Bob Vander Platas’ essay in the Register supporting the State ordered prohibition of abortion was a poor attempt to rationalize his religious beliefs. (See link below.) Most would agree that if an abortion is to be done, it is best done at the earliest stage possible, ideally during the first trimester. Iowa should not be prohibiting abortions or other “elective” surgeries that increase a person’s health risk if they are delayed. Currently, hospitals in Iowa are not that close to capacity, and surgical masks are different than the N95 masks. This is one area where restrictions should be eased now.
Stay-at-home and shelter-in place orders appear to be no different than what I see happening in Iowa, regardless of what you call it. In all cases, people are still free to walk, shop for groceries, get medicine, access medical care, all while social distancing. Iowans are doing their part to bend the curve to help not overload our healthcare system. Those who want further protection can quarantine themselves as much as they want. Those who criticize Governor Reynolds for not using different terminology are just playing politics.
I don’t doubt the good intentions of our government leaders, including elected officials and public health regulators, as they tighten restrictions on our freedom of movement.. We are “bending the curve” and easing the pressure on our health care system. But unless an effective anti-virus drug is found and administered to everyone very quickly, bending the curve will only delay the time before most of us will become infected, and will lengthen the time that we all suffer emotionally and economically.Why is our response to this situation so dramatically different than our response to the flu or automobile accidents? Both the flu and auto accidents kill tens of thousands of Americans each year and are preventable. We could dramatically reduce those deaths if we used the same extreme measures that we are using against COVID-19. But what is the point of living if we have to stay away from our family and friends? For a few weeks, fine. For several months or more, not acceptable. Life has risks. We need to balance the costs and the benefits of our efforts. Soon, we need to once again let people decide for themselves how much risk they are willing to take.
- Seniors and others on Medicare, disability, pensions, and other fixed incomes – they will continue to be paid.
- People who have had no reported W-2 earnings during the past year – since they have been getting by on unearned income
- People who have household earnings around or over $75,000 per year – they qualify for unemployment benefits.
Don’t give grants, but make low-interest rate loans available. We can decide later whether or not to forgive any loans. Don’t allow unrelated “riders” on any pandemic response bill. For example, don’t’ forgive student loans, don’t add any permanent employer mandates such as child care, sick pay, paid family leave, etc. Watch out for and deny other special-interest legislation trying to take advantage of this crisis.
Please try to balance costs versus benefits. We have lived normally with the flu killing tens of thousands of U.S. citizens every year. I am a senior – age 66 – and I don’t need any bailout.
Contrary to the Register Editorial on 12/1/2019, we should not add long-term care as a new benefit under Medicare. (See link below to The Register’s Editorial urging Medicare coverage of long-term care.) If we want to solve problems using the force of government, we should do the minimum needed to solve the problem. In this case, the problem is making sure that people receive medically necessary long-term care, not making sure that money is left to people’s heirs.We currently have a pretty good situation: Many people voluntarily purchase private long-term care insurance. Many others who could afford insurance choose to take a risk and not buy it. Taxpayer-funded Medicaid covers the cost of long-term care for those who are unable to pay. For those in the middle – not on Medicaid, but who would struggle to pay for private long-term care insurance – Medicaid already goes a long way to help them qualify for long-term care coverage. For example, if one spouse of a married couple needs long-term care, the other spouse gets to keep a house and a car and some income, even though Medicaid pays for the long-term care of the first spouse.The best long-term, sustainable solutions to our problems is to give voluntary, free choice to people and then expect them to be responsible for their decisions. To the extent that we allow our government to force everyone into one-size-fits-all welfare programs, there will be ongoing, unsustainable frustrations, disagreements, and dependency problems.
The Des Moines Register recently published a report about Madison County Boar of Supervisors considering a requirement that wind turbines be setback 1.5 miles from the nearest home. Ben Johnson, a cardiologist who lives in Madison County was quoted as saying, “Industrial wind turbines have never been proven to be safe, nor free of adverse health effects,”
It is difficult, if not impossible, to prove that anything is safe or free of adverse health effects. For example, driving or riding in a car at any speed has never been proven to be safe. No amount of second-hand barbeque smoke has been proven safe. Eating chocolate has never been proven free of adverse health effects. We live in a risky world. It would be impossible to live our lives if we were prohibited from doing anything that was not proven safe or free from adverse health effects.
We should not have policies that prohibit things until they are proven safe or free of adverse health effects. Unless something is proven to be unreasonably dangerous, it should be allowed.
As the Des Moines Register reported yesterday, the Mayor of Jamaica, Iowa and her husband were busted two days earlier at about 4:20 p.m. (no joke) for growing 18 marijuana plants inside their home. The various related charges include a Class “D” Felony for the manufacture and possession with intent to deliver less than 50 kilograms of marijuana.
It’s a shame that our laws in Iowa still make it a crime to do something that is peaceful, voluntary, and uses no force or fraud against others. Marijuana prohibition laws do little to make our state safer, and yet do great harm to people who are victimized by them. In this case, if these two people are found guilty of the felony, they could be sentenced for up to 5 years in prison, be required to pay up to $7,500, lose their voting rights, be disqualified for military service or student loans, and more. Compare that to the fact that nothing happens to a person in her home who is found to be brewing 5 gallons of beer – a standard home-brew batch – and possessing, say, 10 to 20 more gallons that were brewed earlier.
Marijuana is no more dangerous than alcohol, and yet today we see the same unintended consequences resulting from drug prohibition that we saw from alcohol prohibition in the 1920s and early 1930s: violence, deaths from impure products, and the arrest and punishment of people who are otherwise honest and peaceful. Make no mistake, the violence associated with the illegal drug trade is caused by prohibition laws. If Walgreens moves into a community, CVS doesn’t send out a gang to kill them. When drugs are delivered to a pharmacy, both parties don’t carry weapons to protect themselves. Instead, they call the police if someone uses violence against them. But you can’t can’t call the police for help if you’re dealing in illegal drugs.
We need to follow the trend in other states and around the world: Legalize recreational marijuana and treat addiction using a medical model, just like alcohol. Let your elected representatives know your feelings. That is the way to get these unjust laws changed.
Link to Register article: https://www.desmoinesregister.com/story/news/crime-and-courts/2019/01/17/jamaica-mayor-ladonna-kennedy-pot-weed-gurthrie-county-crime-marijuana-search-ames-shooting-suspect/2606455002/
Thanks to Susan Voss for her thoughtful essay about the complexities of our health care system, and how difficult it is to reduce costs. (See link to Register essay below.) I don’t claim to have “the answer”, but I do suggest that the following cost saving ideas be given serious consideration.
- Medicare, Medicaid and private insurance should not be required to cover every new drug, product, or procedure that is approved by the FDA. Some are very high cost but provide only marginal improvement over alternatives that cost much less. Also, at least some covered products and procedures would likely be considered not medically necessary by most people.
- Consider shortening the amount of time that government grants a monopoly for patents. Patents are not natural property: humans have copied one another since the beginning of time. Our U.S. Constitution allows patents to be granted to encourage inventiveness, but there is no objective reason why a patent must be granted for 20 years. Why won’t five or ten years work? Maybe the length of the patent should be based on the cost to develop the patented item and whether or not government funds were used to help develop the item.
- Don’t require limits on out-of-pocket payments such as co-payments, especially for very high cost items. A person should have “skin-in-the-game” if they expect their insurance to cover very high cost items. Today, we see the opposite: drug companies offer to help pay people’s out-of-pocket costs so there won’t be so much political pressure on them to lower their prices.
- Allow both pharmacies and individuals to purchase drugs from sellers in other countries that are “deemed” to have sufficient safety procedures in place. If drug companies are free to charge lower prices in other countries, then pharmacies and individuals should be free to purchase the drugs from those other countries.
- Allow Medicare and Medicaid to negotiate with drug companies on prices they pay for the drugs that are covered by the programs. Right along with that, Medicare and Medicaid should be allowed to develop formularies (lists of drugs that are preferred over other therapeutically similar drugs), that give beneficiaries a financial incentive to use the preferred drugs and a penalty for using higher cost drugs.
Our health care wants are unlimited. Our ability to pay is not. We, as citizens, should not expect private insurance or our government health care programs to cover everything, regardless of cost. We should expect our government to NOT do things that increase costs, or reduce our choices.