EDITOR'S NOTE: As the Nov. 2 governor's election approaches, reporter Robert Behre is talking with Republican Nikki Haley and Democrat Vincent Sheheen on the biggest issues facing the state. The third installment in the series focuses on health care.
Q: Early projections from the state Department of Health and Human Services show that under the new health care law, almost 500,000 more people in South Carolina will be eligible for Medicaid by 2014. The increased coverage is expected to cost the state $914 million over the next decade. How will the state pay for this?
Haley: "This federally funded health care mandate, which my opponent supports, is dangerous for the people of this state. We cannot sustain the cost and the fact that every individual will be penalized $700 per person. It's something that's not going to help the quality of health care, it's only going to hurt the individuals of South Carolina."
Sheheen: "That is a difficult prospect for a state that already has financial difficulties, and I think the next governor and legislative leaders are going to have to send a message loud and clear to our congressmen that we will expect either changes to be made or support to come to fund the programs that they have created."
Q: If Congress doesn't provide more money to meet future Medicaid costs, how would you propose to cut costs in the program given the matrix created by state and federal mandates?
Haley: "We need to reform the Medicaid system. We need to take abuses out of the system so people who deserve benefits get those benefits and those that are abusing the system no longer get it."
Sheheen: "I think the key to cutting costs in the program is to have a more complete view of health care, so that we emphasize prevention, early detection of problems before they become more expensive. That's the best thing we can do to try to reduce costs in health care in South Carolina."
Q: Even before the new health care law is fully implemented, South Carolina's Medicaid rolls have increased. Since the recession officially began in December 2007, more than 88,000 residents have been added to the state's Medicaid program, now averaging between 3,000 and 5,000 new enrollees per month. How can the state address the massive health care needs of its people?
Haley: "We need to go back to our faith-based organizations and our communities and ask them to help. We need to realize that government is not always the answer. I'm involved with Med Mission at Mount Horeb United Methodist Church. They go out and they offer free health care to people in their community as service. You will see me go to the communities and really go to our medical professions and our faith-based organizations and try to find ways to help these people when they're going through hard times."
Sheheen: "This gets back to what I think is the most important issue in the campaign, and that is job creation. Only with increased job creation in South Carolina and a reduction in the unemployment rate relative to the rest of the nation, will we begin to see answers to health care for our citizens and budget problems for state government. The best way for citizens of South Carolina to have health care is through their employers, and that means we have to have a governor who will spend most of his time recruiting business and industry into South Carolina."
Q: If Medicaid isn't the answer for addressing the health care needs of South Carolina people, how would you combat the state's unhealthy population? How much responsibility should be placed on individuals themselves versus government social welfare?
Haley: "The answer to reducing health care costs and improving the quality of health care for the citizens state is when we incentivize small businesses to offer health care, when we pass tort reform that will actually bring the good quality health care workers to our state and when we reform Medicaid. Those are the answers to bringing down the cost of health care, not mandating health care on citizens."
Sheheen: "The most important responsibility should be on individuals themselves. It's every individual's responsibility to take care of themselves and that ought to be the emphasis of all leadership. There is a role for state government to play in helping to provide affordable health care for those people who need a little bit of help --people who are disabled or who are working but need help with reduced premiums."
Read the Q&A with the candidates Nikki Haley and Vincent Sheheen
Q&A with gubernatorial candidates Nikki Haley and Vincent Sheheen, published 9/13/10Q&A: Jobs and the economy, published 09/07/10