Charles Stafford
53pc
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North Carolina’s Certificate of Need system is imperfect and should be modernized, but full repeal risks destabilizing rural hospitals and weakening essential community services. Health care is not a normal free market because hospitals must provide emergency care, indigent care, trauma services, and behavioral health regardless of profitability. Without safeguards, private competitors can selectively enter only lucrative service lines such as imaging and outpatient surgery while leaving full-service hospitals with uncompensated and high-cost care obligations. The result may be more duplication in wealthy areas, fewer essential services in rural communities, and ultimately higher long-term costs to taxpayers and patients alike. Responsible reform—not wholesale repeal—is the more balanced approach.
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Bill, thank you for a thoughtful and grounded perspective. You’re absolutely right—this will likely be a long fight given how entrenched the special interests are. The German model is an interesting and pragmatic path forward, especially with its requirement that public insurers operate as non-profits while still achieving near-universal coverage without excessive delays or heavy-handed government control.
That said, the urgency here can’t be overstated. The U.S. is spending roughly $5 trillion annually on healthcare—about twice per person compared to other developed nations—yet we still have around 28 million uninsured. That’s simply unsustainable.
The next administration must make healthcare reform a top priority.
At the same time, there are promising private-sector innovations worth building on. Efforts like Mark Cuban Cost Plus Drug Company and emerging direct primary care models show how transparency and competition can lower costs and improve access.
If we can combine smart public policy with responsible private innovation, we actually have a real chance to fix what is clearly a broken U.S. healthcare system. -
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I am committed to formalizing and mobilizing the unaffiliated party in Ashe County…..your organization, concepts, and structure can help make it happen. Please reach to me as schedule. Call or text if my spam filter catches your call. Tks.
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