Letter to the Editor: The Tar Heel State needs to stand up for its communities, especially rural North Carolina

Published 7:55 am Wednesday, December 26, 2018

Those who work in health care are in the business of taking care of people. It is an honor to provide that care and I’ve been fortunate to serve alongside dedicated colleagues throughout my career.

If you need care, health systems and hospitals across North Carolina are available to you — as are the providers, nurses and team members who comprise them. These professionals dedicate themselves to their communities, assuring access to care, where and when you need it.

Our health systems and hospitals are also transforming to meet important challenges facing health care — challenges which are most significant in rural markets.

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North Carolina has the second largest rural population in the United States with over three million people living in rural communities. Communities that also have lower incomes, lower job growth, higher poverty rates and higher health disparities with higher mortality than urban communities.

Vidant Health understands this all too well. We serve 1.4 million people in largely-rural eastern North Carolina, one of the most difficult health care markets in the country.

We stand to lose $40 million as a result of the State Treasurer’s proposal to decrease State Health Plan reimbursements to hospitals and providers. Given we are a not-for-profit organization that reinvests our profits back into the communities we serve, this will have a detrimental impact.

Health systems have a duty to care for every patient. As an elected official, the treasurer has a duty to serve every citizen of North Carolina. If his proposal is enacted, it will compromise our ability to provide essential services — and people who live in rural markets will be impacted most.

These are difficult issues requiring thoughtful solutions, which should be informed by the facts:

  • We don’t know if the treasurer’s plan will solve the state’s liabilities; we do know it will hurt rural communities.
  • The State Health Plan and Blue Cross Blue Shield of North Carolina (BCBSNC) have a long-standing relationship of more than 25 years.
  • Past performance audits show the State Health Plan issues are not new.
  • There has been no public disclosure of what has driven the liabilities for the State Health Plan, nor the fees paid over those 25 years to BCBSNC to administer it.
  • BCBSNC has a history of using market position to its own advantage and to the detriment of providers.
  • A recent American Medical Association study found North Carolinians are in one of the least competitive health insurance markets in the country.

Whether you serve — or are served — by North Carolina health systems and hospitals, I urge you to tell your elected officials these arbitrary cuts are not the right solution. Our representatives need to know you will not stand for changes that are in the best interest of a select few and hurt a majority of our state’s residents — especially those living in rural North Carolina.


Mike Waldrum, MD, MSc, MBA

Chief Executive Officer

Vidant Health