• Research Report

    No, Fix the Roads First: How N.C. has taken transportation out of transportation policy

    posted October 17, 2007 by Daren Bakst
    The Minneapolis I-35 bridge disaster and the poor condition of North Carolina’s bridges should be a wake-up call for policymakers to set sensible priorities for transportation policy. N.C. has 17,782 bridges, of which 5,082 (29 percent) are deemed deficient by the federal government. N.C. ranks 32nd in the nation in percentage of deficient bridges — 10th worst in total number of deficient bridges.
  • Research Report

    Rutherford County doesn’t need to increase taxes

    posted October 3, 2007 by Dr. Terry Stoops, Joseph Coletti, Dr. Michael Sanera
    Rutherford County doesn't need to increase taxes The Rutherford County commissioners are asking voters to approve a quarter-cent sales tax increase and a 200 percent increase in the real estate transfer tax on November 6. But the county has about $25 million over and above its base budget to meet its needs.
  • Research Report

    Macon County doesn’t need a land-transfer tax increase

    posted September 26, 2007 by Dr. Terry Stoops, Joseph Coletti, Dr. Michael Sanera
    The Macon County commissioners are asking voters to approve a 200 percent increase in the real estate transfer tax on November 6. But the county has about $21.6 million over and above its base budget to meet its needs.
  • Research Report

    Reform the Reform: How mental health reform went wrong and what lies ahead

    posted July 17, 2007 by Joseph Coletti
    North Carolina’s 2001 mental health reform was ambitious and well intentioned but flawed. Many proven ideas did not make the final version of reform and lawmakers immediately raided the mental health trust fund to cover a General Fund fiscal crisis in 2001.
  • Research Report

    High-Risk Health Insurance Pools: A step towards an individual insurance market

    posted October 16, 2006 by Joseph Coletti
    Health insurance should act like insurance, not a payment plan for regular medical needs. It should also be available for individuals to purchase in a deregulated market. A high-risk pool for health insurance, as in other insurance markets, would keep premiums affordable for the small percentage of those with significant care needs without raising costs for the entire market. The state of North Carolina should finance any high-risk pool entirely through the General Fund and existing taxes, rather than assessments on insurers or other hidden taxes. Money for a high-risk pool can come from Medicaid savings.
  • Research Report

    Policy versus Performance: Directions for North Carolina’s Largest Transit Systems

    posted May 3, 2006 by Dr. David Hartgen
    North Carolina’s largest public transit systems are often credited with reduced traffic congestion and air pollution, efficient land use, reduced dependence on oil, and much-needed mobility for some residents. Are they fulfilling these missions? How are they performing? Who do they benefit? What do they cost?
  • Research Report

    Your Health, Your Choices: Employers and the State Fail to Meet Individual Health Care Needs

    posted April 4, 2006 by Joseph Coletti
    Health care is again a top priority for most Americans. Health savings accounts offer promise and are growing in popularity among companies and individuals. Three states will soon begin consumer-directed Medicaid pilot programs. These are more realistic approaches than proposals by the NC Institute of Medicine and others to expand Medicaid or to force employers to provide health insurance. Individuals, not companies or the state, are best equipped to manage their own health care. Health care reform should start from this premise.
  • Research Report

    Health Savings Accounts: Consumer-Driven Health Care for North Carolina Public Employees and Teachers

    posted December 14, 2005 by Michael Debow
    HSAs are a form of medical savings account, similar to the now-familiar IRAs. These accounts are the property of the employee and can accumulate interest and dividends like other savings vehicles. Funds that are not used for health care-related expenses can be used for retirement living and can also be willed to one’s heirs. When combined with a high-deductible health insurance policy, an HSA replaces traditional health insurance coverage – and does so in a way that results in a more consumer-driven approach to health care.
  • Research Report

    Certificate-of-Need Laws: It’s Time for Repeal

    posted November 27, 2005 by Dr. Roy Cordato
    In North Carolina and 34 other states, if you are a health care entrepreneur and you want to do anything from adding a new wing or extra beds to an existing hospital, to opening an office that offers MRI or other services, you need a “Certificate of Need” from the state. If this sounds like the kind of central planning one might find in a socialist economy – it is. In North Carolina, the central planning authority is known as the Health Planning Development Agency, part of the North Carolina Department of Health and Human Services. The role of this agency is to plan economic activity provided by medical-care facilities. This is done down to the most minute detail, circumventing the most basic function of private decision-making in a free enterprise system, i.e., the allocation of resources based on entrepreneurial insight and risk taking.
  • Research Report

    Carve the Medicaid Turkey: State Should Eliminate County Share of Medicaid in Five Years

    posted November 20, 2005 by Joseph Coletti
    North Carolina is the only state in which counties pay a fixed percentage of Medicaid costs. Counties have no control over how they spend up to 15 percent of their general fund budget and 39 percent of their property tax revenues. Six counties spend more on Medicaid than on education. Program expansions and higher medical costs have pushed Medicaid’s share of county budgets up an average of 18 percent in five years. The General Assembly should act on the recommendation of its own Blue Ribbon Commission on Medicaid Reform to cap and reduce what counties must contribute to Medicaid.

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