Guest editorials: Supreme Court’s Ruling Lets Us Continue to Bring Men Value to Our Patients

by Bill Leaver, President & CEO, Iowa Health System and Debbie Simon, President/CEO Methodist Medical Center

There’s no doubt about it. The health care industry has anxiously awaited the Supreme Court opinion upholding or striking down the Affordable Care Act. Since its passage, our health system, the largest group of health care providers in Iowa, also serving regions in Illinois, has invested millions of dollars in carrying out provisions of the ACA—provisions that have nothing to do with the individual mandate, co-ops or Medicaid coverage expansion. Accountable Care Organizations (ACOs), bundled payment projects and electronic health records are just a few of the health care delivery provisions of the law in which we’ve invested. The best kept secret about these provisions is that they embody concepts supported by Democrats and Republicans. Now that the court has upheld these portions of the law, we breathe a momentary sigh of relief.

Our next reaction is an appeal – to the public, policy makers and political campaign staff:  Can we move on? Let’s not have the upcoming election, lame duck session and 2013 Congress focus on ripping apart health care delivery provisions of the ACA that will lower the cost, increase the quality, and improve the patient experience in the health care setting.

As a country we face two incredible challenges: one, to balance the budget and reduce our federal debt; second, to ensure that our private sector companies and their employees can be competitive in a global economy. Part of the answer to meeting these challenges is figuring out how to make our health care system deliver better outcomes for our patients and be more affordable for all Americans. To do this, we must pay for care differently and clinicians must deliver the care differently.

Physicians, nurses and others across Iowa, Illinois and the country are already working on this under provisions of the law. Iowa Health System and Wellmark have entered into an agreement to do this in many parts of Iowa.

In one of Iowa Health System’s regions we established one of the first Medicare Accountable Care Organizations in America — an alliance of a hospital, local doctors, home health care providers and a behavioral health center. Working together, these providers emphasize prevention by encouraging electronic and real-time communications between a patient’s healthcare providers, early-interventions, disease management plans and healthy lifestyle counseling. This opportunity was provided by the health law. Already it has led to reduced admissions of chronic disease patients to the emergency room and is helping many patients live happier, healthier lives in their own homes.

Another example is the coordination of primary care and behavioral health care into a coordinated care model to keep patients mentally and physically healthy.  Of 500 patients in this “community support system,” only 1 percent of them are admitted for inpatient care per month. This is very low for patients with a history of mental illness.

We are already on our way to reforming health care. Let’s not get derailed.

Allowing these types of programs to continue for Medicare and Medicaid patients will result in lower health care costs. Now that these portions of the Affordable Care Act that help in transforming the delivery of care have been preserved by the highest court, our elected senators and representatives must preserve them. And it is our leaders that can begin bi-partisan efforts to do just that. In Iowa and Illinois, we are fortunate to have elected leaders with seniority, chairmanship and leadership status, a tenacious record in support of health care. Let’s support them in moving health reform forward rather than backward.

Another View – by Kathy Sokolowski, RN, Hanna City

I picked up your newspaper while waiting for my car to get serviced and was very disappointed in your article on the front page. There were numerous areas that I found flaws throughout the article. I was wondering how offering free contraception will improved healthcare for women? The main purpose in taking contraception medication is to prevent conception from taking place. Contraception does not prevent STK or AIDS which would help improve women’s health. I felt that you were very one-sided in the different people that you quoted in your article (all in support of the mandate). There are many individuals who do not support this mandate. There are quite a few petitions going around opposing the HHS mandate. One is at stophhs.com and it has gathered 98,078 signatures. Another petition is at http://womenspeakeforthemselves.com which has collected 30,074 signatures. If you’re so concerned about improving women’s heath then why are you advocating for Natural Family Planning? According to sciencedaily.com, “researchers have found that a method of natural family planning that uses two indicators to identify the fertile phase in a woman’s menstrual cycle is as effective as the contraceptive pill for avoiding unplanned pregnancies if used correctly, according to a report published online by Europe’s leading reproductive medicine journal Human Reproduction.” Natural Family Planning by definition is natural and doesn’t have all the horrible side effects that the birth control pill does, which was another thing that your article seemed to miss reporting on. You wrote about how it helped with certain health problems but failed to mention the greater health risks in taking contraception pills, as according to national cancer institute (http://www.cancer.gov) “a number of studies suggest that current use of oral contraceptives (birth control pills) slightly increase the risk of breast cancer, especially among younger women. Oral contraceptive use is associated with an increased risk of cervical cancer and an increased risk of benign liver tumors.” Also, the journal of the May Clinic, Mayo Clinic Proceedings, had published a key article in it’s October 2006 issue entitled “Oral Contraceptive Use as a Risk Factor for Pre-menopausal Breast Cancer,” which showed an increased risk of 44%. The study also re-enforced the recent classification of oral contraception as Type 1 carcinogens by the International Agency for Cancer Research. My hopes in writing this letter was that in the future your reporting will be more factual and not one-sided.

[Editor’s Note — This article referred to Part II of a two-part story. The focus was NOT about contraception being the answer to women’s health. It covered another segment of the Peoria area population. It was about having healthcare plans that included the choice of contraceeption for the patients]

Dollars, Deception & the Destruction of Middle Class – by Ed Klein, Peoria

Anyone paying attention to what happened when Wisconsin Governor Walker, in spite of grassroots uprising to vote him out of office, may ask how he pulled it off. The answer rests primarily on two factors. One was the influx of millions of out of state dollars … money from right wing billionaires and groups including Americans for Prosperity and the Republican State Leadership Committee.

The second was Walker’s “divide and conquer” strategy. And that’s where Democrats and progressives share a large part of the blame. Throughout the country, Republican governors supported by corporate largesse have employed the “divide and conquer” technique which has taken a sinister turn: resentment of public employees. That sounds illogical when you consider the deep cuts in healthcare, education and public works especially affect lower and middle class voters. We may ask those voters who are bearing the brunt of these cuts, yet helped Walker win, don’t you know what your are doing to yourselves? Aren’t you aware that the money that formerly supported these public services is being handed directly to the rich and corporations in the form of huge tax breaks?

The Republicans succeeded in fermenting indignation against – in their terms – an “elite” that supposedly resents decent hard-working American values. It was formerly feminists and left-wing academics. Now it’s union members and public employees. These, Republican politicians argue, are responsible for the economic recession with their “cushy union benefits by taxing financially-strapped workers who don’t enjoy paid healthcare benefits and job security for themselves.

Where are those who are misled by Republican chicanery? They need to wake up to this insidious plan to make cuts that will devastate those in the lower end of the economic ladder. They include public schools & technical colleges, health care programs, programs for the uninsured, job training, public transportation, & other infrastructure programs.

A June 20th story in the New York Times reported that layoffs of public workers – more than half of them teachers and public employees – are taking a serious toll on local economies. Government jobs are down by more than 700,000 since 2009 due to cuts, and the slashing continues. Layoff notices are going out to teachers and school employees in California, Colorado, Nevada, Ohio and Pennsylvania.

As a result, school closings, cuts in sports, music, art, fewer facilities for kids who need extra help, crowded classrooms, stripped-down curriculum and stressed school staffs are taking place all across America. And we wonder why industry is looking abroad for engineers, technicians and others for jobs requiring highly specialized skills and knowledge.

The Republican mentality of cut, cut, cut is a dangerous trend and it’s become a sinister mantra we had better muzzle before it destroys the American economy and poses a very real threat to our American way of life.

Women’s Equality Day: Questions to be asked – By Dolores M. Klein, Peoria

August 26th commemorates the end of the long struggle for women’s suffrage, and a good impetus for asking a candidate for President where he stands, not on votes for women but about his attitude towards the instrument for full personhood under the law for women. Almost immediately after the 1920 finalization of the ratification of the 19th Amendment, Alice Paul, a leading suffragist, introduced the Equal Rights Amendment, saying, “When you put your hand to the plow, you don’t take it off until the end of the row.”In 1982, it was stopped three states short of ratification in Springfield. Efforts for ratification continue in each new Congress.

Why is it necessary to ask Governor Mitt Romney about his feelings for this Amendment? For the same reason that Candidate for President John F. Kennedy felt impelled to make his famous statement that, as President, he would not be guided by his Catholic faith’s stand on issues of conflict if he was elected.

A Mormon woman, Sonia Johnson, was publicly excommunicated for her E.R.A. activities. I remind my Republican sisters that Republican women joined Democrats in public support for the Amendment. Mary Crisp, co-chair of the Republican Party, resigned when the Amendment (for the first time) was removed from the 1980 Platform. President Ford’s wife, Betty Ford, a constant and determined worker, and Maureen Reagan, Ronald Reagan’s daughter, crossed the country with a sister of Jimmy Carter, speaking for ratification. We may be called “selfish” for daring to raise Women’s so-called “social issues” as a Presidential issue. We know our Equality is a Human Rights issue. So let’s BE selfish and ask the pertinent question!



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