- Associated Press - Tuesday, July 1, 2014

Recent editorials from North Carolina newspapers:

June 30

Charlotte (North Carolina) Observer on contraception ruling being a setback:

The Supreme Court’s narrow 5-4 decision on Monday allowing some for-profit corporations to opt out of contraception coverage under the Affordable Care Act might have turned on this comment from Justice Anthony Kennedy, most often the high court’s swing vote. Because the Obama administration had granted religious accommodations to other groups, he questioned whether the contraception mandate was critical to public health. “It must have been that the coverage was not that important,” Kennedy said during oral arguments.

That was the wrong conclusion. Contraceptive coverage is critical to women, providing access to services vital to their health and well-being. Accommodations that allow religious groups and nonprofits with religious affiliations - though not ideal for a woman’s health needs - are exemptions permitted under the 1993 Religious Freedom Restoration Act, because those groups foster the interests of persons who are a community of believers.

That’s not true of for-profit corporations, as Justice Ruth Bader Ginsburg articulates well in her dissent. “Workers who sustain the operations of those corporations commonly are not drawn from one religious community,” she writes.

What the justices have done in this ruling is to essentially put the personal views of a for-profit company’s owners above the health interests of the women who are employees. They’ve erected a roadblock to affordable access to the most effective method of birth control.

The Court’s majority seemed to seek to minimize the impact of the ruling by applying it only to closely held for-profit corporations - those controlled by a limited number of shareholders. But those corporations employ tens of millions.

In the majority opinion, Justice Samuel Alito noted that the Obama administration has already designed workarounds - having an insurer outside the company provide coverage - for nonprofit religious corporations. They can be used for for-profit employers as well. He also wrote that “the most straightforward way of doing this would be for the Government to assume the cost of providing the four contraceptives at issue.”

What he didn’t say was that such workarounds are being challenged in court as inadequate by religious groups. And federal subsidies for women now without coverage may have great difficulty making it out of the current partisan Congress.

The ruling doesn’t affect the broader aspects of ACA. But it is a setback for women and their right to make personal health care decisions for themselves, rather than have their bosses decide it for them based on their religious beliefs.

A poll last week showed a majority of Americans think that decision should be left to women, and not their employers. It’s too bad a majority of the Supreme Court justices decided otherwise.




June 29

The Herald-Sun, Durham, North Carolina, on posturing:

Deadlines in politics have a way of being ignored, usually at additional cost to the governed. That’s the case with North Carolina’s budgetary process. Today is the last day of the fiscal year, and if legislators were going to implement a new budget to replace the old one and avoid a number of problems that leaving the old in place will trigger, they should have done it already. Or at least they should have it done by the end of business today. Don’t hold your breath.

House and Senate leaders may be further apart on a budget deal today than they were when this short session began months ago. Short of a last-minute deal, the old budget will remain legally in effect until they come up with a compromise. They can stay in session to negotiate, which seems likely. They can also give up and go home, which would be unfortunate, though it would save taxpayers tens of thousands for each day they aren’t in session without making progress.

At the heart of their differences is Medicaid funding, though it’s also become intertwined with teacher pay and staffing levels for teacher assistants. Senators have complained that estimates for Medicaid costs come in too low each year and want to set aside more money to handle that problem. Gov. Pat McCrory’s budget director, Art Pope, has said that’s unnecessary and a bad idea. Allotting so much for Medicaid will force the state to slash positions for teaching assistants, who can’t easily be rehired if the funding emerges later. Pope and state House leaders favor a more modest sum for Medicaid than can be adjusted out of state reserve funds later if necessary.

The Senate also wants to offer heftier increases in teacher salaries than the House and governor, which would only make the cuts for teaching assistants deeper. While the House’s approach - modest teacher raises, modest funds set aside for Medicaid and no reduction in teaching assistants - makes the most sense, negotiations might identify some additional ways out of the conundrum.

This year, as much as any, points to serious problems with our budget system in North Carolina. We shouldn’t leave so much in limbo at the 11th hour.




June 28

Winston-Salem (North Carolina) Journal on Telepsychiatry:

Telepsychiatry has proved to be an effective resource in North Carolina. Thanks to the generosity of a North Carolina endowment, it will soon be available for more patients.

The Duke Endowment (a private foundation that is separate from Duke University or Duke Energy) had already supported state efforts earlier this year with a $600,000 contribution. Now it’s adding $1.5 million for the telepsychiatry initiative, the Journal’s Richard Craver reported last week. The N.C. Department of Health and Human Services will receive $800,000 this year and $700,000 in 2015 for its Office of Rural Health and Community Care.

North Carolina has a severe shortage of psychiatrists in rural counties - there may be none on staff or none available around the clock at rural hospitals or other care centers. Telepsychiatry uses two-way audio and/or video as a rapid response assessment option for people during a mental health or substance abuse episode, or who have a neurological issue like stroke symptoms.

Earlier this year, the N.C. Center for Public Policy Research, a nonpartisan think-tank, said that wait times at rural hospitals have been greatly reduced by telepsychiatry. Patients who were, on average, waiting 48 to 72 hours to get medical help in 2010 are now waiting less than six.

For people in dire straits, this is a great improvement.

“This initiative addresses critical health professional shortages and creates unprecedented community access for individuals in rural and underserved areas to receive treatment for a mental health emergency,” Chris Collins, the director of the rural health agency, told the Journal.

North Carolina’s mental health program has been broken for some time, despite community advocates’ efforts to educate the public and public officials and elicit more support. We’re glad to see this improvement, but even more is needed.



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