EP249: The War on Financial Toxicity in North Carolina, With Dale Folwell, North Carolina State Treasurer

The North Carolina State Employees Health Plan (SEHP) crafted a proposal called the Clear Pricing Project. The Clear Pricing Project proposed to pay network hospitals based on a transparent price schedule. Considering that SEHP purchases benefits for something like 720,000 people in North Carolina at a cost to taxpayers of billions of dollars, this seems reasonable. When you’re the fiduciary for thousands of dollars, let alone add six more zeros, it would seem to be non-negotiable to actually see the numbers and not write a check to a black box. Nonetheless, a few of North Carolina’s largest hospital chains disagreed. They want to bill whatever they want and to do so shrouded by a cloak of secrecy.

I don’t want to put words in anyone’s mouth, but it appears that the CFOs and CEOs of these hospital systems don’t believe that the treasurer of the state has a right to see what he’s spending taxpayer money on. And these CFOs and CEOs have expressed their position with a brutal onslaught of personal attacks against the North Carolina Treasurer’s office.

I feel like this episode needs a trigger warning. As David Contorno, also from North Carolina, has said on this podcast (EP186), the only way to pay less for health care is to pay less for health care. It’s hard to do that if you don’t know how much you’re paying. It just blows my mind when all across this country, financial toxicity is reducing health outcomes while nonprofit health systems—excluding some of the rural ones—are yanking in record profits, and employers and public entities are not messing around when they say that health care prices are an existential threat.

Let’s all get on the same side of this issue, please. Ultimately, it’s everyone’s responsibility to do the right thing right now. In this health care podcast, I am speaking with North Carolina State Treasurer Dale Folwell.

You can learn more at nctreasurer.com.  You can also connect with Treasurer Folwell on Twitter at @DaleFolwell or on Facebook at Dale Folwell.

Dale R. Folwell, CPA, was sworn in as State Treasurer of North Carolina in January 2017. As the keeper of the public purse, Treasurer Folwell is responsible for a $100 billion state pension fund that provides retirement benefits for more than 900,000 teachers, law enforcement officers, and other public workers.