated by regulators and industry insiders has determined his community is not in need of any additional MRI scanners. And even if the board did find a “need” for a new scanner—which it has not—that doesn’t guarantee Dr. Singh could eventually purchase one. The law allows other providers, like the hospital down the street from Forsyth, to fight him at every step of the way. When all is said and done, obtaining a permit for an MRI scanner can cost upwards of $400,000.

North Carolina’s CON regime has nothing to do with protecting public health or safety. In fact, it is one of the worst laws of its kind in the country. By stifling competition, CON laws prevent innovative medical professionals from offering affordable care to patients who need it. CON regimes are designed to create monopolies for established providers, like large hospitals that charge patients high prices, at the expense of smaller innovators like Dr. Singh.

Health care costs and high-deductible insurance plans that charge patients more out of pocket are on the rise. The last thing the government should be doing is standing in the way of doctors who want to invest their own money to provide quality, affordable and transparently priced services. That is why Dr. Singh and Forsyth Imaging Center have joined the Institute for Justice to challenge North Carolina’s CON requirement for MRI scanners in state court.
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