Medicaid is a national problem, not just a state problem. All states are faced with the same incentive to grow their Medicaid programs because of the federal match. Unsustainable Medicaid spending is exacerbating the debt crisis at the federal level. It is paramount that state policymakers put pressure on Washington to reform Medicaid and willingly trade the open-ended federal reimbursement of state spending for freedom from federal roadblocks to make common-sense reforms to their programs.
North Carolina has one of the most expensive Medicaid programs in the Southeast, and Obamacare will expand enrollment from 1.3 million people to potentially over 2 million people in 2014. Without Medicaid reform or tighter eligibility, North Carolina will need to cut some services and payments to doctors. Both options will mean worse care for every person on Medicaid. Gov. Bev Perdue and the General Assembly need to push Washington for exemptions from Medicaid restrictions and greater ability to innovate with premium support and encourage patient control of their own care.
North Carolina needs a thorough review of the number and types of courses offered in its public schools, especially during tight budget times. There is no evidence that school districts or the state has conducted an audit of the costs and outcomes or elective courses. A statewide curriculum audit would be a sound way to reduce costs and refocus our curriculum on the core skills that many of our public school students so desperately need.
In 2010, North Carolina recorded the second-lowest number of high-ozone days of the last decade. Statewide, a total of 106 high ozone monitor readings were recorded over 26 days from April 1 to October 31, with 32 of those readings occurring on just eight monitors in two metropolitan areas. Despite what might be the popular belief, smog levels in North Carolina have been getting better, not worse.
This report highlights eleven action items that North Carolina’s new General Assembly should seek to implement in the first 100 days of the 2011 legislative session. These items touch upon a cross section of public policy areas, including education, economic development, property rights, energy and the environment, health care, the budget, and transparency. We at the John Locke Foundation believe that these items represent straightforward actions that would greatly enhance the liberty and prosperity of North Carolina’s citizens.
Over the past decade the “demand side management” (DSM) model of public policy has crept into the state of North Carolina’s approach to regulation. Advocates of DSM are clear in making explicit their goals of social engineering and the rearrangement of lifestyles. The language in their guiding documents are replete with references to “behavior modification” and “restraining and restricting” certain activities or lifestyle choices. DSM is inconsistent with a free society, where the role of government is to respond to constituent demands, not manage and control them.
There has been significant public attention and concern regarding a proposal by the North Carolina Sheriffs' Association that would allow sheriffs to have access to patients' prescription information for painkillers and controlled substances. The bigger issue is that the state already collects this information and law enforcement, specifically the State Bureau of Investigation, already has access to it. North Carolina should eliminate the database. The incredible intrusion into the lives of citizens greatly outweighs its limited, if any, benefit.
North Carolina policymakers should eliminate provider licensing, certificate-of-need laws, and mandated health insurance benefits. Short of this, the state can accept alternative forms of credentialing and ensure consumers have the right to purchase optional benefits at additional cost. These regulations limit access to health care providers and health insurance by artificially constraining markets.
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