ISSUES
Listed below are just examples – in the areas of healthcare and energy – of the legislation EFFSC will advocate for. Sen. Davis has been the primary champion for reform legislation like this, and as the lawmaker most closely identified with such initiatives, EFFSC believes it is advantageous to expressly leverage Sen. Davis’ name and reputation as part of its advocacy efforts.
Expanding access to healthcare
This legislation expanded the authorized scope of practice for nurse practitioners. Here are the remarks Sen. Davis made to his colleagues to get that bill across the finish line (which are also published here).
There are not enough health-care providers in South Carolina to meet the needs of its residents. In order to truly improve access to health care, there must be an increase in the supply of providers.
South Carolina, with its estimated 3,600 primary-care physicians, ranks 40th among the states with just 77.5 physicians per 100,000 residents (nationally, the number is 90.1 per 100,000). Moreover, there is a strong bias in the distribution of those physicians to urban or suburban areas, and 42 of our 46 counties are medically underserved. One county (Lee) has no physicians at all.
This supply problem is compounded by the fact that medical students increasingly are choosing specialties outside of the primary-care field, as our society places an emphasis and increased value on specialized skills. Primary-care providers have been the backbone of the rural health-care system, and there are ever fewer of them to go around.
So how can we increase supply? One way, I think, is to better utilize our state’s estimated 3,500 advanced-practice registered nurses. These nurses hold at least a master’s degree in nursing, supplemented with advanced education and clinical training to autonomously assess, diagnose and manage a patient’s health care at the primary-care level.
The problem is that South Carolina laws severely restrict the health-care services these nurses are able to provide. These restrictions impose limitations on delivering care and prescribing certain medications, referring patients for diagnostic care and certifying hospice or long-term care for patients.
Perhaps the most restrictive law is the one that prohibits these nurses from providing care outside a 45-mile radius of a supervising physician. Since the majority of physicians practice in urban or suburban areas, nurses who are ready, willing and able to fill unmet health-care needs are legally barred from doing so.
I filed S. 345 to remove these legal barriers so that these nurses are able to stand alongside our primary-care physicians and provide basic health-care services to South Carolinians. Since prices decrease when the supply increases, such a dramatic increase in the supply of providers would not only improve health-care outcomes but also drive down costs.
Moreover, a multitude of studies show that the quality, efficiency, patient satisfaction and cost-effectiveness of advanced-practice nurses’ care is as good as the care provided by physicians. In any event, I believe patients should have the option of choosing to receive health care from these nurses, especially since the alternative now is in far too many cases no care at all.
By passing S. 345, we can cut the red tape that prevents nurses from providing the care they are qualified to give. Better access to health care at a lower cost is a clear win for all South Carolinians.
Increased SC access to contraceptives will help reduce unwanted pregnancies
By Tom Davis
May 25, 2022
It’s not yet official, but there are multiple reasons — from questions posed by justices during last year’s oral arguments in Dobbs v. Jackson Women’s Health to the recently leaked draft majority opinion in that case — to believe the U.S. Supreme Court is poised to reverse Roe v. Wade sometime this summer; if it does, issues pertaining to abortion will once again revert to state legislatures. Here in South Carolina, the battle lines are already being drawn.
After seven years, now is the time for medical cannabis in SC
By Tom Davis
Apr 26, 2022
I began a marathon journey seven years ago to bring relief to thousands of South Carolinians suffering with debilitating ailments. These patients have tried everything under the sun to find relief, without success. They want the right to try medical cannabis, just as Americans in 37 other states can.
Hundreds of people have shared their stories with me. When you look into the eyes of someone desperate to find relief or potentially save the life of a loved one, it’s hard to explain that their elected officials will not grant them medical freedom. It’s critical that we take the S.C. Compassionate Care Act across the finish line this year. Patients have waited long enough.
Increasing competition in energy-generation markets
This legislation spurred competition in South Carolina’s energy-generation markets. Here is an opinion piece Sen. Davis wrote a few days after this bill was signed into law (which are also published here).
​
Last January, on the first day of the 2019 session of the South Carolina General Assembly, Rep. Peter McCoy, R-Charleston, and I filed identical bills titled the “Energy Freedom Act” in the House and Senate, respectively. Two weeks ago, on the last regular day of that session, the bill was ratified as having passed both legislative chambers and sent to Gov. Henry McMaster.
And this past Tuesday, in a Statehouse rotunda packed with media, renewable-energy activists and solar-industry entrepreneurs, I stood alongside the governor as he signed the bill into law.
It has been widely reported that this new law is about promoting clean energy, and that’s partially true. But it’s really about something more fundamental: It is a first and important step away from the energy-production monopolies that have saddled South Carolinians with some of the highest electricity bills in the nation, and toward real competition through an open market of many buyers and many sellers that will provide downward pressure on the cost of producing energy.
Over 60 years ago, the South Carolina General Assembly began passing laws that provided mega-utilities with service-area monopolies and guaranteed them a generous return on their invested capital. That made sense then, given the high fixed costs of building plants and power grids and the general difficulty the South had at the time in attracting investment capital. That same model is essentially still in place today, with Santee Cooper, Duke Energy and Dominion Energy (formerly SCE&G) holding the territorial monopolies.
But as the nuclear-facility debacle in Fairfield County illustrated, with $9 billion having been spent by Santee Cooper and SCE&G (and to be paid for by their customers!) on a now-abandoned project, there are dangers inherent in this model. Mega-utilities with service-area monopolies will inevitably pursue capital-intensive projects because the return they get is directly related to what they spend. There is little incentive for them to embrace cutting-edge technologies in order to lower energy-production costs for the benefit of consumers.
As a result we have not fully benefited from the explosion in information and communications technology which, in other parts of our country, has revolutionized every aspect of the electricity-supply chain. That technology makes it much easier to communicate, coordinate and automate grid interactions and facilitates access to new market participants that are naturally incentivized to innovate.
The Energy Freedom Act will start to open up the grid to this new technology and these new participants. Among other things, like eliminating the cap on the credit to customers for the excess power their rooftop solar panels produce, it says if an independent power producer demonstrates the ability to generate electricity more cheaply than a mega-utility, then that independent producer must be allowed to sell that power to the grid, with savings being passed along to consumers.
The objective here is for consumers to pay rates that are a function of what competition in the energy-production market dictates, as opposed to simply paying a mega-utility a guaranteed rate of return on its invested capital. And also to remove barriers to market-driven innovations, for no one knows what else markets may come up with when the grid is open to all. This latter point was made in a recent piece published in Utility Dive:
“As thousands of new 5G cell towers are installed across the country over the next few years and ubiquitous sensors allow for more sophisticated management of electric load and accommodation of innovation, the ‘Internet of Things’ has the power to revolutionize the electric industry. … Like the telecommunication industry, where customers have transitioned from purchasing a monthly landline service to enrolling in subscription plans for data and messaging services, the electric-utility industry has the potential to deliver innovations in service that have heretofore been unimaginable.”
The Energy Freedom Act will help clear the way for these innovations, but considerable work remains to be done, for the old way of doing business and those who benefit from it never yield to any change without a fight. In particular, careful attention must be paid to the actions of the Public Service Commission, which is charged with implementing the new law. Still, this was a win for South Carolinians and a good first step.