Health Reform and   Primum Non Nocere Revisited        

Several months ago in this space, I discussed my concerns about a Trump presidency regarding the Latin phrase, “Primum Non Nocere,” which means, “First Do No Harm.” Now, at the end of the 2018 Iowa Legislative session, I revisit this phrase to discuss my concerns about the results that this Republican-dominated Legislature and the Republican governor have or are creating.

Given a budget deficit that required cuts for the current fiscal year and a poor farm economy that may worsen, the Republicans have announced the “largest” ever tax cut for Iowans. This will surely lead to even less money for government services in years to come. For health care specifically, Republicans have ignored and continued a flawed private for-profit Medicaid managed care system as well as passed a new law allowing associations to create health plans that will discriminate against people with existing healthcare conditions. This plan, which was pushed by the Farm Bureau and Blue Cross/Blue Shield’s Wellmark, will undermine the insurance market and destroy vital aspects of the vision and gains of the Affordable Care Act (ACA). The plans to be offered will not include ACA-mandated healthcare requirements such as maternity care and mental health care.

Healthcare in Iowa will suffer because of these developments.

On Tuesday night, I will attend a fundraiser for Dr. Andy McGuire who is a Democratic candidate for governor. She is making health care a major focus of her campaign. On Thursday, I will attend a federally-mandated Medicaid Assistance Advisory Council (MAAC) meeting which has the responsibility to critique this Iowa version of Medicaid.

I know examples of patients not receiving services and of some healthcare entities that are owed millions of dollars by these private for-profit managed care companies.

I fear that 2018 will go down as a watershed year for health care in Iowa. I hope that the fall elections will be a referendum on what kind of health care we Iowans want for ourselves and our families and that 2019 will undo some of the damage that is being perpetrated upon Iowans this year.