This op-ed by State Policy Network’s Josh Archambault and the Palmetto Promise Institute’s Oran Smith first ran at Forbes

Long-time talk show host Joey Hudson had to wait an excruciating three weeks for a hernia operation in South Carolina. To add insult to injury, his friend in Florida who had the same diagnosis was able to receive surgery in just three days.

Why the difference? South Carolina has had barriers called Certificate of Need (CON) laws, which are government permission slips needed to start or expand a healthcare business. These laws restricted how many care options he had. With certain hernias, everyday counts, and the pain can be unbearable. But these laws are difficult to repeal with powerful special-interest groups like hospitals fighting to keep them, and those who would benefit from a repeal—patients—are not organized.

South Carolina’s 2023 CON repeal is the most comprehensive in the United States since Pennsylvania’s repeal in 1996. We believe this repeal campaign provides valuable lessons for how to tackle bigger reforms that have concentrated benefits, but diffused costs which impact patient access. Under CON in South Carolina, 30 percent of counties have no OB/GYNs and eight counties have no hospital.

So, how did South Carolina achieve the broad success of a state like Florida without first passing incremental legislation like Georgia, Tennessee, and North Carolina?

Read the full piece at Forbes here.