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Carolina Journal Radio No. 744: Cooper wants court to declare parts of N.C. budget unconstitutional

Carolina Journal Radio / Donna Martinez and Mitch Kokai
The Truth Network Radio
August 21, 2017 12:00 am

Carolina Journal Radio No. 744: Cooper wants court to declare parts of N.C. budget unconstitutional

Carolina Journal Radio / Donna Martinez and Mitch Kokai

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August 21, 2017 12:00 am

Gov. Roy Cooper wants the N.C. Supreme Court to declare part of the new state budget unconstitutional. In a recent court filing, the governor expanded his Cooper v. Berger lawsuit. It now includes a challenge to budget provisions targeting Opportunity Scholarship school vouchers, roughly $1 billion in block grant funding, and the use of $87 million secured from a legal settlement. Carolina Journal Editor-in-Chief Rick Henderson analyzes Cooper’s argument. The N.C. Commission on the Administration of Law and Justice presented a report this year designed to address long-term changes that would improve the state’s court system. State Supreme Court Chief Justice Mark Martin established the commission. He says it offers important ideas that should help guide court policies in the years ahead. Cooper recently signed Britny’s Law. It would allow prosecutors to take a history of domestic violence into account when deciding whether to bring charges of first-degree murder in a domestic killing. During a bill-signing ceremony, Cooper explained his support for the measure. Stephen Puryear, father of the murder victim after whom the law was named, gave thanks to lawmakers and others who pushed for the change. The N.C. House voted this year against the idea of North Carolina supporting a Convention of States to propose amendments to the U.S. Constitution. But representatives later revived the bill and sent it to a committee. One person who has lobbied N.C. lawmakers in favor of the convention is former U.S. Sen. Jim Demint of South Carolina. DeMint is also the former president of the conservative Washington, D.C.-based Heritage Foundation. DeMint explains why he believes the Convention of States offers the best way to help restore limited, constitutional government. As policymakers on Capitol Hill continue to struggle with government-related health care reform, one area outside of government’s focus is thriving. The multibillion-dollar telemedicine industry is thriving. Katherine Restrepo, the John Locke Foundation’s director of health care policy, explains why.


Cherokee ticker 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 I Pacheco got during the next hour, Donna Martinez and I will explore some major issues affecting our state. The Chief Justice of North Carolina's Supreme Court has been pushing for long-term improvements of the state's court system to learn how to measure dub Britney's law could boost penalties for domestic violence abusers who commit murder learn details about the new law, North Carolina's state House of Representatives voted against supporting a so-called convention of states, the convention would suggest amendments to the U.S. Constitution.

Despite the defeat you'll hear for one high profile national conservative who still pushing the idea and will learn about the positive recent developments in telemedicine. The potential impact on healthcare costs. Those topics are just ahead. First, Donna Martinez joins us with the Carolina Journal headline, Gov. Roy Cooper is asking the North Carolina Supreme Court to declare pieces of the state operating budget unconstitutional violation of the separation of powers. Now the governor's request will be heard in late August. It's all part of the case called Cooper versus Berger, one of the folks is following the case very closely. Is Rick Henderson. He of course is the editor-in-chief of Carolina Journal Rick welcome back to the program. Thank you alright so few days ago, the governor filed a new brief in this case, but that is not the totality of the case gives a sense of what Cooper versus Berger is all about. This was a lawsuit that the governor filed in response to legislation that was passed in late December just before going Gov. Cooper took office that removes some powers from the governor's office and transferred the Gen. assembly, and this includes appointment power on subsequent commissions. That was the big issue was that was the issue of him being able to appoint people to various state boards and commissions that are considered executive branch commissions but that the legislative branch is taking some authority. We have talk to now and then on this program about the fact that in North Carolina the governorship is considered to be a week governor were not talking about the person occupying the office, but that the seat itself and it appears that Gov. Cooper is really trying to pursue that and strengthen the seat of the governor right and he's relying on court case that was filed by his predecessor, Gov. Pat McCrory against the Gen. assembly a couple of years ago which the Supreme Court said that yes if if there is a commission board in North Carolina that has some sort of regulatory powers that the if the commission is predominantly any considered report of the executive branch, then the government should have the power to appoint at least a majority of the members of the general assembly can't appoint all and so the oratorio can appoint the majority of them and so that's what he's relying on in this particular case because there were some specific changes that the Gen. assembly made to the law in December that gave Pat McCrory the power to make some appointments on his way out the door. That's one thing that Cooper's object let's talk a little bit about this new brief that the governor and his team have filed in the case. It really goes after the state operating budget which we are operating under as we speak. It began, it took effect July 1. First of all he talks about opportunity scholarships, which are vouchers to private school for low income families.

This is a program that is been funded for several years now in North Carolina what to speak of his complaint here is that the general assembly has written into the budget provision that the funding for the opportunity scholarship program will increase by $10 million a year over each of the next 10 years and they're saying that that has got to be in the governor's budget every year and his his challenge here is that the general assembly can't tell the governor how the governor will spend money Gen. assembly ultimately decides how that money is spent and if the government doesn't like it governor can lead to liberation others.

There has to be a decision about whether the veto can be overridden or sustained, but the governor says it governor believes the vouchers unconstitutional. Number one but the second thing is the governors of the generals and we can't tell me how I'm going to spend money in advance. I I get to make a decision that actually is a constitutional duty of the government budget Gen. assembly.

He also has a section devoted to the use of federal block grants. What's that about. There are number of pieces of money that the state gets from Washington DC generally designated to go to for various purposes and what he's saying here is that the general assembly in its audit has most recently passed operating budget is trying to move that money around in ways that the governor did not intend, and also to some extent he's climbing in ways that are not allowed under federal law that there are strings attached to these grants Gen. assembly stride to tamper with them and so in that case he sent generals and was overstepped his bounds by directing money that was that was it already encumbered can't North Carolina that's an interesting question because if you look at the money it's going from essentially federal government to state government.

There simply think that on that particular issue. The governor might really have a legitimate KCl PTA probably has a very good argument to make that case because if for instance the department of Health and Human Services says that at all certain amount of money is going to go to finance pre-k education program score of healthcare for children or something like that in the generals and was is no would like to have it fund something else, then you can argue that the federal government had to provide that money for specific purpose in the general assembly is trying to tamper with that purpose, and therefore has no separation of powers issue now. He also is contending that time, there are issues about settlement money from a Volkswagen case tell us about that case. Another one of those global settlement cases like tobacco lawsuit Volkswagen fabricated some vehicle emissions reports as we that from several years ago and what the auto company did was number 61 and allot a lawsuit to sue Volkswagen and the company agreed to make payments and those payments were divided among states were involved in the lawsuit, and according to the terms of that settlement. The money governor argues the governor has the ability to determine where out of money spent in the legislature, saying it now. It has authority to determine money spent and that's the question is going to involve lots of lawyers repaid welder contracts. Speaking of that year was we talk through these issues for folks who are not attorneys and that would be me and I in your attorney either. It sounds very complex and yet down there somewhere saying well.

The details are complex but they are some basic constitutional issues at play here right that's right doing the, the governor is elected to execute the laws. However, the general assembly annexed the locks and so where we have a conflict among the two branches of government who prevails and under what circumstances, and then again when you have third parties involved such as the federal government. These block grants or private party is Volkswagen that case when you have that third party involved in the house that affected who has the save or how that money is spent. No matter who comes out on top in this case it sounds like these are some clarifications that really do need to be made. Yes, that's true, and we haven't had many instances of divided government in North Carolina. We once again have that now and so this is the case. Once again, which unless the Gen. assembly actually goes in is able to somehow bring in the constitutional authority of the governor of their there's talk about possible constitutional limits doing that and what can it do just by passing a law even if it's over the governor's objection.

That's one thing that the Supreme Court will be asked to decide the end of this month. What's been the reaction from legislative leaders. They basically said that the governors trying to act like he's legislature to that was what Sen. Phil Berger who is the Senate leader from rocking him County said and that the governor is trying to illegally limit the power of the Gen. assembly to do its job and it is an interesting question because it's not sometimes not clear if the general assembly passes a budget and allocates money to a certain agency. How does it have to be spent to see this with the instance involving Atty. Gen. Josh Stein, who had his budget cuts pretty severely by the Gen. assembly and he said well most of my budget is Artie tied up in federal block grant money. It has to be spent to service federal purposes and now I've got nothing left to pay my own attorneys and so that's another issue that has to be resolved. This set hearing is supposed to take place in late August we been talking with Rick Henderson he is the editor-in-chief Carolina journal. Thank you 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. Carolina Journal radio and print on the air and on the web. You can find the information you welcome back Carolina Journal radio amateur coca after 15 months of research discussion in public input. A group called the North Carolina commission on the administration of law and justice released its report this year report is designed to help guide the work of the state judicial system in the years ahead.

Our next guest is the person most responsible for that commission is the Hon. Mark Martin Chief Justice of the North Carolina Supreme Court. Thanks for joining us. Absolutely, thank you so much Mitch. Why was the commission of the source, the commission on the ministration of law and justice a good thing to put together well. First and foremost we have 10 million N. Carolinians who utilize the court system. It may not be that were in the court regularly, but we benefit from a court system that handles criminal and civil cases appropriately. So what we see is about every generation or so we have to come in and study a system and really assess what's working well what's not working well so in North Carolina history. We had a commission known as the bell commission that started in the 1950s and then finished his work in the 1960s and we have some amazing accomplishments. We ended up with a unified court system, which replaced kind of a hodgepodge of municipal courts where you might have the same infraction in Asheville in Raleigh but radically different process and procedures and even outcomes and so from the bell commission we were able to achieve a unified system. We also were able to achieve a Court of Appeals during that time because we realize that one Supreme Court was not able to handle the caseload of the state that was rapidly increasing in population and in the number of civil and criminal cases. So we come into the 1990s, and we have a commission known as the Medlin commission and the Medlin commission acknowledge that which we still know and that is that our courts were woefully behind. From a technology perspective is that brought us to the point at which I thought we should evaluate the system again to make sure that the outcome in these court rooms represents the truth and represents justice and represents a uniform outcome across the state were a very diverse state. We have we have the eastern seaboard. We have the Piedmont. We have the western part of the state have 100 counties and is so important to make sure if we have the same facts. We also have the same outcome in all of these counties and that's why we felt among other reasons why we needed to take a comprehensive look at the system in this group did working for more than a year.

As we mentioned at the top as it move forward.

What were some of the top things that came out of the work of the school. Well we we realize that we had a lot of work to do on the technology front. And so one of the chief of strategies. It will be implementing now is known as the E courts strategic technology plan, and this is going to make sure that we have a comprehensive e-filing system not only for our appellate courts, which is been in place for some time, but also for our trial courts that are in 100 counties in that process almost 3 million cases a year and this system will make all documents be accessible to every citizen 24 seven and so is a very important project for us.

We are also looking at ways to make of the system work better for minor juvenile offenses and we have legislation. In this session of the Gen. assembly that directly flowed from the work of the commission to ensure that for nonviolent offenses that these are handled in the juvenile court.

We can have whole family treatment so to speak and turn around as many young people as possible to become contributing members of the can. The economy in the in the global marketplace. One of the things I heard in your discussion about some of the changes that are being made is that would be better for this court system to be operating a little bit more like the way the people operate the rest of their lives using technology better to simplify things so you don't have to go in physically fill out forms after Park at a parking space stand alive, but you could do is much as you can on the on your computer get things done that absolutely we have national survey data, which shows that 76% of Americans would like more court resources available online and that number skyrockets to 86%. If we consider citizens under 40 and so I think if you look at the private sector, Amazon, and other providers you have this wonderful online experience in many respects, and then you come to the courts in your dealer first generation technology so we'd like to modernize and update so to speak. Our our system so people can have that same 24 seven type accessibility and it may be, in many situations they will not even have to go to a courthouse can transact business online.

If we do nothing in the courts operate as they have the kinds of problems or challenges as I can create long term.

We just say that the courts are doing fine. We don't need to make these investments or make the exchange. Well, I want you to consider the fact that each year a week rate.

Another $30 million or 30 million documents that we are having to store so to do nothing actually means increase in expense as we have to secure additional facilities to warehouse all these expanded files of materials that have to be put somewhere so to do. Nothing means that the courts would continue to fall behind to a point where they would really have no technology.

Our relationship to the rest of society. And so, as we've seen, the private sector and other parts of government move forward in this area. There would be an increasing disparity and I think citizens would look at the court simply say what is wrong, how come we can't have accessibility to online resources online that disposition of minor offenses, etc. so I think it's it's in the imperative Institute to accept this challenge and to try to to basically take the steps we need to to an NSS catch up to where other institutions are at this point in time your report or the report of the group came out in March. What's the response bit of people who are going to be making these decisions within state government within the Gen. assembly said you know this. This makes sense. We do need to do something about these things.

I think the responses been very positive and there there have been some favorites of the raise the age legislation is supported by 70% in North Carolinians. According to the latest civets hospital and also the e-filing plan will receiving a lot of good feedback from not only those who work in the legal system, but those who also be the beneficiaries of greater openness and transparency of all court operations and also the Civics education recommendations have also been praised by many.

We live in a time according to recent polling data where only 26% of Americans can name all three branches of government and 31%, according to a recent poll cannot name any branch of government so we also need work to make sure that the people of the state and country are aware the fact that in it in a Republic. We are the government and we have to know how government works so we can be effective in our role as citizens time remaining is short, but if people would like to learn more, including many more the details about this report that those put together after 15 months of work the North Carolina commission on the ministration of law and justice. How would they find information well I'm pleased to share they were trying to practice what we preach and this this document. The report recommendation is accessible online and they need only go to you been listening to the voice of the Hon. Mark Martin Chief Justice of the North Carolina Supreme Court. Thanks much for going live on Carolina journal radio just 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. No permission to shine the light on what North Carolina government and the bureaucrats who run it are doing in your name and with your money will never wane and because of that our reach and influence are growing through all of our distribution outlets we reach more than 1 million N. Carolinians every month so make sure you stay informed.

Read the monthly print edition of Carolina journal. Then check in several times a day, Carolina that's where you'll find fresh stories, opinion pieces and updates on government politics and your money.

Carolina journal. We hold government accountable to you. North Carolina is changing not just day-to-day but outward to our minute to minute and 2nd to 2nd, how can you keep up with the changes, especially the ones that affect you, your family, your home, your job, make the John lock foundation and Carolina journal part of your social media diet on Facebook like the John lock foundation like Carolina. Journal follow us on Twitter at John lock in the sea and at Carolina journal news, insights and analysis you'll find nowhere else. Thanks to the experts at the John Locke foundation and thanks to the first-class investigative reporting of Carolina journal. Don't wait for the morning newspaper. Don't wait for the evening news if it's happening now it's happening here the John Locke foundation and Carolina journal. Have you covered with up to the second information like us on Facebook the John Locke foundation and Carolina journal follow us on Twitter at John lock in the sea and at Carolina journal 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 the work foundation to receive a portion of your purchase amount that's right you shop and Amazon donates money to ask the John Locke foundation.

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Don't forget log onto today by something nice and help defend freedom. Support the John Locke foundation will Qubec Carolina journal radio why Michiko North Carolina has a new law targeting domestic violence.

It's called Brittany's law governor Roy Cooper recently signed domestic violence is a crime that plagues our society.

It rips families apart. It harms our economy and it destroys lives according to the North Carolina coalition against domestic violence 82 people lost their lives due to domestic violence incidences and so far this year. Domestic violence has taken the lives of 37 N. Carolinians, a single life lost his word, like too many in 2000 and 2014 Britney per year, lost her life to domestic violence.

She was 22 years old and the new mother too often, domestic violence killers escape full justice because prosecutors struggle to convince jurors that the offender's crimes meet the definition of first-degree murder. Brittany's law gives prosecutors the option to charge a domestic violence killer with first-degree murder if that offender is already been convicted of certain crimes against the same victim Britney per years father Stephen joined Cooper at the bill signing ceremony or sunlight side.

Britney was awesome.

Thank you Gov. Cooper for having us here today great honor to be here. Britney would be embarrassed by this attention. Britney Gordon per year was the kindest, most loving person ever known. She cared for others.

Britney walked into a room. He was like the sun started shining her smile was contagious. Britney was sweet as so and everybody loved Britney set for her boyfriend. Britney got along with everyone this day and age where so many people disagree and so many things. One thing Britney is done brought Republicans and Democrats together, North Carolina hundred 58 to on issue that affects so many different people, domestic violence, if Brittany's law helps one family not lose a loved one, make sure that one martyr never gets out and all of our time and efforts are worth it. Thanks so much to the 158 senators and representatives that voted for Brittany's law.

We look forward to continue working with you all in the future.

Last but definitely not least, thank God for giving us 22 years with Britney, Jordan, per your I wish it was more that's Stephen Currier, father of Britney per year. She's the namesake of the new Brittany's law allows prosecutors to use a history of domestic violence as the basis for first-degree murder charge will return with more Carolina journal radio in 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. 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 will Qubec Carolina journal radio why Michiko guy. He has served as one of the most vocally conservative members of the U.S. Senate.

He is served as president of one of the most widely recognized conservative policy groups in the nation's capital heritage foundation.

Now he is lending his name and support to the effort to mount a constitutional convention of states he is Jim DeMent is our guest Carolina journal radio.

Thanks for joining us, Mitch. Thanks for having me, it's good to be a North Carolina why was this an issue that you thought was worthy of your attention and support the convention of states.

That's an easy question to answer was in the house and the Senate for 14 years worked at heritage. A lot of this was to try to restrain the growth of the federal government to try to restrain spending balance the budget and frankly after all those years fighting with other folks like Sen. Tom Coburn. We may have slowed the growth a little. We may be band earmarks, but was convinced that Washington will never stop spending that is there only two ways are going to stop a national bankruptcy.

One is if we just hit a wall and have an economic meltdown. The other if the states exercise their right to: amendments convention to restrain the federal government. Some people say look, we just need more people like Jim to bet like a Tom Coburg is if we got more those people in there. We could stop this train and get things moving.

What why do you as someone who wanted to see these things change. Think that's just not could have well it's it's a good thought, and I certainly had it. I started a group called the Senate Conservatives fund and I helped elect a lot of new people in 2010 and 14, including Marco Rubio and Ted Cruz and Mike Lee and Ryan Pallotta folks who came in to do just what we were talking about, but the system just is bigger than any one individual or groups of senators or house members, and frankly, we're worse off now than we were when I came to Congress in 1999. So were losing ground on spending. We've got $20 trillion in debt and a projection of over 30 and not too many years.

There's no plan to ever balance the budget. So what we need to do is recognize that Washington will not and it's no longer even possible that it can fix itself.

No matter who is elected. Some people of probably heard of the convention of states that are really familiar with how would work.

Tell us what you like about this concept will first of all I I have a lot of misinformation. Like a lot of Americans admit whenever I heard of this people were talking about a constitutional convention which sounded like a free-for-all to rewrite our Constitution. I didn't like that idea at all. I knew Washington one following the Constitution. Anyway, so I wasn't sure we had that much to lose, but once I really understood article 5 and in his right there. It's clear, it's probably the most clear legislative language of red that the founders gave us two ways to amend the Constitution. One is for Congress to propose amendments and then 38 states ratified the other is for states to call a convention to propose amendments that 38 states ratified. Frankly, when people say we could have a runaway convention. I say listen already got a runaway Congress.

We got runaway courts we got the rights of states and people have been run all over what we have to lose. I don't see any way that you could have a runaway convention under article 5 we are speaking with Sen. Jim to vent the former US senator from South Carolina. Also the former president of the conservative Heritage foundation now one of the leading supporters of the convention of states anytime that we have talked on this program about convention of states we always hear from some people even some conservatives who are very concerned to think that there will be some sort of runaway event or that the people who are behind this are trying to do something other than getting an amendment that would deal with spending what sort of assurances do you give to people who who hear you say convention of states and say way to screw it up. Well, George Soros and the people on the left do not want to convention the states. They've been working for decades to centralize power in Washington. There's no group of people that want to do this for special interest. In fact, I think, states like California, Illinois, New York, a very liberal states once they understand this they're going to like it just as well as those of us from South and North Carolina because it's not it's not an effort to try to tell people how to live or what to do. It's to determine where things are decided who decides how you're going to live and if California wants a socialized healthcare system that's fine. South Carolina hopefully can have a free market healthcare system. What I tell people is is that if 34 states call a convention around specific subject matter which is what the convention state project does.

If that convention produces anything outside of that subject matter. It will be challenged in court for years and there's no chance 38 states ratified because I can imagine South Carolina, North Carolina, sending delegates to a convention to have amendments with specific subject matter and something else comes up and then they ratify. I just don't think so. I have a lot of concern and I feel there's a lot of risk with what Congress does a lot of risk that the courts could take away our rights Second Amendment First Amendment, but there are there. It seems to be no risk if the states come together and calling convention for amendments not to rewrite the Constitution for amendments and then 38 states have to ratified so folks need to realize that there was a lot of debate when article 5 was written.

It was first written window with only Congress proposing amendments and then the argument started that hate. What we need is if the federal government gets out of control.

We need to realize they will never come up with amendments to restrain themselves.

So this is a way that our founders intended.

It's a kind of an emergency brake or break glass full handle type thing that that state should've done 10 or 20 years ago and we need to get at this very quickly because I'm not sure our country has for five years of continued spending before we hit some kind of wall so that's why I'm in North Carolina right now talking with legislators. The Senate here is already past it. If the house could pass it this year would give us a lot of momentum.

12 states have already passed the convention of the states project. Three. Subject matter amendment area me to call for convention if North Carolina added their name this year would be a huge boost. You didn't use the word but you certainly express the concept and that is the idea of federalism, making sure that a lot of this discussion points in decision-making returns to the states which founders thought they were going to be the driving force behind policy anyway. Is that does that help sell people on this this well about the good, but when I mentioned federalism a lot of people bringing him talking and I think I'm Tyrell more federal government. But if we if we should just have one amendment that said we were serious. The first time. That's all we made the reason we have to do this is the federal government is ignoring the 10th amendment there ignoring the rights of states they views the commerce clause to basically give the federal government access to every area of our lives. So what we have to do is come back and provide clarification to the federal government because right now they are no structural constraints on what the federal government can spend. They don't have to balance the budget, there's no limit to taxation or spending there's no limit to unfunded mandates on the states and their no limit to terms terms in office, which I honestly believe could be the most important thing that comes out of this one person is going to be watching this fight as it moves forward is Sen. Jim to Beth. Thanks so much for joining.

Thank you, Mitch boron Carolina journal radio just if you love freedom we got great news to share with you now.

You can find the latest news, views, and research from conservative groups all across the state. All in one place North Carolina one-stop shopping for North Carolina St. movement and North Carolina

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All of that from the Pope Center for higher education policy commentary and polling data from the Cintas Institute 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 Martinez despite the U.S. Senate's failure, at least for now to move forward with repealing and replacing Obama care. Healthcare innovation is taking place around the country and right here in North Carolina.

Our next guest points to telemedicine as an example, a multibillion-dollar industry and a leading innovator in the healthcare arena. Catherine Restrepo is the director of healthcare policy for the John Locke foundation Catherine welcome back to the ground so it sounds really cool but what is to say telemedicine teasing using technology providers. The technology to deliver healthcare at a distance so there's only primary care shortage areas in North Carolina and there's over hundred 45 in fact and so fair a patient living in a rural area of the state and they can take time off of work. It's difficult with them with their schedule for their child to be seen while they're working in managing their family schedule it so much easier in many cases to just have a virtual visit with their physician who is at a distant location, talking about something like Skype on your laptop. Something like Skype you can face time on your on your iPhone but there's also the secure HEPA complaint platforms that providers use fair for hip purposes and in privacy protections for patients and hippo being a federal law that requires certain certain security procedures in order to protect very sensitive information. Yes, exactly. Okay, so I could do it may be.

I'm on my phone I can do it on my laptop any other applications for that is, does having to do with the telephone itself or is it all visual medium is not just visual thing can have virtual visits like talking about, but there is also an app called Tele dock and it's actually a market leader in the world of telemedicine has about 70% of the market share when it when you're looking at these telemedicine apps and on eminence. It's just that simple. Because the patient can call in for a consult with primary care physician or specialist first certain meeting on urgent medical issue they're facing and within a matter of minutes a physician will call them back and or their immediately connected in a matter 10 minutes or so in a majority of these consult to resolve just over the phone stage is so convenient and pays down overuse to ordering something online and having a box show up on the doorstep to fulfill the convenient and it's a menu that's a keeping healthcare simple and semi-weights you because I'm in the states back to when the telephone was first invented, I mean there have been stories of an anecdote that physicians calling patients at their houses to save them a check from going to make house calls very interesting that you mention something a moment ago that I want to get back to you and that is that there are hundred and 45 areas in North Carolina where there's a problem with access tells more about yesterday's severe primary care physician shortage and that's for lots of reasons, but so telemedicine.

The great thing about telemedicine is that it leverages the scarce resources which are if you primary care providers out there practicing.

Whether it's in a rural area in urban area and the connecting with more patients living in underserved areas. There where there is limited access is not just that the primary care level on a lot of rural hospitals are partnering with larger specialty hospitals are centers of excellence for their having Tele Tele stroke unit installed or the connecting with the Tele stroke unit that the larger hospitals. So if a patient this can save a patient from being transferred to a larger hospital because they can be assessed first stroke in the smaller hospital he was patient closer to home much more convenient for families. Are we finding Catherine that patients consumers of healthcare are comfortable with this type of technology into looking after looking at the market research, a kind of varies. A lot of people still aren't.

I mean, there's definitely an increase in the amount of virtual visits. There's been a 20% increase in virtual physician visits within the past year, but there's still a lot of consumers who are really not familiar, you have not used telemedicine by other surveys show that even though they haven't used it they be willing to just because on access is so important to them and just the convenience of using and it's one of those things that probably just have to get used to it. I can recall over the past several years. When we heard so much from healthcare analysts like yourself saying, look, stay out of the emergency room of the cost at hand because that's so expensive and you may not need that level of care.

So go to one of those urgent centers are one of those clinics in and a drugstore implanted needed timepiece that to write yes and and that that's a great transition to rely MD that's another app that patients have access to the founders of that app.

It's the company started by an independent group of emergency efficient physicians right here in Raleigh North Carolina so their platform on an offer in exchange for $50. A patient can have virtual visit with them and this can save them a trip, even from the urgent care. They can still be treated in the comfort of their own home seven 775 or $200 minimum urgent care visit.

It's $50. That was an amazing so on your phone you actually order order some shoes online or you could do you call a friend, or you could actually have a visit with your doctor and it's pretty amazing when you think about the whole thing. Catherine is this covered by insurance. Yes instant it depends. Insurance companies having coloring talent covering telemedicine services send Blue Cross Blue Shield North Carolina has since the mid-1990s. There Tele psychiatry services because I really need is a video consultation with a psychiatrist in the technology and equipment is relatively it's not as complex as compared to other other types of intelligence and initiatives that some insurance companies have on there also laws out there so far 32 states have telemedicine parity laws so that forces insurance companies to cover telemedicine services and there's different types of parity laws. So with 11 type of highlights there's coverage parities that you have to cover the services and its payment parity.

Some insurance companies actually forced to pay physicians the same rate for that service.

They deliver through telemedicine the same rate as it would be an in office visit, so their stifling controversy among staff because on that topic because on telemedicine. It's really can be very cost-effective and so it does make sense necessarily to pay provider for service can be done.

You know when he doesn't. You don't need to cover the facility fee or other technicians or other staff members if it's just him and the patient in one of the most time costly programs that we as taxpayers pay for not only the state level, but at the federal level is the Medicaid program. TM originally designed as you've written about many times to help the poor widows and things like that but that is been expanding base of people is this potentially one way using telemedicine to try to may be lower costs but still give people access and quality care. Yes, absolutely. And in fact North Carolina's Medicaid program has been covering telemedicine services for almost 20 years and it's time we are talking about this now because many Co. and the Sec. of the Department of Health and Human Services of North Carolina. She's said she would like to submit an amended amendments to the waiver for our state Medicaid reform.

That's continue that's currently being reviewed at the federal level and one of those amendments talks about tell more telemedicine initiatives more telehealth initiatives and, in fact, I'm glad you mentioned that because we want to have you back at a future program to talk about that Medicaid waiver request sharing as you've written, there are some really interesting and good components to it, but you do have concerns about the friendliness of some of the administrators in the state government right now to expanding Medicaid even writing about why that would be a bad idea. So have you talk more about that talking Catherine Drapeau she's the director of healthcare policy for the John Locke foundation. Thanks very much, think that's all the time we have for the program this week. Thank you for listening on behalf of my cousin is okay Martinez join us again next week. More Carolina general radio Carolina journal radio is a program of the John Locke learn more about the John Locke foundation, including donations that support programs like Carolina journal radio send email to development John Locke call 66 GLS 166-553-4637 journal radio nation airline is maintaining running all opinions expressed on this program nearly mentioned about Michelle or other foundation is any airline sponsored Carolina radio again

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