Category Archives: Health

Is ‘Breaking Bad’ the best medical drama ever?

This doctor thinks so, and makes a pretty compelling case. An excerpt:

While most medical shows—much like the health system at large—focus on acute presentations, hospitalizations, and procedures, Breaking Bad follows its patients far beyond the walls of the hospital. When Hank, the DEA agent brother-in-law of the show’s meth-cooking protagonist, Walter White, is shot by the cartel, he is immediately rushed to a hospital where he gets the usual TV doctoring: wailing sirens, complex jargon, rickety stretchers and tense surgeons. But while most shows would either move on to the next thrilling emergency or end with the patient disappearing into the credits, Breaking Bad did neither. After initially being scared witless by the thought of being discharged, Hank spent almost an entire season in bed, obsessing over minerals and pornography. He became depressed, despondent, and angry. He vacillated between motivation and apathy. In short, he didn’t stop being sick as soon as the bullets were pulled out of his chest or when he was discharged from the hospital. If anything, that’s when his journey started. While most shows focus on the heroics of EMTs, surgeons, and doctors, Breaking Bad shows that the heroism of patients and their caregivers goes on long after they have moved on from an acute care facility. And importantly, Hank walks with a limp to this day, dispelling the notion of magical cures.

Another telling scene that somehow escapes the attention of most medical shows is the look on the faces of Skyler and Marie, Walt’s and Hank’s respective wives, when they receive their spouses’ medical bills. Not only do the bills make no sense to them, the doctors appear as bamboozled and helpless as the patients. In fact, a popular Internet memesuggests that Breaking Bad would not have been possible in a system which provides universal free health care, such as Canada’s, because Walt would never have been desperate to collect the money for his treatment. …

Good points, I thought.

If “Breaking Bad” has appeal in Britain, it’s probably for the same reason that westerns were once popular abroad. A depiction of a health care system so wild, primitive and uncivilized, where every man is on his own, is probably particularly fascinating for people who don’t have to fret about such things. It’s even set in the wild West. (Hmmm. According to this, it’s NOT popular over there, so forget my theorizing. I guess it’s just too far-fetched for them.)

But aside from health-care politics, it’s true that “Breaking Bad” is more like real life. There’s no brilliant cure within 43 minutes. Hank still walks with a limp…

Summer cold, the ‘different animal,’ has me in its grippe

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I’m quite frustrated that I can’t find video for the old Contac commercial with the jingle that went:

“A summer cold is a different animal
an ugly animal… oooh!
It hits you in the summer,
When you’ve got a lot to do!”

Hey, I didn’t say it was Shakespeare, I just said I wish I could find the video.

Anyway, I seem to recall someone deriding the ad at the time, saying that a summer cold was in no way different from a winter one. It’s never felt that way to me. To me, there’s always been something particularly miserable about going out on a hot day with the runny nose, raw throat, mental cloudiness and vague feverishness that comes with such a bug.

And my belief was vindicated last week with this section-front piece in The Wall Street Journal, “Summer Is the Real Season for Bad Colds, Not Winter.”

And in fact — the bugs themselves are different:

Colds in summertime can last for weeks, at times seemingly going away and then suddenly storming back with a vengeance, infectious-disease experts say. A winter cold, by contrast, is typically gone in a few days.

The reason for the difference: Summer colds are caused by different viruses from the ones that bring on sniffling and sneezing in the colder months. And some of the things people commonly do in the summer can prolong the illness, like being physically active and going in and out of air-conditioned buildings.

“A winter cold is nasty, brutish and short,” says Bruce Hirsch, infectious-disease specialist at North Shore University Hospital in Manhasset, N.Y. “But summer colds tend to linger. They can go on for weeks and reoccur.”…

The piece also notes that because summer colds linger so long, people mistake them for allergies.

I knew better when mine first struck a week or two back. I had been using a new nasal spray that had my allergies under great control. And then one day, bam, my nose is running anyway. And I feel like total crud, Ferris.

Also, my grandchildren had been passing a bug back and forth, and my wife had had it. So, not just allergies.

The piece also notes, “A summer cold’s symptoms also can be surprising. Along with the sniffles, sufferers may also get a fever, diarrhea and achy body.”

I’ve had all of those, except — I think — the fever. And I could be wrong about that. In a meeting this morning at ADCO, my wary colleagues were accusing me of having fever, partly because every time I touched the surface of the conference room table, I left damp handprints.

I don’t know. I just know it feels pretty lousy.

How are y’all feeling?

Join the bradwarthen.com Walk for Life team!

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Proud members of the championship 2010 team — Mark Stewart, Kathryn Fenner and Doug Ross.

OK, I’ve finally gotten around to setting up our team for the Walk for Life on Oct. 5, as promised previously.

Here’s how you sign up. Go to this page, click on “register” on the left-hand side, then click “I agree,” and then click on the “Join a team” button. Then click on “Please select a team.” Pretty high up on the pull-down list you will see “bradwarthen.com.” Join that one. (Pretty intuitive, right?)

Then follow the rest of the steps logically. Registration will cost you $25, but you can give more, and I encourage you to do so. After you’ve signed up, go out and get your friends to give even more money. I’ll post more instructions on how to do that later. In the meantime, Doug Ross can probably tell you how to do it, because he did such a great job of fund-raising the last time we had a team, two years ago.

I’ve set a $1,000 goal for the team, but we can exceed that — can’t we?

Click on this link to see how we’re doing toward that goal.

So sign up, be generous (and/or get other people to be generous), and I look forward to seeing y’all on Walk day!

Red Cross: ‘Spread the word. Help avert a shortage.’

More poor SC kids than ever are obese

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Remember that good-news story that I included in a recent Virtual Front Page, about how fewer poor kids are obese than previously?

Well, that doesn’t apply to SC, as you probably saw already:

The CDC study released in early August drew a lot of attention because it found childhood obesity rates were decreasing in 19 states and rising in only three. The study didn’t include data from 10 states.

South Carolina was omitted because a CDC request for data in 2011 went to an inactive email account at the S.C. Department of Health and Environmental Control, according to agency spokesman Mark Plowden. Because South Carolina didn’t send in timely data that year, it wasn’t included in the study of four-year trends.

The percent of obese children ages 2-4 years in the WIC in South Carolina has grown from 13.3 percent in fiscal year 2009 to 14.1 percent in 2010, 14.7 in 2011 and 15.6 in 2012, Plowden said…

This, to me, is another argument for restricting the kinds of foods that can be obtained with “food stamps” — with caveats for availability, considering “food deserts,” etc. I see the problems with such a move. But I also think we should work to overcome the problems, because kids are killing themselves with food that we’re buying for them.

Whatever we’re doing now to ensure proper nutrition for the poor obviously isn’t accomplishing everything that it should..

Studies: smoking dope can lead to schizophrenia

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By Torben Hansen, via Flickr

What I had always heard, and even seen in real life, was that teenagers who smoke a lot of dope tend to have trouble maturing, that things that are going on in their undeveloped brains get derailed, with long-term cognitive effects. Hence the phenomenon of the 30-year-old stoner who seems in some ways like a 15-year-old.

But I don’t recall having read this before, even though the research results seem to have been out there for awhile:

There is a significant and consistent relationship between marijuana use and the development of schizophrenia and related disorders….

Though they receive little attention in the legalization debate, the scientific studies showing an association between marijuana use and schizophrenia and other disorders are alarming. A 2004 article in the highly respected British Journal of Psychiatry reviewed four large studies, all of which showed a significant and consistent association between consumption of marijuana (mostly during teenage years or early 20s) and the later development of schizophrenia. The review concluded that marijuana is a “causal component,” among others, in the development of schizophrenia and other psychotic disorders.

A 2007 study in the Lancet, a British medical journal, concludes that using marijuana increases the risk of young people developing a psychotic illness, such as schizophrenia. This risk is greatest—up to a 200% increase—among those who use marijuana heavily and who start using at a younger age.

So I pass it on, for those who still think the stuff’s harmless, and Sheriff Lott was a Blue Meanie for busting the Olympic swimmer.

And yeah, for those who think it’s a terrific argument to say “Alcohol’s worse” — it may be indeed. But we tried outlawing that, and it didn’t work out, because it was too far ingrained in the culture. I’m not ready to give up on this ban. We have enough trouble with alcohol.

Who’s up for a bradwarthen.com Walk for Life team?

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The actual walkers from our 2010 team — Mark, Kathryn and Doug.

Some of y’all will recall that a couple of years back, this blog fielded a team in the Palmetto Health Foundation Walk for Life, and we did rather well.

While only four of us actually walked — Mark Stewart, Kathryn Fenner, Doug Ross and me — we came in 18th in most amount of money raised. That wasn’t a staggering amount, just under $1,000 at last official count (I thought we went over a thousand, but I can’t find record of it now), but it was pretty good considering that we got a late start.

Doug Ross was our playmaker on that one, raising $450 by himself. I hope he’ll be returning for this go-round, and help us set the pace.

The Walk is on Saturday, Oct. 5, this year, so that gives us plenty of time. I have not actually set up the team yet, so hang onto your money until we do. But I have attended a team captain’s meeting the other night, and picked up the paperwork.

I’m posting this to gauge interest out there, but also to create peer pressure on me to follow through. So press away, and don’t let me slack off.

I’m toying with the idea of getting special T-shirts done (of course, everyone who participates will get an official T-shirt from the Foundation, but a lot of teams set themselves apart with special shirts). But then each person would have to pay for them (what, you think this blog is made of money?), and I’d rather see our fund-raising energies go to fighting breast cancer. Anyway, share your thoughts on that.

And stay on me about this.

Click on the image for more info…

Haley’s reckless CON madness gets madder by the minute

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When we last looked at the matter, Nikki Haley had vetoed funding for the certificate of need process that state law requires before new health facilities can be built and operate — leaving DHEC with an unfunded mandate, and SC hospitals in limbo on major plans.

Her action exhibited a blithe destructiveness across a wide spectrum, from public health policy through economic development.

And the stupid House failed to override her.

Today, it all got crazier:

S.C. hospitals, nursing homes and physicians can go ahead with plans for expansion or adding services without state approval after a program was not funded next year.

The S.C. Department of Health and Environmental Control will suspend the Certificate of Need program on Monday, agency director Catherine Templeton said in a letter.

The state House upheld a veto by Gov. Nikki Haley over $1.7 million in funding for the program this week.

“DHEC has no independent authority to expend state funds for Certificate of Need, and therefore, the veto completely suspends the program for the upcoming fiscal year,” Templeton said.

The agency will not take action against any work done while the program is suspended unless told to do so by the General Assembly, Templeton said…

Wow. So… hospitals are just supposed to go ahead with multi-million-dollar projects without going through the approval process that the law still requires, funding or no funding, and not worry about any future legal ramifications? Really?

Then this afternoon, this release came out:

Chairman Brian White and Representative Murrell Smith of the House Ways and Means Committee Issue a Statement Regarding Governor Haley’s Certificate of Need (CON) Veto

(Columbia, SC) – On Wednesday, June 26, 2013, the South Carolina House of Representatives sustained Governor Haley’s budget veto number twenty by a vote of 56-65. The effect of this veto reduced general fund support for the Department of Health and Environmental Control’s Certificate of Need (CON) Program by over $1.4 million.

“The House of Representatives did not intend to eliminate the CON Program or its statutory requirements. In fact, the House believes there are a number of ways for the CON Program to retain its function and purpose. The Governor has the sole power to appoint DHEC’s governing board and is ultimately charged with enforcing the CON law. If the Governor and the agency director wish to unilaterally discontinue the program, as they have indicated, then that is a decision that lies exclusively within the executive branch and one which may be contrary to law but is certainly contrary to the will and intent of the House of Representatives.”

# # #

OK, that release is really badly worded, especially that last sentence. But what the lawmakers appear to be saying is that even though they went along with cutting the funding, they had NOT meant for DHEC to ignore the law — they had meant for it to find the money somewhere to continue the program. Which, of course, was grossly irresponsible on the part of lawmakers — they should have overridden. One of the least defensible dodges of irresponsible legislators is the old “Oh, find the money somewhere” gag. When, you know, they’re the ones who decide what gets funded and what doesn’t.

This is some bad craziness, people. I would think that Ms. Templeton were doing this outrageous thing as a protest of the governor’s irresponsibility, if she weren’t like, you know, the gov’s protege.

The only thing I can think of to fix this problem is the same thing that Joel Lourie is suggesting — that the General Assembly should go back into session to fix the problem and appropriate the funding for the program.

It’s a lot of trouble to go to, but this is a serious matter. One knowledgeable observer (which means, “someone who understands the world a lot better than our governor does”) said to me today, “I suspect there’s going to be a very interesting lawsuit here.”

Hey, more than just one. I can see hospitals suing each other, subcontractors suing contractors when work is started then halted, just a free-for-all.

This is amazing.

Haley still fighting the Lexington County battles of yesteryear — while hurting the Lexington of today

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I found it interesting that Nikki Haley, whose former employment by Lexington Medical Center raised ethical questions from many, once again vetoed funding for the operation of the Certificate of Need program.

If you’ll recall, several years back, when Lexington Medical was fighting to get a certificate to do open-heart surgery, the CON process was the bête noire of Lexington County politicians. The state bureaucrats had let Palmetto Health start an open-heart program, so why were they picking on Lexington County?

That issue is now behind them, after a deal struck by Providence and Lexington that allowed Lexington one of the Catholic hospital’s certificates. So folks in her old district by no means benefit from her defunding the program.

In fact, they wouldn’t have back in the day, I suppose — since this action doesn’t obviate the legal requirement for a CON; it just prevents the state from having the means to process one.

And today, this veto — unfortunately sustained by the House — positively harms her former employer, since Lexington is awaiting a CON for a $7.9 million expansion of its radiation-treatment facility.

So no one can accuse the governor from playing hometown favorites with this veto. No, her sin in this case looks to be mere blind, foolish, destructive ideology.

The contemptible SC Senate kills Medicaid expansion

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Of course, in the Senate’s defense, it is merely doing what the contemptible SC House and our contemptible governor did before them:

COLUMBIA, SC — The state Senate killed Medicaid expansion on Tuesday, the last hope for supporters who wanted to extend health insurance benefits to South Carolina’s working poor.

The vote was 23-19, with two Republicans – Ray Cleary of Georgetown and Paul Campbell of Berkeley County – joining all of the Senate’s 17 Democrats present in voting for the expansion. Four senators, one Democrat and three Republicans, were absent.

The proposal would have accepted $795.8 million in federal money to pay for health insurance for about 320,000 South Carolinians beginning Jan. 1. There would have been no direct cost to the state. Because the proposed Medicaid expansion was an amendment to the state budget, it would have expired after one year. Lawmakers would have had to vote to expand coverage again next year…

Congratulations to Sens. Ray Cleary and Paul Campbell for doing what is unquestionably, indubitably the right thing. I can’t say I know either of them, really, but I’ve heard Paul Campbell speak, and suspect that he’s one of the brightest people in the Legislature. The retired regional president of Alcoa, he’s a man of accomplishment who seems to have a good grasp of how the world actually works. This vote is consistent with that impression.

As for the rest, particularly those who voted against this for no better reason than the fact that it has the name “Obama” attached to it, and that’s what you’re expected to do if you’re a Republican in South Carolina… well, you’ve just demonstrated once again why I hold partythink in such low regard.

Yes, one can rationalize all day and all night about how there are better ways to achieve the goals of Obamacare, but when you’re all done, you haven’t changed the fact that this is the only plan in effect, or likely to come into effect. This is it. You either do it, or give the idea of significantly broadening access to health care the back of your hand.

Dueling videos, opening shots in 2014 campaign

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James Smith’s comments about Nikki Haley and “corruption” should also be taken within the context of the above ad from the Democratic Governor’s Association.

Meanwhile, with the video below, Haley supporters show that they want to run against Barack Obama again. But at least this ad mentions Sheheen, which is something.

How do the ads strike me? As I indicated earlier, I’m a little leery of the word “corruption.” Yeah, Nikki Haley has a serious transparency problem, she’s not very good at paying her taxes on time, and that $40k she got from Wilbur Smith when she was in the House raises a questions that have not yet been answered. But “corruption” is a word I tend to use for something more overt, more red-handed. Early in my career, back in Tennessee, I saw out-and-out corruption — Gov. Ray Blanton selling pardons. He went to prison for it. Maybe that made me overly fussy. The things the DGA are citing here are real problems, and they provide us with plenty of reason not to vote for Nikki Haley; I’m just quibbling over the word.

The Sheheen/Obamacare ad is just disgraceful. But then, so is the governor’s position of refusing to accept federal funds to expand Medicaid, so I see it entirely in that context. For me, her position is indefensible, so the ad is as well. Then there’s that additional ugliness of playing to the fact that “Obama” is the boogeyman to so many white voters in South Carolina. “Obamacare” is used as an incantation, with the operative ingredient being “Obama,” not the “care.” The issue is secondary to the fact that that awful Obama person is associated with it.

Bishop Guglielmone on Medicaid expansion in SC

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Cindi Scoppe had a column, way back on the St. Patrick’s Day, in which she cited a letter by Bishop Robert E. Guglielmone, the head of the Roman Catholic in South Carolina, advocating for Medicaid expansion in SC.

I meant to say something on the subject then, but didn’t get to it. Which is ironic. Cindi’s not even Catholic (OK, she’s a kind of Catholic; she’s Anglican — but not Roman Catholic).

Anyway, something came up to remind me of it this week — a story in the Anderson paper about religious leaders in SC pushing for Medicaid expansion — so I thought I’d go ahead now and share the bishop’s letter.

It is a letter that, unlike the pronouncements of our governor and the House leadership, makes all the sense in the world:

February 20, 2013
Dear Brothers and Sisters in Christ,
To be Christian means that we are concerned about the wellbeing and health of all people. God took on flesh to restore the integrity of broken and wounded humanity. Indeed, Jesus made healing of the sick central to his ministry. “He came to the world to make us fully human, to help us to realize our human dignity as creatures made in the image of God. He came to bring the fullness of life” (USCCB Pastoral Letter: Health and Health Care, Nov. 19, 1981).
Throughout the centuries, the Church has carried on the ministry of Jesus by establishing
hospitals and nurturing the apostolate to the sick in response to the needs of suffering people. Pope John XXIII included medical care as a basic right founded on the sanctity of human life in his encyclical, Pacem in Terris. Reaffirming this traditional concern for today, Pope Benedict XVI wrote that “Health is a precious good for the person and society to promote, conserve and protect, dedicating the means, resources and energies necessary so that more persons can enjoy it. Unfortunately, the problem still remains today of many populations of the world that do not have access to the necessary resources to satisfy fundamental needs, particularly in regard to health. It is necessary to work with greater commitment at all levels so that the right to health is rendered effective, favoring access to primary health care” (Benedict XVI: Message to the Pontifical Council for Health Care Ministry, Nov. 18, 2010).
The Catholic Bishops of the United States have consistently called for access to health care forall our citizens: “Our approach to health care is shaped by a simple but fundamental principle: ‘Every person has a right to adequate health care. This right flows from the sanctity of human life and the dignity that belongs to all human persons, who are made in the image of God.’ Health care is more than a commodity; it is a basic human right, an essential safeguard of human life and dignity” (USCCB Resolution: A Framework for Comprehensive Health Care Reform, June 18, 1993). While the Church’s call for access to health care reflects an application of the Gospel to a contemporary need and therefore reflects the urgency of the Gospel, determining how to implement such access is open to prudential judgments of how to make it happen most effectively. We must continually discern wise solutions to the challenges we face, solutions that are both economically and politically viable. In that task of discernment, however, we as Catholics bring time-honored principles of Catholic social teaching to inform our reflection.
The Patient Protection and Affordable Care Act (PPACA) now being legally enacted in our
country is an attempt to bring health care access to a broader range of citizenry in the United States. It is not perfect. In fact, the U.S. Catholic Church is deeply concerned about mandates associated with aspects of the law that would require religious institutions to provide contraception coverage, asking us to violate a consistent position by the Church on this. There are also many concerns about how to rein in the costs of health care so that its expansion is affordable to our country. However, providing access to health care is consonant with Catholic social teaching. Indeed, it is more than consonant — it is called for by Catholic social teaching.
This spring, our South Carolina state legislature will consider whether to opt into the expansion of Medicaid as provided for by the Affordable Care Act. Persons eligible for Medicaid would be expanded by about three hundred thirty thousand more South Carolinians who live near the poverty line but previously have not been eligible. Key state-wide elected leaders and many in the General Assembly have voiced their opposition to this expansion. Leaders of our state’s hospitals, including Catholic hospitals, on the other hand, have endorsed this legislation. It will expand their ability not only to serve the poor of our state but to pay for those services. The State of South Carolina would be required to pay for ten percent of the total cost of this expansion after three years of full funding by the Federal Government. This will require us as a state to find the revenue to pay for this expansion. It will cost us.
Bearing a cost for the sake of something greater is the heart of our faith; it brought us salvation. At the same time, we can and must make this expansion and our whole healthcare system more effective and economically viable. If health care funding as envisioned by the Affordable Care Act is not perfect, we nevertheless are not powerless as a society to refine and make it more effective even as we implement it.
I write as your Bishop in noting the call of Catholic social teaching, and I appeal as a fellow
citizen in making a case for acceptance of Medicaid expansion by our state. I urge my fellow Catholics to study this issue and form your own prudential judgment on its wisdom. However, I ask that you start that evaluation with a presumption in favor of what the Church says is a good to be pursued in society, namely, the flourishing of all people through access to health care. Hold as well our faith conviction that shared sacrifice for a greater good and concern for the poor make us more like Christ. Make your views known to your legislators. For my part, I believe Medicaid expansion offers a step forward for South Carolina.

In the Lord’s Peace,
Most Reverend Robert E. Guglielmone
Bishop of Charleston

I heartily disagree with Mia on food stamps and junk food

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Here’s the latest from Mia McLeod:

Dear Governor,

Seriously? Can you just “SNAP” and in an instant, delete certain foods from some South Carolinians’ grocery lists?

Sure, obesity is a genuine, significant health concern for too many people in this state. But that’s not why you’ve made a recent “SNAP” decision. You know it. We know it. And soon, citizens across this state will know it too.
Contrary to South Carolina’s definition, “SNAP” doesn’t mean “Simply Nonchalant About the Poor.” It’s actually a federal program, fully funded by the USDA. Now, isn’t it ironic that our state’s most notorious critics of “BIG” government, are arrogantly hypocritical enough to assume the despicable role of “BIG Brother” when it’s politically expedient?

As asinine as this latest stunt is, it’s even more offensive. Targeting a segment of the population in furtherance of your own political agenda is one thing. Refusing to allow federally-funded healthcare for hard-working South Carolinians while in the same breath, expressing concern about obesity and its impact on their health and well-being, is another.

You don’t want the federal government telling us whether to accept or how to spend our federal tax dollars when a state match or financial investment is required. But yet, you wanna dictate which foods we can buy with SNAP, a fully-funded federal program that doesn’t even require state funds?

The list of qualifying items that can be purchased with SNAP is very straight-forward. As with any program, there’s always room for improvement. But last time we checked, you were able to make nutritional decisions for your family without our intrusion or input. We’re just wondering why you think we need yours.

And since your cronies are traveling the state at our expense, trying to convince us that this is about obesity prevention, perhaps we’ll remember your “heartfelt” concern on our next nonemergency trip to the ER…if we can even find and get to a hospital that’s still open and accessible.

With all due respect, Governor, when it comes to obesity, it’s not the foods that we’re able to buy on SNAP that are making us fat. Perhaps it’s your empty rhetoric that’s making us sick.

If you really cared about this state’s obesity rates or us, you’d do what is well within your purview and power to ensure that we have access to quality, affordable health care, just like you do.

You’d realize that some of us would love to eat the same fresh and organic foods that your family enjoys, but because of “food deserts” across this state, many of us are without the means or access. If you’re genuinely concerned about addressing obesity, you could start by addressing that.

If only we could “SNAP” back from the regressive, debilitating tactics of centuries past, we’d all feel much better. So while South Carolina continues to reek of ignorance, intolerance and insanity, many of our best and brightest continue to leave this state in search of parity, inclusion and meaningful opportunities.

But unlike obesity and other chronic conditions, many never return. Neighboring states too often become the benefactors of our most creative minds and talented contributors. And we’re left with a weaker South Carolina.

So as you continue to cater to your political base by serving folks like us up on a party platter, the only thing that seems to be getting fatter is your reelection campaign account.

At some point, obesity may no longer be an issue for South Carolina. Under your “leadership,” our state is gradually becoming so malnourished on so many levels, it may not be strong enough to “SNAP” out of it.

But you still can, Governor, before it’s too late.

p.s. – South Carolina’s forgotten citizens (a.k.a. – your “other” constituents) may not be members of the Tea Party. But in number, we’re “the real majority.”

She really doesn’t like the idea, does she?

Well, I do. Still. So I guess I’m playing the “despicable role of Big Brother.”

Yes, there are reasons to be concerned about people who live in “food deserts.” I don’t dismiss that, and I can’t say for certain that the stores that now sell junk food in those communities would shift and sell healthier stuff if that’s all their poor patrons could buy. I think that might happen, but I don’t have the full faith in markets that some do.

So that should be thoroughly studied and taken into account before a final decision is made. But I most certainly do not agree with those who have a philosophical, rather than practical, objection to insisting that tax money not be used to buy foods that ruin the health of the poor.

The populists will call this patriarchal, but we are indeed in a position for taking responsibility for people when we undertake to feed them. We are culpable for providing people with the means of poisoning themselves when we could adopt a policy that prevents it.

When we discussed this previously, my old friend and respected colleague Burl Burlingame noted, “when the government wants to experiment, they do so first on the poor.” That may seem a particularly devastating argument against this change. But I submit that we have been running the experiment for half a century now, and the results are in: Paying for junk food kills poor people. It’s time we stop it, and do what we practically can to have a positive, rather than an actively negative, effect on people’s health.

Smith: Anti-Obamacare witness transported on state plane

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Here’s an interesting release that just came in:

Rep. James Smith Responds to Use of State Plane by Right-Wing Radio Host

Today, some members of the South Carolina General Assembly learned that one of only two people to testify in favor of H.3101, otherwise known as the Obamacare Nullification Bill, at today’s subcommittee hearing, was given special travel arrangements by being flown to Columbia from Washington, DC on Palmetto 2, a state airplane. Dr. Walter Williams, a professor at George Mason University and popular right-wing radio host, gave testimony in favor of H.3101 today in Columbia after his taxpayer funded flight was authorized by Spartanburg State Representative, and lead sponsor of H.3101, Bill Chumley. The other person testifying in favor of the bill was a prominent Tea Party activist Kent Masterson Brown, who admitted he was paid $7500 to testify.

Representative James Smith, a member of the House Judiciary Subcommittee on Constitutional Laws, released the following statement in response:

“This is the height of hypocrisy and politics at its worst. For taxpayers to be forced to foot the bill so that an out-of-state political zealot can push his extreme agenda is not only a dereliction of his duties as a public servant, it is just fundamentally wrong. During his testimony, Dr. Walter Williams espoused the abuses of government spending and intrusion while engaging in precisely the same behavior. While we work to make health care more affordable and accessible to our citizens, Representative Bill Chumley, would rather frivolously spend tax dollars to fly Tea Party ideologues down to South Carolina on the state airplane. I call on Representative Chumley to immediately reimburse the taxpayers for his reckless and irresponsible decision to spend tax dollars to promote his own extreme Tea party agenda.”

####

Gee, I didn’t even know that a single member of the Legislature could authorize something like that…

Mia McLeod on Medicaid expansion in SC

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Speaking of people who sort of seem like they’re running for higher office, here’s the latest missive from Mia McLeod:

Well…ladies & gentlemen, it’s time to “weigh-in.” And unlike her Republican counterparts in New Jersey, Florida, Arizona, Nevada, Ohio, New Mexico, North Dakota and Michigan, your Governor is once again “flexing” her Tea Party muscles and refusing to support healthcare coverage for uninsured South Carolinians.

So what separates her from a growing list of anti-Obama Governors who have recently decided to expand Medicaid in other states? Common sense and compassion, for starters.
And if South Carolina refuses to expand healthcare coverage, here’s a glimpse of the impact on hard-working folks like you:

Higher medical costs – as the uninsured forego preventive care and are forced to seek medical care in the emergency room, hospitals will be forced to shift those costs to insured individuals and employers.
Less independence – as our seniors, veterans and disabled citizens forfeit access to home health and other medical care, it’ll be extremely difficult for them to lead independent lives.
Fewer options – as our state refuses federal funding to the tune of 100% for the first 3 years, neighboring states will gladly accept and use our federal tax dollars to cover their uninsured.
Poor quality of life – as hard-working folks forfeit medical care they need to live longer, healthier lives, our state misses opportunities to be more proactive, productive and economically sound.

But this is South Carolina. Obviously, expanding Medicaid makes sense, but don’t take my word for it. Here’s what Republican Governors (in other states, of course) are saying…

“No mother or father should despair over whether or not they can afford — or access — the health care their child needs. Quality health care services must be accessible and affordable for all — not just those in certain zip codes or tax brackets,” said outspoken Obamacare critic and Florida Governor, Rick Scott, as he reflected on the death of his mother and her struggle to raise five children with little money, while worrying constantly about having family health coverage.

Arizona Governor Jan Brewer also made national headlines when she supported Medicaid expansion, acknowledging that it would lessen the impact of uncompensated care that drives up medical costs to hospitals and taxpayers.

New Jersey Governor Chris Christie has said, “Let me be clear, I’m no fan of the Affordable Care Act…” but it’s “now the law of the land,” acknowledging that rejecting it would mean that New Jersey’s tax dollars will be spent elsewhere.

While Nevada Governor Brian Sandoval was the first Republican governor to officially embrace Medicaid expansion, his decision seemed to be based primarily upon the recognition that it wouldn’t be wise to forego an infusion of federal dollars into his state’s economy.

The same is true for South Carolina. Are you listening, Governor Haley? (Oops! rhetorical question…)

Expanding healthcare coverage to people who can’t otherwise afford it should be a no-brainer. States can opt-in or out at anytime, “risk-free” for the first 3 years. That’s an offer Republican Governors across the nation believe is too good to refuse, because while expanding healthcare coverage is voluntary, picking up the tab for the uninsured, isn’t.

Our Governor has said that SC can’t afford to expand Medicaid. With 100% federal funding for the first 3 years and 90% thereafter, how can we afford not to? It creates over 40,000 jobs, covers over 250,000 uninsured South Carolinians, infuses our state’s economy and improves our quality of life and health.

So while she focuses on restricting foods purchased using federally funded programs like WIC and SNAP (in the name of obesity prevention) or “disease” designations for obesity, here’s an idea…

Let’s expand healthcare coverage so that South Carolinians who struggle with obesity and other medical conditions can get quality, affordable healthcare that focuses on prevention and treatment to help them live longer, healthier, more productive lives.

This isn’t a partisan issue. We all want the strongest military, the best schools, quality, affordable health care, meaningful job opportunities and the ability to live, work and age with dignity. Part of government’s role is to help ensure that every citizen has access to healthcare because a healthier population is a huge, proactive step towards a stronger workforce and business community, improved quality of life and more vibrant economy.

South Carolina is only as strong as its weakest. If our state’s leaders lack the collective compassion and courage to expand healthcare coverage to “the least of these,” the biggest losers won’t just be the uninsured. South Carolinians, insured and uninsured, will pay the ultimate price. Our state will be the biggest loser. But wait…isn’t that what we’ve been since we elected her 3 years ago?

Governor Haley was elected to represent all of us. The sooner she and her party’s leaders “swallow that pill,” the healthier we’ll all be…

SC Dems and Medicaid expansion: Why is common sense a minority position in SC?

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You may have read Adam Beam’s story in The State over the weekend about SC House Democrat’s proposal to at least take the three years of free Medicaid expansion that the Feds are offering:

COLUMBIA — Imagine someone offered to give you $4.1 billion over three years, and if you did not take it, your neighbors would get the money instead.

That is the situation South Carolina is in with the federal government, according to S.C. House Democrats who are pushing for the state to expand Medicaid – the joint federal-state health insurance program for the poor and disabled.

The money is not really free, Republicans counter. After three years, South Carolina would have to start paying part of the cost of expanding Medicaid – anywhere from $613 million to $1.9 billion by 2020 – depending on a number of variables.

That’s why Monday, the day that the S.C. House begins debating the state’s $22.7 billion budget, Democratic lawmakers are going to propose an amendment that would accept federal money for the first three years of the Medicaid expansion – when the feds would pay 100 percent of the cost – and, then, automatically end the expanded program…

Well, today, the House Dems held a press conference to talk further about their proposal. The reasons were the usual: It makes no sense to turn down something that won’t cost the state anything for three years, especially when it addresses a critical need. It makes no sense for those of us who have insurance to be paying more to underwrite the most expensive kind of care for people who don’t have coverage. And of course, they hit the angle that it’s the decent, moral, compassionate thing to do.

As for the claim that expansion will cost a couple of billion by 2020, the Dems expressed polite contempt for journalists who would pass that on without investigating its veracity. Gilda Cobb-Hunter called the claim “specious at best.”

I’ll let the number-crunchers sort that out. My point in writing about this is to say that everything the Democrats said today not only made perfect sense, but should be perfectly obvious.

And I have to wonder — why has such a common-sense proposal become a minority position in South Carolina? Because don’t fool yourselves — SC Democrats have little chance of having their way.

Four years ago, the Republican leadership in the General Assembly thought Mark Sanford had lost his mind when he wanted to let stimulus money that was going to be spent anyway be spent elsewhere instead of in South Carolina. And they were right.

Now, the standard GOP position is to turn down this program, just because it has the name “Obama” attached to it.

What’s wrong with us in South Carolina?

From SCDP: A roundup of objections to Haley’s Medicaid stance

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There seems to be a new communications director over at the SC Democratic Party — Kristin Sosanie — and she put out a release today that is somewhat more substantive and detailed than the emotional, nyah-nyah stuff we usually get from political parties.

I found it interesting, and relevant, enough to pass on in its entirety:

March 7, 2013

To: Interested Parties

From: Kristin Sosanie, SCDP Communications Director

RE: Governor Haley at odds with rising tide of public opinion on Medicaid expansion

As the debate over Medicaid expansion continues, support for bringing tax dollars back home is echoing around South Carolina and Governor Haley is on the defensive trying desperately to explain her choice to put partisanship ahead of the best interests of the people of the state.

Let’s review: In the past week alone, members of the public, hospital leaders, businesses, state leaders and editorial boards have all spoken out in support of the expansion:

Survey finds majority in SC support Medicaid expansion. “More than half of older adults in the state disagree with Gov. Nikki Haley’s plan to turn down Medicaid expansion, according to a survey by the AARP. The survey found that 54 percent of the respondents support expanding Medicaid to cover low-income adults.” [The State, 03/06/13]

Head of S.C. hospital group says politics blocking Medicaid expansion. “There is a lot of ideology and politics in this debate — it is not just a financial question,” said Thornton Kirby, the state hospital association’s president and chief executive officer. He said South Carolina and other Republican-leaning states “don’t want anything to do” with a federal health-care reform initiative championed by President Barack Obama. [Independent Mail, 03/04/13]

Charleston Chamber to Gov. Haley: accept Medicaid expansion. “There are two options,” said Bryan Derreberry, president and CEO of the local Chamber. “South Carolina can accept the Medicaid expansion and receive 90 percent of costs from the federal government, or reject the plan and absorb 100 percent of the costs and lose revenue from Washington, D.C.” [The Examiner, 03/07/13]

Editorial: Expanding Medicaid in SC. “The only conceivable reason to reject the expansion of Medicaid would be to make a hollow political statement in opposition to Obamacare. But that is political grandstanding at the cost of losing billions of federal dollars to other states and denying health care coverage to hundreds of thousands of uninsured South Carolinians. And that, we think, would be impossible to justify.” [Rock Hill Herald, 03/02/13]

Sheheen: SC lawmakers should put ideology aside, accept Medicaid expansion money. “I call on Gov. (Nikki) Haley and every Democrat and every Republican to heed the example of other states and provide leadership that will mean more tax dollars in South Carolina that belong to South Carolinians,” the Camden Democrat said. [Associated Press, 03/07/13]

Also remember: Governor Haley is out on a ledge as Republican governors around the country (many of whom have been staunch opponents of Obamacare) have put partisanship aside and decided to act in the best interests of the people of their states by opting-in:

Florida Governor Rick Scott: “I Cannot In Good Conscience Deny Floridians That Needed Access To Health Care.” “‘While the federal government is committed to paying 100 percent of the cost, I cannot in good conscience deny Floridians that needed access to health care,’ Mr. Scott said at a news conference. ‘We will support a three-year expansion of the Medicaid program under the new health care law as long as the federal government meets their commitment to pay 100 percent of the cost during that time.’” [New York Times, 2/20/13]

Ohio Governor John Kasich: “Ohio Taxpayer Dollars Are Coming Back To Ohio.” “Kasich has said his proposed Medicaid expansion would save the state $235 million over the next two years, free about $100 million in local funds for mental-health and addiction services, and ‘Ohio taxpayer dollars are coming back to Ohio to support a significant need we have which is the insurance, the health coverage of poor, working Ohioans.’” [Columbus Dispatch, 2/12/13]

New Jersey Governor Chris Christie: “We Are Putting People First” – Not Expanding Medicaid Would Send Taxpayer Dollars Elsewhere. “‘[R]efusing these federal dollars would not mean that they wouldn’t be spent. It just means that they will be used to expand health-care access in New York, Connecticut, Ohio or somewhere else. … It’s simple. We’re putting people first.’” [NPR, Political Junkie, 3/4/13]

Finally: Governor Haley’s chief points of opposition have been debunked by researchers at the University of South Carolina’s Moore School of Business, who found that the economic benefit of bringing taxpayers’ dollars back in-state would create 44,000 jobs in South Carolina.

Medicaid Expansion in South Carolina: The economic impact of the ACA. “By 2020, the total annual economic impact of the increase in federal funding due to the ACA Medicaid expansion on the state of South Carolina will total approximately $3.3 billion in economic output, $1.5 billion in labor income, and support nearly 44,000 new jobs for South Carolinians. Approximately one – third of these jobs (15,000) are projected to occur outside of the health care industry due to the economic multiplier effect.” [USC Moore School of Business Report December 2012, accessed 03/07/13]

So, in the face of such widespread support, two questions remain: How long will Governor Haley continue to make decisions based on ideology? And what will she say to South Carolinians who lose their jobs because of her Tea Party allegiance?

MedicAID, Larry, not MedicARE. There’s a difference…

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Note: After this post was published, the Grooms campaign sent out two corrections. The first did not correct the “Medicare” mistake. The second, at 4:52 p.m., did. The original release moved at 4:18 p.m.

Just got this, about 14 minutes ago, from Larry Grooms’ campaign for the GOP nomination in the 1st Congressional District:

LARRY GROOMS ISSUED A STATEMENT ABOUT DEMOCRAT VINCE SHEHEEN’S FISCALLY IRRESPONSIBLE DEMAND TO EXPAND MEDICARE

Charleston, SC – Republican State Senator and Candidate for Congress Larry Grooms issued the following statement today about State Senator Vincent Sheheen’s desire to expand Medicare in South Carolina:

State Senator and Candidate for Congress Larry Grooms issued the following statement:

“There is no question the federal governments desire to expand Medicare is a horrible idea for South Carolina and this nation. I stand firm with Governor Nikki Haley on this issue and will continue to fight against this massive federal government overreach.

I was deeply concerned to see Senator Sheheen’s comments today about his desire to expand Medicare – but I wasn’t surprised. What he and President Obama can’t seem to grasp is that we are on a path to bankrupting this state and nation. In fact, if Sen. Sheheen and Barack Obama have their way, in three years South Carolinians will owe almost 2 Billion dollars to the federal government. This is a deplorable and quite frankly, immoral thing to do to the people of this state.

I, for one, will stand firm with Gov. Haley and will continue to push my colleagues in the South Carolina Senate to do the same. If elected to Congress, you better believe I’ll take the fight for fiscal sanity to Washington so that Governors like Nikki Haley will never be faced with such a ridiculously harmful proposition.”

-30-

I added the boldface on the “Medicares.”

Um, Larry — I just checked. Sheheen hasn’t said anything about expanding Medicare. Perhaps you’re thinking of Medicaid. I’m not aware that the governor has taken any particular stand on Medicare lately, either. But she is standing against expanding Medicaid…

To help you out, Larry, here’s a story from Adam Beam about what Sheheen did say today, headlined “Sheheen endorses expanding Medicaid.”

AARP poll: SC grownups favor Medicaid expansion

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I say “grownups” because all the respondents were over 45. It was the first word that came to mind. I’ll allow that there may be some grownups out there younger than 45. Anyway, here’s a report from the Charleston paper on the poll:

Most South Carolina adults interviewed for a new poll think the state government should expand Medicaid eligibility to include more low-income residents.

The poll was commissioned by AARP, a group in favor of expanding Medicaid in South Carolina under the Patient Protection and Affordable Care Act. A statement about the poll was published Tuesday on AARP’s website, but the full results have not been released.

It found that 54 percent of 800 adults polled in February favor Medicaid expansion and 57 percent disagree with Gov. Nikki Haley’s decision to decline federal money to accomplish that. All of the adults included in the survey were 45 and older.

South Carolina has a choice to opt out of the expansion because the state would eventually need to pay for part of it — 10 percent of the costs by 2020. The federal government would fully fund Medicaid expansion for three years and at a minimum of 90 percent after that…

Maybe when Nikki Haley gets to be 45, she’ll develop a more sensible approach to this, too. It’s possible. I don’t know what the excuse of the GOP majority in the Legislature might be.

By the way, AARP is lobbying in 40 states (including SC) for Medicaid expansion. But that should come as no surprise, since AARP has a lot of grownups in it…

Of COURSE food stamps shouldn’t pay for junk food

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I actually meant to address this subject a couple of months ago, when I read this op-ed by Louis Yuhasz, the founder of an anti-obesity nonprofit in Charleston:

Our foundation works with a 17-year-old girl who weighs 495 pounds. At home she’s fed a diet of convenience store food, bought at convenience store prices, largely at taxpayer expense. Rare is a salad or lean meat. Processed, packaged food is all she knows. And it’s slowly killing her.

But she won’t leave this earth without costing us all a small fortune. She’ll need knee replacement surgery before she leaves her 20s, and in her 30s her hips will fail her too. Taxpayers can probably expect to pay for a long stay in a nursing home for her, because of the toll diabetes will take on her vision and limbs.

If ever there was an example of solving one problem while creating another, it’s the food stamp program in America. Through it, as one critic recently suggested, our government is “subsidizing the obesity epidemic.”…

Don’t get him wrong, he explained. The food stamp program has done a lot of good, and saved lives. But it needs to be changed:

So here’s something Washington should think very seriously about: strictly limiting what foods can be purchased with the money we provide SNAP recipients. We already impose limitations: Beneficiaries can’t use their payments to buy alcohol or cigarettes. Why not take it one step further and bar the purchase of foods that are making us fat and sick, at least with the money coming out of taxpayers’ pockets?

Where would we draw the line? If it comes from the meat, seafood, produce or dairy sections, it’s probably good to go. Or maybe we could use an even more general standard: If my 100-year-old grandmother would recognize it as food, it is.

On the other hand, if the ingredient list includes added sugar, high-fructose corn syrup, synthetic trans-fats, industrial seed oils, any ingredient name longer than four syllables, or if it would survive a nuclear holocaust, then put it back on the shelf, or at least buy it with your own money…

I’ve never gone along with the people who want to ban junk food, the way they’ve done with limiting soda intake in New York. But I have no problem at all with limiting what our tax dollars pay for. Besides, obesity costs us too much. We’re paying for it on the front end and the back end, as Yuhasz noted:

SNAP is expensive at $65 billon, but get a load of what obesity costs us in direct medical costs: $190 billion per year. Almost three quarters of Americans are either overweight or obese. Almost one in five children are clinically obese, and what used to be called adult-onset diabetes is one of the biggest health problems among kids…

So now I see in the paper today:

COLUMBIA, SC — Seeking to slow the childhood obesity epidemic, South Carolina health leaders would like to limit the purchase of sugar-filled drinks with food stamps.

Catherine Templeton, director of the Department of Health and Environmental Control, and Lillian Koller, director of the Department of Social Services, have exchanged thoughts on the subject. They agree that cutting the intake of sugary drinks could improve the health of the state’s children, but they are struggling with how to use the food stamp program as a tool in that effort, and especially with whether the federal government will allow it.

Several similar efforts, most notably by New York City, have failed to gain approval from the U.S. Department of Agriculture, which runs the Supplemental Nutrition Assistance Program, commonly referred to as food stamps. The feds told New York in 2011 that they agree with the goal of limiting intake of sugary drinks, but the city’s proposal had operational challenges and impacted too many people. They suggested a test program on a smaller scale…

I’d like to see SC be used as that test case, as Joey Holleman’s story goes on to suggest. Wouldn’t it be wonderful for our state to be in the vanguard of improving health for once?

This seems to me like something that left and right ought to be able to get behind. I can imagine arguments against it, but I can’t imagine any good ones.