Competing Medicaid op-eds: Specifics best platitudes

Over the weekend, the Wilmington StarNews published a pair of competing op-eds on the subject of Gov. McCrory’s Medicaid privatization plan — one by Adam Linker of the N.C. Health Access Coalition and another by HHS Secretary Aldona Vos.  

Unfortunately, the two pieces serve as a kind of microcosm of the first few months of the McCrory administration’s public performance.

In a detailed and fact-based critique, Linker shows that  the privatization plan is half-baked and based on failed models elsewhere. He explains why siphoning off public money to private companies is a silly and wasteful idea and shows how it has already led to disastrous consequences in other states. In short, as in so many other areas in which the Governor has staked out a public position thus far this year, the op-ed demonstrates that the administration is embracing failed ideas.

Meanwhile, Wos’ response is consistent with previous administration responses to similar critiques in other areas: It doesn’t say much other than to regurgitate ideologically-based platitudes and promise to provide more details later — all of which might be okay if McCrory and Wos hadn’t already committed the state a radical overhaul that they clearly don’t understand in anything other than the most general way.

Sadly, however, as in those other areas — be it unemployment insurance, rejecting the Affordable Care Act or any number of others — the McCrory administration appears to be committed to a strategy of avoiding specifics and hoping the public won’t catch on.


  1. Gene Hoglan

    April 15, 2013 at 12:05 pm

    Yawn, more of this silo talk. Perhaps these people need to be put in some silos themselves for a while and let the adults take care of business.

  2. Doug

    April 15, 2013 at 1:12 pm

    If you switch the names for paragraphs two and three you would have just as effective a story. Ideology based platitudes come just as much from this side as others. The truth as jlp said a few weeks ago is that we won’t know until it is tried. The leftists definitely know this as almost every program they put into place had failed elsewhere….but only because we did not try it. How come it is a good thing to try all these failing leftist programs with no hysteria, but when the new regime tries something new the sky is falling? Hypocracy defined…..a classic case of the Ignorance of Liberalism.

    April 1, 2013 at 6:46 pm
    “There is not enough information to determine if we are on the “right path”. Many decisions good or bad take years or even decades to take significant effect.”

  3. Adam Linker

    April 15, 2013 at 2:18 pm

    Doug, you can actually look at other states to get an idea of whether or not something works. The plan proposed by McCrory sounds quite a bit like one that has been tried in many states and has failed. This isn’t a partisan issue. A Democrat in Kentucky enacted the same policy and it has been disastrous. The quickest, and harshest, reaction to privatizing Medicaid in NC came from conservative Republican Nelson Dollar.

  4. Doug

    April 15, 2013 at 4:46 pm

    You can also look at what we have now and it is just as disastrous. Maybe neither solution is the answer, but we know the socialist route we are following is fraught with high cost, poor patient outcomes, and limited supply. Unfortunately you guys choose to ignore the poor performance of the program you advocate rather than keep an open mind that there are other ways of doing things.

  5. Adam Searing

    April 15, 2013 at 4:58 pm

    Over $1 billion saved in just the last few years along with a national award from NC’s conservative US Senator Richard Burr just last week for improving quality of care. Go NC Medicaid – I’m sticking with the Burr/Dollar conservative Republican caucus on this one.

  6. Doug

    April 16, 2013 at 11:11 am

    Yeah, I will stay away from that democrat lite guy. He is becoming too “DC” what with that stupid gun vote and praising the corrupt Medicaid. The good thing is your “award winning” entity will be able to compete in the marketplace for the contracts. If they are so good then more power to them to help clean up the poorly run government program that exists now. Which I guess it is all relative….”hey we are the best of the worst”…..at least that is somehting.

  7. Gene Bridges

    April 16, 2013 at 4:42 pm

    Doug writes: but we know the socialist route we are following is fraught with high cost, poor patient outcomes, and limited supply.

    None of this is, of course, true. High cost: NC has one of the most, if not the most, cost efficient Medicaid system in the nation. It’s so efficient other states look to us. Even our own state Medicaid Director has noted this in committee hearings. Doug says “Socialist,” but our state Medicaid Director offers real numbers to back up claims.

    Poor patient outcomes: By what measure? All Governor McCrory’s offered is a vague statement that he wishes to “improve patient outcomes,” but his office has never said anything about what the measurement is. I have an MPH, and we did a lot of work in evaluation. What evaluation measures is he using? What data is Doug using to make his claim? We have none, because, as we all know, Doug will never produce any. By the way, I happen to be sitting here with a copy of DHHS own report on health outcomes on CCNC, and the numbers for most of their network goals were achieved and exceeded. Utilization was extremely high – higher than most items I’ve seen before. So, Doug, spare as the falsehoods about poor patient outcomes. We all know Doug has *never* seen a report and he wouldn’t know how to read it if he did.

    Limited Supply: Newsflash, Doug, this is healthcare. “Limited Supply” is as much a problem for a privatized system as it is for the current one. In fact, it can be a bigger problem Take a person living with HIV living in County X on Medicaid. If the system is privatized, he may be forced to seek treatment in county or region Y – and Region Y may well be where NC Baptist Hospital /WFU Medical Center is currently serving over a 1000 clients in its HIV clinic right now because Moses Cone closed its clinic, vs. his current option to live in Forsyth or Guilford and be treated at UNC, Duke, or Wake where there are more resources. Put simply, privatization does not selected for increased supply.

  8. Doug

    April 17, 2013 at 11:09 am

    Gene, where is your backup for your premise. All I know is there are monthly, weekly stories I see that show some Medicaid/care inefficiencies. You can keep believing what you want, but look at when government got involved with healthcare ~1960’s and look at how costs have responded. If there are not poor patient outcomes, then show and independent study….of course DHHS will show great outcomes. Good luck with that.

    All I know is we have a broken system, that is about to get even more broken and expensive with Obamacare. Just look at google and you will see all the overages and increased costs and limiting of healthcare that is about to happen. Teh last one I saw I believe was from the CBO, which usually tries to skew their analysis in favor of government and the party in power. You know when they say it is bad, we are in for a whole bunch of hurt in these government programs.

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