This is a proposed political ad for our upcoming election to be paid for by a proposed political action committee named Pre-Existing Conditions Political Action Committee (PEC PAC).
PEC PAC commercial — Take One. Continue reading
Category Archives: Exchanges
Health Reform and a Primer for Democratic Presidential Candidates in Iowa
What every presidential Democratic candidate — many of whom will be speaking at the Iowa State Fair this week — should know about Iowa health reform:
1. Iowa suffered greatly by having a Republican-dominated state government (governor, Senate, and House) during the aftermath of the enactment of the Affordable Care Act (ACA). With a Republican governor and most recently a Republican Senate and House in Iowa, we had a miserable attempt at a Marketplace/Exchange; no support for our attempt at a health-care Co-Op (Co-Oportunity Health, which had 120,000 members in one year of operation); passage of association health plans, which allow for discrimination against persons with co-existing conditions; and, overall, an unbelievably negative atmosphere in general regarding anything that concerned the ACA.
Health Reform and Iowa’s Next Governor
(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.
Health Reform and Spudnutz
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.
Health Reform and Blood Money
In 2003, Iowa used part of its portion of the 1998 Tobacco Settlement monies to help build a new Supreme Court Building. During those years and later, Iowa Republican legislators sought to reduce the funding and scope of the Iowa Tobacco Use Prevention and Control Commission, which was created to use the settlement monies to help Iowans to either quit smoking or not start. I said at that time that using the Tobacco Settlement monies for any use other than health care was wrong. As a former chair of the Tobacco Commission, I viewed this money as blood money because it was being paid out to partially compensate for the death and disease that cigarettes had caused Iowans for many decades.
Similarly, I use the same term, blood money, today regarding the U.S. Republican House and Senate efforts to repeal and replace the Affordable Care Act with a plan that will reduce wealthy individuals’ taxes by more than $600 billion over 10 years by taking a similar amount of money from the Medicaid program and from subsidies used to supplement poor and low-income individuals’ effort to pay for premiums in the individual health-insurance market.
Health Reform and the Orphan Called the Individual Health-Insurance Market
Last week, the buzz in Washington, D.C., where I heard numerous lectures and personally talked to two U.S. representatives and two U.S. senators, was about impending health-care legislation in the Senate and particularly focused on the imminent crisis in Iowa, where there probably will be no insurers for the individual insurance market in 94 of its 99 counties in 2018.
Seventy thousand Iowans may not have health insurance next year in a state that prides itself as an insurance state. Iowa is the poster child for the deficiencies in the individual insurance market. Across the nation, only a few counties in Tennessee have that known potential for 2018, though several potential fixes are being discussed at the federal and state levels.
Health Reform and Primum Non Nocere
Following the admonition to “First do no harm,” I will refrain from sharing a post I wrote before the presidential election that would not promote a productive conversation regarding the future of health reform. Instead, I will share some immediate thoughts regarding the future President Donald Trump.
Health Reform and Uber and Food Trucks
Recent economic trends nationally and in Iowa include the proliferation of Uber contract-driver taxi services and owner-operated food trucks. Both of these services rely on individuals starting a small private business in the competitive world of commerce.
My brother, my father, and my grandfather have all been owners of their own small businesses. The gumption and personal sacrifices needed to take on all the requirements necessary to run a successful small business have always humbled me. From advertising and marketing to hiring and personnel management, to municipal, state and federal regulations, to eventual retirement, a small-business person needs to consider every aspect of their business. Despite this, many individuals crave the freedom and independence that running their own businesses or being independent contractors allows. Given the other options of being someone else’s employee in a large business or a government worker, I sympathize with and support individuals who are willing to risk their time, resources, and self in these challenging endeavors.
Health Reform and ACO Incentives – Getting It Right
We need to get this right. As I have said last month, I continue to be dismayed by the evidence that health-care costs are not being controlled. For example, in Minnesota, one of nation’s top health-care managed states, Blue Cross and Blue Shield announced that it would not sell individual insurance policies next year due to concerns over cost. Skyrocketing health-care costs will affect the affordability of private insurance and the existence of public health-care programs such as Medicare, Medicaid, and subsidized insurance sold under the Exchanges.
Health Reform and Medicare for All … Seniors
One of my favorite movies is White Christmas, which starred Bing Crosby and Rose Mary Clooney. In one scene, Rose Mary Clooney’s character sings a song in a nightclub about her unhappiness with Bing Crosby’s character. She sings, “Love, you didn’t do right by me … you planned romance that just hadn’t a chance, and I am through.”
In a fashion similar to that Irving Berlin song, after years of touting private health insurance by helping to create the Healthy and Well Kids in Iowa (HAWK-I) — Iowa’s CHIP program, and working with CoOportunity Health — Iowa’s health-care co-op that went bankrupt, I have come to the conclusion that the private health-insurance market under the Affordable Care Act (known as the ACA or Obamacare) has not done “right by me.” More importantly, it has not “done right” the citizens of the country. For reasons that I will clarify later, I now support expanding Medicare to individuals 55 years of age in a graduated, voluntary enrollment process.