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A Dangerous Game with Potentially Disastrous Consequences for Franklin County

First and foremost, let me take this opportunity to personally thank Senator Doug Berger for his unwavering support of the Franklin County Cancer Center.  Throughout his entire career, he has been an ardent supporter of improved access to quality healthcare, particularly for the medically underserved.  His staunch support of our Cancer Center is completely consistent with his ethical commitment to the best interest of all the people of his district and the entire state.

Approximately one year ago, Greg Beier, head of hospitals for Novant, and a recognized expert on access to advanced medical technology, when asked whether Franklin County could qualify for a Linear Accelerator (LINAC) under the new law, replied, “Never.”

Senator Berger and his staff, around the same time, went to the trouble to research this exact issue before the Senator attended a meeting of the Franklin County Medical Society.  In fact, it was Senator Berger who personally communicated to all present at that meeting, that if the LINAC housed within the Franklin County Cancer Center were to be shut down, that the probability that another LINAC would be permitted to replace it was “Zero.”

Despite being informed of the consequences of trying to shut down the LINAC, certain parties intentionally ignored the best interests of the entire population of Franklin County, and tried to shut down the Cancer Center for their own personal gain. Whoever is behind the effort to shut down our Cancer Center may claim they were simply seeking clarification of the legal status of the center.  That claim is disingenuous at best.  They are playing a very dangerous game, the most likely outcome of which would be that Franklin County would lose its Cancer Center forever.

Dr. McLaurin incurred more than $35,000 in legal expenses to accurately demonstrate to the CON Section the facts surrounding the establishment of this extremely complicated enterprise.  He was able to prove that the Cancer Center is now, and always has been, in complete compliance with the law.  The attorney for the NC Department of Justice, who handled the case for the state, said that “someone was putting intense pressure on the CON Section to shut down your LINAC.”  She further stated that, if we were unable to adequately defend against the challenge, the DOJ was prepared to issue a “cease and desist” order, shutting down the center immediately.  If Dr. McLaurin did not have the resources necessary to hire CON attorneys to provide a reply to the CON Section, the center would be closed today.

The parties who put pressure on the CON Section to shut down the Cancer Center paid nothing to initiate the challenge, and continue to try to hide their identities.  They are very familiar with the CON process, and are fully aware that the sheer financial burden imposed by $400 per hour lawyers is often sufficient to thwart otherwise legitimate projects.  They may have insinuated that they could always build a newer and better center at some time in the future after the existing Cancer Center was forced to close, but that is extremely unlikely.

First of all, the legal avenue by which Dr. McLaurin established the cancer center by making it operational under a certain monetary threshold no longer exists. That pathway was eliminated by a change in the law on August 26, 2005. Now all new linear accelerators (LINAC’s) require a CON before they can even be purchased. This fact is confirmed in detail in the recent determination of “no review” provided by the CON Section for the existing LINAC, which details the impact of the change in the law in 2005.

Secondly, it is very unlikely that anyone could obtain a CON for a LINAC in Franklin County, because the population and demographics simply don’t support it. Furthermore, CON’s for LINAC’s are highly prized by all cancer care providers, and the competition for them is fierce.  The last time the Division of Facility Services determined that the need for one more LINAC existed in the service area which encompasses Franklin and Wake counties; there were 5 applications for that CON, all of them in Raleigh.

Finally, the acquisition of a very expensive new LINAC is simply not a viable business venture in Franklin County. It is no secret that Franklin County is not the richest county in the state.  Because of the high percentage of elderly, uninsured and underinsured patients in the county, the “payer mix” is unfavorable for reimbursement.  In order to support the acquisition of very expensive medical equipment (UNC-CH recently submitted a CON application for a LINAC costing $9.8 million) there must be adequate reimbursement to service the debt, afford the sky-high service contract to keep the equipment running, and pay the highly-trained personnel to run it.

It is likely that the people behind the legal challenge understand all of this.  So it is implausible that they would be unaware of the potential consequences of their actions.  It is also unlikely that their efforts to shut down the Cancer Center will end even after the CON decision has been rendered. If Dr. McLaurin had not prevailed in defending the Franklin County Cancer Center’s right to operate, or if he is unable to overcome their continuing efforts to undermine his center, it is almost inevitable that Franklin County will be deprived of this very valuable, life-saving service forever!

One must ask, is this the kind of reputation Franklin County wants to have when it comes to recruiting new businesses or services to this community?