LEGISLATURE NEEDS TO START INVESTING IN PREVENTION

IT'S APPALLING THAT South Carolina was one of five states that didn't spend
a penny of its cigarette lawsuit settlement money on smoking prevention and
cessation programs this year.

But it's difficult to criticize the Legislature for diverting the money to
more immediate needs, such as keeping Medicaid solvent. When you get
yourself into a situation where you must choose between providing medical
care to someone who's going to die without it and providing programs that
will keep people from eventually developing medical problems that demand
care, even the most responsible government (or individual) is going to make
the decision to temporarily forego those preventive measures.

What is disturbing - and what needs to be criticized - is that our state's
failure to fight smoking is not simply a reaction to tight budget times.

When the state was rolling in money, our Legislature never adequately
funded smoking prevention programs. We've never spent more than $2 million
a year to try to keep kids from smoking, or to help people stop once
they've started, even though we used our share of the tobacco settlement
money to set up a $440 million trust fund and the Centers for Disease
Control says South Carolina needs to be spending $24 million to $62 million
each year in anti-smoking efforts.

Yet it is indisputable that such expenditures are smart investments.
Studies show that we can cut the number of teen smokers in half, and even
reduce adult smoking, with aggressive media campaigns. The payoff comes in
reducing the huge amounts of money taxpayers spend to provide medical care
for people who have diseases caused by smoking. Every household in South
Carolina is paying $485 a year in taxes to provide medical care for people
who have diseases caused by smoking. The total tab for smoking-caused
illnesses in our state is $854 million a year - with $307 million of that
covered by the taxpayer-funded Medicaid program.

What's even more disturbing - and what demands even more criticism - is the
fact that this short-sighted approach to public policy is not limited to
smoking. Our state has never taken seriously enough the need to invest in
any kind of prevention program. We've never invested enough in prison-based
education and drug-treatment programs to steer criminals into jobs instead
of more crime when they're released. We've never spent enough on public
education and job-training to make sure kids can get good jobs and stay out
of trouble to begin with. We've never spent enough on early childhood
programs to make sure kids are ready to learn when they go to school - and
thus able to take advantage of the education programs that help them lead
productive lives.

We know that this approach is going to cost us more in the long run: The
lack of an adequately educated population means there are fewer good jobs
in the state, which means we have to spend more to provide Medicaid and
other services for people who don't have jobs, and we have to spend
inordinate amounts of money on prisons for those who turn to crime.

This isn't a radical concept. To the contrary, it's the stuff that the sage
cliches your mom taught you are made of: A stitch in time saves nine; an
ounce of prevention is worth a pound of cure. Cliches become cliches
because they speak universal truths. As individuals, most of us would be a
lot better off if we followed Mom's advice more often. Society is no different.