Court Opinion

ID: 9686448
Source: CourtListenerOpinion
Date Created: 2023-08-24 15:48:27.756296+00
Date Added: 2024-06-11T18:18:19.024334
License: Public Domain

Caporale, J.,
dissenting.
In my view the majority has reached a result which is legally incorrect, and I therefore respectfully dissent.
Grand Island is in Nebraska Department of Health planning subarea III, which consists of 21 counties in the south-central part of the state. The area includes Adams County, in which the city of Hastings is situated; Buffalo County, in which the city of Kearney is placed; and Hall County, in which the city of Grand Island is located.
At the time of the hearing before the Nebraska Certificate of Need Appeal Panel, radiation therapy was available within subarea III at two places: Kearney, at a site 43 miles from the proposed location of the linear accelerator for which applicant seeks approval, and Hastings, at a point only 26 miles from the applicant’s proposed facility.
Although the linear accelerator at Kearney has been in place since September of 1982, it was not delivering 6,000 treatments per year at the time of the appeal panel hearing. Moreover, the evidence fails to establish that the cobalt unit in Hastings was then delivering 6,000 treatments per year. While the evidence *130suggests that the applications of cobalt and linear acceleration therapies differ, the evidence is that an application for the installation of a linear accelerator at Hastings had already been approved. There is no evidence that such approval has been withdrawn or that installation of the approved unit has been abandoned.
Pitted against that history is the applicant’s prophecy, through its assistant administrator, that its additional accelerator will deliver 7,550 cancer treatments per year. That prediction is based on the assistant administrator’s assumption that the applicant will entice cancer patients in varying percentages from 17 counties, only 9 of which are in subarea III. This witness himself concedes that his assumption concerning the applicant’s market shares from those 17 counties is but a “gut reaction,” that is to say, a guess without any statistical foundation whatsoever — speculation, pure and simple. Not only does the evidence reveal no basis for the number of patients the applicant assumes it will capture, the assumption completely ignores the fact that a linear accelerator has been approved for positioning at Hastings. For those two reasons alone, there is no more relationship between the applicant’s presaging of 7,550 treatments per year and reality than there is between reality and a tale by the Brothers Grimm.
The true basis for the applicant’s effort is best revealed, perhaps unconsciously, by the local medical practitioner’s lament that the Grand Island hospitals lose patients “because we have to let them go somewhere else for radiation therapy.” While such a parochial concern is understandable, it has no legal significance. See Beatrice Manor v. Department of Health, 219 Neb. 141, 362 N.W.2d 45 (1985), which holds that merely demonstrating a local demand for a nursing home does not establish a need for one. In so holding, we observed that while demand connotes an immediate preference to live in a particular nursing facility, need focuses on long-range plans to provide required services to an entire population.
The Legislature in its wisdom has enacted legislation designed to eliminate unnecessary duplication of certain medical facilities in an effort to reduce the overall cost of health care for the citizens of the state. This court is obligated to *131adhere to that legislatively declared policy.
For the foregoing reasons, I would reverse the decision of the district court affirming the appeal panel and reinstate the decision of the Certificate of Need Review Committee denying the application.
Shanahan and Grant, J J., j oin in this dissent.