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Haymarket: No Hospital For You, Says Virginia

By Greg L | 30 June 2010 | Prince William County | 20 Comments

Crystal Clear Conservative covers the recent developments about establishing a new hospital in Haymarket, pointing out the unusual behavior of the Commonwealth in trying to kibosh the idea.  I still don’t understand why the state has the power, or even the inclination, to say no to a private enterprise wanting to expand access to healthcare.  Does Virginia have some interest in maintaining health care monopolies in the state or something?  As long as the venture will adhere to current state and federal regulatory requirements concerning the quality delivery of care, it makes no sense at all for the Commonwealth to have any input on this more than it would for an auto body shop to expand their business.

Fast forward to June, the Commonwealth of Virginia is now deciding the fate of Prince William Hospital System’s application to build a hospital in Haymarket. Right now, the fate is not looking too good for PWHS, as the Division of Certificate of Public Need (COPN) recommended that the State Health Commissioner, Karen Remley, deny PWHS’ application to build. Why would the Division of COPN stand in the way of the proposed hospital? The staff director in the COPN division has questions based on the area’s population growth and does not think that the transportation problems warranted a hospital.

Seriously, are we in danger of having too much convenient access to hospital care? If a private business wants to expand and provide a public service while adhering to all state and federal laws and regulations, what business is it of the state to second-guess the business model for the venture?  When Virginia can effectively cost contain Medicare and Medicaid, which has long-term structural budget busting cost implications, maybe then they’ll have the credibility to weigh in authoritatively on a business model.  Until then, this at least smacks of protectionism.  More likely, it’s just another episode of “Bureaucrats Gone Wild!”

Let the free market decide.  Governor McDonnell, here’s a great opportunity to demonstrate those principles you espouse so often.



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20 Comments

  1. Brian L. said on 30 Jun 2010 at 10:15 pm:
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    Considering that the Commonwealth of Virginia will be expected to bail out any hospital we build around here (due to our increasing — at least up here in Fairfax — “undocumented, uninsured” population, I can totally understand how they could come to this decision.

    Obviously, it’s not the *right* decision, but since we’ve got our government mandating levels of service and care that a private business will be expected to provide (free of charge), I’m afraid we’re already pretty hosed.

  2. What to Do said on 1 Jul 2010 at 7:34 am:
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    When it comes right down to it,I think Brian is correct.
    We are going to see many,many things happen and they have been happening.Until we put a stop to the influx of “Illegal Aliens” it will only get worse.They want these small health care places,then they can get money from their Congress people to keep them afloat.Ask Principi,he knows how it’s done.?

    The General Assembly passed this year an ammendment to the temporary family health care , HB 1307,that immediately section 15-2-2292 will force our County to draw up our Codes to comply with State.

    Size will be about the half size of a trailer. It will not be on a permanent foundation and of course can be put in a back yard of any single family detached residential area.

    There’s already a Person that has these ready to be sold.

    Maybe thats why this was pushed through so fast as someone had a friend in Richmond?

    We already have alot of junk in the back yards,as there is 2/3 large sheds,there are many additions that were presented one way to the County Permit and something else built. The County has a hard time enforcing laws on the books now,what is going to happen when we add all this mess? And we have no say in it.

    Someone needs to take control of these situations as little by little our Country is changing and it’s not for the good of the majority of our citizens.

  3. Big Dog said on 1 Jul 2010 at 8:21 am:
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    One of the reasons PWH is seeking to open a hospital in
    the Haymarket area is to balance the huge increase of indigent
    patients (many illegal) in Manassas with paying patients.

    This is part of a larger issue that pro-illegals refuse to
    address - the tremendous net expense of illegal immigrants
    to local jurisdictions and vital institutions such as those
    that provide healthcare. PWC and the two cities would
    be a good location for an unbiased objective study
    of this type. And of course, a follow up question will
    be, who must pay to cover the difference?

  4. American Veteran said on 1 Jul 2010 at 9:03 am:
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    Sounds like ANOTHER mess that flows from the Leftwing in Congress and the White House. A simple issue of placing a hospital facility in a community that lacks such service is burdened with the impact of supporting the illegal (non-paying) population and potential future bankruptcy of the proposed hospital?

    For those American citizens wandering through life oblivious of the real impact of the huge illegal alien army that occupies the USA - take another look at the local impact. Your taxes support these parasites. You and your neighbors are victims of illegal alien violence - through drugs and gangs. Our law enforcement officers are at risk encountering violent illegals. And the huge Federal bureaucracy that touches the illegal alien problem - either remains inactive due to Leftwing political appointees or forced into apathy.

    America’s illegal alien problem is a national security problem AND an economic black hole. We can no longer afford either burden. The solution remains inescapable. Deportation of ALL illegal aliens, along with their anchor babies, is the solution, along with a secured border. The Nation only needs the will. Historically, we have exercised such will in dealing with illegals. We need to reclaim those values that lead to the right solutions in the past.

    PS: And if the Border Parol would empty out their Washington DC HQ of all their officers on TDY, we could increase the security at the border too. I don’t think a citizens review panel of the US Border Patrol’s HQ operations would make the organization’s senior executives happy. It is so sad to see US Border Patrol officers walking around DC (which is overrun with illegals) packing their side arms and wearing the ranks of full colonel or even flag officers. How pathetic is that? It makes us look like a banana republic. LEOs are civil servants. If they want military rank, they should have joined the military.

  5. Groveton said on 1 Jul 2010 at 12:15 pm:
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    From the posting at Crystal Clear Conservative, “It appears that there is a disconnect between Richmond and the rest of the state. How would the COPN Division know what is best for the residents of Western Prince William County?”.

    Could it be that Virginia’s conservatives are finally “getting it”? Yes, there is a disconnect. That disconnect is memorialized in Virginia’s obsessive adherence to the legal philosophy known as Dillon’s Rule. Under Dillon’s Rule the nanny state in Richmond tells Virginia’s counties what they can and cannot do. One thing they can’t do is build a new hospital without the nanny state’s permission. It’s no different than the nanny state in Washington telling us in Virginia what we can and cannot do. Well, actually it is different. The US Constitution provides rules with regard to the powers to be exercised by the federal government vs. the states. Many state constitutions specifically empower the localities to have certain powers too. Not Virginia. All effective power rests in Richmond including the power of people who have never been to Western Prince William County to consign citizens of Western Price William County to die in an ambulance stuck in traffic rather than receiving local care.

    Some time ago I made a similar point about Dillon’s Rule on this blog. GregL made the argument that dilluting Dillon’s Rule would let Northern Virginia loicalities take away his right to bear arms. I won’t bother to explain that’s it’s the constitution and not the county government which gives him that right. However, I will point out that the US Supreme Court just overturned gun bans in Chicago and one of Chicago’s suburbs. Can we take the absurd argument of Prince William County’s government defying the US Constitution off the table in the Dillon’s Rule debate?

    The government which governs closest to the people governs best.

    “Bureaucrats Gone Wild!” is as true in Richmond as it is in Washington.

    Be a real conservative - put as much political power as possible closest to the people. End Virginia’s addiction to Dillon’s Rule.

  6. Advocator said on 1 Jul 2010 at 12:27 pm:
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    Dillon’s Rule is only invoked by lawmakers who pose it to their constituents as an excuse for not sponsoring and passing legislation that the constituents want, but the legislators’ rich contributors do not.

  7. Just the Facts said on 1 Jul 2010 at 12:30 pm:
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    Groveton - amen to that! In addition, the Dillon Rule allows developers to have excessive influence over our land use policies in Prince William County. We are subject to the new law restricting the use of proffers, and thus depriving us of an important revenue source. PWC is also limited in many other ways, such as being prohibited from imposing impact fees and requiring adequate public facilities (roads, schools, etc.) before allowing new development.

    Conservatives believe in self-determination and local governance. The Dillon Rule stands in opposition to those principles. In fact, it is based on the premise that “us yokels ain’t smart ‘nuff to figure stuff out on our own.” Richmond holds all wisdom and needs to make our decisions for us.

    Our Republican leaders in Richmond should put eliminating this abomination at the top of their agenda. Maybe then we could determine our own land use policies and decide for ourselves when we need a new hospital.

  8. zuzu said on 1 Jul 2010 at 12:35 pm:
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    So…how do we get rid of it? What must we do and how soon can we get started??

  9. zuzu said on 1 Jul 2010 at 12:48 pm:
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    Anyone going to the “We the People” event this Sat. (7/3) at Ritchie Lake (Bealeton, VA)??

    http://www.anamericanevent.org/

  10. Just the Facts said on 1 Jul 2010 at 1:15 pm:
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    The only way to get rid of it is for the legislature to pass a bill and the governor to sign it. Republicans could do it if they want. That would mean defying big-business, big-money contributors. Anyone taking bets on who the true conservatives might be, and who is just taking orders from campaign contributors?

  11. Groveton said on 1 Jul 2010 at 2:33 pm:
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    Dillon’s Rule is a legal philosophy originally defined by a judge in Iowa named John Dillon over 100 years ago. The philosohpy simply says that localities are not definied anywhere in the US Constitution. There is no mention in the constitution of cities or counties for example. Based on that Judge Dillon postulated that local government existed only at the will of the states. He never said that states couldn’t give power to localities he just said it was the states to give. Legally, there is no requirement for there to be any govenment below the state level. Practically, every state in the United States has extensive local government. The question becomes one of how the state choses to empower the localities.

    The strongest way for a state to give localities power is through the state constitution. Some powers vested to the state in the US Constitution are given to localities through the state constitution. The weakest way for a state to give power to the locality is by insisting that all power be given through the normal legislative process. In other words, the state legislature has to pass enabling legislation before the locality has the right to act. Needless to say, that which can be given through enabling legislation can be taken away through enabling legislation.

    Virginia is essentailly an enabling legislation state. Therefore, it’s fair to say that Virginia uses a strong version of Dillon’s Rule in its government.

    In my opinion, the best way to devolve some power permanently from the state to the localities would be through the Virginia Constitution. Unlike the US Constitution Virginia’s constitution has been rewritten many times - eight to be exact. The latest constitution (the one now in force) was the result of a process which cuminated in a state-wide vote to adopt the new current constitution in 1970.

    I believe that the Virginia constitution can be amended by request of the state legislature. The General Assembly puts forth a proposed constitutional amendment which must first pass the General Assembly. Then, there is a waiting period before it can be taken for the mandatory state-wide vote. I believe that the waiting period is one year but it might be that there has to be an election of the House of Delegates (once every two years) between the GA passing the amendment and it going to a state wide ballot. Either way, it doesn’t happen overnight but it does happen.

    In order to properly dillute Dillon’s Rule in Virginia the voters would have to elect state legislators who would propose amendments to the Virginia constitution devolving some specific powers to the localities. Local health care planning could be one of those powers for example. Then, the state would have to approve the amendment in a state wide vote.

    The first step is to ask your representatives in Richmond why they believe a hierarchial nanny state run out of Richmond is in the best interests of their constituents. Those who refuse to work to dillute Dillon’s Rule should be voted out of office.

    I am not a lawyer. So, I am happy to be corrected on any of the legal or proceedural points in this comment.

  12. Big Dog said on 1 Jul 2010 at 2:51 pm:
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    Too many members of the Virginia GA are pompous hypocrites -
    they cry and whine about overbearing stupid and costly
    mandates from the Feds and then turn around and do twice as
    worse to our local jurisdictions.

  13. Just the Facts said on 1 Jul 2010 at 2:59 pm:
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    Groveton, thanks for your much more informed and detailed explanation of the process for getting rid of Dillon. I gather from your comments that the GA must pass a constitutional amendment rather than just a bill. The question remains, however, who are the true conservatives who believe in letting people rule themselves, and which elected officials are just taking orders from big-money campaign contributors?

  14. Big Dog said on 1 Jul 2010 at 3:24 pm:
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    The Presidentl’s speech today in favor of amnesty for
    illegal immigrants was an Obamanation!

  15. Advocator said on 1 Jul 2010 at 3:41 pm:
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    I agree with Goveton’s explanation, but I still posit that the Dillon “Rule” (more aptly called a “policy”) is invoked more as an excuse not to introduce legislation than as an actual barrier to legislation. Even if the state’s constitution were amended to override it, legislators who favored the interests of their big money contributors over their constituents’ interests would find reasons to foil popular initiatives.

  16. Advocator said on 1 Jul 2010 at 3:44 pm:
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    I’ll be there, Zuzu.

  17. Red, White and Blue said on 1 Jul 2010 at 9:26 pm:
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    Good discussion!

    BIG DOG: I couldn’t agree more. He wants those 10 million votes within the next decade. We have gone from a country of opportunity to a country of entitlements. How about Lindsay Graham’s comments today: The Tea Party will die and is unsustainable. I am sure am glad he wasn’t around in 1774 -1775. As I said in another post, the GOP is just as afraid of the Tea Party as the democrats. America and its citizens have been relegated to the backburner.
    Also, Obama said that the border is safer now than during the last 20 years. If that’s the case, why ask for a gun ban? And how about Phoenix being the kidnap capital of the USA? All those drugs, all the videos of the armed illegals and how does he explain all those signs the Feds just posted in Arizona telling folks how bad certain areas are and that they should not continue further or risk harm, specically mentioning armed people and drugs. Safe? This guy just doesn’t want to protect the citizens, he wants to protect the illegals and get those votes.
    I guess all those murders in Mexico are not violent. Just a matter of time with a weak link like him to let the gangs come further North.

    Groveton, nice explanation of the Dillon Rule.

  18. Groveton said on 2 Jul 2010 at 5:36 am:
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    Big Dog - I agree with you about the GA.

    Just the Facts - You make a fair point about big money still playing a role.

    My belief is that home rule (a term often applied where Dillon’s Rule / Policy has been dilluted) has its pros and cons. However, in Northern Virginia, I think the pros outweigh the cons. Here’s a summary:

    Pros -

    Easier to tailor local policy to local needs. Transportation is an obvious point in VA. From the original post, health care too.

    Easier for taxpayers to see the results of government. When the GA takes some action specifically for Wise County, Va I have no earthly idea whether it’s a good idea or a boondoggle. When my county takes an action, I know other county residents and I can see the action. Arguably, I could drive to Wise County, Va and find out for myself or read newspapers and/or blogs from the area. However, its a lot of work. Under home rule, Wise would enact the laws that make sense for Wise (within the home rule powers) and generally would have to pay for Wise - specific support. Their money, their choices.

    More taxpayer - elected official interaction. I can visit every supervisor in my county if I feel strongly enough about something. Or, I can effectively organize a group like Help Save Manassas with representation in each supervisory district. That’s much harder (generally impossible?) at the state level. There are 100 state delegates and 40 state senators. In addition, there are many issues which are important locally but not in every locality. Illegal immigration is one. I know plenty of people in Richmond who can’t for the life of them understand why the people of Prince William County are so upset about illegal immigrants. That’s because many of the localities around Richmond don’t have a substantial level of illegal immigration.

    Cons -

    Judge Dillon generally felt that local politicians were less competent and more easily corrupted than state legislators. Given the bad behavior by governments in many cities at the time (1880s) he may have been right. Today, I am not so sure. Perhaps the best local politicians still seek office at the state level but I generally agree with Big Dog about the lack of quality in many members of our General Assembly.

    Decisions at the state level get more publicity than decisions at the local level and, therefore, are harder to corrupt - either through illegal means or through legal lobbying and/or campaign contributions. This was undoubtedly once true. However, the advent of the internet and local blogs along with the general failure of the mainstream media has put a crimp in this argument.

    Poorer localities will stay poor while richer localities will stay rich. There is some merit to this belief. However, nothing prevents people from one locality from moving to another. In fact, I’d argue that there are some localities in Virginia which have bleak future prospects and people should move to places with better economic prospects. However, I’d still support some form of income sharing among Virginia’s localities (which happens today). But I’d cap the amount of money that can be moved in the locality wealth redistribution schemes and I’d let the localities send the money they get (either through direct taxation of their citizens or through locality redistribution) however they think best.

    Finally, for conservatives in Northern Virginia, there is a political angle. A conservative like Mr. Horn living in Arlington probably gets some modest benefit by having a more conservative state legislature exercise sunstantial power over a liberal county government like Arlington. Taxes may be the most obvious area of benefit. Some liberal counties in Virginia would probably try to “go California” if they had teh chance to do so. Then, they would fail and the citizens would elect more conservative representatives who would eventually restore sanity. The process would be brutal but ultimatley it would be a good outcome. Yet, in fairness, I must say that the nanny state in Richmond is only a problem to the extent that the nanny is a problem. Mary Poppins was a nanny but she ultimately helped the kids. The question is whether Nanny Richmond is helping or hurting Northern Virginia. I say “hurting” but I can see some counter-arguments.

  19. Patty said on 2 Jul 2010 at 8:27 am:
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    Richmond will not let western PW have a hospital but the General Assembly will let them have grandma pods (HB1307):

    http://leg1.state.va.us/cgi-bin/legp504.exe?ses=101&typ=bil&val=HB1307&Submit2=Go

    Three cheers for Dillon’s rule…not. They use it to force SPECIFIC ordinances on local communities but when something is needed for the state they shy away. Did I hear someone say E-verify? Maybe it’s not the Dillon rule that is at fault. Maybe the fault lies with the GA.

    Funny how that works.

    Hello GA, when will you regulate the height of our fences? While you’re at it send some money to fund our zoning department so they can inspect all those grandma pods that you want in our back yards.

    No chance for a public hearing - NONE!

  20. Big Dog said on 4 Jul 2010 at 1:42 pm:
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    Over a decade ago, the City of Manassas, to combat slum lords
    and overcrowding, passed a strong rental inspection law to insure all
    rental property met code. It only applied to the areas of most need
    at the time like GTS and helped greatly to improve that community.
    The City of Williamsburg liked it so much they modeled one like it
    for their entire jurisdiction. Sadly that upset a powerful Williamsburg
    property owner who took his objection to pals in the GA who then
    voted to kill such laws for the entire commonwealth - Manassas included.

    Dillon’s rule hurts local citizens time after time. It is archaic trash
    that should be thrown away.

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