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.
Category Archives: tobacco
Health Reform and IQOS
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.
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.
A Culture of Coverage and Health Reform
(This month’s blog post is the text of an article that I was asked to write for a professional publication.)
As chair of the Iowa Tobacco Use Prevention and Control Commission, I was responsible for helping to guide Iowa’s anti-smoking efforts by following a mission statement created by the Iowa Legislature that read, “to foster a social and legal climate in which tobacco use becomes undesirable and unacceptable.” In this same vein of using legislation to create social change, I will review the actions derived from the Affordable Care Act (ACA), also known as Obamacare, in Iowa. From this family physician’s reading of the ACA, I submit that the underlying social change goal is to create a “culture of coverage,” which means that, within certain constraints, the citizens of the United States, and residents of Iowa in particular, will have the expectation that they have health coverage and that they will, in part, be responsible for securing that health coverage.
Obviously this 2,000-page law has many more elements, approaches, and objectives, but for me, this “culture of coverage” is the overarching goal. It is with this goal in mind that I discuss what I perceive as the unfolding of the ACA in Iowa.