The following post is written by my friend Phillip Belcher. I asked if I could share. I've been so busy recently…maybe I'll start giving my friends an outlet to vent…that way, I don't feel so guilty for neglecting Seeding Spartanburg while I work on Citizen Spartanburg. :)

By Phillip Belcher

Dear Members of the Spartanburg County Legislative Delegation:

I recently read in the Spartanburg Herald Journal of an effort by two of your members to take from County Council the power to appoint members to the Board of Spartanburg Regional Health System. The rationale for the effort seems to be that state representatives should have the ability to appoint board members to organizations that receive state dollars through Medicaid. 

This is a curious development. First, as far as I know, Spartanburg Regional is a well-run, efficient, award-winning health system. It provides millions of dollars of free care annually to uninsured residents of Spartanburg County and beyond. I am not sure what improvements your appointees will bring to the table. Secondly, please bear with my annoying tendency to take arguments to their logical conclusions. So, if your concern is that the legislative delegation should have some say in the governance of organizations that receive state dollars, I suppose that corporations receiving tax subsidies, tax breaks, fee-in-lieu agreements and similar forms of what some have called “corporate welfare” should beware. They, too, could become targets for legislators who want a seat at the boards of all organizations that get tax breaks. This is a message that should probably be included in corporate recruiting materials so that companies like BMW and Boeing will have all the information they need to make relocation decisions.

If the issue is one of cost control, here are a few recommendations that would decrease the amount of money the state spends on health care:

1. Support efforts to expand health insurance coverage. If everyone in the state were insured, then S.C. residents would not be forced to seek their primary care at the most expensive location possible—hospital emergency rooms.
 
2. Restore and increase funding to the South Carolina Campaign to Prevent Teen Pregnancy. Hospital costs increase when babies are born prematurely or without adequate prenatal care. And, while you’re at this, mandate science-based pregnancy prevention curricula as part of the health education programs in all public schools. Health education is already taught. There’s no reason not to teach what’s proven to be effective.

3. Support efforts to create a rating system for early childhood development centers in South Carolina. Parents have a right to know the quality of the child development centers in which they enroll their children. High quality early learning has been proven through longitudinal studies to improve health outcomes, reduce crime and recidivism, increase home ownership, and increase employment. The Federal Reserve has calculated that every dollar devoted to high quality early care and education of young children produces an approximate 16% return on investment. South Carolina’s current rating scheme is woefully inadequate—sort of like the constitutional guarantee of a “minimally adequate” education. You’ll need to ignore the for-profit child care lobbyists who will complain that increasing standards will put them out of business. Many of the same for-profit chains operate in our neighboring states. Those states have rating systems, and the for-profit centers appear to be doing just fine. And, you might want to look at survey data from Spartanburg County which shows that cost is not the most significant factor for parents choosing child development centers anyway. Parents have as much a right to know the quality of child development centers as they do the quality of the restaurants where they take their families to eat. One more thing.  If you want to attract high-paying white collar and high-end manufacturing jobs to South Carolina, you should pay attention to the quality of child development centers. Those employers are.

4. If you want to reduce Medicaid and other health expenses, raise the tax on tobacco.  This is a proven way to reduce smoking, and smoking is a major health problem in South Carolina and the source of much of the expenditure of state money on health care.

5. Do what you can at the state level to promote sensible land use planning. Automobile emissions are higher in poorly planned communities, and poor air quality is a significant contributor to the skyrocketing number of asthma cases.
 
This is just a start. The data show these steps to be effective. If cost is the issue, be bold and take actions that will really make a difference. Of course, if the real issue is aggregating power, then maybe your two members are on the right track.