Issac J. Bailey | The government we want, the government we deserve

We don’t do government well in South Carolina because we don’t like government.

We celebrate government failure.

We reward it time and again at the ballot box.

Government doesn’t have to work; all it has to do is adhere to a particular ideology.

That’s the message we’ve sent to the good folks in Columbia.

That’s why no one should be surprised that most of our Social Security numbers were exposed because of lax state government security and oversight, and that there was no real bidding process before we spent $12 million on a credit protection firm.

That’s why not many people in South Carolina are shocked that our school system has long been ranked near the bottom in the country, given that we haven’t even decided to fund it up to the minimum level the state itself says is necessary to educate our children.

That’s why our roads system is not up to snuff, despite the presence of competent and dedicated engineers in the Department of Transportation.

That’s why we lost more than $100 million in federal funding because of an out-of-date system used by the S.C. Department of Social Services to track child support payments.

We were the only state in the union with that problem.

We don’t want government to be effective here.

Why would we? It would take away an important talking point.

I want to be wrong, want what I’ve just written to be hyperbole.

But I’m a South Carolina native who has watched for decades as outcomes matter less each year. It seems to matter little if our schools don’t actually improve or our roads get better or we get healthier.

Now, on the heels of the Social Security numbers breach, we are on the cusp of another test.

If Gov. Nikki Haley and the GOP-dominated General Assembly can’t come up with a viable, sensible, effective plan to increase access to the state’s health care system and get re-elected any way, it will prove my point.

The Kaiser Family Foundation, one of the most respected authorities on health care policy in the country, released a report this week outlining the potential effects of the Affordable Care Act on individual state budgets.

It found that in most states, the increase in cost would be modest (some states would actually see a small net gain in spending power) while millions more of the uninsured would receive coverage.

South Carolina is one of eight states that has decided to buck the health reform law. It doesn’t want to expand Medicaid. It would rather the federal government set up the insurance exchanges that are designed to bring down costs.

According to Kaiser, the Affordable Care Act could reduce the ranks of the uninsured in the state by about 57 percent.

The cost to the state would be about a 5 percent increase in Medicaid spending, a pretty significant rate of return.

Other gains would come from increased federal matching rates for some current Medicaid beneficiaries; reduced state spending on non-Medicaid health care that has been given to poor, uninsured residents; and “additional revenue, including general revenue increases caused by the boost to state economic activity that would result from increased federal Medicaid dollars being spent within the state.”

“Even in states with the highest level of increased Medicaid costs from expansion, new state spending relative to general fund expenditures is approximately 1 percent or less if uncompensated care savings are included,” the Kaiser report said.

To recap:

Our governing philosophy for at least the past quarter of a century has led to poor academic performance, a health care system that is largely off limits to the poor, bad health outcomes and a variety of other problems that linger like sores that just won’t heal.

We reward this performance at the polls because the triumph of a particular political vision has become more important than effective government.

We should stop blaming the folks in Columbia.

They are doing just what we sent them there to do.