Letter to the Editor

Responding to Bumgarner's commentary

Saturday, April 27, 2013
Gov. Terry Branstad

Imagine a health insurance plan where you pay nothing for your health care and have no incentives to improve your health. Imagine a plan that pays your doctors on quantity of services provided, instead of the quality of services and healthy outcomes.

Imagine this plan has increased the number of people participating by 65 percent over the past decade and increased in cost by 129 percent. Despite serving more and paying more, every single health metric for those on the plan has gotten worse, not better. Imagine a plan whose main financier faces a mountain of debt, spends more than it takes in every year and has not had a budget in four years.

Do you have confidence in this plan? Would you want state leaders to invest money in this plan without demanding improvements to health outcomes?

Unfortunately, this plan is reality and it's called Medicaid. The Senate wants to add 150,000 more Iowans to the program without improvements that our fellow citizens deserve. I believe adding 150,000 Iowans to a broken, unsustainable program is the wrong choice for patients, providers and taxpayers.

The feeling is bipartisan. In 2009, President Obama stated: "I want to say this publicly. As we move forward on health care reform, it is not sufficient for us simply to add more people to Medicare or Medicaid to increase the rolls, to increase coverage in the absence of cost controls and reform. And let me repeat this principle: If we don't get control over costs, then it is going to be very difficult for us to expand coverage ... Another way of putting it is we can't simply put more people into a broken system that doesn't work."

Medicaid should be a promise of better health for our neediest Iowans. I believe that Iowa, where your legislator is a neighbor, where we enforce the requirement for a balanced budget and where we have our financial house in order is a better partner than Washington to keep this promise.

We have already seen the federal government fail to keep promises. The Obama administration cut the long-term care entitlement and cut the small business health insurance options featured in the Affordable Care Act. There are plenty more examples of broken federal promises from special education funding to water infrastructure funding. As failed promises turn into larger and larger cuts to care, Medicaid patients could be the collateral damage. I do not want to see that happen.

I am not simply opposing Medicaid expansion. I want to create an improved health care program for the neediest Iowans, called the Healthy Iowa Plan. I believe true compassion is ensuring our population gets healthier, not simply covering them in an antiquated program like Medicaid. Crafting our new Healthy Iowa Plan took careful deliberation but underscored numerous opportunities to extend better health care options for Iowans. The flaws in the current Medicaid system also became clear. With an Iowa-crafted plan, we can succeed where the federal government failed by doing reform right.

I am committed to health care for working Iowans. The Healthy Iowa Plan will offer state coverage for every Iowan below the poverty level while offering affordable and subsidized private insurance through the exchanges for others. However, I am committed to more than just coverage. I am committed to a health care system that improves the health of Iowans, and I will work with anyone who shares my goal of a healthier state.

The Healthy Iowa Plan offers local health care services to patients. It requires a primary care doctor within 30 minutes or 30 miles for someone on the plan. But most important, the Healthy Iowa Plan focuses on measures that make Iowans healthier, such as health risk assessments, annual physicals and preventative measures. It encourages individual health ownership by asking everyone to contribute a modest amount, but waives contributions for those actively participating in healthy behaviors.

Iowans have always come together to find solutions that work for our unique state. The Healthy Iowa Plan is an Iowa-based solution to the health care challenges we face. It is a promise to Iowans we can keep today and in the future.

- Spencer Hospital CEO Bill Bumgarner wrote a guest commentary which appeared on the Tuesday, April 23 edition's opinion page.

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