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CAROLINA JOURNAL North Carolina C a R O L I N a State Wrestles with Medicaid Costs, Solutions by Dan E

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CAROLINA JOURNAL North Carolina C a R O L I N a State Wrestles with Medicaid Costs, Solutions by Dan E INSIDE THIS ISSUE: DEPARTMENTS Should the North Carolina 2 C A R O L I N A Education 7 ‘Amazon Local Government 10 From Page 1 14 tax’ on on- Higher Education 17 line sales be Books & the Arts 20 Opinion 24 repealed?/3 A MONTHLY JOURNAL OF NEWS, ANALYSIS AND OPINION Parting Shot 28 JOURNALFROM THE JOHN LOCKE FOUNDATION September 2012 Vol. 21 No. 9 STATEWIDE EDITION Check us out online at carolinajournal.com and johnlocke.org Coastal Wind Projects Come Under Fire such, they are not compatible with the low-level military flying operations Concerns from three that take place in the coastal area. Col. Jeannie Leavitt, commander of Sey- fronts put wind plans mour Johnson Air Force Base, stated her concerns about the project in a July in jeopardy on coast 16 letter to Perdue. “Wind farms and the windmills By Don Carrington that comprise them will have a sig- Executive Editor nificant impact on the training of F- RALEIGH 15E aircrews conducted by Seymour Beaufort County wind energy Johnson Air Force Base,” she wrote. project that won conditional ap- On Aug. 18, Perdue issued Executive proval in March from the North Order 124 requiring all state agencies ACarolina Utilities Commission faces to consider the military’s requirements major hurdles and may never get to Wind projects on the North Carolina coast are meeting resistance from three fronts: for low-altitude aviation training areas erect a single turbine. wildlife officials concerned that wind turbines would kill eagles and tundra swans, before approving any project. Among the obstacles facing the the military concerned that the tall turbines would imperil military flights, and Repub- In addition to the military’s con- Pantego project are the potential for a lican presidential nominee Mitt Romney’s preference for market-based approaches cerns, wind turbines may kill birds that Mitt Romney victory in the Novem- to alternative energy rather than government subsidies. (Eagle and Romney photos by CJ’s Don Carrington, F-15 photo courtesy of Seymour Johnson Air Force Base fly nearby, and several protected spe- ber presidential election, conflicts with Information office) cies of birds — including bald eagles military aviation training, and the and migrating tundra swans — occupy prospect that the wind turbines will could be enough to kill this wind proj- Large-scale commercial wind the Pocosin Lakes National Wildlife cause the death of too many birds. ect and others. projects depend on federal subsidies Refuge and surrounding area. Pantego Through spokesmen and position The Pantego project, being de- as well as state renewable energy man- Wind has not estimated the impact a papers, Republican presidential nomi- veloped by Pantego Wind Energy, a dates to create a demand for the elec- wind farm would have on these birds. nee Romney has made clear that he wholly owned subsidiary of Chicago- tricity produced by their wind farms. would urge Congress to end a federal based Invenergy, would generate up Without those subsidies, it would be The project tax credit for wind energy that makes to 80 megawatts of electricity using economically infeasible to build and Formed a year ago, Pantego the alternative power source economi- 49 wind turbines situated on approxi- operate them. Wind Energy is a subsidiary of Chica- cally feasible. But no matter who wins mately 11,000 acres of privately owned Wind turbines, essentially huge the White House, objections from the land located east of Washington, N.C., three-bladed windmills, typically rise military lodged with Gov. Bev Perdue near the town of Pantego. 400 to 500 feet above the ground. As Continued as “Coastal,” Page 14 Wilmington Could Become Home of the Braves PAID council meeting. RALEIGH, NC U.S. POSTAGE The city would use rent paid by PERMIT NO. 1766 NONPROFIT ORG. Ballpark project Mandalay and the proceeds from a 2.5 cent per $100 tax increase to pay off the requires voter OK bonds. The tax increase would raise the of $37 million bond taxes on a house valued at $100,000 by $25 a year, or $50 a year for property By Barry Smith proved, the city plans to build a 5,500- Associate Editor valued at $200,000. seat stadium which a Class A Atlanta Baseball supporters say having WILMINGTON Braves affiliate would call home by bout one week after the 2012 a modern minor league stadium and 2014. team located on the riverfront can help World Series champion is de- The city plans to enter into an cided, Wilmington voters will stimulate the downtown economy. agreement with Mandalay Properties, They point to the success of the Dur- Amake their own decision about base- which manages other Braves affiliates, ball. They’ll be voting on a $37 million ham Bulls Athletic Park and surround- to manage both the stadium and the ing development as an example of bond referendum for a riverfront mi- minor league team. City officials said nor league baseball stadium. what such a facility can bring. at press time they hoped a final memo- Supporters also say the stadium The Wilmington City Council in randum of understanding between the early August voted to place the bond city and Mandalay would be ready for The John Locke Foundation 200 W. Morgan St., #200 Raleigh, NC 27601 referendum on the Nov. 6 ballot. If ap- approval in time for the Sept. 4 city Continued as “Wilmington,” Page 15 PAGE 2 SEPTEMBER 2012 | CAROLINA JOURNAL North CaroliNa C A R O L I N A State Wrestles With Medicaid Costs, Solutions By Dan E. Way built around market-oriented incentives. JOURNAL Associate Editor “Until you align incentives to make that matter, es- RALEIGH pecially in a financial kind of way, you’re not likely to get Rick Henderson Managing Editor s North Carolina continues to shift most of its Med- much different [results],” Trail said. icaid recipients into its showcase Community Care But North Carolina’s system has passionate defenders. Don Carrington of North Carolina program, some say the central- “CCNC is a free-market intervention, but is readily Executive Editor Aized system needs free-market reforms to avoid chronic and distinguished from the managed care model in that it strikes costly budget overruns. at the cost and quality problems in a fundamentally differ- Mitch Kokai, Michael Lowrey But state lawmakers have little interest in embracing ent way,” said Robert Seligson, executive vice president and Barry Smith, Dan E. Way the full-risk, managed care programs used in other states. CEO of the North Carolina Medical Association. Associate Editors Health care provider organizations also oppose tinkering Like managed care, CCNC looks at financial perfor- Chad Adams, Kristy Bailey with a CCNC plan they say has improved patient outcomes mance data to identify potential cost-saving strategies, David N. Bass, Lloyd Billingsley while reimbursing them at higher rates than the national Seligson said. Kristen Blair, Sara Burrows average. But it also implements strategies at the provider level Roy Cordato, Becki Gray The debate mirrors arguments in other states that are that “are clinically driven, and make use of clinical expertise Sam A. Hieb, Lindalyn Kakadelis seeking, with limited success, to that is seriously lacking in tradi- Troy Kickler, George Leef constrain spending on Medic- tional managed care models,” Karen McMahan, Donna Martinez, aid, the program that provides Seligson said. Karen Palasek, Marc Rotterman health care to the poor and dis- “Our feeling is this: A lot of Michael Sanera, John Staddon abled. CCNC often is cited as a the things that full-risk managed George Stephens, Terry Stoops Andy Taylor, Michael Walden model that works. care will say it can do to reduce Karen Welsh, Hal Young “There is no silver bullet” Medicaid costs are already being John Calvin Young that addresses all Medicaid chal- done though CCNC,” said Don Contributors lenges in every state, said Rep. Dalton, vice president of public Nelson Dollar, R-Wake, who relations at the North Carolina Joseph Chesser, Garrett Hunter, chairs the Joint Legislative Over- Hospital Association. Xia Mai, Lexxie Monahan sight Committee on Health and “I’m not really sure why Hubert Papes, Daniel Simpson Human Services. But he is opti- it makes a difference who runs Shane Williams Interns mistic about North Carolina. Medicaid” if quality care is de- “We have found the solu- livered, budgets are met, and Published by tion. What we are working on savings are realized, said Chris- The John Locke Foundation now is maximizing better ways tie Herrera, vice president of 200 W. Morgan St., # 200 of what can be done with CCNC, policy at the Foundation for Raleigh, N.C. 27601 what sort of innovations, what sort of additional programs” Government Accountability, a free-market think tank in Na- (919) 828-3876 • Fax: 821-5117 can be added to the nationally recognized plan, Dollar said. ples, Fla. State-run plans also have high overhead costs, but www.JohnLocke.org Despite that praise, Medicaid spent $200 million more “are able to hide their costs more” than full-risk managed three years ago than lawmakers allocated in their initial Jon Ham care providers, she said. Vice President & Publisher budget and about $600 million too much two years ago. In Empowering patients to make their own choices the budget year ending June 30, Medicaid had a budget of among competing plans reduces the political power of en- John Hood $14.2 billion but still amassed a deficit of $375.4 million, said trenched advocacy groups, she said. As an example, she Chairman & President State Budget Director Andy Willis. cited a five-county pilot program in Florida that has saved Craigan Gray, director of the Medicaid program, was $118 million annually.
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