Opinion: Daily Journal

A Good Idea from Charlotte

RALEIGH – Even though I am a Mecklenburg County native (I can’t quite bring myself to say “Charlottean,” as I grew up just outside the city limits), I can understand the negative feelings that many North Carolinians have towards the Queen City. Charlotte is the biggest city, it is chock-full of bankers and others typically resented by those in smaller towns and rural areas, it is arguably the least interested in the rest of the state, and its location next to South Carolina reinforces its “Great State of Mecklenburg” sentiment.

But occasionally, the folks down there do have a good idea. A historical example is American Freedom (I subscribe to the theory that the Mecklenburg resolves of 1775 did, in fact, constitute a bona fide call for independence). A more recent example is Medicaid privatization.

As described in an article in today’s Charlotte Observer (see here), Mecklenburg County implemented a pilot program five years ago to contract out portions of its Medicaid caseload to private health plans. Although changes in reimbursements and the marketplace have led to fewer companies participating, the contracting process has still resulted in a comparable or even improved level of service to recipients while controlling cost.

During the past five years, Medicaid expenditures have risen twice as fast in the rest of North Carolina than they have in Mecklenburg. Advocates argue that expanding the system to the Triangle and Triad regions – rural areas may not be suitable given the lack of private options available – could save the state nearly $40 million.

That’s not all we need to do to find savings in Medicaid, which will see statewide costs exceed projections by hundreds of millions of dollars in the coming fiscal year. Our forthcoming alternative state budget calls for slicing state appropriations to the program by about $125 million in FY 2002-03. But the privatization initiative would be a good start.

Not bad for a bunch of arrogant city slickers.