Unhealthy: Forget the salary. Why privatize Medicaid?

Editorial by Fayetteville Observer, September 18, 2o13.

Another day, another McCrory salary kerfuffle. Once again, a well-paid and politically connected employee has been appointed to a top job at the state Department of Health and Human Services.

Margaret Peal, a 42-year-old former East Carolina University lecturer, is also a McCrory campaign donor, an Eastern North Carolina Tea Party organizer and an anti-abortion activist.

Given those credentials, left-leaning activists will be on her case like crows on road kill. They'll be missing the point. Peal's not the issue. The project she was hired for should be.

Unlike some other recent appointees to HHS, Peal has credentials to justify her $95,000 salary. It's the project she'll work on that's disturbing. She'll join the group planning to turn over administration of the state's Medicaid program to private management. We've yet to hear why it's necessary to do it.

Medicaid in North Carolina is managed by Community Care of North Carolina, a community-based, physician-directed public-private partnership that has won national awards for effectiveness and efficiency. CCNC has had such success that other states - including some that went down the privatization road - have come here to check it out and copy our system.

On Wednesday, CCNC's chief executive, Dr. Allen Dobson, was in New York, sharing North Carolina's successes with other leaders at a conference on "Driving Transformation in Medicaid." Earlier this year, the organization won the Healthcare Leadership Council's Wellness Frontiers Award.

The program has succeeded in keeping Medicaid recipients healthier in a more cost-effective way. But now, the McCrory administration wants to hand the job to private companies. This may save short-term money but, given the track record elsewhere, won't meet communities' needs.

It raises a fundamental question: What is the purpose of government? Is it to simply spend less money? Or is it to deliver the services state residents need, and do it in the most efficient way possible?

It is the latter. But it appears the McCrory administration prefers the former. That will result in unmet needs that eventually will cost us more money. It means residents not getting adequate medical care on a routine basis, and thus showing up in emergency rooms for the most expensive possible care when their conditions become acute. And in a vacuum of insurance, who pays? Ultimately, we do.

Let's worry more about that than we worry about someone's $95,000 salary.