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Stray Thoughts

Is this how Iowa wants to save money?

7/10/2018

Don’t be surprised if a guy named Jamie Campbell turns out to be one of the key players in the 2018 race for Iowa governor.

Campbell’s name will not be on the ballot in November.

He will not be crisscrossing the state, appearing at one campaign event after another.

But don’t let anyone kid you. Campbell will be talked about, either by name or indirectly. His experience with state government will be an important factor as Iowans decide whether they want Gov. Kim Reynolds or retired Des Moines businessman Fred Hubbell to lead our state for the next four years.

Jamie Campbell is a 45-year-old resident of the Adair County town of Fontanelle. He is paralyzed from the neck down, unable to move his arms or legs or to breathe without the assistance of a ventilator.

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A freak wrestling accident in 1988 paralyzed him when he was a 16-year-old high school student. Doctors at the time said he might only live another 20 years, given his fragile medical condition.

Campbell is still here nearly 30 years later. He lives in his own home, not in a care center. He is a member of the board of directors of the Nodaway Valley School District and is a familiar figure at youth softball and baseball games in Fontanelle.

But Campbell could not live without the health care that is paid for by Iowa’s Medicaid program, which covers about 600,000 people who are low income or disabled. They represent about one-sixth of Iowa’s population.

Campbell has become a symbol of all that is wrong with the unilateral decision Gov. Terry Branstad and Lt. Gov. Kim Reynolds made in 2015 to take the operation of the Medicaid program out of state government and turn it over to for-profit insurance companies.

Branstad promised that privately run Medicaid would be more efficient and economical and would save state government a few hundred million dollars annually. He assured Iowans that medical care for the poor and disabled would not suffer.

This is where Jamie Campbell enters the picture.

“They said nothing would change — that my benefits would stay the same,” Campbell told the Des Moines Register. “But I’m smarter than that.”

Before the privatization of Medicaid, state managers determined it would be less expensive for Campbell to live on his own, rather than in a nursing home. He was all for that, because he wants the independence that would not be available in a care center.

For Campbell to safely remain at home, Medicaid pays for a nurse to stop by twice a day, in the morning and at night, and for less expensive home aides who bathe, dress and feed him, give him his medications, and do laundry and meal preparation.

In 2017, after privatization of Medicaid, United Healthcare tried to cut the number of hours Campbell’s home aide could spend caring for him. He appealed, and an administrative law judge decided the evidence was overwhelming — that he needs all the hours of help that he had been receiving.

Fast-forward to last month.

United Healthcare notified Campbell again that it intends to cut the number of hours of home aide time he receives. “These are not medically needed,” the insurer said in the notice sent to Campbell.

Specifically, United Healthcare had been paying for a home aide to spend about 158 hours per month — about five hours a day — assisting Campbell. The company now says it will only cover about 66 hours per month, which is about two hours per day.

You do the math. The home aides are paid $10 to $11 per hour. Nursing home care for someone like Campbell, who depends on a ventilator, averages about $600 per day, the Register reported.

Campbell is fighting the notice from United Healthcare. He worries that if the hours for his home aides are cut so dramatically his health could deteriorate as he sits in his own urine and feces while waiting for his aide to report to work.

Reynolds staunchly defends privatized Medicaid, in spite of the problems that have marred it — problems that include complaints about covered services now being denied by the private companies, about hospitals and other medical providers waiting many months to be paid, about some small providers closing because of low and slow payments, about the University of Iowa dental college no longer accepting new Medicaid patients, and about the seemingly never ending changes in the amount the state supposedly is saving through privatization.

Hubbell calls privatized Medicaid a nightmare and says Reynolds “must face the people of Iowa and take ownership for her failure.”

The governor has an uphill fight to explain to Iowans why Iowa’s Medicaid program should eliminate $60 a day in home aide assistance for a paralyzed man, while the chief executive of the corporation that is trying to make the change was paid $66 million last year — a salary that accumulated by $180,800 per day.  

Voters will get to decide on Nov. 6 whether Kim Reynolds is correct or whether Jamie Campbell is right. I would think twice before betting against a scrappy former wrestler from Adair County. ♦

Randy Evans can be reached at DMRevans2810@gmail.com

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