In 2013, the General Assembly swatted down federal money to help implement ObamaCare in North Carolina. That may have appeared to be a setback for the statism crowd, but recent events have me — and others — thinking it was just a bump in the road.
Have you noticed the rapid expansion of UNC Health — an arm of the state government — into local health care markets all over the state? There are ads on TV right now about a “partnership” between UNC Health and the local hospital network in Johnston County. Part of the privately owned Pinehurst Medical Clinic has partnered with UNC Health. Rocky Mount-based Nash Health has also teamed with UNC Health. Caldwell Memorial Hospital in the western part of the state has come into the UNC fold. CarolinasEast Health in New Bern has partnered with UNC on a cancer treatment center. High Point Regional Hospital has also merged with UNC. And the list goes on.
The voters and their elected leaders in Raleigh have emphatically said NO to increased government involvement in our health care delivery system. Despite all that, we have a significant arm of our state government sinking its claws deeper into an awful lot of formerly private health care providers. It’s so much easier for government to take over health care when it already owns most of its delivery apparatus.
For what it’s worth — Gov. Pat and DHHS secretary Wos have been singing the “Let’s Go Expand Medicaid” song quite cheerfully in recent weeks.
In the Asheville area, attention is being drawn to a state and federal effort to entice the county government to implement an arguably unnecessary expansion of its department of social services facilities:
[…] Buncombe commissioners voted to more than double the size of the existing DHHS building (just renovated in 2012) by adding seven more floors and a 650-space parking garage.
1. Reportedly, DHHS is not in compliance with regulations governing office space requirements. With some social service employees working in close proximity to one another, DHHS Director Mandy Stone fears client confidentiality could be compromised. She cited “space regulations” that could put Buncombe at risk of losing federal funds.
2. Stone also pointed out in her presentation that Medicaid expansion would increase their client base.
But Stone’s two arguments for spending $48.5 million in taxpayer dollars appear to be on shaky ground. State lawmakers have no plans to extend Medicaid in N.C.
Aimee Walls of the N.C. School of Government notes that the state regulations cited by Stone have not been updated since 1990 (NCAC 67A.0103 and .0105). The language is fuzzy and unclear as to whether these are actual requirements or just recommendations/guidelines. The withholding of federal funding “may” occur when agencies are not in compliance with the standards. I asked the N.C. DHHS:
1. Did the state department of health and human services find Buncombe to be in non-compliance with state regulations NCAC 67 A.0103 and 0105?
2. Have other counties been forced to comply with the space requirements?
The short answer is “no.” The written response from the state DHHS communications officer, Alexandria LeFebvre, was that Buncombe was being “proactive.” And that “we [N.C. DHHS] frequently work with counties to identify space needs and also support them maximizing federal reimbursement for the overhead cost of space.” It appears that the 24-year-old state regulation has no teeth. The state essentially works with counties to maximize spending of federal tax dollars on capital projects that may not be necessary. Federal tax dollars amount to around $14 million for Buncombe’s project, but where will the remaining $34.5 million come from?
Consider this, the existing building is only open 8 a.m.–5 p.m. Monday through Friday. Why not extend the hours to open earlier and close later? Why not open on Saturday to spread out the staff hours and benefit clients’ schedules? Why should taxpayer dollars fund the expansion of an underutilized building? Demand for welfare services may be on the decline as Buncombe has one of the highest employment rates in the state.
Hmmm. “Maximize spending of federal tax dollars on capital projects that may not be necessary.” How many more places is this type of thing happening? The McCrory administration is trying to have us go into debt to pay for road projects there allegedly is NO MONEY to pay for. Yet, here they are handing over cash for financing something of dubious necessity. We’ve got $18 trillion in federal debt and our elected ”honorables” in Washington keep printing money and handing it out for stuff like this.
This sure smells like a back door method to deepen and broaden government’s hold on the very fabric of our lives.