Public and private
Our government should be smart, efficient, fiscally sound, non-intrusive when possible and regulatory where appropriate. It should be seen as a boon, not a burden, to "we the people" who comprise it. America's economic system is built on individual free enterprise. Much of our economic and social strength is based in healthy, fair competition. On the other hand, an overdriven model of privatization can take our greatest strength too far and make it a weakness.
An anti-government approach to government that habitually seeks to privatize — pension plans, school funding, health care — serves an unthinking retreat into hyperindividualism. But fears about our culture can't be allayed with new levels of individual isolation. The problem with the attempt is that the beauty and strength of American freedom is pushed to a dangerous and dysfunctional extreme. We still live in community. We are still "we" the people.
Let's look at health care in Iowa. Privatization has not been the savior it was meant to be. It has led instead to loss of health providers, disabled Iowans enduring lengthy appeal and legal processes only to face renewed care denials, lack of public information about private companies lest debate be "clouded," degraded dental care, ridiculed patient complaints and baffling shifts in financial reporting from the state.
The majority Republican 2018 Iowa legislature assumes a position of pride for responding to concerns about privatized Medicaid. Newly-legislated accountability for MCOs is, however, only a band-aid on a system that needs surgery. Making a small correction to alleviate a large problem of your own creation is not a solution. It's a control tactic. It does not serve the common good … which is what good government is supposed to do.
Karen A. Larson
Candidate for Iowa House District 1