Joseph D. Coletti
Joseph Coletti is Fiscal Policy Analyst at the John Locke Foundation, an independent public policy organization in Raleigh, North Carolina. He has served as editor of newsletters and briefing books on the Japanese economy and U.S.-Japan relations. Coletti led marketing research and forecasting projects with J.D. Power and Associates in Detroit and Tokyo. He also served as Director of Policy and Communications for the U.S. – Japan Business Council in Washington, D.C., before joining the Locke Foundation. Coletti received a bachelor’s degree from the University of Michigan and a master’s degree from the Johns Hopkins University Paul H. Nitze School of Advanced International Studies.
Friday, May 9, 2008More CON jobsKeeping supply away from demand By Joseph D. ColettiCategories: Certificates of Need (CON), North CarolinaState officials in North Carolina rejected applications for certificates of need (CONs) this week from two regional hospitals to build satellite facilities in rapidly growing areas in Wake County (around Raleigh & Cary). The regulators doubted the demand projections from the hospitals. So people in these areas will continue traveling 20 minutes or more one-way to reach urgent care facilities. H/T - Jon Sanders
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Tuesday, March 18, 2008What if My Wife Suggests I Whiten my Teeth?NC lets mall kiosks survive to brighten another day By Joseph D. ColettiCategories: North Carolina, Retail ClinicsYou may have seen the teeth whitening kiosks in the mall. You may have even used them. The North Carolina Dental Society raised questions about their safety and the state board of dental examiners wondered whether workers at these kiosks were practicing dentistry. The verdict for now: the state board will handle things on a case-by-case basis.
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Friday, March 7, 2008Mental Health ProblemsBy Joseph D. ColettiCategories: Medicaid, North CarolinaThe Raleigh News & Observer last week ran a five-part series on the state's six-year attempt to reform mental health care. Lefties wanted to pin the blame on "privatization," but the articles more clearly demonstrate problems in the state-run hospitals and Medicaid payment for services. Reaction to the series has focused on spending state funds more wisely and insisting on local accountability.
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Friday, March 7, 2008UNC Health Care to Charge UpfrontBy Joseph D. ColettiCategories: North Carolina"UNC Health Care's data suggest that it must collect most patient fees upfront if it is to collect them at all," according to a story in the Raleigh News & Observer. This is the health system connected to the University of North Carolina. UNC Health Care's CEO, William L. Roper, joined in 2004 with the goal of making the system profitable (it receives five percent of its operating budget from the state). The system drew criticism the last time it tried to collect upfront payments. UNC Hospitals stopped its practice of placing liens on homes to collect debts that year after a well publicized case. The legislative session doesn't start until mid-May and the presidential circus will be in town before then. We'll see what happens.
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Thursday, February 21, 2008Rationing CareBy Joseph D. ColettiCategories: Medicaid, North CarolinaDid a local mental health agency in southeastern North Carolina authorize more care than its clients needed? Did a lot of new people sign up? Or is essential care much more expensive this year? The agency is still trying to answer these questions. In the meantime, the Southeastern Center for Mental Health may ration care for its clients seeking mental health, substance abuse, or developmental disability services paid with state money. Southeastern got $7 million in state money for fiscal year 2007, but spent just $4.6 million. For the current fiscal year, which runs through June, the legislature allocated that same $4.6 million plus some extra money for a crisis center. Providers apparently operate on a calendar-year basis and sent a "rush of reimbursement bills" in December. North Carolina is in its seventh year of reforming its mental health system with, at best, mixed results.
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Monday, February 11, 2008Debating health careCandidates reflect partisan differences in NC By Joseph D. ColettiCategories: North CarolinaThe six major candidates for governor in North Carolina (two Democrats and four Republicans) took part in two separate debates on health care last Thursday. Surprisingly for all the talk that conservatives don't do health care, there was at least a rhetorical distinction between the Republican and the Democratic debates with some recognition of a role for consumers and prices. All six would-be governors emphasized the need for personal responsibility, but the two Democrats put their focus on covering children as a first step to universal health insurance -- small victory here, Lt. Gov. Bev Perdue stopped herself before she called it universal health care, possibly meaning a recognition that coverage is not care. Two Republican candidates talked of a need to get universal coverage with cooperation between the private sector and public sector, but even Bill Graham, who wants a "community-rated" connector in a state that does not have community rating, referred to his plan as consumer-driven health care. Charlotte Mayor Pat McCrory exemplified the problem of viewing everything through the lens of illegal immigration in his constant return to the topic as a cause of high costs. Overall, the debates presented plenty to worry about in specific plan details, but a reason to be optimistic about the overall direction of the health care policy debate.
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Wednesday, February 6, 2008Not Necessarily Medicaid reliefNC Counties not getting promised help By Joseph D. ColettiCategories: Medicaid, North CarolinaFrom the start, North Carolina required counties to pay 15% of the non-federal share of Medicaid. As state and federal expansions of the program became more onerous, counties sought relief from the growing part of their budgets over which they had no control. They thought they got this relief from the legislature in 2007, but some counties say they are facing higher Medicaid cost than projected and will get less relief than promised.
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Monday, February 4, 2008So much for Mississippi FootballBill would ban restaurant sales to the obese By Joseph D. ColettiCategories: Mississippi A Republican state representative in Mississippi, apparently trying to take the Mike Huckabee approach to national office, wants to stop restaurants selling food to nearly one-third of adults in the state. Mississippi has the highest rate of obesity in the country (31.4 percent) and Rep. W. T. Mayhall, Jr.'s, bill would ban restaurant food sales to the obese.
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Monday, January 28, 2008Prices Online from the NC BluesBy Joseph D. ColettiCategories: North CarolinaNow that Blue Cross Blue Shield of North Carolina (BCBSNC) customers have had a year to get used to HSAs, the insurer has begun providing - online to its members - average prices for typical procedures, chronic disease treatments, medications, and other items. Although it does not show prices for each individual provider, the online tool does show how costs differ as a person goes from their physician's office, outpatient facilities, or hospital inpatient. Other insurers have also begun offering more information as HSAs have become more common. Seems that as people start paying for medicine, they start paying attention to prices. Who knew?
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Thursday, January 24, 2008LTC in NCBy Joseph D. ColettiCategories: Medicaid, North CarolinaIn a new report for the John Locke Foundation, Steve Moses of the Center for Long Term Care (LTC) Reform highlights some of the positive steps North Carolina has taken to address the burden of long-term care on Medicaid in the state. These include a tax credit for purchases of LTC insurance, emphasis on home and community-based care, and estate recovery laws that appear robust. But the state should use the tools it has available to limit Medicaid payment for care to the indigent and encourage individuals to tap their home equity and other sources of private payment.
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