CONs are the means where states prohibit competition for their “pals”.
CON laws of course are primarily designed to protect existing market shares of medical providers. In the past I worked both sides of the fence for my employers. I can help argue for and against the licensing of a tenth MRI machine in a geographical area.
I spent more than a decade obtaining CON approvals for a national developer of full service retirement communities and was part of the national health planning process when CON laws were being developed in the mid 1970s. One of the earliest targets of the CON process were CT scanners. At the time CT scanners cost over $1 million and were seen by health planners as expensive hospital “toys” that had little medical need. Fortunately the CT technology became less expensive avoiding CON review thresholds and the life saving benefits were better understood. Had the CON bean counters prevailed there would only be a handful of CT scanners in the US and thousands of patients (including my wife who had a CT scan that detected a large cancer tumor on her kidney) would have died.