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E-cigYou’ve got to hand it to the tobacco corporations and their high-priced lobbyists; when it comes to deceptive messaging and tactics, no one does it better than the merchants of death.  Apparently, nearly a century of practice really does make perfect in developing lies and half-truths and massaging them into feel-good media messages and legislation.

Consider the latest case in point in North Carolina. Big tobacco is currently ramming through legislation in both houses of the General Assembly that sounds as if it is all about motherhood and apple pie. The bill (which as been introduced and advanced in both the Senate and the House at the behest of the industry) operates under the title: “Prohibit E-Cigarette Sales to Minors.” 

“Electronic cigarettes” of “E-Cigarettes,”  as you probably have heard, are just the latest  tool for delivering life-threatening poison (i.e. addictive nicotine) to humans. E-cigs are already being advertised throughout the country as a hip and semi-safe alternative to traditional cigarettes. They’re already finding their way into schools and other places young people look for ways to be cool.   

Prohibiting their sale to kids sounds like a good idea, huh?

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pinocchio statuteIn announcing his plan to privatize North Carolina’s award-winning Medicaid program, Community Care of NC, Governor Pat McCrory laid out five key reasons that in his view privatization is necessary.  The only problem?  None of them hold up under the even the most cursory scrutiny.  I’ll thoroughly debunk each in turn:

McCrory’s #1 claim why NC should privatize:  “[NC Medicaid Community Care] does not focus on measuring and improving overall health outcomes for recipients”

Community Care is proven to provide much better access to health care services that results in measurable improvements in health shown through changes in health service use.

For example, an exhaustive study last year of how children and others on NC Medicaid are using health services found that children with asthma enrolled in Community Care spent much less time admitted to the hospital and in the emergency room than children not enrolled.  At the same time these children with asthma spent more time in their family doctor’s office and getting medication to manage their condition.  This is the very definition of a better health outcome.

And Community Care doesn’t stop there.  CCNC has a detailed process for measuring quality of care delivered by providers statewide and encouraging better quality– the “Quality Measurement and Feedback” program.

McCrory’s #2 claim why NC should privatize:  “[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 might want to take a look at the actual Medicaid card sent to people on Medicaid when they sign up.   It includes the name, address and phone number of the Medicaid recipient’s family doctor or health practice printed right on the card.  You don’t get much easier direction as to who to call first when you get sick than that.

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Health careIt would seem like a no-brainer.  The NC Senate passed and the NC House is expected to act shortly on a bill that would reject expanding Medicaid to 500,000 North Carolinians under the Affordable Care Act.  If that wasn’t enough, the bill would also reject the establishment of a state-federal partnership health exchange under Obamacare where people can buy health plans with tax credits to make coverage more affordable.  When NC was on track to develop a state/federal partnership health exchange the state received $74 million in Affordable Care Act money two months ago to update our computer systems and establish the exchange.  The no-Obamacare bill would force NC to return this money.

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There was criticism of NC’s innovative Community Care of NC program and the NC Medicaid program as a whole in yesterday’s audit of Medicaid being trumpeted by the McCrory Administration.  Let’s take a broader look at the facts.  For the period 2007-10 (the latest year annual stats are available) North Carolina’s annual spending growth in Medicaid was 3.5% – almost half the national average and the lowest rate of spending growth of any Medicaid program in the United States.  A “broken” program?  No.

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Today’s headlines highlight a audit of the state Medicaid program that shows an over $1 billion shortfall.  “Shocked, shocked, I tell you!” are Republican Governor Pat McCrory and DHHS Secretary Aldona Wos that the Medicaid agency did not meet its budget:

Dr. Aldona Wos, secretary of the state Department of Health and Human Services, said at the news conference that the agency will change the way it operates. “Cost overruns will not be tolerated and will not be acceptable,” she said. “There’s a budget for a reason.”

But the major finding in the audit, the one that has gotten all the headlines, that NC’s Medicaid program wasn’t able to meet the budget set for it by the Republican majority in the General Assembly (and passed over former Democratic Governor Perdue’s veto) shouldn’t be a surprise to anyone.  As former DHHS Secretary Lanier Cansler said on August 4, 2011:

“It’s just really going to be next to impossible to achieve this budget, and I’m not sure where the legislature will go with that,” Cansler said. “The fact that this budget plays into next year (means next year) is going to be a difficult budget year as well.”

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