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Poverty and Policy Matters

There are few situations in life that are clearly win-win. When you see one, you have to take advantage of it.

That’s why North Carolina should reverse course and expand Medicaid. When you have the chance to improve health care for hundreds of thousands of people and actually save money, you should jump on it.

In a recent News & Observer editorial, the paper called the decision not to expand Medicaid “wildly irresponsible and hugely expensive.” That’s precisely correct, and let’s explore the first part of the statement a bit more.

Turning down Medicaid expansion turns down $50 billion in federal funding and prevents roughly 400,000 of our neighbors from getting covered. That makes expanding Medicaid an obvious choice.

But also consider that preventative care saves money over the long run. Insuring people means they get to go to the doctor, which means we pay less to prevent disease. This leads to lower costs for taxpayers and better lives for our people. An excerpt from the N&O piece:

Community Care said in a news release: “The medical costs for low-birth-weight babies average $49,000 in a baby’s first year of life, or more than 10 times more than babies born without complications. A low birth weight also increases a child’s risk for long-term medical and developmental complications and the likelihood of incurring additional expenses for social services and educational needs in later years.”

Kate Berrien, manager of Community Care’s pregnancy project, said North Carolina now leads the South in having the fewest births before 39 weeks. That’s a lot of savings and a vast increase in the quality of life for many children born to low-income mothers. And it’s an achievement attributable to innovations in community-level care that were developed in North Carolina and are being adopted across the nation.

It’s a win-win situation. Tom Wroth, CCNC’s chief medical officer, said, “We’ve been able to align improving clinical quality with lower cost.”

Read that last paragraph again. Improving quality care with lower cost is a win-win. So is expanding Medicaid.

Commentary

Curious about the real cost of vouchers? Check out these two great op-eds from Rev. Dr. Arnetta Beverly and Margaret Arbuckle in the Greensboro News-Record.

Rev. Beverly focuses on why risky vouchers schemes violate the North Carolina constitution:

Article IX, Section 6 of the North Carolina constitution declares that public funds for education “shall be faithfully appropriated and used exclusively for establishing and maintaining a uniform system of free public schools.”

The language could not be clearer: Under our constitution, funds that must be used “exclusively” for the public schools cannot be used to issue private school vouchers.

That’s not all. The constitution requires that taxpayer funds must be spent “for public purposes only.”

Arbuckle’s piece highlights the very real human consequences of this ill-advised program:

Vouchers have horrible consequences, including misuse of public funds, violating separation of church and state and compromising children’s educational outcomes in unaccountable schools. This is a bad idea, wrong in its concept and implementation. The consequences for our public education system will be dire.

Both are well worth your time in advance of tomorrow’s hearing at the North Carolina Supreme Court.

Commentary

Today should be a national holiday.

No, not because of EITC Awareness, although the post below this one highlights that important issue as well. Because of Fred Korematsu, who was born on this day 96 years ago.

Korematsu was born in Oakland, Calif., but his U.S. citizenship didn’t keep him from being arrested for refusing to be relocated to an internment camp in 1942. He challenged his arrest in court, and two years later the case made its way to the Supreme Court. Korematsu challenged the constitutionality of Executive Order 9066, the decree that forced the relocation of people of Japanese descent to internment camps. The court ruled in favor of the government and against Korematsu in what is now widely considered one of its worst decisions. The majority of justices claimed the detentions were not based on racial discrimination but rather on suspicions that Japanese-Americans were acting as spies.

After World War II, Korematsu was released. But the conviction remained on his record for 40 years until it was finally overturned in 1983.

California was the first state to make Jan. 30 a holiday. Four states now honor Fred Korematsu on this day, and we should expand that number. He was a hero who believed in the U.S. Constitution, earned the Presidential Medal of Freedom and continued to advocate for civil rights until his death in 2005.

 

Commentary

Last year nearly 18,000 people died in the world from terrorism. This was a record high.

That figure includes all deaths by explosives along with every other means terrorists use to commit violence. This statistic also includes the entire world population of 7 billion people. It tracks violence in war zones, failed states and other troubled places where no real government exists, let alone regulations.

From 2000-2010, about 335,000 Americans died from firearms.

That means that the worst ever year for terrorism, which includes all terrorist violence, throughout the entire globe of 7 billion people, cost a little more than half as many lives as guns cost during an average year in one country, which happens to be the richest country in the world and an ostensibly functioning democracy.

I wrote this a few weeks back about why things have to change in America. It doesn’t have to be this way.

Commentary

People fear the unfamiliar. It’s human nature. When a new threat emerges, our minds often race about it — even when the same old threats are far more worrisome.

This is one reason a healthy (heh) number of my friends are anxious about the Ebola virus. Maybe yours are, too. Heck, maybe you are. Well, here’s the good news: while certainly a frightening disease, Ebola is unlikely to be a widespread public health threat in this country.

There’s bad news, however. Another, less flashy threat to public health is far more dangerous to people in North Carolina and states like it. (The additional bad news: it’s also deeply troubling that Americans are more concerned about a disease killing one person inside our borders than the nearly 5,000 Ebola has killed in Africa so far. That’s a topic for another day.)

The real public health threat is the failure of some American states, including the Old North State, to expand Medicaid.

Medicaid expansion would help more of our neighbors get health insurance, which is vital in preventing the advance of disease — and the early deaths that come with that disease. Here in North Carolina alone, about half a million people lack health insurance that would have been covered had we made the choice to expand Medicaid.

What does that mean? It means more preventable deaths every year. A team of researchers for Harvard found that failure to expand Medicaid could mean as many as 1,145 more deaths in North Carolina every year.

Based on those numbers, that’s about three more preventable deaths in North Carolina every day. Think about the math of that. Read More