May 28, 2010
Blaming privatization for bad legislative priorities
Posted by Joseph Coletti at 3:50 PM
Paul Brinich, a psych professor at UNC, is against privatization because of the experience with mental health reform since 2001. But the problems he describes are not the result of privatization:
The LMEs [local mental health care managers] were supposed to be the new architects of local services; but the LMEs did not have the money necessary to attract a full range of providers, nor could they properly coordinate their efforts.
The lack of funding was because politicians decided mental health funding was a low priority.
Despite this, one LME has done a better job taking care of its patients at less cost than the rest of the system. PBH (Piedmont Behavioral Health) was able to operate under a Medicaid waiver that paid it per person served instead of for each service provided. PBH was then able to work with providers and consumers to find the right mix of services, pay for things not normally covered by Medicaid, and avoid paying for care that consumers did not need.
PBH's success was all but unnoticed until the community support services fiasco a couple years ago, but management documents its success keeping people out of state hospitals and on track with their treatment. The budget this year finally expands, to two more LMEs, the Medicaid waiver under which PBH has been able to accomplish this.
Given the performance of state-run mental hospitals before and since 2001, can anyone seriously suggest that the unreformed system would have done better?
New Carolina Journal Online exclusive
Posted by Mitch Kokai at 3:01 PM
The latest Carolina Journal Online exclusive features Anthony Greco's CarolinaJournal.tv report about the real size of North Carolina's budget, which is much larger than the $19 billion discussed in most media reports.
Three good reads on health care reform
Posted by John Hood at 1:47 PM
Here are three good reads on health care reform, all written or co-written by John Goodman of the National Center for Policy Analysis.
In this first piece, from Goodman’s blog, he questions the need for a government insurance mandate to address the supposed “free rider” problem of uninsured Americans consuming medical services. Those who make the argument don’t seem to understand the basic math of the situation:
Imagine a community in which everyone dutifully pays health insurance premiums every month, except Joe — who spends his money instead on other consumption. Then one day Joe gets sick and finds that he cannot pay the full costs of his medical care. So the rest of us — being compassionate sorts — chip in and pay for the remainder of Joe’s care. Upshot: When he was healthy, Joe got to consume all his income instead of paying premiums and after he got sick he managed to “free ride” on everyone else’s generosity. You can think of this as both an ethical problem and as an economic problem. Ethically, Joe is getting an undeserved benefit paid for by others bearing an undeserved cost. Economically, Joe is imposing an external cost on others. If we let Joe get away with not paying his own way, others might emulate his example, and the cost could grow through time.
Turning to the “mandate solution,” let’s add a bit of realism here. On the average, people without health insurance consume only about half as much health care as everyone else — after adjusting for other characteristics; and of the amount of care they consume, they pay for about half from their own resources. So, roughly speaking, the “free ride” for the average uninsured person is equal to about one-fourth of what everyone else spends on health care.
With these facts in mind, it should be clear that forcing Joe to buy insurance that pays for the same amount of care everyone else gets is not fair or equitable. That would be overkill. It would be overkill four times over. To get Joe to pay his own way, we need to take from him an amount of money equal to one-fourth the average health care spending of insured people and either distribute it to everyone else or put it in a fund to pay for uncompensated care required by Joe and others like him.
There is a solution, but ObamaCare don’t contain it. In fact, ObamaCare worsens the problem.
In another article, Goodman argues that consumer-driven health care remains the best approach for deterring wasteful consumption of medical services. And in a third piece, he discusses the deleterious fiscal impact of ObamaCare’s Medicaid expansion on state budgets.
JLF's own Joe Coletti has commented on these issues, too. Check out this and this.
D'Annunzio threatens to sue Fetzer
Posted by David N. Bass at 1:43 PM
Just when you think it can't get more bizarre, it does. Tim D'Annunzio, 8th Congressional District GOP candidate, has threatened to sue state GOP Chairman Tom Fetzer.
According to ConservativeNC.com:
Mr. D'Annunzio is considering filing a civil law suit against you [Fetzer] in which he would seek damages in excess of five million dollars ($5,000,000.00) caused by your comments, which resulted in matters from his youth and allegations from a divorce which occurred fifteen years ago being used to impugn Mr. D'Annunzio and to hold him up to ridicule, harming him in his campaign, his business and professional life, and causing great pain and anguish to his family.
The curious part is that D'Annunzio said at a press conference Wednesday that he didn't fault anybody in the Republican Party and wanted them to support him again. Not sure how suing will accomplish that.
re: I don't have
Posted by Dr. Roy Cordato at 1:25 PM
Does this mean that we will soon be seeing Bill Clinton with his hand raised in front a grand jury once again? Maybe saying something like "it depends on what the meaning of the word bribe is"?
'I did not have ... formal discussions ... with that congressman ...'
Posted by Rick Henderson at 11:01 AM
You can't make this stuff up. The White House is expected to issue a statement today admitting that former President Bill Clinton was used as the intermediary to
bribe lean on informally check the interest of Pennsylvania Rep. Joe Sestak in taking a position with the Obama administration if he would drop out of the Democratic Senate primary.
From The Washington Post's Greg Sargent:
The White House maintains that Clinton's overtures to Sestak merely constituted an effort to gauge his seriousness about the race, the sources say, adding that Clinton was informally discussing the range of options open to Sestak as part of a larger conversation meant to ascertain Sestak's thinking.
Yeah, informal discussions. Nothing concrete mentioned. Sounds about right.
Posted by Dr. Roy Cordato at 10:51 AM
This is a very good article by Sheldon Richman, editor of The Freeman magazine. Here are some snippets making Sheldon's point:
...a libertarian who holds his or her philosophy out of a conviction that all men and women are (or should be) equal in authority and thus none may subordinate another against his or her will (the most
common justification) — that libertarian would naturally object to even
nonviolent forms of subordination. Racism is just such a form (though
not the only one), since existentially it entails at least an
obligatory humiliating deference by members of one racial group to
members of the dominant racial group...Seeing fellow human beings locked into a servile role – even if that role is not explicitly maintained by force – properly, reflexively summons
in libertarians an urge to object...Another, related, libertarian reason to oppose nonviolent racism is
that it all too easily metamorphoses from subtle intimidation into
outright violence. Even in a culture where racial “places” have long
been established by custom and require no coercive enforcement, members
of a rising generation will sooner or later defiantly reject their
assigned place and demand equality of authority. What happens then? It
takes little imagination to envision members of the dominant race —
even if they have professed a “thin” libertarianism to that point —
turning to physical force to protect their “way of life.”...a libertarian campaign
against racism in public accommodations should take the form of
boycotts, sit-ins, and the like, rather than assault and destruction of
property... it follows that State action is also
beyond the pale, since government is force. Hence the libertarian
objection to government bans on segregation in privately owned places...It would be a mistake, however, to think that ruling out government
action would severely limit the scope of protest...lunch counters throughout the American south were being desegregated
years before passage of the 1964 Act. How so? Through sit-ins,
boycotts, and other kinds of nonviolent, nongovernmental
confrontational social action.
I would also add that an ideology of racism is inherently collectivist in its world view. Racisim strips people of their individual identity and judges them as part of a group or collective. On the other hand, an ideology of true anti-racism, i.e. an ideology that judges people as individuals and not as members of a race (and we can include gender or sexual orientation) is inherently an individualist ideology. Racism and collectivism go had-in-hand.
Special interest group receives hefty grant from State Board of Education
Posted by Dr. Terry Stoops at 09:44 AM
The State Board of Education has agreed to a $168,500 contract with the NC Association of School Administrators (NCASA) for "professional development services for NC Principals."
The director of the NCASA is Bill McNeal, former superintendent of Wake County Schools, former superintendent advisor to the State Board of Education, and member of the state's Race to the Top team.
House budget has more debt than Senate sought
Posted by Joseph Coletti at 09:41 AM
That $451 million non-voter-approved debt the Senate debated as a separate bill earlier this week has grown to $500 million in the House budget proposal.
If politicians want us to believe they really are cutting into the muscle and bone of state government, they should stop trying to go around the backs of voters to borrow money they can't afford.
Byron York explores the president's 'Sestak questions'
Posted by Mitch Kokai at 08:50 AM
Byron York's latest contribution to the Washington Examiner delves into the investigation of whether the Obama administration offered a Pennsylvania congressman a big government job in returning for dropping plans to challenge Sen. Arlen Specter.
"I can assure the public that nothing improper took place," Obama said, echoing earlier statements from White House officials who denied any wrongdoing. "There will be an official response shortly." And that was that.
Obama's brief answer brought a smile to Rep. Darrell Issa, who has been pursuing the Sestak issue in his role as ranking Republican on the House Committee on Government Oversight and Reform. "That means the answer will be forthcoming after the lights go out for the weekend," Issa said shortly after the news conference. "While the president is away and nobody's available, a statement will come out."
The way Issa sees it, the White House has to thread the needle when it finally responds to Sestak's charges. A retired Navy admiral, Sestak is now the Democratic candidate for Senate from Pennsylvania, and the White House wants all the Democratic senators it can get. So they can't come out and call Sestak a liar or a hack. On the other hand, they can't admit that what Sestak is saying is true, because that would be, in the words of top White House adviser David Axelrod, a "serious breach of the law."
You might be a progressive if...
Posted by Dr. Roy Cordato at 08:32 AM
...you choose A as your answer to the following question.
Which of the following do you believe should be regulated by the government?
A. the choice of how much salt to consume made by an adult.
B. the choice of whether or not to have an abortion made by a 12 year old girl.
Berger bill would penalize state for late refunds
Posted by David N. Bass at 08:19 AM
State Sen. Phil Berger, the Republican's minority leader, introduced a bill Monday that would impose a 10 percent penalty on state government for tax refunds issued 45 days or later after a taxpayer files a return.
Paul Woolverton of The Fayetteville Observer reports:
"If I file a tax return, and I'm late, then the state's going to assess me penalty and interest from day one," Berger said. It's only fair, he said, that the state should be penalized if it's late with the taxpayers' refunds.
"I'm saying they've got 45 days to give Mr. Smith or Mr. Jones or Ms. Jones their money back, because it's their money; it's not the state's money."
Refunds have moved out slowly because the recession has reduced the state's tax income. The government is hanging onto the money longer to cover its expenses.
In 2009, the refunds ran behind, too, but all were issued - 2.7 million refunds worth $1.9 billion - by May 13.
So far this year, according to the Department of Revenue, 2.4 million refunds worth $1.7 billion have been issued. The state has to pay interest, at a 5 percent annual rate, on any refunds issued after May 30.
Revenue Department spokesman Thomas Beam said the agency has no comment on Berger's legislation.
Carolina Journal recently reported on the state's doubling of tax reviews for large families this year. Some taxpayers say it's just another revenue grab on the part of a cash-strapped state.
Berger's bill isn't going anywhere, obviously, but it's a good concept and good political move in an election year.
Latest dispatches from the campaign trail
Posted by David N. Bass at 07:25 AM
- State Sen. R.C. Soles, D-Tabor City, defends his bill that could benefit his district attorney friend Rex Gore.
- Americans United for Change ad rips Republican Richard Burr on the Gulf oil leak and the environment.
- State Sen. Julia Boseman, D-New Hanover, says she can’t return illegal campaign contributions because her campaign is broke.
- Charlotte Observer columnist says voters have only two choices in the 8th Congressional District: scary and scarier.
- The N.C. Free Enterprise Foundation analyzes business trends in the Tar Heel State and how they might impact the election.
- Winston-Salem Journal editorial: “North Carolina law is among the most restrictive in the nation when it comes to third parties and independent candidates."
- To exhibit his grassroots support, 8th Congressional District GOP candidate Harold Johnson announces Tea Party endorsements.
This weekend on Carolina Journal Radio
Posted by Mitch Kokai at 06:58 AMState senators have approved a budget plan. Their counterparts in the House are working on their plan now. Becki Gray will discuss the budget and other issues attracting state legislators’ attention during the next edition of Carolina Journal Radio.
The Senate budget did not include money for the governor’s proposed N.C. Mobility Fund, which is billed as a tool for targeting more of North Carolina’s transportation money to congestion relief. You’ll hear Department of Transportation Chief Operating Officer Jim Trogdon defend the Mobility Fund. You’ll also hear a critique from Joe Coletti.
State Revenue Secretary Kenneth Lay has promised state lawmakers that additional taxpayer spending of $10 million, mainly on new Revenue staff, would produce $110 million in new revenue from delinquent corporate taxpayers. You’ll hear highlights from his recent presentation on the issue.
Jay Schalin of the Pope Center for Higher Education Policy will join us to discuss a recent report on teacher training programs in the UNC system.
And Robert Murphy of the Mises Institute, author of The Politically Incorrect Guide to Capitalism, will explain why the capitalist system does not deserve blame for the recent economic slump.
New Carolina Journal Online features
Posted by Mitch Kokai at 06:49 AM
This week's Carolina Journal Online Friday interview features Donna Martinez's conversation with Roy Cordato about the Clean Smokestack legislation's impact on North Carolina air quality.
Karen Palasek's guest Daily Journal explores the benefits of going back to school.
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