CITED SOURCES

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2. Adrion, Emily, et al. “Out-of-Pocket Spending for Hospitalizations Among Non-Elderly Adults.” Journal of the American Medical Association Internal Medicine. (September 2016). Accessed December 2016.

3. Adrion, Emily, et al. “Out-of-Pocket Spending for Hospitalizations Among Non-Elderly Adults.” Journal of the American Medical Association Internal Medicine. (September 2016). Accessed December 2016.

4. “Quick Facts, Census Data.” Average monthly rent for North Carolinians was $920 in 2014. (2014). Accessed December 2016.

5. “BCBSNC Treatment Cost Estimator.” (2015). Accessed March 2016.
Information from BCBSNC treatment cost estimator tool (Search criteria: Knee replacement, 2000 miles from Raleigh): The cost of a knee replacement is listed at $12,029 under the Blue Value, Blue Options and Blue Advantage plans at Sampson Regional Medical Center, Clinton, NC. The same procedure is listed at $49,538 under the Blue Value, Blue Options and Blue Advantage plans at Betsy Johnson Regional Hospital, Dunn, NC.

6. “BCBSNC Treatment Cost Estimator.” (2015). Accessed March 2016.
Information from BCBSNC treatment cost estimator tool (Search criteria: Screening colonoscopy, 25 miles from Charlotte, NC): The cost of a colonoscopy is listed at $986 under the Blue Value, Blue Options and Blue Advantage plans at Charlotte Medical Clinic, Charlotte, NC. The same procedure is listed at $6,718 under the Blue Value, Blue Options and Blue Advantage plans at Carolinas Medical Center, Charlotte, NC.

7. Alexander, Ames, et al. “Prices soar as hospitals dominate cancer market.” The Charlotte Observer. (April 2015). Accessed May 2016.

8. Martin, Edward. “Bigger, if not better.” Business North Carolina. (March 2015). Accessed May 2016.

9. Alexander, Ames, et al. “Prices soar as hospitals dominate cancer market.” The Charlotte Observer. (April 22, 2015). Accessed May 2016.

10. Gooch, Kelly. “Medical Billing Errors Growing Says Medical Billing Advocates of America.” Becker’s Hospital Review. (April 12, 2016). Accessed August 2016.

11. “Medicare Compliance Review of University of North Carolina Hospitals for the period January 1, 2011 through September, 30 2012.” Department of Health and Human Services Office of Inspector General. (February 2015). Accessed August 2016.

12. Gooch, Kelly. “Medical Billing Errors Growing Says Medical Billing Advocates of America.” Becker’s Hospital Review. (April 12, 2016). Accessed August 2016.

13. Privet, Chris. “An Ounce of Prevention Is Worth a Pound of Health Care.” Blue Cross and Blue Shield of North Carolina Blog. (Feb. 3, 2015). Accessed June 2016.

14. “Heart Disease: Heart Disease Behavior.” Centers for Disease Control and Prevention. (August 2015). Accessed June 2016.

15. “Heart Disease: Heart Disease Behavior.” Centers for Disease Control and Prevention. (August 2015). Accessed June 2016.

16. “2015 NC Prevention Report Card: The State of Our Health and How We Can Get Better.” Prevention Partners. (2015). Accessed June 2016.

17. Andre, Claire, et al. “Voluntary Health Risks: Who Should Pay?” Markkula Center for Applied Ethics. (Nov. 13, 2015). Accessed June 2016.

18. “2015 NC Prevention Report Card: The State of Our Health and How We Can Get Better.” Prevention Partners. (2015). Accessed June 2016.

19. “North Carolina State Guesstimated 2016 Government Spending.” U.S. Government Spending. (2016). Accessed June 2016.

20. “2015 NC Prevention Report Card: The State of Our Health and How We Can Get Better.” Prevention Partners. (2015). Accessed June 2016.

21. “2016 NC Regional Prevention Report Card.” Prevention Partners. (2016). Accessed December 2016.

22. “The State of Obesity in North Carolina.” StateofObesity.org. (2015). Accessed December 2016.

23. “2016 NC Regional Prevention Report Card.” Prevention Partners. (2016). Accessed December 2016.

24. “2016 NC Regional Prevention Report Card.” Prevention Partners. (2016). Accessed December 2016.

25. “2015 NC Prevention Report Card: The State of Our Health and How We Can Get Better.” Prevention Partners. (2015). Accessed June 2016.

26. “Misuse of Prescription Drugs.” National Institute on Drug Abuse. (2016). Accessed December 2016.

27. “The opioid crisis in America’s workforce.” Castlight Health. (2016). Accessed December 2016.

28. “Health Care Costs From Opioid Abuse: A State-by-State Analysis.” Matrix Global Advisors. (2015). Accessed December 2016.

29. “Annual Report to the North Carolina Medical Society.” North Carolina Department of Health and Human Services, Division of Public Health. (October 2015). Accessed June 2016.

30. “2016 NC Regional Prevention Report Card.” Prevention Partners. (2016). Accessed December 2016.

31. “2015 NC Prevention Report Card: The State of Our Health and How We Can Get Better.” Prevention Partners. (2015). Accessed June 2016.

32. “Smoking & Tobacco Use: Health Effects of Cigarette Smoking.” Centers for Disease Control and Prevention. (February 2016). Accessed June 2016.

33. “Advocates Press Anti-Smoking Campaign.” North Carolina Health News. (October 2015). Accessed June 2016.

34. “2015 NC Prevention Report Card: The State of Our Health and How We Can Get Better.” Prevention Partners. (2015). Accessed June 2016.

35. Angell, Marcia. “Why do drug companies charge so much? Because they can.” The Washington Post. (Sept. 25, 2015). Accessed June 2016.

36. Johnson, Carolyn. “Why America pays so much more for drugs.” The Washington Post. (Feb. 25, 2016). Accessed December 2016.

37. Dennis, Brady. “Nearly 60 percent of Americans – the highest ever – are taking prescription drugs.” The Washington Post. (Nov. 3, 2015). Accessed June 2016.

38. Walker, Joseph. “Price Increases Drive Drug Firms’ Revenue.” The Wall Street Journal. (Oct. 5, 2015). 2016 Pulitzer Prize Finalist in Explanatory Reporting; click “Price Increases Drive Drug Firms’ Revenue.” Accessed December 2016.

39. Mukherjee, Sy. “How Mylan Got Away With Its Enormous Price Hike for the EpiPen.”Fortune. (Aug. 22, 2016). Accessed November 2016.

40. Angell, Marcia. “Why do drug companies charge so much? Because they can.” The Washington Post. (Sept. 25, 2015). Accessed June 2016.

41. Walker, Joseph. “Price Increases Drive Drug Firms’ Revenue.” The Wall Street Journal. (October 2015). 2016 Pulitzer Prize Finalist in Explanatory Reporting; click “Price Increases Drive Drug Firms’ Revenue.” Accessed December 2016.

42. Marshall, Kyle. “Do generics always save you money? It’s complicated.” Blue Cross and Blue Shield of North Carolina Blog. (June 2, 2016). Accessed June 2016.

43. Marshall, Kyle.“Do generics always save you money? It’s complicated.” Blue Cross and Blue Shield of North Carolina Blog. (June 2, 2016). Accessed June 2016.

44. Sarpatawi, Ameet. “Why many generic drugs are becoming so expensive.” Harvard Health Publications. (Oct. 22, 2015). Accessed June 2016.

45. Morgenson, Gretchen. “How Valeant Cashed In Twice on Higher Drug Prices.” The New York Times. (July 29, 2016). Accessed December 2016.

46. Thomas, Jennifer. “Blue Cross Blue Shield CEO: Losses tied to health care reform ‘unsustainable’.” Charlotte Business Journal. (May 23, 2016). Accessed June 2016.

47. Angell, Marcia. “Why do drug companies charge so much? Because they can.” The Washington Post. (Sept. 25, 2015). Accessed June 2016.

48. Spiro, Topher. “What if drugs were priced based on their effectiveness?” CNBC. (Oct. 12, 2015). Accessed June 2016.

49. BCBSNC Internal Data – NC Book of Business – Commercial & Medicare, 01/01/2015 – 12/31/2015. Accessed December 2016.

50. Farber, Madeline. “This Acne Treatment Now Costs Almost $10,000.” Fortune. (Sept. 21, 2016). Accessed December 2016.

51. Pollack, Andrew, and Tavernise, Sabrina. “Valeant’s Drug Price Strategy Enriches It, but Infuriates Patients and Lawmakers.” The New York Times. (Oct. 4, 2015). Accessed December 2016.

52. “Super spending: U.S. trends in high-cost medication use.” Express Scripts. (May 13, 2015). Accessed June 2016.

53. DeNavas-Walt, Carmen and Proctor, Bernadette. “Income and Poverty in the United States: 2014.” United States Census Bureau. (September 2015). Accessed June 2016.

54. “Super spending: U.S. Trends in High-cost Medication Use.” Express Scripts. (May 13, 2015). Accessed June 2016.

55. “Super spending: U.S. Trends in High-cost Medication Use.” Express Scripts. (May 13, 2015). Accessed June 2016.

56. “A Study of Cost Variation for Percutaneous Coronary Interventions (Angioplasties) in the U.S.” The Health Report of America, Blue Cross Blue Shield Association. (July 16, 2015). Accessed December 2016.

57. “Costliest Cities 2015.” (2015). Raleigh ranked 6th highest in regard to the cost of a lower-back MRI and 4th for head/brain CT scans. Accessed March 2016.

58. “Costliest Cities 2015.” (2015). Charlotte ranked 7th highest for head/brain CT scans and tied for 5th highest for preventive gynecological scans. Accessed March 2016.

59. Newman, David, et al. “Prices For Common Medical Services Vary Substantially Among The Commercially Insured.” (April 27, 2016). Accessed December 2016.

60. Barrette, Eric, and Kennedy, Kevin. “The Price-Quality Paradox in Health Care.” Health Care Cost Institute. (April 2016). Accessed August 2016.

61. Cooper, Zack. “Why Is Healthcare So Expensive?” Yale Insights. (February 12, 2016). Accessed May 2016.

62. “A Study of Cost Variation for Percutaneous Coronary Interventions (Angioplasties) in the U.S.” The Health Report of America, Blue Cross Blue Shield Association. (July 16, 2015). Accessed December 2016.

63. “AHIP Issue Brief: How Much Does It Cost? Health Plan Tools Empowering Consumers with Provider Price Information.” America’s Health Insurance Plans. (August 2015). Accessed May 2016.

64. “2016 Employer Health Benefits Survey.” Kaiser Family Foundation. (Sept. 14, 2016). Accessed December 2016.

65. Salamido, Gary. “Job Creators Pick up Tab on Government Mandates.” North Carolina Chamber. (March 18, 2015). Accessed June 2016.

66. “2016 Employer Health Benefits Survey.” Kaiser Family Foundation. (Sept. 14, 2016). Accessed December 2016.

67. “U.S. Health Care from a Global Perspective.” Commonwealth Fund. (Oct. 5, 2015.) Accessed December 2016.

68. “National Health Expenditures 2015 Highlights.” Centers for Medicare and Medicaid Services. (2015.) Accessed February 2015.

69. “2016 Employer Health Benefits Survey.” Kaiser Family Foundation. (Sept. 14, 2016). Accessed December 2016.

70. Salamido, Gary. “Job Creators Pick up Tab on Government Mandates.” North Carolina Chamber. (March 18, 2015). Accessed June 2016.

71. Katterman, Scott. “Headwinds cause 2014 risk corridor funding shortfall.” (Oct. 5, 2015). Accessed May 2016.

72. Restrepo, Katherine. “North Carolina Lawmakers Don’t Like Obamacare’s Mandates, But They Like Their Own.” (July 30, 2015). Accessed June 2016.

73. Restrepo, Katherine. “North Carolina Lawmakers Don’t Like Obamacare’s Mandates, But They Like Their Own.” (July 30, 2015). Accessed June 2016.

74. Restrepo, Katherine. “North Carolina Lawmakers Don’t Like Obamacare’s Mandates, But They Like Their Own.” (July 30, 2015). Accessed June 2016.

75.Frederick Polls. (2016). In a year-over-year survey conducted by Frederick Polls, more than 800 North Carolinians were polled to learn their feelings about health care. When asked “In general, do you have more of a positive or negative opinion of the quality of health care available in North Carolina?” 27% responded negative in June 2012, 33% percent responded negative in April 2014 and 41% responded negative in September 2016. Accessed December 2016.

76. “Tighter Patent Rules Could Help Lower Drug Prices, Study Shows.” (Aug. 23, 2016). Accessed December 2016.

77. “Tighter Patent Rules Could Help Lower Drug Prices, Study Shows.” (Aug. 23, 2016). Accessed December 2016.

78. Kesselheim AS, Avorn J, Sarpatwari A. “The High Cost of Prescription Drugs in the United States: Origins and Prospects for Reform.” Journal of the American Medical Association. (Aug. 23, 2016). Accessed December 2016.

79. “Going Beyond Clinical Walls: Solving Complex Problems.” Robert Wood Johnson Foundation. (October 2014). Accessed December 2016.

80. Claxton, Gary, et al. “Payments for cost sharing increasing rapidly over time.” Peterson-Kaiser Health System Tracker. (April 12, 2016). Accessed July 2016.

81. Abelson, Reed. “Health Insurance Deductibles Outpacing Wage Increases, Study Finds.” The New York Times. (Sept. 22, 2015). Accessed July 2016.

82. “New Kaiser/New York Times Survey Finds One in Five Working-Age Americans With Health Insurance Report Problems Paying Medical Bills.” The Kaiser Family Foundation. (2016). Accessed July 2016.

83. Walker, Joseph. “Price Increases Drive Drug Firms’ Revenue.” The Wall Street Journal. (October 2105). 2016 Pulitzer Prize Finalist in Explanatory Reporting; click “Price Increases Drive Drug Firms’ Revenue.” Accessed December 2016.

84. Hill, Andrew, et al. “Andrew Hill, Anton Pozniak And James Freeman, Chelsea And Westminster Hospital.” United Nations Secretary-General’s High-Level Panel on Access to Medicines. (Feb. 25, 2016). The estimated costs to produce imatinib to treat chronic myeloid leukaemia are between $128 and $216. Accessed August 2016.

85. Patton, Mike. “U.S. Health Care Costs Rise Faster Than Inflation.” Forbes. (June 29, 2015). Accessed May 2016.

86. Adrion, Emily, et al.“Out-of-Pocket Spending for Hospitalizations Among Nonelderly Adults.” Journal of the American Medical Association Internal Medicine. (June 27, 2016). Accessed July 2016.

87. Adrion, Emily, et al. “Out-of-Pocket Spending for Hospitalizations Among Non-Elderly Adults.” Journal of the American Medical Association Internal Medicine. (September 2016). Accessed December 2016.

88. “Quick Facts, Census Data.” Average monthly rent for North Carolinians was $920 in 2014. (2014). Accessed December 2016.

89. “Costliest Cities 2015.” Castlight. (2015). Raleigh ranked 6th highest in regard to the cost of a lower-back MRI and 4th for head/brain CT scans. Accessed March 2016.

90. “Heart Disease: Heart Disease Behavior.” Centers for Disease Control. (Aug. 10, 2015). Accessed June 2016.

91. “2015 NC Prevention Report Card: The State of Our Health and How We Can Get Better.” Prevention Partners. (2015). Accessed June 2016.

92. “Annual Report to the North Carolina Medical Society.” North Carolina Department of Health and Human Services, Division of Public Health. (October 2015). Accessed June 2016.

93. “2015 NC Prevention Report Card: The State of Our Health and How We Can Get Better.” Prevention Partners. (2015). Accessed June 2016.

94. “North Carolina State Guesstimated 2016 Government Spending.” U.S. Government Spending. (2016). Accessed June 2016.

95. “2016 Employer Health Benefits Survey.” Kaiser Family Foundation. (Sept. 14, 2016). Accessed December 2016.

96. “U.S. Health Care from a Global Perspective.” Commonwealth Fund. (Oct. 5, 2015). Accessed December 2016.

97. Katterman, Scott. “Headwinds cause 2014 risk corridor funding shortfall.” Milliman. (Oct. 5, 2015). Accessed May 2016.

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