Weekly Briefing

North Carolina is at an important juncture in its history. Nearly a decade into the new century, most state leaders have yet to fully embrace the idea of North Carolina as a modern, forward-thinking state that is engaged on the world stage. Rather than actively and affirmatively engaging the future and using all the tools at our disposal (public and private) to build a prosperous and environmentally sustainable economy that benefits as many people as possible, too many leaders are thinking small - of a society driven only by individual greed and comfort for those who can grab it and of a government whose main task is to abet such a model. 

The results of this passive, stick-in-the-mud approach are plain to see: large and growing economic, regional and racial divides, a resurgence of nativism, an increasingly obsolete, inadequate and regressive public revenue system, a fragile and endangered natural environment, persistent corruption in government and an often disabling cynicism in the general public.    

Over the next several weeks, NC Policy Watch will be offering a series of policy prescriptions designed to address this situation. We call it "Agenda for Progress 2009." In it, readers will find an ambitious but practical set of "can do" proposals that will, if enacted, move North Carolina aggressively into the future.

These proposals will not be easy or pain free. They will require some sacrifice from all corners - particularly those who have benefited the most from the current system. But they will also be forward looking and sustainable - the kinds of affirmative steps that appeal to our best instincts and that reject the narrow-minded, "dog eat dog" selfishness of those who seek to take the state back in time. We welcome your feedback and suggestions.

Issue # 1 - Healthcare

No issue on the American policy scene stands out like the proverbial sore thumb more than healthcare. Put simply, our laissez faire system of big profits and poorly managed expenditures is broken and unsustainable. We spend twice as much per capita as any other advanced country while reaping poorer results when it comes to life expectancy and other key health outcomes.

Here in North Carolina, the ranks of the uninsured continue to swell and the pressures on our economy (and state budget) continue to increase. As our population ages, we simply must adopt dramatic changes in order to avoid fiscal and economic collapse. 

Ultimately, comprehensive federal action will be necessary to fix this problem. In the interim, however, individual states can do much to help themselves and to act as laboratories for innovative change. In this regard, North Carolina should seize the opportunity to advance practical and pragmatic changes that can directly improve the quality of the lives of its citizens while at the same time bettering the state's economy.

The plan: Guaranteed affordable choice  

Recently, the North Carolina Health Access Coalition released a special report that provides a blueprint for commencing the kinds of reforms that will be necessary to build a 21^st Century health care system. Entitled Guaranteed Affordable Choice: A plan to provide quality health coverage to all North Carolinians, the report lays out several doable, common sense steps that state leaders can and should enact in the near future. Key, near-term recommendations are summarized below. (You can check out the list of initial organizational endorsements here).

Cover every child and make prevention a priority - Every sick child should have a family doctor from whom to obtain care. Affordable child health coverage that makes regular doctor's visits, exercise, and eating right a priority for families promotes health and reduces health care costs. To meet this objective North Carolina should:

• Fully fund the existing NC Health Choice and Medicaid programs so that all eligible children can enroll.
• Change the new NC Kids Care sliding-scale premium health insurance program so that all North Carolina families who don't qualify for Medicaid or Health Choice can buy coverage. Families earning above 300% of the Federal Poverty Level ($63,600 for a family of four) will pay the full cost of coverage. Families earning less will pay premiums on a sliding scale depending on income, with higher-income families paying more.
• Families able to afford health coverage for their kids but who fail to purchase it will pay a penalty on their state income tax returns.

Make health insurance less expensive for small businesses and their employees - The rising costs of health insurance hit small businesses hardest. Innovation and creativity are stifled as businesses and entrepreneurs have to waste time, energy, and money pursuing increasingly unaffordable health plans to cover themselves and to attract employees. Like everyone else, small business owners want affordable health coverage. To meet this objective North Carolina should:

• Ban insurance companies from charging more to small businesses because owners, workers, or family members have pre-existing health conditions.
• Consolidate the small business and individual health insurance markets to better spread risk, lower costs, and allow individuals to more easily purchase coverage.
• Enact a subsidized small business health plan, sold on the private insurance market that provides real coverage at an affordable cost.
• Subsidize the health plan so it is truly affordable for all small businesses.

Control healthcare costs - Important cost control measures should include:

• Moving the state health care system toward preventing disease first rather than treating it last. Smoking cessation, exercise, healthy diets and regular visits to the doctor should be encouraged in every health plan offered in North Carolina.
• Living a healthier lifestyle cannot start and end with health insurance changes. We must increase funding and encourage innovation around public health education in schools, workplaces, and public facilities.
• North Carolina should join the state consortium on drug costs and effectiveness spearheaded by Consumer Reports (http://www.crbestbuydrugs.com/) and use information on classes of effective and lower cost drugs to reduce drug costs for all health plans - both public and private.
• Establish a "North Carolina Institute for Health Care Quality, Cost, and Research" as a collaborative effort between the state and major public and private universities with substantial health care research capabilities. The Institute would collect and initiate research on the main drivers of health care costs - the increasing use of expensive new high technology procedures, medical devices, and drugs. Research will examine the effectiveness of new treatments as compared to older, established treatments and make recommendations for coverage of new procedures. The Institute will disseminate research, cost saving summaries, policy recommendations, and public health information to legislators, policymakers, health care providers, and state residents.

Going forward

Though practical and relatively modest in scope, the Health Access Coalition reform proposals will not be easily attained. The combination of powerful corporate interests and reactionary ideological opponents constitutes a formidable roadblock to progress. Expected state revenue shortfalls won't help.

As the recent collapse on Wall Street has so vividly demonstrated, however, we operate at tremendous risk to public well-being when we turn over essential elements of our economy to ideologues and the unrestricted hands of enormous, profit-driven private interests that bear no responsibility to the common good. To build a sustainable and just community, we must invest in public structures that direct and utilize market forces rather than simply becoming slaves to them.

Thus, while it may be a tough fight, healthcare reform is one that North Carolinians simply cannot shirk or afford to lose if they hope to seize control of their collective destiny. Now is the time to get started.  

To learn more about (or endorse) the Health Access Coalition's plan for guaranteed affordable choice, contact Coalition director Adam Searing at adam@ncjustice.org.

Action item #1 - Guaranteed, affordable health care choice

North Carolina is at an important juncture in its history. Nearly a decade into the new century, most state leaders have yet to fully embrace the idea of North Carolina as a modern, forward-thinking state that is engaged on the world stage. Rather than actively and affirmatively engaging the future and using all the tools at our disposal (public and private) to build a prosperous and environmentally sustainable economy that benefits as many people as possible, too many leaders are thinking small - of a society driven only by individual greed and comfort for those who can grab it and of a government whose main task is to abet such a model. 

The results of this passive, stick-in-the-mud approach are plain to see: large and growing economic, regional and racial divides, a resurgence of nativism, an increasingly obsolete, inadequate and regressive public revenue system, a fragile and endangered natural environment, persistent corruption in government and an often disabling cynicism in the general public.    

Over the next several weeks, NC Policy Watch will be offering a series of policy prescriptions designed to address this situation. We call it "Agenda for Progress 2009." In it, readers will find an ambitious but practical set of "can do" proposals that will, if enacted, move North Carolina aggressively into the future.

These proposals will not be easy or pain free. They will require some sacrifice from all corners - particularly those who have benefited the most from the current system. But they will also be forward looking and sustainable - the kinds of affirmative steps that appeal to our best instincts and that reject the narrow-minded, "dog eat dog" selfishness of those who seek to take the state back in time. We welcome your feedback and suggestions.

Issue # 1 - Healthcare

No issue on the American policy scene stands out like the proverbial sore thumb more than healthcare. Put simply, our laissez faire system of big profits and poorly managed expenditures is broken and unsustainable. We spend twice as much per capita as any other advanced country while reaping poorer results when it comes to life expectancy and other key health outcomes.

Here in North Carolina, the ranks of the uninsured continue to swell and the pressures on our economy (and state budget) continue to increase. As our population ages, we simply must adopt dramatic changes in order to avoid fiscal and economic collapse. 

Ultimately, comprehensive federal action will be necessary to fix this problem. In the interim, however, individual states can do much to help themselves and to act as laboratories for innovative change. In this regard, North Carolina should seize the opportunity to advance practical and pragmatic changes that can directly improve the quality of the lives of its citizens while at the same time bettering the state's economy.

The plan: Guaranteed affordable choice  

Recently, the North Carolina Health Access Coalition released a special report that provides a blueprint for commencing the kinds of reforms that will be necessary to build a 21^st Century health care system. Entitled Guaranteed Affordable Choice: A plan to provide quality health coverage to all North Carolinians, the report lays out several doable, common sense steps that state leaders can and should enact in the near future. Key, near-term recommendations are summarized below. (You can check out the list of initial organizational endorsements here).

Cover every child and make prevention a priority - Every sick child should have a family doctor from whom to obtain care. Affordable child health coverage that makes regular doctor's visits, exercise, and eating right a priority for families promotes health and reduces health care costs. To meet this objective North Carolina should:

• Fully fund the existing NC Health Choice and Medicaid programs so that all eligible children can enroll.
• Change the new NC Kids Care sliding-scale premium health insurance program so that all North Carolina families who don't qualify for Medicaid or Health Choice can buy coverage. Families earning above 300% of the Federal Poverty Level ($63,600 for a family of four) will pay the full cost of coverage. Families earning less will pay premiums on a sliding scale depending on income, with higher-income families paying more.
• Families able to afford health coverage for their kids but who fail to purchase it will pay a penalty on their state income tax returns.

Make health insurance less expensive for small businesses and their employees - The rising costs of health insurance hit small businesses hardest. Innovation and creativity are stifled as businesses and entrepreneurs have to waste time, energy, and money pursuing increasingly unaffordable health plans to cover themselves and to attract employees. Like everyone else, small business owners want affordable health coverage. To meet this objective North Carolina should:

• Ban insurance companies from charging more to small businesses because owners, workers, or family members have pre-existing health conditions.
• Consolidate the small business and individual health insurance markets to better spread risk, lower costs, and allow individuals to more easily purchase coverage.
• Enact a subsidized small business health plan, sold on the private insurance market that provides real coverage at an affordable cost.
• Subsidize the health plan so it is truly affordable for all small businesses.

  Control healthcare costs - Important cost control measures should include:

• Moving the state health care system toward preventing disease first rather than treating it last. Smoking cessation, exercise, healthy diets and regular visits to the doctor should be encouraged in every health plan offered in North Carolina.
• Living a healthier lifestyle cannot start and end with health insurance changes. We must increase funding and encourage innovation around public health education in schools, workplaces, and public facilities.
• North Carolina should join the state consortium on drug costs and effectiveness spearheaded by Consumer Reports (www.crbestbuydrugs.com) and use information on classes of effective and lower cost drugs to reduce drug costs for all health plans - both public and private.
• Establish a "North Carolina Institute for Health Care Quality, Cost, and Research" as a collaborative effort between the state and major public and private universities with substantial health care research capabilities. The Institute would collect and initiate research on the main drivers of health care costs - the increasing use of expensive new high technology procedures, medical devices, and drugs. Research will examine the effectiveness of new treatments as compared to older, established treatments and make recommendations for coverage of new procedures. The Institute will disseminate research, cost saving summaries, policy recommendations, and public health information to legislators, policymakers, health care providers, and state residents.

Going forward

Though practical and relatively modest in scope, the Health Access Coalition reform proposals will not be easily attained. The combination of powerful corporate interests and reactionary ideological opponents constitutes a formidable roadblock to progress. Expected state revenue shortfalls won't help.

As the recent collapse on Wall Street has so vividly demonstrated, however, we operate at tremendous risk to public well-being when we turn over essential elements of our economy to ideologues and the unrestricted hands of enormous, profit-driven private interests that bear no responsibility to the common good. To build a sustainable and just community, we must invest in public structures that direct and utilize market forces rather than simply becoming slaves to them.

Thus, while it may be a tough fight, healthcare reform is one that North Carolinians simply cannot shirk or afford to lose if they hope to seize control of their collective destiny. Now is the time to get started.  

To learn more about (or endorse) the Health Access Coalition's plan for guaranteed affordable choice, contact Coalition director Adam Searing at adam@ncjustice.org.

 

North Carolina is at an important juncture in its history. Nearly a decade into the new century, most state leaders have yet to fully embrace the idea of North Carolina as a modern, forward-thinking state that is engaged on the world stage. Rather than actively and affirmatively engaging the future and using all the tools at our disposal (public and private) to build a prosperous and environmentally sustainable economy that benefits as many people as possible, too many leaders are thinking small - of a society driven only by individual greed and comfort for those who can grab it and of a government whose main task is to abet such a model. 

 

The results of this passive, stick-in-the-mud approach are plain to see: large and growing economic, regional and racial divides, a resurgence of nativism, an increasingly obsolete, inadequate and regressive public revenue system, a fragile and endangered natural environment, persistent corruption in government and an often disabling cynicism in the general public.    

 

Over the next several weeks, NC Policy Watch will be offering a series of policy prescriptions designed to address this situation. We call it “Agenda for Progress 2009.” In it, readers will find an ambitious but practical set of “can do” proposals that will, if enacted, move North Carolina aggressively into the future.

 

These proposals will not be easy or pain free. They will require some sacrifice from all corners - particularly those who have benefited the most from the current system. But they will also be forward looking and sustainable - the kinds of affirmative steps that appeal to our best instincts and that reject the narrow-minded, “dog eat dog” selfishness of those who seek to take the state back in time. We welcome your feedback and suggestions.

 

Issue # 1 - Healthcare

 

No issue on the American policy scene stands out like the proverbial sore thumb more than healthcare. Put simply, our laissez faire system of big profits and poorly managed expenditures is broken and unsustainable. We spend twice as much per capita as any other advanced country while reaping poorer results when it comes to life expectancy and other key health outcomes.

 

Here in North Carolina, the ranks of the uninsured continue to swell and the pressures on our economy (and state budget) continue to increase. As our population ages, we simply must adopt dramatic changes in order to avoid fiscal and economic collapse. 

 

Ultimately, comprehensive federal action will be necessary to fix this problem. In the interim, however, individual states can do much to help themselves and to act as laboratories for innovative change. In this regard, North Carolina should seize the opportunity to advance practical and pragmatic changes that can directly improve the quality of the lives of its citizens while at the same time bettering the state’s economy.

 

The plan: Guaranteed affordable choice  

 

Recently, the North Carolina Health Access Coalition released a special report that provides a blueprint for commencing the kinds of reforms that will be necessary to build a 21^st Century health care system. Entitled Guaranteed Affordable Choice: A plan to provide quality health coverage to all North Carolinians, the report lays out several doable, common sense steps that state leaders can and should enact in the near future. Key, near-term recommendations are summarized below. (You can check out the list of initial organizational endorsements here).

 

Cover every child and make prevention a priority - Every sick child should have a family doctor from whom to obtain care. Affordable child health coverage that makes regular doctor’s visits, exercise, and eating right a priority for families promotes health and reduces health care costs. To meet this objective North Carolina should:

 

• Fully fund the existing NC Health Choice and Medicaid programs so that all eligible children can enroll.
• Change the new NC Kids Care sliding-scale premium health insurance program so that all North Carolina families who don’t qualify for Medicaid or Health Choice can buy coverage. Families earning above 300% of the Federal Poverty Level ($63,600 for a family of four) will pay the full cost of coverage. Families earning less will pay premiums on a sliding scale depending on income, with higher-income families paying more.
• Families able to afford health coverage for their kids but who fail to purchase it will pay a penalty on their state income tax returns.

 

Make health insurance less expensive for small businesses and their employees - The rising costs of health insurance hit small businesses hardest. Innovation and creativity are stifled as businesses and entrepreneurs have to waste time, energy, and money pursuing increasingly unaffordable health plans to cover themselves and to attract employees. Like everyone else, small business owners want affordable health coverage. To meet this objective North Carolina should:

 

• Ban insurance companies from charging more to small businesses because owners, workers, or family members have pre-existing health conditions.
• Consolidate the small business and individual health insurance markets to better spread risk, lower costs, and allow individuals to more easily purchase coverage.
• Enact a subsidized small business health plan, sold on the private insurance market that provides real coverage at an affordable cost.
• Subsidize the health plan so it is truly affordable for all small businesses.

 

  Control healthcare costs - Important cost control measures should include:

• Moving the state health care system toward preventing disease first rather than treating it last. Smoking cessation, exercise, healthy diets and regular visits to the doctor should be encouraged in every health plan offered in North Carolina.
• Living a healthier lifestyle cannot start and end with health insurance changes. We must increase funding and encourage innovation around public health education in schools, workplaces, and public facilities.
• North Carolina should join the state consortium on drug costs and effectiveness spearheaded by Consumer Reports (www.crbestbuydrugs.com) and use information on classes of effective and lower cost drugs to reduce drug costs for all health plans - both public and private.
• Establish a “North Carolina Institute for Health Care Quality, Cost, and Research” as a collaborative effort between the state and major public and private universities with substantial health care research capabilities. The Institute would collect and initiate research on the main drivers of health care costs - the increasing use of expensive new high technology procedures, medical devices, and drugs. Research will examine the effectiveness of new treatments as compared to older, established treatments and make recommendations for coverage of new procedures. The Institute will disseminate research, cost saving summaries, policy recommendations, and public health information to legislators, policymakers, health care providers, and state residents.

 

Going forward

 

Though practical and relatively modest in scope, the Health Access Coalition reform proposals will not be easily attained. The combination of powerful corporate interests and reactionary ideological opponents constitutes a formidable roadblock to progress. Expected state revenue shortfalls won’t help.

 

As the recent collapse on Wall Street has so vividly demonstrated, however, we operate at tremendous risk to public well-being when we turn over essential elements of our economy to ideologues and the unrestricted hands of enormous, profit-driven private interests that bear no responsibility to the common good. To build a sustainable and just community, we must invest in public structures that direct and utilize market forces rather than simply becoming slaves to them.

 

Thus, while it may be a tough fight, healthcare reform is one that North Carolinians simply cannot shirk or afford to lose if they hope to seize control of their collective destiny. Now is the time to get started.  

 

To learn more about (or endorse) the Health Access Coalition’s plan for guaranteed affordable choice, contact Coalition director Adam Searing at adam@ncjustice.org.< -->

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This entry was posted on Wednesday, September 24th, 2008 at 11:52 am and is filed under Weekly Briefing. You can follow any responses to this entry through the RSS 2.0 feed.