Five candidates for governor disagreed on whether to raise the state's lowest-in-the-nation cigarette tax - and how to spend the money - at a Friday debate
The debate, sponsored by the S.C. Hospital Association, was a focused, substantive discussion on issues ranging from tort reform, mental health care funding, health care agency restructuring and how to entice doctors to practice in rural areas.
The hospital association has for years lobbied to raise the state cigarette tax and use the revenue to pay for health care for low-income residents, and state schools Superintendent Jim Rex and state Attorney General Henry McMaster had a dust-up last weekend about the tax.
The three Democrats, attorney and former lobbyist Dwight Drake, Rex and state Sen. Vincent Sheheen, D-Kershaw, all favored raising the tax while Republican McMaster did not. Repulican Lt. Gov. Andre Bauer said he would like any cigarette tax increase to include an equal tax cut.
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But the three Democrats differed on how to spend the money, with Rex proposing a larger tax increase to the national average of $1.34 a pack - to fund health care, agriculture marketing, cessation programs and prevent teacher furloughs. Sheheen, the only person in the debate to vote to raise the cigarette tax, said he would put the money into health care, calling the decade-long failure to raise the 7-cents-a-pack tax shameful. Drake, a former lobbyist for the country's largest tobacco company, said it was politically impossible to raise the tax to the national average, and touted a smaller 50-cent-a-pack increase.
"It's not right to tell someone you're going to do something that can't be done," Drake said.
As he has for several weeks, Bauer said the state needs to wean residents from public services such as health care. When asked about the lack of funding for mental health services patients who are often treated in hospital emergency rooms Bauer said the state needs to break the cycle.
"At what point are we going to say enough is enough?" Bauer asked.
Sheheen said he would protect the Department of Mental Health's budget and push for more low-cost ways to treat patients before they become ER problems, including psychiatric services by telephone. Rex said the cigarette tax could pay for mental health care.
McMaster said ERs should be protected from lawsuits if they turn away mental health patients.
The candidates were split on whether, and how, to restructure state health care agencies.
Bauer, Drake and Sheheen wanted to add the Department of Health and Environmental Control to the governor's cabinet. Most agreed restructuring was not a cure-all and said an effective governor could improve those agencies.
The candidates were also split on two leading legal changes to bring down the cost of health care: nonbinding arbitration of disputes, and requiring the loser in lawsuits to pay the costs.
All the candidates supported arbitration, but only Sheheen and Bauer would require those who lost cases to pay the costs. When asked if the state should provide incentives to doctors who promise to practice in rural areas, all but McMaster supported the idea.
McMaster questioned how the state would pay for the incentives.