States have three direct policy levers to control Medicaid growth: eligibility, services, and payments. North Carolina’s mix of policies has led to some of the highest costs in the South, but the Blue Ribbon Commission on Medicaid Reform would make it even costlier. Tennessee and Mississippi, the two Southern states with higher per capita costs in 2000, have since made significant changes. Georgia and Virginia present different ways to reduce costs, while a 2001 report for the General Assembly presented largely unexploited savings.
N.C. is currently considering important modifications to its tort law, especially its application to medical malpractice. Proponents say it's the only way to ensure quality medical care remains affordable in N.C. Opponents say fluctuations in interest rates and the "insurance cycle" in general account for premium changes, and that tort reform would imperil the health of North Carolinians by "subsidizing" negligent physicians.
Most Americans agree that public education is in trouble. While legislators and educators have tried to fix failing schools by increasing funding, expanding regulations, or intensifying requirements for teachers, these changes have only served to patch a broken system. Public education in America needs radical reinvention, and charter schools provide an effective and powerful way to transform the educational system.
More than a decade after the passage of the Americans with Disabilities Act (ADA) in 1990, disability policy in the United States remains fraught with uncertainty, dashed hopes, and contradictions. While most persons living with disabilities today have an unprecedented quality of life — largely the product of medical and technological advancements that would have seemed more the realm of science fiction than science fact a generation or two ago — they are also experiencing some surprisingly negative trends.
North Carolina has now joined many other states and the federal government in debating solutions to the problem of rising costs in medical malpractice insurance. Evidence suggests that flaws in our tort laws and procedures are a major part of the problem. Proposed state legislation to cap “pain and suffering” awards and implement other reforms represents a good starting point, but state lawmakers should also look at a “loser pays” rule and judicial oversight of expert testimony to reduce the impact of junk science and quack medicine on jury deliberations.
The state legislature is currently considering the idea of "decoupling" North Carolina's income tax code from the federal tax code in order to avoid implementation of several tax reductions associated with a federal economic-stimulus package. But North Carolina's weakened economy desperately needs the $258 million boost that adjusting state taxes on business and personal investment would provide. Policymakers could offset any revenue loss by reducing spending.
Gov. Mike Easley's proposed budget adjustments for FY 2002-03 help to frame the coming fiscal debate in North Carolina. The plan relies primarily on increasing revenues — including more than $400 million in tax hikes, $250 million from a theoretical state lottery, and $210 million from raiding the state‘s Highway Trust Fund — rather than on budget savings. And contrary to the governor's assertion, his plan would increase state spending in the midst of a fiscal emergency.
The American Lung Association's annual "State of the Air" reports are treated as scientific and informative by the state news media. They are neither. They use outdated information that reflect changing weather patterns rather than real pollution and are biased against jurisdictions like North Carolina with high numbers of ozone monitors. As a result, the reports supply propaganda for lobbyists for heavier regulation but do a great disservice to science and the general public.
A new study in the Journal of the American Medical Association alleges a significant increase in lung cancer risk for those exposed to high-levels of particulate matter, commonly called soot. In North Carolina, the news media and others have cited the study to boost support for the proposed Clean Smokestacks bill. But according to expert analysis, the study is so flawed that it should have been rejected by the journal. Moreover, it does not establish a case for new regulation.
To date, debate over the proposed Clean Smokestacks bill has focused primarily on the purported air-quality benefits, which would be negligible. Little attention has been paid to the cost, which could be substantial given North Carolina's already high electricity and tax rates compared to its neighbors'. This study estimates the impact on such institutions as school districts and manufacturers. The higher prices and lost jobs must be weighed against any potential benefits.
