Tag Archives: pat mccrory

All Posts, ethics, justice, medicaid, north carolina, public education, race

WHY DON’T PEOPLE TRUST GOVERNMENT?

Did you ever play a game with a child who wanted to change the rules after something didn’t go his way?  As a child matures, parents and others teach him fair play and we expect him to accept fairness, honesty and basic decency as guiding principles by about the age of 10.

The few who don’t learn those lessons generally become known as whiners, bullies or both.  They typically get their next lessons in places lacking adult supervision.  The bullies get put in their place by somebody who stands up to them and the whiners are ignored until they figure out how to socialize. Most eventually learn to succeed without getting their own way every time.

A few folks never learn the lesson, and as big people (I’m reluctant to characterize them as adults) they are still bullies or whiners.  Their behavior puts the leaders of North Carolina’s Legislature in these categories.  (Please excuse the all-male characterizations in this column.  I don’t know what else to do when all of the Republican leaders are boys.)

Phil Berger, Tim Moore and his predecessor Thom Tillis, as leaders of the House and Senate, changed the rules to enable Republican Governor Pat McCrory to politicize state employment.  Specifically, they passed a law allowing him to hire up to 1500 political appointees into various positions in state government.

When Roy Cooper defeated McCrory for Governor, the bullies decided to change the rules again.  The easiest way to do that was to revise state laws before the inauguration so that Cooper could not veto changes.  They arranged a sneak attack at the end of a special session for flood relief by announcing plans to adjourn and re-assemble on the same day for another special session.  It became obvious that they had been gathering signatures to authorize the session for some time.  They allowed about five hours for introduction of legislation.  In that brief time, carefully crafted legislation increasing the power of Republican leadership and drastically reducing the Governor’s authority was introduced.  The plan was conceived well in advance.

Republicans have the votes to pass these bills.  Given their history with HB-2, they may do it before this column is published.  They can do it without serious debate and without time for consideration by the public.  That’s how they passed HB-2, and North Carolina has paid a heavy price for it.

Here is some of what they want to do.

  • Reduce the number of political appointments by the new governor from 1500 to 300. This would also make about 1200 McCrory political appointees into permanent state employees.
  • Eliminate the Governor’s two appointment slots to the boards of state universities.
  • Remove the state’s Chief Information Officer (responsible for information technology across all state offices) from appointment by the governor and have that position appointed and supervised by the Lieutenant Governor (a Republican).
  • Re-organize and merge the State Boards of Elections and Ethics in ways that reduce the Governor’s appointments and guarantee Republican chairmanship during election years.
  • Make the Superintendent of Public Instruction (Republican) independent of supervision by the Board of Education
  • Require that all of the Governor’s cabinet appointments be confirmed by the Senate.

There is a lot more in these bills and there is no way that anyone can adequately understand their implications without time for consideration and debate.  Much like HB-2, there will be unforeseen consequences in addition to the apparent self-serving intent.

There are two ways to prevent this impending train wreck.  One is for enough Republican legislators to stand up to the bullies leading their party by refusing to pass the bills in a special session.  They can insist on adequate consideration by the public and the legislature.  If they fail, Governor McCrory could grow a spine and veto the bills.  Taking such firm action might even create the possibility of resurrecting a political future for him.

Are there enough Republican legislators who value fairness, honesty and decency and who have the courage to stand up to bullies?  Is Governor McCrory, who no longer needs the support of the bullies, willing to stand up and be counted?  If these bills pass, is there any form of cheating that should be off limits to whoever has power?

I’ll close with a quote from one legislator.  “This is why people hate us.”  He’s right.

For those who are interested, here are links to the as-filed versions of some of the bills submitted for the special session as posted on the website of the North Carolina General Assembly

SB 4 :   http://www.ncleg.net/Sessions/2015E4/Bills/Senate/PDF/S4v0.pdf  Ethics, elections and court reform bill creates Republican advantage and control of elections Board

HB 17:  http://www.ncleg.net/Sessions/2015E4/Bills/House/PDF/H17v0.pdf changes public instruction, UNC and department head appointments and authority of Superintendent of Public Instruction

HB 6:  http://www.ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=2015E4&BillID=H6 creates independent CIO nominated by Lt Gov

Link to all 21 house bills submitted for the special session:  http://www.ncleg.net/gascripts/lastaction/todaysaction.pl?Biennium=2015E4&ActionChamber=H&DateReport=12%2F14%2F2016

Link to all 7 senate bills for special session:  http://www.ncleg.net/gascripts/lastaction/todaysaction.pl?Biennium=2015E4&ActionChamber=H&DateReport=12%2F14%2F2016

 

 

All Posts, budget, economy, medicaid, north carolina, poverty

MEDICAID AND MANAGEMENT INCOMPETENCE

“What are the most important decisions that you have made in your work?” Ask that question of executives who have been successful in leading complex organizations and a clear majority will give an answer that has to do with choosing the rest of the leadership team. That is a lesson which Governor Pat McCrory is learning in the school of hard knocks while North Carolina taxpayers fund his tuition bills.

Shortly after Dr. Aldona Wos was named Secretary of Health and Human Services for the state, I pointed out that her principal qualification appeared to be the success that she and her husband had in raising money for Governor McCrory’s and President George W. Bush’s election campaigns. In a column at the time, I described her as “…a physician who has not been involved full-time in health policy or medical practice for many years…President Bush rewarded Dr. Wos by appointing her as Ambassador to Estonia. Likewise, the Governor made her DHHS Secretary and she hired a young McCrory campaign staffer, Matthew McKillip, as the Chief Policy Officer of DHHS. At age 24, he has no previous health service education or experience but he has worked for a right wing think tank and now he is leading health policy development for the state.” She proceeded to select others for the DHHS team including Ricky Diaz, a McCrory campaign staffer hired as the top public information officer. He was forced to resign after lying to the press about violations of medical record confidentiality laws.

Wos picked Carol Steckel, another conservative ideologue but one with substantial experience in Louisiana, to re-organize the Medicaid program. Steckel resigned after only eight months. Dr. Laura Gerald resigned as the State Health Director as did Dr. Rebecca King, the state’s top dentist, citing differences with Wos and the administration. Wos and the Governor publicly misinterpreted the findings of the North Carolina Auditor to create the appearance of extraordinarily high administrative costs in the Medicaid program. They used that interpretation to support their goal of privatizing Medicaid. Protests by the auditor and health professionals later demonstrated that the state’s administrative costs are actually quite moderate.

Wos changed the application and enrollment procedures for Food Stamp assistance and her new process takes months for many low income families. It is so bad that the federal government has warned the state that funding for administrative costs will be withheld if improvement is not made promptly. She implemented a new computer system for making Medicaid payments to physicians and other health care providers despite credible warnings that it was not workable, resulting in payment slowdowns that have jeopardized the financial survival of health care providers (doctors, hospitals, therapists and others) who depend heavily on Medicaid.

She is promoting an idea for addressing our troubled state mental health system by merging several quasi-governmental regional agencies into a smaller number without addressing the underlying issues about how and by whom services are delivered to living, breathing patients. Thinking that this administrative re-shuffling will improve mental health services is a bit like preventing the sinking of the Titanic by rearranging its deck chairs. It may appear that something is being done but the ship is still headed for the bottom of the ocean.

The biggest problem in this case is not with Dr. Wos. The major problem is with a Governor who has “rewarded” (punished might be a more apt description) political allies by putting them in highly responsible leadership positions for which they are unprepared. In this case the Governor chose someone who ideologically agrees with him but lacks necessary experience then he offered encouragement as she put other unqualified people in key roles. More recently he has failed to take action as a series of high level staff resigned. The debilitation of DHHS began with the appointment of unqualified personnel and that has demoralized more capable members of the department’s team.

DHHS is by far the largest and most expensive department of state government – comparable in fact to the Titanic. A ship so large cannot turn on a dime and ours is clearly in peril. Unless the Governor acts soon, DHHS will take many thousands of mentally ill and low income North Carolinians down along with some of our health care providers. It remains unclear whether Governor McCrory and Secretary Wos will go down with the ship.