Illustration: Lazaro Gamio/Axios

North Carolina faced damages of more than $10 billion from Hurricanes Bertha and Fran in 1996, part of a string of disasters that forced the insurance industry to evaluate how much coastal risk it was willing to sustain.

The big picture: Despite wholesale reforms in insurance and increased awareness about future vulnerability for coastal property, developers built 113,000 new homes in coastal North Carolina from 2000-2014, ProPublica notes.

Why it matters: Florence will restart the post-storm hamster wheel. Local officials will mull whether to rebuild or to buy out residents, even with staggering losses for the uninsured and increasing liabilities for those within insurance's broad umbrella.

  • And climate change, which is raising sea levels along the shore and causing more intense inland rainstorms, is only heightening disaster risks.

A different process is playing out in Puerto Rico, the WSJ reports:

  • "Government officials say they don’t want to rebuild communities on land that is vulnerable to soil erosion, chronic flooding and destruction from future storms."
  • “'We need to move families to a safe place,' said Luis Burdiel Agudo, president of the Economic Development Bank for Puerto Rico."
  • "The government is set to receive $20 billion of federal funding to rebuild... It is giving some homeowners an ultimatum between moving and receiving funds to rebuild."

Between the lines: Mainland coastal areas like North Carolina and Houston, Texas, know these dangers exist. So, too, do those living in and governing areas vulnerable to inland flooding from slow-moving tropical storms and hurricanes, such as Harvey and Florence. Their main mechanism is the buyout.

  • "Harris County [Houston] has only bought out about 3,100 properties since 1985. That’s fewer than half the homes on the district's priority buyout list. Hurricane Harvey damaged at least 69,000 properties in the county," ProPublica reports.
  • "North Carolina Gov. Roy Cooper said in a press briefing on Sunday that the state would have to 'look carefully' at buyouts of repeatedly flooded properties," the WSJ notes.

The bottom line: Expect this debate to get worse, with taxpayers on the hook for growing catastrophes and increasingly hot political battles between insurers and homeowners.

Go deeper: Florence updates, where 23 deaths have been reported

Go deeper

1 hour ago - Health

The top-selling drugs in the U.S. in 2019

Data: IQVIA, company financial documents; Chart: Andrew Witherspoon/Axios

The 10 highest-selling drugs in the U.S. last year gave away more than $23 billion in rebates to insurance intermediaries, but still netted almost $58 billion in sales.

The big picture: The U.S. drug pricing system is filled with confusing numbers, and many entities profit off the flow of drugs, but pharmaceutical companies retain a vast majority of the proceeds.

Caitlin Owens, author of Vitals
2 hours ago - Health

America's flying blind on its coronavirus response

Illustration: Aïda Amer/Axios

A month after the Trump administration changed how hospital data is reported, the public release of this data "has slowed to a crawl," the Wall Street Journal reports.

The big picture: This is the latest example of how the world's wealthiest country just can't get it together.

Updated 2 hours ago - World

Pandemic plunges U.K. into "largest recession on record"

The scene near the Royal Exchange and the Bank of England in the City of London, England. Photo: Tolga Akmen/AFP via Getty Images

The United Kingdom slumped into recession as its gross domestic product GDP shrank 20.4% compared with the first three months of the year, the Office of National Statistics (ONS) confirmed Wednesday.

Why it matters: Per an ONS statement, "It is clear that the U.K. is in the largest recession on record." The U.K. has faired worse than any other major European economy from coronavirus lockdowns, Bloomberg notes. And finance minister Rishi Sunak warns the situation is likely to worsen.