The die might well be cast on the rejection of Riverside Health System’s current plan to build a hospital on the outskirts of Smithfield.

We go into Friday’s “fact-finding” conference to be held by state Health Commissioner Dr. Norman Oliver in Richmond with low expectations that he will reverse his staff’s recommendation to deny a “certificate of public need” for the 50-bed hospital. That’s no fault of Isle of Wight and Surry elected, appointed and civic leaders, who turned out in big numbers for an October public hearing and have flooded VDH with letters in support of the project.

Barring a surprise reversal by Oliver, the community should quickly turn the focus of its lobbying efforts to overdue reform of Virginia’s approach to regulating the health care marketplace. So-called “certificates of need,” which are needed from the state to build much of anything in the way of medical facilities, have become too inflexible in a modern economy where consumers are accustomed to choices when purchasing products and services. Head-scratchers like the rejection of a Smithfield hospital also fuel cynicism about the process, especially when bureaucrats’ logic includes availability of hospital beds in Norfolk and Virginia Beach. True, you can get to Riverside’s anchor hospital in Newport News in 30 minutes if you are extremely lucky when crossing the James River Bridge, but it’s just as likely to take longer. And if Suffolk’s hospital is part of the calculation, a comparison must be made to Franklin and Southampton, which has its own full-service hospital about the same distance from Suffolk as Smithfield is.

Isle of Wight, as the fastest-growing community in rural Western Tidewater, deserves its own hospital by any metric, especially when a reputable provider like Riverside is willing to risk its own money on construction, maintenance and operations.

We urge Isle of Wight’s and Surry’s delegation in the state legislature to carry the water on a thorough legislative review of anti-competition laws in the health care sector. The coming legislative session is a timely occasion to do so, with the Republican Party taking control of the governorship and the House of Delegates. The GOP historically has been the party of free markets, which are sorely needed in the medical sector.