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Carolina Journal Radio No. 861: Mecklenburg rejects local sales-tax increase

Carolina Journal Radio / Donna Martinez and Mitch Kokai
The Truth Network Radio
November 18, 2019 8:00 am

Carolina Journal Radio No. 861: Mecklenburg rejects local sales-tax increase

Carolina Journal Radio / Donna Martinez and Mitch Kokai

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November 18, 2019 8:00 am

Mecklenburg County voters recently rejected a sales-tax increase. It was advertised as raising money for “arts and parks.” Joseph Coletti, John Locke Foundation senior fellow, has examined the impact of the timing of local sales-tax votes on the likelihood of their approval. He’s found that voters are less likely to endorse these tax hikes during high-turnout elections. Public schools have struggled for years with a racial achievement gap. But recent research is pointing toward ways to help improve minority student performance. Seth Gershenson, professor of public policy at American University, explains how a teacher’s race can make an impact on a student’s success. His most recent study applies that finding to charter schools. As N.C. legislators haggled over budget issues during the summer and early fall, one of their fights involved the future of the state business franchise tax. You’ll hear arguments for and against reducing that tax. The General Assembly has taken several steps in recent years to address the opioid crisis. During a recent speech at Western Carolina University, Sen. Jim Davis, R-Macon, recapped recent opioid-related laws. Davis also offered ideas about the next steps North Carolina should pursue in fighting the effects of powerful, dangerous drugs. Medical debt can cause major hassles for many North Carolinians, especially those with low incomes. Jordan Roberts, John Locke Foundation health care policy analyst, is working with a group called RIP Medical Debt to address the issue. The group purchases low-income patients’ medical debt and wipes it clean, often for pennies on the dollar. Roberts hopes to raise $30,000 in an attempt to relieve as much as $2.5 million in old medical debt in central North Carolina.

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From chair to current and the largest city to the smallest and from the statehouse into the schoolhouse Carolina Journal radio your weekly news magazine discussing North Carolina's most of public policy events and issues welcome to Carolina Journal radio I Michiko guy during the next hour, Donna Martinez and I will explore some major issues affecting our state teachers race could play a role in determining a public school students chance for success. You learned about recent research that applies that finding to charter schools North Carolina lawmakers continue to haggle over a plan to cut the states business franchise tax you hear details Republican support. The plan Democrats oppose it. North Carolina has taken multiple steps in recent years to address the opioid crisis leaving lawmaker recaps those steps. He also sets out ideas to pursue in the future will learn how a group called RIP medical debt is helping to remove a major burden for low income patients in North Carolina.

The John Locke foundation's healthcare policy analyst describes his role. Those topics are just a headfirst Donna Martinez joins us with the Carolina Journal headline on November 5 Mecklenburg County voters gave a thumbs down to a proposed sales tax hike that was sold by supporters as a way to fund the arts and parks in that county actually makes twice in five years that Mecklenburg voters have said no to higher sales tax. The County is one of many North Carolina counties that have attempted to convince voters over the years to raise sales taxes Joe Colletti follows the sales tax hike effort in North Carolina. He's a senior fellow with the John Locke foundation is now talk about some really interesting data on this Joe. Welcome back to the show. Glad to be here in Mecklenburg County. There was a whole lot of money there would that was spent by supporters of the quarter sent to hike in the sales tax to try to get this passed but it didn't make it give us a sense of the factions.

What was the argument like in Mac. Sure there is a very special mention lot of money spent $1 million over million dollars spent in favor of the August sales tax hike. The opposition group, the main opposition group had about $1000. There's some others' money spent but yeah that's that was no those were the odds that that were there with that million dollars that was coming from the Carolina Panthers and from the Chamber of Commerce and from a number of other organizations and and the votes, broke down the same way that it was the downtown or in Charlotte as it's called uptown crowd was in support of having the sales tax passed in the suburbs and the poor areas of Charlotte were against it and that's what we saw with the votes and that's kind of what we saw with who it was councilmembers and count and commission members back off them on the on the County commission entry for Kari. She had a Democrat and Republican, both coming out against this part of it was about the regressive nature part of it was about what the money was being used for that arts was the main selling point when it first came out and and that people didn't necessarily trust that the money would be used the way that the County commission said it was on arts on education and on and on, parks and even tried to bribe the northern cities in Mecklenburg County by saying that a portion of the money would go to Huntersville and the places of their didn't work. Interesting that debt was the messaging wrong or are North Carolina voters. In this case, those in Mecklenburg County really paying more attention. Perhaps to fiscal issues and what's going to directly impact their wallet. That's where the question comes at his taxes continue to lose more often than not. But people are still willing to support bonds and so we sit we saw across a number of bond issues past so it's not necessarily that people are looking for fiscal responsibility. It's that if they see that it's a tax hike and they see what it's being used for, especially in this case there is some there is some reticence to go to go along with a visit in this case, especially because the sales tax is generally regressive that it affects poor people with the takes a higher percentage of a poor person's income than it does a wealthy person's income and the money was going to go 22% of it or 45% of it to the arts, which is mainly which is mainly the ballet in groups like that that that are more patronized by people with higher incomes.

There was there. That was where some of the discomfort came this time.

In addition to the just general opposition to higher taxes which which which explains where the Americans for prosperity in some of the Republican opposition came from.

That's very interesting what you mentioned about the difference in perception, perhaps between a sales tax hike and a bond referendum. We saw during the election and in early November in Durham, for example, they passed overwhelmingly in affordable housing bond so it might be the issue itself. If people think that something is quote worth it or not, yet, and despite the, the, the language changes that the Gen. assembly has tried to impose on on bond issues at the local level over time.

There still not necessarily so there's partly the issue what it's worth, what is going to be used for affordable housing versus the arts in the perception that go along with those but also partly the when a bond passes there's a there's an people may go into it with an assumption that food the top, the city Council or the county will be able to figure out how to use the money appropriately so that we may not have a tax increase in the future. We recognize that it is it has a tax impact. But it may not necessarily mean higher taxes directly and also that perception.

I think between sales tax. That means that's coming out of my purse right now. The next time I go to buy something, whereas that bond. It's kinda nebulous out who pays for it and when went down the road I will worry about that. Yeah it says there is there is a delay between the the bond vote and when that eventually gets translated into property taxes because there's the there's the about a year before the bonds actually get issued and then another year before you start paying debt service on them but even with in wake County, where there been a number of bonds passed, including a billion-dollar school bond a couple years ago. The translation of that into a higher property taxes we seen our property taxes in wake County wake County now has higher taxes and property taxes in Mecklenburg but it may not be that you connect the bond that we passed a couple years ago to the higher taxes today Joe. It's interesting that Mecklenburg with this sales tax hike going down the second time in Mecklenburg that they tried to pass that and damp scads of other North Carolina counties have been putting this quarter sent sale tech sales tax hike on the ballot.

Over the past few years some interesting analysis of that tell us what you found out and taking a look at the sales tax votes since 2008 when we can take a look at what the turnout was four votes found that generally 10% increase in turnout means a 2.2 and 1/2% decline in the percent of people voting for tax increase. So, the lower the turnout and people.

There's a general rule that people understand that the lower the turn of the more likely you are to have higher taxes in and to have more support for a tax increase, but it really came out in the numbers that you could see that it was 10% increase and then turn out to 1/2% decrease in the percent of people voting for Nickens, see that in this one that in 2014. The last time that this was on the ballot in Mecklenburg. There is 37% turnout 61% of the people voted against this time he lost 54% of of the people voting for or voting against while you had turnout followed by a 20 x 20%.

So, but that's part of what with this journalism is done on the outside as well as we want to make sure that these votes happen when there is greater turnout when every County precinct is voting so Michael Berg is one of only two counties where you can have a vote on a bond during a municipal election and we sin, we see that next year we have to votes in the primary and none indicated yet in the in the general election, but there, the higher the turnout which you have in presidential elections in primaries and presidential primaries, the lower the likelihood of passage and Joe what you're really getting to here is if you are an elected official who is listening to Joe Colletti's analysis.

Your thinking there is strategy to this set as to when they might put these things on the ballot so there's a lot of behind-the-scenes death that goes on, they don't just you know pull out of the air, the date that something's going to be on about you primaries are more likely than in the general election municipal's are more likely but there are few that may have fewer options to start gaming with with time than they used to.

What's a fascinating analysis of what has gone on in North Carolina over the past 10 or 12 years as more than 70 counties of Gonda voters.

My goodness at least 160 times asking to raise the local sales tax by 1/4 sent. You can read Joe's analysis of all of this at John lock.thanks so much think you say when this much more Carolina journal radio to come in just a moment tired of fake names tired of reporters with political axes to grind.

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We hold government accountable for you. Look at that Carolina journal radio I Michiko got one of the most vexing problems in public education is an achievement gap between white minority students are next guest has conducted research on ways to address this problem. Dr. Seth Gershenson is professor of public policy at American University. Welcome to the program. Thanks for having me happy to be here. Let's get into one of your key findings that actually predates your most recent study, and that is that when it comes to this achievement gap and addressing it, the teachers would race makes a big difference.

Also yeah that's right so study that we published two years ago has gotten a lot of attention and it builds on previous work that shows that when students have the same race teacher. They have better test scores and we built a network to look at long-run outcomes that we really care about you know the test score gap is really only interesting to the extent that test scores predict long-term outcomes like earnings, college graduation, and so on. So we look to see whether these race match effects really do carry out to long on outcomes and we do so using two different data sources. One is a actual experiment where students and teachers were randomly assigned to classrooms in Tennessee. The other is in North Carolina and in both data sets.

We find very compelling evidence that yes when you have at least one black teacher in elementary school, black students are submissively more likely to complete high school and to enroll in college so that so shows that those same receipts for effects on test scores are not one-off flukes or anything like that but they really do affect students long-run outcomes. This leads that into a new study that you've done for or in connection with the Fordham Institute.

This involves this effect the same race teacher effect and charter schools tells about that right so the pharmacist was interested in whether the use of race match effects that are traditionally documented in traditional public schools also show up in charter schools. So once again we got data from North Carolina North Carolina education research data center is a group at Duke and North Carolina University North Carolina that make very rich of ministry of data available to researchers and this really gave us an opportunity to dig in and see what's happening in charter schools and the short answer is yes. These race match effects to exist in charter schools and their actually bigger severe effect on test scores is about twice as large as a dozen traditional public schools. Do you have a since the from the research as to why so generally we don't know exactly why, but there's likely a few different reasons. One reason in particular has to do with expectations.

We think there's a similar same race effect on teacher expectations are much more likely to expect the student will complete college and another work that I've done with colleagues at Johns Hopkins. We show that teacher expectations matter for college completion and long-run outcomes as well. So one factor. Certainly this idea of high expectations another related idea is a role model effect where, especially for more disadvantaged students. Seeing a teacher who looks like them from a neighborhood like there's this sends a signal that you know rising trooper for professional career in the middle class is possible and then the third story is that there's probably better communication and there's different names for this type of communication and some people might call it culturally relevant pedagogy for teaching the hidden curriculum, but these ideas are all interrelated in the sense that when you have a teacher who looks like you you you get more out of the relationship and build a deeper, more trusting relationship that is the voice of Prof. Seth Gershenson of American University talking about this new interesting study done in connection with the Fordham Institute involving teacher race and charter schools so you have some interesting findings what you hope will come out of this. I know that there are some ideas of where to go forward, get a second important question so that the first obvious responses. Well then let's hire a more diverse teaching force. The student population in the United States is about 50% white. Right now, and the teaching force is 80 to 85% white, so there's an imbalance there. So a lot of people will read our research and others research on the topic and say well we have to diversify the teaching force and while that's certainly an important and laudable goal.

That's not feasible in the short run of the reason is that the supply of nonwhite teachers just isn't there right now so there's a pipeline problem or supply problem so long-run goal is to absolutely get more nonwhite black and Hispanic teachers into cutter should say students in the college and interested in teaching career. But that's very much a longer-term goal so for policymakers and and school leaders right now. What can we do today.

There's a few things.

One is to make a more creative use of the diversity that we do have in our classrooms. So one a simple idea is that if there's a handful of black teachers in the school say we could rearrange the school day so that all students interact with all teachers over the course of a year. Maybe that's through having different special topics are missed mixing classes or things like that. Another idea is that these role model effects don't necessarily have to come from teachers. We can also bring professionals from the community into schools to give little, you know, career fair type presentations or other just discussions about what they do and how they were successful in school and so on. So for example this really neat experiment where a high school in France had. This is in exactly the same context is here this ice conference had female scientists come to ninth grade science classrooms and give short 50 minute presentations about what they do in a given day at the work in this had a big effect on female high school students later enrollment in college and science and stem programs so that wasn't teachers that was just bringing in professionals and and sort of benefiting and piggybacking on this role model effect so we could actually do things like that and and public schools here. And lastly we can do much better at training all of our teachers of all backgrounds to better empathize and work with students of all backgrounds and I gather from research. Another important thing was making sure that these teachers have high expectations for all students. Yeah, exactly. And so that's what I meant by some of these training programs and professional development programs.

There's a lot of compelling work right now that even a relatively short one hour training program can move the needle on teacher sympathy levels expectation levels and attitudes towards students of different backgrounds for teachers of all types. So third there are professional developing opportunities out there that all teachers of all backgrounds would benefit from. One thing I wanted to clarify before we wrap up is this notion of the. The impact of the teachers race. This doesn't mean that a student has to have the teacher of the same race to succeed, just at least some access to having someone of the same race at some point whether it is the teacher or someone from the outside right yeah so a few points about that. The first one of the more nuanced results and in our work is that for a lot of this benefit comes from just having one black teacher. So in other words, the extra benefit of a second black teacher is relatively small. Once you've had that first exposure and similarly in the in the Fordham study, we show that the effects are muted in schools with black principles which is really interesting so government suggests that sort of any sort of exposure. Sort of delivers this role model benefit under this race match effect and then again we can we can use that information to veterans to more strategically allocate our teachers of her teachers that we have what's very interesting research. We thank Dr. Seth Gershenson Prof. public policy and American University for sharing that knowledge with us. Thanks.

Thank you. Love more on Carolina journal radio just if you love freedom we got great news to share with you now. You can find the latest news, views, and research from conservative groups across North Carolina all in one place North Carolina conservative.com it's one stop shopping for North Carolina's freedom movement@northcarolinaconservative.com. You'll find links to John Locke foundation blogs on the days news Carolina journal.com reporting and quick takes Carolina journal radio interviews TV interviews featuring CJ reporters and let foundation analysts, opinion pieces and reports on higher education James G. Martin Center for academic renewal, commentary and polling data from the scimitar's Institute and news and views from the North Carolina family policy Council.

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You also support freedom. Don't forget log on to smile.amazon.com today, something nice and help defend freedom, help support the John Mott foundation. Welcome back to Carolina journal radio I Mitch coca North Carolina legislators continued to debate the future of the state business franchise tax. Republicans want to cut the tax eventually eliminating the first proposed cut drew an objection from Democratic Sen. Floyd McKissick.

He's concerned about lost revenue, there's no guarantee that can be additional revenue going to the state and we look at the projected financial losses here at home we get to 2023, 24 were talking about three and $40 million and if you go to the cumulative losses in that. By that point in time he would've exceeded $1 billion, so we're basically my implementing this legislation agreeing that just in the next 3 to 4 years billion dollars in revenue that we are writing off the charts in our books and that does give me concern because I know there's substantial expenses and needs in the state. The need to be addressed and I'm not hearing a burning concern from these businesses to say got to get this reduced. If so, those businesses that pay franchise taxes would be here North Carolina day Republican Sen. Paul Newton responded to McKissick's complaint, he focused on the role of taxes in North Carolina's economic growth you don't improve your status by standing still. If we become complacent and don't find ways to attract additional employment additional capital investment then we will be left behind. I guarantee you not only estate surrounding us, but across the United States and other parts of the world they want every employer and we are getting in North Carolina so we cannot stand still.

We also judge to have the number one economy in North Carolina this year but CNBC that doesn't happen by standing still.

I thought would be interesting to know your course we lost out on Amazon's second headquarters and they would have if they had located North Carolina that would've been through, based on their own projections of capital investment $3.75 million a year that they would've paid for the privilege of being in North Carolina whether they made a dime or not, Newton placed the franchise tax proposal in a larger context. We owe it to the next generation of North Carolinians to do things differently smarter to make sure were creating good jobs for their kids and their grandkids. The only way to do that is to attract capital investment and attract jobs to North Carolina franchise tax. Make no mistake about it. If you do you like penalizes capital investment. It penalizes the more you invest today. The more you invest in North Carolina, the more you're going to be paying for that investment where his father states that is not the case that's Republican State Sen. Paul Newton he's defending legislative Republicans plan to reduce with the hope of eventually eliminating North Carolina's state business franchise tax return with more Carolina journal radio and among where doubling down on freedom at Carolina journal radio were proud to bring you stories that impact your life and your wallet. And now get twice as much freedom when you also listen to our podcast headlock available on iTunes and@johnlocke.org/podcast Locke is a little bit different.

It's a no holds barred discussion that challenges softheaded ideas from the left and the right light. Carolina journal radio Hemlock is smart and timely but with headlock you'll hear more about the culture wars get some more humor as well. We guarantee great information and a good time that's listen to Carolina journal radio each week and listen to headlock to remember, you can listen to headlock@johnlocke.org/podcast or subscriber download each week iTunes Carolina journal radio and headlock just what you need to stay informed and stay entertained both brought to you in the name of freedom by the John Locke foundation. Welcome back to Carolina journal radio I Mitch coca North Carolina's Gen. assembly is taken several steps in recent years to fight the states problem with opioid drugs.

Republican State Sen. Jim Davis discuss those efforts during an event at Western Carolina University sponsored by the Center for the study of free enterprise, Davis recalled how a conversation with a friend in law enforcement directed his attention to the issue. He said I'm tired of young people in body bags. We gotta do something about this issue and so there. From that moment I became a champion dealing with this issue, an unlikely candidate are combatant in this war against opiates and other drugs because I spent most of my life ignorant of the magnitude of the issue. I was an individual who before Nancy Reagan made it popular. I was a just say no individual that work for me being scared straight. Davis says his attitude about opioid abuse has changed over the year over time in dealing with this issue. I've transition from what's wrong with you to what happened to you and has made a huge difference in our life approach this opioid issue in all all addiction issue others so tobacco, alcohol, drugs, sex work, whatever your addiction is, it usually is impacted by something that happened to you and also in this journey I've learned about Ace's adverse childhood experiences and I'm convinced that were never going to be able to treat our way out of this problem. Never gonna be able to incarcerate ours our way out of this problem. We need to address the underlying issues. The adverse childhood experiences the PTSD and all those things that that the precipitate this addictive behavior. Davis were counted for his Western Carolina University audience. The laws approved in Raleigh to deal with opioid. The first substantial measure was named the stop act stop act is intended to reduce the supply of unused misused and diverted opioid circulating North Carolina and also route is intended to reduce doctor shopping and improve care by requiring prescribers to use tools and resources that help prevent inappropriate prescribing.

Another thing that came out of the stop act was a directive from that legislation to to begin a task force for opioid sentencing reform again like I said law enforcement tells us they cannot arrest their way out of this problem. So we were looking at ways that we could take low-level offenders. Those offenders who had like a month supply of drug which would put them over the limit to make to put them in the classification of being dealers and but they had all these drugs for their personal use, and so we wanted away in order to divert those individuals who didn't have a violent history into treatment rather than incarceration. Unfortunately when you're incarcerated. You only have a one in six chance of getting significant drug treatment and are prison system and so it's all the more important that we can divert these individuals. Again, there are nonviolent to drug treatment courts into and the treatment rather than incarcerating them after the stop act.

State lawmakers approved another piece of legislation with an easy acronym. It was called hope act.

This topic focused on prescriptions going from doctor to patient or prescriber to patient in the hope act is about stemming the flow lawful pharmaceuticals into the illegal drug sales and illegal use of learned a lot in this journey and found out that some people that pet owners they abuse their pets even break their dog's legs in order to take him to the veterinarian to get opioids for their pet and then they take them. I've learned about individuals, nurses and and nurse practitioners that them hospitals that are diverting opioids to their own personal use or selling it learned about the individuals that have diluted the medication and and substituted it with you know with the other things that State Sen. Jim Davis one of the legislative leaders on bills dealing with opioids. He mentioned 1/3 piece of legislation after the stop act and hope act was the opioid epidemic response act. It had several interesting pieces including decriminalize the use of testing strips and again that was a hard heart so for somebody who doesn't want to enable bad behavior, but the a lot of the overdoses have to do like you learned within the witches in those 5200 times more potent than morphine. And that's the drug that's really coming on a lot of people that are going to treatment programs may come out to go to their old dealer and they take some some drugs again and if if a slice from fentanyl. That's 5200 times more potent than morphine then that's a lot of overdoses so would we decriminalize the use of testing strips before that testing strips were used by drug dealers and we removed that the band Davis also highlighted the death by distribution law, which aims to punish drug dealers who contribute to their customers deaths. It was met with a lot of the a lot of worries about unintentional consequences.

But we implemented in that legislation were very careful not to dilute the good Samaritan law that we passed earlier and so is not perfect. There's no such thing as perfect legislation in the legislature. Davis as the work is not over. What is the general assembly still need to do. We need to regulate pain point clinics more a lot of pain clinics. They used to be really rampant off I 75 in Florida.

They've got a handle on. And we need to regulate those North Carolina on the problems that were dealing with with control subs reporting system and with regulating all these things as were so close to other states and people can just go over across the state line in and have access to drugs and and the and prescriptions, and other places. There is another long-term goal. I've tried to get benzodiazepines as part of the control subs reporting system Xanax and Valium are two common benzos and our our overdose.

People tell you that about 40 some percent of the overdose victims have benzos in their system, but that is another thing that we have to live to fight another day.

This once a centralized agency targeting treatment when you do is establish the state opioid treatment authority with registration fee. There a lot of bad actors in the treatment world out there and there's a lot of money to be made. If you're a bad actor. There's money to be made. If you're a good actor but not so much and we have some incredibly good programs in North Carolina in this country, but they're expensive but there are some bad actors and so I attempted to put in legislation that would require treatment facilities to join a nationally recognized authority so that we knew that when people go there for treatment.

They're getting good treatment not just wasting money. North Carolina also could see a piece of national lawsuit settlement money were looking at getting billions of dollars from these pharmaceutical companies that push these opioids and like somebody like the nurse said there is a there is a good use for opioids in the medical field. My wife just had back surgery three weeks ago today and she had Sentinel postoperatively and and she had some some other opioids and she didn't take him all unfortunately for that. She didn't need him, but that what she said was you take a Tylenol and Motrin together. There were effective. Some studies show that they're just as effective as opiates, but we need to ensure that the money that we get from these pharmaceutical companies comes to a central clearinghouse in the state and that clearinghouse ensures that that money doesn't get diverted to another budget item in the state budget.

It goes to treatment to help those individuals and families impacted by the opioid crisis. Davis plans to leave the general assembly after 10 years of service. He knows the fight against opioid abuse will continue this prescription drug abuse advisory committee will outlast me, but their other champions in the legislature to continue our fight against this modern day playing on our society that State Sen. Jim Davis speaking recently at Western Carolina University will return with North Carolina drone radio in a moment really influence you either have it or you don't and at the John Mott foundation we have it, you'll find our guiding principles in many of the freedom forward reforms in the past decade here in North Carolina. So while others talk or complain or name call. We provide research solutions and hope our team analyzes the pressing issues of the day jobs, healthcare, education, and more.

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We are the John lock foundation. Welcome back to Carolina Journal radio I'm Donna Martinez past decade we've had a big debate in this country over how to expand access to affordable health insurance and if audible healthcare, but despite passage of the affordable care act Obama care, affordability of insurance and care remains elusive to some, particularly those who have high deductibles and high co-pays with their insurance policies that can lead to medical bills that some folks simply cannot pay our next guest is working with a private effort to help wipe away old medical debt that's dogging some low income North Carolinians Jordan Roberts is the healthcare policy analyst for the John Locke foundation he joints now to talk about this Jordan, welcome back. I thought Obama care was going to make insurance and care, affordable yet it hasn't. That's right so you know we we steer all the times of our people struggling to afford insurance and then a lot of times, even when they have insurance, it doesn't work for them in that you know you pay a premium and you expect somebody are met all of your medical care to be covered, but then you go to the hospital, go to the emergency room and you wind up with a huge surprise bill or a balance bill from you know a doctor that was in the network and then the insurance company says you're on the hook for that. So you know what we have trouble with affordability. We also have trouble with insurance not working the way it's supposed to for folks tell us about a balance bill and a surprise bill you mentioned both of those. Why are they so that's that. This is some of the most pervasive issues with insurance is that when you go to the hospital and get a procedure done. Your insurance company in the hospital negotiate to pay what you know they think is a fair rate and sometimes if it's the hospital charges more than what the insurer is willing to pay the hospital will balance bill a patient and send them the remainder of the bill.

So that's one example.

If there's just a disagreement between an insurer and a provider and that the patient really has no say in that than the other example is us a surprise bill is when you go and get a procedure down and the hospitals and network your surgeons and network with and the anesthesiologist is out of network and so you think your coverage you paid your coinsurance and your deductible when all of a sudden you get a surprise bill from an anesthesiologist is not network and that's could be double, triple what the procedure cost you in the first place and once again being out of network. Your insurance is not can it cover that said, this happens all the time many different examples of different ways. It can happen.

But you know the main point is that the patient really has no recourse or any way to know negotiate this bill or anything enough oftentimes are stuck that so no matter how or why it comes, you're going to get a statement in the mail that says that you owe and could be thousands of dollars now. Yet, you said you can't challenge this you just have to look at it and say, okay, how do I pay this sorry the reality is that some people, particularly those who are of modest income levels so living paycheck to paycheck simply cannot pay the bill so the bill ends up going to collection right so that's what happens. Sometimes these hospitals will you try to go and collect these wages and collect these bills in different number of ways.

We heard there's a big story in a South Carolina that they were using the local revenue departments to garnish tax returns to get these bills back, sometimes even to see patients and taken to court so yeah there's a lot of different ways that they can go about it. But once again the patient just really doesn't know it has no means to pay that when they were inspecting the bill in the first place. So this then becomes an issue for their credit report as they tried to go ahead and pay their other bills, knowing that this big bill is looming, it's gone to collection the hospitals trying to get the money then the hospital can also sell off that debt. Private collection firms yeah and so that happens to you and the nuts off the hospitals books, which is their eventual goal to get paid anything civil take whatever and now the debt is over to a collection agency which is become a pretty big industry now because of so many outstanding medical bills with our convoluted healthcare system. So this is a pretty persistent you know industry here that will by dad and then own the debt and then that they use different means to try to collect it to. Just like the hospital. This is where it gets really interesting and Jordan. You are involved in a project and this is a private project outside of the John Locke foundation right where you are a policy analyst, but you got involved in an effort to try to actually help these people who are now being dogged by this old medical debt. It's hurting their their credit report and it's something just looming in their lives.

Tell us about our IP medical that yes I'm really excited for service projects underway and partnering with RIP medical debt to wipe out as much medical old medical debt as we can for individuals in North and South Carolina and said the individuals for the debt in order to qualify for the program. The debt has to be the individuals to be making less than two times the federal poverty line have to more than 5% of their annual income, and other debts have to be greater than the total assets of these that were talking at the lowest income individuals that really have no means to pay these off and the great thing about RIP medical debt is. It was started by two old collection agency executives and sell what they now do is they sponsor campaigns like mine to raise money. I will give them the money and they will purchase portfolios of old debt off the secondary debt market where were likely to talk about before that these collection agencies abroad and there, wipe it completely clean and no effect on their credit so it's really great and the best part about partnering with RIP medical debt is the collection agency expertise allows them to purchase the debt for pennies on the dollar so far, roughly comes out to every dollar that I can raise wipe out about $100 of old medical debt.

Jordan, this is really amazing because you're talking about something here where governments not involved in private effort. It's you as an individual reaching out to literally impact and change the lives of unknown numbers of North Carolinians and South Carolinians as well around in your effort, that's amazing yeah I'm really excited about it or not, you know, I hope what we can do here is raise as much money as possible raise the awareness of this issue that a lot of times these people come to this debt through no fault of their own and this is not to say that you shouldn't pay your bills and should should collect up debt that you should rack up that that other people didn't pay off this is you really people that fall victim to the problems of our healthcare system through no fault of their own. Just trying to access care, and then all of a sudden they're hamstrung by some thousand multithousand dollar bill that you know lingers forever. So there's the people were trying to help out become victim and really have no other means to get out of the red Jordan I have to applaud you because this really does fit into the mission of free enterprise and personal responsibility. Individuals reaching out to help other people. Again, no government involved in this is this is really what it's all about account.

If people are interested in finding out more about Jordan's effort and RIP medical debt. Just send an email over to Jordan. Jordan you want to give out your email address. Yeah. So my email is jroberts@johnlocke.org and I also have a link for the fundraiser page. If you go to BIT.LY\Jordan Roberts my name you'll find my RIP medical debt fundraising page, you cannot donate money there to also there. There's a link to buy tickets to an event, a fundraising event that I'm holding in February. All ticket proceeds will go towards the fundraiser so we hope that everyone can join us for a night of our food and drinks raising awareness about this issue that's plaguing our neighbors and Jordan and again Jordan is a healthcare policy analyst Terrence John Mark foundation. Thank you very much based on the time we have for the program this week listening on behalf of my cohost Mitch. I'm Donna Martinez will join us again next week for more.

Caroline internally Carolina journal radio is a program of the John Locke foundation to learn more about the John Locke foundation donations that support programs like Carolina journal radio send email to John Locke call 1866 Jayla 166-553-4636 Carolina journal radio is the John line foundation airline is maintaining Carolina broadcasting system, Inc. all opinions expressed on this program are so clearly reflect the station.

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