> health care provider requiring a "certificate of need" [0] to open up, the results are always the same: no competition

That was the exact motivation of CoNs. Guess who lobbied for them? The healthcare industry.

Depending on the state you're in, it could be anything from bureaucratic red tape to dissuade new providers to the near-literal "We will ask your competitors how much business they will lose by you opening," that gives those competitors the ability to object on those grounds alone.