North Carolina mandated that all insurance plans provide contraceptive coverage back in the 1990s.  Churches were clearly exempted, but not entities like hospitals and schools that employ and educate many women –even a majority of women – who are not affiliated with the religion of the organization that started the institution and who deserve the same health coverage as all other women in the United States.

Why was this not a major issue in NC?

1.  It’s a justice issue.  Covering birth control as part of preventive coverage saves families $26 a month on average, helping families in tough economic times.

2.  Birth control is basic preventive care – it respects others to make important life decisions and gives people more options over when and whether to have child.

3.  Coverage of birth control services with no co-pay helps prevent unintended pregnancies and reduces the need for abortions.

The federal Affordable Care Act looked to many states and followed NC’s commonsense exemption of churches and primarily religious institutions almost exactly.

Here’s the federal Affordable Care Act’s definition of a “religious employer” who would be exempt from the mandate to offer contraceptive coverage to employees:

A religious employer is one that:  (1) has the inculcation of religious values as its purpose; (2) primarily employs persons who share its religious tenets; (3) primarily serves persons who share its religious tenets; and (4) is a non-profit organization under Internal Revenue Code section 6033(a)(1) and section 6033(a)(3)(A)(i) or (iii).  45 C.F.R. §147.130(a)(1)(iv)(B)

Here’s North Carolina’s definition of a “religious employer” who would be exempt from the mandate to offer contraceptive coverage to employees:

(e)        …As used in this subsection, the term “religious employer” means an entity for which all of the following are true:

(1)        The entity is organized and operated for religious purposes and is tax exempt under section 501(c)(3) of the U.S. Internal Revenue Code.

(2)        The inculcation of religious values is one of the primary purposes of the entity.

(3)        The entity employs primarily persons who share the religious tenets of the entity. (1999?231, s. 1; 1999?456, s. 15(a).)

Despite a large and conclusive study five years ago that confirmed the results of many smaller studies, cardiac surgeons continue to surgically insert mesh tube or “stents” into partially blocked vessels around the heart.  Why is this a problem?  For the 30% of stent recipients who are having these devices put in simply because of ongoing chest pain, this painful and sometimes risky surgical procedure is clearly and conclusively no better at controlling symptoms or reducing death rates than medication and changes in lifestyle.

There is really no debate about this point.  Yet, five years later surgeons are still routinely doing hundreds of thousands of these  procedures at $17,000 a patient.  Clearly saving money in our health system is about much more than giving doctors clear information about costs and benefits of treatments.

Dick Gerrish, secretary of the Wilmington Lions Club, said that currently his branch of the Lions Club provides eye exams and glasses to five or six people a month, serving “the employable” first.

“And we probably have about 10 people on the waiting list,” he said.

So, out of the thousands of people on Medicaid in the Wilmington area, some 5-6 will be able to get eyeglasses they need, but the rest are out of luck.   Although GOP  predictions that “private charity” would step in to fill the needs  neglected for the poor aren’t coming true, at least they saved us all the 1 cent sales tax they let expire.

Now that’s the kind of smart Medicaid reform we need and not this rush to cut, cut, cut.

That’s where the new independent, nonprofit organization FAIR Health comes in. FAIR Health (fairhealthconsumer.org)was created to cast light on the black box that has historically surrounded health costs and insurance reimbursement. The organization does something we take for granted in almost any other industry – it provides consumers reliable cost information for specific procedures in a given geographic area.

Click here to view the embedded video.

1.  Back in 2007 I proposed the museum exhibit that the state Department of Health and Human Services put together with an excellent and very compact overview of NC’s eugenics sterilization program be given a prominent and permanent home at the NC Museum of History.  It’s great to learn about the Wright Brothers, but there are other aspects to NC’s history we must never forget.  How can we learn from our history if great exhibits like this remained stored away and quickly forgotten?

2.  As Adam Linker has suggested, why tuck a historical marker about the eugenics program on a side street when it could go on the Capitol Square?

3.  There are other ways to remember.  One of the most prominent social workers and reformers in the country, Ellen Winston, who served as the first national Commissioner of Welfare in the Johnson Administration was a prime mover in NC’s eugenics program.  Her role and the role of the institutions she represented like UNC and the state welfare program should more fully explored.

What are some of the consequences of not facing up to this history?  Well, a few years ago the NC Medical Care Commission allowed a experiment of a fake blood substitute (Polyheme) to go forward in Durham where victims picked up by ambulance were involuntarily given this experimental fluid – and continued involuntarily receiving it in the hospital.   Only one problem with this involuntary experiment on Durham’s population:

“Scarier was the study’s safety data, which went against Polyheme in every way measured. Patients treated with Polyheme reported more serious adverse events, more heart attacks and greater risks to the kidneys than the control patients.”

Let’s be clear.  Just a few years ago people in Durham involuntarily received a “treatment” that was highly experimental, to which they or their families never consented – even after consent could be gotten in the hospital – and, as a result of which, some of them most likely died or became very, very ill.  Now tell me we don’t need to better remember our shameful NC history of involuntary medical procedures.

Click here to view the embedded video.