“The system is working in silos, and the silos  are not communicating,” McCrory said. “We want a coordinated system of providers.”
“[NC Medicaid Community Care] lacks a culture of customer service and operates in silos , making it difficult for recipients to know where to go to receive the right care”
Governor McCrory obviously isn’t too familiar with his own Medicaid system in his own state where every patient in NC Community Care has the name and phone number of their family doctor printed  on their Medicaid card. In addition, NC Medicaid’s Community Care program coordinates providers from hospitals to family practices statewide in fourteen well-defined community networks. This system has saved so much money and improved health care so drastically that NC’s conservative US Senator Richard Burr  just gave NC Medicaid Community Care yet another national award just last week.
So the Governor is clearly misinformed about NC Medicaid but, even so, why all the focus on “silos”? Like most North Carolinians I’ve seen many a graceful grain silo on our beautiful country roads. I guess he’s trying to imply that we North Carolinians don’t work together enough with this metaphor, although why selling off our award-winning Medicaid system to a bunch of out-of-state Wall Street companies is going to fix us up by putting all our “silos” together is really a head-scratcher.
Actually, it turns out that McCrory uses this “silos” metaphor so much that the fact it came up in the Medicaid program shouldn’t be a surprise. Silos pop up so frequently that you’d think Governor was born on a farm instead of in Columbus, Ohio. For example:
On the state budget: “I’m going to have to move spending within the silos , McCrory said, “and move it to areas where there’s greater need and take it from areas that have less need.”
On vocational training: “which is very close to my heart,” to determine “how can we tie in those silos  in a better way.”
On education in general: “The K through 12 silo , the community college silo and the university silo.”
On the UNC budget: “We’re doing the budget in these silos  instead of looking at the big picture,” he said, at a Board of Governors meeting at UNC Pembroke.
On government in general: For far too long, our state’s departments and agencies have operated in silos , often ignoring the needs of the very people we serve and creating inefficiencies with your tax dollars.
The “silos” talking point is repetitive and it’s not very effective, especially describing how we organize health care under our Medicaid program in North Carolina. Our providers and communities work together more closely than in most other states in the nation to deliver efficient and effective care. The Governor would do better to learn more about his own excellent Medicaid program and leave the “silos” alone to define our rural North Carolina heritage.