- Associated Press - Monday, June 5, 2017

Des Moines Register. June 23, 2017

Iowa’s incredibly shrinking government must raise revenue

The Iowa Legislature has long had 150 members. But perhaps it’s time to eliminate about, say, 16 of them. That 11 percent reduction would equal the cuts to the state’s executive branch workforce over the past six years.

Such legislative shrinkage would also be in keeping with the philosophy of Republicans, who now control the Iowa House, Senate and governor’s office. They talk incessantly about the need for smaller government and lowering taxes, which reduces revenue to operate government.

Why not fewer lawmakers?

The remaining 134 members could do more with less, the way all other government employees are doing amid budget cuts, mid-year revenue shortfalls and the loss of more than 2,000 workers.

Of course it’s unlikely the political party in charge is going to embrace this suggestion. So they should outline their ideas for how the state will continue to fund salaries, health insurance and other benefits for them and their staff. Because an unwillingness to make cuts creates an obligation to generate revenue.

Yes, generate revenue, a phrase Republicans shudder to utter. It means entertaining the elimination of tax credits and corporate giveaways or even - gasp - raising taxes. It means reconsidering the use of our tax system to reward people for doing things they were going to do anyway, like opening a business, giving to charity or saving for college.

While conservatives insist tax breaks are not the same as “spending,” they have the exact same effect on the state’s coffers: The money is not there to fund government services. And those breaks do not miraculously pay for themselves; they starve the state of revenue, as Kansas recently learned before lawmakers had to raise taxes in an attempt to rescue the state from fiscal disaster.

It is becoming increasingly clear that Iowa needs more money. Cuts to state staff and services in recent years are creating unnecessary and unacceptable risks and problems for Iowans.

As few as five state troopers are on duty overnight to patrol the entire state. That is one trooper for every 620,000 Iowans. It can take hours for an officer to get to the scene of an accident, and there is little chance rural areas are ever patrolled.

Families are waiting up to two weeks for a loved one’s remains and cannot plan funerals due to a backlog of autopsies at the Iowa Office of the Medical Examiner. Staff shortages are contributing to the delays.

Lawmakers who oversaw the loss of about 1,000 workers at the Iowa Department of Human Services have the audacity to criticize the agency for not adequately investigating child abuse allegations. The state’s child abuse hotline received 50,000 calls last year, an increase from each of the previous three years. Do lawmakers plan to answer the phones?

Remaining human services staff are stretched thin. Less time to work with troubled families may have contributed to a 16 percent increase in terminations of parental rights between 2012 and 2016. Removing children from biological families forces the state to spend more on subsidies for foster and adoptive families.

In only a few years, the state has closed two mental health facilities, the Iowa juvenile home in Toledo, seven DOT maintenance garages, two driver’s license stations and 36 unemployment offices that were replaced by kiosks, which were not maintained and ultimately shuttered, too. Iowans are likely waiting longer for everything from court dates to help filing an unemployment claim. Is

Iowa government small enough yet to satisfy Republicans? And why haven’t all their reductions put the state in a better fiscal position? Instead, Iowa is limping through the current fiscal year.

In January, lawmakers approved a $118 million mid-year budget cut, and Iowa pulled $131 million from the state’s cash reserves to fill financial gaps. With only weeks left in this fiscal year, a new analysis revealed an additional $100 million shortfall, which will mean dipping into savings again. A recent Register investigation found the state did not have enough cash to pay Iowans’ tax returns this year at the same pace as previous years.

There comes a point when government has too little money and too few staff to adequately perform its most basic responsibilities. Iowa has reached that point.

And the situation could quickly become much worse if Republicans in Washington follow through with proposed cuts to programs including Medicaid and food assistance. President Donald Trump’s proposed budget would reduce federal grant funding to Iowa by $100 million.

Though Republicans refuse to acknowledge it, Iowa has a revenue problem. The answer is generating more, not collecting less.

_____

Sioux City Journal. June 25, 2017

Obesity study should be wake-up call to action

Obesity is, literally, a large and growing problem across the world, including here at home in America.

In what is called the most comprehensive research done on the subject of obesity to date, a new study - in which data was compiled from 1980 to 2015 - published earlier this month in The New England Journal of Medicine reports these troubling statistics:

- More than 10 percent of the world’s population is obese.

- Rates of obesity in 73 countries at least doubled between 1980 and 2015.

For the United States, the study done by the Institute for Health Metrics and Evaluation at the University of Washington and funded by the Gates Foundation reports these sobering numbers:

- Combining children and adults, the U.S. showed the largest obesity increase in percentile points, from an obesity rate of 10.5 percent in 1980 to 26.5 percent in 2015. 26.5 percent - that’s more than one in four Americans.

- 12.5 percent of children were obese in 2015, up from 5 percent in 1980.

For the study, which examined 195 countries, obese is described as a body mass index of 30 or higher.

The findings represent “a growing and disturbing global public health crisis,” according to the authors of the study.

“People who shrug off weight gain do so at their own risk - risk of cardiovascular disease, diabetes, cancer, and other life-threatening conditions,” said Dr. Christopher Murray, an author on the study and director of the Institute for Health Metrics and Evaluation. “Those half-serious New Year’s resolutions to lose weight should become year-round commitments to lose weight and prevent future weight gain.”

Because obesity impacts society in a variety of ways, including increased health care costs, increased disability costs, and increased workplace absenteeism, this study should be a wake-up call to action in the U.S., in our view.

Due to today’s national debate about health care - in particular, the costs associated with health care - alone, the results of an obesity study like this one should resonate throughout the country. According to the Campaign to End Obesity, annual health care costs for obesity-related illnesses in the U.S. are nearly $200 billion, or nearly 21 percent of total medical costs.

“This study shows what we know: No country in the globe has reduced overweight or obesity levels. This is astounding given the huge health and economic costs linked with overweight and obesity,” Barry Popkin, a professor of nutrition at the University of North Carolina, told The New York Times.

The challenge of reducing obesity and becoming a healthier country is significant, multi-faceted and will not be met overnight, of course, but for inspiration, Americans need look no further than the successful effort to decrease use of tobacco.

In 1964, Luther Terry issued the first U.S. surgeon general’s report on smoking and health, linking cigarette smoking with lung cancer, heart disease and emphysema. According to the Centers for Disease Control, 42 percent of Americans smoked cigarettes in 1965, the year after Terry’s report. By 2015, 50 years later, the rate was reduced to 15 percent. Clearly, a national anti-smoking commitment - including warning labels, restrictions on advertising, public service initiatives, higher taxes and smoke-free laws - have showed dramatic, positive results.

Similarly, fighting what we believe is a necessary fight against obesity requires collective national acknowledgement of how serious the problem is and collective national embrace of a comprehensive, sustained strategy for action involving all of American society - government, the health care industry, schools, nonprofits, private businesses, communities, neighborhoods, families and individuals.

We can think of no better time to begin than today.

___

Dubuque Telegraph Herald. June 23, 2017

Opioid battle can be won

Here’s a one-question quiz:

Over the decades that such statistics have been kept, what cause of death showed the largest year-over-year increase in the United States?

Guns? Nope.

HIV-AIDS? Wrong.

Motor-vehicle accidents? Wrong again.

According to data compiled by The New York Times and reported this month, an estimated 59,000 to 65,000 people died of drug overdoses last year, exceeding the single-year peaks for causes with which Americans are more familiar: Car crashes in 1972, HIV-AIDS in 1995 and firearms in 1993.

Drug overdoses jumped more than the 19 percent in 2016 compared to 2015 - the biggest increase for any cause of death in any year.

Now, the leading cause of death among Americans younger than 50 is drug overdose. The sobering statistics of early 2017 indicate that overdose will retain its dubious standing for the foreseeable future.

Drug overdose - with the emergence of opioids fueling the trend - is a national epidemic, and its dark cloud by no means has bypassed the tri-state area. Members of this community struggle with opioid addiction. For others, their struggle ended in death, leaving behind grieving and devastated families and friends.

Over the years, this country turned around negative trends concerning deaths by traffic accidents, HIV-AIDS and firearms. It hasn’t been easy, and there continue to be too many tragedies in those categories. But progress was made, and progress can be made concerning opioid addiction and overdose deaths.

Just as none of those other causes of death declined due to one single action, reversing the scourge of drug addiction will require many different steps in a calculated, cooperative manner. There are many pieces in the puzzle.

Among those pieces are objective assessments of the problems, the possible solutions and the barriers to those solutions.

Last week, the Dubuque City Council heard an update from a coalition of public health officials, representing the public and private sectors, regarding major health care issues. Opioid addiction and mental health care were front and center. While those illnesses frequently manifest themselves in manners that require law-enforcement intervention, they are, at their root, public health issues.

It’s positive to see how various stakeholders are collaborating to tackle these serious problems. Solutions include improving communication, changing policies, enacting legislation, expanding treatment facilities and improving training and education.

Stakeholders are not just talking about the problem. Some steps are already being taken. For example, pharmacies in Hy-Vee supermarkets in four states, including Iowa and Wisconsin, no longer require a prescription for naloxone, the drug proven highly effective in reversing the effects of an opioid overdose. That makes it easier for people with an opioid problem - or their family and friends - to access the drug in privacy and have it available should an overdose occur. In making their announcement last month, Hy-Vee officials said pharmacists also will help naloxone purchasers learn how to recognize an overdose and to properly administer the drug.

No one is suggesting that stocking up on naloxone is a long-term solution. This community lacks in-patient treatment and detoxification facilities. In Iowa, lawmakers talked a good game last session but in the end failed to pass any substantial legislation to combat the epidemic.

Meanwhile, all should acknowledge that doctors, whose prescription of opioids for pain management often is blamed for subsequent addiction, face pressure on a couple of fronts. Many of their patients have come to expect a pain-free experience, even after the most invasive procedures or serious mishaps, and demand strong medication. Meanwhile, administrators and marketing departments at clinics and hospitals place significant weight upon rankings and ratings based on surveys completed by those patients. If physicians don’t prescribe strong-enough medication, they argue, patients filling out surveys are likely to give the doctor and hospital unfavorable marks.

In the tri-state area and all across the country, the opioid epidemic is poised to get worse before it gets better. But, if experience with other public health challenges is any indication, with hard work, resources, education and cooperation, it can get better.

___

Burlington Hawk Eye. June 25, 2017

A tale of two videos

The video cuts out before the shot is fired.

But the 42 seconds of body-camera footage released Thursday by the Lee County Sheriff’s office provides more than adequate evidence to anyone who sees it Deputy Dakota Foley acted correctly June 12 when he discharged his sidearm at the hammer-toting suspect in a rural Montrose home invasion. The clip supports the decision by the Iowa Attorney General’s office Foley was justified in shooting 29-year-old Joshua Welborn.

At the 11-second mark in the video, as Foley approaches the scene, the first of several loud, metallic bangs is heard.

At 18 seconds, deputies identify themselves outside the trailer home.

More banging follows as deputies close in. Then, at 29 seconds, the door swings open and Welborn, clearly visible in lights we presume are from a squad car, emerges carrying a hammer in his right hand.

At 30 seconds, Foley tells Welborn to stop.

At 32 seconds, Welborn is ordered again to show his hands - this time at gunpoint. Welborn raises them briefly, but lowers them again, all the while walking with purpose toward the deputy.

At 34 seconds, Foley tells Welborn to stop. Welborn doesn’t. Foley backs away, repeatedly shouting for Welborn to stop, the tension in his voice rising with every “Stop!”

At 38 seconds, Deputy Evan Bentley appears in the video.

At 40 seconds, Welborn turns toward Bentley, who begins backing away, his sidearm also raised as Welborn continues his approach.

At 42 seconds, with Welborn an arm’s length from a back-pedaling Bentley, the video cuts out.

We know what happened next, even without seeing it. The clip puts viewers on the edge of their seats, as a real-life drama unfolds in real-time. Imagine how it must have felt for the deputies, who had to make a split-second life-and-death decision.

Viewing the footage, we cannot imagine anyone reaching a conclusion other than the one Assistant Attorney General Scott Brown did in clearing Foley of wrongdoing.

In the face of real danger, Brown wrote, Foley showed “great restraint.”

“(Foley) attempted to resolve a very intense situation peacefully and fired only when it became necessary,” Brown added.

Like Brown, we admire Foley’s restraint up until the shot was fired. Bentley’s, too. They are a credit to their training. Welborn, who was struck in the chest, survived and has been charged with first-degree burglary, assault on a police officer and second-degree criminal mischief. If convicted on those charges, he faces at least 25 years behind bars.

The home invasion and shooting occurred 10 days before the ruling was issued. The video from Foley’s body camera was released the same day by Lee County Sheriff Stacy Weber. Other than clear visual evidence of Brown’s assertion Welborn raised the hammer in the moment after the published video clip cuts out and before Foley fired, the story of the incident is adequately told. If any additional footage is available, either from Bentley or from dash-cam video in their patrol cars, it was not released. Doing so would be superfluous.

Credit also goes to Brown for his speedy investigation, and to Weber for deciding to release the video to the public, though no Iowa rule or law required him to.

Nearly 2 1/2 years into The Hawk Eye’s effort to obtain more than the 12 seconds of body-camera video released from the January 2015 shooting of Autumn Steele by Burlington Police officer Jesse Hill, no additional footage - either from Hill’s body camera, the dash-cam in his squad car or video collected by other officers at the scene that day - has been provided to the public. Hill was cleared after a too-long investigation by Des Moines County Attorney Amy Beavers, who unlike her counterpart in Lee County, Clinton Boddicker, chose not to ask for outside help from the AG’s office.

The next step in the lengthy process involving the Iowa Public Information Board to obtain that video, which this newspaper maintains is a matter of public record, is an August hearing before an administrative law judge. The outcome is by no means certain.

What is certain, however, is Iowans are done a disservice by the scattershot release of police video, frequently made public only when its captures feel-good images of law enforcement. Time long since has come for the Legislature to adopt a set of rules ensuring the public has predictable access to this valuable resource for police oversight.

Lawmakers, sitting on your hands no longer is an option.___

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