But let us ask a simple question. “Are taxpayers getting the most health for the money they spend on health care?” My answer is no – not by a long shot.

We spend more money for health services per person than any nation on earth. Year after year we devote a larger and larger portion of our paychecks, our payrolls and our state and federal budgets to health care services.

Maybe we wouldn’t worry about all of this spending if our outcomes were better, but they aren’t.

The United States is falling behind the rest of the world in infant mortality and life expectancy – and here in South Carolina we have one of the lowest life expectancies and highest infant mortality rates in the U.S.

With such high costs and such poor outcomes, why would we throw more money at the system without first demanding improved efficiency, quality, and accessibility?

The Affordable Care Act, known as Obamacare, says expand first and worry about the rest later.

Connecticut expanded early under Obamacare and just reported a $190 million Medicaid deficit – in spite of subjecting their citizens to a massive tax increase.

California just raised taxes in part to cover their Medicaid deficit and yet needs $350 million more to pay for Obamacare next year.

That’s not us. That’s not South Carolina.

The federal government likes to wave around a nine-dollar match like it is some silver bullet, some extraordinary benefit that we cannot pass up.

But what good do the nine dollars do us when we can’t come up with the one?

And what good are any dollars when they come through a program that doesn’t allow us the flexibility to make the decisions that are in the best interest of the people of South Carolina?

In the end, I cannot support this expansion for a very simple reason: it avoids addressing our health system’s high costs and poor outcomes.

As long as I am governor, South Carolina will not implement the public policy disaster that is Obamacare’s Medicaid expansion.

Instead, we need to improve health care value. And we will.

Rally Jan. 14, the first day of the legislative session. Among the demands was that lawmakers accept the federal grant to expand Medicaid, a move that would save an estimated 1,400 South Carolina lives. Join the Truthful Tuesday movement! Details at TruthfulTuesday.net.