Health care spending sparks forum debate

How much government should spend on health care was the core issue of a Saturday morning debate that placed Democratic and Republican lawmakers at odds and even involved some members of the audience at an Eggs and Issues forum in Fort Dodge.

A plan to expand Medicaid, favored by state Senate Democrats like state Sen. Daryl Beall, of Fort Dodge, was the topic that exposed differences between the two political parties. Before the forum was over, a few audience members took the microphone to denounce the potential Medicaid expansion, the federal health care reform law commonly called Obamacare and government spending in general.

State Rep. Tom Shaw, R-Laurens, sided with those who believe government spends too much money.

”The government beast always needs to be fed,” he said.

State Rep. Helen Miller, D-Fort Dodge, said government is necessary to provide services that individuals cannot.

”The last time I checked, I can’t remove snow from the roads, I can’t provide my own fire protection, I can’t provide my own police protection,” she said. ”We need courts to administer justice. We need places to house those who commit crimes. There is a need for government whether we like it or not.”

About 40 people attended the forum at Iowa Central Community College. Eggs and Issues is sponsored by the Greater Fort Dodge Growth Alliance and the college.

Earlier in the forum, Beall said that expanding Medicaid would provide insurance to more people and cost less than a rival plan touted by Republican Gov. Terry Branstad. Medicaid is the joint federal and state health insurance program for the poor. Expanding it is an option under the federal health care reform.

According to Beall, Branstad’s plan would cover 50,000 fewer Iowans than would be covered under the Medicaid expansion to be considered by the Senate Monday.

Initially, the senator said ”Expanding Medicaid costs nothing.”

Later in the forum, after Jim Hirschberg, of Lohrville, challenged that statement, Beall said there would be no cost to the state for the Medicaid expansion until it was fully implemented. At that point, he said, the state would be responsible for 10 percent of the added costs.

The federal money for an expanded Medicaid has already been committed, Beall said, adding that the money will go to other states if Iowa doesn’t take it.

Beall said he believes there is a role for government in ”promoting the general welfare and health of our nation.”

Shaw said he’s concerned about expanding Medicaid because of complications that can ensue when working with the federal government. He said Iowa doctors already get low reimbursements from Medicaid. He added that some doctors want to retire early because they’re tired of dealing with the program.

He added that the same people who oppose property tax reform because of the fear that the state government wouldn’t cover the revenue losses cities and counties will experience are willing to believe that the federal government will provide most of the money for an expanded Medicaid program.

Pat Larson, of Gowrie, brought the federal health care reform to the attention of the lawmakers and the audience when he asserted that it will cost him $20,000 to buy health insurance under the program.

”We need to stop this thing,” he said.

When Beall asked him what he thought the solution to the problem should be, Larson replied ”I don’t think we need to expand things any more than they already are. I think we have to start shrinking. People need to start doing more for themselves.”

The lawmakers also received another request to consider raising the state’s 21-cents per gallon gasoline tax.

”We are attempting to do a lot of projects, but even though we’re doing a lot of projects we’re falling short of covering the needs,” said Webster County Engineer Randy Will. ”I’m pleading with you to consider more revenue.”

Webster County Supervisor Bob Singer asked the lawmakers to suggest a solution for addressing the backlog of infrastructure repairs.

”The bottom line answer to your question is money,” Miller said. ”There’s no doubt about that, but the 800-pound gorilla in the room is, where are you going to get it?”

Shaw said he would be willing to use some of the state’s $688 million general fund surplus to pay for some projects.

”I see absolutely no reason why major projects, projects that need to be done, cannot be identified, prioritized and a portion of that $600 plus million spent on fixing those needs,” he said.