August 7, 2025 • 34 mins
Trump’s latest round of tariffs is now taking effect. Governor Stein signed a stopgap spending measure to keep government running but vetoed a school choice bill. Mitch Kokai from the John Locke Foundation discussed efforts to clarify confusion surrounding North Carolina’s Certificate of Need (CON) laws. Meanwhile, a Carolina Journal opinion piece highlights how those laws can lead to higher healthcare costs, with one patient choosing to drive to South Carolina for an MRI.
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Speaker 1 (00:09):
It's five oh five and welcome into a Thursday edition
of The Carolina Journal News Hour, News Talk eleven, ten
ninety nine to three WBT. I'm Nick Craig, a good
morning to you. Tariffs ranging from ten to forty one
percent are officially set to take effect today for multiple
countries as the ongoing trade battle and war out of
(00:30):
the White House continue. This comes months after the world
was capitulated into a spiraling trade war following President Donald
Trump's Liberation Day announcement, which happened back on April the
second of this year. The looming thread of tariffs has
created a pretty significant amount of uncertainty for businesses across
(00:52):
nearly every industry, as deadline after deadline for implementing tariffs
have been repeatedly pushed back in an attempt to broker deals.
The tariffs that went into effect on August the seventh
reflect the change in a rate from what was threatened
initially during the Liberation Day announcement. Joseph Harris, a fiscal
(01:14):
policy analyst over at the John Locke Foundation, tells The
Carolina Journal from April to second to July thirty first announcements,
the average tariff rate among the included trading partners declined
from twenty five percent to nineteen percent. Among the most
significant rate reductions were Cambodia forty nine percent to nineteen percent,
(01:38):
Vietnam forty six percent to twenty percent, and on the
other hand, Switzerland received the largest rate from rate increase
from thirty one percent to thirty nine percent. In a
July thirty first announcement, sixty nine trading partners were included.
Eight of these partners saw no change in their tariff
(01:59):
rate from that early April announcement. Among the remaining sixty
one partners whose rates were adjusted, nineteen experienced increases, while
forty two of those countries saw decreases. The average proposed
terif rate for all of those countries combined dropped twenty
dropped from twenty five percent in April to an average
(02:21):
of nineteen percent in the latest announcement. The new ranking
rates range from the low of ten percent, which is
applicable to the United Kingdom, Brazil and the Falcon Islands,
to a high of forty one percent for Syria. Joseph
Harris said the United Kingdom, Brazil, as well as others,
(02:42):
are subject to the lowest tariff rate of ten percent
in the July thirty first schedule, placing them well below
the average of all of the countries. Although many of
the July thirty first tariff rates are lower than those
announced in April, they still represent added costs that could
result in higher prices for certain goods if those costs
(03:05):
are passed along to consumers. India is set to face
an additional twenty five percent tariff for a combined fifty
percent final rate, which is set to take effect in
about three weeks, according to the folks inside the administration.
According to the Executive an executive order signed by President
Donald Trump on August the sixth, the additional tariffs are
(03:29):
in response to India's imports of Russian oil as well
as the ongoing Russian invasion of Ukraine. In addition to
the individual teriffs for each nation, there is already a
fifty percent tariff on steel and aluminum that went into
effect back on June fourth, as well as a twenty
five percent tariff on automobiles and automobile parts. This is
(03:52):
already impacting the industry and North Carolina manufacturers, as General
Motors recently announced a net Tek tariff impact of more
than one billion dollars that was in the second quarter
of the fiscal year, and an estimated annual impact of
four to five billion dollars due to some of these
new tariffs. According to GM, they who manufactures those vehicles,
(04:17):
as well as GM Defense, a subsidiary of GM, who
also makes vehicles for the Defense Department. They have a
facility in Concord. Despite the overall reduction and average tariff
rates since April, today's implementation still mark a substantial escalation
in trade barriers for many countries, as businesses and consumers
(04:40):
may soon feel the ripple effects as these added costs
filter through the global supply chain and influence prices. We
have been keeping a very close eye on tariffs and
the impact here across the state of North Carolina. We've
got additional details and are continuing coverage of that over
on our website This Morning Line of Journal dot Com,
(05:01):
where it's now five to ten, News Talk eleven ten,
ninety nine to three WBT. For those that follow things
that go on in the state of North Carolina, public
policy and things of that sort, you may be familiar
with Certificate of need. It's also called con and it
essentially is a process in which healthcare systems across the
state of North Carolina. Healthcare providers have to go to
(05:22):
the State of North Carolina to get a certificate of
need to expand capacity. We've got a new opinion piece
from Mitch cookei over at the John Locke Foundation, the
headline cutting down on con case confusion. He joins us
on the Carolina Journal News Hour. Mitch, con has been
a longtime discussion in the state of North Carolina. It's
a little bit in the weeds on the policy side,
(05:43):
but it has a huge impact on pretty much everybody
from the mountains all the way to the coast.
Speaker 2 (05:48):
It really does, because certificate of need determines how much
healthcare supply we have in North Carolina. It's essentially a
government permission slip, and any healthcare provider of any type
wants to build a new hospital or other health care facility,
add some beds to an existing hospital, or even buy
a major piece of medical equipment has to go to
(06:10):
the government to get this permission slip. If they don't
have it, they can't move forward with any of those
types of projects.
Speaker 3 (06:16):
Now.
Speaker 2 (06:16):
Con from the advantage point of public policy, it's bad
public policy. It basically reduces options for consumers and ends
up raising costs. And so it would be a good
idea to get rid of certificate need or CON if possible,
and that's something that the state Senate actually would do
this year. They put eliminating the CON laws repealing the
(06:39):
CON laws in their budget, but because we have no
final budget deal, that idea is still in limbo. And
so the opinion piece that you're talking about says, well,
if we can't get rid of CON, maybe the next
best thing at this point is for the courts to
clarify some of the confusing rulings that come out with
a lot of CON cases. What typically happens is health
(07:02):
care providers are always in competition with each other, and
in one way they compete is to try to get
one of these certificates and stop their opponents or competitors
from getting one. So one recent case involves sixty seven
hospital beds in western North Carolina. The state decided that
(07:23):
there was this need for sixty seven hospital beds to
serve a four county area and had some applications to
get the CON. The winning application came from advent Health,
which is one of these major health care providers that
wants to build a new hospital in Weaverville. And then
Mission Health, which runs a big hospital in Ashville, also
(07:46):
wanted to add sixty seven beds to its existing.
Speaker 3 (07:48):
Hospital in Nashville.
Speaker 2 (07:50):
But because the state regulators gave the con to advent Health,
Mission Health can't expand. So Mission Health went to court.
Health's argument against the advent Health con was that, wait
a minute. Anytime there's been a new hospital that's been
approved in North Carolina for a con, it has always
(08:13):
had to have a licensed general operating room. This advent
Health proposal didn't have one, So what gives why did
regulators change the situation? They didn't really explain that they
had changed this long standing policy, and so Mission Health's
legal argument was that that was a agency error, the
(08:35):
agency being the Department of Health and Human Services, and
that that error had substantial prejudice against Mission Health. The
wording is important because in previous con rulings, the courts
have said for a challenger to win a case, they
have to show agency error and substantial prejudice, and basically,
Mission Health is saying, look, this is an example of
(08:58):
both agency error and substantial prest judice. Lower courts have
ruled against Mission and in favor of the Department of
Health and Human Services and by extension, Advent Health. So
the Mission Health asked the State Supreme Court to take
up this case, and it says in its petition to
the court, look, if you take this case, you can
(09:18):
deal with some of these other rulings that have come
out about con in recent years that are contradictory and confusing.
We know that we have to show agency error and
substantial prejudice, but there really hasn't been a clear definition
of what is substantial prejudice. We think that this case
shows it. Lower courts have said that it doesn't.
Speaker 3 (09:38):
Show substantial prejudice.
Speaker 2 (09:39):
So Supreme Court, please take this case to tell us
what exactly is substantjudice so we can know and other parties.
Speaker 3 (09:47):
Can know moving forward with these concases. Now.
Speaker 2 (09:49):
It's interesting to note that against this proposal, both advt
Health and the State Department of Health and Human Services
that file documents saying, wait a minute, these may be
some interesting issues to take up. This is not a
case to do it because Mission Health didn't even prove
there was any kind of agency error. If they can't
prove agency error, it's a moot point. Don't take this case.
(10:13):
If you want to deal with this issue, wait for
another case where it's more on point. But I think
the main point of this opinion article is that con
cases are long involved, take a lot of money, a
lot of time.
Speaker 3 (10:25):
They're very confusing.
Speaker 2 (10:26):
So it would be nice, whether if it's with this
case or another case, for the State Supreme Court to
step in and say, this is exactly what a con
challenger has to prove to be able to win a case.
This is what amounts to agency error, This is what
amounts to substantial prejudice that would make the proceedings go
forward in a lot smoother way in the future. And
(10:48):
for folks who are saying, why should I care about this, Well,
the sooner that these things get resolved, the sooner that
the healthcare providers can start building these facilities, offering the services,
adding more healthcare supply. So that should mean more convenience,
lower cost for the patients. Now, the thing that would
(11:09):
be best for more options, lower cost, more convenience would
be to get rid of con entirely, which the State
Senate wants to do. But if that's not going to happen,
then the courts at least could make the process a
little less confusing and have a little less contradictory rulings
coming out.
Speaker 1 (11:28):
We'll continue the discussion on certificate of need with Mitch
Koki from the John Locke Foundation coming up after this.
You're listening to The Carolina Journal News Hour. It's twenty
two minutes past the hour. Welcome back to the Carolina
Journal News Hour news stock eleven, ten ninety nine three WBT.
(11:51):
You don't forget if you miss any portion of our
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You can listen to it after the fact on your
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It's available in Google Play, Apple Podcasts, Spotify, anywhere you
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(12:14):
Carolina Journal News Hour Podcast. Download and subscribe now. Mitch
COKEI of the John Locke Foundation continues with us on
the Carolina Journal News Hour. He's got a brand new
opinion piece up the headline, cutting down con case confusion
that's referring to certificate of need across the state of
North Carolina. So there's a couple of different angles and
areas to take this conversation. North Carolina consistently has been
(12:37):
on the top of the list, and it's not where
you want to be for the most expensive healthcare in
the United States. We've seen multiple surveys over the last
couple of years that show that a lot of that
is being attributed to certificative need and Mitch, as we
follow these legal processes go down and there's a variety
of these various cases across the state. You're putting a
(12:58):
huge burden on the state courts system on something that
many folks believe should just be struck out by the
General Assembly, and unfortunately that has yet to happen. But
I can only imagine the burden that that's putting on
the court system with these same similar cases time and
time and time and time again. Anytime somebody's ruled against
in a certificate of need.
Speaker 3 (13:19):
Yeah, you see.
Speaker 2 (13:20):
These court cases arise in two circumstances. One is that
multiple healthcare providers try to get a con, only one
gets the con and.
Speaker 3 (13:29):
So the losers will sue.
Speaker 2 (13:31):
The other occasion is that there is not even a
competition but just one provider gets one of these certificates,
and then competitors who didn't even apply for the con
will say, well, wait a minute, there's something wrong with
that application and try to block it.
Speaker 3 (13:47):
So there are a lot of.
Speaker 2 (13:48):
Different cases moving through the courts at various stages that
deal with certificates of need. I think if the Supreme
Court does take this case or one of the others
that are out there and clarify what a challenger to
a con will have to prove to be able to win,
that would make things a lot easier. As we said,
the easiest option would be for the State House to
(14:10):
go along with the State Senate say we're just getting
rid of this con process entirely. But if we're going
to keep having it, then the rules in the court
system that deal with who can challenge a con when
are they going to be successful? Making those as clear
and simple as possible would help everyone because the ultimate
(14:31):
goal should be not having as much restriction on health
care supply, letting there be more healthcare supply and so
that the healthcare providers could spend more time building their facilities,
getting their equipment, doing what they need to do to
serve patients, rather than spending time in courtrooms fighting it
out over who can get this government permission slip Mitch.
Speaker 1 (14:53):
I think for those that follow politics, maybe even not
that closely, they're familiar with the healthcare lobby this up
in Washington, d C. And imagine it exists pretty heavily
here in North Carolina as well. Those various entities have
been very much in favor of the certificate of needs
for quite some time. As you talk about competing providers
(15:16):
can go into an area and try and box their
competition out. I would imagine that probably plays a large
part into why maybe we've seen dozens of other states
move forward with revoking certificate of need, yet North Carolina
not only has it, but has one of the most
restrictive anywhere in the nation.
Speaker 2 (15:34):
That's right now. Back in I believe it was the
seventies that that has started. The federal government required state
governments to have a con process, but then during the
Reagan administration in the eighties.
Speaker 3 (15:45):
That requirement was gone.
Speaker 2 (15:47):
The Reagan administration, folks running this wait a minute, is
completely against anything you know about economics that if you
restrict supply that you're going to lower costs. No, you're
actually going to raise costs and you're going to give
people few options. So once that happened, about fifteen states
got rid of con law. And it doesn't mean that
they don't have health care in those states or that
(16:08):
their health care is worse than it is in other states.
But North Carolina has maintained its Certificate of Need regime
and it has one of the strictest. And you mentioned
the healthcare lobby. It's interesting because these health care providers,
including all of the major health care providers, will fight
tooth and nail against each other in these individual concases.
(16:28):
But when you ask them, well, wouldn't it be better
to just get rid of them, they say no, no,
because what they want to do is have the entrenched
interests fight it out rather than allowing some new health
care provider to come in. That's one of the reasons
why if some outside providers who aren't already in an
area North Carolina, if they'd like to enter the picture,
(16:52):
the folks who are already there will fight them tooth
and nail against it. If some provider that's not a
major health system wants to open a clinic or some
sort of surgery center, that's always fought we remember that
one of the things that happened with Kahn in the
State Supreme Court and the not too distant past was
a new burn eye surgeon who wanted to do surgeries
in his own vision center. What didn't have a con
(17:15):
he went to court to fight at the State Supreme
Court basically is allowing him to go forward with his suit,
but they kicked it back to the trial level, so
that case is going to wind on for several more
years before it could ever get a final decision. Right now,
it's just a mess in terms of how this process
plays out in the courts. Anyone who wants to add
(17:37):
hospital beds, build a new hospital, buy this major piece
of medical equipment, they can basically estimate that it's going
to take years and probably tens of thousands, if not
hundreds of thousands of dollars to finally get permission from
the government to do what they ought to be able
to do without government permission and just serve customer demand.
Speaker 1 (17:59):
It's incredibly restrictive and it again of impacting the citizens
of North Carolina is a large part as to why
healthcare is so expensive in this state. Mitch your pieces
cutting down on a con case confusion case confusion. Where
can folks get those details?
Speaker 2 (18:16):
They can read it at Carolina Journal dot com. And
in fact, Carolina Journal dot com has a lot of
stories on CON. So if you're interested, just go in
there search for CON. You'll see plenty of articles and
they will probably make you shake your head.
Speaker 1 (18:30):
We appreciate the details. This morning, Mitchkoki from the John
Locke Foundation joins us on the Carolina Journal News Hour.
It's five point thirty five. Welcome back to the Carolina
Journal News Hour. Good Thursday morning to you. News Talk eleven,
ten ninety nine to three WBT, turning our attention to
(18:52):
some statewide news this morning. North Carolina Governor Josh Stein
has officially signed a stopgap spending measure into law, doing
that Wednesday evening. Earlier in the week the Council of
State meeting, he called it a quote band aid. He
signed also signed a bill aimed at cracking down on squatters,
(19:12):
and veto to bill to expand school choice, which is
likely to set up another override battle with the Republican
led legislature at tuesdays a Council of State meeting, The
governor said, in response to the budget quote We've got
teachers and students counting on real raises. We've got law
enforcement who need real raises so that they can address
(19:35):
the vacancies that exist throughout state government and in local government.
Inflation and is reel, and there is no pay raises
for state employees in this mini budget. House and Senate
budget writers have been stalled on a full budget deal
since June and July, as the leaders of the two
chambers continue to have major disagreements on how to deal
(19:59):
with tax cuts and some other major policy items across
North Carolina. However, they do indicate that they are still
trying to negotiate towards a final budget deal. It's unclear
if that is actually going to happen in this legislative
long session with only a couple of voting days scheduled
for the rest of the year out of the North
(20:20):
Carolina General Assembly. So that mini budget has been officially
signed and now goes into law. However, the governor also
vetoed a bill that would make North Carolina eligible for
a new federal tax credit program for donating to certain
K through twelve educational scholarship programs. The legislation in the
(20:42):
state House bill eighty seven passed late last month, and
it seeks to allow the state to participate in a
new federal program designed to increase funding for private schools, homeschooling,
and other educational expenses. This new federal program was established
under President Donald Trump's One Big Beautiful Bill, and that
(21:06):
of course has been now fully is now in the
process of being fully implemented by the Trump administration. The
federal bill passed in early July requiring states to opt
into the tax credit program and establish some rules for
qualifying organizations that people can donate to. In North Carolina,
(21:27):
the State Educational Assistance Authority would establish the rules and
keep a list of qualified organizations. Individuals wanting the full
seventeen hundred dollars per dollar tax credit would only be
able to get it by donating to one of those
groups that is on the qualified organization list from the
(21:49):
State Education Assistance Authority. The North Carolina House approved the
program in a sixty nine to forty seven vote last week,
after the state Senate approved it thirty to nineteen in
the early part of last week as well. Supporters of
the legislation noted its potential to further the GOP led
(22:10):
General assemblies prioritization of offering alternatives to public schools. Across
the state of North Carolina, the school voucher program has
been incredibly popular over the last couple of years, as
North Carolina is set to spend more than five hundred
million dollars on its school voucher program. Opponents of the program, however,
(22:33):
say it would effectively It would effectively divert federal revenues
to nonprofits without placing any accountability requirements on private schools
that may ultimately receive the donated funds through those nonprofit charities.
They also noted that similar tax credit schemes that don't
exist for many other charitable organizations, such as those that
(22:57):
support disaster relief. The Democrat governor said in a statement
on Wednesday, quote school choice is good for students and parents,
and I have long supported magnet and accountable charter schools
because public schools open doors of opportunity for children in
every county of this state. Congress and the administration should
(23:20):
strengthen our public schools, not hollow them out, cutting public
education funding by billions of dollars while providing billions in
tax giveaways to wealthy parents. Already sending their kids to
private schools is the wrong choice. Those comments there from
governor Democrat Governor Josh Stein are very similar to what
(23:42):
we've seen with previous Democrat governors like Roy Cooper, similar
comments from Stein earlier this year. As the major divide
between Republicans and Democrats continues to exist on school choice,
Senate Leader Phil Berger a clap back at this, saying
either you support school choice or you don't. Governor Stein
(24:03):
could have made North Carolina a leader in school choice
and parental freedom by signing the Educational Choice for Children Act,
but instead he's attempting to usurp the General Assembly's authority
to set tax policy. Now it's relevant, of course, while
Senate Republicans do have the veto proof majority, House Republicans
(24:26):
need one Democrat to come across the aisle to move
forward with a veto override. As we've seen over the
last two weeks, there have been a variety of Democrats
across the state that have been willing to do so.
And it is important to note because this original legislation,
again House Bill eighty seven, did pass with two Democrats
(24:49):
voting in favor of it. Representative Shelley Willingham, the Democrat
out of Edgecombe County, and Representative Carla Cunningham, the Democrat
out of Mecklenburg. We saw both of them work with
Republican legislative leaders last week to override eight veto override
or override eight vetos, I should say, signed by Governor
(25:11):
Josh Stein and you would suspect that this legislation also
could be going down the same path as lawmakers are
expected to be back. Potentially, there is a voting day
coming up at the end of this month for lawmakers
to make their way back to Raleigh. We'll see if
they'll do so, potentially dealing with things like hurricane continued
(25:32):
Hurricane Helene relief, potentially some more VETO overrides. We'll keep
an eye on those details right here on the Carolina
Journal News Hour. In some other statewide news this morning,
the North Carolina Labor Commissioner in Luke Farley has announced
that his department has recovered more than two and a
half million dollars in unpaid wages for workers across the
(25:56):
state over the last fiscal year. Many of these workers
have waited months or in some cases, even years to
get their money. The recovered wages come from thousands of
complaints investigated by the Department of Labors Wage and Our Bureau.
It enforces the North Carolina Wage and Hour Act, which
(26:18):
ensures that employees receive the compensation that they're legally owed.
The cases involve a wide range of violations, including unpaid
final paychecks, with held commissions, overtime shortfalls, as well as
improper deductions across industries such as construction, retail, hospitality, health care,
(26:40):
and manufacturing. Farley told the Council of State earlier this week,
quote that is the money that was earned by hard
the hard work of North Carolina's workers, and they deserve
every penny. Our department is determined that they deserve every
penny of that and so my job as the commandititioner
(27:00):
is to do so. But the job of the Department
as a whole as well is to stand up for
those workers that aren't paid their promise wages. And I
will tell you just from a personal perspective, somebody failing
to pay what they promised a worker is personally offensive
to me. And our Wage and Hour Bureau is aggressively
(27:21):
pursuing wage and hour cases against the people who aren't
paying for what they promised. A spokesperson for the Department
of Labor told The Carolina Journal in an email that
the wages recovered were paid to about eighteen hundred employees
and ranged from fifty dollars for one person to a
(27:42):
whopping a three hundred and forty seven thousand dollars for
another individual. As well, most of the wages collected were
were collected through the Department of Labor. Farley added that
out of the two and a half million dollars that
was recovered, it represents the ability to pay rent by
groceries and plan for people's futures. North Carolinians who believe
(28:05):
that they have not been paid properly are asked to
contact the Department of Labor. There are links on the
Department of Labor website where you can reach out and
go through the process. If you believe that some of
your wages have been withheld inaccurately, you can go through
that process. Information on that exists this morning over on
(28:26):
the Department of Labor website. We've also got a link
this morning on our website as well, Carolina Journal dot com.
The headline Labor Department recovers over two point five million
in unpaid wages for workers. Good morning again, it's five
point fifty two. Welcome back to the Carolina Journal, News Hour,
(28:48):
News Talk eleven, ten ninety nine three WBT, continuing our
discussion on certificate of need this morning. We had an
opinion piece that ran over at Carolina Journal last month
by Christy Gupp, and the headline is I drove to
South Carolina for an MRI to avoid higher prices from
nc's con laws that certificate of need, she writes in
(29:10):
her piece. While opinions differ on North Carolina certificate of
need laws, I wanted to share a personal story that
may resonate with others seeking affordable healthcare and coming short.
About a year ago, my son needed a shoulder MRI.
As I began shopping around, I was dismayed by the
high prices I found locally. The sticker shock inflated to
(29:33):
the five plus thousand dollars range for this simple image
at a few facilities, albeit lower in cost, even the
independent radiology practices were still too expensive. Then I recalled
that in twenty twenty three, the South Carolina legislature ultimately
repealed its certificate of need laws, a bold move to
(29:55):
open up healthcare competition across their state. I thought to
my myself, why am I not looking for this MRI
just over the border in South Carolina? And surely the
certificate of need repeal has had time to drive down
prices there. And it turned out that my instincts were right.
I found an MRI of the shoulder without a contrast
(30:18):
at a lovely independent ortopedic ortopedic practice in Fort Mill,
South Carolina, for just three hundred and thirty dollars cash.
I didn't need to haggle with insurance or struggle through
the prior authorization projects process. I just texted my direct
primary care doctor and he sent the order. I paid online,
(30:40):
and my son and I made our way to Fort
Mill on a cool spring morning last year. It was
a short and ninety minute drive. When we checked in,
the excellent staff took great care of my son. I
walked back to the area where they'd purchased a newly ope,
a new MRI machine and watch them set up my
son for there. When I returned to the waiting area,
(31:02):
I was greeted with a cup of coffee and settled
in for about thirty minutes. Before I knew it, his
images were complete, and they made a digital copy of
it for us to take with us. Because I'd paid
three hundred and thirty dollars ahead of time, we were
all set. Next we enjoyed a nice lunch and did
some shopping. I know our modest spending in Fort Mill
(31:25):
that day didn't make national headlines, but those dollars could
have stayed in North Carolina if the price had been right.
I think the grand total we spent just over the
North Carolina border was approximately seven hundred dollars that day,
a sum that I would have gladly paid in my
home state if that were possible. The lowest price for
(31:47):
just the MRI, excluding lunch and retail shopping, was between
two and five times what I spent on everything we
consumed in South Carolina that day. The article from Christy
gupp And goes on to say, I know, I'm just
one person in North Carolina didn't miss that money, But
what if ten thousand other North Carolinians followed my lead
(32:10):
and voted with their feet, taking their dollars south of
the border. Fort Mill is just a stone's throw from Charlotte,
one of the state's most populous cities. Atrum Health and
Novone have some of the highest prices in the nation.
What happens when word gets out that our southern neighbors
have allowed competition to do what it does best reduce
(32:32):
costs when you're paying cash. The law of supplying demand
still applies, and in fact, it works very well. Members
of the North Carolina General Assembly should be listening to
their constituents who can vote for them or not. I
know the allure of listening to lobbyists from the state
hospital groups must be strong, but the needs of your
(32:54):
voters in your home districts should be a higher priority.
Your constituents need to see save money on healthcare. High
health care costs are burdenstom to state citizens, and too
many local hospitals are doing financial harm to their communities.
We need better choices in opening up the marketplace to
(33:14):
new entities that will compete for our business will lower
the overall cost and yield happier citizens. Furthermore, North Carolina's
employers who offer health plans to their workforce need more
choices too. They have a legal requirement to apply a
fiduciary standard of care when overseeing how those health plan
(33:37):
dollars are spent. More choices will help our states job
creators also comply with the fiduciary standards that are impossible
to achieve in today's healthcare economy in the great state
of North Carolina. So as you, as we've talked about
throughout the show this morning, certificate of need continues to
be a major discussion and a major financial burden for
(34:01):
those throughout the state of North Carolina. This opinion piece,
headlined I drove to South Carolina for an MRI to
avoid higher prices from North Carolina's con laws, was written
by Christy Gupton. It's available on our website, Carolina Journal
dot com. That's going to do it for a Thursday edition.
WBT News is next, followed by Good Morning BT. We're
(34:22):
back with you tomorrow morning, five to six right here
on Newstalk eleven, ten and ninety nine three WBT
It's five oh five and welcome into a Thursday edition
of The Carolina Journal News Hour, News Talk eleven, ten
ninety nine to three WBT. I'm Nick Craig, a good
morning to you. Tariffs ranging from ten to forty one
percent are officially set to take effect today for multiple
countries as the ongoing trade battle and war out of
(00:30):
the White House continue. This comes months after the world
was capitulated into a spiraling trade war following President Donald
Trump's Liberation Day announcement, which happened back on April the
second of this year. The looming thread of tariffs has
created a pretty significant amount of uncertainty for businesses across
(00:52):
nearly every industry, as deadline after deadline for implementing tariffs
have been repeatedly pushed back in an attempt to broker deals.
The tariffs that went into effect on August the seventh
reflect the change in a rate from what was threatened
initially during the Liberation Day announcement. Joseph Harris, a fiscal
(01:14):
policy analyst over at the John Locke Foundation, tells The
Carolina Journal from April to second to July thirty first announcements,
the average tariff rate among the included trading partners declined
from twenty five percent to nineteen percent. Among the most
significant rate reductions were Cambodia forty nine percent to nineteen percent,
(01:38):
Vietnam forty six percent to twenty percent, and on the
other hand, Switzerland received the largest rate from rate increase
from thirty one percent to thirty nine percent. In a
July thirty first announcement, sixty nine trading partners were included.
Eight of these partners saw no change in their tariff
(01:59):
rate from that early April announcement. Among the remaining sixty
one partners whose rates were adjusted, nineteen experienced increases, while
forty two of those countries saw decreases. The average proposed
terif rate for all of those countries combined dropped twenty
dropped from twenty five percent in April to an average
(02:21):
of nineteen percent in the latest announcement. The new ranking
rates range from the low of ten percent, which is
applicable to the United Kingdom, Brazil and the Falcon Islands,
to a high of forty one percent for Syria. Joseph
Harris said the United Kingdom, Brazil, as well as others,
(02:42):
are subject to the lowest tariff rate of ten percent
in the July thirty first schedule, placing them well below
the average of all of the countries. Although many of
the July thirty first tariff rates are lower than those
announced in April, they still represent added costs that could
result in higher prices for certain goods if those costs
(03:05):
are passed along to consumers. India is set to face
an additional twenty five percent tariff for a combined fifty
percent final rate, which is set to take effect in
about three weeks, according to the folks inside the administration.
According to the Executive an executive order signed by President
Donald Trump on August the sixth, the additional tariffs are
(03:29):
in response to India's imports of Russian oil as well
as the ongoing Russian invasion of Ukraine. In addition to
the individual teriffs for each nation, there is already a
fifty percent tariff on steel and aluminum that went into
effect back on June fourth, as well as a twenty
five percent tariff on automobiles and automobile parts. This is
(03:52):
already impacting the industry and North Carolina manufacturers, as General
Motors recently announced a net Tek tariff impact of more
than one billion dollars that was in the second quarter
of the fiscal year, and an estimated annual impact of
four to five billion dollars due to some of these
new tariffs. According to GM, they who manufactures those vehicles,
(04:17):
as well as GM Defense, a subsidiary of GM, who
also makes vehicles for the Defense Department. They have a
facility in Concord. Despite the overall reduction and average tariff
rates since April, today's implementation still mark a substantial escalation
in trade barriers for many countries, as businesses and consumers
(04:40):
may soon feel the ripple effects as these added costs
filter through the global supply chain and influence prices. We
have been keeping a very close eye on tariffs and
the impact here across the state of North Carolina. We've
got additional details and are continuing coverage of that over
on our website This Morning Line of Journal dot Com,
(05:01):
where it's now five to ten, News Talk eleven ten,
ninety nine to three WBT. For those that follow things
that go on in the state of North Carolina, public
policy and things of that sort, you may be familiar
with Certificate of need. It's also called con and it
essentially is a process in which healthcare systems across the
state of North Carolina. Healthcare providers have to go to
(05:22):
the State of North Carolina to get a certificate of
need to expand capacity. We've got a new opinion piece
from Mitch cookei over at the John Locke Foundation, the
headline cutting down on con case confusion. He joins us
on the Carolina Journal News Hour. Mitch, con has been
a longtime discussion in the state of North Carolina. It's
a little bit in the weeds on the policy side,
(05:43):
but it has a huge impact on pretty much everybody
from the mountains all the way to the coast.
Speaker 2 (05:48):
It really does, because certificate of need determines how much
healthcare supply we have in North Carolina. It's essentially a
government permission slip, and any healthcare provider of any type
wants to build a new hospital or other health care facility,
add some beds to an existing hospital, or even buy
a major piece of medical equipment has to go to
(06:10):
the government to get this permission slip. If they don't
have it, they can't move forward with any of those
types of projects.
Speaker 3 (06:16):
Now.
Speaker 2 (06:16):
Con from the advantage point of public policy, it's bad
public policy. It basically reduces options for consumers and ends
up raising costs. And so it would be a good
idea to get rid of certificate need or CON if possible,
and that's something that the state Senate actually would do
this year. They put eliminating the CON laws repealing the
(06:39):
CON laws in their budget, but because we have no
final budget deal, that idea is still in limbo. And
so the opinion piece that you're talking about says, well,
if we can't get rid of CON, maybe the next
best thing at this point is for the courts to
clarify some of the confusing rulings that come out with
a lot of CON cases. What typically happens is health
(07:02):
care providers are always in competition with each other, and
in one way they compete is to try to get
one of these certificates and stop their opponents or competitors
from getting one. So one recent case involves sixty seven
hospital beds in western North Carolina. The state decided that
(07:23):
there was this need for sixty seven hospital beds to
serve a four county area and had some applications to
get the CON. The winning application came from advent Health,
which is one of these major health care providers that
wants to build a new hospital in Weaverville. And then
Mission Health, which runs a big hospital in Ashville, also
(07:46):
wanted to add sixty seven beds to its existing.
Speaker 3 (07:48):
Hospital in Nashville.
Speaker 2 (07:50):
But because the state regulators gave the con to advent Health,
Mission Health can't expand. So Mission Health went to court.
Health's argument against the advent Health con was that, wait
a minute. Anytime there's been a new hospital that's been
approved in North Carolina for a con, it has always
(08:13):
had to have a licensed general operating room. This advent
Health proposal didn't have one, So what gives why did
regulators change the situation? They didn't really explain that they
had changed this long standing policy, and so Mission Health's
legal argument was that that was a agency error, the
(08:35):
agency being the Department of Health and Human Services, and
that that error had substantial prejudice against Mission Health. The
wording is important because in previous con rulings, the courts
have said for a challenger to win a case, they
have to show agency error and substantial prejudice, and basically,
Mission Health is saying, look, this is an example of
(08:58):
both agency error and substantial prest judice. Lower courts have
ruled against Mission and in favor of the Department of
Health and Human Services and by extension, Advent Health. So
the Mission Health asked the State Supreme Court to take
up this case, and it says in its petition to
the court, look, if you take this case, you can
(09:18):
deal with some of these other rulings that have come
out about con in recent years that are contradictory and confusing.
We know that we have to show agency error and
substantial prejudice, but there really hasn't been a clear definition
of what is substantial prejudice. We think that this case
shows it. Lower courts have said that it doesn't.
Speaker 3 (09:38):
Show substantial prejudice.
Speaker 2 (09:39):
So Supreme Court, please take this case to tell us
what exactly is substantjudice so we can know and other parties.
Speaker 3 (09:47):
Can know moving forward with these concases. Now.
Speaker 2 (09:49):
It's interesting to note that against this proposal, both advt
Health and the State Department of Health and Human Services
that file documents saying, wait a minute, these may be
some interesting issues to take up. This is not a
case to do it because Mission Health didn't even prove
there was any kind of agency error. If they can't
prove agency error, it's a moot point. Don't take this case.
(10:13):
If you want to deal with this issue, wait for
another case where it's more on point. But I think
the main point of this opinion article is that con
cases are long involved, take a lot of money, a
lot of time.
Speaker 3 (10:25):
They're very confusing.
Speaker 2 (10:26):
So it would be nice, whether if it's with this
case or another case, for the State Supreme Court to
step in and say, this is exactly what a con
challenger has to prove to be able to win a case.
This is what amounts to agency error, This is what
amounts to substantial prejudice that would make the proceedings go
forward in a lot smoother way in the future. And
(10:48):
for folks who are saying, why should I care about this, Well,
the sooner that these things get resolved, the sooner that
the healthcare providers can start building these facilities, offering the services,
adding more healthcare supply. So that should mean more convenience,
lower cost for the patients. Now, the thing that would
(11:09):
be best for more options, lower cost, more convenience would
be to get rid of con entirely, which the State
Senate wants to do. But if that's not going to happen,
then the courts at least could make the process a
little less confusing and have a little less contradictory rulings
coming out.
Speaker 1 (11:28):
We'll continue the discussion on certificate of need with Mitch
Koki from the John Locke Foundation coming up after this.
You're listening to The Carolina Journal News Hour. It's twenty
two minutes past the hour. Welcome back to the Carolina
Journal News Hour news stock eleven, ten ninety nine three WBT.
(11:51):
You don't forget if you miss any portion of our
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It's available in Google Play, Apple Podcasts, Spotify, anywhere you
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tap the subscribe or follow button, and you'll get a
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(12:14):
Carolina Journal News Hour Podcast. Download and subscribe now. Mitch
COKEI of the John Locke Foundation continues with us on
the Carolina Journal News Hour. He's got a brand new
opinion piece up the headline, cutting down con case confusion
that's referring to certificate of need across the state of
North Carolina. So there's a couple of different angles and
areas to take this conversation. North Carolina consistently has been
(12:37):
on the top of the list, and it's not where
you want to be for the most expensive healthcare in
the United States. We've seen multiple surveys over the last
couple of years that show that a lot of that
is being attributed to certificative need and Mitch, as we
follow these legal processes go down and there's a variety
of these various cases across the state. You're putting a
(12:58):
huge burden on the state courts system on something that
many folks believe should just be struck out by the
General Assembly, and unfortunately that has yet to happen. But
I can only imagine the burden that that's putting on
the court system with these same similar cases time and
time and time and time again. Anytime somebody's ruled against
in a certificate of need.
Speaker 3 (13:19):
Yeah, you see.
Speaker 2 (13:20):
These court cases arise in two circumstances. One is that
multiple healthcare providers try to get a con, only one
gets the con and.
Speaker 3 (13:29):
So the losers will sue.
Speaker 2 (13:31):
The other occasion is that there is not even a
competition but just one provider gets one of these certificates,
and then competitors who didn't even apply for the con
will say, well, wait a minute, there's something wrong with
that application and try to block it.
Speaker 3 (13:47):
So there are a lot of.
Speaker 2 (13:48):
Different cases moving through the courts at various stages that
deal with certificates of need. I think if the Supreme
Court does take this case or one of the others
that are out there and clarify what a challenger to
a con will have to prove to be able to win,
that would make things a lot easier. As we said,
the easiest option would be for the State House to
(14:10):
go along with the State Senate say we're just getting
rid of this con process entirely. But if we're going
to keep having it, then the rules in the court
system that deal with who can challenge a con when
are they going to be successful? Making those as clear
and simple as possible would help everyone because the ultimate
(14:31):
goal should be not having as much restriction on health
care supply, letting there be more healthcare supply and so
that the healthcare providers could spend more time building their facilities,
getting their equipment, doing what they need to do to
serve patients, rather than spending time in courtrooms fighting it
out over who can get this government permission slip Mitch.
Speaker 1 (14:53):
I think for those that follow politics, maybe even not
that closely, they're familiar with the healthcare lobby this up
in Washington, d C. And imagine it exists pretty heavily
here in North Carolina as well. Those various entities have
been very much in favor of the certificate of needs
for quite some time. As you talk about competing providers
(15:16):
can go into an area and try and box their
competition out. I would imagine that probably plays a large
part into why maybe we've seen dozens of other states
move forward with revoking certificate of need, yet North Carolina
not only has it, but has one of the most
restrictive anywhere in the nation.
Speaker 2 (15:34):
That's right now. Back in I believe it was the
seventies that that has started. The federal government required state
governments to have a con process, but then during the
Reagan administration in the eighties.
Speaker 3 (15:45):
That requirement was gone.
Speaker 2 (15:47):
The Reagan administration, folks running this wait a minute, is
completely against anything you know about economics that if you
restrict supply that you're going to lower costs. No, you're
actually going to raise costs and you're going to give
people few options. So once that happened, about fifteen states
got rid of con law. And it doesn't mean that
they don't have health care in those states or that
(16:08):
their health care is worse than it is in other states.
But North Carolina has maintained its Certificate of Need regime
and it has one of the strictest. And you mentioned
the healthcare lobby. It's interesting because these health care providers,
including all of the major health care providers, will fight
tooth and nail against each other in these individual concases.
(16:28):
But when you ask them, well, wouldn't it be better
to just get rid of them, they say no, no,
because what they want to do is have the entrenched
interests fight it out rather than allowing some new health
care provider to come in. That's one of the reasons
why if some outside providers who aren't already in an
area North Carolina, if they'd like to enter the picture,
(16:52):
the folks who are already there will fight them tooth
and nail against it. If some provider that's not a
major health system wants to open a clinic or some
sort of surgery center, that's always fought we remember that
one of the things that happened with Kahn in the
State Supreme Court and the not too distant past was
a new burn eye surgeon who wanted to do surgeries
in his own vision center. What didn't have a con
(17:15):
he went to court to fight at the State Supreme
Court basically is allowing him to go forward with his suit,
but they kicked it back to the trial level, so
that case is going to wind on for several more
years before it could ever get a final decision. Right now,
it's just a mess in terms of how this process
plays out in the courts. Anyone who wants to add
(17:37):
hospital beds, build a new hospital, buy this major piece
of medical equipment, they can basically estimate that it's going
to take years and probably tens of thousands, if not
hundreds of thousands of dollars to finally get permission from
the government to do what they ought to be able
to do without government permission and just serve customer demand.
Speaker 1 (17:59):
It's incredibly restrictive and it again of impacting the citizens
of North Carolina is a large part as to why
healthcare is so expensive in this state. Mitch your pieces
cutting down on a con case confusion case confusion. Where
can folks get those details?
Speaker 2 (18:16):
They can read it at Carolina Journal dot com. And
in fact, Carolina Journal dot com has a lot of
stories on CON. So if you're interested, just go in
there search for CON. You'll see plenty of articles and
they will probably make you shake your head.
Speaker 1 (18:30):
We appreciate the details. This morning, Mitchkoki from the John
Locke Foundation joins us on the Carolina Journal News Hour.
It's five point thirty five. Welcome back to the Carolina
Journal News Hour. Good Thursday morning to you. News Talk eleven,
ten ninety nine to three WBT, turning our attention to
(18:52):
some statewide news this morning. North Carolina Governor Josh Stein
has officially signed a stopgap spending measure into law, doing
that Wednesday evening. Earlier in the week the Council of
State meeting, he called it a quote band aid. He
signed also signed a bill aimed at cracking down on squatters,
(19:12):
and veto to bill to expand school choice, which is
likely to set up another override battle with the Republican
led legislature at tuesdays a Council of State meeting, The
governor said, in response to the budget quote We've got
teachers and students counting on real raises. We've got law
enforcement who need real raises so that they can address
(19:35):
the vacancies that exist throughout state government and in local government.
Inflation and is reel, and there is no pay raises
for state employees in this mini budget. House and Senate
budget writers have been stalled on a full budget deal
since June and July, as the leaders of the two
chambers continue to have major disagreements on how to deal
(19:59):
with tax cuts and some other major policy items across
North Carolina. However, they do indicate that they are still
trying to negotiate towards a final budget deal. It's unclear
if that is actually going to happen in this legislative
long session with only a couple of voting days scheduled
for the rest of the year out of the North
(20:20):
Carolina General Assembly. So that mini budget has been officially
signed and now goes into law. However, the governor also
vetoed a bill that would make North Carolina eligible for
a new federal tax credit program for donating to certain
K through twelve educational scholarship programs. The legislation in the
(20:42):
state House bill eighty seven passed late last month, and
it seeks to allow the state to participate in a
new federal program designed to increase funding for private schools, homeschooling,
and other educational expenses. This new federal program was established
under President Donald Trump's One Big Beautiful Bill, and that
(21:06):
of course has been now fully is now in the
process of being fully implemented by the Trump administration. The
federal bill passed in early July requiring states to opt
into the tax credit program and establish some rules for
qualifying organizations that people can donate to. In North Carolina,
(21:27):
the State Educational Assistance Authority would establish the rules and
keep a list of qualified organizations. Individuals wanting the full
seventeen hundred dollars per dollar tax credit would only be
able to get it by donating to one of those
groups that is on the qualified organization list from the
(21:49):
State Education Assistance Authority. The North Carolina House approved the
program in a sixty nine to forty seven vote last week,
after the state Senate approved it thirty to nineteen in
the early part of last week as well. Supporters of
the legislation noted its potential to further the GOP led
(22:10):
General assemblies prioritization of offering alternatives to public schools. Across
the state of North Carolina, the school voucher program has
been incredibly popular over the last couple of years, as
North Carolina is set to spend more than five hundred
million dollars on its school voucher program. Opponents of the program, however,
(22:33):
say it would effectively It would effectively divert federal revenues
to nonprofits without placing any accountability requirements on private schools
that may ultimately receive the donated funds through those nonprofit charities.
They also noted that similar tax credit schemes that don't
exist for many other charitable organizations, such as those that
(22:57):
support disaster relief. The Democrat governor said in a statement
on Wednesday, quote school choice is good for students and parents,
and I have long supported magnet and accountable charter schools
because public schools open doors of opportunity for children in
every county of this state. Congress and the administration should
(23:20):
strengthen our public schools, not hollow them out, cutting public
education funding by billions of dollars while providing billions in
tax giveaways to wealthy parents. Already sending their kids to
private schools is the wrong choice. Those comments there from
governor Democrat Governor Josh Stein are very similar to what
(23:42):
we've seen with previous Democrat governors like Roy Cooper, similar
comments from Stein earlier this year. As the major divide
between Republicans and Democrats continues to exist on school choice,
Senate Leader Phil Berger a clap back at this, saying
either you support school choice or you don't. Governor Stein
(24:03):
could have made North Carolina a leader in school choice
and parental freedom by signing the Educational Choice for Children Act,
but instead he's attempting to usurp the General Assembly's authority
to set tax policy. Now it's relevant, of course, while
Senate Republicans do have the veto proof majority, House Republicans
(24:26):
need one Democrat to come across the aisle to move
forward with a veto override. As we've seen over the
last two weeks, there have been a variety of Democrats
across the state that have been willing to do so.
And it is important to note because this original legislation,
again House Bill eighty seven, did pass with two Democrats
(24:49):
voting in favor of it. Representative Shelley Willingham, the Democrat
out of Edgecombe County, and Representative Carla Cunningham, the Democrat
out of Mecklenburg. We saw both of them work with
Republican legislative leaders last week to override eight veto override
or override eight vetos, I should say, signed by Governor
(25:11):
Josh Stein and you would suspect that this legislation also
could be going down the same path as lawmakers are
expected to be back. Potentially, there is a voting day
coming up at the end of this month for lawmakers
to make their way back to Raleigh. We'll see if
they'll do so, potentially dealing with things like hurricane continued
(25:32):
Hurricane Helene relief, potentially some more VETO overrides. We'll keep
an eye on those details right here on the Carolina
Journal News Hour. In some other statewide news this morning,
the North Carolina Labor Commissioner in Luke Farley has announced
that his department has recovered more than two and a
half million dollars in unpaid wages for workers across the
(25:56):
state over the last fiscal year. Many of these workers
have waited months or in some cases, even years to
get their money. The recovered wages come from thousands of
complaints investigated by the Department of Labors Wage and Our Bureau.
It enforces the North Carolina Wage and Hour Act, which
(26:18):
ensures that employees receive the compensation that they're legally owed.
The cases involve a wide range of violations, including unpaid
final paychecks, with held commissions, overtime shortfalls, as well as
improper deductions across industries such as construction, retail, hospitality, health care,
(26:40):
and manufacturing. Farley told the Council of State earlier this week,
quote that is the money that was earned by hard
the hard work of North Carolina's workers, and they deserve
every penny. Our department is determined that they deserve every
penny of that and so my job as the commandititioner
(27:00):
is to do so. But the job of the Department
as a whole as well is to stand up for
those workers that aren't paid their promise wages. And I
will tell you just from a personal perspective, somebody failing
to pay what they promised a worker is personally offensive
to me. And our Wage and Hour Bureau is aggressively
(27:21):
pursuing wage and hour cases against the people who aren't
paying for what they promised. A spokesperson for the Department
of Labor told The Carolina Journal in an email that
the wages recovered were paid to about eighteen hundred employees
and ranged from fifty dollars for one person to a
(27:42):
whopping a three hundred and forty seven thousand dollars for
another individual. As well, most of the wages collected were
were collected through the Department of Labor. Farley added that
out of the two and a half million dollars that
was recovered, it represents the ability to pay rent by
groceries and plan for people's futures. North Carolinians who believe
(28:05):
that they have not been paid properly are asked to
contact the Department of Labor. There are links on the
Department of Labor website where you can reach out and
go through the process. If you believe that some of
your wages have been withheld inaccurately, you can go through
that process. Information on that exists this morning over on
(28:26):
the Department of Labor website. We've also got a link
this morning on our website as well, Carolina Journal dot com.
The headline Labor Department recovers over two point five million
in unpaid wages for workers. Good morning again, it's five
point fifty two. Welcome back to the Carolina Journal, News Hour,
(28:48):
News Talk eleven, ten ninety nine three WBT, continuing our
discussion on certificate of need this morning. We had an
opinion piece that ran over at Carolina Journal last month
by Christy Gupp, and the headline is I drove to
South Carolina for an MRI to avoid higher prices from
nc's con laws that certificate of need, she writes in
(29:10):
her piece. While opinions differ on North Carolina certificate of
need laws, I wanted to share a personal story that
may resonate with others seeking affordable healthcare and coming short.
About a year ago, my son needed a shoulder MRI.
As I began shopping around, I was dismayed by the
high prices I found locally. The sticker shock inflated to
(29:33):
the five plus thousand dollars range for this simple image
at a few facilities, albeit lower in cost, even the
independent radiology practices were still too expensive. Then I recalled
that in twenty twenty three, the South Carolina legislature ultimately
repealed its certificate of need laws, a bold move to
(29:55):
open up healthcare competition across their state. I thought to
my myself, why am I not looking for this MRI
just over the border in South Carolina? And surely the
certificate of need repeal has had time to drive down
prices there. And it turned out that my instincts were right.
I found an MRI of the shoulder without a contrast
(30:18):
at a lovely independent ortopedic ortopedic practice in Fort Mill,
South Carolina, for just three hundred and thirty dollars cash.
I didn't need to haggle with insurance or struggle through
the prior authorization projects process. I just texted my direct
primary care doctor and he sent the order. I paid online,
(30:40):
and my son and I made our way to Fort
Mill on a cool spring morning last year. It was
a short and ninety minute drive. When we checked in,
the excellent staff took great care of my son. I
walked back to the area where they'd purchased a newly ope,
a new MRI machine and watch them set up my
son for there. When I returned to the waiting area,
(31:02):
I was greeted with a cup of coffee and settled
in for about thirty minutes. Before I knew it, his
images were complete, and they made a digital copy of
it for us to take with us. Because I'd paid
three hundred and thirty dollars ahead of time, we were
all set. Next we enjoyed a nice lunch and did
some shopping. I know our modest spending in Fort Mill
(31:25):
that day didn't make national headlines, but those dollars could
have stayed in North Carolina if the price had been right.
I think the grand total we spent just over the
North Carolina border was approximately seven hundred dollars that day,
a sum that I would have gladly paid in my
home state if that were possible. The lowest price for
(31:47):
just the MRI, excluding lunch and retail shopping, was between
two and five times what I spent on everything we
consumed in South Carolina that day. The article from Christy
gupp And goes on to say, I know, I'm just
one person in North Carolina didn't miss that money, But
what if ten thousand other North Carolinians followed my lead
(32:10):
and voted with their feet, taking their dollars south of
the border. Fort Mill is just a stone's throw from Charlotte,
one of the state's most populous cities. Atrum Health and
Novone have some of the highest prices in the nation.
What happens when word gets out that our southern neighbors
have allowed competition to do what it does best reduce
(32:32):
costs when you're paying cash. The law of supplying demand
still applies, and in fact, it works very well. Members
of the North Carolina General Assembly should be listening to
their constituents who can vote for them or not. I
know the allure of listening to lobbyists from the state
hospital groups must be strong, but the needs of your
(32:54):
voters in your home districts should be a higher priority.
Your constituents need to see save money on healthcare. High
health care costs are burdenstom to state citizens, and too
many local hospitals are doing financial harm to their communities.
We need better choices in opening up the marketplace to
(33:14):
new entities that will compete for our business will lower
the overall cost and yield happier citizens. Furthermore, North Carolina's
employers who offer health plans to their workforce need more
choices too. They have a legal requirement to apply a
fiduciary standard of care when overseeing how those health plan
(33:37):
dollars are spent. More choices will help our states job
creators also comply with the fiduciary standards that are impossible
to achieve in today's healthcare economy in the great state
of North Carolina. So as you, as we've talked about
throughout the show this morning, certificate of need continues to
be a major discussion and a major financial burden for
(34:01):
those throughout the state of North Carolina. This opinion piece,
headlined I drove to South Carolina for an MRI to
avoid higher prices from North Carolina's con laws, was written
by Christy Gupton. It's available on our website, Carolina Journal
dot com. That's going to do it for a Thursday edition.
WBT News is next, followed by Good Morning BT. We're
(34:22):
back with you tomorrow morning, five to six right here
on Newstalk eleven, ten and ninety nine three WBT
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