Our state faces a variety of health care challenges on a multitude of fronts. I have been lucky most of my life to have access to (usually) affordable health insurance options; typically through my employer. Over the last decade, that has become more difficult for a lot of Iowans; young and old.
Today, we face a few challenges which we must address.
First, after three years, it is clear our entrance into Managed Care Organizations for our Medicaid service management, has not worked out as planned. Service has gone down, late payments to providers is up, and our state’s costs have also not produced the savings we had been promised as taxpayers. In fact, we have saved 80% less than projected.
Second, our state is in a mental health crisis. With the passage of HF2456 (https://www.legis.iowa.gov/legislation/BillBook?ga=87&ba=hf2456) in the most-recent session, we are on our way to a modern mental healthcare delivery system. But this bill isn’t the end. We have to remain focused on ensuring our students have access to mental health resources and that we find innovative ways to bring mental and behavioral health professionals to our state; as well as providing the needed funding mechanism updates to support this growing need across the state.
Third, we are missing the mark on our medical marijuana laws and must do more to take health care out of the hands of the legislature and put it into the hands of our health care professionals.
We all know healthcare is incredibly complicated but it is also incredibly important to the strength of our communities and our overall quality of life.
My Priorities to Improve Healthcare Are:
Increase Rural Access to Healthcare
With increasing costs in insurance, we should explore opening up options on Direct Primary Care healthcare options. It was proposed this past year, but did not make it through. Allowing DPC in Iowa would allow individuals and families to another option to pay for preventative and general medical treatment.*
Create Caregiver Support Network
Degenerative diseases like Alzheimer’s and dementia will create a tsunami of wealth destruction across our state, and inflict increasing costs on our medical system. Research has shown the value of remaining in ones home but those costs are typically borne by close family members at a significant cost to themselves; and subsequently, our communities. Research has also shown the value in support networks and respite care for these caregivers and I support the creation of a state network through the Iowa Department of Public Health.
Raise the Cigarette tax
Our current tax rate for a pack ranks 29th in the country and the cost to our health care system due to tobacco use is $1.28 billion in the state. An increase of $1.50 in the tax is estimated to decrease youth smoking by over 16%, encourage quitting, and produce nearly $30 million in savings both in over medical costs and in Medicaid.
Reform the Medicaid Managed Care Fiasco
Unilaterally changing our $4 billion Medicaid program in a short time period has only lead to decreased outcomes, decreased satisfaction and increased rejection rates unheard of under traditional Medicaid. I believe we need to move Iowa’s disabled populations back into state management and “fee for service”, while those who need LT Care with unique needs can stay in the MCO arrangement.
If we keep the status quo system, we must invest in oversight to protect the most vulnerable Iowans.
Update our Medical Marijuana Program
Expand the list of medical conditions allowed under the medical cannabidiol Act. One way to do this is to allow the medical cannabidiol board to make recommendations directly to board of medicine for consideration and adoption by rule, rather than by legislative action.
Allow THC levels higher than 3 percent. After speaking with families of patients who have benefited from medical marijuana prior to Iowa’s new law, there is tremendous benefit to enacting this update to the law. I would rely on the medical cannabidiol board and the board of medicine to make the appropriate rules to provide the best level care possible for Iowans.
Do you have thoughts or concerns about healthcare?