April 23, 2025

Two minute read: Simple steps reaping huge rewards.

If you're not yet familiar with health care's newest neologism, you're gonna luv this one: "bedlocked." 

How about some super simple life-extending action steps that just might come in handy in an emergency?

Get a PCP while the getting is good.

February 26, 2025

Where's a funnel when you need one?

I was thinking of posting about some of the legislation currently being proposed to address Iowa's crisis of health care worker shortages. In the past, they've given us laws to limit malpractice claims and discourage nurses from being "travelers," which have had zero positive impact. So what's next in leadership's bag of tricks?

Instead, I've decided to wait until after the first funnel, March 7th. In the meantime, I can only hope and pray that some of these pointless--albeit very expensive--"solutions" will die a natural death and never see the legislative light of day. 

February 12, 2025

Two-minute read: Is Iowa keeping up with its neighbors?

Is there value in comparing oneself to others? Yes, when we're talking about how a state fares in the battle for workers. I dug into health care-related stats for Iowa and its "Upper Midwest" neighbors, now and in 2030. See for yourself. It’s not looking good for Iowans. 

How tough will the competition for workers get?

February 2, 2025

Quack quack quack

No argument, the failure of leadership to assure safe and accessible health care for every Iowan is epic. But what rule says the minority party is not allowed to hold its own public hearings on the shameful state of affairs in our nursing homes? Rural health care? Worker shortages? 

Pointing the finger at Republicans is great sport for Democrats and the stuff of headlines, but passing more laws is NOT the answer to every problem.

Care for a little cheese with that whine? DMR 2/2/2025

January 8, 2025

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.

December 20, 2024

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

December 6, 2024

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

November 21, 2024

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

October 22, 2024

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!

September 17, 2024

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

August 27, 2024

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

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. Read on:

Des Moines Register of July 13, 2024

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?