Proving once again the truism that no candidate is right about everything, John McCain is talking about a health care "plan" that sounds an awful lot like the standard GOP laissez-faire approach, which is, "Let’s help them that has put away money to pay for their own health care, and forget (to use the euphemism) everybody else."
This is further evidence supporting Mike Huckabee‘s observation that most Republicans don’t have a clue how regular folks who don’t have a bunch of money live.
I offer a genuinely conservative vision for health-care reform, which
preserves the most essential value of American lives — freedom.
That’s libertarianese for "The last thing in the world we would want government to do is help anybody. (After all, if it did that, you might stop hating it.) Remember, we stand up for your freedom to suffer and die from lack of affordable health care."
Here’s what it said in my Treo (copied and pasted from an e-mail from Cindi, who set up the meeting):
The Editorial Board will met at 9 am on Thursday, Oct. 18, with Emma Forkner, the (still sort of) new director of the Department of Health and Human Services. There’s nothing in particular on the agenda, although the agency has been in the news lately over questions about its new private Medicaid transport system. And there is of course the ever-present issue of how our state (and others) pay for Medicaid.
We will meet in the Board Room on the third floor.
And that was what it was, a get-acquainted meeting. But I report it for the same reason I’m trying to report all such contacts, because I want you to know who I’m talking to, and some readers — such as "GreenvilleGuy" on this post — are very suspicious of the supposedly cozy relationships between us and newsmakers.
Since there was nothing in particular we were looking for in the meeting, I had a good time talking big picture, and I was able to launch freely onto digression without Cindi kicking me under the table.
For instance, we learned that while 25 percent of Medicaid recipients were on some kind of managed care plan — translated into private-sector terms, either a PPO or HMO — 75 percent of recipients are on, essentially, a fee-for-service plan. She hopes that, thanks to the waivers GreenvilleGuy decries, those numbers will be reversed in 18 months to two years.
Fee-for-service? I asked. Isn’t that essentially what we in the private sector had 30 or 40 years ago? Yes.
After acknowledging that she was new to this world, I asked why she thought it took so long to institute such cost-saving measures as managed care in the public sector, when out here in the private world, our employers are constantly tweaking our insurance to save costs? (I had spent two hours the previous day hearing how my own insurance will change come Jan. 1.)
She hesitated to answer, so I gave her MY answer: Because whether you’re talking state employee insurance or Medicaid, the public at large doesn’t really want to take anything away from anybody. That makes it tough for anybody who answers to voters, or anyone who answers to someone else who answers to voters, to institute cost savings — whereas private employers can change things as they please, and what the hell are their employees going to do about it?
She agreed. This led to her problems with getting anything done in the civilian public sector. She had come up in the military, where you’re part of an organization that is disciplined to turn on a dime. That makes the military less regulation-bound that the civilian public sector, which for a lot of people is counterintuitive.
Since I grew up in the Navy, and have always thought the military way of running things superior (to ALL civilian systems, public and private), we got along swimmingly.
Here’s a discussion going on back on this post that I think is worth elevating to a separate post, to bring in some more voices.
Someone named "msbobbie" wrote the following in response to this:
This legislation has two aims. The first being to encourage more
people to become dependent on government. Have you not heard anyone say
"The more I do for myself, the more they take away from me"? The second
being a continued push by the Democrats to paint Republicans as
uncaring and mean spirited. Have you not watched the way they smirk
every time they introduce something like this?
I have no problem with helping people who need a helping hand, but I
think it should be temporary so they will be encouraged to do more for
themselves instead of remaining dependent on the taxpayers.
What "msbobbie" says SOUNDS very sensible, which is why a lot of people say it.
But I’ve never been able to subscribe to it, if only because of personal experience. My entire adult life, I have been right up against the ragged edge of not being able to pay medical bills — no matter how much money I was making or how hard I was working, and that’s WITH medical insurance every step of the way.
I have therefore always been acutely aware of how easy it would be to be caught perpetually in a cycle of NEVER being able to pay for necessary medical care, as opposed to it being a temporary condition.
This doesn’t sound right, but I’ll go ahead and say it to make my point: If you go by just about any objective measurement you choose (educational attainment, scores on standardized tests, etc.) I have more on the ball than the average person. That means the MAJORITY of people in this country are a little less able to cope with the complex challenges of maintaining health and paying for it.
If you take those factors, and then take away any kind of private insurance coverage, it boggles the mind. How on Earth can people in that situation EVER expect to get their heads above water?
Mind you, I’m assuming a certain amount of medical costs. People who spend their lives in good health, never needing a doctor (a situation as alien to my experience as being from another planet), often don’t understand what I’m talking about. Maybe they have one big crisis in their families, they get through it, and put it behind them. I’ve never been blessed that way, and there are an awful lot of people like me. We work hard, we contribute, but we have medical expenses ALL THE TIME, and they get heavier and heavier year after year, WITH insurance. Anybody in a similar situation — and there are so many, many people who are MUCH worse off than I have ever been, thank God — who doesn’t have insurance is likely to be stuck in a financial hole for a lifetime.
Noticing questions raised in response to this post, a colleague passed along info collected yesterday, after an editorial board discussion of the issue:
The claim: The proposal would allow coverage of families earning $83,000. The facts: The bill essentially sets an income ceiling of three times the poverty rate for a family of four – $61,950. Beyond that, the federal government would not pay a state its full SCHIP match, which averages about 70 percent. New York state is seeking a waiver that would allow its residents to qualify if their income is not above four times the poverty rate – $82,600 for a family of four. The current administration or future administrations would have to approve that request. New Jersey would still be allowed to cover families with incomes three and one-half times the poverty rate – $72,275 for a family of four.
Here’s the full news story from which that was gleaned:
By KEVIN FREKING Associated Press Writer WASHINGTON (AP) – Congress’ proposal to expand a child health care program gives states the financial incentive to expand eligibility for coverage to families of four earning about $62,000 a year. That’s a figure that seldom emerges in the claims and counterclaims being tossed about. The Bush administration and many Republicans oppose the proposal as a big step toward socialized medicine. They much prefer to cite $83,000 – the ceiling that would apply to families of four only in New York state, and then only if the Health and Human Services Department approves a requested amendment to the state’s current SCHIP plan. Democrats, 45 Republicans in the House, many Senate GOP colleagues and other supporters of the expansion prefer to rattle off the figure $40,000. They say that about 70 percent to 80 percent of enrollees in the program would be children in families with incomes less that twice the poverty level. The poverty level is defined by the Census Bureau as $20,650 for a family of four. Just what would happen under the bill passed Tuesday by the House, up for a vote later this week in the Senate and then sure to get a veto from President Bush? Here are some of the claims, and what in fact the bill would actually do: The claim: The proposal would encourage families to substitute public insurance for private insurance. The facts: The Congressional Budget Office projects that about 3.8 million people would become insured as a result of the bill, and about 2 million more will move from private coverage to public coverage. CBO Director Peter Orszag said the substitution rate of one-third was "pretty much as good as you’re going to get" absent a mandate on employers to provide coverage or the insuree to buy it. The claim: The proposal would allow coverage of families earning $83,000. The facts: The bill essentially sets an income ceiling of three times the poverty rate for a family of four – $61,950. Beyond that, the federal government would not pay a state its full SCHIP match, which averages about 70 percent. New York state is seeking a waiver that would allow its residents to qualify if their income is not above four times the poverty rate – $82,600 for a family of four. The current administration or future administrations would have to approve that request. New Jersey would still be allowed to cover families with incomes three and one-half times the poverty rate – $72,275 for a family of four. The claim: The bill would make it easier for children of illegal immigrants to get government-sponsored health coverage. The facts: Currently, states are required to seek proof of U.S. citizenship before they provide Medicaid coverage, except in emergencies. The states now require applicants to show documents like birth certificates or passports in order to prove U.S. citizenship and nationality. The bill would allow applicants to submit a Social Security number instead. Michael J. Astrue, commissioner for the Social Security Administration, said that matching a Social Security number with an individual does not allow officials to verify whether someone is a U.S. citizen. The claim: The proposed 61 cent tax on a pack of cigarettes is a tax on the poor. The facts: According to a recent analysis by the National Center for Health Statistics, smoking rates are higher for those who live in poverty or near poverty than among wealthier individuals. Also, a more dated analysis cited by the National Center for Policy Analysis, a conservative think tank, states that two-thirds of federal tobacco taxes come from those earning less than $40,000 a year.
Lindsey Graham’s "explanation" of why he voted against SCHIP is completely inadequate, even insulting. He seems to have no rational argument against it, so he resorts to the most primitive gesticulations of the witch doctors of the Republican tribe, shaking the word "government" at it as though it had magical powers to chase away evil spirits.
Why in God’s name would anyone (that is, anyone who is not hypnotized by ideology beyond the ability to reason) reject health care simply because the government is involved in providing it? I grew up in the United States Navy receiving "government" health care from the time I was born until the day they tossed me out into the cruel civilian world as an adult, and guess what? Gummint medicine worked as well as any other.
FOR IMMEDIATE RELEASE Contact: Wes Hickman or Kevin Bishop
September 27, 2007
Graham Opposes Expansion of Government-Run Health Care
WASHINGTON – U.S. Senator Lindsey Graham (R-South Carolina) today will vote against the conference report on the State Children’s Health Insurance Program (SCHIP). The legislation is expected to pass the Senate. The House of Representatives has already passed SCHIP and President Bush has said he will veto it when it reaches his desk. “I was very concerned when the SCHIP program was created in 1997 it would eventually be expanded beyond its original purpose,” said Graham. “From the start, there were worries SCHIP could serve as the first brick in the road to national health care. Sure enough, a decade later, Congress will expand the program and add dozens of new bricks on the pathway toward government-run, government-controlled national health care.” Graham noted several problems with the SCHIP legislation including:
The expanded SCHIP program moves our nation closer to a single-payer, government-run, government-controlled national health care system.
The SCHIP program, created in 1997, was originally designed to provide health insurance to low-income children. Under the new expansion, the program will now cover adults and families earning as much as $82,600 a year. This year 13 percent of SCHIP funds will go to adults, not low-income children.
The program encourages people to move from private health insurance to government-funded health insurance. According to the Congressional Budget Office (CBO), 2 million individuals who are currently insured will move from private insurance to government insurance.
“There are many very serious problems with this legislation,” said Graham. “This bill doubles the cost of the SCHIP program and is a giant step toward nationalized healthcare. In addition, no longer are we just covering low-income children, but adults can now join the program. Finally, we encourage families to drop private insurance and join the government program. This is a very bad day for our health care system and the American taxpayer.” ####
We got there sort of late, and some of the vendors were shutting down, but we bought some pork chops, Italian sausage and breakfast links from Emile, and some okra from somebody else — nice little tender ones, too, none of your stringy gigantic pods you tend to get late in the growth cycle. Oh, yeah — and a couple of pounds of ground Angus beef.
It was a little pricey — to which my wife, an organic gardener since college days, says it’s better this way because when she goes to the supermarket she’s tempted to buy stuff she doesn’t need. I also find it hard to reconcile the ideas of "local" and "fresh" with frozen meat. But as Juanita says, if you’re not going to do hormones and preservatives and all that garbage, you have to freeze it. She says that with one of those looks and tones like she can’t believe she married, and bore 5 children for, such an idiot.
Hey, but I’m down with the whole Mr. Natural thing, and always have been. When she and I were first married, and living in what had been her grandparents’ house in Jackson, TN, we were really into that stuff. So much so, in fact, that right after we started living there, a natural-foods store called The Pumpkin Seed opened in a tiny space at the back of what had been her grandfather’s drug store across the little side street the house was on. It was run by a couple a little older than we were who had dropped out and had a dairy farm up in Carroll County. They would give us free manure for our garden — which was about 30 feet from the door of their shop. Since dairy products are deadly to me, I never had any of their milk, but they said it was really good except for the taste of the onion grass the cows ate.
Which sort of brings us back to Emile’s farm, where the hogs graze on whatever they want, and lie around and do whatever they want, except, presumably, watch TV, because that would make them get all flabby.
Emile’s a political guy and sure enough, there’s a political statement in this farmer’s market, which is a deliberate alternative to the State Farmers Market, which caters to a lot of out-of-state vendors and products, and which is subsidized by a lot of tax money, which Emile is against. (So are we, for that matter — we’ve fought unsuccessfully to keep state money from being wasted on the new one out at the end of Shop Road.)
And seeing as how it’s such a political farmer’s market and all, it was fitting that Emile said our own Doug Ross had dropped by earlier, which sort of blew his mind, meeting somebody he’d previously known only virtually in the flesh. And while we were there, Bud Ferillo came by and got himself a late breakfast of fresh strawberry crepes. So it was a happening place.
Emile says he’s going to send us some more info on where to buy local and natural on a regular basis, and I’ll post it here when I get it.
I ain’t gonna work on Emile’s farm no more… hang on, I gotta get my ax, cuz I’ve got another one comin’ on…
First, I had breakfast with our own Doug Ross, frequent commenter on this blog. How this meeting developed is complicated. It went sort of like this — Doug filed a comment that I did NOT publish, but meant to turn it and my reply into a separate post, until Doug complained (as a guy who has the common decency and courage to use his real name — note him holding up his picture ID — and who therefore has certain rights on this blog) that his comment hadn’t been posted, and I e-mailed him with my phone number so I could explain, and he suggested coffee instead, and next thing your know, it evolved into him meeting me at my habitual morning spot, the Capital City Club. Anyway, I learned that Doug lives out in Blythewood, he works in software, and he’s a Red Sox fan. Everything else you need to know about Doug you can find out from reading his comments on the blog. Oh, one other thing — we chatted briefly about his long-ago suggestion that we have a get-together of regular commenters sometime. Maybe that would be a good way to mark my millionth page view, which I estimate we’ll hit probably sometime in the next year. What do y’all think?
Oh, one last thing — Doug said I recently ran video of someone who Doug’s family said looked a lot like him, only younger. I’m guessing that was B.J. Boling of John McCain’s S.C. staff — don’t you think?
Lately, I’ve been bringing a Styrofoam cup of coffee in to the office with me most mornings, and I’ve noticed a disturbing phenomenon — tiny coffee-colored beads of "sweat" pop out on the sides of the cup during our morning meetings.
This is indicative of a lack of structural integrity, it would seem to me — coffee actually leaching through the cup, like tritium through soil.
The question this suggests is, What is leaching from the cup into the coffee?
Today was the most dramatic manifestation of this phenomenon I’ve yet observed. During a meeting with
folks from Providence Hospital, the tiny beads turned into huge drops that started running down and filling up the ashtray I was using as a coaster. (Sorry about the poor, Loch Ness-monster-quality focus in the picture. I was trying to shoot it without my action being noticed, because I didn’t want Sister Judith Ann thinking "this wacko’s taking pictures of his coffee," and hauling me back to Providence’s psych ward — if it has a psych ward. Diagnosis, Dr. House? Styrofoam poisoning.)
Finally, I had to excuse myself to go fetch my "Office Space" mug.
So, what can Styrofoam, ingested this way, do to you? Does it affect the brain? If so, that would explain so much about this blog, wouldn’t it? All of my detractors — and quite a few of my friends — would go away satisfied that at last, they had found the one factor that accounted for a vast range of previously inexplicable behavior.
Dr. Richard Carmona, former U.S. Surgeon General, came by Tuesday to promote the worthy agenda of the Partnership to Fight Chronic Disease. That’s yet another of those groups — such as this one, and this one, and this one (not to mention the one that advertises at the top of this blog) — that has established a presence in South Carolina in order to try to get the presidential candidates to address their issues of concern. As with the others, the effort is avowedly nonpartisan, and just as avowedly disinclined to promote any one solution over others.
Anyway, I asked the former Surgeon General whether his recent headline-making appearance at a congressional hearing — at which he complained that the Bush Administration, as is its wont, pressured him to get in line politically, regardless of science — had any effect on his ability to be heard across the political spectrum. I didn’t see why it should have, logically speaking, but I had long ago realized that political partisans don’t feel compelled to speak logically. His response was encouraging:
As long as I had him, I figured I’d ask him what he thought about South Carolina’s recent failed efforts to raise our cigarette tax:
Finally, I asked the question that I had always wanted to ask, and which I would not have been allowed to ask if my more task-oriented colleagues had been present (but fortunately, they were not): What’s with the Navy uniform (which one could also word, How come a "general" is wearing an admiral’s uniform?)
Here’s an interesting e-mail from someone who was traveling with Sam Brownback yesterday, and sat in on the editorial board meeting, but had a minor question about the accuracy of the way I quoted the candidate in one instance.
I pass it on because I think the attention Sen. Brownback would like to focus on cancer is worthwhile, and I hope it can gain some traction beyond his candidacy — which I’m afraid is probably not long for this sin-stained world.
Anyway, here is the question:
From: LOUIS W NEIGER Sent: Thursday, August 16, 2007 10:32 AM To: StateEditor, Columbia Subject: Please forward to Brad Warthen
Mr. Warthen, Your article in 8-16-07 concerning Brownback and the editorial board was I believe mostly fair. One point I may suggest that you did not correctly high light what Brownback said. he would "end cancer in 10 years" My notes show, Brownback was saying, allowing government to loosen terminal cancer patients restrictions on new treatments and drugs and to investigate what will work and this would "end cancer in 10 years." Your statement sounded like he personally would end cancer. What did your tape say????????? Thanks Sincerely Louis Neiger,CLU Newberry
Here is my initial response:
You left out
a crucial word from the quote. My column quoted him as saying he wanted to
"end DEATHS to cancer in 10 years." As I recall, he said he wanted to change
cancer from a terminal to a chronic disease.
I’ll see if I
can find that bit on my recording, and post it on my blog for you. You might
also want to look at the
blog version of my column, as it has links to additional
material.
— Brad
Warthen
And, most importantly, here is actual audio of what he said. (By some bizarre coincidence, I did quote him accurately.) An excerpt, for those who have trouble playing the clip, which goes to the heart of the distinction that might have caused Mr. Neiger to think my quote was inaccurate:
This will not end people getting cancer. People will still get it. But you’re gonna be able to treat it as a — what I want to do is be able to treat it as a chronic disease, not as a terminal one.
Rudy Giuliani was playing to a very small crowd — the seats immediately behind him were (as often the case with such events) stacked with some of his best-known local supporters, such as Rusty DePass and Gayle Averyt, hardly "faces in the crowd" in this town — but he was in fine form as he addressed his "town-hall" meeting at the Columbia Metropolitan Convention Center.
On both immigration and health care, he managed to slip in the idea that America is one heck of a great place (which it is). On immigration, that’s why all those bothersome illegals want to come here. On health care, the fact that folks who have a choice come to this country for health care rather than vice versa is in his book (but not in mine) evidence that we do, too have the best system among advanced countries.
Anyway, enjoy my rough videos from this afternoon’s session. (By the way, with regard to what I said about it being a "small crowd" — note that in the second clip, many of the seats in the not-so-well-lit sections were empty. I should add that at least a couple of those that were not empty were taken up by those lazy freeloaders in the working press.)
Barack Obama got a warm reception at the College Democrats of America confab over at the Russell House today. The kids liked his JFK-style, rise-to-the-challenge-of-a-new-generation idealism. I liked it, too. I think it’s something that sets Obama apart, in a positive way. I might write about it in my Sunday column.
But I had to smile when this was his biggest applause line (up to that point in the speech, anyway).
Now, before you dismiss these kids as totally self-interested and selfish — he’s talking about a real problem. Whether he’s got the solution or not, I don’t know. But as the father of five kids, four of whom are in their 20s, I’ve had to deal with the painful spectacle of watching my kids work very hard trying to make it on their own, yet struggle to pay medical bills when they arise, because their jobs don’t provide them with coverage.
Our whole health care "system" is price-adjusted for those of us who have health insurance, and too expensive even for us. For young adults without that benefit, it’s a cruel joke.
Why should young people starting out in the world have to settle for a job that gives them such bennies? It really limits them to following established paths rather than going out and taking risks to innovate and move our country forward. At least, it limits them if they listen to their old man, who worries so much about them that he keeps saying, "Go for the thing with the benefits!"
Partly, I do that out of frustration. I work myself to death to take care of my family, and once they turn 19, or graduate from college, I can’t take care of them any more, no matter how hard I work. And then I see them struggle without the umbrella of health protection I’ve always had. I try to help them out with cash at times, but at such prices it’s beyond my pocketbook, much less theirs.
In any other civilized country in the world, this would not be a worry.
So yeah, I laughed at the big applause Obama got on this, but what he’s talking about isn’t really funny.
Actually, they took it last time, but my iron was too low then to do what I went for — double red cells. It’s cool — literally. They take out a couple of pints of whole blood and remove the red cells. Then they pump it back in. As it goes back in, it’s clear. And not quite as warm as it was before. Quite refreshing on a hot day. (I hope that wasn’t one detail too many for you. Hey, at least I didn’t headline this, "My Blood Runs Cold." I could have, you know. I’m not proud.)
Also — and I haven’t fully figured out why this is — even though there are two channels, the needle itself is smaller, and therefore less painful. It takes longer, though.
I’ve only been allowed to do it once before. They have all these rules. Your iron has to be higher, your height and weight have to be at certain levels. (Women have to be bigger than men have to be for this, which seems weird.) Also, according to the sign in the picture, you have to be type B or O. Of course, most of us are O, aren’t we?
Last time, they said it was too low for the "Alyx" system, which is what they call the double-red-cell thing. But I could donate whole blood. I almost walked out, but stayed and did that. Guilt, you know. Fortunately, it’s been quite a while since my iron was so low they wouldn’t take any at all.
But today, the iron pills I’ve been taking, and the big bloody steak I had at lunch (which has caused me indigestion the rest of the day) worked! My iron was at 41, and it only had to be 40. Whatever that means.
It was cool. You should try it. I don’t want to be holier than thou on this, I just feel obliged to tell you that we’re always shorthanded in this part of South Carolina, and constantly have to import blood from other regions. That’s how I got started, after hearing that over and over. Guilt.
Whenever any kind of bomb goes off, there is likely to be collateral damage. At least, that’s the case with our bombs, since we’re not trying to hurt the innocent when we drop them.
With terrorists, it’s sort of different. The randomness of the victim’s identities is sort of the point. The more random, the more a bomb is likely to spread terror.
Well, I’ll tell you what I think: Keeping our current system is no way to avoid that problem. If you don’t think we’re drawing a lot of foreign medicos to this country, you haven’t been to a major hospital or to a local doc-in-the-box lately.
This is not to cast aspersions upon physicians with accents. It is to say that as long as we remain the kind of country that attracts the educated and ambitious from abroad (we can agree on that, can’t we, even though a lot of y’all out there don’t want to attract folks to come pick our strawberries?), we will be vulnerable — unless those societies over there change.
Hence my preference for offense over defense in the war on terror. And in baseball, for that matter — I certainly prefer batting to standing in the outfield. Don’t you? Sure, we have to play some tenacious D, but it’s crazy to let the bad guys be the ones batting all the time.
I want us to remain a free and open land of opportunity. That means encouraging other countries to be the same.
Check out the letters to the editor today and be edified.
It seems that a guy who speaks for the insurance industry doesn’t like our own Paul DeMarco’s idea for a single-payer health-care system. Well, that settles that. If the middlemen, who would be completely eliminated along with all their lovely profits, think it’s a bad idea, why on Earth should anybody listen to a mere physician such as Paul?
Anyway, for y’all who are too lazy to click, here’s the letter:
Government monopoly won’t help health care Guest columnist Paul DeMarco (“Really fixing U.S. health care,” June 5) argued that single-payer health care should be implemented in America. Although Americans are clamoring for health care reform, this is one proposed solution that should be taken off the table. Under a single-payer system, the government could hold a monopoly over health care coverage, offering only one insurance plan option. If the government decided to reduce funding or deny coverage for medical technologies or procedures, Americans would either have to forgo potentially life-saving procedures or finance them out-of-pocket. Under the current system, if people are dissatisfied with their plan, they can simply switch insurance carriers. Any possible savings from a single-payer system would be quickly eaten up by increased use, and bureaucratic inefficiencies would replace functioning free-market systems. The result would be an overburdened, underfunded system that is more cumbersome to navigate than the current one. We should seek alternatives to a single-payer system to ensure health care for all.
I was interested in how he brushed over the "any possible savings" part. Savings, of course, would be inevitable, because you would eliminate the third-party profits. Whether that were "quickly eaten up" in the way he suggests or some other way is certainly possible, but not inevitable.
Received this e-mail from one of the folks working against the tide to raise the cigarette tax:
Dear Brad, This Sunday, July 1 marks the 30th anniversary since South Carolina’s last cigarette tax increase. (July 1, 1977) The South Carolina Tobacco Collaborative is very appreciative of the editorial support that The State has lent to this issue for many years, and particularly this year. I know that John O’Connor is already working on a story about the cigarette tax to run this Sunday, and I’d like to ask you to consider writing an editorial to accompany that article and to highlight this unfortunate anniversary. Obviously, we had hoped that we could get this legislation passed before the July 1 date, but we are certainly thankful to be closer to an increase than we have been in 30 years. As you know, the SC Tobacco Collaborative and our member organizations (American Heart Association, American Cancer Society, American Lung Association, South Carolina Cancer Alliance, Campaign for Tobacco-Free Kids, etc) strongly support an increase that would bring our state’s cigarette tax to the national average. When we started this legislative session, the national average had just reached $1.02. While our legislature was in session, four other states passed cigarette tax increases, meaning that the national average has climbed to $1.06. We’re not just falling further behind each year that we fail to pass this tax — we are literally falling further behind each month that we fail to pass this tax. Most notably, Tennessee passed a 42-cent tax increase, which will bring their cigarette tax to 62 cents per pack, and increase the southeastern average. The South Carolina Tobacco Collaborative will continue to build our grassroots support over the next six months. We are greatly optimistic that the Senate will pass this tax very early next session and will do everything we can to keep this issue in front of legislators and the citizens who vote for them.
Don’t hesitate to call if you have any questions!
Thanks, Kelly
Kelly Davis Cigarette Tax Campaign Coordinator SC Tobacco Collaborative
This message was sent on Thursday, but I’m just reading it at a little before 9 p.m. Friday. Sunday’s page is gone, and I can tell you it contains no editorial on this subject (although I do make a passing reference to it in my Sunday column). I haven’t the slightest idea whether the newsroom will have a story on this or not Sunday. One can only guess about such things. In fact, such outside sources are more likely to know what the newsroom’s doing than I am (by design), but they can’t possibly know for sure.
But I do know this — as the memo says, no action can be taken for another six months. Time enough to write about it between now and then.
Just about every morning, I run into my friend Samuel Tenenbaum at breakfast, and we talk about various wonkish things, and have a high old time ingesting caffeine and blueberries.
And just about every morning, he mentions that it’s past time I should write about AARP’s program, Divided We Fail. Essentially, it’s an effort by AARP to get candidates in the presidential campaign talking about important domestic issues such as health care.
Shortly after he started working at AARP — and Divided We Fail is his particular mission — I dropped by his office and shot this video (with my phone, sorry about the low quality), which is essentially his answer to my question, "What are you doing here?"
At around that same time, Jane Wiley and others from that organization came by to see the editorial board and talked to us about the same thing. And we have yet to write about it, whereas others who don’t run into Samuel all the time have already written about it. That’s Jane pictured below. (If I shot video at that meeting, I’m having trouble finding it now.)
Well, we’ve had the Legislature winding down, etc., and all sorts of other excuses. But Samuel (and Jane, in her lower-key way) is (are) right to nag me about it.
This is one of several efforts going on in our state that do the very same thing, only with different issues. I wrote previously about the folks trying to raise the profile of global warming in the campaign. There’s also something going on backed by Bono of U2 and saving-the-world fame, and something else pushed by Bill Gates and his lady. I plan to do a column on the whole phenomenon, now that it’s summer.
But in the meantime, check out the grainy video, as Samuel summarizes it better than I could, and then look at the Web site.
It’s just not enough for our own Dr. Paul DeMarco to solve our education problems. Now he’s fixing health care. I like what he says, anyway. Who am I to argue? He’s the doctor, after all. In case you don’t know what I’m talking about, check out his op-ed piece that was in the paper today. An excerpt:
It is a complex issue, but it comes down to whom to trust: an industry
that deals with patients at arm’s length and is ruled by the almighty
dollar; or physicians, who deal with you face-to-face, who suffer with
you when you are unable to access essential care and whose oath calls
them to service, not just to higher income.
That’s why I am eager to announce the formation of a new group devoted
to creating a single-payer plan for our state and country. The
organizational meeting for a South Carolina chapter of Physicians for a
National Health Program will be held at 2 p.m. Saturday at Thorny’s
Steakhouse, 618 Church St. in Conway. The national group was founded in
1987 and now boasts more than 14,000 members (everyone is welcome; you
need not be a physician to join).
Dr. DeMarco is doing his bit. What are the rest of us going to do?
As communities across South Carolina have rushed to protect workers and patrons in restaurants and bars — in response to public demand, and a recent Surgeon General’s report — they have faced one major barrier: The Legislature doesn’t want them to do it, and passed a law several years back forbidding them to do so.
If the General Assembly as a body were not actively hostile to public health, all it would have to do to foster a new dawn is get out of the way — repeal its pre-emption of local governments.
Instead, in actions that might baffle Machiavelli, it has taken idealistic legislation that would place a statewide ban on smoking in such public accommodations, watered it down to meaninglessness, and included even more emphatic language making sure that local governments can’t go beyond the meager changes in this bill.
In the attached video, you can hear some women who have been working hard to get this far on a workplace smoking ban, only to find it blow up in their faces — in multiple ways.
For instance, the legislation now:
Bans smoking in restaurants, but not bars.
Allows bars to pretty much define themselves AS bars, rather than setting rations of food-to-alcohol or some such.
Allows such establishments to buy their way out of the ban with a one-time fee. All they have to do is call themselves a bar, and ban kids for part of the day — letting the kids breathe the poisons from the upholstery during the hours that the joint goes BACK to being a "restaurant."
Put enforcement of the provisions, such as they are, under the Department of Revenue — there is, after all, that fee to collect — rather than the Department of Health and Environmental Control.
Leaves those workers at places that decide to call themselves "bars" completely unprotected from this workplace hazard.
Most of all, makes sure local standards can’t be any better than the state’s.
That last part is what has public health advocates ready to kill the bill altogether — which has some of our relatively-benign-but-less-thoughtful lawmakers (and that’s a large subset of the General Assembly) — dismissing them as soreheads not willing to take "half a loaf." But it isn’t half a loaf; it’s a serious setback.
The whole country is fed up with being forced to breathe the toxins put out by an obnoxious minority in public places, and finally laws across the nation are starting to reflect that. The movement has been strong in South Carolina as well, with 11 bills moving through the Legislature that among other things raise the cigarette tax (a lamentably pitiful amount), and ban smoking on school property, in cars that have kids as passengers, and in the aforementioned public accommodations.
There were originally something like 19 bills, which testifies to the fact that this was a movement welling up from the people of South Carolina through their representatives, not a focused campaign by any interest group. "It’s not health Nazis dictating policy," said Lisa Turner of the American Heart Association.
That actually presents a tactical liability to those working in our behalf and against the skillful, deep-pockets, recently-reinforced tobacco lobby. They know that if they kill the bar-restaurant bill, the bad stuff will just be tacked onto one of the other bills they are counting on passing.
All the momentum out here in the real world is on the side of those of us who want to breathe clean air. But the local lobbyists for tobacco companies, who tend to be some of Columbia’s best — from Dwight Drake to Tony Denny — have been making highly effective use of their close relationships with key decision-makers in the State House.
They are like highly skillful generals on the losing side of a conventional war — giving ground in ways that make their opponents pay the maximum for every inch, while all the time looking for the main chance that will suddenly tip the balance back in their favor, despite all the odds.
To see how this works in microcosm, check the video, in which a lobbyist for the American Lung Association describes her shock at first, seeing House Judiciary Chairman Jim Harrison attend a subcommittee meeting on the restaurant bill, then seeing the members chat back-and-forth with the tobacco lobbyists across the room whenever they had a question, ignoring the experts from the state health department that were sitting there.
The women in the video went on and on about how their phones have been lighting up with folks from their national organizations wanting to know, what in the world is happening there? Georgia, after all, not only bans smoking in any place that EVER serves kids — which pretty much covers all restaurants — and has 27 local ordinances that go farther than that. All of this, remember, is in response to the public demand — to which local governments tend to be more sensitive than state lawmakers.
Since these health advocate met with the editorial board, North Carolina has voted NOT to ban smoking. So at least South Carolina isn’t totally alone in its backwardness.
So the House decided to increase the cigarette tax to about a third of the national average? Well, whoop-te-doo.
Of course, at least it’s something. And if you’re going to cut a tax with the money, the grocery tax is a far better choice than the income tax, because the former is actually comparatively high, while the latter is not. It also funds a youth smoking cessation program, so on the whole it’s pretty decent legislation, certainly better than doing nothing.
There was a lot of fuss made about lawmakers not using all the money for Medicaid or some such. This did not bother me. As I’ve said before, I don’t really care what happens with that money, you could burn it and still accomplish the most significant goal that has motivated me to want to raise it all these years: Study after study has shown that if you raise the price per pack, fewer kids become nicotine addicts.
Anyway, Medicaid costs — just like the costs of those of us who are in private health insurance plans — are climbing so fast that even if you had devoted all the money to that, it would only cover one year’s increase in the expense. Then what do you do? The answer to rising Medicaid costs is the same as the rising private health care costs: We need to overhaul the entire system, and that is one of those few things that might have to be done on the federal, not the state, level.
For details on exactly what happened on this vote, I share with you this memo that my colleague Cindi Scoppe prepared for me. Enjoy:
On Wednesday, the House voted 78-37 to increase the cigarette tax by 30 cents and reduce the sales tax on groceries by 1.6 cents. (H 3567) The tax increase is projected to bring in about the same amount of money as the tax decrease, around $100 million.
There were actually two major questions concerning the cigarette tax: whether to increase it and, if it was to be increased, what ELSE to put in the bill.
The Ways and Means Committee bill increased the cigarette tax by 30 cents, reduced the sales tax on groceries by 1.5 cents, expanded Medicaid coverage, funded a youth smoking prevention program and paid for a couple of other programs. It was designed this way in order to satisfy two separate constituencies in the House: those who would only vote for a tax increase if it was offset by an equal or larger tax decrease, and those who wanted money from a cigarette tax increase to go to Medicaid and other health initiatives. The problem was that this meant the bill would have actually cost the state about $100 million. To see the details of that package, go to the April 20 version of the bill and scroll down until you see the Fiscal Impact statement.
After initially sticking by this plan, the House eventually changed course and voted 64-52 to strip out nearly all of the spending and make the bill a straight swap: a higher cigarette tax for a lower sales tax on groceries. Here’s that vote, followed by the vote to pass the bill:
Voting to strip out the Medicaid spending: Ballentine Bannister Barfield Bedingfield Bingham Bowen Brady Cato Chellis Clemmons Cooper Crawford Delleney Duncan Edge Frye Gambrell Gullick Hagood Haley Hamilton Hardwick Harrell Harrison Herbkersman Hinson Huggins Kelly Kennedy Kirsh Leach Littlejohn Loftis Lowe Lucas Mahaffey Merrill Mulvaney Perry Pinson E. H. Pitts M. A. Pitts Sandifer Scarborough Shoopman Simrill Skelton D. C. Smith G. R. Smith J. R. Smith W. D. Smith Spires Stewart Talley Taylor Thompson Toole Umphlett Viers Walker White Whitmire Witherspoon Young
Voting to keep the Medicaid spending in the bill: Agnew Alexander Allen Anderson Anthony Bales Battle Bowers Branham Brantley Breeland G. Brown R. Brown Ceips Clyburn Cobb-Hunter Coleman Cotty Dantzler Davenport Funderburk Hart Harvin Hayes Hiott Hodges Hosey Howard Jefferson Jennings Knight Limehouse Mack McLeod Miller Mitchell Moss J. H. Neal J. M. Neal Neilson Ott Owens Parks Rice Rutherford Scott Sellers G. M. Smith Stavrinakis Vick Weeks Whipper
—————————————- The House passed the bill by a vote of 78-37: Those who voted in the affirmative are:
Agnew Allen Anderson Anthony Bales Ballentine Bannister Bingham Bowen Bowers Brady Branham Brantley Breeland Ceips Chellis Clemmons Clyburn Cobb-Hunter Coleman Cotty Crawford Dantzler Delleney Funderburk Gambrell Gullick Hagood Hamilton Hardwick Harrell Harrison Harvin Herbkersman Hiott Hosey Howard Huggins Jefferson Jennings Kelly Knight Limehouse Littlejohn Lucas Mack Mahaffey McLeod Merrill Miller Mitchell Moss J. H. Neal J. M. Neal Ott Owens Parks Perry Pinson E. H. Pitts M. A. Pitts Rice Rutherford Sandifer Scarborough Simrill Skelton D. C. Smith G. R. Smith J. R. Smith Stavrinakis Stewart Taylor Toole Vick Walker Whipper Whitmire
Total–78
Those who voted in the negative are:
Alexander Barfield Battle Bedingfield G. Brown R. Brown Cato Cooper Davenport Duncan Edge Frye Haley Hart Hayes Hinson Hodges Kennedy Kirsh Leach Lowe Mulvaney Neilson Scott Sellers Shoopman G. M. Smith W. D. Smith Spires Talley Thompson Umphlett Viers Weeks White Witherspoon Young
to be at certain levels. (