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Carolina Journal Radio No. 750: Lawmakers head back to Raleigh for special session

Carolina Journal Radio / Donna Martinez and Mitch Kokai
The Truth Network Radio
October 2, 2017 12:00 am

Carolina Journal Radio No. 750: Lawmakers head back to Raleigh for special session

Carolina Journal Radio / Donna Martinez and Mitch Kokai

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October 2, 2017 12:00 am

The N.C. General Assembly returns to work Oct. 4. In addition to gubernatorial vetoes and unresolved bills from this year’s regular “long session,” legislators could address proposed constitutional amendments and a plan to redraw judicial election maps. Becki Gray, John Locke Foundation senior vice president, analyzes legislators’ priorities as they prepare to head back to the capital city. Many people believe science should guide public policy. That idea sounds good, but the science used to make public policy decisions can be shoddy. John Staddon, Duke University professor emeritus, is writing a book about the scientific method. He says much of what passes for science today has little to do with the empirical research that could help policymakers as they make decisions. State lawmakers are debating whether to redraw election maps for judges across North Carolina. The idea has generated plenty of debate. During a recent meeting on the topic, Rep. Marcia Morey, D-Durham, a former judge, questioned the head of the state Administrative Office of the Courts about current plans for judicial redistricting. A Charlotte woman is suing the state over rules that block her from opening a school focusing on makeup artistry. The woman, Jasna Bukvic-Bhayani, is working with the Institute for Justice to challenge those regulations in court. Just after the lawsuit was filed, Bukvic-Bhayani, a potential student, and IJ attorneys discussed the suit during a news conference in Charlotte. You’ll hear highlights. North Carolina’s certificate-of-need restrictions continue to block medical providers from developing new facilities and purchasing major equipment unless they obtain state government’s permission slip. Katherine Restrepo, John Locke Foundation director of health care policy, discusses the latest case in which overly burdensome state CON rules stand in the way of medical innovation.

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From Cherokee to current attack from 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 public policy events and issues welcome to Carolina Journal radio why Muskoka during the next hour, Donna Martinez and I will explore some major issues affecting our state. Many people think science should help guide public policy debates will check with one Duke University professor who asks us to beware though of bad science, some state lawmakers want to redraw election maps for judicial races across North Carolina. You'll hear highlights from a recent debate on the topic, you learn why a Charlotte woman has filed suit against state rules that blocker from opening up a makeup school and speaking of state rules learn about the latest roadblocks created by North Carolina's out of date. Certificate of need restrictions. Those topics are just ahead. But first, Donna Martinez joins us with the Carolina Journal have lie just days from now, North Carolina lawmakers will return to Raleigh for another special legislative session.

This one is expected to last at least several days. So why are they coming back, what will they address, and what special session say about having a part-time legislature that he Gray is a senior vice president for the John Locke foundation. She will be following the session very closely.

She's here with a preview Becky welcome back. Thanks. Now there's a whole lot of different areas said that they could be covering, but one at the top of the list is said judicial districts what they want to do what we hear Mr. having some committees now. This got a lot of controversy during these past sessions. What this would do is it would redistrict the judicial districts, cross what kind of had a lot of focus on congressional redistricting, legislative redistricting, now they're looking at judicial redistricting on its little bit of a different animal because judicial districts don't have to reflect one man one vote. They just have to distribute the states judicial resources in an equitable way so that every North Carolina has access to the judicial system.

I'm a little bit controversial and that would there was a map that was rolled out at the end of session without a lot of review from a lot of the stakeholders on judges, district attorney's people that are really involved in the court system, but they're talking about perhaps bringing those maps out during this October session for about something we're watching out written a column about it on for Carolina Journal couple months ago. Actually, my column was cited during the legislative committee this week on so it's something that you we would like to say we think clearly. Since these judicial districts have not been looked at for 60 years that it needs to be done again.

We need to be sure with the changes in demographics that again, the judicial system is payer for all North Carolinians, but it needs to be done in a very thoughtful, very careful way. There's also been a lot of analysis from you and others at the Locke foundation about doubt something called the re-codification of the criminal code and it's a really am theoretical concept, but it has lot of consequence for people write a little bit wonky at first blush on down what this would do as it would take all of the criminal violations that are scattered all through the North Carolina statutes, but also indebted in a lot of the licensing boards. The occupational boards. A lot of agencies there are criminal violations that are outlined in the criminal code in North Carolina is a mass on its difficult for attorneys to make sense of it, much less individuals. Just imagine if you will. You want to start a business and you want to make sure that you make the right investment that you do things all according to the law but everywhere you turn there barriers and all of this stuff is embedded so deeply across our whole system makes it very difficult figure it out so you left with the with the choice you move forward with your business doing the best you can. Making those investments or do you stop for fear that you might inadvertently through no really no fault of your own might get into some sort of legal problems, even criminal things being opposed against you criminal violations. So it's a burden it's also a real barrier to people starting their business people starting businesses proceeding with occupations.

That is, thanks so what this would do it just sets up a commission of experts in this area and there about 12 people. It would be under the supervision of the Chief Justice of the North Carolina Supreme Court to go through all of these mounds of laws and statutes and rules and regulations bring all of those criminal violations under one code, organize it, clean it up and go back to the Gen. assembly with a clean slate.

If you will a clean closet of our criminal code and say you know here's what we've got. Then you can began to go through that and look at. Does this make sense to some in a desist sentencing commission need to make some changes so this is the first staff in a real cleanup of North Carolina's criminal code has significant ripple effects through lots of parts of our lives to support the state government. They want support to businesses entrepreneurship on so it is a very very important first-out to do this and this is something that has been. It is right for consideration in the October session representative Dennis Riddell has been a real leader in Dallas. As I've spoken to legislators and don't know of any opposition to dance. We hope and believe the time is come to tackle the us get it done and then began to also do the other reforms that will be possible when we know what is exactly in our criminal code will speaking of rules. There's also some speculation that state legislators will be looking at rules that have a financial impact, where they can either this is something else and again on the John Locke foundation. Her colleague John Sanders has written exclusively thoroughly about this on what this would do is in addition to the laws being made by our elected officials, members of the general assembly there also rules that are put into place that agencies by bureaucrats across state government, now part of this makes sense in that as the general simply passes laws in order to implement those laws that some of the agencies would have the authority to make rules to make those laws go into effect. This is all good government sufficiency. We want that to happen, but what happens when a state agency imposes a rule that has significant financial cost that would have a significant impact on a particular industry on taxpayers on the economy. If there's a rule that is put into place for say let's just say $100 million cost of the economy over five years. What this rule throttle legislation would do is, it would send that rollback to the general assembly and just say hey can you take a look at this. Is this worth the is this worth the impact of the economy when it done is first of all, its oversight it's more transparent and also hold elected officials accountable for those rules that might have a significant impact on our economy rather than unelected or an unelected perhaps appointed bureaucrat, buried deep in the state agency is not accountable to the taxpayers, who in many cases are going to be absorbing that hip to the economy. This is something that just makes perfect sense to me on it is the next step in the regulatory and rules forms that we've seen in the general assembly and again this is eligible for consideration. When the generals only comes back next week and were really hopeful that there gonna take a good hard look at this and pass that the Senate has actually passed it were waiting on the house to take action so we can see legislators do anything with some potential overrides of Gov. Cooper could very well there are four bills that the governor has has veto that are right for veto override on there's been discussion there's been to some of these things are controversy all some of them. Donna asked the general something that very slim, though there is a higher threshold for bills that had will have to be overridden by the governor. So there's some question of even if there votes are, they are to override these. There's also one bill that is sitting on the governor's desk for him to either sign or veto on he doesn't he be will have to do it.

I believe before this session begins in October could see another veto which we would add to that list of bills to veto override the thing in this latest one House Bill 56 there's a provision in there that we were very much in favor of that repeals the plastic bag man in Dare County along the northwestern coast of North Carolina northeastern coast of North Carolina on in that southern where we were very much in favor of head again have written at the John Locke foundation. That's another one that were watching very closely as they prepare for their session. Becky this so will be several times now that the legislature has come back into a special session after the. The original session has actually gone home. So what is it say this must be part-time legislators do we have that so well I think so and there's a couple extenuating circumstances with this one is the redistricting that we sing lawsuit after lawsuit waiting for court decision, waiting for three-judge panels to make decisions that the general simile has to act on those said that's part of why they've had this coming back because of the long question why can't the generals and we get their work done. Is it too much work for them to do think it's worth a reminder that at the beginning of session very long lag time of them sort of getting up to speed and really getting down to work. I don't know that we need full-time legislature think the short time legislature if they'll do their work will work just Becky Gray, senior vice president for the John Locke foundation. Thank you Becky, thank you.

Say with as much North Carolina journal radio to come in just a moment government plays a key role in your life affecting your paycheck the way you educate your kids the way you do business. How can you tell if government is doing a good job making the right choices. Spending tax dollars wisely. Carolina tackles those questions every day.

The John Locke foundation publishes Carolina journal imprint each month and on the web each you'll find exclusive investigative reports on topics. No one else is covering what else a rundown of the best new stories, editorials and opinion columns in North Carolina. John Hood's daily Journal news stories and important public and the voices of the newsmakers themselves at Carolina journal radio and print on the air and on the web. You can find the information you welcome back Carolina journal radio amateur co-guy. Many people argue that we should turn to science to help answer controversial political questions but does science always yield the right answers.

Our next guest is a scientist and he's writing a book on the scientific method is also highlighting the differences between good science and bad science. Dr. John Steadman is professor of psychology and professor of biology and neurobiology of emeritus at Duke University. Thank you for joining us again. Garbage. So we often hear about this during political debates.

This notion that we should rely on scientists we should do with the science tells us that your scientist does it make sense to always defer to science in these political debates if it's good science and makes total sense of the different engineer shows you the bridges falling apart to fix it. You should probably listen to, but when it comes to less developed sciences are reported fairly services that deal with more difficult subject matter. Not so much of it social science is to some degree, an oxymoron lemon there's a lot of social science are some examples in the book where it makes massive claims that when you look at exactly the signs are which. This is based you for the baseless. So there's a lot of stuff, like the in the book. I also talked about from the cold. The reproducibility crosses the basic ideas. If you think a course is busy and you should be able to produce the every time or almost every turn.

Well it's turning out that there are large areas of social science was simply not true. People try and do an experiment that's already been done and it doesn't work and if you look at the assumptions that underlie these the studies you begin to see words in chatting with the John Locke foundation.

I understand that one of your one of your starting points is a well-publicized study that showed that the threats to racial status promote tea party support among white Americans. That was the actual name of the study you dissect this and tell us why the science is not necessarily what we might expect. While I admit the title is catchy is not well the problem is that you read the title again on the title is threats to racial status promote tea party support among white Americans.

Threats status on the website where the site this thing first appeared. They said this energizes the racial threats energize the tea party until a lot of people were already predisposed to believe if you look at exactly how they did it. Basically what they did was have people tick boxes and are such a whole bunch questions that one question you could us is why a whole bunch of questions. The only one they were interested in was the one about the tea party but was better than this for distracted list of all the Christian I want.

They found with a small number of people who were racially threatened. That's the their expression. A small number of people who are racially threatened versus not racially threatened to favor the Teapot Dome is there's a slight preponderance of people who were threatened, who favored the people know what hell of a certain well they were threatened by being shown a picture of Pres. Obama.

The been artificially darkened so the assumption was no proof.

The assumption was that they saw a really dark person Obama. This would make them just leap into the arms of the tea party. What they found was that out of 255 people 25 people said that we must be members.

The tea party if they were shown the Dr. Berman and 15 for the Difference of 15 people out of 255 is the basis for the claim that racial threat was threatened increases devotion to the teapot in the tea parties that for racist organization when you get into. So you find that first of all, the effect is not in any way reliable was highly unlikely if the somebody repeated the study they would get the same was the second of all, the number of interpretations is very very large why did they embed this question in a list of confusing questions what expectations that the subjects were the subjects were trolled from the Internet to use something called mechanical Turk to get people to volunteer for this and other Internet access so they don't really know a whole lot about who these people were and so on and so and so the point is the study.

If you look at its assumptions simply baseless that there is no reason to believe is first presented as if racial threat is not actually measured is a course which is not actually demonstrated all of the tea party, a racist organization which is also not proved serving the whole thing is simply playing plague to the orders we are speaking with Dr. John Steadman, professor emeritus at Duke University. Your scientist back in when you started in science of someone said hey this is going to be our study that were going to use to show that a causes be what they been laughed out of the room and told this is how you do science well it depends on what Emily and I have unembarrassed almost to say that I have literally never lose never use. No hypothesis. Statistical testing in any paper that I published. I do like the method many many years ago when I was a student. I think a bit of proof just so my work is done with single subjects at that time there were a group experiments of the sort that were done they were generally accepted, they were less political people. Probably a little bit more critical than but know this conversation been going on forever begin with the medical artificial who really invented all the stuff was a very brilliant and he did not make these kinds of mistakes but the people who followed him more more more for reasons to serve the messages since the social need.

Again, talk about it since the need to publish these poor guys and universities for guys and ladies they have to publish if they don't publish the promoted research grants left to look for job so it's a it's a really an imperative need to publish is very hard, but if you look at some of the important work in the history of science in the work of this one. Think of is Charles. Though Lucian right.

How long did the work on this project before he actually published well say how about 20 years, but he worked for 20 years to get the evidence for it, but he didn't publish until he was scooped by Alfred Russell Wallace.

I the stimulus from Wallace that got him to finally publish because he wanted to get it really really right. Almost no side to snow. These are almost none almost, they have to produce results to use for years, otherwise they are out they don't have a job so the incentives and the current scientific environment.

I think a very very very good looking and see why they are back in history and why it started out much better than snow. I would say but now the pressure is so high, the probability is so low pay the mortgage with the recent scrubs thing you have problems they go to get results in one thing about this in the HST method with its 5% significant guarantees a result, you can be doing after the nonsensical work. If you do enough of it. Enough of it will be significant to the publication.

I think that's what's worth what sounds like one reason we should be very skeptical when we see something billed as science that attempts to tell us a political philosophy of the left or the right. That is the voice of Dr. John Staten.

He is University Prof. emeritus thanks Lattimore and Caroline full color throughout every issue more visual storytelling.

We've revamped Carolina journal to make it easier to read a new look and a new feel. But one thing hasn't changed and it never will. That is our commitment to truth and transparency in government, you can still count on Carolina journal for investigations into government spending revelations about boondoggles and vetting of corruption.

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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 will go back Carolina journal radio I Michiko got some lawmakers want to redraw election districts for judges across North Carolina. The idea is generating plenty of debate democratic representative Marcia Mori is a former judge. She questioned Marion Moran of the administrative office of the courts about the latest proposal you have any concerns about the fiscal responsibility of that paying judges for lodging pain judges for travel and having availability of judges traveling almost 440 miles round-trip Durham to Mantia soldiers were given the managerial flexibility to use this system and the authority of the Chief Justice. We will do everything we can to minimize that impact both fiscal and both on our human resources and the availability of commissions you, therefore there would be no reason to reduce the number of divisions from 8 to 5 in the AMCs view is almost rhetorical because it's a policy consideration, I have to work within the confines of what given to work with since Warren wouldn't take a position on the issue.

Mori asked him what he had heard from others have judges come to you express their concerns from Superior Court District Court about this proposed HB 717 years of Superior Court judges. There is a general rule, except in a couple of areas have expressed to me that they would rather witness take its course and is always that there is an open and complete a conversation if you will. There generally call for the I have read over Superior Court judges that were incredibly upset, believing that the franchise of the people in their county or in Northern District was being disruptive. What they called your gear. I have had District Court judges tell me they are quite pleased with the I have had other District Court judges rated Nancy. I think if you dig into that original 717 Leah will find that there are winners and losers, and that some of the folks who consider themselves winners make share of the advice say something that goes along was born. I'm good with that math. I just can't say anything about and then there's folks who consider themselves losers for myriad reasons they call and say why aren't you doing something about it surprise you that I have gone and talk to at least 20 districts. I have not heard one this court judge be in favor of this redistricting, it would not surprise me at all of 272. Just record your there are winners and losers and folks that have political careers. Sometimes they will not share in a group or they will share with a one-to-one basis. That's Marion Moran, head of the administrative office of the courts he's answering representative Marcia Mori's questions about a plan to redraw state election districts for judges with more Carolina journal radio with a moment really influence you either have it or you don't and at the John Locke foundation. We do, and that's not bluster in a private survey of more than 250 North Carolina political insiders 87% said we influence them either a great deal a good amount. So while others talk and complain.

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Expand your choice of schools for your kids. Widen your job opportunities and improve your access to doctors. The recipe for stability and a bright future. The John Locke foundation were dedicated to making North Carolina first and freedom were dedicated to you.

Welcome back Carolina journal radio I Michiko got Charlotte sits at centerstage for one of the latest battles against state government overreach recent news conference in the Queen city highlighted a lawsuit. It involves a proposed school focusing on makeup. Justin Pearson is an attorney with the Arlington, Virginia based law firm. The Institute for Justice. Today we are here to talk about talk about that. We call this morning challenging North Carolina on yes move right as an experienced makeup artist to teach makeup.

The students would like to learn from her point melodic mom is the attorney who will be leading the case against overly burdensome state regulations as an expert makeup artist here in Charlotte. She owns her own studio license to practice makeup artistry and she's even appeared on local television twice to share her expertise.

Now she wants to teach others how to apply makeup like her. I do makeup school.

Unfortunately, North Carolina won't let her no problem with applying makeup with someone yet has a problem with the teaching others how to apply makeup. Last fall when you try to open a makeup school North Carolina Board of cosmetic art examiners came and told her she couldn't because she didn't have a license for this to get a license enough to satisfy the board's curriculum and equipment requirements for every hour you spend talking about makeup.

North Carolina wants to spend as many as five hours teaching irrelevant material removal and facial billing also wants to spend more than $10,000 on unnecessary equipment like machine facial machines even though she doesn't need or want these requirements don't make any sense. It doesn't make sense forcing makeup school for spent hundreds of hours teaching skills makeup artist will use.

Yes, the students like Julie Goodall just want to hear you talk about makeup, but North Carolina wants them to paper lessons and unrelated subject, mom. System requirements are more than just bad public policy. These requirements are also unconstitutional under the First Amendment. The government can't wildlife and that's why he doesn't really have teamed up with his book, which by Yanni is the lead plaintiff in the case she wants to open the makeup school and she explained why my right mind that everyone how well this not able to learn anything about everyone that I now overlap rated the right there without mean time and money is something that really just to answer questions from assembled reporters among them. Why is this idea so important to work.

Why teach these makeup skills to others, makeup, and very rewarding. People are always happy one and love the feel and look great thing that you can do that.

I wanted there's no limit very rewarding job. Is there a market for the school that focuses solely on makeup without the additional skills that state government believes the school to teach many, many people are wanting to learn because the only way for you and you are cosmetology people, even though you may Fill education and most feel. I think right now and need people could give makeup tips on YouTube. Why is state government, stopping Ya's new book, the rich from pursuing her school that I thinking, makeup and videos that sign everything however not able to have a proper school where you can just react when she learned that the state would not allow her to set up her makeup school call and maybe a month we had the only thing I can do it if you know that I think so. Neither one of which does not have to do to comply with state requirements. It wouldn't be any additional makeup makeup very few hours so you learn very well but not as much efficiently because that might not need additional training herself. She would have to teach her students five hours of other material for every hour she devotes to the task at hand. Makeup artistry perspective student Julie Goodall is the second client that the case she says she wants to go beyond what you can find on social media.

I want to know the difference, and then teaching you how to play a line whereas she can tell me right now down think it ridiculous. Does Goodall have time to go through hundreds of hours of training for skills. She doesn't want me. I really had extracts you know that from your stand then flip your hair different way that's not what I meant and I just want to learn about makeup better apply.

While this focus on makeup attorney melodic mom address the question of whether there are larger issues involved. This is bigger than makeup were filing this lawsuit to vindicate a principal under the First Amendment. The government can't require a license just to teach something, including makeup artistry the constitutional issues that make this complete worthy of a lawsuit.

The Constitution generally protects people's right to speak for living. That's true whether their authors or teachers including Peter the makeup artist Institute for Justice chooses cases focusing on constitutional rights. Why this one attorney Justin Pearson offered perspective, the national wall from where the nation's largest Rotarian public-interest law. What that means is that we don't charge a client.

Instead, we provide pro bono legal reps and patient individuals. We have seven offices around the nation and our headquarters for Justice short has been extremely successful in one reason because RJ made the decision early on he is free speech rights, economic liberty educational that's Justin Pearson, attorney with the Institute for Justice.

That group is working with the owner and a prospective student of Charlotte school for makeup artistry their fighting state efforts to block that school with more Carolina journal radio with a moment if you love freedom we got great news to share with you now.

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Welcome back to Carolina journal radio I'm down to Martinez the John Locke foundation's Catherine Restrepo has written extensively about North Carolina's certificate of need law which forces hospitals and Dr. groups to apply for and receive state government permission slip before they can add new services or equipment. Things like surgical beds, MRI machines, things like that. While the state is now determined that government officials should decide whether or not North Carolinians are given access to innovations and better services.

And now another real world example here in North Carolina.

Catherine joins us now to talk about what's happening. She of course is the director of healthcare policy for the Locke foundation Catherine welcome back thinking we have to North Carolina hospitals. They both want to offer a special cancer treatment.

Tell us the story several deep hospital and you can see them both in their application to either build a cancer treatment center for proton therapy which is a special cancer treatment for tumors located in the back and spinal areas. And you know anything about certificate of need. These laws were really enacted to promote and to make sure that there is equal amounts of healthcare resources and facilities across the street across the state. While at the same time making sure that healthcare costs are contained and to reduce right away healthcare costs that have been happening since the past 40 years but in fact it's actually denying patients from lifesaving treatment like this scenario are talking about now and it's really incredible because just to emphasize this. There are two hospitals that say look, we think that we can offer the care and the service to people who obviously if you have a tumor of that type you're in a dire situation. They want to try to provide the care but they can't just go ahead and do it until they apply for and receive permission. It just seems crazy.

If you if you go back to the history of certificate of need others mentioning earlier is always run away healthcare costs after the enactment of Medicare and Medicaid in 1965 and so it was originally federal mandate and so under the Nixon administration states in order to receive Medicare and Medicaid funds they had to implement the certificate of need program so is this centralized planning regime at the state levels that have to make sure that there can there can't be too many inventory surgery centers or see many hospitals are too many facilities offering treatment like proton therapy for cancer patients and so that's why this law was enacted in the first place. How is it that the state could possibly determine what they think the so-called quote need for medical services is. I mean, are they literally sitting around the table and saying well.

It sounds terrible but we think that a certain number. People are going to be diagnosed with this type of cancer.

Certain number of people will have heart surgery. Well, the way they determine what is needed in certain areas of the state is that every year they had the taking inventory of all facilities and certain types of health services. There's 25 total North Carolina that are regulated under the certificate of need program based on population growth or projections in and on higher utilization of certain services. That's how they determine if there is, in fact, I need from more of a central planning viewpoint. However, I think it's better for for markets or for hospitals themselves in their own community to decide to make that business to fishing themselves, whether it's worth the investment to build a new cancer treatment center or new inventory surgery center. Catherine this application process were talking about. It's not just like one page and you turn it in and then tomorrow they give you a call yes or no yes very lengthy and there's there's multiple steps there. First you have to cement a letter of intent of the project that you desire.

In this case the cancer treatment center and then the Department of Health and Human Services you think I can take anywhere above 9850 days and then there's a public comment. So the public comment period for the Duke and UNC on cancer treatment center applications that can be October 10 sets coming up that the Dorothy Dix hospital, the former psychiatric hospital and so after the public comment. Then there is further review and depending on when whether the Department of Health and Human Services approved application you can even have a third-party come in and deny that approval and then I can go to the office of administrative hearing and in the Supreme Court of the North Carolina state so meantime while all of this process goes on to mention the fact that is incredibly costly for these applications to put together, etc. yet people who are suffering who could potentially be helped by this special cancer treatment and yet the facilities aren't there to help them exactly it's it's a serious situation and certificate of need it. It's no longer relevant because we are further transitioning hospitals are further transitioning from fee-for-service reimbursement for services to more of their their solidifying contracts with insurance companies whether getting paid based on the value of the care that they deliver. So based on patient health outcomes are cost savings that had her getting paid so you only think about certificate of me trying to bring in healthcare costs and reduce higher utilization rates and fee-for-service healthcare claims that providers are submitting is no longer the case for specialty care like cancer treatment. Now there are states to have repeal this law. They no longer have this anticompetitive law on the books but is there a reason North Carolina continues to go forward with this share. I mean if the protectionist policy at the protections certain hospitals like it because once if they have proton therapy are certain services mean they like it because it allows them to prevent other competitors come from acquiring those the same types of facilities or services to compete against.

So that's the battle right now. It's really the protectionist policy and its denying any patients are lost in the mix that too often the case in the healthcare industry. Now, not just because of so many regulations and less choice in the marketplace.

It's interesting you terminate as a battle because it really is. But there are some victories that those of us who believe in free markets that have made in this area. Tell us at some of the services that are exempted from the certainty of me thought well back in 2005 in 2006 there was some certificate of need reform so if and if doctors want to have their own colonoscopy units. They didn't have to go through the certificate of need process to do that and said they're actually able any standalone procedure rooms are facilities there there paid by Medicare. On average, 45 to 60% less than that same procedure being performed in a full hospital setting and so this is been able to save the Medicare program over $200 million within six years, and not just on one service that has that is no longer heavily regulated compared to 25 others that are what's so fascinating I think, is that if legislators have determined that it is quote okay to exempt one particular area from the certificate of need law when it just makes sense that they would exempt them all yes.

But now, at the same time any type of reform any type of incremental low motivational momentum movement towards towards full repeal is is still a plot point in time. Now those who support certificate of need laws and there are many people who do and there are some legislators who do and that's why to battle in order to try to move forward in terms of freer markets and and competition but the supporters say that what if you get rid of this law that it's going to somehow hurt rural hospitals and the people that they serve.

Tell us about that argument right and argue against that argument.

If you think about it.

There's so many other factors that are certificate of need alone. If you if you got rid of certificate of me there so many other factors that are hurting rural hospitals on rural hospitals.

A lot of times the heavier caseload of Medicare and Medicaid patients. And we know that Medicare and Medicaid pays below market values are what private insurance companies pay them for certain services. So whether you have certificate or need or not. Rural hospitals are still suffering, so ceiling goes away. Will hospitals are still going to have problems, but they'll be able to compete will be able to compete with larger hospital systems, who in many cases, actually when these applications over rural independent hospitals. Catherine is a common occurrence that we have essentially two or maybe even more than two operators.

Whether it's a group of doctors or hospital who have to try to compete for the services yes some do get approved but at the end of the day, not just the certificate of need lots denying patient care process itself@patient care. That's all the time we have for the program this week. Thank you for listening on behalf of my cohost Donna Martinez hope you'll join us again next week for more Carolina journal radio Carolina journal radio is a program of the job. To learn more about the John Locke foundation donations support programs like Carolina radio send email to development John Locke 66 GLS 16655346 Carolina journal radio nation airline is all opinions expressed on this program nearly show or other programs foundation is airline sponsored radio again

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