It is time for a dramatic change in the COPN laws in the state of Virginia.   At a time when we are dissecting healthcare in every imaginable way to try and improve quality and value,  these laws  stand in stark contrast to our efforts.   It is only with competition that will ever be able to the lower the extortionate cost  and suboptimal quality of modern healthcare.   The current deficits in healthcare are largely due to the hospital and healthcare system monopolies. Without substantial change in these laws, actually even better repeal, we are just not going to get to these twin goals. It's frankly not in the interest of "big" healthcare.