As a family physician and health-care advocate, I have fought for universal health-care access for more than 25 years.
In 1997, I advocated for the proposed Healthy and Well Kids in Iowa (HAWK-I) program by writing in an op-ed that a “child with a laceration on the arm goes to the school three days after the injury happened. The wound is held together with a bandage of rags and electrical tape. The child has no insurance.”
After four days in Cuba, seeing much countryside and touring three cities – Cienfuegos, Havana, and Santiago de Cuba, I have some reflections regarding health care, there and here in the United States.
Former Vermont Governor Howard Dean speaking this week at the 2016 Democratic National Convention quoted Donald Trump. According to Governor Dean, Donald Trump said that he’s going to replace the Affordable Care Act (ACA) with “something so much better” — something “‘Yuge,’ no doubt.”
In researching this “something so much better,” I could find only a mismatched set of random ideas such as buying health insurance across state lines, establishing Medicaid block grants for each state to administer, allowing Americans to import medications, eliminating the individual mandate but still preventing insurance companies from excluding patients based on pre-existing conditions, and expanding tax exemptions for corporate health insurance to individuals.
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.
60. I start and end this blog post with selected lines from poems. Dylan Thomas began his Poem in October with: It was my thirtieth year to heaven. Today marks my sixtieth year to heaven (I hope), and, instead of Dylan Thomas describing the beauty of Wales in October on his birthday, I am witnessing six months and thirty birthdays later the beauty of Iowa in April. April brings the brightest green grass of the year, the snow-white blossoms of the pear tree in my back yard, and the soon-to-be-red blossoms of my crabapple tree in the front yard. Colors seem to explode from every flower and bush.
Birthdays also mark time in relationship to other events, including the anniversary of the Oklahoma City bombing. Albert Einstein died 60 years ago yesterday. Sixty years ago this month, Churchill left office as the prime minister of Great Britain. The American Revolution started 240 years ago on this date. For me, dates give a sense of one’s location in both the positive and negative swings of history. Correspondingly, numbers can give us perspective and relative significance of the people, events, and details of our lives. Today, I review some numbers that I have heard over the past several months, numbers that cause me to reflect on health reform, both positively and negatively.
It is with sadness that I acknowledge the takeover of the cooperative health-insurance company, CoOportunity Health, by the Iowa insurance commissioner. I have touted CoOportunity Health many times in this blog, and I have strongly felt it was a critical part of the current health-reform efforts in Iowa. My sadness is even greater for the 100,000 individuals who had insurance with CoOportunity Health. These individuals’ confidence and coverage are jeopardized because of this action. The health and peace of mind of friends, family, and patients who I know are insured by CoOportunity Health are a major concern for me at this time.
I ask the few remaining independent voters — those who have not yet decided for whom they will vote in the U.S. Senate race between Iowa State Senator Joni Ernst and U.S. Congressman Bruce Braley — to give me two minutes of your time.
I am Dave Carlyle, a family physician and hospice medical director from Ames. I grew up in Denison. This is where, during my summers home from college, I learned the value of hard work by sweating 10 hours a day at the Iowa Beef Packers slaughterhouse. After medical school at the University of Iowa and family-medicine residency in Waterloo, I practiced nine and a half years in Kossuth County. I have now practiced 21 years in Ames. My family has been serving Iowans for 160 years. My two daughters, both of whom are physicians, also care for Iowans.
One of my proudest moments, which was photographed — the photo is displayed in my office at the clinic — is the 1998 signing ceremony for the Healthy and Well Kids in Iowa (HAWK-I) program. I stood with representatives of several medical societies and an Iowa family that included a mom and three daughters while Governor Branstad signed into law a program that helped to make Iowa a leader in the nation in the percentage of insured children.
I worked long and hard with Democratic legislators, Republican Representative Brad Hansen, who also is in photo, and Republican Senator Nancy Boettger to create a program made possible by federal funding that created a public-private system to insure children. For my efforts, in 1999 I received a national Public Health Award from the American Academy of Family Physicians. During the negotiations for the HAWK-I bill, I clearly remember that then-Governor Branstad did not want a quasi-independent board to supervise the program. He stated that in his administration he did not want to add “silos” that prevented him from overseeing the actions of state government.
Fast forward to 2013-2014.
Over the past months I have been inundated with requests for campaign contributions, and I looked for a way in which to make informed decisions about which candidates to support. In last month’s blog post, I shared two questions I posed to Iowa candidates running for U.S. Congress, the Iowa governorship, and the Iowa Legislature. The questions asked were an effort to engender better knowledge of just two of the complex issues surrounding the Affordable Care Act (ACA). At that time, I said I would make a $1,000 campaign contribution to the candidate who provided the most-specific answers to my questions and allow the responses to be posted on this blog. If I received thoughtful responses from several candidates, the $1000 contribution would be shared.
To date, I have received only one response, that of Senator Jack Hatch, who is running for Iowa governor. I have posted his response below. I sincerely appreciate Senator Hatch’s response. The opportunity for candidates to submit a response to my questions remains open until August 15. S.S. McClure, editor and publisher of McClure’s Magazine, once said, “The vitality of democracy depends on popular knowledge of complex questions.” I seek candidates’ answers for just two of the many complex questions surrounding the ACA. Please let the candidates you support know about this campaign-contribution opportunity. Help me share “popular knowledge about complex questions.”
Celebrate! I celebrate the birth of my granddaughter and the birth and growth of CoOportunity Health. This week, as I drove with my wife and my 2-and-a-half-year-old grandson across the city of Des Moines so we all could meet my newborn granddaughter, I pondered the emotions involved with parenthood: the pride that — even as a grandparent, with only a small part in the creation of this tiny, new life — is still an overwhelming emotion, responsibility, joy, and sincere thanks. Each of these emotions fill a parent, grandparent, or godparent. At the baby’s birth on Tuesday evening, May 27, I was so moved and will continue to be throughout this beautiful child’s life into her adulthood.