State treasurer aims to combat health care costs


N.C. State Treasurer Dale Folwell speaks at the Nash County Republican Convention Thursday at Nash Community College in Nashville.


Staff Writer

Sunday, March 18, 2018

N.C. State Treasurer Dale Folwell stopped by the Telegram office on Thursday to talk about the state’s financial position, the growing cost of health care and what he plans to do to improve the state’s bottom line.

Since Folwell was elected in 2016, he has taken his responsibilities as the “keeper of the public purse” quite seriously, executing a laser-like focus on reducing budgetary shortfalls in the state’s pension and health care plans and plugging drains in the state’s finances.

“It’s not enough to know there is a problem — somebody, at the end of the day, has to fix it,” he said. “I think I am good at this. I enjoy it and it is important to me.”

Folwell said his office writes a check every month to one out of every 10 adults in North Carolina either as an employee or a retiree and so carries both a heavy weight of responsibility and a lot of clout when it comes to influencing financial dealings. He uses this power to help save the people of North Carolina money, he said, as in the case of the $73 million in fees for the state’s retirement plan he saved in the past year alone.

And he used this power when he demanded a billion-dollar surety bond to protect the state from potential rising health care costs if the proposed merger between Atrium and UNC Health Care had taken place this month. That merger is no longer happening.

Folwell’s work with the state pension plan has now made it one of the top five in the country, according to a new report from S&P Global.

However, North Carolina also has one of the five worst funded health care accounts for state employees — including teachers — in the country. As of now, the plan has a $35 billion hole in it, the result of decades of heath care promises made without funding set aside to pay for them. This is a situation that Folwell said he is seeking to rectify through increased funding efforts, decreased expectations on the part of new employees, greater transparency in health care costs and eventually, medical tourism.

One of the issues Folwell said he is working on is better education about the health care plan and greater transparency regarding costs. He said many state employees think that Blue Cross Blue Shield is the state’s health care insurer, when they are actually the third-party administrators of the state’s plan. So Folwell had new insurance cards designed that read “Your state health plan, paid for by you and taxpayers like you.”

“I want our employees to remember who is really paying for health care,” Folwell said.

Folwell said he is working to achieve greater transparency in health care costs so that consumers can make better-informed decisions that will save money for themselves — and the state — in the long run. For instance, Folwell said he knows of some surgical procedures that vary in cost by more than $50,000, depending on which medical facility is used — but patients don’t have any way of comparing costs now.

Increased transparency can eventually draw medical tourism to areas of the state that offer better health care value, he said. And the increased competition for these services should help drive health care costs down, he added

“We have the population and the health care centers to make this work,” Fowell said. “Consumers want to make medical decisions based on quality, affordability and accessibility. We simply want to put that power in the hands of the people.”

Folwell said these issues are not just important to state employees, but to all North Carolinians because they affect the state’s ability to pay for other services.

“This is a very serious matter,” he said. “This health plan is insolvent. Bill Gates and Warren Buffet seven years ago said the single biggest threat to public education over the next two decades is how states account and pay for the unfunded pension and health care liabilities. This is already happening in other states. If we don’t fix this, it’s going to suck all the money out of the state budget for the next 20 years.”