- Associated Press - Monday, January 22, 2018

Des Moines Register. January 18, 2018

Iowa legislature could save lives with this change

Nearly one in five Iowans says they or someone close to them has experienced a medical error. These include receiving the wrong medication and mistakes during surgery or treatment, according to a new poll organized by the Heartland Health Research Institute.

David Lind, who runs the Clive-based company, spent $47,000 to hire a professional polling firm to survey more than 1,000 randomly selected Iowa adults. Nineteen percent of respondents reported experiences with an error, most commonly in a hospital.

Consider just how many people that finding represents. Iowa has about 2.2 million adults; 19 percent amounts to more than 400,000 people.

The majority of those who reported an experience with an error said it resulted in a “serious health consequence,” and one-third reported serious financial consequences.

The Iowans alive to answer the phone when a pollster called are the fortunate ones.

Medical errors kill an estimated 251,000 Americans annually, according to a 2016 study. Researchers suggested if the Centers for Disease Control and Prevention tracked errors as a category in mortality data, they would be the third-leading cause of death in this country, behind heart disease and cancer.

But the federal government does not track them.

Hospitals and medical personnel in Iowa are frequently not required to report them.

And patients have no idea whom to contact when they are misdiagnosed or develop a surgical site infection. Researchers are left to make educated estimates about how many people are affected - and conduct polls.

That is unacceptable.

Iowa lawmakers should establish a central database in a state agency and require all health facilities and providers to report all errors and adverse outcomes. Lind’s survey found the vast majority of Iowans support such required disclosure. Patients could also report errors to the database.

That is the first step to better understanding the extent of the preventable mistakes, implement safety programs to reduce them and measure the impact of those efforts. With real data, Iowans will not need to rely on a poll estimating how many of us are injured in health facilities intended to heal us.

Americans would not tolerate telephone surveys to determine how many people die in car accidents or contract HIV. We do not rely on polls to gather mortality data on cancer or heart disease. Such information is routinely collected, compiled and reported by state and federal agencies.

That is not the case with medical errors. And when entities like the Iowa Healthcare Collaborative trumpet a reduction in medical errors based on select data voluntarily reported by some hospitals, Iowans may be misled into believing an organization in this state is comprehensively gathering data.

No organization is doing that. Neither is a government entity.

“The medical establishment likes to argue they are already over-regulated, yet with preventable medical errors, their reporting practices are virtually nonexistent,” Lind said. “Even in states that have mandatory reporting requirements on medical errors, which Iowa is not one of them, there is considerable under-reporting by providers.”

That is primarily due to fear of lawsuits and tarnishing reputations. Yet a lack of information makes it difficult to recognize and respond to threats to public health.

Consider what we know about opioid-related deaths. The CDC collects data from states and reports numbers of deaths - 47,055 in 2014, for example.

The agency has determined these deaths, frequently occurring in young people, are reducing overall life expectancy for Americans. Collecting data on deaths also allows us to know going forward whether any reforms intended to save lives are working.

Without concrete data on medical errors, we don’t know definitively how many people are affected or whether any efforts are successful in reducing mistakes.

And that should bother the heck out of Iowans. Many of us will be patients in a health facility at some point in our lives. That means being at risk of receiving the wrong gas in an oxygen line or having the wrong knee replaced during surgery.

It means if the heart attack you’re seeking treatment for doesn’t kill you, a hospital-acquired staph infection just might.


Sioux City Journal. January 18, 2018

Guns don’t belong in Woodbury County Courthouse

For the protection of those who work inside the building and for the public who conducts business there, the Woodbury County Courthouse - all of the Woodbury County Courthouse - should be free of guns.

The idea of allowing guns in some areas of the courthouse, but not in others, is folly. How do you properly enforce that system? Once an individual with a gun is inside the building, who or what will stop him or her from going wherever he or she wants with the weapon, including areas considered off limits? Besides, why are all sections of the courthouse not deserving of the same level of security?

As we have said before in this space, the proper way to make the courthouse safe is a complete prohibition on guns.

This goal was met in 2014 when the Woodbury County Board of Supervisors banned guns in the courthouse and restricted access to one door staffed by security officers and equipment. However, passage of a package of gun-related proposals by the Legislature last year threw courthouse security into question.

As we predicted, a provision of the legislation stating an Iowan can sue any city, county or township that passes a firearm ban if the individual believes he or she is adversely affected by it had a chilling impact in Woodbury County. In June, the county board rescinded the courthouse gun ban in response to the bill.

Complicating matters further was an Iowa Supreme Court order in June banning weapons in “courtrooms, court-controlled spaces, and public areas of courthouses and other justice centers occupied by the court system.” Last month, the state Supreme Court issued a revision to the order under which local officials can make a written request to allow guns in areas of courthouses not controlled by the judicial system. On Tuesday, the Woodbury County board voted to send a letter to Third Judicial District Chief Judge Duane Hoffmeyer requesting the public be allowed to carry guns into some areas of the courthouse.

One simple, reasonable solution to this craziness exists.

Due to the nature of the public business conducted within these buildings, no one besides law enforcement officers should be allowed to carry a gun inside a courthouse. It isn’t some egregious infringement of the Second Amendment to ask owners of guns to check weapons at the door to the Woodbury County Courthouse, do their business inside, then pick them up on their way out.

Only the Legislature can clean up the mess its new law created for Woodbury County and, likely, for other counties.

Lawmakers should pass a bill that gives local government bodies the legal right under state law to adopt a ban on weapons in public buildings. Once that measure takes effect, Woodbury County supervisors should reinstate a complete ban on guns in the courthouse.


Fort Dodge Messenger. January 14, 2018

Reynolds sets out important goals

Gov. Kim Reynolds delivered her first Condition of the State Tuesday. She told lawmakers - and her fellow Hawkeye State residents - that Iowa is doing well but has important challenges to confront in the year ahead.

The governor pointed with pride to some of Iowa’s strengths:

. It is ranked as the third best-managed of the 50 American states.

. It ranks No. 1 as a good place for middle class families to live.

. Iowa’s high school graduation rate is the highest in the U.S.

. The unemployment rate in Iowa is among the lowest in the nation.

“The success of our state has come from our people: hard-working and disciplined; innovative and driven,” Reynolds said. “The condition of our state is strong because Iowans are discovering and unleashing opportunities in our schools, on factory floors, on main streets, and around kitchen tables.”

Reynolds said that despite the ample good news about Iowa, she and the Legislature must move aggressively to keep the state on a successful trajectory. Here are some of the issues the governor wants Lawmakers to tackle this year:

. Legislation to ensure water quality needs priority attention.

. State taxes need to be reformed. Assorted adjustments are required quickly because changes in federal tax laws could cause Iowans to pay more state income taxes.

. Legislation is needed to give farmers, small business owners and their employees access to health insurance they can afford.

The governor regards making sure that Iowans have the skills needed to prosper in a rapidly changing labor market to be of huge importance. That’s why she has been a leader in promoting a multifaceted state initiative to strengthen education in Iowa concerning science, technology, engineering and mathematics - usually referred to by the acronym STEM. In her remarks Tuesday she again stressed the importance of that undertaking.

She also strongly supported the Future Ready Iowa project and urged passage of the Future Ready Iowa Act.

“Future Ready Iowa will create an environment where opportunity is unleashed,” Reynolds said. “A place where high-paying new jobs are seamlessly linked with a motivated and highly-skilled workforce. . (The bill) creates opportunities for Iowans of all ages and experiences. Opportunities to get the skills they need for a rewarding career.”

Reynolds sees Iowa as poised for a remarkable 21st century.

“My vision for the future is an Iowa overflowing with opportunity - opportunity for our working families, young people, and our communities, both rural and urban,” she said. “My vision is to give the people of Iowa a place to call home that unleashes opportunity at every turn.”

Reynolds delivered a speech that set out a prudent policy course for the Legislature.

Perhaps of greater importance, she sought to inspire Iowans. In our state the obstacles to success in life already are far fewer than in many other places. People who have goals and work hard will do well here. Our governor wants lawmakers to partner with her to make sure Iowa remains a superb place to live that affords its residents countless ways to achieve their dreams.

The Messenger applauds her message. We urge members of the Legislature to give her recommendations careful consideration.


Dubuque Telegraph Herald. January 18, 2018

The ‘swamp’ remains deep

The farther we get from his 2016 election victory and his inauguration 52 weeks ago today, the less we hear President Trump discussing his oft-repeated campaign promise to “drain the swamp.”

The original use of “drain the swamp” referred to the practice of draining low-lying wetlands to curb breeding areas for malaria-carrying mosquitoes. The political reference to “drain the swamp” is to get rid of the environment that permits bad government - including waste, fraud, mismanagement and conflicts of interest.

Before and since he won election to the U.S. House, Dubuque Republican Rod Blum has included “drain-the-swamp” planks in his campaign platform. With Congress’ approval ratings at or near record lows, it’s a stance that tends to resonate with voters, even if Blum’s colleagues are loathe to get on board.

Nonetheless, the congressman representing northeast Iowa continued that initiative last month, introducing another batch of “drain-the-swamp” proposals. It’s probably best if you read about them here, because it is unlikely you will see Congress pass them and President Trump make them law.

The Fiscal Responsibility Act. H.R. 4512 would cut federal lawmakers’ pay each year the federal budget is not balanced. Introduced last Dec. 1, it has zero cosponsors.

The No Golden Parachutes for Public Service Act. H.R. 4511 would ban former lawmakers from lobbying current congressional members, officers or employees. Zero cosponsors.

The No Congressional Vehicle Leases Act. H.R. 4510 states that taxpayer dollars may not be used to lease vehicles for more than 30 days. This one could be labeled a bipartisan measure, since its only cosponsor is a Democrat, Rep. Tom O’Halleran, of Arizona.

The Blum proposal garnering the most support among his colleagues is the No Congressional First Class Flights Act. H.R. 4509 mandates that upgrades to first-class airline seats will not come from taxpayers’ pockets. Three other representatives, all Republicans, have joined in as cosponsors.

These four pieces of legislation make sense - so much so that we’re more likely to see Blum walk on top of the swamp than see the swamp drained through passage of these measures. But it’s worth calling public attention to these issues.

And while we’re thinking about how Congress conducts itself, let’s not stop there. Perhaps it’s also time to take another look at the self-promoting mailings lawmakers (including Blum) send out at taxpayer expense, the prevalent practice of not paying the interns in their offices, and the long and excessive recesses lawmakers schedule for themselves.

The swamp is deep. Unfortunately, noting the tepid response to Blum’s proposals, it is likely to remain so for some time to come.


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