Panel discusses future of healthcare in Iowa

By Carter Howe

howethom@grinnell.edu

Practicing physicians and healthcare policy experts held a panel on the shortcomings and future of Iowa’s health care system Wed. night at Saints Rest. Among other things, the discussion centered around the improvements to health care gained from the ACA, the challenges of rising costs that persist, how to expand mental health care in Iowa, the importance of preventative care and the effect of Medicaid Privatization on Iowa and the impacts of the new presidential administration.

The panelists were asked about the failed American Health Care Act, the Republican plan to replace the ACA. Though they were quick to criticize the bill, saying it would fail to bring down costs or entice the young and healthy ,as well as increase premiums for elderly, they said there are still structural problems in the health care system the ACA did not fix. Rising premiums, copays and the fact that the economic incentives of the healthcare system are often not in line with what is least expensive for patients all must still be addressed.

Panelist Jennifer Vermeer, assistant vice president for Health Policy and Population Health at University of Iowa Health Care, expanded on this notion, saying that because the US health care system pays doctors per procedure they provide, there is not always an incentive to provide low-cost, high quality care.

Increasing access to mental health care and how to do so in a largely rural state like Iowa was another big topic of conversation. According to Vermeer’s colleague and panelist, John Stovie, Iowa ranks 47th in the nation per capita for psychiatrists and mental health treatment.

Stovie believes the declining stigma around mental health related treatment has been both a blessing and a curse. It has led to more people getting diagnosed and seeking treatment, but has also put a strain on a system that cannot handle the additional caseload. There is a need for creative solutions in bringing more psychiatrists to Iowa.

Panelists discussed the need for more preventative care and education to lower costs and address health problems before it is too late. Stovie mentioned the high cost of sending ambulances to rural areas, and how education about how to prevent injuries, especially from farm equipment can do a good amount of the preventative work. This education has brought injury reductions in rural communitites.

Stovie also said increasing preventative care in older, rural areas like Iowa is difficult because there is an attitude that one should only go to the doctor if they absolutely have to. “ The problem … is that the most effective way to manage your health and keep costs down is to use it preventatively and take care of yourself,” Stovie said.

Panelists also talked about the effect of the privatization of Medicaid in Iowa in 2015, which increased bureaucracy and decreased the reimbursements hospitals and physicians receive. Doctor Laura Ferguson ’90 of Grinnell Family Medicine attributed the closing down of Central Iowa Family Planning in Grinnell to Medicaid privatization, and the clinic not receiving their previous Medicaid funding.

Ultimately, co-organizer of the event Abby Griffith ’08, who works as a nurse at Grinnell Regional Medical Center, said she hopes the event helped people to be more informed about the specifics of healthcare policy and that people will continue to stay informed and voice their concerns to their legislators, especially by calling their local elected officials.

“I’ve recently started to get more active with just understanding and the legislation that’s being brought forward, and part of that is just by talking to the legislators,” Griffith said. “If you do know about something or if you learn more about something, … you can actually provide them with education that they don’t have.”