Health Reform and the 2014 Iowa Senate Race

I ask the few remaining independent voters–those who have not yet decided for whom they will vote in the US Senate race between Iowa State Senator Joni Ernst and US 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 ten 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 twenty-one years in Ames. My family has been serving Iowans for one hundred sixty-years. My two daughters, both, who are physicians, also care for Iowans.

I am a passionate Iowan and have worked to promote health care coverage in Iowa for twenty-five years. Why? Because health care coverage is proven to save lives, reduce suffering, and provide peace of mind.  My work regarding health care coverage for children led a Republican state senator to call me the godfather of the HAWK-I children’s health program.

Most of the time Iowa is a fly over state without a lot of national interest or media attention. Recently my wife and I were within a few hours of departure and a major airline switched our flight assignments to a smaller plane for a flight from Charlotte to Des Moines. Symbolically and actually, this told us and 11 other passengers that we also should be flying over Iowa instead of flying to Iowa. Usually, this kind of Iowa snub is fine with me. It allows us as Iowans to control our destiny, particularly regarding our quality of life and the care we provide to and for each other.

The current US Senate race has brought in millions of outside-of-the-state dollars as well as out-of-the-state consultants, many of whom had never before set foot in Iowa. This money and these consultants seek to tell us Iowans how to vote and why to vote for certain candidates. These outside consultants have created statements such as “Obamacare is a disaster,” “Obamacare cost billions of dollars,” and “Obamacare forced cancellation of insurance policies and lead to higher insurance premiums for Iowans.” Repeal of the Affordable Care Act (ACA) has been promised many times and brought to a vote in the US House more than 50 times.

You undoubtedly have a family member, friend, or associate who has received health care coverage under the Affordable Care Act, either because of improved private insurance options, as a young adult remaining on their parent’s health insurance, or Medicaid expansion. Repeal would force these individuals into the ranks of the uninsured. Who else in Iowa would suffer? Or, a different way to ask this question: How have Iowans been helped by the Affordable Care Act?

One hundred and eight thousand of our family members, friends, and fellow Iowans now have Medicaid. Ninety-six thousand Iowans and Nebraskans have health insurance with a new cooperative insurance company—CoOportunity Health—made possible by the Affordable Care Act. No one who had individual health insurance with Wellmark Blue Cross had their individual health insurance cancelled; their rate increase this year was zero percent and announced rate increases for next year are similarly low.  Additionally, small businesses insuring with Wellmark will see rate increases of less than five percent for next year. Thousands of young adults have health insurance through their parents’ plans. Medicare recipients have seen their medication “donut hole” shrink. Two Medicare Accountable Care Organizations (ACOs) in Iowa improved quality of care to Medicare recipients while saving money for Medicare. One of these ACOs will return significant savings to local family medicine practices in Winterset, Cherokee, and Le Mars, which helps support those Iowa communities.

In Iowa, repealing the Affordable Care Act would place thousands of Iowans’ lives at risk by taking away their health care coverage, would raise health insurance rates, would diminish our local health providers, and would cost our parents who are on Medicare higher drug costs while providing them with lesser quality care at a higher cost to all of us.

Any candidate who supports repealing the Affordable Care Act has been listening to far too many out-of-state consultants and not doing his or her homework about the true effect of those outside-of-Iowa who donate money to Iowa political campaigns and those out-of-state consultants will be flying over Iowa once again, literally and figuratively. To them I say good riddance.

Finally, I have an 1855 map of Iowa which is the year my great, great-grandfather came to the banks of the Mississippi River. This map, which has served Iowans well for just shy of one hundred and sixty-years, has a flaw. The town of Algona, where I practiced in Kossuth County, is misspelled as Angola. Similarly, I believe the Affordable Care Act has some minor flaws which should be corrected. Nevertheless, like the 1855 map, I believe the Affordable Care Act should and will serve Iowans well for a long time in the future.

I fully support the Affordable Care Act. I fully support Congressman Bruce Braley in his bid to be our US Senator because I believe in his vision of Iowans caring for each other.

You can watch this “conversation” with Dr.Carlyle on You Tube at