Guy Fasciana's column last month, regarding why the funding for the South Carolina Medicaid system is reaching crisis level, is symptomatic of a larger problem in this state. South Carolina needs fewer self-serving special interest groups using this budget crisis to further their own financial agenda. Mr. Fasciana, as the manager of the Children's Respiratory Center in Greenville, is charged with the duty of making sure money gets into the hands of the doctors.

The taxpayers of South Carolina do not need another baseless accusation that serves medical providers, rather than the state Medicaid program and its beneficiaries. Now is the time for providers, pharmaceutical manufacturers, insurers and policy makers to come to the table to find ways to institute genuine reform to ensure that the Medicaid system will survive for the next generation. Finger pointing is no longer acceptable. We must work together to ensure that a safety net is there for our less-fortunate citizens, without taking the taxpayers for a ride with a system that in the past was fraught with inefficiency.

The health-care community should spend less time on infighting and more time examining viable options for South Carolina's Medicaid system, such as Gov. Mark Sanford's proposed Medicaid waiver. Gov. Sanford and Department of Health and Human Services Director Robert Kerr recognize that the system needs to be updated, and they are trying to find a solution. This change may seem drastic for a "one size fits all" government, but in actuality, it is the norm for most working South Carolinians who have access to private insurance.

Gov. Sanford wants to give our Medicaid beneficiaries choices in the market. Beneficiaries have several options to choose from, including a full-service insurance product or HMO.

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These models will enable Medicaid recipients to choose a primary care doctor, ensuring them a medical home. This will curb costly and unnecessary trips to the emergency room, and have our Medicaid recipients participate financially, in a small way, for the first time. This will allow insurers and physicians to work together in disease management programs to keep diabetics and asthmatics out of the emergency rooms and hospitals.

The facts could not be clearer -- if we don't work together to find an answer to the ever-increasing costs of the Medicaid system, the taxpaying citizens of South Carolina will see a decrease in other public goods such as law enforcement, roadways and education. Why? Because the Medicaid system as we know it today is growing at over three times the rate of inflation. It has doubled over the past 10 years in its size of expenditures, and will consume more than 25 percent of the state budget within another seven years. That's why we must act.

The focus of the debate should not be on who is getting paid too much or too little, but on the actual root of the problem. South Carolina is responsible for the medical care for almost a million men, women and children, as well as being a good steward of taxpayer money. The manner in which we manage this enormous task will shape the economic landscape of South Carolina for generations to come. Undertaking such a monumental task requires a coalition of people who are willing to work together to do what is best for this state.

All members of the health-care community need to rally behind instituting genuine Medicaid reform, whether it comes in the form of Gov. Sanford's Medicaid waiver, South Carolina Healthy Connections or other options that enable beneficiaries with the same options that working South Carolinians have: coordination of care, disease management and a primary care physician. It is time to set aside petty arguments and focus our effort on finding a way not only to better serve the nearly 1 million of our citizens relying on South Carolina to provide quality medical care, but also to ensure that we can continue to even fund the Medicaid program. We owe it to the recipients and the taxpayers to develop a system that will provide quality care at the lowest cost.

Coordinating care through options such as medical homes and health maintenance organizations will put our health-care delivery for the poorest South Carolinians back on track. But we can only get on track if we all work together.