By Dr. Ira Williams
Lawful authority.
Who has lawful authority over all components of the health care delivery system (health systems, hospitals, surgery centers, etc.) throughout the state? All events regarding the GHS transfer of ownership during the past several years demonstrate no obvious answer to that question, and no evidence that that question has even been asked. A compilation of facts and best-known information will hopefully initiate a more thorough consideration of how to determine if any person or persons possess lawful authority over the South Carolina health care delivery system.
Did GHS break the law governing South Carolina hospital governance when a very small group of individuals, the majority in their GHS board position as unpaid volunteers, and who were expected to contribute only approximately 110 hours of board service and five days at retreats and conferences per year, and each was to be limited to two three-year terms, signed a presumed to be legal document transferring ownership to themselves?
That rightfully questionable event apparently took place in a vacuum as far as every elected person in Columbia was concerned because neither Gov. Haley, or McMaster, Attorney General Wilson, or any member of the legislative leadership took notice or voiced interest.
Historically South Carolina has created three health care agencies, DHEC, DHHS, and Medical Examining Board. In addition, three fundamental facts regarding the delivery of health care support the understanding that each state is responsible to create and maintain an effective health care delivery system:
- All medical care is local.
- States license doctors.
- All 50 state medical examining boards are over 100 years old, and each board has a mission statement containing the phrase, “to regulate the practice of medicine.”
Yet the South Carolina health care delivery system has been publicly acknowledged to be “broken’:
- Spence Taylor, GHS President said, “Even if you cured cancer you couldn’t get it to the people because the medical system is broken”, Greenville Journal, 2010.
- Ingo Angermeier, then president/CEO Spartanburg Regional Hospital, and former SC Hospital Association President said, “There is no question that our nation’s healthcare system is broken”, Greenville Magazine, 2011.
Furthermore, the South Carolina Legislature is comprised of 27 standing committees (Senate 14, House 13) and the words health care do not appear on the page.
Every discussion regarding the unilateral GHS decision to lawfully or unlawfully transfer ownership of the largest South Carolina health system containing over 10 percent of all hospitals in the state clearly demonstrates what has always been missing – there is NO functional lawful authority regarding this state’s health care delivery system.
The health care delivery system directly impacts the lives of every living person in the state, plus those yet unborn. Everyone is subject to that “broken system” from one’s first breath to their last breath. Thus, the GHS issue and the current process to determine who will be the next governor provides an excellent opportunity to seek answers to critical questions, i.e.:
- Identify the lawful authority of the current system.
- Why is the current system “broken”?
- Are steps being taken to address that critical understanding?
- Should a health care standing committee be created in both Houses?
These questions go far beyond the purview of the Greenville County Council or the Upstate legislative delegation, and everyone in South Carolina deserves careful consideration of both the GHS transfer of ownership and the entire, clearly acknowledged “broken” health care delivery system. Fortunately, Mike Riordan and Dr. Spence Taylor have publicly acknowledged their need to be transparent; therefore, the public should feel assured of a willingness of all qualified parties participating in open discussions.
Ira Williams is an author of three books on the health care delivery system and is actively consulting in an effort to reopen a closed rural hospital in South Carolina, while also serving as a surgical malpractice expert in litigation cases.
