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WHERE WILL YOU BE WHEN THE MUSIC STOPS?

Health care demands are escalating, resources are dwindling and leadership is
failing. The only viable solution is building "Bridges to Health Care Access."




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JULY 13, 2024


WHAT TRANSPARENCY IN STATE GOVERNMENT ACTUALLY LOOKS LIKE



“Together with leaders from all state agencies, we identified opportunities to
align operations, resources, and services to better meet the needs of Iowans.”
Or so Govenor Reynolds said when she promoted her massive state "reorganization"
in 2023. 

Not long ago, I sought statistics from the Iowa Deparment of Health and Human
Services on Iowans' incidence and prevalence of mental illness. I was intially
told I would need to go through the FOIA procedure to request that (apparently)
highly protected information. It was not until I pitched a hissy and threatened
to publicize this totally irrational obstacle that the data was provided. 

At a time when our health care system is strained to the limits and our policy
makers have their heads in a very dark place, only the light of day will lead to
informed health care access and decision making for Iowans. Don't forget to
bring your night goggles.

Des Moines Register of July 13, 2024



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JUNE 11, 2024


TWO MINUTE READ: FROM THE UPPER MIDWEST? RUH-ROH.



The six states that comprise the Upper Midwest (Iowa, Nebraska, South Dakota,
North Dakota, Minnesota and Wisconsin) have a common challenge: Their working
age populations (18 to 64) are shrinking. At the same time, total populations
are growing, along with their senior cohorts. And the number of new health care
jobs is dramatically rising. It makes for a very bad combo platter.

Shall we try all rowing in the same direction?



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MAY 14, 2024


TWO-MINUTE READ: WHILE YOU WERE SLEEPING ON FEBRUARY 21 . . .



You know those letters you get every once in a while from a doctor you see, or
may have seen in the past? The ones that tell you there was a cyberattack and
you got hit? Well, it seems an estimated 85 million Americans should have gotten
one of those by April 21, but didn't. You may be among the one third of U.S.
patients whose medical records have been hacked:   

History's most significant health care cyberattack hiding in plain sight



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APRIL 29, 2024


TWO-MINUTE READ: JIM MORRISON STILL ROCKS.



If you study the history of the Baby Boom, you will find it was always a
surprise when those 70+ million people showed up for kindergarten, college,
homebuying, yada yada yada.

And now, being in line for health care resources that were already far below
demand is another head-scratcher for policy makers and stakeholders. "Those who
do not learn history are doomed to repeat it."

History lesson from a legend of rock-n-roll



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APRIL 18, 2024


TWO MINUTE READ: HOW DID THEY NOT SEE THIS COMING?



In hindsight, it's not tough to see that a Baby Boom would result in an Elder
Boom 70 years later. If you're wondering where all the health care workers (and
auto mechanics) went, here's the answer. 

Never assume there's someone in charge



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APRIL 4, 2024


DOES CAPPING WAGES GROW THE HEALTH CARE WORKFORCE? HMM, LET'S SEE . . .



The Iowa legislature is on the fence about whether it's a prudent move to limit
the earnings of "traveler" or "contract" health care workers (this will most
directly impact hospital nurses and nursing home CNAs). Their theory is that
once the traveler nurse making $80 per hour can again make only $43 per hour as
a hospital employee, she/he will quickly return to the fold. 

Probably not. But as one legislator said on a hot mic, "If we could put these
contract agencies out of business, we'd do it, but this is as close as we can
get." Well, yes, as long as the Iowa Constitution is still around. 

Those posing as worker advocates suggest it's time for "a broader conversation
about health care workforce shortages"? Now, that is actually not true. That
time was 15 to 20 years ago. To propose that the way to grow our census of
health care workers is by limiting their earnings potential is like saying the
way to put out a fire is to ban the use of matches. 

But by all means, form another "study group" or "task force" or "collaborative"
to consider whether Iowans' access to health care is threatened, especially when
registered nurses continue to hold the #1 spot for job openings at IWD and 71%
of our rural hospitals are already operating in the red. Tick tock.

Des Moines Register article of April 4, 2024


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MARCH 14, 2024


YOU LOOK AWAY FOR A JUST A MOMENT, AND . . .



Meanwhile, as we're mesmerized by the geopolitical or economic shiny object du
jour, health care giant UnitedHealth Group's subsidiary, Change Healthcare, is
dealing with what is now called the most significant health care cyberattack in
U.S. history. (One in every three health care claims in the U.S. are processed
by Change Healthcare.) So far, it has paid $22 million in bitcoin ransom in an
attempt to restore data since the February 21 attack.

Granted, there's little (read: nothing) you and I can do as individuals to stop
these attacks or even to get policy makers or stakeholders to provide adequate
security for our personal health care information. However, we CAN maintain our
own digital and print records of crucial health care information. In an
emergency or when seeing a new provider, you may be the only one with access to
your medical history, current medications and existing conditions. Don't mess
around--write it down. 

Change Healthcare cyberattack jeopardizes medical data



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MARCH 6, 2024


TWO MINUTE READ: AGEISM. IT ISN'T JUST FOR SENIORS.



Medicine has come a long way over the past 20 years--a really long way. But it
can't seem to get ahead of rising cancer rates for younger folks. That's right,
those under 50 are at a greater risk for getting a cancer diagnosis than ever
before. This is some scary stuff.

Cancer stats are going the wrong direction.


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FEBRUARY 19, 2024


TWO-MINUTE READ: I SEE DEAD PEOPLE.



I know, I know, you don't want to think about death and dying. Few people do.
But understanding trends gives us another peek at why we are short health care
workers. Really.

Why so many obits these days?


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FEBRUARY 5, 2024


TWO-MINUTE READ - JUST DO IT, ALREADY!



I totally get that going to the doctor is high on your list of Stuff I Don't
Love To Do. But besides possibly spotting an issue that bears watching, there's
another reason to see your physician at least once a year. Even if you feel
fine. Even if you don't want to.

Annual exams: Can you guess the head fake?


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JANUARY 2, 2024


WHY IT'S IMPORTANT TO LOOK BEYOND THE HEADLINE



Iowa's Governor Kim Reynolds is bragging that Iowa has been ranked second in the
nation for having the best health care system. Oh, that it were so.

The source: WalletHub. (What?) That head-shaker aside, when you look at
WalletHub's methodology, you see it includes the U.S. Department of Health and
Human Services data on Health Professional Shortages Areas (HPSAs).

So here's a look at WalletHub's methodology:

The real story behind the press release of January 2, 2024



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DECEMBER 6, 2023


TWO-MINUTE READ - WHY WE NEED DATA GEEKS



Census data on its own can be overwhelming, and, admittedly, meaningless. But if
we put the pencil to those numbers and reduce them to simple ratios, they
explain our current and future health care workers shortages.

Dependency Ratios and the Caregiver Support Ratio



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NOVEMBER 20, 2023


2-MINUTE READ NO.1 - THREE MORE DOCTORS IS A START--SORT OF



Senator Chuck Grassley recently announced that Iowa has secured three more
Medicare-funded residencies as part of the 2021 Consolidated Appropriations Act,
which was signed into law in December 2020 (note how quickly solutions get
implemented). 

Here's the backstory on that: 

Jo's 2-Minute Read on how Congress is addressing physician shortages


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NOVEMBER 2, 2023


PLANNING TO TALK ABOUT MAKING A PLAN IS NOT REALLY A PLAN, NOW IS IT?



The CMS proposal for maximum patient-to-staff nursing home ratios is not the
solution to health care worker shortages. At the same time, with Iowa losing 26
nursing homes over the past 15 months and a moratorium on any new facilities,
Governor Reynolds' plan to "enter into a genuine state-federal dialogue" is not
really a plan either, is it? (And you can bet that similar ratio regs for
hospitals are not far behind.)

If the current level of proactive leadership in addressing this crisis of health
care access continues, Iowans are so monumentally screwed.

Iowa Capital Dispatch: CMS regulating nursing home staff ratios



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OCTOBER 21, 2023


FOR THE LOVE OF GOD, TAKE THE DAY OFF.


Ted Lasso reminded us that the happiest creature on Earth is the goldfish. It
has a ten second memory.


Today, enjoy nature's awesome Fall palette, give yourself a break, and be a
goldfish. 😀

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