Sanford stood up for quality of state’s heart care centers

By DON ALEXANDER AND SCOTT J. PETIT

Guest columnists

With more than 35 years combined experience as heart doctors, we have handled tens of thousands of cardiac procedures and understand the needs of patients. As such, we can confidently say that Gov. Mark Sanford’s decision to veto a bill allowing Lexington Medical Center to begin an open-heart program was principled, wise and in the best interests of the citizens of South Carolina.

We take great exception to the full-page ad that ran in The State on Sunday that said Gov. Sanford appears more interested in “the process” than the health care needs of the people of Lexington County.

If anything, Gov. Sanford’s decision shows that he has the best interests of the people of South Carolina in mind, and that he’s willing to do something rarely done in politics — base his decision on reason, not political pressure.

The Certificate of Need process exists to ensure that decisions about health care programs and expenditures, such as those involving open-heart surgery programs or constructing new hospitals, are made in an open forum, with the Department of Health and Environmental Control making the final call.

The process exists to allow knowledgeable, trained individuals to sort through the extremely complex issues involving health care resources and the needs of the community, while insulating the process from political pressures exerted by parties with deep financial interests.

Nearly 75 percent of states rely on the Certificate of Need process to ensure the best delivery of limited health care resources to all citizens. In states without a CON system, the risk of dying from open heart surgery is 21 percent greater, the overall cost of health care is higher, and access to care for the poor is worse, according to information published in the Journal of the American Medical Association.

In other words, the Certificate of Need process is in place because it works.

Lexington Medical Center applied to build an open-heart surgery center some two years ago. That request was denied for several reasons:

• Existing programs within an eight-mile radius of Lexington Medical Center are not at capacity.

Currently, there are six approved open-heart operating rooms functioning in the central South Carolina region. These rooms can perform a total of 3,000 open-heart cases per year. Currently, fewer than 1,500 cases per year are being performed.

That number has decreased steadily during the past several years, and will continue to decline, due to advances in medical and catheter-based stent therapies, neither of which requires operating room space.

• Also, testimony before DHEC and the Administrative Law Court showed that patients from Lexington County were being provided timely and quality care by other providers in the region.

The bottom line is adding further capacity at another hospital will only dilute available manpower and capital resources while decreasing efficiency. Giving Lexington Medical Center approval to begin an open-heart program is not only not in the best interests of Lexington County, it jeopardizes treatment of heart patients throughout the Midlands.

Further, we are dismayed by assertions that current care capacity is costing lives in Lexington County; there is no data or sworn testimony to support this.

Today, the need to bring a patient directly into open-heart surgery is rare because of our ability to administer life-saving drugs in any hospital emergency room, along with advanced technologies such as those involving stents, available at Lexington Medical Center.

Also, air transportation enables Lexington County patients to receive care that is just as prompt at all open-heart operating rooms in the region, when you account for operating room setup time and staff availability.

In simplest form, Gov. Sanford has taken the position that we should have a CON process and live by it or scrap it, but not go down the worst of all routes, which is to have a process driven by the size of one’s political voice. In so doing, he has chosen to put the health care needs of South Carolinians as a whole before political expediency.

The governor made the right decision, and the Legislature should agree when it comes time to consider upholding the governor’s veto.

Dr. Alexander is a cardiologist in Columbia. Dr. Petit is a cardiovascular surgery specialist in Columbia. Both practice primarily at Palmetto Health hospitals.