South Carolina’s James Louis Petigru was a Civil War-era lawyer, judge, congressman and most notably the attorney general who opposed South Carolina’s use of nullification of federal laws and, after Abraham Lincoln was elected president in 1860, opposed state secession.

He famously quipped, after learning that his state had seceded from the Union, “South Carolina is too small to be a republic and too large to be an insane asylum.”

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While not insane, the state was a little nutty when it rejected Medicaid expansion under the Affordable Care Act (ACA). South Carolina has one of the highest percentages of uninsured people in the country.

The leaders of the state are leading the people down a dead-end street. They support tax cuts for the rich and health care cuts for the poor. South Carolina is a red state with blue needs — more health care, less poverty, better schools and fewer jails.

Nikki Haley, the former governor of South Carolina and President Donald Trump’s former ambassador to the United Nations, was born in Bamberg, South Carolina, a small city of approximately 3,600 people.

The Bamberg County Hospital, where Haley was born, closed on April 30, 2012 for lack of money. Not only did people lose health services but Bamberg County Hospital workers lost their jobs.

Many other small rural hospitals and workers faced the same fate in South Carolina when the state rejected the $10 billion over 10 years it would have received if it had expanded Medicaid.

A recent article in the Greenville News reported that when hospital beds fill up in the state, patients are boarded in emergency rooms. It is inhumane and economically foolish and morally wrong to argue against expanding Medicaid when 50,000 jobs and greater health care is involved.

Arguing against keeping rural hospitals open, like Bamberg County, makes no sense. It’s arguing for sickness and unnecessary death.

It’s a national problem, but recently South Carolina’s Greenville News documented the situation locally when 80-year-old Ron Miller of Pickens County collapsed at home two days after surgery and had to be rushed back to the hospital and readmitted. The problem was there were no available beds at that hospital or any of the hospitals in Greenville.

The paper reported, “The phenomenon, called boarding, occurs when hospitals hold patients in the ER until they find a bed for them on a medical floor.” Dr. Ryan Stanton, a spokesman for the American College of Emergency Physicians, an ER physician with Central Emergency Physicians in Lexington, Kentucky, has indicated it’s a growing problem across the nation. It’s a simple problem of supply and demand.

There are more patients than there are beds. A further concern is whether patients forced to stay in the ER for long periods of time have the same equipment made available to them and receive the same level of care that those in hospital beds receive.

Expanding Medicaid could help, but South Carolina is a state that pretends to resent big government and federal dollars, even though 32 percent of its general revenue comes from Washington for education, health care, airports, highways, seaports, the big military presence in the state and more. South Carolina couldn’t exist without federal dollars. It, apparently, just doesn’t want to receive Medicaid funds for its neediest citizens.

There is a better South Carolina on the horizon and Congressman Joe Cunningham (SC-01) is an example. He’s the new Democrat from the Lowcountry and he’s worked to reinstate the ban on offshore drilling, protect Lowcountry jobs from damaging tariffs and fix South Carolina’s ailing infrastructure. On Jan. 3, 2019, he said he was “ready to roll up his sleeves and get to work” and he has. South Carolina needs more Joe Cunninghams.

We all do.

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