The House Bill to establish the “Access to Health Care Policy Council” would create a council with the stated goal of “providing access to appropriate and affordable health care on a regular basis to all North Carolinians.” While the goal of ensuring North Carolina citizens enjoy broad access to health care is admirable, close examination of the current bill reveals opportunities for improvement (and reasons for fear). As written, HB 2688 raises some concerns about fairness, diversity of opinion and special interest influence. In order to create a more inclusive, well-rounded and less vulnerable Council, the following issues should be addressed:
• Diversity of Opinion
As currently written, there are no assurances that diverse viewpoints on how best to address health care policy will be represented. The appointment process includes the mandate that “the appointing authorities shall make every effort to reflect the geographic and ethnic diversity of the State.” However, no mention is made of providing for diverse opinions. If the Council is sincere about improving North Carolina’s health care system, it will make an effort to consider a range of perspectives and encourage an open discussion among potentially conflicting philosophies.
• Overlooking Current Problems
There is no provision in the current bill to provide an open and honest assessment of current policies that may be limiting access to healthcare. A council created to make policy recommendations going forward must first closely examine policies and programs that may be creating unintended obstacles to affordable healthcare. Only after such examination can any serious solutions be considered.
• Special Interest Influence
As it is currently formatted, the Council will be vulnerable to capture by special interests. Indeed, this body should take great care in insuring this legislation – as well as the Council and recommendations that flow from it – do not come under the influence of parties seeking to gain advantage through political means, or by advocacy groups bent on realizing their narrow agendas. Stop-gaps for this Council being co-opted should be considered carefully.
• Vague Terminology
Some crucial elements of the bill’s language are inherently vague. Terms such as “integrated system” and “appropriate and affordable health care” are highly ambiguous. Such ambiguities increase the likelihood of excessive power being granted to both the Council and the State, coming at the expense of North Carolinians who have a right to choose health care options that best suit their needs (e.g. would the Council, rather than N.C. families, be in a position to determine what “appropriate” health care is?).
• The Meaning of “All”
Repeated use of the phrase “all North Carolinians” in reference to health care goods and services implies that health care is an inherent right of citizens. Such a right does not exist, however. More appropriate language would thus be “more North Carolinians.” We believe the current terminology is a not-so-thinly veiled commitment to incremental socialism.