North Carolina Now; North Carolina Now Episode from 10/04/1996

Iraq October fourth tonight. The side effects of health care and politics in North Carolina now. Good evening and thanks for joining us as we wrap up another week of North Carolina now. I'm Robyn Minnie at the informal read in the tray. Tonight we'll talk to Joe Robinson a soloist with the New York Philharmonic and native Tarheel about playing with the North Carolina Symphony. Also the first

presidential debate is just days away. A bit later in the show I'll explore why these debates are such a critical part of the election process. But first this evening we have the fourth in a series of your voice your vote reports leading up to the November 5th election. Our media consortium has polled North Carolinians across the state to find out how they feel about various pressing issues among them health care the cost of health care tops the list of concerns among our respondents. And tonight Bob Garner takes a look at a pilot project in one North Carolina county aimed at reducing the cost of Medicaid Services. The Carolina Panthers are no doubt the most popular and successful new NFL franchise in history. But there's another less visible venture underway in Charlotte Mecklenburg County that has the potential to have a much greater impact on people's lives. The aim is to put all of Mecklenburg county's Medicaid recipients into managed care under an HMO or health maintenance organization. It's a cost reduction measure reflecting a

primary concern in our state. Be Your Voice Your Vote poll of North Carolinians this summer tells us that 51 percent of Tarheel surveyed said cost is their number one health care concern and 44 percent of respondents said cost is the number one area in which government should be involved in health care. Medicaid is one of the main areas in which some candidates say government can help reduce health care costs. From that standpoint both of the main gubernatorial candidates favor the experiment. Governor Jim Hunt. We're going to put about 33000 Medicaid patients in managed care and hopefully that will free up some money that we can then use to help lower income people get care. Republican candidate Robin Hayes also mentioned secondary benefits. This has significant potential savings for government. But it also has a much bigger element in that we're involving recipients of Medicaid in preventive medicine. The effort to get away from very expensive emergency room

care have an ongoing relationship with a primary care doctor. Here's how it works. Federal state and county funds are used to make a single payment for each Medicaid client each month whether or not they receive services. The payments range from 40 to $100 depending on age and medical situation. The insurance companies operating the HMO does use that money to pay providers for all health care services for that patient and to cover administrative costs. Any leftover funds are profit the recipients choose from among several HMO knows and can usually choose a primary care provider who is the access point for all health services. The Carolina's healthcare system is a medical conglomerate that is deeply involved in the experiment. It operates to HMO Zend several health care providers such as Carolinas Medical Center in Charlotte alone. Vice president Russell gerund says Medicaid recipients get their own HMO card which hopefully provides better access because of very low reimbursements.

Not a lot of physicians especially primary care who are already so busy. We're seeing a lot of Medicaid patients. And so they the state hopes that maybe more is ations want to see Medicaid patients because they'll be part of plans that have private private members as well as in all managed care systems. There is a major emphasis on prevention. I think market forces which drives this country. Are joining with the health care establishment. Certain elements of the health care establishment to really put some form into prevention. Healthy Lifestyles the right way to raise kids the right way to care for kids that they don't get sick. That includes free programs on things like weight control newborn education and smoking cessation. But there are concerns one general question about HMO is and managed care is with the emphasis on controlling cost in order to make a

profit. Do most provide all the care a patient needs and care and maintains HMO networks are very comprehensive in their approach to Medicaid. So this would cover transplants neonatal. This would cover really any any kind of health care need there ass. This HMO managed care model for Medicaid patients probably won't the employer met it in every area of North Carolina because there aren't enough HMO is in certain areas. But there's another form of Medicaid managed care that's been under way for several years. It's called Carolina access and it's working in 43 counties. There are no HMO those involved health care providers are recruited to provide not only primary care but to coordinate all care for Medicaid recipients. Providers are paid by the state for services rendered according to the Medicaid schedule and are also paid $3 a month per assigned patient for their administrative work. Medicaid clients are required to choose a primary

care physicians from among those we contracted with. Once they did they must receive all of their services from that position or have it authorized by their physician and or we don't pay for the service. The so-called gatekeeper model used in Carolina access is mainly concerned with saving money since primary care providers may authorize new treatment almost anywhere but as the name implies it does aim to open the door to the service of specialists. The primary care physician is responsible for making the referrals appropriate to a specialist a specialist who might not open their doors to Medicaid clients may very well take a referral from a colleague. This is my patient my medicaid patient even though I might not want to take all Medicaid patients. I'll take them from this colleague where I also get commercial referrals in private pay referrals. The Carolina access gatekeeper model is mandated to be expanded state wide and will eventually co-exist with the HMO managed care option in several counties. The bottom line for both of course is saving taxpayers money improving preventive care

and giving Medicaid patients more health care security. If you'd like to get more detail on health care as an issue in the 96 campaign be sure to look for the special your voice your vote coverage in this Sunday's edition of one of our partner newspapers. Coming up a bit later presidential debates and the role they play. But first Michel Louis joins us from the news desk with a look at the latest from around the state Mitch. Thanks Robin. Good evening everyone. Topping our news for the fifth time in 11 years North Carolina Insurance Commissioner Jim Long is rolling back automobile insurance rates and an announcement today Commissioner long ordered insurers to reduce rates by eight point three percent. Automobile Insurance companies had requested a rate increase. Long says the facts don't support having a rate hike. But insurers can appeal the decision according to the latest data. North Carolina ranks the sixth lowest in auto insurance premiums. Republican

gubernatorial candidate Robin Hayes is offering his own version of a welfare program. Hayes contends incumbent governor Jim Hunt's welfare plan isn't good enough. State Representative Hayes says his program focuses on limiting cash payments to welfare recipients and making them buying jobs within 90 days of getting benefits. The hunter program currently in effect requires parents of school age children to find employment or enroll in education programs. A number of school systems in North Carolina have united to receive federal money for classroom computers and access to the Internet. The school systems represent the five counties of Guilford Wilkes Surrey Stokes and person. The challenge grant for technology and education amounts to 4.9 million dollars. The funds will be used to buy about 700 computers to service about 35 of the poorest schools in the five counties. The bulk of the grant will be spent in the county with the largest school system Guilford County the state's newest and largest prison processing center is now open. The Craven Correctional Institution is a

seven hundred twelve cell facility located in eastern North Carolina. The function of the institution is to test evaluate interview and screen and mates for prison job assignments and jail programs. The institution was built at a cost of more than 24 million dollars and replaces processing at Hoke and Southern correctional institutions. Craven is expected to be running at full capacity by next spring. Attorney General Janet Reno was in Charlotte this morning to celebrate the 50th anniversary of USC Charlotte Charlotte. I wondered how they ever am column because of the tension given teachers. Because of this it's now cross country around the world. It is people's future and the sense of some 2000 alumni and guests were on hand today for the anniversary convocation. Among them members of the first class of 1946 and the school's founder Bonnie Cohn Charlotte College was founded in response to the

G.I. bill in 1946 and joined the U.N. system in 1964. Now for a look at Saturday's Weekend weather. Cooler temperatures a forecast for the entire state tomorrow. The majority of the state will reach about 65 degrees for a high. Wilmington could see 70. And the mountains won't get beyond the high 50s partly to mostly sunny conditions should make for a beautiful weekend day. In today's business news North Carolina Agricultural watchers say alternating hot and cold weather this year will take a bite out of the state's apple harvest. The North Carolina apple crop is projected to yield about 4.3 million bushels this season about one third less than last year. The price of grocery store apples is not expected to reflect the shortage. Most of the state's apple crop is sold to juice and sauce producers and most of the supermarket apples in North Carolina come from Washington State and California where they're seeing a bumper crop this year. And now for a look at what happened on Wall Street today.

Tomorrow night you and CTV will rebroadcast the opening night of the North Carolina symphonies 1996 97 season. The concert was originally

broadcast September 7th but because of the power outages caused by Hurricane Fran many of you didn't get to see the show. Joe Robinson an oboist with the New York Philharmonic and native of Lenore is featured as a principal soloist. Earlier I spoke with him about coming home to perform. What is it like playing in front of a hometown audience that's very and has been anyway very reassuring and a lot of fun. I mean I play for so many audiences that are strange to me all over the world we just come back from a three week tour in Europe and so it's not only it's a luxury but a kind of a special feeling of the affection that I you know enjoy when I'm back here whether it's a chamber music concert or the con I'll be playing in Davidson in April or a recital of the Congo play in Lenore in February.

I want to ask you about your beginnings because you come from a very small rural community and Lenore and your first step beginnings in music started with the high school band. What was it about that experience that made you want to move into music as a career. Lenore I think people there would say it's not so rural as all that and the band was one of the remarkable music education programs in the country if not the world. I mean it was started is the first high school band in North Carolina by a wealthy man whose family had been involved in furniture manufacturing there and there was a conservatory really was the first school of the arts in North Carolina. I mean when I started I had. An instrument as good as the one I play now handed to me free. All of the instruments were just given to kids there and there were 92 people in my graduating class in high school and in from the if you stretch and take one year from my era. Anyway in the north in the in our high school band

we produced the tuba player of the Minnesota Orchestra the first bassoon of the Dallas Symphony the composer in residence of the St. Louis Symphony and a freelance flutist who's playing in New York in addition to myself. So it proved you know that there's a musical talent everywhere and it just you know takes a program like Lenore's to make it manifest and I tell people who wonder about my sort of strange. It's a quasi rural gettings that I have one of the most privileged starts as a young musician that I know about and it's not really we're all remarkable in the whole of it. I kind of never outgrew the high school band again. Well I certainly didn't mean to demote the community of like no I don't like it Roland it's just all about everybody spanked Yeah right. Let's talk about then you because I did have a chance to look at your resume a little bit and then from the high school band a lot of people go

into then they focus on the musical training that you took a little different route in the fact that you went to Davidson College and studied economics and with an english. Was it at that point that you still really didn't know what you wanted to do or why did you decide to go the academic route. Well my parents had a kind of mountaineer common sense a concern about the profession. I didn't share it totally when I was 17 and you know crazy about music but I certainly appreciate it more now that I realize it's very chancy kind of way to make a living. And it's probably akin to professional baseball is that they're really it's a pyramid that's very big at the bottom and small at the top then. So I really just you know decided to hit my musical bets and. I don't feel that I was handicapped

by my liberal arts training at Davidson In fact just to the contrary and I just had an article published in the Wilson Quarterly last year about the fact that Davidson College opened the door for me to the best OBO teacher in the world a man who had retired and was living in France when I found him on a Fulbright there after I was at Davidson and later on I wrote a letter that helped me win my audition at the New York Philharmonic and that is it tonight this response was Well it could not have been more fortuitous or persuasive. So I think in the moment of you know my greatest sort of professional testing it was my English major that. Save the Day. Tell me about some of the pieces that you will be performing. I'm playing the Vaughan Williams Oboe Concerto which I think is one of the two best romantic concertos written for the instrument. The others regard Strauss But Vaughan Williams wrote the piece in 1045. He was

a Festivus student of folk melodies and folk songs in the British tradition. And so this music is has some very enduring Danny Boy themes and frankly I feel because of the Scots-Irish. You know my genes in me and I have influence in this community here that it was appropriate. I've feel a particular affinity for them for that piece and I think that well I hope the audience will like the kind of horn Pyatt pipe dances and it's a beautiful wistful melodies that remind me of the Scottish Highlands I just visited. The other is a piece by an American composer Tyson street who has been living and working and teaching in Boston and it's a piece I played in The New York Philharmonic in 1903 called Adagio in the flat for oboe and strings. I think it's remarkable that an American who is alive today would

write a piece that sounds like good stuff Mahler or Wagner but not because it's strictly imitative but because it involves the same sort of musical language. And in a very dramatic way. So I get to explore the song full and dramatic potential of the instrument throughout a wide range. And I think too that that piece is very accessible you know and nobody then suppose and not many people who would have heard unfortunately of Dyson straight more after this I hope but it's so it's a wonderful piece and I think people in the orchestra really enjoyed it today. I'm sure everyone in North Carolina is looking forward to the performances. Thank you very much for having me. You can see Joe Robinson's performance with the North Carolina Symphony right here on UN see TV tomorrow night at 8:00 this Sunday Bill Clinton and Bob Dole will face off in the first of three presidential and vice presidential debates.

Let's take a look at this a very American tradition decision it might be well if you would ask yourself Are you better off than you were four years ago. There are some moments in presidential debates that make history. Who can forget Ronald Reagan chiding Jimmy Carter. There you go again or Lloyd Benson scathing comment to Dan Quayle. I served with Jack Kennedy I knew Jack Kennedy Jack Kennedy was a friend of mine. Senator you're no Jack Kennedy or George Bush's confusion over citizens question about the economy. You know I'm not sure I get it help me with the question and I've got the answer. What is it that lodges these moments so deeply in our collective conscience and makes the presidential debates so important to Americans. Well that's the one time that our whole country 250 million people in their own homes can join together to see and hear the candidates. That isn't possible any other way the ancient Greeks thought you couldn't have a democracy

with more than 30000 people. And they picked that number because that was the number who could assemble on the hills in Athens and here one speaker. We can't do that in our big country except through radio and television. And that's why the debates are so important there are uniting force. If anyone knows debates it's Newton Minow novel the first opening statement by his father the minnow has been instrumental in organizing every televised presidential debate since the first one in one thousand sixty election when John F. Kennedy and Richard Nixon squared off in front of approximately 70 million American viewers what President Kennedy told me after he was elected that he didn't believe he would have been elected without the debates. That's how important he thought that they were. That same debate was covered by hell Bruno. Now political director for ABC News. Bruno was assigned backstage where he heard but didn't see the debate.

It was my impression that Nixon not necessarily had one but he had done quite well for himself. But television viewers judged JFK to be the clear winner. Bruno in the country learned an important lesson. Appearances count. And in that Nixon had simply been outmaneuvered. He had gotten tricked into not wearing makeup when he came into the debate. They asked him if he wanted makeup and he looked at Jack Kennedy and Jack Kennedy wasn't wearing make up. So Nixon trying to be just as good as Kennedy said well he didn't want makeup either. Then about three minutes before they went on Kennedy put makeup on. So Kennedy came on with makeup and Nixon who had been sick came up with. Doubt it today you won't find presidential candidates making that mistake. Candidates and their handlers leave nothing to chance. Everything from the seating arrangements to the stage decorations to the choice of moderators is fought over.

Good evening from Atlanta and welcome to the vice presidential debate sponsored by the nonpartizan commission on presidential debates. So what happens when an un coached candidate slips by the handlers. And I know how governments how American governments can be. Admiral James Stockdale Ross Perot's running mate in 1992 had not been trained for television was his visible discomfort with the medium torpedoed his message. Who am I. Why am I here. To him. How Bruno moderated the debate. It was his intent to frame his answer and I understood that completely. And the reaction to it of course from the public in the media was that it was some comical thing and it wasn't at all it was a very thoughtful man reflecting on what this was all about.

Compare that to this guy Jim Baker. You talk about trickle down economics. You thought it was the worst economy in 50 years you have you know details you know use my displeasure with your friends how do you know it's obvious that I want to go back to make a point. So was this a debate out of control or a chance for viewers to judge the character of the candidates in today's less structured debates the format is crucial. I was intrigued by the debate that my colleague Carol Simpson moderated which was a combination of the single moderator Plus the citizens asking questions and that night the most poignant question of all the hardest hitting have to come from the citizen. We have a question right here. Yes. How has the national debt personally affected each of your lives. And if it has it how can you honestly find a cure for the economic problems of the common people. If you have no experience in what's ailing them.

Newton Minow was also won over by the role of the citizens. I think the journalists very often are playing inside baseball they're getting into things that are of interest only to have the Washington journalistic community. I think the citizens are reflecting what's really on people's minds and I think that's a good thing. That format proved to be popular with viewers but unnerving for politicians who can't predict citizens questions as easily as they can reporters. This year during the primaries candidates left empty seats at forums where they were slated to go face to face with the public. Here's a CBS new poll report 76 still despite all the problems that viewers and voters over the last few decades have had an unparalleled chance to watch the presidential candidates appear side by side and spell out their vision for America. Very often when I've been at the debates everybody's interviewing everybody

else after the debate. And I'm always asked one question. Who won the debate. And I say the same thing every time. And that is the American people won the debate. You can watch the upcoming presidential debate right here and you can see TV this Sunday evening at 9:00 p.m. That's all we have time for for this evening we hope you'll make plans to join us Monday. Have a great weekend. Good night.