November 30, 2022
Interview conducted by Holly Pisarik, Senior VP of Advocacy & Policy Counsel, SCMA, and Ben Homeyer, President, 1101 Public Affairs on Nov. 3, 2022.
About Senator Verdin:
Chairman, Senate Medical Affairs Committee
Republican – Laurens
District 9 – Greenville and Laurens Counties
Years in Public Service: 2001 – Present
Send an email to Senator Verdin
You have been the chairman of Medical Affairs for several years now. Items from medical marijuana to abortion to reforming DHEC to COVID issues have come through in the last few years. It’s safe to say that your committee has handled some major and tough issues. What do you think the committee will see this year?
It’s just a continuation. I have been serving on the Medical Affairs Committee for 18 or 19 of my 22 years, and I was very fortunate and honored to chair the Agricultural and Natural Resources Committee for eleven years and loved every minute of it. Given the opportunity to chair the Medical Affairs Committee, I felt compelled to do it.
It’s never easy. It seems that nothing we handle in the committee is ever easy. I guess that’s the reason that next year will be very much a continuation of this year. And in fact, we’re still in this year. We had a conference on 5399 just yesterday!
You have always had a very Pro-Life stance on abortion. Since it appears that 5399 is not going to become law in any fashion this year how do you think the body will handle the issue in the upcoming session? What do you think will happen?
Based on what you saw in conference there is consensus starting to coalesce around blending the bills. We thought that this would be very difficult to attain. I think that we are in for a very long, possibly successful floor debate, although I hate to speculate because we’ve been so strained to try to build consensus in the wake of Dobbs. There have been arguments that the matter is not mature enough to find that consensus, at which point the counter argument is that we’re 50 years mature.
The political maturation of the whole question of abortion hasn’t been as demonstrable as the medical side of the practice of abortion. Maybe the political dynamics sat still because of court intervention 50 years ago. What didn’t stand still was medical practice — the advances in the practice of medicine and the advances in the application of medicine through technology. In the early 1970s, what would have been accomplished through surgical procedures in utero wouldn’t have been anything like it is today. The ability to diagnose fatal anomalies would not have been nearly as advanced then as it is today. So much has transpired.
Now, as we try to grasp this new political dynamic, everything has been thrown back to the states. Finding those “mesh points” between where medicine has taken us and the sentiments of the body politic is the toughest thing that I have ever experienced. Nothing has been more difficult in my 22 years. As we consider the human equation, it is the most visceral subject matter that has ever come forward. Regardless of your perspective, there’s hardly a person in South Carolina that has not been touched in some way. Regardless of where you came from, it has been painful.
Our committee has received hundreds and hundreds of points of contact from citizens of South Carolina, each with a story that is very poignant. This is not lost on legislators. We are trying to find the consensus within our body politic so that we can encapsulate this complex issue within our context of 170 legislators. I imagine that every one of those 170 legislators will tell you that it’s been the toughest piece of work that’s ever been attempted around here.
Repeal of CON which came through your committee is one of the SCMA’s top legislative priorities again this upcoming session. The SCMA would like to thank you for being instrumental on this issue in the Senate. What do you foresee happening on CON repeal/reform this upcoming legislative session?
This is one issue that we have to address. Time will not solve this issue on its own. I fully expect numerous CON bills. I think that it only stands to reason that the Senate passed bill sponsored by Senator Climer is a reasonable vehicle, and I’m hoping that House leadership will signal that they hear it, see it, and are on it.
We only have one new Senator to weigh in on these matters over the previous two-year session, but there is a different House. I’m anxious to see what the House is going to look like as it relates to medical choice, medical freedom, and medical service availability. I’m hoping that it’s an improved outlook. I really appreciate Murrell Smith and I think that he’ll be a fantastic Speaker, and I am confident that Ways and Means will be in good hands.
If it’s the will of the Senate for CON to come shooting out of the box again, I certainly will accommodate and facilitate. I also believe it’s incumbent upon the House to take measurable action early. There is a lot of impetus here, and I really believe that this is going to be the year. There’s a lot at stake here as it relates to medical choice availability. Whatever it takes, I’m committed.
You have one of the largest health care providers in your county in Prisma Health, do you often talk to physician constituents? If so, what concerns do they share they have with you?
I’m thankful that the associations and societies can hire professional lobbyists to convey the messages. That said, the physician’s words are far more powerful than a lobbyist’s. Their relatable human experiences have so much impact. It’s dramatically pronounced when it’s personal and real.
In my particular community, I feel like I have great touch. I just had coffee two days ago with two physicians that live in my district. They reached out and asked to discuss some things that they see in the practice of medicine in South Carolina. Our conversation was very attuned to issues relating to their scope of practice and how they interact with other medical professionals. They relayed real experiences that I was thankful to hear. I would solicit more of that!
As physicians, how do you make those touches with your legislator when you are so committed to your patients and to your practice? How do you engage in the political process? I would encourage you to reach out as best you can.
I might take my time in dealing with a lobbyist, but I’m going to have my feet planted in the concrete if one of my physicians reaches out. When you think about who in the community demands respect, at the top of the list it’s going to be your ministers and your doctors. It’s going to be the people that you trust with your life. If you trust someone with your life or your well being, that’s a powerful voice. Someone who takes the Hippocratic Oath and commits their life to it, and it manifests and is demonstrated daily in the local community, believe me … I’m listening.
In the upstate we have an osteopathic teaching hospital. You have always been supportive of OD’s along with the MD’s. We supported S712 which would establish a healthcare professional loan forgiveness program for MD, DO, PA and advanced practice nursing students in their final year of school or recently graduated, to work in the most needed areas of South Carolina. Being a rural legislator is this something you could get behind?
Yes, certainly! I am so thankful for what I’ve seen at all of the South Carolina medical school institutions. We are going to have to be very creative and committed to incentivizing young people of South Carolina to pursue these professions with confidence. The overwhelming debt load coming out of medical school is crushing.
What can we as South Carolinians do? We need to get creative with lessening that debt burden. I am very hopeful and anxious to make strides in this regard … not only with the cost of education, but with the sustainability of the practice, especially if it is in a less affluent, less populated region. Depopulation of South Carolina’s rural communities is almost grievous.
Thankfully South Carolina is a small enough state that we’ve been able to cover a multitude of deficiencies, including through technologies like telehealth. As the comfort level among practicing physicians, administrators and patients increases, expand it. Promote it.
Telehealth isn’t a panacea, but it certainly is a tool in the doctor’s bag. If the doctor and the patient are comfortable, and they don’t believe that there’s been any degree of diminished care or service, there’s no excuse for insurance underwriters or anything structurally that interposes itself between the doctors and patients. We have to be ever mindful of enhancing and maintaining the sanctity of the doctor/patient relationship. I want to see equity in reimbursement. If we’re going to continue to be upward and onward rather than regressive, it’s imperative that the relationship between a doctor and patient not be diminished, and if telehealth is an effective tool, then let’s not drag our feet on it.
To the point that it requires statutory remedy to get the framework adjusted and modernized, I want to see us continue ahead with our legislative efforts, but I do believe that there’s a lot that can be done without statutory fix. To the degree that we can get out of the way and let doctors and their patients relate, let’s do it.
In some respects, the fate of the farming industry and the healthcare industry have been on similar tracts – corporatization. In SC, we see that happening, and the SCMA believes that the market is heavily slanted against physicians. Do you think the SC legislature has a role to play in preserving the independence of the physician and his/her ability to practice? Do you believe this trend in farming and healthcare harms the consumer/patient?
I believe in free market principles and freedom of choice, but then you have the dynamics where things are so expensive that you can’t pay out of pocket and you can’t self-insure. The vast majority of the population is beholden to an underwriter. You have inflation within the healthcare cost delivery system. All of these factors make it harder for the independent practitioners to remain independent and still have a gratifying experience within their profession. It takes a tremendous degree of fortitude.
I go to an independent physician. They are highly regarded, highly respected, hardly has a day off, operates within the contextual strain of owning a business, managing a business … all the ancillary things to practicing medicine.
But can the government enforce some type of decentralized devolution? No, I don’t think we can. Medical students are going into school foundationally already thinking that it is a corporatized world. They may be second or third generation physicians, and their parents and grandparents may have had varying degrees of independence and they may still aspire to that, but it’s a shrinking percentage. But for those that have the means and the will, we need to get out of the way and let it continue to be a decentralized and more personal application and delivery of healthcare.
As for the amalgamation that has been in effect now for the better part of two decades, I don’t think we can put the brakes on it. Instead, I think we find ways to improve it.
Physicians can find benefit in collectively gaining encouragement in numbers, with a unified voice and spirit. To be able to have active, innovative membership that will go out and recruit other active members — it’s going to take a committed group of physicians to go to that level of organization and communicate with one voice to other entities. It will require a commitment on the part of the physicians not to be subsumed by those greater corporate entities. It’s something that will need to be continually honed, and legislators need to be attuned to it.
I salute you as an association and trying to do those things necessary when you can. Coalesce communally as a profession, because who is keener on protecting the practice of medicine than doctors?
Beyond what we’ve talked about, what are your top legislative priorities this year?
Everything we’ve talked about! Now that I’ve been immersed in state government for 22 years, I’ve realized that nothing really happens fast, and I’m more appreciative of that. You don’t want us doing radical things. We get there incrementally, and a lot of the challenges we work on are not going to have solutions best administered or applied overnight.
I believe that the most significant and dynamic governmental restructuring in South Carolina is still ahead of us. We worked long and hard for years on restructuring DHEC, and I want to get this across the finish line. I believe that it is past time for South Carolina’s environmental and public health administrations within the public arena to be not only separated, but also brought under the cabinet form of government, directly accountable and responsible to the Governor.
For issues related to the Department of Mental Health and Department of Disabilities and Special Needs, I want to come to grips to the degree that my committee will have jurisdiction there. I believe it will be the best service to the tax payors and to the stakeholders to take this step forward. I believe that it will be the most significant work that we’ve done to streamline and to make more efficient and responsive any area of state government in 30 years, so that’s big for me.
Is there anything specific that you would like to say to SC physicians?
Thank you to the association for reaching out. Speak early and often to us. I believe that you’ll find that legislators will have listening ears. There’s a reason that so many people have found South Carolina over the last several years. It’s more than good sunshine. It’s warm hearts and good will. There’s a general outlook on life that there’s a place to be nurtured, to be comforted and a place to grow and prosper. Thank you for being such a vital and integral part of that equation.
Is there anything with which the SCMA can assist you?
Keep on keeping on. Thank you for maintaining your presence here as we work so intimately. Generally, it doesn’t matter if you’re a republican, democrat, lobbyist, or legislator – there’s an awareness and an appreciation of one another. There’s a lot to be said for the intimacy of community. The more familiar you are with your neighbor and the more you’ve listened regardless of your perspective, the more likely we are to drive a spirit of consensus.
Keep advocating and keep speaking to us. We help each other by sharing and by continuing to care.