RALEIGH – The thing about Big Government is that at some point the spaghetti charts of bureaucracies and programs get so unwieldy that even attempts to hold them accountable are ignored with seeming impunity. That’s what is apparently happening with the biggest centralized department of state government – Health and Human Services.
Now Republicans, and even Democrats, are growing tired of the department’s refusals to comply with a statute passed three years ago to creating an independent apparatus focused on accountability and program efficacy.
“Legislative Republicans and Democrats bristled at excuses Department of Health and Human Services officials gave Tuesday over their failure to create a mandated watchdog program.
“Do you understand how frustrating this is for the members of the General Assembly? Three years now we have required the creation of an office,” Sen. Ralph Hise, R-Mitchell, said during a Joint Legislative Oversight Committee on Health and Human Services meeting.
The 2015 General Assembly passed a law creating the Office of Program Evaluation Reporting and Accountability. Lawmakers were concerned that while DHHS gets the second highest level of state funding after education, the agency provides scant information on cost or outcome measurements. The current $5.2 billion DHHS budget accounts for 23 percent of the state General fund.
The law required the DHHS secretary to appoint a director to oversee OPERA, an independent division that reported directly to the secretary. The director’s position remains open.
While the department issued an update on the OPERA mandate, Hise scoffed at the department’s lack of transparency.
“Once again we get another report that for all practical purposes the department has done nothing,” he said. “It looks to me as if there’s just certain evaluations the department doesn’t want done.”
OPERA’s duties include evaluating DHHS programs, listing all programs and publishing the list on a department website; developing an inventory of all contracts, department data, and records; and conducting announced and unannounced inspections of all DHHS facilities — including interviews with employees.
“A statute is not a suggestion,” said committee co-chairman Rep. Josh Dobson, R-McDowell.
“Nobody wants to be accountable, and numbers and data hold you accountable,” said Sen. Tommy Tucker, R-Union.”
“A lot of times we’re doing things over, and over, and over, but the outcomes are not changing because we’re not evaluating and having the accountability,” said Rep. Carla Cunningham, D-Mecklenburg. She said the independent OPERA program is necessary.”
When it comes to Big Government, it doesn’t get much worse than government run healthcare programs. They rarely, if ever, accomplish the ends set out for them, and spend exhorbitant amounts of money while failing to reach goals year after year. They are massive redistribution programs, and, combined with federal spending matches, are by far the biggest source of government spending in the Old North State.
Is there any question why they are dragging their feet? How would it look when program evaluations proved just what a giant waste of taxpayer money many of these government-run healthcare endeavors are?
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These are entrenched interests that feed off of bigger budgets and the hubris of their ‘government healthcare savior’ roles.
On top of all this, the aforementioned lawmakers got updates on a centralized healthcare records system, in which the State collects and holds healthcare data on every North Carolina citizen with out even asking individuals for their consent.
In another matter, Christie Burris, director of the state Health Information Exchange Authority, updated lawmakers on the state’s NC HealthConnex program, which will put every North Carolinian’s health records on a centralized database.
Patients have legitimate concerns about their electronic health records being sent beyond their doctor’s office, and the risk they would be illegally accessed, said Rep. Greg Murphy, R-Pitt. He asked whether patients who don’t have insurance must sign waivers to release their health records.
Burris said North Carolina is an “opt-out state,” which means “every citizen is automatically opted in to the Health Information Exchange until they exercise their right to opt out.” She promised high security safeguard standards for the state and its vendors.
Rep. Nelson Dollar, R-Wake, was concerned whether government agencies would be able to access people’s health records, and Sen. Jeff Tarte, R-Mecklenburg, raised a red flag about the state automatically collecting that information.
“I don’t think most North Carolinians recognize … their most personal clinical and health information is now owned by the state of North Carolina,” Tarte said. “They have the option to opt out, but they never had the option to opt in, and that’s troublesome.”“
Excuse me? State government bureaucracies, which took years just to process claims and properly classify physicians within the NCTracks program after its botched roll out, are going to collect and safeguard your health records with out your consent?
To say this is troubling is an understatement. Big data is certainly useful in discovering and unlocking efficiencies, but it becomes dangerous when combined with Big Government. There is no good reason for the government attempting to manage the health of every North Carolinian via such programs – that is not their proper role, and never will be.
To Big Government Bureaucrats though, you aren’t really an individual with rights above and beyond their government authority; you’re just another brick in the wall, and they’ll stack you however they please.
Read more from Dan Way at Carolina Journal here.