The Tax Scrooges

ScroogeTax day seems to bring out the Scrooge in some people. Take for instance the gentleman who wrote into the Hendersonville Times News with a letter entitled “Pretty soon, we’ll all be on the dole.” His letter reflects an attitude held by many that our state government is wasting money, and the services the state provides are only benefiting lazy people who don’t want to work. These perceptions couldn’t be farther from the truth.

A breakdown of our state budget shows that approximately 60% of the budget goes to education. One fourth of the budget is spent on health and human services to care for poor children and the disabled, blind or mental ill in our state.

North Carolina’s cash assistance welfare program ended ten years ago. Work First, which now provides Temporary Aid to Families in Need for a limited period of time and requires recipients to work, has reduced the number of people ‘on the dole’ by 85%.

Many of the people seeking assistance from state health and human service programs are working full-time but do not have access to employer-provided health care and do not earn enough to afford private insurance. This chart prepared by the Cecil G. Shep Center, shows over 50% of adults earning less that 200% of the Federal Poverty Level are uninsured; 68% of children in this income level have no health insurance. These children, like tiny Tim Cratchit, cannot afford to see a doctor when they are sick.

Figures for the State Earned Income Tax Credit show the same thing, people are working hard but are not earning enough to keep pace with the rising costs of necessities like housing and child care. This year, one out of five NC families claimed an Earned Income Tax Credit on their federal tax return. Of these families, 69% earned less than $20,000 for the year.

Programs like the Health Choice for children, the High Risk Insurance Pool and the State Earned Income Tax Credit are not a waste of tax-payer money but proven, effective programs that can help lift millions of North Carolinians out of poverty.

Scrooge found his redemption in helping others. Now that tax day has passed, maybe those begrudging North Carolina taxpayers can soften their hearts and open their eyes to see that government programs that help the poor ultimately benefit all of us.


Why should dental care be different than medical care?

Rotten teeth1There was a tragic story published in the Washington Post today about a 12 year old boy, Deamonte Driver who died as a result of an untreated tooth infection; the family was uninsured and had lost their Medicaid coverage.

This story demonstrates how easily children can fall through gaps in our health care system and how important regular examinations and care are for any child. A routine $80 tooth extraction could have saved this child’s life.

Deamonte's death and the ultimate cost of his care, which could total more than $250,000, underscore an often-overlooked concern in the debate over universal health coverage: dental care.

Action for Children has put forth a proposal called Carolina Care for Children, which provides health insurance coverage for children whose families earn between 200% – 300% of the federal poverty level. The program is along the same lines as Governor Easley’s recommendations for expanding the children’s health insurance program.

Carolina Care for Children is a good proposal BUT it does not initially cover dental care.  Dental care the proposal says “will remain under study.”  That’s a polite way of saying we have bigger problems with dental care in North Carolina.

It boils down to a supply problem. According to health experts we do not have enough dentists willing to accept Medicaid or Health Choice payments. Nor do we have enough dentists serving patients in rural areas.

One solution would be to open our borders to dentists currently practicing in other states.  
We have created a barrier by requiring dentists, even those who have been practicing for years, to take the North Carolina dental exam at considerable expense.

The current policy appears to benefit the dentists in North Carolina by keeping the number of dental offices low and the prices for care high but it does not help our children. Isn’t it time we made dental care as accessible as health care?


Inflation chipping away at SCHIP

Health ChoiceThe state children’s health insurance program, Health Choice (or as it’s more generically referred to, SCHIP), is a big success. It’s so successful that Governor Easley has recommended expanding eligibility from its current level of 200% of the federal poverty level to 300% FPL. This would mean 12,000 more children in our state would be covered by health insurance. Governors in other states have embraced the SCHIP program and many have expanded their coverage to include more children (and some adults) above 200% FPL.

Since it was created as part of the Balanced Budget Act of 1997, the SCHIP program has decreased the number of uninsured low-income children across the county by one-third.

Here’s the rub, SCHIP was set up on a block grant with fixed annual funding levels. As health care costs have risen over the past ten years, SCHIP funds have not, leaving states to make up the difference.

The National Governors Association sent a letter to Congress this week stating…

On behalf of the nation's governors we urge you to make the State Children's Health Insurance Program (S-CHIP) a top priority in this first session of the 110th Congress. Governors are united in support for this important program that serves over 6 million children nationwide. Coverage in the program will be jeopardized without your immediate action to prevent federal funding shortfalls.

Congress has an opportunity to fix problems and strengthen the SCHIP program. Let’s hope they act so that the recent gains in children’s health coverage are not lost.