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Carolina Journal Radio No. 748: Price-gouging laws create more problems than they solve

Carolina Journal Radio / Donna Martinez and Mitch Kokai
The Truth Network Radio
September 18, 2017 12:00 am

Carolina Journal Radio No. 748: Price-gouging laws create more problems than they solve

Carolina Journal Radio / Donna Martinez and Mitch Kokai

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September 18, 2017 12:00 am

Devastation in Texas linked to Hurricane Harvey and the threat of East Coast damage from Hurricane Irma helped lead to higher prices at N.C. gas pumps. State officials also invoked North Carolina’s price-gouging law. Roy Cordato, John Locke Foundation senior economist and resident scholar, explains why the law ignores the laws of economics. He explains the link between price-gouging restrictions and gasoline shortages. While U.S. Supreme Court justices enjoy a brief break in their work, Ilya Shapiro is busy analyzing the court’s work from the past year. Shapiro is senior fellow in constitutional studies at the libertarian Cato Institute and editor-in-chief of the Cato Supreme Court Review. During a recent visit to Raleigh to speak to the Triangle Lawyers Chapter of the Federalist Society, Shapiro analyzed the court’s latest term in a one-on-one interview with Carolina Journal Radio. As N.C. legislators deal with court orders to redraw election maps, they’re hearing input from the public about the best way to approach that task. You’ll hear highlights from a public hearing linked to the legislative redistricting effort. State policymakers are concerned about the recent revelation that a chemical called GenX has been dumped into the Cape Fear River since the early 1980s. Gov. Roy Cooper has asked the General Assembly for more money to address the issue. Meanwhile, the legislature’s Environmental Review Commission traveled to Wilmington to take public comment on the GenX issue. You’ll hear highlights from that meeting. Telemedicine offers great promise for addressing American health care needs in the future. But Katherine Restrepo, John Locke Foundation director of health care policy, has raised concerns about legislative proposals to create “telemedicine parity.” Restrepo explains what that concept means and why she believes it could prove counterproductive.


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 amateur coca during the next hour, Donna Martinez and I will explore some major issues affecting our state as the US Supreme Court wraps up its annual break scholar with the libertarian Cato Institute analyzes the high courts work from the past year. You recently visited Raleigh to offer his assessment. State lawmakers are facing court orders to redraw state election maps you hear what some members of the public think about the process. The controversial chemical. Jen X is attracting attention from Gov. Roy Cooper and the Gen. assembly. You hear highlights from a recent public meeting on the issue and will explain why one proposal to boost telemedicine in North Carolina might not be as good as it sounds. Those topics are just ahead. First, Donna Martinez joins us with the Carolina Journal headline when you live in North Carolina hurricanes are an unpleasant fact of life. Aside from the obvious concerns over personal safety and property damage were also occasionally subjected to shortages like gas, ice and other things. And when the wake of a natural disaster. Some government officials decide to intervene to prevent what they call price gouging. Our next guest says these folks need to resist that temptation hears here to explain why Dr. Roy Coronado is a senior economist for the John Locke foundation. He's been writing about this right. Welcome to the show good to be your Donna in the wake of hurricane Harvey which of course in Texas and Louisiana Gov. Roy Cooper asked his Atty. Gen. Josh Stein to investigate gas stations and an incidence of what he called price gouging for salt.

What is that price. I do know you will have to ask the governor. There is no economic definition of that. I've looked through all the major economic textbooks is not even in the index has no legitimate economic meaning it's some price. The politicians think is to the fact is, is that nobody can charge higher than the market price. The price that brings together supply demand that changes at different times and the changes during natural disasters and that there is a state law about their you is a state law and if you read is very vague as to what it is you know it's kind like pornography. They know it when they see so yada yada sleep. There really is no rigorous definition and is probably different in different states. Why a price would be gouging in one state and not another.

Some states most states and I think the fact that North Carolina outside of Texas. Certainly in the region is the only state that declared its price gouging law in the last few weeks in the law the phrase is kind of interesting talking to abnormal market disruptions. Right now the case of hurricane Harvey. The abnormal disruption with righty of the pipeline pipeline okay so is that the subjectivity in in the swelling what you want is in an abnormal market disruption is the price system to react to it. That's the beauty of prices.

They moved to accommodate abnormal market disruptions right and when you don't allow that to happen.

You get shortages best example is the OPEC in the 1970s when they embargoed the United States that was an abnormal market disruption.

There were big price controls on gasoline oil that Nixon but put in place at that point in time we had huge gas lines we get gasoline lines and other shortages went in the state when there are abnormal market disruptions because of the price gouging loss. What they do is they prevent prices from rising to what we conference call equilibrate the market meeting supply and demand matching what happens is that people own flock to gas stations, demand goes up price should go up and that's what happens but but it doesn't. So what I got right.

Here's the thing about that I think is interesting.

It's kind of counterintuitive is let's say were in the middle of trying to recover from right your storm so we want gas in her car so we go to the pomp and the price is higher now are all self interested so we want to pay as cheaper prices possible and in and not have to fork over more money to insured like to, but are you saying that in order to make sure there's enough supply that we should want the price to go up. Yes it becomes like to see the best cure for high prices is high prices and what it means is is. Look what you want to happen just the people you want people to conserve in those situations you want suppliers to produce more or to bring more to the market. If you allow the price to go up. It encourages both of those things higher price discourages people from porting what we really need to be protected from the greed of our fellow consumers during use. What happens people go out and if their free cars, they will fill out all three callers righty Philip thanks why I don't know the cars would sit there during hurricane.

Anyway, what they do instead of that gas being in the tanks at the gas stations there in people's garage.

It's in people's garages and dump higher prices discourage that the higher the price the less likely it is, people will purchase more gasoline than they expected to need. On the other hand, higher prices encourage more supply. It incentivizes people to bring in more supply from out-of-state and not just gasoline but we Weathers bottle water or ice or whatever the case may be, a high price and higher profits will encourage people to truck in ice or they will go to truck in bottled water or those kinds of things could just something they might not do if there wasn't enough profit and that's exactly right as transportation costs, and so on.

The higher price encourages that sort of thing. So what you have at the higher prices during these time periods is the right thing happening to have the prices discouraging unnecessary consumption or purchases not even consumption and encouraging more supply because of the higher profits that it brings. There's a couple of classic examples of this and I'd like you to explain why it was written by our good friend Dr. Mike Monger University where he talks about Emily was in the wake of hurricane Fran. Yes, it was the classic example of the truck full of ice. But the ice was priced high higher than what you would typically on a regular day with storm have to pay for a container of ice. The people didn't want to pay that and take them there.

The funny thing is they didn't want to pay. They were waiting in line to get what what what happened was is that the that some people from the young people from Goldsboro decided hey we could bring we could rent some trucks refrigerated trucks fill them up with bag size having to borrow 500 bags ice over to downtown Raleigh where there they couldn't get any right ice and they sold it.

Now they sold it they were asking $11 a bag for that ice and people were lining up to get it so they were willing to pay that amount. The cops came along and shut them down, took the rice actually allowed it all to melt. The point is is and people will end up with no ice. So the question here isn't ice at $11 a bag or two dollars back. It's ice $11 bag or no ice and and what that high price did was incentivize these people and what would've happened is other people would've caught on and said hey you, we can get $11 a bag will as more ice comes in.

The price goes down right and people can serve at $11 a bag and I can buy as much ice as as they would at at two dollars a bag. But the point is is that it really tells people what if that goes back to ice were saving $200 worth of food. That's a good deal lawfully or not quite sure that is ideal, but the interesting thing right is that in that example and in others as well. The person shot charging the higher price for the product is considered a Goucher. Yes, they were considered a gouge I would consider him a hero right they would to all this trouble brought all his eyes from Goldsboro which which where they could get a cheaply they brought it here.

They offered at the people people could say no right. I mean, they can say no there's no ice orders ice 11 dock say no if no one is forcing anyone not only forced to enter the picture with the cops who came in and force these guys to shut down or prevented them so that interestingly enough, a lot of people cheered when these guys got hauled off in handcuffs.

Some people clapped as the yeses given away. They turned around they had no no ice exec.

You can read all about the issue of economics and the so-called price gouging laws written by Dr. Roy Coronado John Locke.Gordon stay with us much more 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 in print 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. Carolina journal radio in print on the air and on the web. You can find the information you welcome back Carolina journal radio I Michiko got US Supreme Court justices might be enjoying a break in the action, but this is one of the busiest times of year for our next guest. He spends the time in between Supreme Court terms analyzing rulings from the previous year and looking ahead to the big cases likely to be decided in the next year. Ilya Shapiro is a senior fellow in constitutional studies at the Cato Institute and editor-in-chief of the Cato Supreme Court review. Welcome back to the program. Good to be back. The biggest change of the Supreme Court in that past year was in personnel tell us about the impact of new associate justice new course right. This term was, lower key in terms the case is decided, precisely because the absence of that nine seats after just school is passing and the delay in in confirming courses, refilling that seat meant that the court took a lower profile cases and fewer of them and will get into that, but forced himself. He participated in 17 cases this term, remarkably, he agreed with Justice Thomas on everyone will see how long that continues and you know so far he is use what people expected weather.

Whether that was a good thing or bad thing but a stylish writer, textual list is first question on the bench was washing we just follow the plain meaning of the text of minutes mind blowing stuff here, but the that theme continued in various writings and he jumped right in the new justices typically their first majority opinion it's assigned is unanimous one, and this was the same case year, forgettable technical case, but just as courses took the opportunity to write separately more than a dozen times beyond that. And indeed, the he wrote separately, more than in in June alone more than Justice Kagan did in her first two terms on the bench.

In addition to having you corsets know the bench. What were some of the other big cases from your vantage point.

Well were in North Carolina as well start off with our packing him versus North Carolina First Amendment case which asked whether sex offenders still maintain their of their First Amendment rights. Now sex offenders are an interesting class of felons after they've served their time or pay their their dues observe their probation and whatever else there are still certain restrictions on on them. They can't live within a certain distance of schools and other places where minors congregate, etc. so they have to register well in the digital age states have tried to figure out how to apply those kind of restrictions online so you can't go on Nickelodeon's website or interact with kids in various other ways.

North Carolina actually had a much broader common outlier sort of restrictions for online access and the way that the law was written not only could you not seek out the kids to talk to or what have you, but the way was lot look below was written, it would bar you from accessing not only use things like Facebook say or Instagram, but potentially the New York Times website or web MD or YouTube because those are sites where you create a profile and can interact with people in the comments and under North Carolina stage without prohibitive.

So long story short, the Supreme Court unanimously struck down that North Carolina law, not because states can't restrict sex offenders online about because they have to tailor it to an end. Indeed sex offenders do have First Amendment rights. Of course a big deal here North Carolina since it's our own law of the big cases that were on your mind while staying in North Carolina. There's the redistricting case. Cooper these reduction cases are really weird kind of apply the Goldilocks standard one race comes to bear. You can't use race too much, but it turns out you can't race use race to little with the voting rights act.

In this case, North Carolina had to has to go back to the drawing board for one district, not not the whole board, but the it's it's really you know not a kind of a groundbreaking ruling or standard, but I don't know what a certain point that the course and after throw up his hands and say you know we can't police this anymore president really depends on how Justice Kennedy feels any given day, and indeed next termer to see some potentially something revolutionary when it takes up a case involving a Wisconsin map about partisan gerrymandering, no allegations of a racial impropriety but can't use a party designation not too much and both Republicans and Democrats do this when they take control or supermajority or what have your legislator try to gain partisan advantage it all come down Justice Kennedy again and I imagine that this will be a physical because there really aren't any manageable standards to apply in those kinds of cases we are chatting with Ilya Shapiro he is a senior fellow in constitutional studies at the Cato Institute also editor-in-chief of the Cato Supreme Court review, which is one of the reasons why he's looking very carefully at all of these cases as you are analyzing everything that that the court did during the pastor are there some trends that you notice well not really mean in general every year for Supreme Court reporters try to come up with some sort of theme for the term road turn to laughter turned to the right of course libertarian moment. That was my favorite. A few years ago, but it's not like the justices, one on the summer break decide collectively or individually.

Oh let's move to the right. This term overlooks moves or even Justice Kennedy. He's not saying oh I did.

I was too liberal distraught.

I need to be know it's just the function of the amalgam of case that's on their docket. Now that the court does pick its own docket. So if it feels that the administrator agencies are going way too out of whack either to the left or to the right and the need to slap them down. Well, you know that will result in a certain set of results in a certain way and this term in particular. Though the cases were lower key.

There were fewer of them. A modern dumpster modern, but in history as the lowest production of opinions. After argument, 62, so did a very good job of putting themselves out of business as a great job if you can get at you and I have the smartest lawyers and lawyers in America working for you.

Your summers off to go to Europe and you only produce 62 opinions and it's great but anyway other than the theme of the whatever you, the trend is a return to the status quo from before Scully's death. So we have this weird interregnum of a justices where many cases were decided much more narrowly than they otherwise would be Medicaid simply want taken because the court wanted to avoid having those ungainly 44 splits that that don't decide anything and so it's just waiting for really four for the next vacancy because if for whatever Justice Kennedy decides to retire. We could see a telegraph from Salzburg at any moment our or a year from now or when the Justice Ginsburg departs the court if it's proper another Republican president who makes that replacement on the court will shift to the right and Chief Justice Roberts will be the swing vote, as it were going to ask you about the fact we had the dog that didn't bark and that was that no Justice decided to retire which obviously means rid of the same court coming back next unless something bizarre happens.

As the court does prepare to come back. What's a big cases that will be on its docket for the next term.

Well were going to go back to the us what we been expecting the last few years, which is essentially a blockbuster turn-of-the-century. I think it's going to be our seventh one this decade something like that number big case I mentioned in the gerrymandering political gerrymandering are Wisconsin, the biggest criminal law case involves cell phone site location information. That is when you're walking around always have these phones or pockets and they're paying off towers that information that data you know who you talk to your message text messages, what have you.

But where you are is reported by Verizon or T-Mobile or whoever you use do the police need a warrant to get at that information.

Traditionally, if you're analyzing it like while you throw a garbage or speak loudly and people can overhear you that's all that's all for grabs in the public but that's called 1/3 party doctrine because you're given this information to the third party to your provider but you know is there an expectation of privacy or have you taken certain steps their encryption.

All of these sorts of issues. Will the police need a warrant to the court treads lightly in these tech cases, but this could be groundbreaking. One of the people is going to be watching very closely to see if that result takes place sad to see what happens with the rest of the court's terms is you Shapiro, senior fellow in constitutional studies at the Cato Institute and editor-in-chief of the Cato Supreme Court thinks about the goings on Carolina Journal radio just a moment.

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Support the John Locke foundation will connect Carolina Journal radio I Michiko got North Carolina lawmakers have heard contrasting arguments about the best way to draw congressional and legislative election maps during a recent public hearing Mike Jennings invoked the Bible before Congress adopted the Constitution voting rights.

There was the golden rule.

I believe the criteria will create an open process and promote fairness in elections. I think that would be consistent with the cold golden rule I know in the past, others have drawn jurisdiction districts to favor favor them agree that was wrong.

Time to turn the corner as do the right thing. Stuart treat others as you would have them treat you. I encourage you to be allowed to be touched by the better angels of your nature small business owner Richard Greene offered some ideas what I've learned as being a small businessman is innovation and progress is dependent on competition and listening to what's going on around you business world is full of large, very powerful companies failed. Kodak's Xerox failed to follow that lesson. The same is true in government.

So I urge you to adopt the districting process. It is nonpartisan in nature that is based on geography and doesn't deal with any demographic information of any measure. I believe this is critical to our legislative process. It is critical to the progress of our communities enters critical to our democracy state Republican Party Executive Director Dallas Woodhouse challenge the idea of drawing districts specifically to favor Democrats. We think the Goldilocks standard of using race I would have to use a little bit a race but not too much rice to go away and that no racial considerations ought to be made now. We also think the use or discussion of statewide election data is completely irrelevant even though it is largely favorable to the North Carolina Republican Party that has won an overwhelming amount of the statewide election races in the past six years. We do not elect people on a system of Parliament like they do in in Europe. It is not the job of this committee to make a political party that lost 76 North Carolina counties in the presidential election, competitive because they are uncompetitive in vast swaths. Vast areas of the state listening to a sampling of public comments about electoral redistricting in North Carolina, will return with more Carolina Journal radio 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 or a good amount. So while others talk and complain.

We get to work providing research solutions and help our team analyzes the pressing issues of the day jobs, healthcare, education, and more. We look for effective ways to give you more freedom, more options, more control.

Our goal is to transform North Carolina into a growing, thriving economic powerhouse that is the envy of every other state. Our research is actually help policymakers make decisions that ensure you keep more of what you earn. 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 guy residents of southeastern North Carolina are raising questions about Gen X a chemical that's been deposited into the Cape fear River. For decades, Gov. Roy Cooper asked state lawmakers for an extra $2.6 million to address the issue.

Legislators decided to convene a meeting of the environmental review commission in Wilmington Republican Sen. Michael Lee was first to address the group. We first found out about it. Our first reaction was did this because the problems that our youngest child has anatomical abnormalities of birth that calls him have brain surgery spine surgery, stomach surgery, throat surgery be hearing impaired and take medication every morning and every night having a shot every single night for the next 10 years with human growth hormones was our first response was grounded in logic, rational thought or steeped in scientific research, it wasn't meant it was it was emotional was emotional response and you can see that a lot of people that are here. It's very, very personal.

Lee wants to do more than study the problem. The administration's request came down and respectfully understand studies, epidemiology, and all that but 37 years. May we need an action plan today and I think that's what people in this area and this Cape fear watershed drink in the water every day. They want an action plan.

Not everyone is on board with Sen. Mike Lee's idea Democratic representative Deb Butler raised concerns our governor Roy Cooper has made a reasonable and thoughtful request of this North Carolina Gen. assembly for money to pay for more scientists, toxicologists and chemists at the Department of environment equality and the Department of Health and Human Services.

Those are watchdogs for keeping our water clean. I know it comes as no surprise to most of you that those agencies have had to fire in excess of 70 staff members. Since 2013 due to budget cuts and now they simply need more manpower to do the necessary testing and to enforce the permits to prevent would-be polluters from discharging harmful chemicals into our water Republican representative Holly Grange responded. This is not a political issue to me. To me this is a public health issue and there are still many questions that need to be answered.

And that's the purpose of this commission is to answer this question we need to find out what processes failed. That said that this would this situation might occur here in Wilmington and who knows where else in the state so I thank you for coming here to address this. What is foremost in my mind is that we all all citizens deserve clean drinking water that is free of all contaminants new Hanover County commission Chairman Woody White offered his own assessment of the Gen X controversy. I thought about the two miscarriages. My wife before I focused on was for and that's what all these people back here and think about with their children and their grandchildren.

We haven't at that moment time considered science or logic, or who's at fault who was asleep at the switch.

What should've been done. What's the statutory scheme regulatory process is the best. I was thinking about that don't know who what happened who did what. I know somebody put something in the river that didn't belong there and somebody in the state should've prevented it and it I don't know if he or she was Republican or Democrat if it was a man or a woman or consortium of all the above and I don't care.

White recounted his meeting with officials from the company responsible for Gen X when the mayor not our respective bodies asked for keyboardist come here and we met across the hallway. They did that. I don't know why in the world. They did or who their counsel, walked to their lawyer was wonderfully still work for because because they came here, we found out that Ted's family, his children and grandchildren and my family, my children and a lot of the other people have been drinking the stuff for 37 years. We didn't know that they told us the state didn't tell us it wasn't a website we could go to there was a permit.

We could look at. I don't care what it's called what I do know is that its predecessor chemical poison tens of thousands of people in Ohio and West Virginia and DuPont paid hundreds of millions of dollars.

After 17 years, finally admitting that they poison people willfully and intentionally.

We didn't know that on June 15 they told us about Gen X now. What if they had decided you know what get good legal counsel here politely word and decline the request come down there meet with Maren Commissioner.

There were just not say anything. We would know that sit here today. The kid couldn't tell us that HHS probably couldn't tell us that for decades. Nobody Stoltz so I hope that you all will will not get sucked into the inside the beltway mentality of playing politics with this.

I see why bosons would be tempted to do that. There's plenty of blame somewhere I don't know where lots. I think evidence at some point during the enforcement process and the oversight process needs to answer those questions.

Why did Sasso and white in their guys and gals has to figure this out for 37 years. What in the state do it so there's those are good questions, and future enforcement actions and oversight functions.

We have to know those answers, but this process is exposed systemic and unimaginable regulatory failures at the federal and state level, and we have an incredible opportunity as a community as a state because this is a North Carolina issue.

We have an opportunity here to set aside whatever arguments we might have other issues and agree on what everybody else agrees to safe drinking water, noble people polluted and if you put it going to get punished and we got have an enforcement mechanism that ensures the people that the water safe Wilmington Mayor Bill Sabo offered state lawmakers additional information safe drinking water is what we want online. We want water between the Republican victory for your and delivering to citizens of this region. What I personally found in this whole process is the federal laws, state laws, federal agencies overseeing this state agency singers. Sometimes they're not talking to each other or through talking to each other regulatory process of the federal levels differ from the reprocessed prospects that is right we have an opportunity here to get it right and make it a bipartisan.

This is a public health issue for not only citizens in this region but throughout the state. Most workers one thing I found his compounds and chemicals are in every river in the state of North Carolina. The citizens of this great state should be given that information to know at least what is in their drinking more, you been listening to some of the testimony from the state environmental review commission's recent meeting in Wilmington. The topic what to do about the controversial chemical Gen X will return with North Carolina journal radio if you the freedom we got great news to share with you now. You can find the latest news, views, and research from conservative groups all across the state. All in one place North Carolina one-stop shopping for North Carolina St. movement had 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 Locke foundation analyst plus opinion pieces and reports on higher education. All of that from the Pope Center for higher education policy commentary and polling data from the Cintas Institute and news and views from the North Carolina family policy Council. That's right, all of that, all in one place North Carolina that's North Carolina spelled out North Carolina Log on today. Welcome back to Carolina journal radio Donna Martinez technology is revolutionizing how we access and how we deliver care but some medical professionals are reluctant to embrace what's called telemedicine because some of those services are not covered by insurance out an issue that the state of North Carolina is now looking into and that is gotten the attention of Catherine Restrepo. She is the John Locke foundation's director of healthcare policy. She's here to tell us why she's just a little bit concerned about that gap and welcome back to the program. Thank you think you have any tell us more about what it is that the general assembly has directed the state's Health and Human Services agency to do well on October 1. Department of Health and Human Services.

They're supposed to submit a policy recommendation report to the legislature looking at telemedicine only advancements that all the telemedicine initiatives that are happening in surrounding states, and whether or not those states have parity laws and that's really the main issue were talking about here and so essentially a parity law is the question of should the government force insurance companies to cover telemedicine benefits and all the health plans that they sell to policyholders and the idea is that if it forces insurance companies to cover these benefits than more doctors, more providers, more hospitals will use telemedicine and implement other telemedicine initiatives hospitalwide for more policyholders because this is a way to be more cost-effective method of healthcare delivery. Let's remind our listeners what telemedicine really is. Give us the spirit basically tell nice and it's just delivering healthcare at a distance and it can be done through all these different modalities through tablet through computer through telephone.

I mean, doctors have been doing telemedicine since the LAT 1800s on the telephone was invented to diagnose patients over the phone, saving them from having to go to the patient's home to do a diagnosis so telemedicine is really advanced, especially in the past couple of decades.

It's this booming industry to multibillion-dollar industry and a lot of payers are playing catch up as to whether there covering these benefits and implants. Catherine and the peace that you've written about this which folks can read it. John You noted that a number of states. In fact, a lot of them more than 30 states actually have these laws that require an insurance company to cover telemedicine in the benefits package right 32 states to five, but North Carolina does not have a parity law. Yes, we don't. And there is no need for one.

Because the market has been working to I mean hospitals providers again are using telemedicine on their own without parity laws to expand access to patient care me, North Carolina.

There are many rural areas, North Carolina and hospitals, health systems and providers are aware of that and so that's why they're embracing telemedicine help us understand a little bit more about how it is that telemedicine could be growing and could really be helping a lot of people you mentioned and wrote rural areas most prominently, but without that requirement because all the states have that requirement in North Carolina. Doesn't something some folks might be scratching their heads and single. Hey, wait a second.

That doesn't make sense right. Well, it is. I think it's a false notion to think that if the state doesn't have a parity lots behind the times on telemedicine and that's simply not true.

You mean if you look at North Carolina. There's so many things that are happening the telemedicine across all spectrums of care, from primary care to specialty care on looking at Carolinas healthcare system. For example, they had this tele-ICU program where they had this command center staffed with intensivists and specialists outside of Charlotte mint Hill and it's it's like these providers are an extra set of eyes and ears. They connect through through the computer monitors and rural hospitals where and Burrell hospitals with ICU units that are shortstaffed with intensivists and other specialists as well. So it's a way where patients in rural areas that are affiliated with Carolinas healthcare system don't have to be transported to a main harbor and main flagship hospital.

They can be cared for closer to home, and it saves hospitals money and save them on readmissions penalties because they're just closely monitoring their patients. But it's all at a distance that has so many different benefits that I can think of enemy number one.

A lot of times I think traditional thinking has been well if you quote live near a really good medical facility, you've got it made.

If you get sick and if you don't live near something they may be in trouble. Yes, it addresses that whole rural urban divide issue in healthcare and equitable access to healthcare and telemedicine is really helping Phil fill this gap.

One can only imagine to how much more convenient. That makes it for the patient who doesn't have to worry about transportation when they're using this kind of of technology and were talking about phones here right I mean you can actually text doctors or you can do this on your laptop and they can actually see explain things to you yes yes at the primary care level.

There's lot of texting going on. There's a lot of virtual encounter. Virtual visits between a physician and patient through through a laptop or a tablet or their own phone and there's many apps called mobile apps out there for telehealth services that are that are HEPA secure HEPA compliant, meaning that they comply by patient privacy laws and it's just an easier way and more much more cost-effective for patients to get access to basic healthcare needs. For example, rely MD that's that's healthcare at that homegrown in North Carolina, a group of emergency fishes. Physicians created it and patients can access a licensed physician practicing in North Carolina.

Three rely MD for a $50 out-of-pocket and that's compared to traveling at me so much more cost-effective because compare that to traveling up to 30 miles or more patients in more of a rural area to go to their primary care physician office and pay if they're paying cash out of pocket that can be hundred $50 so you there's some serious savings that can happen to hear so much Catherine about folks who have concerns about access to care and you mentioned the rural urban situation, but one would think that those who have those concerns must be looking at telemedicine in direct primary care in saying that this is just opening up so many opportunities in such greater access for people kinda levels the playing field so so absolutely in the great thing is that you know we don't have a parity law but providers are still noticing how telemedicine there's this shift from fee-for-service medicine to value-based contracts. In other words, doctors and hospitals are paid a prepaid package to care for patients within a defined budget or within a defined amounts of payment and there, including telemedicine as a benefit with and not healthcare package and it's really is paying dividends for many people at the Gen. assembly has been looking at different things at around the subject of healthcare innovation and damp medical care providers and all that and actually made some progress that you wrote about in your having to do with nurses being able to deliver care through telemedicine. Yes, Gov. Cooper. He just signed off a not too long ago last month.

I believe legislation that weighed its basically updating this.

This multistate license reciprocity that nurses have said they can practice they can see patients and others living in other states. Nurses that are licensed here in North Carolina that also includes the fact that they can they can deliver telemedicine services to patients in other states as well so that goes again back to the access issue in removing these barriers to licensure and removing barriers to care on can really help extend the reach of care to more patients there telemedicine to other providers.

Some in in the medical field faced similar obstacles and in being able to deliver care.

This way yes then and that's currently what's going on with the Federation of State medical boards. There's this interstate medical licensure compact that doctors are now signing on to. So I think 17 to 19 states have signed on to this compact and it still in the works.

As far as the operations and and how it's going to play out is very similar to the nurse licensure compact where where doctors can practice in multiple states gain licensure in multiple states and see patients living in the states. What's really fascinating piece about this innovative technology that really isn't expanding access to medical care. It is called the telemedicine and Catherine Restrepo has been writing about

Her latest piece headlined. Don't force insurance companies to pay for telemedicine services and as she's explained. North Carolina does not have what's called a parity law and Catherine says it doesn't need to have one either. And thank you very much. Thinking that's all the time we have for Carolina internal radio this week. Thank you for listening on behalf of my cohost Michiko Kai. I'm Donna Martinez.

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