One less barrier to vaccination

One less barrier to vaccination

Gazette Column
Amid measles outbreak and emergency mandates, Vatican makes position change public For vaccination advocates, there’s bad news and good news. Let’s start with the bad. Although deemed eradicated in 2000, measles is making a record comeback in the United States. Health officials have, for the second week in a row, added dozens of new cases, bringing the nationwide total to 465 as of last week. Not only does this mark the highest number of cases in a five-year period, highly contagious measles is now present in a third of U.S. states, including Iowa neighbors Illinois and Missouri. More measles cases occurred in the first three months of 2019 than in all of 2018, according to the Centers for Disease Control and Prevention. Although 2014 remains the year since 2000 with the most…
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Why state leaders needed to step back from work requirements

Why state leaders needed to step back from work requirements

Gazette Column
State work requirements for Medicaid recipients appear to be scuttled, at least for this year. That’s a good thing because research and experience show the numbers don’t add up for participants or for taxpayers. The bill passed by the Iowa Senate, Senate File 538, required the Department of Human Services to petition the federal government for permission to implement Medicaid requirements beyond those already in place at the federal level. Those new stipulations centered on work requirements. Specifically, “able-bodied” recipients would need to work or volunteer a minimum of 20 hours each week, and government officials would need to make larger investments in software and staffing in order to track the changes with the increased veracity required by the bill. Sticks of chalk sit around a partially completed drawing of the…
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Eli Lilly’s insulin gesture isn’t enough

Eli Lilly’s insulin gesture isn’t enough

Gazette Blog
In mid-February the comment period closed for the Federal Drug Administration's proposed approach to transition insulins as regulated drugs to biologics and biosimilars. Indianapolis-based Eli Lilly and Company noted in its comments that it wanted to introduce its own versions. And, on Monday, it did just that. Lilly will begin selling an authorized generic of Humalog 100 for $137.35 per vial, which is roughly 50 percent below the insulin's current list price. As an authorized generic the insulin will be identical to the brand-name, except for the label, and will be manufactured in the same facilities. The generic will be called Insulin Lispro, according to company reports, and sold through an Eli Lilly subsidiary, ImClone Systems. Introduction of the authorized generic is a compromise, of sorts. The pharmaceutical company is…
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Iowa bills target emergency insulin access gap

Iowa bills target emergency insulin access gap

Gazette Column
Two bills making their way through the Iowa Legislature would help diabetics receive live-saving insulin in emergency situations. Senate File 291, sponsored by Sen. Carrie Koelker, R-Dyersville, and House File 447, sponsored by Reps. Andy McKean, R-Anamosa, and Lindsay James, D-Dubuque, are working their way through the human resources committees in their respective chambers. Their aim is fairly narrow in that they would allow Iowa pharmacists to dispense a 30-day supply of insulin to those with an expired prescription in an emergency circumstance, even when a physician's authorization cannot be obtained. Similar bills - known as Howdy's Law or Kevin's Law - have been passed in several other states following the advocacy of Dan and Judy Houdeshell of Ohio. Their son, Kevin 'Howdy” Houdeshell, ran out of insulin over the…
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Lawmakers should end religious exemption

Lawmakers should end religious exemption

Gazette Column
Iowa lawmakers dispatched two proposals that would have allowed more parents to forgo required and necessary vaccinations for their children. That's good, but not enough. It's time to take a closer look at the state's lax vaccination rules. According to the Iowa Department of Public Health, more parents are seeking religious exemptions to vaccination requirements - four times the number from only 15 years ago. At the county level, the percentage of parents taking a religious exemption varies widely. In Buchanan County, for example, 356 religious exemptions were filed in a total enrollment of 3,515. Larger Linn County had 744 religious exemptions from a total enrollment of nearly 40,000. That's partly because state law doesn't require parents to cite specific religious teaching against vaccinations to claim the exemption. All it…
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Iowa Republicans are devaluing women – again

Iowa Republicans are devaluing women – again

Gazette Column
Iowa Republicans are once again making clear that they value the potential of pregnancy more than they value women. Their latest missive is Senate Study Bill 3143: “An act relating to the prerequisites for and prohibition against an abortion related to the testing for, and following the detection of, a fetal heartbeat, providing for a repeal, and providing penalties.” A nearly identical bill, HF2163, was introduced in the Iowa House: “An act recognizing the rights and protections accorded each life from the moment of fetal heartbeat detection, prohibiting the performance of an abortion if a fetal heartbeat is detected, providing for licensee discipline, and providing a repeal.” Both bills basically state that, once a fetal heartbeat is detected by ultrasound, a pregnant woman cannot legally obtain an abortion. Doctors who defy the…
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Layperson standard for emergency care is under attack

Layperson standard for emergency care is under attack

Gazette Column
Hundreds of Americans who recently sought treatment in emergency rooms have had insurance claims denied, leaving them owing thousands of dollars in medical bills. Is this the next health care battle in Iowa? Those with denied claims live in Missouri, Georgia and Kentucky and are insured by Indianapolis-based insurance giant Anthem. In Iowa, the company operates as Amerigroup, which provides Medicaid managed care. A letter, sent last year, spells out Anthem’s new emergency room policy in bold, blue text: “Save the ER for emergencies — Or you’ll be responsible for the cost.” Those with denied claims believe the insurance company is making decisions based on medical diagnosis instead of problems that led to emergency care. A 27-year-old Kentucky woman, for instance, sought care for what she believed to be potentially lethal…
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Maybe the answer is fewer rural hospitals

Maybe the answer is fewer rural hospitals

Gazette Column
Midwestern health providers and stakeholders are speaking out, and what they have to say is surprising. Could fewer hospitals bridge the widening urban-rural health gap? A new report highlighting the challenges and opportunities in rural health care across Iowa and six other Midwestern states says small communities need more flexibility to customize health care services, workforces and facilities to meet individual needs — even if, in some communities, it results in the loss of a full-service hospital. The Bipartisan Policy Center and the Center for Outcomes Research and Education spoke with more than 90 thought leaders and key stakeholders in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming to compile the report, which was released this month. [caption id="attachment_1874" align="alignleft" width="500"] Stethoscopes hang in a clinic hallway on May…
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Iowa Republicans blinded by abortion

Iowa Republicans blinded by abortion

Gazette Column
However shortsighted, expensive and harmful the resulting policies may be, Iowa Republicans remain obsessed with abortion. Last legislative session, they chose to scrap the Iowa Family Planning Network waiver, primarily funded by the federal government, and replace it with a new program funded solely by the state. That initiative, now known as the Family Planning Program, took effect July 1. Both programs provide men and women of childbearing age who do not qualify for Medicaid a cost-effective way of accessing reproductive health services including contraception, exams, screenings and testing. The Iowa switch wasn’t proposed because the original program was riddled with fraud or otherwise ineffective. In May 2016, the University of Iowa Public Policy Center concluded that more than 80,000 women had used the Iowa Family Planning Network waiver since…
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Triage for mental illness makes sense

Triage for mental illness makes sense

Gazette Column
Iowans need jail alternatives County law enforcement officials are asking Iowa lawmakers to create regional triage centers for Iowans experiencing mental health episodes or an addiction crisis. It would be a much needed and smart move by lawmakers. The six triage centers proposed by the Iowa State Sheriffs’ & Deputies’ Association would assess individuals committed voluntarily or involuntarily so that those people can receive proven treatment that’s cost-effective. Currently, these people in crisis are being funneled into highest cost care, generally hospitals, jails and prisons. The flip side of the coin is why this is happening, and has been happening for several years. Iowa doesn’t have nearly enough treatment options for those with mental illnesses. This was true four years ago, when I wrote a two-part series about a Johnson County criminal case. It involved…
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