Recent editorials from North Carolina newspapers:
The News & Observer of Raleigh on Medicaid billing errors:
The state Department of Health and Human Services last year processed 127 million claims for payment through the federal/state health care plan for the poor and disabled, and the claims were for a staggering $11 billion. A state audit concluded that about $835 million was improperly paid to providers. That may be a small fraction of the total, but it's still too much. The federal government pays two-thirds of the money, the state the rest.
The 13 percent error rate, while disputed by DHHS, is lower than the previous year's 24 percent. That's still not bragging rights territory, particularly when Gov. Pat McCrory's new administration was going to make DHHS more efficient.
Some errors had to do with paperwork, some with payments to providers who weren't eligible to receive them and some of the sample of errors didn't show a Medicaid rate cut that was retroactive. The audit looked at a sample of 396 payments to get its findings, and that's of course a fraction of all the payments. The department says better procedures are in place.
The Medicaid program has had problems with information technology, and former DHHS Secretary Aldona Wos hired a number of outside consultants with fat contracts in various roles. She caused some turmoil with her management style within a department that performs important services for people who need the state's help. Whether the department is doing better overall under Secretary Rick Brajer, who came to the job after a career mostly in private industry, remains to be determined.
The Asheville Citizen-Times on Swain County's lawsuit against the National Park Service and the U.S. Department of the Interior:
Swain County is moving to file suit against the National Park Service and the U.S. Department of the Interior, two of this newspaper's most esteemed federal agencies.
And we hope they win.
Indeed, if there's any justice they should win, or at least break a calcified appropriations process that has left the county holding the bag on a promise from the federal government.
Before wading in further, let's back up a bit. Say, several decades.
In the early 1940s, the federal government began acquiring land to build Fontana Dam. More than 44,000 acres were added to the Great Smoky Mountains National Park in 1943, and many residents of that acquisition, along with those whose land would be submerged with Fontana's waters, were relocated. An accord was reached between Swain County, North Carolina, Interior and the Tennessee Valley Authority promising a new road for the north shore of the lake, contingent on congressional funding.
In stops and starts over the years, a few miles of road were built, with the stretch appropriately being dubbed "The Road to Nowhere."
With prospects for a road dimmed due to environmental concerns and costs, in 2003 a Swain group arrived at a figure of $52 million as compensation for the broken promise. NPS came down in favor of a settlement four years later, and three years after that, in 2010, Swain received an initial payment of $12.8 million.
A year later $4 million was appropriated for Swain, but that payment was yanked back in a congressional frenzy curbing earmarks. In 2012 another payment was authorized but not released by the NPS. In subsequent years funding never made an appearance in the federal budget.
So nearly $40 million is still on the table, the government is routinely stiffing Swain County, and the beat goes on.
So why a lawsuit now?
Because the agreement compensating Swain County is on the clock, running out in 2020. Time to move.
Compensation for Swain has been a bipartisan focus for N.C. politicians. Democratic Rep. Heath Shuler, a Swain native, did a lot of the heavy lifting on the issue, and it's been taken up by his successor, Republican Mark Meadows. Meadows said, "I support the efforts of the County Commissioners to pursue legal action to ensure the funds they were promised are released to the county. I will continue to work through possible legislative remedies and encourage the current administration to see this as a priority, while at the same time working with local elected officials to make sure Swain County residents get what is promised and deserved."
We agree Swain deserves this money, although with the current broken budget process in Congress, it will be a steep climb.
Now, $40 million is a lot of money. On the other hand, given the size of the federal budget, we're talking about loose change in the couch cushions. For example, in recent days a story surfaced about the DEA and DOD spending $86 million on a counter-narcotics plane to be used in Afghanistan.
The plane has never been there. It is, in fact, inoperable and was found sitting on jacks here in the U.S.
Those are what we call budgetary priorities. It's time Swain County became one.
The Fayetteville Observer on state licensing:
Would you feel good about letting an unlicensed (and possibly untrained) hair stylist give you a new hairdo? Would you feel comfortable having an acupuncturist stick needles in you if you didn't know how he'd been trained? Would you feel safe letting an unlicensed locksmith change the locks in your home?
No? You've probably got a lot of company. We wouldn't feel good about any of those scenarios either.
But some groups in North Carolina are critical of state licensing requirements, saying they're a roadblock to entrepreneurs, a hurdle that keeps people from starting businesses.
In some cases, they're right about the bar being set too high. Bureaucracies have a natural tendency to make things too complicated, to flex their muscles just because they can. And that does impose some economic penalties on would-be business owners.
But there's a real possibility that in trying to streamline things, the General Assembly may go too far. A legislative committee will consider a bill today that may indeed take too many steps toward a kind of freedom that may not be good for the rest of us. Among other things, it would eliminate license requirements for laser hair practitioners and electrologists, sign-language interpreters, irrigation contractors, public librarians, recreational therapists, acupuncturists, athletic trainers, foresters and locksmiths.
All of those occupations are specialized and require advanced training. The existence of a state license helps consumers verify that they're doing business with a professional who's not likely a fraud.
Do we really want people to just read a book about electric hair removal, then hang out a shingle and give themselves on-the-job training with unsuspecting customers?
There has to be some reasonable intersection where consumer protection and economic expansion can meet. Rather than shredding the state's licensing requirements and the boards that administer them, we'd like to see the General Assembly set up studies that will take a hard look at each of the licensed professions and find ways to make licensing as simple as possible — without endangering consumers who use those services.
Yes, the marketplace itself will eventually weed out the frauds and the incompetents, but too many people will be hurt in the process. We need licensing that is streamlined, safe and practical.