Two minute read: New Year's Resolutions for Iowa's leadership

I'm pretty sure Iowa is approaching that "fish or cut bait" moment in its evolution. The escalating crisis of health care access has highlighted labor shortages in an industry where a break in the supply chain causes more than just inconvenience or higher prices--it  endangers lives. But to be honest, the dearth of potential workers plaguing health care is a burden in every employment sector.  

In 2025, I would wish for my state that leadership, both private and governmental, would acknowledge the perfect storm that quickly approaches and prioritize finding solutions that will enable Iowans to achieve best health outcomes--all Iowans. 

The first step to recovery is to acknowledge the problem.

A New Year, a new chance to schedule an interesting program!

Are you that person who pledged to find more interesting, relevant and informative speakers for your organization in 2025? Well, it's time to do just that.

Jo's keynote presentations for 2025

An epidemic of medical errors

 

See? It's not just me.

You know I love a good fact-based rant, which is why I hope Dave Elbert of the Business Record never stops writing. He just shared one of my own tirades and I thank him for the early Christmas present. 

Dave and I come from two very different angles on the "health care" failures of Iowa's leadership. Together, they paint the picture of a future that does not bode well for Iowans' health and well-being. 

Here's to a New Year we hope will bring awakening. 

The Elbert Files: December 6, 2024

Sorry to be saying "Told you so."

 

Two minute read: Every Iowan recognizes the odor of fertilizer.

How many realize that 40 percent of Iowans live in "rural" Iowa? That means the life-threatening challenges faced by rural health care directly impact nearly half of all Iowans. 

Today is Rural Health Day in Iowa. I'm sorry to say that does not hold the promise one might hope for. 

Governor Reynolds' Proclamation is, well, disappointing

Two minute read: The issue EVERY candidate is avoiding.

I cast an early ballot today, along with thousands of my fellow Dallas County citizens. It was heartening to see so many Iowans being so engaged. To be clear, I have no way of knowing their political dispositions and, for purposes of this post, it doesn't matter. 

Iowans face a threat to their health and well-being and this perfect storm of supply, demand and systemic failures does not care one jot whether you lean left or right. If you are in its path, you are in danger. Read on:

For the love of Iowa and your own health, vote!

Two minute read: Vanishing workers and hospitals. Help.

Iowa's population is projected to grow over this decade. Not as much as in the past (down by almost half), but, still, growing. That is a two-edged sword, as our "cohort in the middle," the working age population, is not only not growing, it is shrinking.

Twenty-three percent of our projected job growth will be in health care, an industry which relies heavily on labor, from direct care workers to brain surgeons. And we are already seeing the impact that inflated wages and expenses and reduced Medicare/Medicaid reimbursements are making on our ability to access health care in Iowa. Not good. Read on: 

Projected job growth and threats to rural health care

Two-minute read: Will Iowa thrive, or even survive, in the coming years?

Every ten years, the United States conducts a nationwide census. You can only imagine our ability to gather data in this day and age, so it takes awhile to put it all into a package that folks other than professional data-gatherers can use to make plans. 

National population demographics were released last fall, but states are just beginning to complete their own calculations, and it's a big day for me! Iowa's projections have arrived! Read on:

Looking into Iowa's demographic crystal ball

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. Read on:

Des Moines Register of July 13, 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?

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

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

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

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