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Commentary

The powerful combination of history, an inexhaustible money machine and shameless gerrymandering produced impressive electoral victories for the Right in this week’s election, but it also remains a powerful truth that when you actually ask voters directly for their opinions on core pocketbook issues, they continue to favor progressive solutions.

You’ve probably already heard about the overwhelming success of several minimum wage hike proposals around the country, but here’s another striking example in which even red state voters voted overwhelmingly for the progressive position: Medicaid expansion in Wisconsin.

On Tuesday, the Badger state held an advisory referendum in which voters in 19 counties and one mid-size city were asked whether the state should expand Medicaid under the Affordable Care Act.

The vote: Yes – 73%, No-27%.

Now, mind you, the referendum wasn’t just conducted in a few liberal bastions. Read More

Commentary

Medicaid expansionIn case you missed it over the weekend Ned Barnett of Raleigh’s News & Observer had an on-the-money column about the latest  bizarre claim from the McCrory administration that we can now expand Medicaid under the Affordable Care Act because they have “fixed” what was a “broken” system. As Barnett notes:

“It’s good news that the governor is now open to doing the right thing about Medicaid expansion. Even Tillis now says he might favor it. Refusing to do it could cost the state $51 billion in lost federal money over the next decade, according to a report from the Robert Wood Johnson Foundation.

But this change of position shouldn’t pass without a look at the rationale for not doing it in the first place. Wos’ reign at DHHS has been marked by massive provider payment problems, an exodus of staff, plummeting morale and expensive consultants hired to fill in the gaps. Now she’s saying that the administration of Medicaid has been fixed and it’s ready to take on a half-million new recipients.

If that turnaround is true, Wos has accomplished an amazing feat of introducing efficiency and accountability. Yet there’s nothing to suggest that is the case. DHHS under Wos remains an agency riddled by vacancies and burdened by a reputation for administrative dysfunction that has discouraged top applicants. But the Medicaid program itself was never “broken”. It has operated in North Carolina for decades and in recent years has successfully held down administrative costs compared with the national average. Medicaid’s “out-of-control costs,” which Republican legislators say busted the state budget, reflect wishful budgeting. Simply putting a number in the budget won’t hold down costs. People need treatment, and when there’s a recession Medicaid rolls grow. With the economy now improving, Medicaid costs are coming in under budget.”

In other words: It’s great that McCrory and Wos want to expand Medicaid and even fine if they want to delude themselves about the reasoning, but anyone who’s been paying attention knows their claims and rationales are bogus.
Commentary

Art Pope 3Phil BergerThe talk about Medicaid expansion for North Carolina in 2015 from political leaders without much power to do anything about it continues. Gov. McCrory and his HHS Secretary keep talking about expansion as does, rather amusingly, lame duck Speaker/U.S. Senate candidate Thom Tillis. Obviously, expansion would be a terrific thing and is horrifically overdue as the current absurd obstructionism is literally costing thousands of lives per year — all in the name of nothing but conservative ideology.

Sadly, however, neither of these stances by McCrory or Tillis will amount to a hill of beans come next legislative session unless the real conservative bosses in North Carolina politics give their assent. Those two bosses, of course, would be Senate President Pro Tem Phil Berger and the most important conservative power broker in state politics, Art Pope. After all, the General Assembly has already passed a law to prevent McCrory from doing the deed without their approval and, for all we know, Tillis could well be reduced to trolling the halls of the General Assembly next year as a lobbyist or McCrory lackey.

Meanwhile, there are few if any positive signals from Berger and Pope to be found. Berger says he’s still opposed and Pope…well, his hirelings continue to spout mean-spirited nonsense and gibberish on the subject.

Of course, all of this could change. The powers-that-be in the health care industry want expansion and understand the tremendous good it would do — both for people and in need and, perhaps even more importantly from the corporate perspective, their profits. Add to this the fact that conservative majorities in the General Assembly could be slightly smaller next year and there’s certainly reason to hope that the politics on the issue will continue to improve.

That said, when you’re dealing with true right-wing believers who don’t even bat an eye as their policies literally result in thousands of unnecessary deaths per year, it’s hard to see what’s going to bring about the change of heart. Moreover, at this point in his governorship, Pat McCrory gives literally no indication that he has the ability lead or shape the debate.

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

Commentary

Medicaid expansionConservative political support for one of the central components of Obamacare continues to grow. The latest conversion: North Carolina House Speaker Thom Tillis.

This is from a story by reporter Craig Jarvis in Raleigh’s News & Observer about Tillis’  televised appearance on Time Warner Cable’s “Capital Tonight” show last evening:

Medicaid: Asked if he thought it would be likely that the state legislature would expand Medicaid coverage after refusing to do so previously, Tillis said it might make sense once the state has better control of the financing of the program, which is notorious for its cost overruns.

He said he didn’t have an ideological objection to expanding the coverage. But he said when the state auditor told the previous governor that money was being wasted on it, the appropriate response would not have been to make it bigger and more costly.

“I would encourage the state legislature and governor to consider it if they’re completely convinced they now have the situation under control,” Tillis said.

In other words, the Speaker is echoing the McCrory administration’s imperfect but mostly encouraging line on the issue. Let’s fervently hope that Tillis’ successor as House Speaker and Senate President Pro Tem Berger adopt this same common-sense stance so that the matter can be disposed of as early in 2015 as possible.