It’s not too late to insure a healthier South Carolina

In this Nov. 12, 2014 file photo, the website, where people can buy health insurance, is seen on a laptop screen in Portland, Ore. (AP Photo/Don Ryan, File)

“My dear Ben, Nobody is working for socialized medicine — all my Health Program calls for is an insurance plan that will enable people to pay doctor bills and receive hospital treatment when they need it ... I am glad you wrote me because there are a lot of people like you who need straightening out on this subject. Sincerely yours, Harry”

— Letter from President Truman to a friend in Missouri in 1949

I don’t know that President Obama has hand-written many letters like this, but the message is as relevant today as it was in Truman’s time:

It’s in our nation’s best interest that its workers are healthy and don’t go broke trying to stay that way.

Nowhere is this reality more compelling than in South Carolina, where our workforce, and consequently our economy, is far more vulnerable than those of most states.

Much of that vulnerability comes from large sectors of the state’s economy that rely heavily on seasonal and part time workers, who may work two or three jobs and still not have access to health insurance.

Access to health insurance is equally challenging for small business people on whom the state is principally dependent for new job creation, while growing numbers of South Carolinians over 55, who no longer employable in their fields, are struggling to find affordable insurance at the time of their lives they need it the most.

Even the state’s stubbornly high rates of preventable chronic disease come into play, since these conditions can be managed with proper medical care that would allow workers to stay on the job.

Similarly, workers with disabilities and other pre-existing conditions are being overwhelmed either by staggering monthly insurance premiums or out-of-pocket medical bills.

Workers in our rural areas are suffering as well, even when they can get insurance. Many rural hospitals are inching toward insolvency under the weight of caring for patients without insurance. Some have closed or been bought up, and this loss of local services has left thousands in rural employment without access to basic medical care.

If South Carolinians could look beyond partisan rhetoric over the Affordable Care Act, it would become increasingly clear that maintaining the status quo is costing us far more and inflicting greater pain than we can afford. We are just getting further behind.

During the recent economic downturn, our state’s unemployment rates were among the highest in the country, and remained that way longer than those in all but a handful of states.

As a consequence, unemployed and underemployed South Carolinians were without substantial incomes longer, and consequently without the means to pay for critical needs like medical care.

Post-recession bankruptcies, a kind of morning-after hangover, even today continue to drag down our recovery. Over the past three years, as the national economy has become increasingly robust, these rates have declined by an average of 13 percent a year across the country. However, during that same time, we in South Carolina have experienced an anemic decline of barely 3.6 percent, the worst in the country.

This statistic is particularly worrisome because the number of individual bankruptcies in our state has remained disproportionately higher than in other states, and it is no surprise that the leading contributor to individual bankruptcy is unpaid medical bills.

Health insurance, or the lack of it, affects every workplace. Recent studies suggest that uninsured workers are far more likely to miss days of work or even lose their jobs when they get sick. Fearing unaffordable medical bills, these workers are also less likely to seek out medical care, instead exposing their colleagues to contagious illnesses, threatening productivity and increasing employer costs.

They are similarly reluctant to take their sick children to a doctor, even when their symptoms suggest a communicable disease like measles, chicken pox, or whooping cough. This is especially important since South Carolina has gone from first in the nation in childhood immunizations in 1995 to a much lower ranking in 2014.

Sunday is the last chance for most South Carolinians to sign up for private health insurance online at Those needing in-person assistance can call the Palmetto Project’s statewide enrollment center at 888-998-4646 until midnight as Sunday turns into Monday.

Right now is time to change course.

Steve Skardon is executive director of the Palmetto Project.