As the cost of health care and health insurance premiums continue to rise, North Carolina families and employers are struggling to pay the bills. There is much discussion about how to cover the rising cost. Most plans promote government subsidies, government sponsored universal care, insurance purchasing pools, etc.. These proposals all attempt to treat the symptoms, but not the real problem.

We need a comprehensive health plan for North Carolina that doesn't just try to identify ways to cover the costs, but rather ways to genuinely improve the health of North Carolinians and actually reduce the cost of health care.

It is a fundamental mistake to make the assumption that government should take charge and solve the problems of health care through continued expansion of programs such as Medicare and Medicaid. This is particularly true because it is a fact that government cannot currently identify the resources to pay these costs in coming years as an increasing segment of our population ages and retires.

I propose that we aggressively implement a three part plan to improve the health of North Carolinians while making health care more accessible and affordable:

1. We must create a new "Culture of Health" in North Carolina by promoting, educating, encouraging, and providing new incentives for our citizens to make decisions that lead to healthy lifestyles, preventative care, and effective chronic disease management. Achieving and maintaining good health for ourselves and our children must be an essential priority for our State and is worth our very best effort. Through these efforts we will not only improve our lives, but have a significant impact on health care costs. In my own businesses, I have achieved health care savings by promoting annual physicals and health risk assessments for my employees, identifying and treating small health problems before they become major health issues. Programs like the Asheville Project demonstrate the cost savings that can be achieved through the promotion of preventative care, improved lifestyles, and better management of chronic diseases like diabetes and asthma.
2. We must embrace a consumer driven health care system which provides greater incentives for patients to be more prudent in making their health choices. I say "health choices" because this relates not only to health care services, but also healthy lives. For example, greater promotion and utilization of Health Savings Accounts (HSA's) and higher deductible insurance plans provides new opportunities for personal savings and increased incentive for leading healthy lives. We will obviously continue to support safety net coverage for our low-income population, but we must explore opportunities to create incentives for all segments of our population, including Medicare and Medicaid consumers, to choose wisely and effectively when making health choices. We should encourage more employers to participate in health care insurance and other health initiatives and can do so through tax credits and other incentives.
3. We must work to make our health care system as effective and efficient as possible. Current dollars expended in health care are not commensurate with the results achieved because so many dollars are spent on activities that have no impact on our health. This goal may be accomplished by:

• Eliminating unnecessary and costly rules and regulations that result in the expenditure of our health care dollars on activities that add absolutely no value to our health care.One hour of Emergency Department care should not equal one hour of follow-up paperwork.
• Promoting and incentivizing the use of technology to record and share important health information among care providers. The ability of care providers to access a patient's complete health information will not only create new efficiencies in our health care system, but have a positive impact on the overall quality of care. Electronic health records and health information exchange can avoid costs and medical errors by making all care providers aware of diagnostic tests, treatments, and drugs prescribed by other physicians and care givers. We can avoid duplication, over-utilization, and improper prescribing of drugs and other health services.
• Promoting greater transparency in health care treatment and charges. Patients must understand "what, why, and how much" to have greater controls over their health choices.
• Promoting and incentivizing the use of primary care physicians rather than Emergency Departments for minor health problems.
• Reforming medical liability laws as appropriate to help eliminate unnecessary diagnostic testing and treatment that may be ordered solely for the purpose of defending the physician or caregiver from potential legal liability.