This diary is about public health in Iowa but likely demonstrates how easy it is to confuse the public, even those knowledgeable about an issue. I recently attended a seminar by Dr. Marionette Miller-Meeks, the Director-Designee for the Iowa Department of Public Health (IDPH). Overall, I did not sense gross politicization of the department and that she was a “reasonable” Republican, but on further reflection I realized a scary thing. Namely, that I almost fell for a very subtle talking point – If you are concerned about public health budget cuts in Iowa, blame that Obama fellow for his future funding proposals for the Centers for Disease Control (CDC). Luckily being a scientist and a liberal, I decided to check the facts.
Dr. Miller-Meeks our Director-Designee ran against Dave Loebsack for Congress. Her appointment, therefore, is clearly a political one. As we all know, while this is all too common, it always bears watching. The good news is that Dr. Miller-Meeks has healthcare experience; however, if you were to identify the top 50 public health officials/practitioners in the state (and maybe the top 100), her name would not be on the list.
To give her credit, she is a personable woman whom I believe does care about her patients and Iowans in general. What happened - something she may not even have been aware of - was that she shifted the blame for deep budget cuts in our Department of Public Health away from the Iowa legislature and governor onto Obama.
It went like this:
Used the favorite talking point of all politicians from both parties that we all have to tighten our belts – no indications about the disproportionate impact of this belt tightening on vulnerable Iowans through specific cuts to public health.
Stated that it was hard that the first thing she had to do was tell county public health officials that their budgets would be cut. No acknowledgment that this was almost exclusively due to state budget cuts. No talk of being an advocate at the state level for public health funding.
She stated that Obama’s budget included a cut to the CDC. Although his proposed funding I feel is WAY too modest, my research indicates that there will be a net increase to the CDC if Obama’s budget stays as is. Please someone double-check that since as usual reporting on it is terribly confusing.
She also stated that she and Governor Branstad had written a letter and were lobbying for “restoration” of the CDC funding.
Net message: Don’t pay any attention to the Iowa budget process and draconian state cuts to support services accompanied by tax cuts, we’re the good guys just trying to do the right thing. In fact, we are trying to help protect Iowa’s public health system from being cut by President Obama.
These statements weren’t all together in a logical flow, so it was easy to sit back and get lost in the reasonableness. And again, I doubt she was deliberately trying to give that message. But in the end, if Dr. Miller-Meeks does not recognize the short sightedness of state budget cuts to public health and is not a strong and vocal advocate for state funding, then we will continue to see degradation of our public health services. By the way, the governor will be touring the state to get feedback on which of those pesky regulations you would like to see eliminated!
Other good news is that there is no open discussion about the constitutionality of the Patient Protection and Affordability Act in Des Moines.
Other bad news is from the Ready or Not? report by the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation. The report notes:
.. that the almost decade of gains is in real jeopardy due to severe budget cuts by federal, state, and local governments. The economic climate change has led to cuts in public health staffing and basic capabilities, which are needed to successfully respond to crises. Thirty-three states and Washington, D.C. cut public health funding from fiscal years (FY) 2008-09 to 2009-10, with 18 of these states cutting funding for the second year in a row. The report also notes that just eight states (Alabama, Arkansas, Kentucky, Nebraska, North Dakota, South Dakota, Texas, and West Virginia) have increased funding for two or more consecutive years.
Iowa ranks last with Montana in the scoring. Check out your state.