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Carolina Journal Radio No. 811: Lawmakers look into controversial pipeline fund

Carolina Journal Radio / Donna Martinez and Mitch Kokai
The Truth Network Radio
December 3, 2018 8:00 am

Carolina Journal Radio No. 811: Lawmakers look into controversial pipeline fund

Carolina Journal Radio / Donna Martinez and Mitch Kokai

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December 3, 2018 8:00 am

A state legislative committee plans to hire an outside investigator to look into a controversial $57.8 million fund tied to the Atlantic Coast Pipeline. Rick Henderson, Carolina Journal editor-in-chief analyzes the decision to seek outside investigative help. Henderson explains why the fund has raised concerns about North Carolina’s environmental permitting process. Some people want to target hate by censoring or banning so-called “hate speech.” Nadine Strossen, professor at New York Law School and former national president of the American Civil Liberties Union, disagrees. During a recent visit to North Carolina, Strossen touted free speech as the best tool to fight hate speech. A special N.C. legislative committee is studying the treatment of student-athletes on University of North Carolina campuses. During the group’s first meeting, one senator questioned a representative of the NCAA about the group’s role in overseeing big-money football and men’s basketball programs. A top advocate of school choice in North Carolina has a new leader. Mike Long recently joined Parents for Educational Freedom in North Carolina as its new president. Though new to PEFNC, Long is a native North Carolinian with more than three decades of experience in public and private school education. Millennials’ desire for on-demand services could lead to major changes in the future of American health care. That’s the assessment of Jordan Roberts, John Locke Foundation health care policy analyst. Roberts discusses the shift away from traditional health care services toward urgent care, retail clinics, telemedicine, and direct primary care.

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From Cherokee to current attack from the largest city to the smallest town and from the statehouse into the schoolhouse Carolina Journal radio your weekly news magazine discussing North Carolina's most public policy events and issues welcome to Carolina Journal radio why Michiko got during the next hour, Donna Martinez and I will explore some major issues affecting our state. This week's edition of Carolina Journal radio was brought to you by Blue Cross and Blue Shield of North Carolina working every day to transform the health system for North Carolinians or probation available at today.

Some people want to fight hate by censoring or even banning so-called hate speech will speak with a prominent national civil liberties expert who recommends a different approach by new North Carolina committee is studying the fair treatment of student athletes at the state's public universities will hear highlights from one of the groups first meetings at top advocate for school choice in North Carolina has a new leader. You hear from the president of parents for educational freedom in North Carolina will share his priority list and will explain how millennial's could drive major changes in the future of American healthcare desire for on-demand services could threaten traditional healthcare models. Those topics are just ahead.

But first, Donna Martinez joins us with the Carolina Journal headline legislative committee investigator will be hired to determine who did what, with regard to Gov. Roy Coopers to $58 million fund that fund attached to the Atlantic coast pipeline project.

Legislators want to know if the governor's conduct was illegal and also if there was pressure applied to the pipeline operators to agreed to turn over funds during the permitting process for the pipeline.

Carolina Journal has been reporting extensively on this story Rick Henderson as editor-in-chief.

He joins us now with the latest update welcome back to the program. First of all recap for us if you would what is defined in the project that is in question here because pipeline is a major gas conduit natural gas conduit to squad distortion West Virginia and eventually will flow around the Dell VI 95 corridor on site from the state border down to Robson camp and the purpose of this is to provide a higher volume of natural gas for potential economic development, manufacturing facilities, it might not have enough gas available to do the sorts of things in some of these economically distressed communities. The fund itself was set up separately from the money that any sort of large project developer sets aside to handle environmental damage or environmental restoration is required by unearthing large amounts of land and possibly distorting streams and things like that.

In this case the operators who were several utilities including Duke energy, set aside $11 million to pay for this environmental litigation.

Now after that was agreed to and after that looked like everybody was ready to put pen to paper and approve the pipeline coming through North Carolina have gone through all federal processes because it does have to get certain permits in order for it exceeded federal approval of any suit state approval letter to go through that process. Then, suddenly, a second fund appeared right around the time that the state announced that it was going to issue all of the water quality permits and the like for pipeline. Therefore, this is the $58 million fund is in question. What's questionable about the fund is first of all, it was set up outside the normal environmental litigation process, and secondly, the way it turned out, the governor controls the money which is, it raises all sorts of separation of powers and constitutional issues. According to the North Carolina Constitution, the only people who were allowed to spend money given to the state. This not designated for us for some other purpose, such as federal Medicaid money and food safe stuff like that general symbol general assembly has to at least authorize the spending.

At some point, even if the general assembly doesn't actually dole out the money in this case. This was done entirely behind their backs. This was done by Gov. Cooper and initially was supposed to go to his Department of environment, division of environmental quality and is that during the process of apparel during the process of negotiations. The function went from going to the state with Gov. Cooper is the agent going to Gov. Cooper directly. All of this that you described Rick headset really generated so many questions on both sides of the political aisle, including from at least one quite prominent environmental organization. What we saw happen was that the general assembly then created a special committee to start looking into this a few days ago. That committee held its first meeting and the determination at that meeting was to hire an official investigator.

That's a pretty serious move will it really is because one thing, this investigator will have subpoena power. This person will have the possibility to compel deposition testimony potential for people could conceivably issue arrest warrants of the rise, that level was my criminal referrals to two federal officials to state officials to issue warrants and things like that. Now the what happened here. The reason that there's so much uproar about this was that after the fund was announced before the money started flowing. General assembly said the governor can't do this is of the general assembly essentially took control the fund itself and said it was want to spend this money for to help the school systems that were going to be in the affected areas and so some Democrats are not real happy with that. There may not be happy with the governor having fun with there also may not be happy with the fact the general symbol is taking this but in some Republicans even more happy about the fact that that this was going to happen because this $57.8 million has come from somewhere, most likely is going to come from ratepayers and it looks like people who buy electricity you are getting any measure a customer of exact utility companies involved in the pipelines of the way that this fund has been described as sort of pay to play but as if Duke energy at all. You have to pay $57.8 million bribes. The terms used to do business in North Carolina with this pipeline to be paying. We are really paying a bribe to business in which is what is really got a lot of people upset and then the environmental groups of cells are upset also because they don't really think that there was necessarily adequate supervision of some of the permitting process and they also don't think that the money should be discretionary like this if it's going to go with the money supposed to go for environmental issues.

As you environmental issues, not for other purposes as the governor is allowed to do under this agreement.

In fact I'm here at the John Locke foundation, our senior fellow Don Vander Vartan, who is set at current Senior fellow the former Sec. of the Department of environmental environmental quality during the McCrory years he has concerns about the timing of the permits versus this fund even questions about the propriety of the fund itself aside, just the timing.

Because he's wondering he feels like there's a possibility that the permitting process in North Carolina has been compromised will yes because the issue is if you are going to build a large project in the state. Then of course you should be expected to make good on any damage to make break whole people who were damaged during the process. However, if in addition, of that you have to's pay money into funds that are discretionary, then indeed what you're essentially doing is you're saying you can have. You have to basically pay walking around money paying bribes and effect to officials to do business here. Businesses are going to it are going to relocate North Carolina if they feel like there to be shaken down by public officials just coming to the state or to expand their operations or whatever, that's one thing the Don Vander Vartan concerned about and also he's concerned about is used to the process because what happened during the course of this permitting was that initially memorandum was drafted saying the money was going to go to DEQ number two was going to go to the state through the governor, the number three sky go to the governor and their actually, we were able to unearth through Dr. very's documents were mailed on earth affected at one point there were two documents presented to the related presented to Duke energy once it will approve the permit. One will say that I the permits was almost as if you say sign here or you lose your right to business in the state. And that's really concerning some work at the investigator then that presumably is looking into the questions about the governor controlling the fund itself by the constitutionality of that and how money has to be appropriated and are received by the state, but then also this whole permitting question is a wide scope about who authorized this fund to be created who was involved in it.

From what we can tell so far people inside DEQ didn't have much to do with these look like people inside the governor's office, possibly political appointees who were trying to do something to make the governor with good network and have you back. I'm sure a number of times as this investigation goes forward, and information is released. Carolina Journal will be reporting on this. You can read all of that and Carolina Rick Henderson. She thank you Rick thank you stay with us much more Carolina Journal radio to come in just a moment. This week's edition of Carolina Journal radio is brought to you by Blue Cross and Blue Shield of North Carolina working every day to transform health system from North Carolinians.

More information available at today. voters have spoken in North Carolina. How can you make sense of what they said about the legislature Congress, the courts, the Constitution Carolina Journal has you covered in print each month.

Online every day. Carolina Journal is your source for up-to-the-minute information about North Carolina state government policies and their impact on you Carolina Journal offers in-depth analysis of the election's aftermath, then looks ahead to 2019. How will elections affect your family, your wallet, your schools, your business find out in the free Carolina Journal newspaper Carolina Journal your number one source for government news that affects you visit Carolina today. Welcome back Carolina Journal radio I Mitch coca. Most of this shutter at speech that promote hate. We'd like to see less hate, but how we go about achieving that goal.

Somewhat to ban or limit hate speech. Our next guest says that's not the answer. Nadine Strauss and his professor of constitutional law at New York Law School.

She's the former national president of the American Civil Liberties Union, the ACLU and she's author of the new book. Hate why we should resist it with free speech.censorship welcome to the program.

I'm delighted to be here.

Mitch, the title of your book sort of takes it takes away the thunder of my first question was well for Duckett to censor what should we do sounds as if your message is. Let's rely on free speech and we should rely on free speech, but we should also rely on other non-sensorial measures. Let's not forget what we talk about hate. We're talking about not only hateful ideas and attitudes which certainly can be and should be combated with more speech including education and debate. Apologies support for the people who are disparaged reaching out with a compassionate attitude toward those who are hateful, trying to redeem them as has happened but were talking about hateful conduct, including violent conduct discriminatory conduct we should punish those through antidiscrimination laws and through so-called hate crime or bias crime laws and while we have many such laws.

We don't have a full complement that I and other civil libertarians advocate. For example, in many states and at the national level of government. It is still completely lawful to actually discriminate in employment, housing, and so forth.

On the basis of sexual orientation and gender identity.

That to me is hate or bias or discrimination in action and we have unfinished business in making that unlawful likewise. Here's a very controversial topic, including in your fair state of North Carolina but voting rights. I think their factual disagreements about the extent to which various voting laws that state and local governments are disenfranchising disproportionately certain minority groups who traditionally have been subject to hatred and discrimination, including racial minorities, to the extent that is a problem. I help all of us would agree that laws that discriminate in voting should be reformed, so a range of measures match that evidence has shown to be not only consistent with the First Amendment and individual liberty and democracy, but also more active than censorship in promoting all of the values that advocates of hate speech laws champion, which I also support equality, dignity, diversity, inclusivity, societal harmony and individual well-being. That is the voice of Nadine Strauss and Prof. of constitutional law at New York Law School. Also author of this book why we should resist it with free speech, not censorship. Some of the folks listening to us and I'm guessing will will take issue with some of the things that you're talking about but I like all of them are dealing with actions activity, not the speech itself. Why is it so harmful for those who say will hate speech is terrible.

Why shouldn't we been like why do we not target the speech itself, we do not target the eye Dia or the message or what the Supreme Court often calls the content or viewpoint of the speech.

The mere fact that individuals, including the vast majority of individuals in our society or the vast majority of government officials hate the message and consider it to be hateful or for any other reason dislike that content of speech is never a justification for censoring it. Rather, government says in that kind of situation. The remedy is more speech, not less.

However, you go beyond the content of the speech to its context, and in a particular actual contacts under all the facts and circumstances the message. This speech directly causes certain specific imminent serious harm, then the speech can and should be punished. For example, if it's targeted at an individual or small group of individuals and means to and does instill in the target a reasonable fear of being subject to violence or some other kind of harm that is what the law recognizes as a punishable threat and I can give you an example. Mitch, if you'd like to show they viewpoint new or content neutrality principle which is when speech may not be punished versus what is often called the emergency principal when speech directly in a specific context directly causes certain harm can be punished Charlottesville in 2017 really illustrated both in different situations. First, the mere fact that these message was deeply offensive and hateful including you will not replace us Jews will not replace us. I am a Jew, whose father was a Holocaust survivor.

I'm sure that message is odious to everybody but to those of us with that personal connection, especially so. Nonetheless, I was completely supportive of the ACLU's defense of the free-speech rights of those white supremacist to utter those hateful messages.

Despite the horrible content. However, we run later on they showed out with master groups that were brandishing lighted torches and firearms. That to me satisfies the test of a shrew. The rat right meaning to instill a reasonable fear on the part of the audience at whom it's directed that they will be subject to harm. I certainly would have felt intimidated if I were there and that would've stopped me from even from raising my right to express my ideas are time is running short.

But what problem do we face if we do actually ban or censor the speech itself.

What's this could lead to the people might not be thinking about when they think oh banning hate speech itself that stuck every problem. It's not a big deal, and most people think that because they want to censor what they consider to be hate speech and the truth is, when you look at how various kinds of speech completely across the political spectrum has been at CAC as hate speech by one politician or another by one citizens group or another.

Literally no speech that addresses at least any controversial issue of public policy is going to be safe. Let me just take the issue of the criminal justice system, black lives matter advocacy has been attacked as hate speech only lives matter advocacy has been attacked as hate speech lives matter advocacy has been attacked as hate speech. My favorite is on a number of campuses advocating for free speech has been attacked as hate speech. It's it's inherently subjective and that means it best unfettered discretion in those who enforce the law and none of us should want to hand over our own free-speech rights to any lawmaker but that should be especially true of political minorities, racial minorities and others who are never going to wield political power. You can learn much more by reading the book is titled hate what we should resist it with free-speech, not censorship. Its author is Nadine Strauss and Prof. of constitutional law at New York Law School. You might remember her as longtime national president of the American Civil Liberties Union, the ACLU thinks about her joining thank you for having me mention level on Carolina journal radio just a moment. Did you know you can now advance freedom and free markets just by shopping with Amazon it's true online shopping is now a great way to support the John Locke foundation just shot using the Amazon smile program and designate past the work foundation to receive a portion of your purchase amount that's right you shop and Amazon donates money to us.

The John Locke foundation.

So here's how it works longtime to Amazon smile.

It's the same Amazon you know same products same prices. But here's what's better. Amazon donates .5% of the price of your eligible purchases to pass the John Locke foundation to try to be sure to designate the Locke foundation is a nonprofit, you want to support. It's that easy. So now not only will you enjoy what you buy.

You'll also support freedom. Don't forget log on to today by something nice and help defend freedom. Support the John Locke foundation voters have spoken in North Carolina. How can you make sense of what they said about the legislature Congress, the courts, the Constitution, Carolina journal has you covered in print each month. Online every day.

Carolina journal is your source for up-to-the-minute information about North Carolina state government policies and their impact on you Carolina journal offers in-depth analysis of the election's aftermath, then looks ahead to 2019. How will elections affect your family, your wallet, your schools, your business find out in the free Carolina journal newspaper Carolina journal your number one source for government news that affects you visit Carolina today 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 it's one stop shopping for North Carolina's freedom movement and North Carolina You'll find links to John Locke foundation blogs on the days news Carolina reporting and quick takes Carolina journal radio interviews TV interviews featuring CJ reporters and lot foundation analysts, opinion pieces and reports on higher education from the 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. That's right, all in one place North Carolina that's North Carolina spelled out North Carolina Try it today.

This week's edition of Carolina radio was brought to you by Blue Cross and Blue Shield of North Carolina working every day to transform health system from both Carolinians more information available at today. will go back Carolina journal radio I Michiko got a new state committee is looking at the treatment of college student athletes Republican Sen. Jeff Hart used the group's first meeting. The question, a representative of the NCAA, you got 19,500 teams and you really are direct you have a responsibility to provide that the student athlete opportunity and occasion juxtaposed against approximately 100 of those 19,500 teams being the top Division I men's football program and top Division I men's basketball programs, which are the financial arm and backbone of the organization. I think the average person who is an avid sports fan decoy at the collegiate level and massive capital is conservative as though some strange coming from a but people talk about the salaries that the coaches you know, if you look at most, and saves the highest-paid person state employee is usually the head football and basketball coach men's programs but you look at are used on Cooper's example former coach football coach at Ohio State. He was a winningest coach in a decade, by far, the country and he got fired because he lost three times to Michigan in that tenure. How do we deal with the conflict between higher institutions of learning the need to foster that mission. And yet were promulgating that if these coaches don't when they're making two to $5 million. They're going to disappear. How does that conflict with an admission to get the students educated through a new lot of kids I went and I'm sure the same and you get a lot of these big programs, though there is a ground preparation to become professional athletes and we know we love the ads were going to graduate and go on to something other than what I went to school, play football for right. How do we address that core concern and an accomplice Scott therapy is the NCAA's vice president of legal affairs. The end says regulatory authority doesn't extend to employment on a campus and and when the Association mounted an attempt many years ago. More than 20 years ago now to address salaries of coaches. We were taken to court and we lost soundly so so employment decision, salary decisions, those are within the purview of every campus in every Board of Trustees on that campus to allocate money and that would include the hiring and firing four wins and losses and for other issues, that's an NCAA response to State Sen. Jeff Hart card is among the North Carolina state lawmakers looking into the fair treatment of college student athletes will return with more Carolina journal radio with a moment commitment to truth and transparency in government.

That is the mission of Carolina journal and we are proud to deliver and now proud to tell you the North Carolina press Association has honored to members of our team with awards reporting and writing, that's right, we really do deliver award-winning journalism we shine the light on government spending, reveal the truth about boondoggles and dig deep into programs paid for with your tax money. We keep you in the know in a way other media outlets don't in our reach and influence are growing all of our outlets. We reach more than 1 million N. Carolinians each month so make sure you're one of them are monthly print edition arrives in your mailbox every month. Our online daily news site Carolina has fresh stories, opinion pieces, and more. The award-winning Carolina journal team I reporters make government accountable to you.

Call 1866 JL FINFO for your free subscription will get back to Carolina journal radio I Michiko got a leading advocate for school choice in North Carolina has a new leader, Mike Long is now president of parents for educational freedom in North Carolina and he joins us to discuss his new role, welcome to the job and woke to the program. Thank you, Mitch. Glad to be here to get into PEF in seeing some of the things that it's working on the first of all, tell us a little bit about your background, I understand more than three decades in education well and I'm a born and bred Tar Heel Born in Durham, North Carolina, raised in the public schools. There went to UNC Chapel Hill. After that went into teaching seventh of a grade social studies teacher in the Durham public schools back in the mid-80s I developed a character education program that just blossomed all over the state and all over the country. So I traveled I was training teachers doing school assembly programs working with school boards curriculum, but about everything you can do in education did that for 25 years and into a principalship into a in a private school in Atlanta and then came back to Charlotte at Carmel Christian school is head of school there and then the PEF and C gave a call and said you know all those 30 years of experience in education might help us, take our organization to a whole new level because the school choices truly own a role in North Carolina is one of the leading advocates of it across the country to have you as you described. You had a role in the public schools and in private schools.

What is it about this school choice movement that tells you this is what I should be doing now. I my wife and I raised our two children in the Durham public school system in elementary school and then we found that there were other needs and other areas that we felt they could benefit. We had the opportunity we had the means to put our children in a private school that help meet their educational needs and they thrived my my goal. My heart now is for all North Carolina families to have that very same opportunity.

You mentioned that your previous job before this was working at a private school. Yes, in that role did you work much with PEF and see them, and if so, what was your impression of yes we had students who came to our schools who were benefiting from the opportunity scholarships that are provided by the state of North Carolina. We had students who came to our schools because of scholarships from the disability. Children with learning disabilities because we were able to meet those special needs of those children and to see the faces of moms and dads coming in the door, seeing where here is an opportunity for our child to thrive where in reality they weren't able to thrived because they were forced to go to school because of the ZIP Code. They lived and said that to me was really special. It touched my heart to see those kids grow graduate, go to college. The success that they had. The more I learned about PEF and see and what they do to help promote that throughout the state was just like I said very, very encouraging to me and that I jumped on the opportunity when it came to to help lead that that is the voice of Mike Long.

He is the president of PEF and see which his parents for educational freedom in North Carolina.

So as you work with PEF and senior previous role with her things that you said to yourself, you know, I wish this group would be able to tackle this to it and now you have an opportunity to do that you think one of the strengths of our organization is our parent liaison program. We have apparently a sans in different areas of the state that are directing parents. First of all how to apply for the scholarships. Walk them through the scholarships, point them to the school that will best meet their need.

We want to grow that I would like to see. Apparently a sans in all 100 counties, each of our 100 counties throughout the state. The other thing I'd like to see us do moving forward is to create an opportunity to hold our schools accountable and I don't mean just public schools also mean the private schools. The charter schools, home schools, how do we hold them accountable and their success or their failure all the way across the board. I do want our families to understand we are not at all against traditional public schools. We are all for them. As a matter fact we just want to help them get better and an end and we can do that by working with all of the other opportunities in schools as well.

One of the things I've often heard from people who are big advocates of school choice is just what you were talking about the fact that the more choice you have. It doesn't mean that an attack on the public schools.

It means another opportunity to force them to get better because they're competing for students, yeah, I just came from a private school here in Raleigh where I observed what they were doing they are and one of the things that really impressed me was one room that is devoted to purely character education values.

You know the values of respect, responsibility, maturity, discipline, character of the core values that all of us as parents and grandparents want for our children, our grandchildren about what a tremendous idea what a difference it's making in that school and how these kids learn how they respect one another how it raises the bar the safety element that's their this is something that we can also take into other schools that do not do this to help them get better in this and and especially when this is what parents won't if there's one thing I learned about character.

It's if this is not a liberal conservative it's not a Republican, Democrat, debate, and that's another thing that really encourage me about this organization in the way that it reaches across the aisle and brings people together in a climate of political divisiveness is never seen in our country of the school choice movement is one that brings people together and it's because we are focusing on the needs of our children are new to the job, so I suspect that one of your biggest challenges is learning about the organization what it does what it should do. What do you see as some of the biggest challenges. Overall, school choice, will I think for one, you know the argument of what you're taking dollars away from the public school system. Well from what I've learned so far no were not there so many dollars that go into public schools. It's it's just absolutely incredible and obscene North Carolina. Now take the lead in bringing teacher salaries back to a part where they need to be nationally obscene them, reducing class size and obscene them doing all kinds of things to help the traditional public schools with the funds that they offer you 1.5 million of our children in the state and traditional public schools, and you have another mill million or so that are doing other things. That is significant and we as leaders in government.

We as educators I think we need to listen to our customer base and what our customers are looking for and meet the needs of all of them, so no were not taking money away from public schools. We are adding to that customer base of support and letting them make the decision on what to do with those monies in the brief amount of time that we have left what you expect to see you coming out PEF at sea in the next few weeks or months. What could be the top priority while the top priority will be to grow our parent liaison program so that any parent who wants to look into the scholarship opportunities they can go to PEF and they can get with our apparently a sans that we currently have to walk them through that I'd like to see that grow. I'd like to see one in every county of the state and then on the other hand, I would like to bring in a bipartisan a full coalition of different school opportunities where we bring people from charter to home school to public school to private school to Christian schools bring them together to form a coalition of accountability for all of our schools so that we know what really defines success.

What really defines failure what we can look at where schools are not working well and help them improve. That is one of my number one priorities as I come now into this organization. That is the voice of Mike Long. He is the new president of parents for educational freedom in North Carolina or PEF NC website.

As you heard PEF and C.orc Mike, thanks much, Jonah. Thank you for having a lot more on Carolina journal radio just a moment.

This week's edition of Carolina journal radio was brought to you by Blue Cross and Blue Shield of North Carolina working every day to transform health system from North Carolinians. More information available at today. voters have spoken in North Carolina. How can you make sense of what they said about the legislature Congress, the courts, the Constitution, Carolina journal has you covered in print each month. Online every day. Carolina journal is your source for up-to-the-minute information about North Carolina state government policies and their impact on you Carolina journal offers in-depth analysis of the election's aftermath, then looks ahead to 2019. How will elections affect your family, your wallet, your schools, your business find out in the free Carolina journal newspaper Carolina journal your number one source for government news that affects you visit Carolina today. Welcome back to Carolina journal radio I'm Dina Martina's millennial's are now stepping outside traditional health insurance for medical care and instead this group is choosing things like urgent care, retail clinics, telemedicine, and something called direct primary care are next gas rights that this on-demand mentality from millennial's could markedly change the primary care sector of healthcare.

Jordan Roberts is healthcare policy analyst for the John Locke foundation.

He's been writing about joins us now.

Jordan look back to the show beer so when we think of on demand. I think of the buying things online or having a box show up on my doorstep or Netflix or another streaming service I want to binge watch house of card or something like that but I heard of it in healthcare until you wrote about it right so will receive now is that the traditional health insurance model is just really not as attractive to younger people in our really a wide range of people now and that they really are aren't going to traditional primary care doctor for all of their services and that they're going to these other work are readily accessible arm facilities to get some of the preventative services that primary care doctors can do and what this does is really gives them the convenience to get the services whenever they want and it really takes out the insurance mess out of it. All the billing and you know processes that come with having health insurance. This is so different from the traditional way of receiving healthcare because I can remember back. My first job out of college and I might my first official health insurance plan that was all mine, and the first thing they told me is you must choose a primary care director and that's the person that you know to that you call whenever anything is wrong and we are just really moving away from that to you wanting it to be. I guess more convenient.

Yeah that's right so you have the primary care doctors so important.

Establishing that relationship.

But that's just not really the status quo anymore and you know will receive an is that these services that can be traditionally done primary care doctors can be done at a wide range of places now on so there's a slew of other options to get the services there are a lot cheaper and a lot more accessible to you are a wide range of population. Let's talk a little bit more about some of those options that millennial's are choosing more going out urgent care.

That's right so this is this is, however, I would describe this in between the emergency room and her primary care doctor so you would go to the mood of the emergency room for life-threatening things. Things are to be treated right now. Conditions need to be treated immediately, but the urgent care can address some of these issues.

Not all of them but some of them and it really takes away that costly emergency room setting that you get a lot of the care from receipt.

Emergency room visits on the rise lately and you cannot directly link a lot of high hospital cost to the emergency room care so urgent care gives you another option. Like I said in between her primary care doctor in the emergency room to get some of these services taken care of that. You don't need the emergency room for retail clinics also becoming more and more popular. That's right you see fit in the mixer so these. These are like that in the name retail clinics is there clinics and facilities that are out retail stores like CVS and nothings like that.

So whenever you're doing some shopping.

You can get shots. Small things looked, and this really provides the convenience of being in places that are not the primary care doctor's office and really gives you a cheap option to get a lot of these things done that you don't need to go to the primary care doctor for so these are popping up all over and we see a lot of times is businesses are now employing a retail clinic facility in their companies property now so you have a direct clinician there to see the employees and give them care on site these to work in terms of payment Jordan urgent care and retail clinics is insurance involved here, not not not. It also what what happens is they post their prices for all of these services and so you know up front what you're paying for what that gets you. There's a lot of price transparency and people really like to know upfront that they can get certain service for X amount of dollars and know where to get it and that becomes a really key factor only talk about reforming healthcare to try to expand access and lower costs because so we have to admit, you know, if I go to the doctor. I don't know what the true costs. The behind-the-scenes cost is of the service I'm receiving, exactly, does know my co-pay my deductible right so you know if we can get a lot of those prices out in front of the eyes of our consumers and we can really you know make some leeway into instilling some market initiatives and and self-care. More generally, said those two things retail clinics in urgent care folks listening to SM who maybe are not millennial's man actually access those two because they're pretty visible.

They are out out and about the other two that she wrote about I think might be a little bit more of a mystery. December 1 let's talk about telemedicine. What is it telemedicine services, any type of healthcare that you get electronically through any sort of arm digital source, and I can be over the phone. Store-and-forward pictures and different videos that are providing knowledge about different conditions anything or seeing a doctor right through you know videoconferencing sort of setting so this is where you, you can remotely get services through any type of technology and the reason that this is becoming so important in our healthcare delivery is that it's so easy and so accessible. These are again talking about services that can be done in the primary care doctors offices that are now burning being brought to the patient telemedicine. If you have a rasher called something like this instead of waiting in line at the doctor's office.

You can hop on your phone in almost instantly speak directly with the doctor for fairly low price and get that same service with taking traditional insurance in the primary care doctors completely out of the equation so now instead of having to call for an appointment travel over to the doctor's office. I can take a picture of the weird thing growing on my arm texted hillside hydrides and what is this instant answer is exactly right then there's something called direct primary care, six to understand exactly how this works are so direct primary care it's probably the closest substitute for primary care that I wrote about in this piece and what this is is that say sort of like a gym membership, you pay a monthly fee and you get arm around the clock access to your primary care doctor. All almost all of the elements that you could have the primary care doctor can take care of you and your prescription drugs and it completely takes insurance out of the question.

Primary the direct primary care doctor spend zero time on insurance paperwork. Figuring out how to get reimbursed in complying with all the regulations that are put forth on them and it really allows the key focus of healthcare to allow the doctor to spend as much time with the patient as they can and people, physicians and patients really enjoy that personalized relationship that you get with direct primary care and like I said, no health insurance. One flat monthly rate. Does that mean then that I just don't have health insurance at all or is this in addition to has that worked so in a lot of cases, it means that you don't have health insurance at all. And that's around now under some new federal laws, but a lot of times what happens with direct primary care as you get a supplemental wraparound insurance. A high deductible plan that protects you in the case of some catastrophic event, but all your other primary care services. The day-to-day stuff to be done at the print the print direct primary care physician, physician's office. See you have a lower health insurance premium because you had a higher deductible answer is you only want that policy to cover you if the worst happened exactly the regular stuff like oil changes for the cars are great and usually direct primary care that's right talking with Jordan Roberts.

He is healthcare policy analyst for the John Locke foundation. Thank you Jordan, thank you. Hope you'll join us again next week for more Carolina journal radio this week's edition of Carolina journal writing is brought to you by Blue Cross and Blue Shield working everyday transform health system.

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