Strange but true – Governor Pat McCrory’s proposed legislation for privatizing our award-winning NC Medicaid program (presented to the General Assembly by NC DHHS Secretary Aldona Wos last week) is two pages long.  The Administration’s new policy for DHHS workers on how their email signatures should look (McCrory and Secretary Wos demand 11-point arial font among many, many other things as Rob Schofield reported last week) is three pages long.

Critical health care for 1.8 million North Carolinians v. how state employees should sign their email:  Mixed message, mixed priorities, and mixed signals.

In the Charlotte Observer today I lay out the case for real Medicaid reform in NC that saves money and improves care for everyone.  Not privatization, but a expanding our already successful public/private partnership:

Gov. Pat McCrory has proposed radical privatization for North Carolina’s award-winning Community Care Medicaid program by selling off segments of Medicaid to private health insurers. Aside from McCrory’s dubious rationale, many people are confused as to why he would propose this change on the same day North Carolina’s conservative U.S. Sen. Richard Burr gave a national award to N.C. Medicaid for significantly lowering costs while delivering extremely high-quality care.  Read more here.

 “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.”

Read More…

Recently I was invited by the law school at East China University of Science and Technology in Shanghai to come and lecture  about a nonprofit lawyer’s role advocating to provide healthcare for low-income people in the United States.   Teaching on the other side of the world was a spectacular privilege in many ways, but after going through how North Carolina and other states are currently rejecting federal Medicaid dollars to provide health coverage to our poorest citizens it was one student’s question that struck me the most:

The United States is the richest country in the world, so why exactly can’t you provide health care to the poorest citizens in every state?

Good question!