Today’s N&R takes a look at how Medicaid cuts will affect North Carolina’s hospitals and health services:

North Carolina hospitals and social services agencies are hoping for a presidential reprieve from federal rule changes that they say could cost them more than $2.6 billion over the next five years.

……Among other things, the changes would:

* Reduce the amount of federal money to match state hospitals’ expenditures for treating Medicaid patients and people who cannot pay for their hospital care.

* Reduce the amount of money available for graduate medical education — training interns and residents. Such doctors-in-training at North Carolina’s 14 non-state teaching hospitals and two state teaching hospitals often treat Medicaid patients and the indigent.

Those two changes alone would reduce Moses Cone Health System’s annual Medicaid revenue, currently about $80 million, by about $19.4 million, spokesman Doug Allred said.

Meanwhile, as the Greensboro City Council ponders raising taxes so it can repave roads, the NYT makes a case that I’ve made about the Triad: Local governments have been taking it upon themselves to boost the economy. But the economy will catch up eventually, but don’t worry, the federal goverment will come to the rescue:

State and city governments have yet to shrink the economy; indeed, they have even managed to prop it up. They have quietly maintained their spending at pre-crisis levels even as they warn of numerous cutbacks forced on them by declining tax revenues. The cutbacks, however, are written into budgets for a fiscal year that begins on July 1, a month away. In the meantime the states and cities, often drawing on rainy-day savings, have carried their share of the load for the national economy.

…..But with the cutbacks in state and city outlays canceling out the consumption, the next president, struggling to revive a weak economy, will almost certainly have to consider a second stimulus package.

But what should it be? Should it be a reprise of the checks, relying again on private-sector spending for rejuvenation? Or should Washington channel extra federal money to city and state governments so they can sustain their outlays for the numerous programs that otherwise would be shrunk? The answer, even on Wall Street, is often: subsidize the states and cities.

“If you want to make sure that federal money gets spent, and jobs are created, you give it to them,” said Nigel Gault, chief domestic economist at Global Insight, a forecasting firm.

On that subject, the N&R interviews assistant city manager development Jim Westmoreland. I was talking with a friend who works for the city about Greensboro’s road problems and he assured me Westmoreland is an intellgient and capable individual. But you have to read the inteview twice to figure out exactly what he does:

The overarching goal of this position is to facilitate the delivery of economic development opportunities for the city. …

What I’m here primarily to do is facilitate the structures and the processes that exist within the city, meeting with people who would like to take advantage of the programs that are out there, meeting with developers in terms of helping them understand the opportunities and options available to them.

…The key to success in all this that I have found is how you develop those core relationships between the developers, their engineers, and our core team in terms of the technical review committee engineers and professionals.

About that last part, shouldn’t local government be doing that anyway? And if they weren’t, why not?