(Editor's note: During the month of October, NC Policy Watch is releasing a series of special reports that detail some of the policy initiatives that are likely to gain traction in the North Carolina General Assembly if ideologues on the far right assume significant power in 2011. This is the latest of those reports).
Threats to health care and the environment posed by a right-wing legislature
The 2010 general election commences today at selected polling places across North Carolina that are open for early voting. It should be the start of an interesting three weeks. Will voters turn out in large numbers? Will the pattern of most non-presidential year elections (in which the party out of power usually gains seats) hold? Will the widespread frustration with the pace of the economic recovery lead voters to elect a new, far-right General Assembly?
If such change does take place, voters may get a lot more than they bargained for. As we reported last week in this space and in the Fitzsimon File, the election of an ultra-conservative legislature would likely lead to number of counter-productive policy developments in the areas of state tax policy, consumer protection, and LGBT rights. In this edition of the Weekly Briefing, we look at two more areas: health care and environmental protection.
Health care: backtracking on reform?
With the historic passage of national health care reform this past spring, most Americans are coming to accept and look forward to the fact that the country’s long nightmare as the developed world’s most underinsured and under-served nation is finally coming to an end. As of just a few weeks ago, several important changes regarding issues like pre-existing conditions, lifetime caps and coverage of young adults have already gone into effect. Unfortunately, ideologues on the far right remain dedicated to a strategy that would roll back (or at least gum up the works) for as much of reform as possible.
Here in North Carolina, such action would be likely to take several forms. According to one of the state’s noisiest right-wing voices, the John Locke Foundation, lawmakers should embark upon a complete about-face when it comes to health care policy and embrace a program of aggressive deregulation of insurers and providers. This is from an August 2010 report that the group distributed:
"The simplest alternative to the hodgepodge of licensing requirements, limits to scope of practice, black-market medicine, and political fighting for state approval is to eliminate the need for licensing and certificates of need…. Eliminate the law against practicing medicine, and you eliminate the demand for licensing. There already are a number of methods in the private sector to ensure quality.
Malpractice insurance and lawsuits already provide a legal means of disciplining medical providers that is both more effective and more comprehensive than licensing boards, though still far from perfect. Practitioners often receive credentials from a private, professional association in addition to their state license. Hospitals also review and credential doctors to practice in their facilities. (Emphasis supplied).
Got that? The state's most visible conservative policy group (an organization that would clearly have the ear of several powerful legislative leaders in the event of a conservative takeover) seriously argues that the solution to rising health care costs is for the state to deregulate medicine – literally, for the state of North Carolina to get out of the regulatory business. Under the Locke scheme, North Carolina would simply leave it up to the "market" and self-appointed private entities to decide if any Tom, Dick or Harry's decision to hang out a shingle and proclaim himself a "doctor" is legitimate.
Of course, while such a scenario remains farfetched (hopefully anyway), other extreme proposals may gain real traction. Among these items:
- Elimination of several so-called "optional" services provided to the poor and elderly under the state's Medicaid program. This proposal has long been touted by conservatives and would mean the end of such "extravagances" as ambulance services, dental care, prosthetic limbs and prescription drug assistance for thousands of low-income people.
- Blockage of the creation of a state "health care exchange" for individuals and small businesses as part of the federal reform law. Ironically, this would likely mean that the state would face even greater federal control.
- Closing the door on new admissions to the state's Health Choice program that serves low income children – something that's already been hard to prevent at times during past General Assemblies.
In short, at the very moment at which they have real reason to be truly optimistic for the first time in decades about the coming accessibility of health care, North Carolinians could be empowering a group of lawmakers dedicated to severing the policy rope on which their rescue depends.
The environment: Back to the 1960's
It's hard to think of a field of public policy in which public sentiment and attitudes are more at odds with the messages and priorities that comprise the right's agenda than the environment. At the point in history at which humans are finally coming to grips with the fact that the biosphere itself is genuinely endangered by unfettered, carbon-fueled industrial development and sprawl, conservatives in North Carolina are poised to return the state to the kinds of policies (or, more accurately, the lack of policies) that one would have encountered in the a half a century ago.
Consider, once again, the recommendations of the Locke Foundation. The group's top 2010 environmental policy recommendations include:
- "Abandon all state attempts to fight global warming,"
- Repeal the state's renewable portfolio standard that requires increased reliance on renewable energy for electricity production,
- Repeal the state's painstakingly negotiated 2008 drought preparedness and response law, and
- Privatize the state's public water infrastructure.
Other public initiatives that seem sure to wind up on the state's "endangered policies list" in a conservative, corporate-friendly legislature include:
- Public restrictions on the development of dangerous coal and nuclear power plants,
- Any state opposition to off-shore oil drilling on the Outer Banks,
- Public promotion of solar and wind power and other "green" technologies,
- Road building and land use policies (like the 2009 "congestion relief and intermodal transport" law) that concentrate on combating sprawl, conserving open space, discouraging automobile use and promoting new investments in urban light rail and other forms of public transit,
- Restrictions on billboard placement on rural and/or scenic highways, and
- Maintenance of investments in programs like the Clean Water Management Trust Fund, the Agricultural Development and Farmland Preservation Trust Fund, and any number of programs that fund state parks and open space.
Put bluntly, it is a course of action that's straight out of the playbook of Exxon-Mobil, Massey Coal or the Chinese government – a full speed ahead, no holds barred, damn the consequences, approach that might have made some sense in the era of tailfins and the space race, but that today will only make our already terrifying challenges that much worse.
Going forward
As noted this is the latest of several special features regarding some of the likely agenda items of a far right General Assembly in 2011. Check back frequently in the days ahead for additional reports.
