A Letter to the Editor in re IowaCare Program

In this morning’s Des Moines Register, editor Andie Dominick wrote a column explaining that the IowaCare program is a flawed program.  She formed this opinion based on an interview with Sharon Davis, who is on Medicare, and her son, who in need of coverage for Asperger’s Disease.  Davis asserts that IowaCare is a defunct system.

After reading Dominck’s complaint about IowaCare, I feel that a response to has to be made to address IowaCare.

I am currently a patient under the IowaCare program.  Dominick says that IowaCare is not an option.  To this I reply:  IowaCare is not a failure as Mrs. Dominick perceives it to be.  I disagree with a few of the broad stroke statements that were made.  I hope my personal observation of IowaCare will help clarify several of these misconceptions.

Andie Dominick (Des Moines Register)

Mrs. Dominick and I have one thing in common.  We are both people living with diabetes (if you haven’t read it, please pick up and read “Needles”, Dominick’s personal story about living with diabetes).  I do not know how her experience have been as it relates to health care coverage.  So, I’ll give a synopsis of my experience.

In September 2012, I was diagnosed with advanced stage diabetic retinopathy.  Retinopathy is when the blood vessels around the retina in the eye start to bleed and swell, causing vision impairment.  If not treated immediately, it will cause blindness.  I am a young professional who is affected by the economic downturn and have worked as a temp employee to make ends meet in the best way possible.  For three years, I did not have insurance to cover for medical visits, insulin, and necessary equipment to manage my diabetes.

As a result, my health took a dangerous turn, especially my eyes.  I’ve heard a bit about IowaCare in the past, but thought of it to be another convoluted program that middle class people couldn’t get into because it was only for individuals who had no coverage and little to no income.

Once I was enrolled into IowaCare, I made it a point to learn more about the program and what it offers.  If I was going to save my vision, and my life, then I need to know what it does, rather than complain about its limitations.  In other words, use it to my advantage.

IowaCare, in essence, save my vision and potentially my life.

In regards to Davis’s claim that IowaCare doesn’t provide specialized treatment, that is partially true…and false.  I am receiving specialized treatment for not only my eyes, but also for diabetes through Broadlawns Internal Medicine clinic.  The problem for most who seek treatment at Broadlawns is that they are normally referred to the Primary Care clinic.  Primary care is for general maladies such as colds, flu, and minor health issues.

Sharon Davis (Charlie Litchfield/Des Moines Register)

The major issue is that patients who have more serious health conditions such as diabetes, foot problems, or mental health, should not be sent to primary care.  They should be seeing specialized care.  Broadlawns do have a mental health wing at their campus.  They also have diabetes care, foot care, et cetera. But the prevalent route is to send patients to a form of simple regular care that will not address what they really need.

My interpretation of the Dominick opinion piece is that everyone “assumes” that every condition and every illness would be covered under IowaCare or any other state-sponsored insurance program.

Which leads me to inquire if Mrs. Dominick talked to a larger sample of individuals who are receiving treatment under IowaCare.  She would have probably received several different viewpoints from those who are just as frustrated as Ms. Davis is, or those who have taken the time to ask questions and learn more about IowaCare as I have.

I am disappointed in Dominick’s view that a program is flawed, based on one person’s opinion.  I offer a different observation, for which it should be heard.

There are other programs and coverages out there that people have to research, find, and ask questions about.  I hope I’m wrong in saying this, but it appears to me that Davis assumed that IowaCare would cover everything.  To make that conclusion is not wise.

Neither is not asking questions about what it covers and accepting it “as is”.

All of us know that the new national healthcare plan that the Obama administration will put into place isn’t an “one-size fit-all” operation, and yet we continue to blindly believe that it will be.

Here are my suggestions for improvement of the IowaCare program, if Mrs. Dominick cares to read what a lowly blogger who is in the program thinks:

Location:  There should be consideration to expand the program to other hospitals to serve a regional area (NW, SW, SE, etc).  The push back will be that an established health system will prefer to offer patients their services over a state-supported service that is affordable and feasible for patients who can not afford a $500 visit and travel long distances, to name a few.

Resources:  UI Hospitals is a research hospital that is able to provide a wide range of specialized services to patients.  UI is able to receive federal funds for research and medicine.  Broadlawns is “county hospital’ for the poor and disadvantaged who need primary care.  Over the past few years, Broadlawns have expanded their specialized services, including mental health, but is limited due to their status, and being operated under the auspices of Polk County.  There should be a push for more funding to give Broadlawns the resources that is close or equal to the U of I Hospitals and Clinics.

Education:  in my opinion, IowaCare is not a failure, Mrs. Dominick.  We failed it because we don’t bother educate ourselves in understanding more about programs being offered.  We just “assume” everything is under one umbrella.  The more knowledgeable we are about the different types of programs, the more input and suggestions we can offer to help make the them better and provide expanded specialized services.

If a physician or specialist doesn’t know what type of programs are out there for patients who needs specialized care, then how will the patient know where to go to receive said care?  We are in a world where the internet is at our hands, and patients are going to find the sources to address their health situation.

I was extremely fortunate to have an ophthalmologist who knew the IowaCare program, enroll me in it, and made it a priority for me to be seen by a specialist in Broadlawns Internal Medicine clinic.

Blowing up any health care program would simply put many patients, including me, back to square one:  no coverage.  I don’t have the time to wait for the long-anticipated national health care plan to kick in.

Time is of importance.

My retina specialist put it bluntly this way:

“…people who have health benefits through their job, take them (benefits) for granted.  They’re just pissing it away by not regularly using them for checkups and health maintenance.  People who don’t have insurance and/or health coverage are constantly reminded every day that their health could go sideways.  They are the ones who really care about their health.  It’s all they got.”

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