Health care reform

The new federal health care law will exacerbate many of the problems it was meant to address.

Some of the most effective health care reforms are changes in state policy, most of which are still available. Such reforms would only mitigate the costs to North Carolinians of federal law instead of resulting in a net reduction of health care costs, but they are still needed.

Key Facts


  1. Focus on care, not coverage. Reform should expand access to quality care to more people throughout the state. Enrolling more people in Medicaid does not accomplish this goal.
  2. Give state employees control over their own health. Provide a policy option for state employees to set aside money in a tax-free account to pay their medical expenses. If done with long-term accounts, this would also reduce the state's $29 billion unfunded liability for future retiree health benefits.
  3. Let free enterprise flourish. State restrictions on health insurance, care provision, and capital investment mean patients have fewer options for obtaining excellent care at reasonable costs. Some changes the state could take to offset the cost-raising and access-reducing aspects of national health care reform:
  4. Reform medical malpractice. This means not just putting caps on punitive lawsuit awards, but allowing doctors and patients to agree in writing on the costs of malpractice. Too many injured patients never even file suit.

Analyst: Joseph Coletti
Director of Health and Fiscal Policy Studies