The Missouri governor’s race is gaining national attention for its focus on right to work, and depending on the outcome, the decision on whether Missouri becomes a right-to-work state could come down to south county voters.

Republican gubernatorial candidate Eric Greitens says if elected, he will sign right-to-work legislation as soon as he can to jump start Missouri’s economy. His Democratic opponent, Attorney General Chris Koster, says he will fight right to work, which he believes is wrong for Missouri.

If Koster is elected Tuesday, the outcome of the 1st District Senate race between incumbent Sen. Scott Sifton, D-Crestwood, and Republican physician Randy Jotte of Webster Groves could dictate whether the Republican supermajority in the Legislature has enough votes to override Koster’s promised veto.

Sifton is seeking his second four-year Senate term. Before narrowly defeating former Sen. Jim Lembke, R-Lemay, in 2012, Sifton served in the Missouri House for two years and on the Affton Board of Education for nine years. An attorney for Husch Blackwell, Sifton has two young children who attend Lindbergh Schools.

St. Louis native Jotte is an emergency physician at Barnes-Jewish Hospital and associate professor at the Washington University School of Medicine. A graduate of Harvard Medical School, he also studied at Oxford University on a Fulbright scholarship. He has served on the city council in Chagrin Falls, Ohio, and in Webster Groves, where he lives with his wife, Susan, and two teenage sons.

Whether voters “stand with Scott” or “jot down Jotte” at the polls Tuesday will have a direct impact on whether a Koster veto on right to work would be sustained or overridden, Sifton said.

For that reason and because the seat is one of the most competitive races in the state, Sifton has raised nearly $2 million for his campaign, and Jotte has raised nearly $750,000.

In a district that includes areas that have more union members or retired union members than almost anywhere in the state, it’s not surprising that right to work is something that Sifton says voters ask him about all the time, and not just those who are Democrats or in unions.

Their concern about the policy, which would change union membership to non-mandatory in many jobs where it is now required, boils down to statistics that indicate that states who move to right to work see wages go down by 15 percent on average.

“I don’t know too many families around here who can afford a 15-percent pay cut,” Sifton told the Call. “A lot of folks here are just getting by as it is, and to take more money out of their pockets just because some folks at the top think they can — I think it’s wrong for our families, wrong for our community and wrong for Missouri.”

But Jotte supports right to work not because it would be an “Armageddon or the end of the world” for unions, but because the current system is not working, he said: One of the top concerns on the minds of voters when he knocks on their doors is that they or someone they know is underemployed and have not yet recovered from the Great Recession.

He connects his willingness to try right to work with his willingness to experiment with new and innovative health-care models and funding.

“We need to be willing to change our models, whether it’s in health care or employment or the whole political system,” Jotte said. “I think that the ways of the past are insufficient for the future — you look at the number of jobs that have been lost or gone elsewhere. How do we make sure that we have the highest-paid, most-skilled and satisfied labor force anywhere? I think it’s achievable, but we can’t just say ‘no change.’”

As for whether wages would drop under right to work, Jotte said the argument is not about wages, but bringing companies to Missouri that otherwise may not locate here because of labor rules.

“Right to work is not about what’s the salary employment should be,” Jotte told the Call. “I really believe that the union labor force has the potential to be the highest-trained, highest-quality labor force, and that will pay for itself. You can’t get stuck on these absolutes, you have to be willing to be flexible. If not, we’ll be the last state to change.”

Candidates say they’ll create jobs

Endorsed by the Missouri Chamber of Commerce and the National Federation of Independent Businesses, Jotte said he wants to focus on attracting the “jobs of the future” like the jobs created by the startup companies located at the Cortex innovation community in the Central West End.

“Those may or may not be union jobs, but they’re certainly going to be high-paying jobs,” Jotte said an Oct. 20 South County Chamber of Commerce forum in Sunset Hills. “I think that is really the direction we need to go.”

Sifton also touts his job-creating experience, noting that he has worked hard to get incentives passed that help Missouri compete for high-tech jobs and businesses.

Before Sifton was elected, “Everything we were trying to do in Jefferson City to incentivize job creation frankly was dying in the Senate, and in the time that I have been there, we have seen the logjam break,” he told the South County Chamber.

Among the incentives packages are the wing of the Boeing 777X, data centers and the National Geospatial-Intelligence Agency, or NGA, which decided earlier this year to keep its new $1.6 billion headquarters in Missouri instead of moving to Scott Air Force Base in Illinois.

“We’re not just competing with 49 states, we’re competing with the world, and if we fail to compete, we do pick a loser: Missouri loses,” Sifton said.

Despite the differences in opinion and enough money flowing into the contest to fund television ads on both sides, the Sifton-Jotte race has been a stark contrast to other area legislative races that have seen negative ad after negative ad.

“I’m not running against anything, I’m running for these things,” Jotte said at the forum.

Sifton is well known for his commitment to stay one of the few legislators who does not accept gifts from Jefferson City lobbyists, a practice Jotte pledges to continue if he is elected.

On other issues, the two differ in both expected and unexpected ways: Jotte is against the death penalty, while Sifton supports it, and Jotte is pro-life while Sifton is pro-choice. On guns, Jotte said in a Call questionnaire that he opposed the Legislature’s override of the governor’s veto of concealed-carry legislation this year, because he supports firearms training for people who carry guns from his firsthand experience in the emergency room.

While Jotte is socially conservative, he has not focused on those issues in the race. And while voters in south county tend may be more socially conservative than the average voter, they are also pragmatic, not too far to the right and not too far to the left, Sifton said.

Last spring, Sifton participated in the longest filibuster in Missouri history to try to stop Senate Joint Resolution 39, or SJR 39, a religious-freedom measure voters would have considered Nov. 8 that would have allowed business owners not to serve or participate in gay weddings.

Although Republicans argued the bill was a necessary defense for residents with religious objections to gay weddings, the filibustering Democrats called the bill old-fashioned discrimination.

The delay from the filibuster allowed Missouri’s business community to galvanize against the change, which ultimately contributed to its failure, Sifton said.

“SJR 39 would have been a disaster for St. Louis and Missouri business recruitment,” Sifton said, referencing the economic fallout in North Carolina since that state implemented similar measures in the last year. “I could argue that the only reason Missouri hasn’t taken just as big a hit as North Carolina has is because of our filibuster. If we had not stood firm on that issue, we would have lost the convention business every bit as much as North Carolina has. And I don’t apologize for avoiding that.”

But for Sifton, the fight is also personal: His father Richard, who died in June, was gay, as is his uncle.

“People ask about those issues, and there are a lot of people who are very strongly on one side or the other of them,” Sifton said. “I think folks tend to understand a little bit when they know that my uncle and father are both gay.

“My uncle and his partner have been together for 40-plus years, and I would encourage anybody to have dinner with those two and tell me that they’re not the best guys in the world. Why would you want to discriminate against somebody like that?”

Education is the top issue that voters want to know about as Sifton goes door to door, and both candidates agree the state should fully fund the education foundation formula.

Both agreed in their responses to the Call’s questionnaire that the statewide foundation formula should be restructured, with Sifton saying suburban districts like those he represents do not get their “fair share” under the current formula, and Jotte saying that other state programs need to be structured and run more efficiently to free up money for schools.

To free up money for education and other needed state programs, Jotte wants to experiment with ways to make the state’s Medicaid program more efficient. State revenue grew by nearly $400 million this year, enough to fully fund education, but nearly all of that was taken up by increases to Medicaid.

That is unsustainable, Jotte said.

“And that’s with no Medicaid expansions, no new services, no new patients,” he said. “It’s just the program is like a train without an engineer, out of control.”

Medicaid takes up 30 percent — and growing — of the state’s $27 billion budget, and from Jotte’s experience working with Medicaid patients in emergency rooms, he believes that a sub-population of the heaviest Medicaid users can receive better care for less money by coordinating their care among different doctors.

As it is, if a doctor can’t be found to give an emergency-room patient medicine and treatment on a Saturday, the patient will be admitted to the hospital all weekend.

Fixing health care is the top issue voters ask Jotte about when he knocks on their door.

“The harsh fact of the matter is that there is not a lot of extra money just staying put under some state mattress — we have a very tight budget,” Jotte said. “Because of the Hancock amendment and because of the response of citizens on tax revenue measures, we have to work within our budget.”

But as a physician, “I think I can find a substantial amount of savings in our Medicaid program by providing the right care at the right place and the right time to a very expensive sub-population that I know personally because I’m there all the time,” he added.

But simply looking for greater efficiencies isn’t enough, Sifton said.

“We need representation that advocates for Medicaid expansion as well as greater efficiency in the Medicaid delivery system,” he said. “We also need a state senator who unabashedly supports prescription drug monitoring. I get asked about that on the doors a lot.”

As for why south county voters should take a different path after four years of Sifton, Jotte played off a classic Yogi Berra quote at the chamber forum.

“What do you do when you see a fork in the road?” he asked. “Pick it up.”

Playing off Jotte’s line, Sifton said in his own remarks, “I agree that we’re at a fork in the road, but I think we need to take a way that invests in people and in education.”