Ryan Melton is the Democratic nominee in Iowa’s fourth Congressional district. These are his prepared remarks for the Iowa Democratic Party’s Liberty and Justice Celebration in Des Moines on July 27. You can listen to the speech as delivered here.

At the Mills County Fair Democratic party booth in Malvern a couple Saturdays ago, a high school freshman to be asked me what motivates me to keep going despite the odds in our district, so he too could buy in and join the effort.

Here’s what I told him:

Keith Schneider, a former New York Times national correspondent, is senior editor for Circle of Blue. He has reported on the contest for energy, food, and water in the era of climate change from six continents. This report was first published by The New Lede and is part of an ongoing collaborative project between The New Lede and Circle of Blue that looks carefully at how agricultural policies are affecting human and environmental health.) 

EMMETSBURG, IOWA –Raised in rural Iowa, 71-year-old Maureen Reeves Horsley once considered her tiny hometown in the northwest part of the state to be a blessed space. She recalls a time when the streams here ran clean and the lake water was clear.

The family farm where Horsley grew up was one of more than 1,200 farms in Palo Alto County in 1970. In her memory, the county’s 13,000 residents enjoyed a thriving agricultural-based economy and close-knit neighbors. Cows grazed in verdant pastures. And seemingly endless acres of corn marched to the horizon.

“We had good crops, corn and soybeans,” Horsley said of her family’s farm along the West Fork of the Des Moines River. “You could make it on a small amount of farmland. You felt safe. It was a good life.”

Two generations later, Emmetsburg and Palo Alto County have been radically transformed into a place where many residents worry that the farms that have sustained their livelihoods are also the source of the health problems that have plagued so many families.

Two bills Governor Kim Reynolds signed on May 1 will make advanced testing for breast cancer and other diseases more accessible to Iowans with health insurance coverage.

House File 2489 requires certain types of private health insurance policies to cover supplemental or diagnostic breast examinations such as magnetic resonance imaging (MRI), ultrasound, or contrast-enhanced mammography. House File 2668 requires public and private health insurance to cover biomarker testing for some cancers and other diseases or conditions. Both bills take effect on January 1, 2025.

The authors of this post are Dani Replogle, a staff attorney with the national advocacy group Food & Water Watch, and Michael Schmidt, a staff attorney with the Iowa Environmental Council.

Safe, clean drinking water is a basic human right. In Iowa, that right is under serious threat as nitrate-laden pollution piles up, and state cancer levels rise unchecked. It’s time for the U.S. Environmental Protection Agency (EPA) to step in. We filed a petition last week demanding just that.

Iowans have industrial agriculture to blame for worsening water quality. Over the past twenty years, concentrated animal feeding operations (CAFOs) have steadily replaced family-scale operations statewide. Today, Iowa is home to far more of these enormous polluting operations than any other state. As Big Ag moved in, they consolidated control in Des Moines, permeating state government to tilt the scales in favor of industry.

Randy Evans is executive director of the Iowa Freedom of Information Council and can be reached at DMRevans2810@gmail.com. 

No problem is so big that we can’t run from it—or at least avoid thinking about it. That’s human nature.

There are many concerns that should command our attention but do not. Too often we hope or assume a serious problem will go away or will spare us.

In the aftermath of the COVID-19 pandemic, too many of us discount whatever the scientists tell us—as if the anonymous pundit on social media knows more than the people who have devoted their lives to studying a particular problem.

But there is something else I have come to realize, unfortunately. Government leaders in Iowa have shown little interest in understanding “the Big C”—the widespread presence of cancer in Iowa. 

Iowa House Speaker Pat Grassley (left) and Senate Majority Leader Jack Whitver speak to members of the media on March 14 (photos by Laura Belin)

If you didn’t know Iowa was in the eighth year of a Republican trifecta, you might be forgiven for thinking different parties controlled the state House and Senate after watching the past week’s action.

Dozens of bills approved by one chamber failed to clear the legislature’s second “funnel” deadline on March 15. While it’s typical for some legislation to die in committee after passing one chamber, the 2024 casualties include several high-profile bills.

The chambers remain far apart on education policy, with no agreement in sight on overhauling the Area Education Agencies, which is a top priority for Governor Kim Reynolds. The legislature is more than a month late to agree on state funding per pupil for K-12 schools, which by law should have happened by February 8 (30 days after Reynolds submitted her proposed budget). The Senate Education Committee did not even convene subcommittees on a few bills House Republicans strongly supported.

House Speaker Pat Grassley and Senate Majority Leader Jack Whitver struck an upbeat tone when speaking to journalists on March 14. Both emphasized their ongoing conversations and opportunities for Republicans to reach agreement in the coming weeks.

But it was clear that Grassley and Whitver have very different ideas about how the legislature should approach its work.

From left: Democratic State Representatives Austin Baeth, Molly Buck, Josh Turek, Elinor Levin, Sharon Steckman, and Adam Zabner. Screenshot from video posted to Facebook on February 8.

“When I joined Environmental Protection, I never envisioned that I would be talking about a raccoon bounty, but here we are,” Democratic State Representative Josh Turek said on February 7, while the House Environmental Protection Committee considered the only bill on the agenda that day.

As they weighed in on the bill, Democrats voiced broader frustrations about the committee’s failure to engage with any of Iowa’s serious environmental challenges.

Randy Evans is executive director of the Iowa Freedom of Information Council and can be reached at DMRevans2810@gmail.com. 

These days, with political campaigns that seem to go on forever, Iowans may not recognize the significance of what occurred at polling places across the state on November 5, 1968.

Voters approved an amendment to the Iowa Constitution that day, ending the legislature’s practice of meeting only every other year. Biennial sessions had been a fact of civic life in Iowa since statehood 122 years earlier. 

LATE UPDATE: Republican lawmakers kept this provision in the final version of Senate File 496, which Governor Reynolds signed in May. Original post follows.

Rick Morain is the former publisher and owner of the Jefferson Herald, for which he writes a regular column.

One state registered a significant increase in cancer incidence from 2015 to 2019, the most recent year for which data is available from all 50 states. That would be Iowa. The only one.

According to the Cancer in Iowa 2023 report, only Kentucky ranked ahead of Iowa in the rate of its residents’ cancer cases. But Kentucky’s rate has decreased recently, while Iowa’s grew.

The reasons for those facts remain a mystery. University of Iowa researchers are trying to figure it out.

LATE UPDATE: Republican lawmakers kept this provision in the final version of Senate File 496, which Governor Reynolds signed in May. Original post follows.

Iowa’s leading cancer researchers released sobering numbers last week. Data from the Iowa Cancer Registry indicates that Iowa has “the second-highest overall cancer incidence of all U.S. states” and is “the only state with a significant increase in cancer incidence from 2015 to 2019.”

In addition, Iowa ranks first for “rates of new cases of oral cavity and pharyngeal cancer,” often known as head and neck or mouth and throat cancers. Iowa also has the country’s second-highest rate for leukemia and ranks fifth and sixth for melanoma and non-Hodgkin lymphoma, respectively.

Meanwhile, Governor Kim Reynolds is forging ahead with efforts to stop requiring Iowa schools to teach junior high and high school students that a vaccine is available to prevent human papillomavirus (HPV). That virus can cause cancer in several areas of the body, including the mouth and throat.

Who knew that when you tell a state agency leader to save another $1.3 million somehow, he might cut some important programs and services? Not State Representative Dave Heaton, the Republican chair of the Iowa legislature’s Health and Human Services Appropriations Subcommittee.

Who knew that when you impeach a mayor using a kangaroo court proceeding, a judge might order the mayor reinstated while her appeal is pending? Not Muscatine City Council members.

Follow me after the jump for more on those stories. This is an open thread: all topics welcome.

I’m also interested to know what readers think about Iowa Insurance Commissioner Doug Ommen’s request to waive certain provisions of the Affordable Care Act in order to bring Wellmark Blue Cross/Blue Shield back to Iowa’s individual insurance market for 2018. Elements of the “stopgap” measure violate federal law; health care law expert Timothy Jost told the Des Moines Register’s Tony Leys that some parts of Ommen’s proposal are “extremely problematic” and not likely “doable.” Writing in the Wall Street Journal, Anna Wilde Mathews and Louise Radnofsky saw the Iowa developments as “a key test of the ability to modify the [Affordable Care Act] through executive authority.” Slate’s Jordan Weissmann agreed.

Former State Senator Rich Olive died of cancer yesterday at the age of 66. He represented Wright and Hamilton counties, along with some rural areas in Story and Webster counties, from 2007 through 2010. During that time, he chaired the Iowa Senate Government Oversight Committee.

Many Iowans who knew Olive through his work in the legislature agreed to share some of their memories with Bleeding Heartland readers.

Photo of Rich Olive at the capitol taken by Senate Democratic staff; used with permission.

Brad Anderson, the Democratic candidate for Iowa secretary of state in 2014, has taken a new job as executive director of the Des Moines-based non-profit Above + Beyond Cancer. The official announcement is after the jump. The organization “takes cancer survivors on incredible adventures” in order “to elevate the lives of those touched by cancer” and provide “an example for healthy living and cancer prevention in their communities.”

A former staffer for Senator Tom Harkin and Governor Chet Culver, Anderson has worked on many Iowa campaigns, most famously as manager of President Barack Obama’s 2012 effort in Iowa. Although he lost last year’s secretary of state race to Republican Paul Pate, Anderson proposed a lot of good ideas and ended up winning more votes statewide than the top of the Democratic ticket. I’m sure the whole Bleeding Heartland community (regardless of partisan affiliation) wishes Anderson success in his new position. Most Iowans have been affected by cancer in some way, and there’s no question that “health, fitness and good nutrition” are important for preventing or surviving the disease.

UPDATE: On February 11, Anderson sent an e-mail blast to supporters of his campaign for Iowa secretary of state. Scroll down to read.

The working of Iowa’s state legislature is transparent in many ways. The official legislative website provides thorough, timely and permanently accessible information about bills, legislators, committees, votes, and other events. Most Iowa House and Senate members are accessible to interested constituents, even listing their home and/or cell phone numbers on the web. When the legislature is in session, members of the public can come to the Capitol during working hours and often speak to key lawmakers about the issues they care about.

Nevertheless, it can be hard for those on the outside to figure out what is really going on at the statehouse. So it was last week when the Iowa House approved House File 2109, “An Act relating to vapor products and alternative nicotine products, and providing penalties.” Following the lead of the bill’s sponsor, news headlines made this legislation sound like a step toward protecting children’s health: “Iowa House approves ban on sale of e-cigarettes to minors”; “Iowa House passes ban on e-cigarettes for minors”; “House votes to ban e-cigarette sales to minors.”

The lobbyist declarations told a different story.  

“States’ rights” has typically been a rallying cry among American conservatives, but six Democratic Iowa legislators are concerned that the Trans-Pacific Partnership now being negotiated may infringe on local control and states’ ability to legislate in the public interest. In an open letter, 43 state lawmakers have asked 23 state attorneys general, including Iowa’s Tom Miller, to analyze the Trans-Pacific Partnership’s possible impact on state and local governments.

I’ve enclosed the text of the letter below, along with a news release on the initiative from the National Caucus of Environmental Legislators. The Iowans who signed are State Representatives Chuck Isenhart, Marti Anderson, Dan Kelley and Curt Hanson, and State Senators Bill Dotzler and Joe Bolkcom. The letter spells out ten areas of state regulation that signers fear could be undermined by the Trans-Pacific Partnership. Isenhart stressed that the lawmakers’ concerns go beyond environmental issues, citing Iowa’s support for the biofuels industry as well as state policies to protect consumers and discourage smoking.

President Barack Obama is seeking to fast-track the Trans-Pacific Partnership. Activists who oppose the trade agreement have criticized the secrecy surrounding the negotiations as well as the agreement’s tilt toward corporations and potential to undermine environmental and public health protections.

UPDATE: Bleeding Heartland user cocinero notes in the comments that the American Cancer Society is concerned about this trade agreement. At the end of this post I’ve enclosed a joint statement from Campaign for Tobacco-Free Kids, American Cancer Society Cancer Action Network, American Heart Association, American Lung Association and the American Academy of Pediatrics.

A new study of 201 large municipal water systems in the U.S. found traces of a certain family of toxic chemicals in all of them. The highest levels of these chemicals, known as trihalomethanes, were found in Davenport, Iowa.  

I doubt many presidential appointees have indirectly saved more lives or done more to change American culture for the better than C. Everett Koop, U.S. surgeon general under Ronald Reagan. Koop died today at the age of 96, a legend in the field of public health.

Today’s Sunday Des Moines Register features a long story by Jennifer Jacobs about Representative Bruce Braley considering a run for governor in 2014.  

Syngenta Crop Protection Inc. agreed last week to settle a class-action lawsuit out of court rather than go to trial over claims related to the herbicide atrazine. The settlement could help some utilities in Iowa cover the cost of removing the chemical from drinking water.

Longer days, warmer weather and the approaching end of the school year mean more time outdoors for many Iowans, especially children. Last week Kamyar Enshayan, a Cedar Falls City Council member and director of the University of Northern Iowa’s Center for Energy and Environmental Education, raised an important question: “Is having weed-free lawn worth it?”

The U.S. Food and Drug Administration was poised to implement new rules on sunscreen labels and marketing this summer, more than 30 years after the first sunscreen labeling rules were introduced in 1978. However, sunscreen manufacturers may keep using misleading language when packaging and advertising their products for at least another six months.

Everyone’s talking about the Susan G. Komen for the Cure Foundation’s decision this week to defund (or perhaps not defund) Planned Parenthood. After the jump I’ve posted ten links about the controversy. Hat tip to Political Carnival for this cartoon.

Jason Hancock published a fascinating story at Iowa Independent today about a federal lawsuit against Syngenta AG and its U.S.-based subsidiary, Syngenta Crop Protection Inc. Sixteen communities, including Creston in southwest Iowa, are suing Syngenta because it profits from sales of atrazine while communities have to pay to remove the weed-killer from water supplies. Apparently Creston has a higher concentration of atrazine in its drinking water than any other Iowa city.

Judging from this comment by a Syngenta spokesperson, the key to the company’s defense will be a Bush administration Environmental Protection Agency finding, which asserted that atrazine has no detrimental effects in humans. However, the herbicide is banned in Europe because of numerous studies showing that it enters the water supply and is correlated with certain cancers and birth defects.

We could reduce water pollution if we made polluters pay the cost of removing contaminants from drinking water, but asking farmers who apply atrazine to pay for water treatment is a political non-starter. I don’t know what legal precedent supports suing the manufacturer of a farm chemical over the cost of treating drinking water. Last year the Obama administration EPA ordered the independent Scientific Advisory Panel to conduct a thorough scientific review of atrazine’s “potential cancer and non-cancer effects on humans,” including “its potential association with birth defects, low birth weight, and premature births.” I assume the results of that review will affect the outcome of the cities’ federal lawsuit against Syngenta.

I’m still waiting for so-called “pro-life” activists to support restrictions on farm chemicals linked to birth defects and spontaneous abortions.

Yet another study has found that exposure to the weed-killer atrazine is associated with a higher rate of a birth defect:

Living near farms that use the weed killer atrazine may up the risk of a rare birth defect, according to a study presented this past Friday [February 5] at the annual meeting of the Society for Maternal-Fetal Medicine in Chicago.

About 1 in 5000 babies born in the U.S. each year suffers from gastroschisis, in which part of the intestines bulges through a separation in the belly, according to the March of Dimes. The rate of gastroschisis has risen 2- to 4-fold over the last three decades, according to Dr. Sarah Waller, of the University of Washington, Seattle, and colleagues. […]

The researchers looked at more than 4,400 birth certificates from 1987-2006 – including more than 800 cases of gastroschisis — and U.S. Geological Survey databases of agricultural spraying between 2001 and 2006.

Using Environmental Protection Agency (EPA) standards to define high chemical exposure levels in surface water, they found that the closer a mother lived to a site of high surface water contamination by atrazine, the more likely she was to deliver an infant with gastroschisis.

The birth defect occurred more often among infants who lived less than 25 km (about 15 miles) from one of these sites, and it occurred more often among babies conceived between March and May, when agricultural spraying is common.

A separate study published last year in the medical journal Acta Paediatrica compared monthly concentrations of “nitrates, atrazine and other pesticides” in the U.S. water supply with birth defect rates over a seven-year period. The researchers found, “Elevated concentrations of agrichemicals in surface water in April-July coincided with higher risk of birth defects in live births with [last menstrual periods in] April-July.” The association was found for “eleven of 22 birth defect subcategories” as well as for birth defects as a whole.

The European Union banned atrazine in 2003 because of groundwater contamination, but tens of millions of pounds of the chemical are still sprayed on American farms. It has been proven to enter the water supply and is correlated with increased rates of breast and prostate cancers.

During the Bush administration, the U.S. Environmental Protection Agency maintained that atrazine had no detrimental effects in humans. But in a policy shift last October, the EPA announced that it would ask the independent Scientific Advisory Panel to conduct a thorough scientific review of atrazine’s “potential cancer and non-cancer effects on humans,” including “its potential association with birth defects, low birth weight, and premature births.” The panel will also evaluate research on “atrazine’s potential effects on amphibians and aquatic ecosystems.” Conventional agriculture groups aren’t waiting for the results of the review; they are already lobbying the EPA not to restrict or ban the use of atrazine.

I’d have more respect for the “pro-life” movement if they supported restrictions on chemicals that threaten babies in the womb. I don’t think I have ever heard an anti-abortion activist railing against atrazine or pesticides that can cause spontaneous abortions, though.

UPDATE: Proposed excise tax on insurance looking like a very bad idea too.

One key goal of “health insurance reform” was to prohibit insurance companies from limiting how many dollars they would spend on a patient’s care during a year. This makes sense if you want to eliminate medical bankruptcies, which are unknown in most of the developed world.

But the merged Senate health care bill gives insurance companies an out.

Politicians in both parties have complained that proposed federal climate change bills are “unfair” to Midwestern states, which rely largely on coal to generate electricity. Utility companies and corporate groups have tried to reinvent themselves as defenders of the public interest against those who would unjustly “punish” consumers living in coal-dependent states.

Physicians for Social Responsibility released a report this week on “Coal’s Assault on Human Health.” This report should be required reading for all members of Congress, especially Senator Tom Harkin and other Democrats who have demanded more subsidies for coal-burning utilities in the climate-change bill. From the executive summary (pdf file):

Coal pollutants affect all major body organ systems and contribute to four of the five leading causes of mortality in the U.S.: heart disease, cancer, stroke and chronic lower respiratory diseases. […] Each step of the coal lifecycle–mining, transportation, washing, combustion, and disposing of post-combustion wastes–impacts human health. Coal combustion in particular contributes to diseases affecting large portions of the U.S. population, including asthma, lung cancer, heart disease, and stroke, compounding the major public health challenges of our time. It interferes with lung development, increases the risk of heart attacks, and compromises intellectual capacity.

In yesterday’s Des Moines Register, Lee Rood highlighted some of the extra burdens Iowans bear because of coal-fired power plants. Follow me after the jump for more.

House Republican leader John Boehner was on CNN Sunday morning:

“We’ve got the greatest health care delivery system in the world,” he added. “Why do we want to jeopardize that with a big government run health care system?”

Because our health care delivery system directs about 31 percent of total health spending to administrative costs.

Because our health care delivery system makes Americans more likely to go without certain medical procedures despite astronomical per capita spending on health care.

Because our health care delivery system leads to overuse of emergency rooms by insured as well as uninsured Americans.

Because our health care delivery system leaves uninsured trauma patients 50 percent more likely to die than trauma patients covered by insurance.

Because our health care delivery system causes uninsured people to be denied organ transplants on the grounds that they will lack the capacity to pay for anti-rejection medications.

Because our health care delivery system prompts insured as well as uninsured Americans to delay medical treatment for chronic illnesses.

Because our health care delivery system makes uninsured people much more likely than insured people to be diagnosed with “advanced cancers […] that could have been detected early through proper screening.”

Because our health care delivery system puts paperwork from insurance companies rather than a doctor’s recommendation in charge of the timetable for cancer surgery.

Because our health care delivery system can force cancer patients to forgo radiation or chemotherapy if they lose their insurance.

Because our health care delivery system can leave insured as well as uninsured people with crushing debts after completing cancer treatment or care for a medical emergency.

Feel free to add your own answers in the comments.

UPDATE: MyDD user Trey Rentz adds that medical bills are the leading cause of bankruptcy in the U.S.

For those who are still upset that new coal-fired power plants will not be built near Marshalltown and Waterloo, I recommend reading Jason Hancock’s recent article at Iowa Independent:

People who live near near sites used to store ash or sludge from coal-fired power plants have a one in 50 chance of developing cancer, according to a just released government report kept from the public for seven years by the Bush Administration.

The data, compiled by the U.S. Environmental Protection Agency in 2002 and released Thursday by the watchdog groups Earth Justice and the Environmental Integrity Project, suggests that environmental contamination from the storage sites could last for a century or longer. […]

Coal ash, also known as fly ash, is the waste produced by burning coal. The nation’s power plants produce enough ash to fill 1 million railroad cars a year, according to a 2006 report by the National Research Council. Coal-burning power plants in Iowa produce 20,000 to 30,000 tons of coal ash every year. The Hawkeye State also imports coal ash from Wisconsin, Illinois and Indiana.

As the new study shows, neighbors of coal ash storage sites have an elevated cancer risk even when those sites are functioning normally. Occasional catastrophes like last December’s huge spill in Tennessee add to the contamination problems, but even if all accidents could be prevented, heavy metals and other pollutants would still leach into groundwater at many sites.

I’ve written before about the respiratory problems and premature deaths caused by fine particulate matter, and coal-fired power plants are a leading source of that kind of air pollution.

Now we have proof that solid waste from coal-fired power plants endangers human health too.

Iowa is fortunate not to have two new coal-burning facilities under construction. Those would have been a 50-year investment in the wrong direction, adversely affecting air quality, water quality and of course greenhouse gas emissions.

There is still no such thing as clean coal.

Iowans will be better served by meeting our demand for electricity through clean renewable production as well as conservation and energy efficiency measures.

Mary Lundby, a former leader of Iowa Senate Republicans and the first woman elected Speaker Pro-Tem in the Iowa House, passed away on Saturday after a long fight with cervical cancer.

Her funeral will be on January 21 at 1:00 p.m. at St. Joseph Parish in Marion.

Iowa politicians from both parties have paid tribute to Lundby. You can read their comments in Lynda Waddington’s piece for Iowa Independent, this article from the Cedar Rapids Gazette, and this Des Moines Register article.

I only spoke to Senator Lundby once or twice. My friends who knew her well always spoke so highly of her. I appreciated her support for responsible land use in Iowa (land use issues often cut across party lines when they come up in the Iowa legislature). Lundby was on the advisory council of 1000 Friends of Iowa, a group I’m involved with.

Condolences go out to her loved ones. She was a strong and caring person.

Cancer is a monstrous disease. Women should educate themselves about ways to prevent cervical cancer as well as common symptoms of cervical cancer.

UPDATE: Lynda Waddington shares some memories and links to other reflections at Essential Estrogen.

SECOND UPDATE: 24-hour Dorman reports that Senate Majority Leader Mike Gronstal has “cancelled all committee and floor action” scheduled for Wednesday so that members of the Iowa Senate and the Senate staff may attend Mary Lundby’s memorial service in Marion.

I don’t expect to get everything I want from Democratic politicians in power. Probably liberals like me will have plenty of disappointments in the coming years. But if Barack Obama and the Democratic Congress only follow through on one big campaign promise, I hope it’s health care.

The many injustices of our current health care system have been thoroughly documented by nyceve, among others, but I want to add my two cents.

The 46 million Americans lacking health insurance represent one very large part of problem. Some can’t afford insurance, and others can’t find a private insurer who will sell them a policy for any price. You could spend all day listing the ways uninsured Americans get a raw deal on health care. They can’t afford preventive care and routine diagnostics, so they are more likely to be diagnosed with late-stage, incurable cancer. They are less likely to receive care for any number of chronic illnesses. They live with terrible, crippling pain. Few Americans without health insurance coverage are able to receive organ transplants, though many become organ donors after dying prematurely.

We need to get these people covered and get away from our broken employer-based health care system. Every day Americans who thought they had good benefits are joining the ranks of the uninsured–like my friend whose husband got laid off in October, right before his employer (a small manufacturer) went under. It turned out the boss had secretly stopped paying the health insurance premiums some time before. Or the retirees who worked at Maytag or at John Deere for many years and are now losing some of the health benefits they were promised.

Employer-based health care is also a huge drag on large corporations and our national economy, as clammyc pointed out in this recent diary.

In an ideal world, I’m for a Canadian-style single-payer system (also known as HR 676 or “Medicare for all”), but as a political compromise I would settle for something like what John Edwards and Hillary Clinton proposed during the primaries: mandatory health insurance, which would be portable with no exclusions for pre-existing conditions, and the option for any American to buy into a public insurance plan. Momentum is building in Congress for this kind of reform.

But getting Americans health insurance will solve only part of the problem. It’s shocking how many Americans with “good” insurance go without needed medical care. Only occasionally does a case makes national news, as when the teenager Nataline Sarkisyan was unable to get a liver transplant last year. A recent study found many Americans with chronic illnesses forgo medical care for cost reasons, even if they have insurance.

Then there are the “lucky” people who get the care they need for a medical emergency, but later face financieal ruin when their insurance company denies coverage. Medical bills are implicated in about half of all personal bankruptcies in the U.S.

When I had a medical emergency last winter, I got to the doctor relatively early, I received good care in the hospital, no lasting damage was done to my body, and my insurance company covered almost all of the costs (once we had exhausted our deductible). I remember our relief when the biggest bill arrived in the mail, for about $18,000, and our required payment was only $600. (I recognize that $600 would be a hardship for many families, but we are fortunate to be able to pay that without cutting back on any essentials.)

Yesterday I was reminded again of how things could have turned out very differently for my family. If you are a regular at Daily Kos, you may recognize the handle AdmiralNaismith. Among other things, he wrote a series of diaries about the political scene in all 50 states between April and October. The links to all of those pieces are here, and he wrote an interesting post-election wrap-up diary here.

AdmiralNaismith doesn’t write many personal diaries, but he recently discussed his own family’s “medical horror story”: Drowning in medical bills, despite insurance (another link is here).

He describes the sequence of events, including his wife’s life-threatening embolism, which left his family owing thousands of dollars for medical care–more unpaid bills than AdmiralNaismith earns in three months. He asked fellow bloggers to help pay down the three largest bills, which will otherwise be sent to collection agencies within 30 days. (He’s not asking anyone to send him money directly but provides contact details for the insurer, with name and account number.) A few hundred people paying $10 or $20 each would help enormously.

I will be calling to make a payment on Monday, and I encourage anyone who’s ever benefited from reading AdmiralNaismith’s informative diaries to do the same.

But equally important, I ask the community of Democratic activists, who did so much to elect Obama, to hold his feet to the fire next year on delivering the comprehensive health care reform he promised.

I haven’t been thrilled with Obama’s cabinet appointments so far. My number one hope for the new government is that Ezra Klein is right about what Tom Daschle as secretary of Health and Human Services means:

This is huge news, and the clearest evidence yet that Obama means to pursue comprehensive health reform. You don’t tap the former Senate Majority Leader to run your health care bureaucracy. That’s not his skill set. You tap him to get your health care plan through Congress. You tap him because he understands the parliamentary tricks and has a deep knowledge of the ideologies and incentives of the relevant players. You tap him because you understand that health care reform runs through the Senate. And he accepts because he has been assured that you mean to attempt health care reform.

Please share your thoughts or health care horror stories in the comments.

Several health care providers in Cedar Rapids are making free mammograms and pap tests available this week to women age 40 and older with no medical insurance. Call 319-369-8111 for an appointment, which is required. The appointments are available on a first come, first serve basis.

Wednesday, August 20: Planned Parenthood’s clinic in Cedar Rapids will offer pap tests to women of all ages.

Thursday, August 21: St. Luke’s Breast & Bone Health in Cedar Rapids will provide mammograms and pap tests.

Friday, August 22: Mercy Women’s Center in Cedar Rapids will provide mammograms and pap tests.

Saturday, August 23: RCI Imaging Center will provide mammograms only.

Women, if you are overdue for your pap test or mammogram, call your health care provider today to make an appointment.