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SC Senate policy stakes: Graham, Harrison differ on how to improve health care system

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COLUMBIA — With just a few months to go until South Carolina voters head to the polls to decide whether to reelect Republican U.S. Sen. Lindsey Graham or replace him with Democrat Jaime Harrison, health care remains a top issue for many voters, further underscored by the still-raging coronavirus pandemic.

While Graham has tried for years to repeal the Affordable Care Act and give states more leeway to shape their own health insurance systems, Harrison says he wants to build on the federal law and push South Carolina to expand Medicaid.

On some health care topics, South Carolina's U.S. Senate opponents agree. Both say they would not support the single-payer, Medicare-for-all system proposed by U.S. Sen. Bernie Sanders, I-Vt.

Though Harrison had indicated potential support for Medicare-for-all in a 2019 tweet and ABC News interview, his campaign clarified that his preference is for a public option, which would leave private health insurance companies in tact while offering a government-run competitor.

They both express concern about prescription drug costs rising and rural hospitals in South Carolina shuttering, though they diverge on the causes, with Graham pointing to Obamacare and Harrison attributing it to the state's decision not to expand Medicaid.

Harrison is critical of Graham's leadership during the coronavirus pandemic, chiding him for changing his standards of a successful response. Graham's campaign noted that he recently met with hospital administrators and frontline medical workers and has pushed to bring the medical supply chain from China to the U.S.

This is the first installment of an eight-part series in The Post and Courier over the coming months leading up to the election that will lay out the policy views of Graham and Harrison on the issues that matter most to South Carolina voters.

The responses to this candidate questionnaire have been edited and condensed for space and clarity.

Do you believe the Affordable Care Act — or what remains of it — should be replaced? If so, with what?

Graham: "Instead of a Washington-knows-best approach like Obamacare, I believe we need solutions that empower patients, and those closest to the health care needs of their communities, to provide solutions.  Money and power should be redirected out of Washington and given back to patients and states."

Harrison: "The Affordable Care Act is not perfect, and I would vote to build on its success while fixing what doesn’t work. We can provide health insurance for 400,000 people here by expanding Medicaid under the ACA. We’re one of just 13 states left that has not done so. But following Sen. Graham’s route of fully repealing the law would be a disaster for South Carolina, at the exact moment we need stability in our healthcare system." 

Would you consider voting in favor of a Medicare-for-all, single payer system?

Graham: “I’m a hard ‘No’ on Medicare for All. Medicare for All means Medicare for Nobody." 

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Harrison: "I am not in favor of implementing a Medicare-for-All, single payer healthcare system. I don’t view it as a practical solution, and it’s not how we can quickly and affordably close the uninsured gap in South Carolina. We have laws on the books right now that can help us do that, and we need to end the political games that hold back the Affordable Care Act from helping the most people in this state."

Do you believe prescription drug costs are too high? If so, what would you do about it?

Graham: "Get generics to market quicker through patent reform. Pharmaceutical companies play games with drugs to keep costs high. It’s also time to make foreign governments pay their fair share which will lower drug prices for Americans."

Harrison: "Prescription drug costs are far too high, and many seniors in this state pay too much out of pocket for the lifesaving medications they need every day. Medicare should be allowed to negotiate with drug companies for lower prices on prescriptions. We also need to add dental, vision, and hearing coverage onto Medicare plans, and increase benefits for low-income Seniors who lose their spouses. Expanding Medicaid here would also give hundreds of thousands of South Carolinians the insurance coverage they need to afford prescription drugs." 

How effective do you believe South Carolina and the country’s public health response to the coronavirus has been? If you believe it has been ineffective, what would you do differently? 

Graham: "This is a war between South Carolina, the country, and the virus. Most people fighting the war are in the hospitals and the doctor’s offices. We've had a long tradition of supporting frontline forces, making sure they have what they need to win the war and doing our part. So if you believe we're at war, which I do, how can you contribute to victory? Wear a mask, wash your hands, and practice social distancing."

Harrison: "It did not have to be this way. We had time earlier to marshal the full power of the federal government in the production of tests and protective equipment, but leaders in Washington like Lindsey Graham were too busy denying the danger this virus posed. Well, some five months later, we are reaching the darkest chapter in our state’s fight against the coronavirus — and we are still not prepared for the task at hand. We need to ramp up testing, as South Carolina still ranks near the bottom for testing per capita. We have to build out additional hospital bed capacity while many counties are reaching their limits. And we need to make sure our heroic healthcare workers have the necessary protective equipment like masks and gowns." 

Multiple rural hospitals in South Carolina have closed in recent years. Do you believe this is a problem? If so, what would you do about it?

Graham: "I voted against Obamacare and warned of its dangers. Since its passage we have seen rural hospitals in South Carolina and across America close their doors. That means patients in rural areas have to travel further to seek assistance and in a medical emergency, time is critical. It’s truly a shame and this is one of the many negative legacies of Obamacare."

Harrison: "To me, this is one of the greatest challenges facing South Carolina families. Four rural hospitals have closed in recent years. It is hard to believe, but eight counties in this state have no hospital beds at all — and 15 of our 46 counties have under 100 beds available. The uninsured rate in rural South Carolina exceeds that of our urban areas. Expanding Medicaid would quickly and cost-effectively protect our rural hospitals, and make sure that far more people have the care they need, when and where they need it. This would allow our state to close the coverage gap and provide insurance to 400,000 South Carolinians who need it now more than ever." 

Follow Jamie Lovegrove on Twitter @jslovegrove.

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