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Carter: Freedom of choice in care
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This past weekend as we celebrated Independence Day, many of us paused to acknowledge the heroic efforts of those who have fought and those who are still fighting for our independence. We are blessed to live in the greatest country in the world and, for that matter, the greatest country ever known to mankind.

The 56 men who signed the Declaration of Independence in 1776 were from all walks of life.  Although all of the signers are described as being professional politicians, they represented many different professions.  

The only physician to sign the Declaration of Independence was Dr. Benjamin Rush from Pennsylvania. One of the foremost respected physicians of his time, in 1787, Dr. Rush tried to have the protection of “medical freedom” inserted into the Constitution.  

Dr. Rush warned that unless Americans were guaranteed their medical freedom in the Constitution, “the time will come when medicine will organize into an underground dictatorship and force people who wish doctors and treatment of their own choice to submit to only what the dictating outfit offers.”  

Although unsuccessful in his attempts to have “medical freedom” added to the Constitution, some believe that Dr. Rush’s predictions could potentially become true.        

President Barack Obama has made health care reform his number one domestic priority and has said that he hopes to have his programs through Congress and in place by the end of the year. Many are concerned that we are well on our way to government-run health care and that socialized medicine is almost here.  

In anticipation of these oncoming universal health care mandates, at least one state, Arizona, is introducing a resolution in their legislature that would amend the state’s constitution to assure their citizens have the freedom of medical choice.  

In November 2008, Proposition 101, The Freedom of Choice in Health Care Act, was on the ballot in Arizona and was narrowly defeated by less than 0.5 percent of the vote. Supporters of the new measure believe that this year, a different political landscape in Arizona combined with the fear surrounding proposals coming out of Washington, will lead to a different result.

Needless worry or legitimate concerns? Certainly a case can be made for both.  

Like many, I believe that the health care system in our country is the greatest in the world. However, during the nearly 30 years that I have practiced pharmacy, I have seen a steady trend of erosion of patient rights that has escalated recently.

Most doctors will agree that patient drug therapy is no longer being decided by physicians or pharmacists but instead by insurance companies. Hardly anyone can afford to buy a medication that is not on their insurance’s formulary. And getting a prior approval for coverage of a medication outside ones formulary practically requires an act of Congress.

Many patients who have been stabilized on a particular medication for years are forced to change because it is no longer covered on their insurance.  

Drug manufacturers, whose research and development efforts have resulted in breakthrough drugs over the years, are now questioning whether to continue these efforts out of fear that their new drugs may not be covered on most insurance plans.

Patients are often forced to leave a physician who has provided care for them for years because the physician is no longer in their insurance’s network. The physician-patient relationship, so vital to quality health care, is now jeopardized by the decisions of insurance companies.

As President Obama and Congress grapple over the changes that are to be made to healthcare in America, perhaps they would do well to remember the Hippocratic oath that physicians adhere to in their practice — “to help — or at least to do no harm.”

In Effingham County, Progress Starts With a Plan
Guest Editorial by Susan Kraut, President/CEO of Effingham County Chamber of Commerce
Susan Kraut column
A sold-out crowd of more than 150 business and community leaders gathered at Effingham’s New Ebenezer Retreat Center Sept. 24 for the Chamber of Commerce’s annual State of the County Luncheon, hearing updates on economic growth, education, and infrastructure across Effingham County. (Submitted photo)

At last Wednesday’s sold-out State of the County luncheon, more than 150 business and community leaders heard a message that resonated throughout the program: We have a plan, and we’re sticking to it.

Effingham County City Manager Tim Callanan opened his remarks with that thought. It was simple, but powerful. In an era when news feeds churn with controversy and change, it served as a reminder that behind the scenes, steady planning is happening – and those plans are beginning to bear fruit.

Businesses and residents often express frustration about roads, zoning, parks, schools or economic development, feeling that growth is outpacing action. The truth, as Callanan underscored, is that many of those actions are already underway, rooted in master plans that cover everything from transportation and stormwater to parks, communications and public safety.

The challenge is that plans only matter if people know they exist. Too often, businesses and citizens forget these plans are in place, don’t know where to find them or don’t realize how to weigh in at the right moments. When that happens, the community loses the chance to shape its own future and to express the value of those plans – why they matter and why they’re worth supporting.

Planning delivers progress

Last week’s luncheon highlighted how “plans” translate into progress. Mayor Kevin Exley shared Rincon’s ranking as one of Georgia’s safest cities and the city’s launch of the Citizen Central app – a small but meaningful step toward accessible local government. Springfield’s new city manager, Lauren Eargle, outlined a capital improvement plan that includes sidewalks, drainage and playgrounds, along with the less glamorous but vital work of a $35 million wastewater plant upgrade. Guyton’s city manager, Bill Lindsey, discussed contracting with planning consultants, winning grants for sidewalks, and reinvesting in Bazemore Park and downtown revitalization. These aren’t random acts; they’re evidence of intentional planning.

The school district provided another example when Superintendent Yancy Ford noted that Effingham now serves nearly 14,500 students speaking 33 languages. That diversity is an asset – but it also requires careful, proactive investment to maintain the high standards families expect. His most powerful point concerned ESPLOST, the 1-cent Education Special Purpose Local Option Sales Tax. Thanks to community support over the years, ESPLOST has built classrooms, purchased buses, enhanced safety measures, provided Chromebooks to all students, added security cameras and access-control systems, created inclusive playgrounds and athletic facilities open to the community, supported hands-on learning spaces like Honey Ridge, and established the College & Career Academy – a facility credited by Ford as helping lift the district’s graduation rate above 90% and expanding career pathways for a rapidly diversifying student body. And it has done so without incurring long-term debt.

Why ESPLOST matters

Among these examples of planning, none is clearer than ESPLOST — a long-term, voter-approved blueprint for funding education, renewed every five years to stay ahead of growth. The November ballot will again include the ESPLOST renewal, giving voters the opportunity to continue this proven approach to funding school facilities, technology, safety, transportation, inclusive playgrounds and community-accessible athletic fields. Renewing ESPLOST does not create a new tax; it simply extends the existing 1-cent sales tax, allowing residents, visitors and businesses to contribute to improvements that benefit every student. Without it, many of the projects parents and community members count on – such as new buses, safer schools, modern classrooms, career pathways and accessible playgrounds – would stall or require long-term debt.

Renewing ESPLOST is about more than bricks and mortar. It is not a reactionary measure but part of an intentional, ongoing plan to manage growth and maintain education – reinforcing the theme that plans become progress. As the district’s population becomes increasingly diverse and enrollment continues to rise, sustained ESPLOST funding is crucial to scaling programs, expanding facilities and maintaining the high graduation rates and opportunities that families expect. It is about protecting Effingham County’s tradition of educational excellence, maintaining property values and ensuring the workforce being prepared in our schools is ready to meet the needs of local employers. It is an investment in students, families and the future of our communities.

A call to the community

Effingham County is growing. Growth brings challenges, but it also brings opportunities. As the luncheon demonstrated, leaders at every level are working to guide that growth thoughtfully. The next step belongs to business owners, parents and neighbors – to lean in, stay informed and participate.

When hearing about a master plan, a referendum or a public meeting, don’t assume it is someone else’s job. Look up the plan, attend the forum, ask questions and cast a vote. That is how plans become progress – and how a yes vote on ESPLOST reaffirms and continues the community’s long-term plan for educational excellence, reinvesting in Effingham County’s future.