Nobody Won, Especially America

If I have learned anything in the past year it is that Iowa is a complete joke. There was a time way back in 1976 when I went there to campaign for Jimmy Carter as a college kid that I believed in Iowa as an honest broker and screening committee for our presidential politics. But in the decades since it has become a casino unworthy of the media hype the state has so jealously protected. The time has come for ending this madness. Margins of a few hundred or thousand in a universe only slightly largely than a major league football stadium, in a state so unrepresentative of our nation at large, deciding winners and losers for a population of 300 million? Party hacks bought off with chump change? Roads built to nowhere by presidential administrations owing Iowa their power? Federal expenditures per capita at the top of the food chain? This state is now running a scam on our country that the most scandalous infomercials on cable television wouldn’t dare to present. Its bizarre rules, especially those in the Democratic Party denying secret ballots and banning minority candidates, ought to invalidate Iowa’s oversized influence. Iowa no longer deserves this.

Distancing Rural Health Care

A growing problem in rural America is the growing distances its citizens must travel for health care, thanks to years of hospital and clinic closures as large companies buy and consolidate facilities in rural areas. But also because insurance companies don’t include nearby facilities in their networks. And federal regulators are institutionalizing this trend.

Carol Miller, a community organizer in New Mexico, comprehensively writes about this issue in The Daily Yonder, focusing on the chart below showing how federal regulators propose to allow insurers to discriminate against rural populations and still participate in the markets set up by the Affordable Care Act.

One of the worst things about this table is that it exists and is in the public realm. I am extremely concerned that it might dangerously take on a life of its own. Remember, that just as the Health Professions Shortage Area designation was originally created for use by a single program, there are now are more than 20 programs using it. The standards proposed in this table need to go away and never be used by any program. The goal needs to be access to care for people living in rural and CEAC communities [counties with a population density of less than 10 per square mile], not distances and travel times that will guarantee not only worse access, but also worse health.

ruralInsurance
source: Centers for Medicare and Medicaid Services, Dept. of Health and Human Services

Electability

Who beats Trump? A practiced politician who has never shied away from Wall Street money, who entertains every whim of defense contractors — or a truthteller who will take a wire brush to the moneyed interests who care nothing about working people? Just like Bill destroying lives by reapeling Glass-Steagal. Talk left to your droolers, walk right to your donors.