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Carolina Journal Radio No. 889: Carolina Rebound offers tax, spending recommendations

Carolina Journal Radio / Donna Martinez and Mitch Kokai
The Cross Radio
June 1, 2020 8:00 am

Carolina Journal Radio No. 889: Carolina Rebound offers tax, spending recommendations

Carolina Journal Radio / Donna Martinez and Mitch Kokai

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June 1, 2020 8:00 am

As North Carolina recovers from the negative impacts of the COVID-19 pandemic, the John Locke Foundation is offering help. The new Carolina Rebound project is designed to give policymakers ideas that will help the state recover as quickly and efficiently as possible. Joseph Coletti, JLF senior fellow, discusses Carolina Rebound’s recommendations for state tax and budget policy. The pandemic shut down many N.C. businesses. Even those allowed to stay open had to scramble to adapt their business plans to changing circumstances. Ron Joyce of Triad-based Joyce Farms recently explained during a John Locke Foundation online forum how COVID-19 has transformed his business. Once focused almost exclusively on selling high-quality meat to chefs, Joyce and his team now sell directly to consumers. Joyce discusses the steps his business took to remain viable. One of the most important parts of the COVID-19 story involves the search for an effective vaccine. During a recent Capitol Hill hearing, U.S. Sen. Richard Burr, R-N.C.., questioned Dr. Anthony Fauci of the National Institute of Allergy and Infectious Diseases about ongoing studies of potential vaccines. Even before the pandemic, experts were calling for reform of North Carolina’s public pension plan. Leonard Gilroy, vice president of government reform at the libertarian Reason Foundation, and Jen Sidorova, policy analyst with Reason’s Pension Integrity Project, explain why policymakers should address deficiencies in pension plan funding. In addition to tax and policy proposals, JLF’s Carolina Rebound project recommends changes to state health care policy. Health Care Policy Analyst Jordan Roberts explains how those reforms could lead to better access and outcomes at lower cost.

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From Cherokee to current tagging from the largest city to the smallest town and from the statehouse into the schoolhouse Carolina Journal radio your weekly news magazine discussing North Carolina's most of public policy events and issues welcome Carolina Journal radio I Michiko got during the next hour, Donna Martinez and I will explore some major issues affecting our state covert 19 pandemic shut down. Many North Carolina businesses, even those allowed to remain open had to scramble they had to adjust to major disruptions in their markets to hear how one business owner was forced to innovate during a recent hearing on Capitol Hill. One North Carolina Congressman asked important questions about the search for a covert, 19 vaccine. You hear the even before the pandemic, North Carolina's state government pension plan needed changes to learn why. I will tackle some healthcare policy reforms North Carolina policymakers to address those reforms are part of the John Locke foundation's to Carolina rebound program. Speaking of Carolina rebound. Donna Martinez tackles that topic in the Carolina Journal headline: 19 has affected government budgets at all levels, the federal government. For example, has taken on massive amounts of debt with its relief packages state government here in North Carolina is facing incredible pressures due to lost revenues. Things like income tax and sales tax gas tax, you name it. Not coming in as expected.

So as we look to the recovery mode in our state.

There are sound principles and tactics that will help guide our path forward and they are laid out in Carolina rebound that is the John Locke foundation's game plan to revive North Carolina's economy available@johnlocke.org Joe Colletti is senior fellow with the Locke foundation, one of the authors of this new report. He joins us now to welcome back to the show is going to be here some context about how covert, 19 has impacted North Carolina in terms of the that the fiscal and tax some area near the tourist place that it's had an impact because of the response to it, both personal and government responses to actually shutdown the economy and so as you would expect sales tax revenues fell off greatly in April. The start of the falloff in March. Once things started to slow down and were not sure when that's going revive and as businesses close down the income tax also fell off because people don't have jobs so those two were the biggest impact on the general fund and the sales tax also affected cities and counties, and then we've seen more in the headlines is been the effect on transportation of the transportation department, which is already in financial problems, but because there's not business. And because your people have been told to stay home and if have chosen to stay home. The gas tax is also fallen greatly and so those are the three main areas that we seen on the revenue side, then we've seen some additional spending because schools have had transition to online learning and we've had more people using Medicaid and and in the unemployment situation means that we have more money coming out of the unemployment fund. Then we than we otherwise would. So all of those are some of the impacts that are that if that were first-line impacts on North Carolina itself and then then you have the. The later impacts which is that of the federal response to the carriers acting through through some other assistance that the federal government has provided financially to the state into cities and counties, so it is an incredible situation. Joe and every state is facing its challenges, North Carolina in many ways is in a better position. I use the word better." There considering were talking about a pandemic, but down were in a better fiscal situation than other states. But you have laid out in Carolina rebound again this new report available@johnlocke.org some principles for going forward the tenancy by some in a situation like this is to say government must do something and that typically means to spend more money that is not your guidance. No. Given the situation that North Carolina faces is we outline all the revenue that is fallen off and so the first Prince Hill with the with a problem like that is to stop digging.)

A whole. So the governor's response actually was slower than I would've hoped and would've anticipated, but to cut to freeze hiring into free salaries and to freeze other spending was a good first step is that you just don't spend more money than you have to, because there's enough money that you're probably going to have to spend in response. So the first thing is, don't spend new money and then the other thing is don't raise taxes because this is it of the even though there is a revenue shortfall that we that were experiencing is the root of the revenue shortfall is because people aren't earning money and can't spend money and so why would you raise taxes on people who are already in a bad position and so those are the first two grounding principles is don't raise taxes and don't spend your money and fluid for weight and following on that is, look for ways to cut spending outside of the places that are essential for dealing with the with the with the response.

What about that Joe I mean is said, let's say that policymakers say okay we think that Joe Colletti and the Locke foundation are correct on that simply can't raise taxes and try to get ourselves some more revenue.

Where should they start looking than to start trimming that budget. The place to look is what one thing is that worth putting together is looking at what is been added in the last few years of recurring spending. So let's take a look at the programs that are recent additions to the budget because if North Carolina had been able to function for over 200 years without that program.

Not sure will.

How essential that is in some of those are good spending. They may have a positive impact but let's take a look at those new programs that have been added in say the last 10 states were now in a different contest to so priorities change the things things that made sense. Even a year ago might not make sense anymore. Fortunately it again. One of those fortunate"" things is that the budget that was that the that the legislature passed last year was vetoed by the governor and so that freed up some money to be able to to cover over some holes to get through this year we have a savings reserve.

That's billion dollars over $1 billion, and so that will help with next year and and so the finances may be okay to be able to get through some of these things, but the on the cut side and wit, but some of that so that unspent money is programs that were not implemented.

And so, before going ahead with some of those planned spending increases.

The other thing that the guy that the legislature needs to take a look at is all those things that we were in a spend money on that. The Senate is that were not can even try to pass the budget that was that that that the House overrode the governor's veto on but one of those things that we really just since they know were not going to go forward with that even though we thought. As we were about two weeks before all of this started that that was a great idea. So one of those things that you can start cutting back on capital is a clear one, but there are some operating expenses that can probably be for foregone Joe in Carolina rebound.

You also take a look at the pressures on local government, and you have some advice for cities and counties tells about that. So, just as with food, the state government. The first thing to do is cut back on spending and look for ways for look for places to trim but not at the state level.

We also said let's let's get in the constitutional state constitutional amendment to reduce future spending to keep future spending low and keep future taxes low so that we don't end up in a trip in it and it similar situation when the next recession or pandemic or whatever else it's in at the local level, local governments were drawing down the reserves and in many places and were in some some cases they were well well-off with good reserves. In some places they weren't and so looking for. How do you make sure that that happens so that that that point that the local governments are even stronger. Going forward, and that's starting with the reduced spending but looking at the ways to to to limit the ability for local governments to tax especially the sales taxes which are volatile over compared to a property tax which is pretty consistent all around and Joe. Lastly, I'm getting a lot of federal money coming into the state and and that's in normal times. We have a lot of federal money coming into the state. But now with the cares act in particular $2 trillion, sent out to states, including North Carolina and that's a lot of decisions to make.

We know that they need flexibility on that in the Locke foundation has been at the forefront of the sounding they the alarm, saying, look, a lot of this money right now as the law is written as the cares act is written, it has to be spent on new spending you've written a lot about this. We know the people trying to get the flexibility to essentially backfill is that can happen. It's a good question.

I'm thinking that some of it will.

The question is are our hope is that that the backfill does not come with billions and trillions of dollars of new federal money. Joe Colletti is senior fellow with the John Locke foundation. If you think you say with this much more Carolina journal radio to come in just a moment tired of fake names tired of reporters with political axes to grind.

What you need to be reading Carolina journal, honest, uncompromising, old-school journalism, you expect and you need even better, the monthly Carolina journal is free to subscribers sign up@carolinajournal.com you'll receive Carolina journal newspaper in your mailbox each month. Investigations into government spending revelations about boondoggles who the powerful leaders are and what they're doing in your name and with your money. We shine the light on it all with the stories and angles.

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We hold government accountable for you. Look back to Carolina journal radio. I mixed coca the coveted 19 pandemic is forced business owners and entrepreneurs across North Carolina to think on their feet. How can they adapt their businesses to new circumstances. One of those business owners is Ron Joyce he's president and CEO of Triad based Joyce forms. He recently took part in an online forum for the John Locke foundation 30 important trip with a lot of small farmers produce all important socially or merely heritage for each other very unique animals that are too early to show some thought about in restaurants we have distribution from New England to review is for… Probably use and we had things happen like Katrina walked out one of her big markets for all but one city one area of what we saw within the about a 36 hour. We go Berkshire six or so is our business ground pool of 96% of our budget so we have obligations with animals revolving dish before all that we didn't like likely so we start looking for other opportunities. In discussing this one of our distributors orchard so merely to restaurants in a logical show. It shook them down to we started talking with them about changing our processing, producing retail packages, smaller packages that were suitable or just of the same meat we have been producing process and limited to week. They change their business model, also need to restaurants home delivered in New York City and the surrounding areas by then expanded the Boston and down through Washington DC and so it's been six or seven weeks of their volume with us is almost the same levels of walls, which is been amazing all their part. I wish I had more distributors that were there but our revenuescalm through the roof before all the old Ron Joyce explains how covert, 19 has affected customers preferences.

It seems that people are more interested in where the beach we have a wealthy merchant will we also started the goal. Consumer shown directly, allowing people to schedule all the from our operations.

Joyce explains his company's newest adaptation to cope with IT just launched a program that we have a few of our shells using they were calling it stress market. A lot of these restaurants that reopen billing or take out only book that severely cut into their revenue. So now that we have the largest retail size packages of amazing products just started selling bones and so when you come in and pick up a meal go home on your freezer your freezer and click later this fall will be never considered everything that last model and and will be everything really teach our farmers going to keep the company going to teach our employees and board. But now with this new stress market is helping our shift customers all maintain some revenue and increase revenue because I can do everything that I can think of the product business to Job my customers all survived. Then I really don't have a business to say that's Ron Joyce, Pres. and CEO of Joyce farms located in North Carolina's triad. Joyce emphasizes the role stress plays in the covert, 19 pandemic. This relation we were navigating through is extremely stressful things in our plant were great sidewalks and providing PPE or doing everything we can and were doing that because in order to keep our business going. That's our motivation. People have settable a really amazing be amazed at how much will motivator motivator. Could be losing business to sell third-generation soul. Everything that I have been and then to have it taken away from over something that we have absolutely no polo people talk about the lockdowns may be more of a health challenge in this country than the buyers we all are familiar with the negative aspects of scripts from heart suicide, drug use, alcohol use, drug and alcohol abuse. The health aspects of being shut down organ before worse than the band.

The Joyce explains how his business and others can be affected by different kinds of government leaders, we really have two kinds of leaders in this country will your talk about it at the national level low measures. We have leaders that say that they need to make all the decisions for their constituents that the constituents are smart enough to make their own decisions and be held accountable for those decisions and that it's their role to dictate to them what they do, where they do it when they do it even without soda are allowed to drink and we saying that in the past. Unfortunately, I guess this is been the result of the new Deal and great Society in some place we have people in more I guess and I realized you feel that they want this control to be displayed by our call that day know what's best for themselves and their family so they they need the government to tell them where they need to live when they need to work where the unfortunately we got more more people fall in that category.

On the other hand their leaders to give us credit of having enough commonsense know what's good for us what's good for families for businesses and how to succeed. And we also we the people that that that would likely be given the opportunity to open up each morning willing to take responsibility make sure he is a safe and clean environment as members and why wouldn't he be devastated this business to the there are those of us still God that will take that responsibility will make her own decisions. Allocations over the years asked me wrong, what can we do to help you in your business and also quite honestly stay out of my life.

I'll take care of business grow my business. I'll take the opportunity, but stop putting obstacles in front of us.

That's Ron Joyce, Pres. and CEO of Joyce farms, discussing business challenges link to the covert, 19 pandemic.

Joyce recently took part in an online forum sponsored by the John Locke foundation will return with Carolina journal radio in a moment. If you have freedom we got great news to share with you now.

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Try it today. 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 Locke foundation and Carolina journal part of your social media diet on Facebook like the John Locke foundation like Carolina. Journal follow us on Twitter at John Locke 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 Locke NC and at Carolina journal.

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Don't forget to smile.amazon.com today, something nice and help defend freedom, help support the John Mott foundation will connect Carolina journal radio I Michiko guy among the major subplots of the covert, 19 pandemic story is the search for a vaccine North Carolina Sen. Richard Burr focused on that issue during the recent hearing on Capitol Hill. Burr questioned Dr. Anthony Felty, director of the national Institute of allergy and infectious diseases you are really for all the time of your countermeasure as a matter fact we as you know right from the beginning of right on the accelerator and every aspect, including vaccines and therapies. We actually started in January.

Literally days after virus was known in sequence was published, so no I have never been told anyone to pull back on the development of any countermeasure for any basic research project that we've been involved North Carolina's senior US Sen. had a follow-up question for one of the most visible players in the national discussion of coping. 19. This is one of the fastest developing timeline vaccines and the American people and hopefully people around the world.

What will you find the licensure of that product or the biggest unknowns with this virus development process all seen the first hole is no guarantee that a vaccine is actually as you well know, discussed this many times in the past.

You can have everything you think is place and you don't do staccato immune responses turns out to be protected and durably protect someone to be gun owners will be effective in the way the body responds to viruses of this type. I'm cautiously optimistic that we will with one of the candidates get seasick. The other thing that's an unknown concern, but will be able to get around that by doing the tests probably his hands, mainly the number of vaccines to when the vaccine induces a selloff in the response person gets exposed.

This pathogenesis of the disease, which is always viruses want to make sure those are the two major unknowns on those things to get us out of our I still feel cautiously out the mistake you will have a candidate that will give some decree is only a percentage of will induce immunity protections of the population at all. That's Dr. Anthony foundry of the national Institute of allergy and infectious diseases.

He's answering questions from North Carolina Sen. Richard Burr will return with more Carolina journal radio in a moment where doubling down on freedom at Carolina journal radio were proud to bring you stories that impact your life and your wallet.

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We guarantee great information and a good time – that's listen to Carolina journal radio each week and listen to headlock to remember, you can listen to headlock@johnlocke.org/podcast or subscriber download each week iTunes Carolina journal radio and headlock just what you need to stay informed and stay entertained both brought to you in the name of freedom by the John Locke foundation will connect Carolina journal radio I Michiko got North Carolina state government has one of the nations best funded pension plans, so there is no reason to worry about right. Well, our next guests suggest there is need for some concern and they say now is a good time for needed reforms Leonard Gilroy as vice president for government reform at the libertarian reason foundation.

He is senior managing director of the reasons pension integrity project. Gensler Rover is a policy analyst for reasons pension integrity project they just worked on a recent study of the North Carolina pension plan. Reason and the John Locke foundation.

Welcome to the program. Thank you for having us appreciating your to be so. This is the state pension plan that deals with retired government workers, teachers, and for years we've heard this is in good shape. The funding has been almost 100%, or at least more than 90% for years and years look at this plan, though, and said you know that that the news is not all roses. There some reason for concern. Also will. Thanks for the question, though the work that we've done is looking at this the teachers and state employees retirement system here in North Carolina, which has been historically a regarded as and has been a well-funded plan relative to other public pension plans nationally. What we see though today is a situation which that plan which is been historically healthy today after arguably 10 years at the top of a of a of a bull run in the market, etc. is sitting at 86% funded today when we would rather see pension plans after a decade of markets climbing in and and and moving off the recession be closer to 100% funded, and so it week we got in and in. Login and analyze what's happening there and what what factors are at play and make some recommendations about how to take what is structurally a pretty well designed plan and make some tweaks to oriented for the future. Did I imagine that you did a lot of the legwork on this as you looked at it. What you see is some of the things that stood out stress testing and we put the plan would put their financials into position land. So let's look at what happens if the plan under preforms. One of the interest rate is not an ESI as the plan leadership. Thanks. Why what can happen is all hit the next recession and that's a question I'm pretty shy as being out in evidence has right now so on both scenarios. If the plan under preforms only by 1%. It can accumulate up to 16 billion, and liabilities of the next eight years and right now it's down muddy liabilities right now about 11 billion so it's mine."

If plan under preforms only by 1% which you wouldn't see Mike all that much, but ends up being out a lot at the end of the day and the same and basically the same fiscal impact is blabbed by you know the possible recession.

So we kinda looked at what can happen if they inch is a returns that we had in the last recession can happen in the next couple years and we saw that you know if this contact is can be much the same as you know, as Emily and doubling of unfunded liabilities and we also looked at things like how the funding ratio would be for him and we see that the bill is there is a lot of uncertainty but I by no stress from outside. So basically sounds as if both of you and your coworkers on this, along with John Locke foundation and the Joe Colletti said note that the good times and I can last forever. We never really take some kind hit. How will this pension plan stack up when the next bad time. Hit that right that's right. That's what policymakers across the country should be asking today. Given that we've got over $1.3 trillion of unfunded public pension liabilities at the state and local level across the country again after 10 years of being at the top of the market. You could argue a historic run and we have plans that are still sitting in the you know 70 to 80% funded range on average that suggests there's that there are factors that play beyond even just markets that that we really need to be attuned to the good news. I guess for North Carolina would be that a lot of the design features and the pension plan elements that other states get wrong that that have led to the 1.3+ trillion dollars of unfunded liabilities. Nationally, North Carolina, and in this tea service plan.

The teachers and state employees plan doesn't do a lot of those things. Some of it got some very good design features built-in, and I think that's what's notable is that despite having lots of good design features built-in to pay off your unfunded liabilities faster to be more conservative than other pension plans on that sort of thing nationally.

Still, despite that, you can have just a couple of things that if they go wrong as my colleague Jen was just saying if you are just.

Instead of getting a 7% investment return, which the plan is expecting is that if you get just six which is not a crazy number that I think in our own personal investment histories and I think what we see out there institutions getting this is not an unrealistic or are meant to create fear. This is what if something normal happens and denies as our numbers would suggest.

You can more than double your current unfunded liabilities over the next couple of decades that still, even with mechanisms built to keep it resilient you have on some factors that can still come into play. And so we think that this now is the time before the next recession hits and before every agency is coming to the state appropriators asking for more money that you should take care of first things first, and this would be one of those elements and in terms of fiscal priorities of the state on taking care of the promises made to retired teachers and public workers is up there in terms of the priority list we are speaking with Leonard Gilroy and Jen Sirota with the reason foundation and its pension integrity project you've alluded to them already, but what are some of the things North Carolina should do now. While it has the opportunity. The first thing that stood out when we looked at what brought us to this moment when we had all those unfunded liabilities was the unrealized investment return and investment return is something that is the return that we expect from our portfolio of assets and if you look at the dynamic of the past 17 years, the average return was about 6.3% and the plan is currently at 7% expected return so that see how it's been underperforming and a few look at the turn of the century one. A lot of most plans were fully funded and not Kino section 810% funded. Now it's only about 86.7% cited so it's it's now if you look at the big picture at the dynamic throughout the years has been trending downward since quite a quiet significant depth that it made so another thing that stood out was the interest on that and it's not a very taxing on saying on the plan because that's the most expensive debt and you can have and it's going at least at the rate of the assembly time which is 7% at the high rate for that to grow. That is, I think I would point those two things that you know I would prioritize. But as my colleague said there a lot of things that mankind is correctly and we played out in our report as well because it has been blowing this innovative return and it's putting their unfunded liabilities on the short 12 year amortization schedule and that's much better than a lot of the plans, but at the same time you had to be mindful that you gotta keep improving your finding policy and I may be making those small changes here now so that you don't have to deal with a crisis situation compares pay me now or pay me much more later if that is Leonard Gilroy. You also heard from his college and sitter over there with the reason foundation and its pension integrity project. Thanks much for joining us. They drank a lot more on Carolina journal radio just about really influence you either have it or you don't and at the John Locke foundation we have it, you'll find our guiding principles in many of the freedom forward reforms of the past decade here in North Carolina.

So while others talk or complain or name call. We provide research solutions and hope 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 over your life.

Our goal is to transform North Carolina into a growing, thriving economic powerhouse, the envy of every other state. Our research is how policymakers make decisions that ensure you keep more of what you are. Expand your choice of schools for your kids. Widen your job opportunities improve your access to doctors. The recipe for stability and a bright future for truth for freedom for the future of North Carolina. We are the John Locke foundation. Welcome back to Carolina journal radio time. Donna Martinez as North Carolina begins to emerge from the covert, 19 statewide shutdown order imposed by Gov. Roy Cooper.

The challenges we face are enormous yet so are the opportunities covert, 19 has illustrated the great promise of healthcare innovations and free markets to expand access to care and help lower costs. A way forward with healthcare opportunities is laid out in Carolina rebound that is the John Locke foundation's new game plan for providing our economy healthcare policy analyst who authored part of this new report is here with his recommendations. He is Jordan Roberts Jordan, welcome back to the shell thanks have set the stage for us if you would.

How has Sam covered 19 really impacted healthcare in North Carolina sure to think the biggest thing to point out is that as we saw the early spread of the disease. A lot of the major hospitals and providers. They completely shifted focus. They stop doing elective procedures. They stopped doing some the normal patient procedures that they were doing and switch all their focus to covert treatment that included stocking up on supplies. You know, clearing out holdings to treat covert patients and that completely changes the whole business model of these are providers that are not getting the income from the elective procedures and they were kind of in a wait-and-see.

To see hot with the influx of covert patients would be so a lot of the providers their entire business plan for this year was interrupted, think another thing is we've seen just tragic job loss around the entire country. But North Carolina is not immune to that and so with the arrangement we have in this country where most people get their health insurance from work when you lose your job you may lose your health insurance or seated in our upwards of a million people unemployed here North Carolina. Presumably, a lot of them have lost their health insurance so that affects families and how they pay for health insurance and things like that and then you know the other thing we see it is a lot of long-standing healthcare policies that have governing the practice of medicine have been either changed or waived, and so some things that you used to be illegal in the state are now legal and so were sitting in a changing landscape of the regulatory framework as well. A big impact on healthcare.

Clearly he mentioned the unemployment situation. It's it's huge.

And, unfortunately, oddly enough, at the very time when healthcare workers are on the front lines dealing with covert, 19 there are a lot of healthcare workers that themselves have lost their jobs and people don't realize that and it gets to this question of access to care and medical professionals. Why are healthcare workers being laid off when they're in demand right and then we make sure that we have access to a larger pool yes is it's a peculiar situation as we you know I reserved all these healthcare workers to treat the influx of covert patients. Many of the facilities that employed them could not afford to pay them anymore without the elective procedures so as we need more frontline healthcare workers. Some of them had to be laid off because of the financial situation, so that's something we're dealing with. But North Carolina we have one of the most rural populations. A lot of medical deserts. A lot of medically underserved places and so we say that this is a maldistribution of providers we have enough providers in the state. They're just not distributed in the in the inappropriate way to meet the needs of all these communities and so that's why you know a lot of the recommendations in this piece are about increasing access to medical providers increasing the amount of supply because one thing we did we have and how does an adequate supply around the state.

This includes things like opening up licensure restrictions to allow artist medical providers to hold a license from another state to coming to North Carolina in practice to increase the scope of practice for current providers in the state to allow them to do more for patients and you have things like telemedicine and telehealth allow Cynthia's licensing allow professionals in other states that are in good standing with their medical with their medical boards to treat patients in North Carolina because right now we we actually just restrict access to all these professionals, let's talk about telehealth and telemedicine first because that so many people have been mandated by government in in our state.

Gov. Roy Cooper sent statewide shutdown order to stay home, jobs eliminated, but yet people still need access to healthcare weathers related to covert, 19 or not. And so we've seen more people introduced to the idea of communicating with a doctor or a nurse or pharmacist over theirs. Their smart phone over or their laptop is so oddly enough, it took a pandemic to get more people to realize it is possible to receive quality care. This way you absolutely and so this was already on the rise. But now this this pandemic is shown that you a lot of care that we traditionally go to a brick-and-mortar doctors office for a lot of it can be done over over a virtual meeting such as telehealth videoconferencing, but the one thing I want to point out is that even though as we move forward into a more probably digital health oriented world, there is still a lot of state and federal laws that restrict me of the types of devices one can use where one must be to receive telehealth and get in view of the insured pay for itself, is always different things.

The restricted and so one of the recommendations in the papers just to open up have a very flexible regulatory framework. So there's not any new technology that's restricted from being used or a doctor may want to try something that's illegal and North Carolina things like that and Jordan to. It seems kind of crazy that were living and world that is completely interconnected can have a conversation with someone who is literally around the world from you. And yet if you're trying to access medical care.

There's a real impediment to trying to access someone who isn't physically within the confines of the state of North Carolina that seems such old thinking yeah exactly and this is what I point out in the Carolina rebel recommendations is that so much of healthcare regulations is sort of this old guard mentality that's you know just entrenched interest protecting their turf and notice what I really call for is that we need to break up these old restriction is standout protectionist policies that have governing the practice of healthcare for so long as all they do is limit the amount of supply limit what doctors can do and limit how patients can access Karen with something like medicine and medical care.

Something so personal to the individual and personal decisions being made between a doctor and a patient of the government should get out of the way and not make the try to make these decisions for medical providers and patients and so you all the recommendations and in my section of the Carolina rebound call for the unwinding of some of these protectionist policies that have not achieved their goals and we have 40 or 50 years of evidence that you also point out that some medical professionals are impeded from really providing the the full access of their knowledge and you single out nurse practitioners and also pharmacist tell us about what they could be doing that right now they can't yet so nurse practitioners are no practice, a lot of in primary care settings and so they had in order to practice in North Carolina they have to coat go into a collaborative practice agreement with the physician and so their practice is limited to what their physician allows them to do and to what if they have a supervising physician on hand.

And so what we want to see is that the collaborative practice agreement eliminated so that nurse practitioners can practice however they see fit, and wherever they see fit to help with a maldistribution of supplier of our providers and then on the pharmacist side was seen in other states is that some people are that some states are allowing pharmacist to take up a few more testing and in prescribed treatment of non-chronic diseases. So what this does is it utilizes the healthcare infrastructure that we have and it allows primary care doctors to focus more on some of the big more complicated procedures. Jordan Roberts is healthcare policy analyst for the John Locke foundation. Thank you. Thank you.

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