CHANGE TO "CERTIFICATE OF NEED" SHOULDN'T IGNORE THOSE MOST IN NEED OF CARE: Recently ECU Health announced that it was closing five regional clinics serving women and families in largely rural areas in the eastern part of the state after facing a loss of $46 million last year. There is a reason why the state’s certificate of need program functions to assure a certain economic return for health care providers -- so everyone, regardless of where they live or what their economic status, will have access to the medical services they need. It is not a far-fetched notion that without regulations like certificate of need, medical entrepreneurs would establish services and clinics in the areas of greatest potential profit. As a result, rural or impoverished areas and those without the means to pay for services, would likely be left with even fewer possibilities to find the care they need. Linking the much-needed and too-long delayed expansion of Medicaid to alterations in the state’s certificate of need regulation isn’t about healthcare but about politics. The two issues should be dealt with separately. There is no excuse for any further delay in providing care to the more than half-million North Carolinians who have lacked access for decades – especially with a viable solution available over the last 14 years. Was talking with somebody the other day who brought up the GOP's stubbornness in refusing to embrace an Obama policy. But it's even worse than that. Those who would be served under Medicaid expansion are the working poor, the ones who don't earn enough to qualify for premium supplements. In other words, the people who can't afford to give max donations to candidates' campaign war chests. Blocking Medicaid expansion, or using it as a vehicle to push other policies, are exercises in genuine elitism; something Republicans claim to abhor. But their actions undermine that claim every day we go without expanding Medicaid.
WHY MEDICAID EXPANSION WILL GROW NC'S ECONOMY: North Carolina increasingly leans on tourism and hospitality to boost its economy, but many hardworking folks in this key industry have no insurance to lean on. Even as they serve up quality meals and make restaurants and vacation resorts run smoothly for eager guests, they know that if they get sick or hurt, they will be on their own, perhaps unable to make ends meet. The story is the same across other industries that we all know and depend on. From certain front-line health workers to retail, to our many small businesses, thousands of North Carolinians put in a hard day’s work without access to health care when they are sick. They make too much to qualify for existing support programs, but not enough to afford insurance on the private market. This is what we call the health care coverage gap, and it has long been an unnecessary drain on our otherwise robust state economy. Fortunately, we are closer than ever to closing the coverage gap by expanding Medicaid – as 39 other red, blue, and purple states already have. Expanding Medicaid would have a positive impact on our state’s economy. In addition to creating thousands of new jobs in the health care sector, it would also generate significant economic growth. A recent study found that expanding Medicaid in North Carolina would result in a net gain of $3.9 billion over the next decade, as the increased federal funding and economic activity more than offsets the state’s cost of expansion. This money could be used to fund critical public services, such as education and infrastructure, or to provide tax relief to struggling families. As a longtime business leader in North Carolina and as chair of the Economic Development Partnership of North Carolina (EDPNC), I also cannot emphasize enough the importance of a healthy workforce. Better worker health yields direct benefits to employers. According to some corporate studies, unhealthy workers had absenteeism rates nine times that of healthy workers. Plus, I know from experience that companies thinking about locating or expanding to North Carolina want and desperately need a strong talent pool to pull from. It is time for our legislative leaders to embrace this issue to expand Medicaid for our hardworking citizens who need it. What Gene said.
I'M MY ANCESTORS' HOPES AND DREAMS: Last week, I was talking to a woman at Food Lion. She was close to my age, but doesn’t look like me. The conversation centered around a recent trip she took to Charleston, S.C., where she enjoyed a historical tour of the City Market and former slave auction area. She shared her disdain for how the tour guide engaged in revisionist history, erroneously explaining that no slaves were ever sold in the market. While this may be technically true, no captured Africans were sold inside the Market. Between 1670 and 1808, 1,000 cargoes of enslaved Africans entered the port of Charleston where many were sold on the adjacent streets. Does that somehow make this inhumane act, wrought with depravity, OK and easier to accept? So, are we rationalizing brutality and subjugation to see how much to be comfortable with? It reminded me of a tour I took with my middle son a few years ago through the Hall House Museum located on South Jackson Street. I was enjoying the tour until we got to the final stop at the slave quarters in the rear of the main house. I’ve long made peace that this part of history is a reality in America. I was more interested in how my ancestors lived only blocks away from where I would eventually be raised. What changed my entire enjoyment level was the ignorant and uninformed words of the young female tour guide, who also looked nothing like me. As she moved from one of the only two rooms of the small shack that stood in contrast to the large multi-room home it labored for, she eagerly pointed to the names of slaves that had been etched on the wall. She beamed with pride as she said that after slavery was abolished many of those names willingly opted to remain on the property and continued working because they were treated so wonderfully when they were enslaved there. As I clutched my pearls, my eyes rolled so far back in my head, they momentarily stuck. I thought back to the enslaved people in both scenarios and my heart sank. I thought of my ancestors standing on that platform in the Charleston Market area being stripped of their dignity, humanity and everything that was familiar and safe. In an instant, they had no religion, identity, language, culture, or family. I thought about the slaves at the Hall house, who were given freedom but no plan or resources to enjoy or sustain it. They had nowhere else to go. Neither group had options they could utilize so they did what was necessary to survive. My mind drifted to each of them clinging to hope that one day their progeny would fare better than their present situation. I realize I’m my ancestors hope and the physical manifestation of what they closed their eyes and prayed for while in bondage. A few years ago one of our (Alamance) County Commissioners was arguing against removing a Confederate statue, and he claimed his family didn't have "slaves" per se, they were considered workers and treated like family. And that they gave many of those "workers" land plots at the end of the war. It was either straight-up bullshit or old family lore, which is the stock in trade of historic revisionists.
UNC'S CAMPUS IS A 700 ACRE ADA VIOLATION: Caldwell Hall is home to the UNC Philosophy Department and the Parr Center for Ethics. It hosts classes, events and guest speakers, with multiple professors having their offices on the second floor and basement. It’s an old building filled with new ideas about ethics, metaphysics, logic and political theory. Built in 1912, it's a standing reminder of the ongoing accessibility issues on UNC's campus. The building only has one accessible door in the form of a street-level entrance that leads to the basement. Every other door requires a trip up or down a staircase. To get to any Caldwell classrooms using that on-grade door also requires going up the stairs, as the building has no elevator. UNC is the fifth-ranked public university, and UNC's philosophy department is tied for 12th in the country. Yet, there is no way for anyone who uses a wheelchair to access opportunities in some classrooms. It’s a disgrace. This is UNC’s accessibility issue in an infuriating nutshell – an aging campus, basic accommodations being out of reach and an administration that either can’t or won’t step up. A full renovation would likely cost millions and require finding alternative classrooms and office spaces for the classes, professors and organizations housed in the building. It seems that even small changes, like the installation of a ramp which the philosophy department has “been working for many years on,” or the smaller scale renovation the department has been working on getting approved for the last 10 years, are too low on the University's priority list.So while the funding issues are real, they are also easily fixable given the state of North Carolina’s $6 billion budget surplus. It’s easy to pass the blame for not moving funding exclusively to the General Assembly (which would rather cut taxes then fund critical infrastructure) but remember that some of the Board of Governors – who one would hope would advocate on behalf of the University – were elected by the same General Assembly withholding funding. It’s not just Caldwell Hall. Students protested last year over accessibility issues that left a student activist stranded in Koury Residence Hall, which was built in 2002 — 12 years after the Americans with Disabilities Act became law. The General Assembly's Budget earmarks funding for specific construction projects, so these issues could be fixed via line-item. But again, disabled students and staff don't even make a tiny blip on the GOP's radar. That's why the ADA was passed in the first place, to give power to the powerless. It doesn't matter how good your program is if it isn't accessible.
WHY "THE 1619 PROJECT" WORRIES WHITE AMERICANS: I am old enough to remember when Alex Haley’s “Roots” was first aired on television 46 years ago — and what happened afterward, at least where I lived. “Roots” is the story of Haley’s family, its struggles, triumphs and its decades in slavery. The series aired over a week in January 1977. It led to fights in my school district. Black students, having not heard or seen or been taught any specific truths about our origins in America, directed their anger at White students and fights ensued. “Roots” was a shock to the system. Keep in mind that “Roots” featured a tame version of slavery. It showed whippings. It showed Black children separated from their parents. It didn’t show the rapes by slave owners or the forced “breeding” of African people. It could not show the full scale of the depravity, emotional abuse, torment and murder that drove and sustained American chattel slavery. Nikole Hannah-Jones’s documentary series, “The 1619 Project,” which premiered last week on Hulu, doesn’t shy away from the full inhumanity of American slavery. It makes clear that Black Americans were treated no better and often worse than livestock. It confronts the fact that Black women were bred as if they were cattle. It reveals the full cruelty of American slavery and shows how Jim Crow by design broke African American psyches for decades. And, once more, people will be angry. And that’s what some White people are now worried about. In Florida and in other states, efforts are being made to stifle the teaching of Black American history. When Gov. Ron DeSantis (R) says, “No one should be instructed to feel as if they are not equal or shamed because of their race,” I believe he means White children. These people aren’t interested in racial harmony. And they certainly aren’t interested in Black children. Their continued campaign to discredit Hannah-Jones and the teaching of Black history is about two things: protecting White children — and preventing any initiative to help correct the actions of White ancestors that still afflict Black Americans today. Those who focus on the idea that telling these truths is “divisive” are centering White feelings about our real history. Why deny Black students the feeling of gratitude and pride that comes with knowing how your people endured — so that they can overcome and thrive? Because unintelligent Whites are Zero Sum adherents; what somebody else gains causes a loss to others. And they may be at least partially correct. But if you have an advantage that was built on disadvantaging others, you haven't earned it, and don't deserve it. Fairness is complicated, and by its nature displeases some. But it is critical in a democratic society.
LETTERS TO THE EDITOR
LIZZIE BIDDLE: SCHOOL BOARD IS NO PLACE FOR BIGOTRY: The bill sponsored by Rep. Jon Hardister to change North Carolina law in order to seat Michael Logan on our Board of Education is transparently biased. I am a District 3 constituent and I am concerned that if the bill passes my district will be represented by someone with a racially prejudiced and vindictive mindset. Mr. Logan’s Facebook posts (now removed) tell a story that his supporters try to explain as mistakes in the past. Comments posted as recently as last April are not youthful indiscretions. Further, he has not acknowledged them as mistakes he now regrets. Overt, intentional prejudice has no place on the Board of Education. I applaud the stand most sitting board members are taking against it. It is wrong to say and stand by prejudicial remarks and make policies affecting our children. Mr. Logan’s opinion, though biased and misguided, is his to hold but not as a public official sworn to serve all students with fairness and respect. There are many moral traditions; all have a place. I submit, however, that bigotry is not moral and most certainly should not become an accepted practice. There are other Republicans whom the board would and should approve. The Board has very good reasons for voting this jack-ass down, and Hardister needs to let this thing settle itself.
ROBERT PORRECA: WE NEED TO KEEP THE PISTOL PERMIT: As a handgun owner and former firearms instructor, I support keeping the current handgun purchase permit requirement. Sometimes local jurisdictions, and even federal agencies, do not enter information into the federal database used to vet firearms purchases as they should. Without this information in the federal database, persons who should be denied the right to purchase a handgun slip through cracks and become a danger to the community. The county sheriff’s office is able to check local records that may not be available in the federal database, providing an important resource in protecting society. And as I have mentioned repeatedly, Sheriff's departments are the main officials in dealing with domestic violence and restraining orders. In many ways they are more important than any national database, which is why the gun-nuts want this repealed.
JOANNE DOYLE: OPPOSITION TO "WOKEISM" PROVES IT IS STILL NEEDED: The excellent article on “wokeism” pointed out the irony of language. Those who denigrate and ridicule the “woke” folks are prejudiced against those who are against prejudice. To be woke is to be intelligent and aware of social injustice. It appears that the conservatives who point out the dangers of “wokeism” are trying to win the votes of the uninformed, intolerant members of our fractured society. Here we have the weaponization of a word that actually represents increased tolerance in those who are well-informed. Yeah, it's similar to those who are angry that their intolerance is not tolerated, or the people who call out their prejudice are themselves being prejudicial. A monumental lack of reasoning.
The power has been out now for about three hours, and although it’s still twilight outside, it is utterly dark inside. I tried to read by candlelight, but the flickering was maddening. So I lit an old oil lamp, which not only flickered but also smoked. Scratch the open flame idea. It’s supposed to get down below freezing tonight, so if they don’t get the problem fixed soon, tomorrow morning is going to be frigid. No television, no Internet, just me. And the dark. And a laptop with about 95% charge.
I’m a writer of fiction, so there’s always a story to be told. Or dreamed up, and then told. I know a lot of writers, and many apparently have a Process. A routine they go through to get the juices flowing, as it were. It sounds fantastic, but the only way I know how to create is to grab ahold of the occasional wayward thought and ride it until the wheels come off. To call that a “process” is like calling Barney Fife a law enforcement officer. A big stretch.
But there has been a story percolating in my mind for a few weeks now. I don’t know where it came from, so don’t ask.
My name is Lilah…Well, it’s actually “Delilah,” but my older brother Timothy, who had Down’s Syndrome, either never could pronounce the whole thing, or just preferred the shorter version. After a while it caught on, and I’ve been Lilah ever since.
I say he “had” Down’s, because we lost Timmy yesterday. I’ve been trying to figure out where I am in the stages of grief and I don’t have a clue. In many ways my brother was one of the smartest people I’ve ever known. He always knew when I was happy, or sad, or furious, or whatever I was feeling at the moment, no matter how hard I tried concealing these things from him. I know it sounds crazy, but it’s like he could read my mind. Like it was an open book to him.
One time when I was about twelve or so, a girl in one of my classes said I was a “Plain Jane.” My hair was straight, and that color of light brown that looked like it was dying of thirst. And I had a bad habit of pushing it behind my ears to keep it out of my face, which also served to draw attention to my ears, which were weirdly shaped. I mean, all ears are weird if you think about it, but mine were extra weird. They stuck out a little too far, like I was trying desperately hard to hear something. And what I usually heard was something along the lines of:
“There goes Jane, walking on the plain,” or some other variation. Normally I liked going to school, but there were times I hated it, too.
Timmy caught me sulking one day, and kept asking me what was wrong. I finally blurted out, “I’m ugly, that’s what’s wrong!” He just sat there with his mouth open for a bit, and then yelled, “No you’re not, Lilah! You are beautiful! Like a princess!” And then he started crying, which I really hated, especially considering he was almost sixteen, which is way too old for a boy to be crying. And that made me cry, which really upset Timmy. He considered himself my knight in shining armor, and a knight whose princess is forced to shed tears has failed in his sacred mission.
I learned something that day. I did not have the luxury that other girls my age had, of being able to loudly complain about something, or go fishing for sympathy. I was a big part of my brother’s limited world, and a careless remark on my part could crush his spirit.
When I was fourteen our family moved from Cincinnati to rural Indiana. My dad actually worked in Indianapolis, but he wanted to shelter his family from big city life, I guess. But there was no special school for Timothy like he had in Ohio, so my first day of high school we rode the bus together. My face burned as I heard the other students snickering at the way my brother talked, and I knew it was only a matter of time before things got worse. And they did, but not in the way I thought they would.
I was aware that disabled children were often abused by their caregivers, and disabled girls were especially prone to sexual assault. But what I wasn’t prepared for was being the target of that myself. Why should a Plain Jane have to worry about stuff like that? I now know better, but at the time I was oblivious.
One day in the cafeteria, a Senior named Rob sat down to eat with Timmy and me, and it turned out he lived only a quarter of a mile away from our house. And he had his own car, and offered to give us a ride home instead of riding the bus. Timmy didn’t care either way, but since I dreaded that bus ride, I was more than happy to avoid it. Soon Rob was picking us up and taking us home every day, and he and Timmy started building model rockets and shooting them off. I must admit to feeling a certain amount of relief, that my brother had other interests that gave me a break from being the center of his universe.
In retrospect, it’s very likely Rob’s behavior was merely a ploy, to give him the opportunity to do what he did. To this day I find it difficult to trust the motives of anybody, even after I get to know them. Especially after I get to know them.
One day shortly before Summer vacation, my brother missed school for a doctor’s appointment. Rob picked me up as usual, but when we were on the way home, he said he wanted to show me something he made for Timmy’s upcoming birthday. A really cool rocket, but he didn’t know what color it should be. So we went into his garage, and he went inside to the kitchen to get us something to drink. It was a hot day, and I drained that Coke on ice in short order. While Rob was rummaging around in some boxes, I found myself staring at an old poster on the wall from the 1950’s; a beautiful blonde girl leaning against a shiny automobile, drinking a Coke. She was wearing a red and white striped knee-length dress, and as I was staring at her, the stripes began to move. Like one of those old barber shop poles. That’s the last thing I remember, until I woke up in my garage.
No girl drinking a Coke, no stacks of cardboard boxes. Just me sitting in an old recliner my dad kept saying he was going to take to the dump. My head hurt, and when I stood up I immediately plopped back down in the chair to keep from falling on the oil-stained concrete floor. I still didn’t realize what had happened, and then I felt the wetness in my jeans. I thought I must have peed my pants, but when I finally stumbled to the bathroom, there was blood. Not a lot of it, but my period wasn’t due for a couple weeks, and then it hit me. I was raped. Drugged and raped. And then dumped in my garage, because the bastard knew my parents wouldn’t be home until after six.
I should have called 911. I should have preserved the evidence. I should have done a lot of things. But I put my clothes in the washing machine, took a long, hot shower, and then crawled into bed. And stayed there for three days, claiming to be sick. Which I was. Sick of having to live in a world where such a thing can happen, sick of hearing laughter on the television, sick of trying to figure out what I should do. Who I should tell. And most of all, sick of thinking about what it will be like to see his face. For him to see my face.
As usual, my brother knew something was wrong. Knew I was being plagued by something far worse than a virus. And somehow, he knew who caused it. Maybe Rob had asked too many questions about how I was doing, if I had said anything. I don’t know, and Tim never told me. But Rob ended up in the Intensive Care Unit for two weeks and my knight in shining armor was involuntarily committed to a state institution for almost two years. At first I was worried about him being there, but one of the male nurses said, “Hell, he runs the place, I just work here.”
It’s been fifteen years since I was raped, and I can safely say the road to recovery from trauma like that is never-ending. I still have the occasional nightmare of waking up in some strange place, covered with my own blood. Or being paralyzed, unable to move while cold hands explore my body. But my biggest victory during this time is accepting that it was not my fault, that I didn’t, even inadvertently, cause the assault to occur. And as with many things in my life, I can attribute that to my brother Timothy.
Whenever I had a problem, like a failed job interview or a failed relationship with a boyfriend, Timmy would say, “It’s not your fault, Lilah.” And he would look at me for an extended moment, so I would understand we were talking about more than what was on the surface.
What stage of grief am I in? I don’t know. But I can cry now, which is something.
I considered taking out that preamble,
and I probably will if I submit this elsewhere for publication. But I figured readers here would get something out of that, too.
certificate of need
I agree that without certificate of need, the profit motive will decide the locations for mammograms, chest x-rays, and many other medical support operations.
A lack of the certificate of need will put more pressure on rural North Carolinians to travel to meet their medical needs.
Once again, republicans are showing they DO NOT support rural North Carolina.