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A little-known law, the Set Off Debt Collection Act, allows state and local agencies to collect debts by seizing state tax returns and lottery winnings. The law has been good to UNC Health Care. Last year, UNC Hospitals collected $5.7 million, while UNC Physicians and Associates collected $2 million. Read more here.

More political headlines:

--Departing from this uber-optimism from the campaign trail, Pat McCrory gave a sobering assessment of the economy and the challenges ahead.

A late-in-the-session bill that would change the makeup of the UNC Health Care Board of Directors was expected to zip through the House Rules Committee on Tuesday evening until Democrats blocked it.

Democrats complained they hadn't been given time to read a proposed change in the bill. "Is the three minutes we're giving to it today supposed to be all the attention it gets?" Minority Leader Joe Hackney, an Orange County Democrat, asked House Rules Committee Chairman Rep. Tim Moore, a Cleveland County Republican.

Pat McCrory and Walter Dalton offered sharply different visions of North Carolina on Tuesday, with McCrory portraying the state as staggering through a period of decline and Dalton saying the state was on the rebound.

As for the negative ad war, McCrory called the Democratic Governors Association ad “a total lie,” “garbage’’ and “a personal insult.’’ Dalton said: “It’s a third party ad,” Dalton said. “I think it raises interesting questions.’’ He said he watched two TV news stations do reports on the accuracy of ad, and he said “it looks like it checks out by facts pretty well.’’ Read more here.

More political headlines:

--The Democratic National Convention named their party lineup Tuesday. North Carolina's throw-down will take place at the NASCAR Hall of Fame. (See photos of the venues here.) Democrats this year pride themselves on the fact that – for the first time ever – not a dime in corporate cash will help pay for their party convention in Charlotte. But all the parties welcoming delegates and journalists to town? That’s a different story – and a different pot of money.

Top Republican lawmakers will hold a press conference Tuesday afternoon to announce a breakthrough in the impasse between two of the Raleigh area's top hospitals. (UPDATE: Read the story on the annoucement here.)

Last week, Dome attended a meeting of a legislative committee that was looking at whether UNC Health Care should own Rex Hospital – a partnership opposed by WakeMed, the private nonprofit that made a hostile takeover offer for Rex.

One highlight was when Democrat Rep. Michael Wray told UNC Health Care CEO Bill Roper that they get The N&O in Northampton County and he reads it "pretty regular." He went on to question Roper about a news story in which Roper said the alternative to taking over WakeMed would be "grinding them into the dirt."
In his response to Wray, Roper denied having said that and went on to say, "Let’s go subpoena the writer who wrote that article." (See the video above.)

UPDATED: A Republican state lawmaker is considering legislation to reconfigure the leadership at the UNC Health Care as the legislature continues exploring whether the hospital system gets an unfair advantage against private entities.

Asheville Rep. Tim Moffitt, a management consultant, suggested at a legislative meeting Thursday that the 20-member board of health care system is too stacked in UNC's favor and doesn't allow for divergent viewpoints. He is planning to ask legislative staff to draft legislation that would curtail the board to a dozen members, the bulk of which are selected by the UNC System's Board of Governors instead of the health care entity.

A day after WakeMed CEO Bill Atkinson delivered a stinging indictment of UNC Health Care and Rex to legislators, leaders of UNC Health Care are meeting with legislators to try and temper Atkinson's complaints.

Among the areas they will be disputing is the benefit of UNC residents at WakeMed, the need for additional heart services in the county and the value of Rex to UNC's teaching and training mission.

WakeMed and Rex Hospital, and its owner UNC Health Care, have been in a public battle for more than a year. WakeMed issued a bid to buy Rex for $750 million last may, an offer that UNC officials turned down.

In November, the groups settled into private talks to try to find common ground; those talks continue.

But, Monday, those tensions erupted again as Atkinson addressed a legislative committee charged with determining whether the state ought to sell Rex Hospital.

The stakes are high in this debate. Even if the hospital leaders decide to put their differences aside, the legislature could force changes to the operation of UNC Health Care and Rex, which WakeMed contends had created an unlevel playing field in Wake County.

One legislator suggested Monday that legislators limit the growth of UNC Health Care.

Staff writer Mandy Locke
 

This spring, Tom Fetzer navigated the halls of the legislature, just as he had many times before. Fetzer, a Republican who had previously served on WakeMed's board, was in a strong position. He was former state Republican Party chairman, and his guys were now in power. WakeMed had hired him as a lobbyist to help make the case that Rex ought to be sold.

He started with a simple sales pitch: Wouldn't you like to help close this $3 billion budget shortfall by selling off a $750 million asset that the state shouldn't own? The question the new legislators asked in response was a tougher one to answer, Fetzer said. How did UNC Health Care end up with this hospital, anyway?

The timing was fortuitous for WakeMed. The Republicans who took control of the House and Senate in 2010 cherished private enterprise and despised clunky government. The Democrats who had offered assistance when UNC asked, senators Tony Rand and Marc Basnight, were no longer around.

Soon, Republican legislators were asking questions that UNC had rarely faced. Roper, a conservative Republican himself, was taken aback by the chill in the legislature. "It is really the legislature's role that has raised the stakes," he said.

Read more about WakeMed's lobbying effort on Jones Street and find the entire four-part series on Wake County's hospital war here.

The UNC Health Care System made a plea to lawmakers Thursday asking them not to sell Rex Healthcare after WakeMed's unsolicited $750 million bid earlier this year.

A legislative panel looking to identify and sell surplus state assets considered the contentious issue but took no action.

In his presentation, Dr. Bill Roper, the CEO of UNC Health Care, listed all the reasons why a UNC committee rejected WakeMed's takeover bid, suggesting that Rex is critical to its mission.

Rep. Bill Brawley asked Roper if UNC needed to own a hospital in order to train future doctors.

"We don’t have to own a hospital," Roper responded. "There are some medical schools that don’t. Those med schools that don’t own a hospital are in much worse shape than we are."

Roper did make it clear that selling Rex could cost the state more money in the long run. The system gets $18 million in state appropriations in the current budget. "I can promise you … if God forbid you force us to sell Rex we would definitely be back here next year asking for a whole lot more money from the state," he said.

WakeMed did not get a chance to present its case to the committee. "WakeMed is not a government property," committee Chairman Harold Brubaker explained afterward.

Dr. Bill Roper, UNC Health Care CEO, told the UNC Board of Governors this week why he thinks selling Rex is a bad idea.

Roper briefed the UNC system's governing board about the mission, operations and future of a health care system founded in 1879 as a medical school and now a growing statewide health care network. Medical school training has expanded to Asheville and Charlotte, and of course, the system owns Rex Healthcare facilities in Wake County.

That has been the focus of hot debate since May, when WakeMed made a $750 million hostile bid to buy Rex, its Wake County rival.

Roper said "dismembering" UNC Health Care by carving out Rex would hurt the whole system. "This whole enterprise, this integration, is at risk if we start pulling the parts away," he said.

"The sale of Rex would jeopardize our ability to carry out our mission for those folks who have nowhere else to go," Roper added, referring to indigent patients.

Roper also briefed the board about the system's expansion, including a planned 68-bed hospital in Hillsborough.

A few board members asked Roper about the wisdom of such growth. Roper said the industry is experiencing consolidation; he predicted that in a few years there would be a handful of large health care organizations providing most of the care in the state.

"I want us to be one," he said.