(These are remarks I gave to an audience of 50 Iowans introducing Fred Hubbell, Iowa’s Democratic candidate for governor, at my home on Saturday, June 30. This is belatedly posted here because of technical difficulties with the blog site earlier in the year when these remarks were more timely.)
My wife and I welcome you to our home and are very happy you are here today to meet, greet, and support Fred.
I have just read Walter Isaacson’s biography of Benjamin Franklin, Benjamin Franklin: An American Life, and was struck by Franklin’s “great rallying cry for the new American middle class,” according to the author, or, as Franklin in his pamphlet, Plain Truth, said, “We the middling class people. The tradesmen, shopkeepers, and farmers of the province and city!” I contrast this emphasis with the recent Iowa Democratic gubernatorial debate and the five candidates running in next Tuesday’s primary and separately this past Wednesday, when Governor Kim Reynolds signed Iowa’s new tax-reform law.
Several months ago in this space, I discussed my concerns about a Trump presidency regarding the Latin phrase “primum non nocere,” which means “first do no harm.” Now, at the end of the 2018 Iowa Legislative session, I revisit this phrase to discuss my concerns about the results that this Republican-dominated Legislature and the Republican governor have created or are creating.
School shootings and other mass gun murders, the opioid crisis, homelessness — these social ills all could be improved with adequate attention to the mental-health infrastructure in America. What is missing in most of this current national discussion is that mental-health evaluation and treatment should be a primary part of the solution.
As a family physician, I contend that mental-health evaluation and treatment is too late if we only concentrate on the prospective shooter, the addict, or the schizophrenic person who is living on the street. Do not misunderstand me: We need to help these individuals. What I am specifically saying is that we need to help them, as well as the vast number of people with mental-health diseases, when the diseases first occur or even before they occur.
For a few days of my recent vacation, I was laid low by a viral infection that included, along with other localized symptoms, overwhelming tiredness and emptiness. That ennui that I felt to my bones was all-consuming. I have recovered, thankfully. Regarding the malaise that I had for a few days has given me greater empathy for two of my patients who have had a similar malaise for years. These two patients, who were independently diagnosed, one at the University of Iowa in Iowa City and the other by a national expert in North Carolina, have a condition now called myalgic encephalomyelitis (ME).
2017. The year health reform took it on the chin. The year the middle-class, individual health-insurance buyer was abused by President Donald Trump and the entire Republican Party.
In Iowa, where we almost had no insurers in the individual market, we were left with one for 2018, Medica. One is not a choice. Who knows whether we will have insurers in 2019.
In the chaos of health-care efforts both nationally and in Iowa, today I seek to go back to two basic beliefs: 1) the hope of future generations to learn from past generations’ mistakes and 2) the value of continuity of care for primary health care and, ultimately, health care in general.
The U.S. Senate is now debating a tax-cut bill that includes eliminating the Affordable Care Act (ACA) individual mandate for health-care coverage — a basic tenet for true health-care reform — and, in Iowa, the for-profit, managed-care Medicaid fiasco now has one managed-care organization (MCO) leaving the state and another MCO not able to take new patients. These actions leave the state with only one MCO left to serve Medicaid patients. Given these realities, I shift gears by presenting to you a guest blogger.
She is a third-year medical student who recently spent a month with me in my clinic. She plans to be a pediatrician. I choose not to provide her name. Although she would allow it, I am not sure her medical school would.
Recently, I was on a panel of experts at an American Cancer Society Cancer Action Network (ACS CAN) program that focused on tobacco. As a former member and chairperson of Iowa’s Tobacco Use Prevention and Control Commission, I sat with a longtime friend, Cathy Callaway, who is one of the national associate directors of the State and Local Campaign Team for ACS CAN. As panelists, we discussed the current status and remedies regarding tobacco use and abuse in Iowa.
I’ll share some background on the initial efforts to end smoking in the United States.
Ah, words! Especially to writers, they are more precious than jewels, as essential as air, and powerful enough to create entire worlds. We chase them, massage or mince them, we roll them around in our mouths, savoring every delicious subtlety. Mostly, we love them.
~Tammy Letherer
Ms. Letherer wrote these words on a blog entry titled Why Words Matter (In and Out of the Locker Room), on October 16, 2016. In that post, she discussed her unhappiness with Donald Trump’s language regarding women.
In Iowa, former U.S. Representative Bruce Braley lost his Senate race with Joni Ernst in large part to an audiotape of his words to political contributors in Texas disparaging our senior senator, Chuck Grassley, describing him as “a farmer from Iowa who never went to law school.”
This year’s health-care debate, centered on the Republicans’ efforts to repeal the Affordable Care Act (ACA), has led to many statements by Republican leaders in Iowa that should come back to haunt them this Halloween season and for seasons to come, as Bruce Braley’s words haunted him.
I stood in line at 6:45 Sunday morning to purchase donuts at a very popular local donut shop — Spudnutz — at Lake Okoboji. The line of donut-seekers stretched far out the door. I did not receive donuts until 7:50 a.m. I waited more than an hour for donuts. (Yes, very good donuts). Nine people were working in that donut shop that once housed an auto mechanic shop.
If either the Senate bill or the House bill that was intended to repeal and replace the Affordable Care Act (ACA) became law, I fear none of those nine hardworking people would have health-care coverage in the future. For many of my patients and for, I believe, the employees of Spudnutz, I give thanks for the defeat of the Senate “skinny” repeal legislation.