Iowa Department of Public Health Medical Director Patricia Quinlisk announced today that an Iowa woman contracted listeriosis by eating cantaloupe from a Colorado farm at the center of a widespread outbreak.

The cesarean section rate in Iowa climbed again to 30.37 percent in 2010, and statistics compiled by the Iowa Department of Public Health showed huge disparities among hospitals in the percentage of live births done surgically.

The U.S. Environmental Protection Agency is demanding that the Iowa Department of Natural Resources take steps to reduce fine particulate matter statewide and especially in the Muscatine area, which has long had some of Iowa’s worst air quality.

Particulates contribute to premature deaths and serious heart and lung diseases, not to mention acid rain and other environmental problems. So it’s disappointing to see state officials react to the EPA message with more concern about the polluters than the public’s health.  

While Bleeding Heartland users discuss yesterday’s straw poll in this thread and Tim Pawlenty’s departure from the scene here, this thread is for any other news on your mind this weekend. Links to some disturbing stories that caught my eye are after the jump.

The volatile stock market, Wisconsin recall elections and run-up to the Ames straw poll have dominated political news coverage this week, overshadowing a story that may have more far-reaching implications. Starting in 2014, fuel efficiency and greenhouse gas emissions standards will apply to medium and heavy-duty trucks for the first time in U.S. history.

Iowa Department of Public Health Director Mariannette Miller-Meeks on Friday reversed plans to eliminate the top administrator’s position at the Division of Tobacco Use Prevention and Control. Her comments came several hours after Democratic State Senator Jack Hatch predicted “legal action” to challenge the way IDPH downsized its smoking prevention programs.

Iowa Department of Public Health Director Mariannette Miller-Meeks insisted on August 1 that state efforts to reduce and prevent smoking will continue deep despite budget cuts, which just cost a senior department staffer her job.

Iowa may soon have as many milking coaches as lactation consultants.   After a lapse of about four decades, human breastfeeding has secured its place once again in our culture as the premiere way to nourish an infant.  In a parallel narrative, fresh wholesome milk from cows, sheep, and goats is regaining its reputation as a premiere health food.   To boost that growing reputation, milking coaches are pulling up another milking stool to help people learn more about the realities of milk fresh from the udder.  
 
“We've only used manmade milk (formula and pasteurized milk) for around 60 to 70 years but we've used breast milk and raw milk for 6000 years.   If it wasn't for breast milk and raw milk, we wouldn't be here!” says Brad Hopp, a milking coach near Lawton in northwestern Iowa .   “Learning more about milking helps people understand it better, and I'm all for that.”
 
Although mothers' milk retains some of its mystery in the face of scientific inquiry, mothers these days know how precious it is to their babies' health and growth.   A little mystery in the food supply passes when it's balanced by strong instincts and a solid record of success.   But mystery can feel uncomfortable when it strays too far from knowledge and experience.
 
“The idea of raw milk feels exotic and mysterious to many people in Iowa ,” says Christy Ann Welty, homeschooling mother of two who helps milking coaches and new milkers find each other.   “More understanding and less fear will help everyone as they make decisions about the best ways to feed their families.”  
 
More understanding and less mystery: that's the meaning of “Milkers get it.”
 
A second meaning of the phrase relates to Iowa state law.  
 
Drinking wholesome, fresh milk — fresh from a healthy, grass-fed cow, sheep, or goat without processing through a pasteurization vat — has been illegal since 1968 for most people living in Iowa .   The privilege of choosing whether to drink milk fresh or pasteurized is reserved to the few who control livestock, land, and have mastered the skill of milking; everyone else is restricted to only Grade A pasteurized milk, except for those who are willing to operate in the gray areas of the law.   “Giving away milk is not covered by our rules,” says Dustin VandeHoef, communications director for the Iowa Department of Agriculture and Land Stewardship (IDALS), “but all sales are illegal.”
 
Passages from Chapter 192 of the Iowa Code (state law) say, “Only grade 'A' pasteurized milk and milk products shall be sold to the final consumer, or to restaurants, soda fountains, grocery stores, or similar establishments;” and later, “No person shall within the state produce, provide, sell, offer, or expose for sale, or have in possession with intent to sell, any milk or milk product which is adulterated or misbranded;”  
 
VandeHoef says, “We interpret the words 'adulterated' and 'misbranded' to include raw milk, and this is also the FDA [Food and Drug Administration] interpretation which is adopted into the Code.”
 
The IDALS interprets “sales” to mean “exchanges of value.”   During a phone call to his office, VanderHoef was reluctant to specify which circumstances would be considered prosecutable and which would be outside IDALS's rules.  
 
A broad interpretation of the meaning of “sales” puts giving away raw milk, and even drinking raw milk from one's own animal, into the gray area between legal and illegal: renting a stall in a farmer's barn to shelter your cow if you do not have a barn; bringing a sandwich to the person milking your goat for you; bringing a bottle of wine to a dinner party where the hostess serves raw milk.   Membership in a private kitchen club could be interpreted as a “sale” if one of the members gives away samples of raw milk.  
 
To steer clear of potential gray market entanglement, all milking lessons from “milkers get it” coaches are free, and no donations are accepted.   “We're not trying to get around the law,” says Welty.   “Our purpose is to pass along a valuable skill to people who want to be self-sufficient or live a sustainable lifestyle or simply exercise choice about the food they eat.”

In order to exercise the simple choice of “Fresh or Pasteurized” without engaging black markets or gray markets, a person has to learn how to milk and has to control livestock plus enough land to support it.   One mission of “Milkers get it” is to help people overcome barriers that state law and bureaucracy have erected.   Another mission is to assist efforts to change the state law.
 
Challenging the statute with a court case is lengthy and expensive.   One current lawsuit disputes one circumstance in the gray area of the law: Freitag v Secretary of Agriculture was filed in January 2010 and litigation continues in Linn County 's district court.   Representing two milkers who boarded their cow with a Linn County farmer, the Farmer-to-Consumer Legal Defense Fund “is acting in the capacity of a public interest law firm to protect the fundamental rights of the public at large ….”
 
Changing the statute directly with new legislation is another option.   Small-scale dairy farmers, health food customers, legislators, and many others worked together during Iowa 's 2011 legislative session to lift restrictions against consumers buying raw milk directly from farmers.   “We made progress,” says Francis Thicke, organic dairy operator and former candidate for Iowa Secretary of Agriculture, “but not enough to pass it this year.   We'll try again next year.”
 
Meanwhile, you can pull up a three-legged stool and try a free milking lesson for yourself, and encourage your state legislators to get some hands-on experience, too.   Accurate information and authentic experience are often the best tools for changing engrained habits of mind and for updating rules and procedures.   Milking coaches are ready to introduce all comers to the wholesome experience of squirting fresh milk from the udder of a healthy animal into a warm, foamy pail of milk.   When you feel the rush from a satisfying squeeze, you'll understand.   Milkers get it.

# # #

The Seattle-based group Walk Score released its 2011 rankings of the country’s most walkable cities today. At this page you can view the “walk scores” of the 2,500 largest U.S. cities, or look at cities grouped by region or state.

After the jump I’ve posted some of the Iowa findings, as well as background on the “walk score” and why that number matters. Hawkeye fans can be proud that Iowa City barely edged out sustainability champion Dubuque for having the most amenities within walking distance of its residents.

Hope everyone in the Bleeding Heartland community is enjoying the long holiday weekend. Sounds like the weather across Iowa will be pretty good for the celebrations on July 3 and 4. I love the Windsor Heights parade.

Setting off fireworks at home is illegal in Iowa (rightly so in my opinion), but the law isn’t strictly enforced. Stay safe and remember that firecrackers are one reason July 4 can be a difficult holiday for veterans with post-traumatic stress disorder.

This is an open thread, so all topics are welcome. A few things caught my eye this week:

As of July 1, Iowa boaters are subject to the same blood-alcohol limits as people driving motor vehicles. A long-overdue bill to that effect finally made it through the legislature this year.

The Iowa Department of Natural Resources warned against swimming at six Iowa park beaches because the water contains high levels of fecal bacteria. The no swimming advisories apply to Emerson Bay at West Okoboji Lake, Geode near Danville, Beed’s near Hampton, Backbone near Strawberry Point, Lacey-Keosaqua near Keosaqua, and Springbrook near Guthrie Center. DNR staff have found high readings for bacteria in many other Iowa lakes this summer, so swim at your own risk and try not to swallow any water.

If you find a nice non-feces-contaminated swimming spot, remember that “drowning doesn’t look like drowning,” so it’s important to know the signs that someone is in trouble in the water. Drowning is the second-leading cause of accidental death for children.

I was not happy to learn that organic, “uncured” hot dogs with “no nitrates or nitrites added” do in fact contain nitrates and nitrites, often just as much as in conventional processed meats.

Danny Wilcox Frazier’s photo essay called “Out of Iowa” isn’t new, but I only found it recently. Worth clicking through.

Planned Parenthood of the Heartland announced yesterday that the organization and Planned Parenthood of Southeast Iowa “have signed a letter of intent to merge into one affiliate by June 30, 2011.” Founded in 1964, Planned Parenthood of Southeast Iowa currently serves residents in seven counties through clinics in Burlington, Fort Madison, Keokuk, Mount Pleasant, and Washington. The merged organization will be called Planned Parenthood of the Heartland and will serve women and men in “twenty-five health centers in Iowa, four health centers in Nebraska and three Education Resource Centers in Des Moines, Lincoln and Omaha.” After the jump I’ve posted the full press release announcing the merger plans.

Once the merger is complete, Planned Parenthood of the Heartland will be the only Planned Parenthood affiliate in Iowa, serving residents across the state. In 2009, the largest Iowa affiliate (then called Planned Parenthood of Greater Iowa) merged with Planned Parenthood of Nebraska and Council Bluffs to form Planned Parenthood of the Heartland.

Last December, Planned Parenthood of East Central Iowa signed a letter of intent to merge with Planned Parenthood of the Heartland. That merger is now complete. Planned Parenthood of East Central Iowa was founded in Cedar Rapids in 1980 and had served a five-county area (Linn, Jones, Jackson, Dubuque and Delaware) since 1990.

The D.C. Circuit Court of Appeals lifted an injunction today on federally-funded research involving embryonic stem cells. Last August a District Court judge blocked federal government funding for such research, citing a 1996 law against funding “research in which a human embryo or embryos are destroyed” or discarded. However, two of the three judges on the Appeals Court panel found that the injuntion would impose “certain and substantial” harm on stem cell researchers, and that plaintiffs in the case “have not shown they are likely to succeed on the merits.” Click here (pdf file) for the full text of today’s ruling.

Senator Tom Harkin and Representatives Bruce Braley and Dave Loebsack all released statements today welcoming the decision as a victory for promising medical research. (The University of Iowa’s Carver College of Medicine was among facilities adversely affected by the district court ruling.) I’ve posted those statements after the jump and will update this post if and when other Iowa elected officials comment on the ruling.  

This week Governor Terry Branstad declared April to be “Abortion Recovery Month” in Iowa. Anti-choice organizations and crisis pregnancy centers were invited to the proclamation signing, and women who regret their abortions spoke at a press conference. Human beings have complex reactions to significant life events, and I feel empathy for anyone who feels sad about important choices. However, it is inaccurate to suggest that all women who exercise their legal right to an abortion need to go through a “recovery” process. The American Psychological Association’s Task Force on Mental Health and Abortion concluded in a 2008 report that “among adult women who have an unplanned pregnancy the relative risk of mental health problems is no greater if they have a single elective first-trimester abortion than if they deliver that pregnancy. […] the TFMHA reviewed no evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors.” Some mental health professionals believe that “emotional issues, especially feelings of guilt, begin to rise along with anti-choice efforts to restrict abortion.”

The Iowa House approved a 20-week abortion ban at the end of March. The bill is modeled on a Nebraska statute and is intended to deter an Omaha-based doctor from opening a new abortion clinic in Council Bluffs. It has stalled in the Senate Government Oversight Committee. Committee Chairman Tom Courtney said in mid-April that it was too late in the legislative session to adequately review the bill this year, and he would prefer to take it up in 2012. Council Bluffs Mayor Tom Hanafan, a Democrat, recently urged the Senate to act on the bill before adjourning. The mayor does not want his city to become “home to a clinic that specializes in later term abortions.” Senate Majority Leader Mike Gronstal, who represents the Council Bluffs area, has said he would not block the abortion bill from coming to a vote and is letting the normal committee process work.

Women who are pregnant and planning to stay pregnant should be aware that April is cesarean awareness month. At the request of Iowa chapters of the International Cesarean Awareness Network, Branstad issued a proclamation to that effect. The c-section rate in Iowa rose to 30.2 percent in 2009, the most recent year for which statistics are available. That is way above the optimal level, but the national average is even higher at 32.9 percent. The central Iowa chapter of the International Cesarean Awareness Network posted statistics for c-sections and vaginal births after cesareans (VBACs) in Iowa hospitals here. Unfortunately, more than three quarters of Iowa hospitals prohibit pregnant women from even attempting VBACs. The U.S. Department of Health and Human Services’ Healthy People 2010 initiative set a goal of reducing the cesarean birth rate for low-risk women to 15 percent for women giving birth for the first time and 72 percent for women who have had a prior cesarean birth. Having a doula present during labor has been proven to reduce the need for cesareans and other major interventions.

Whether or not they are able to become pregnant, all sexually active people should be aware that April is STD Awareness Month. The Centers for Disease Control has lots of relevant facts and figures here. Planned Parenthood of the Heartland clinics across Iowa are encouraging people to get themselves tested for sexually transmitted diseases.

This is an open thread. What’s on your mind this weekend, Bleeding Heartland readers?

UPDATE: State Representative Kurt Swaim is not running for re-election in the new House district 82, which covers Davis and Van Buren counties and most of Jefferson County, including Fairfield. Swaim and fellow Democrat Curt Hanson were both placed in that district, but most of the population lives on Hanson’s current turf. Swaim was one of four House Democrats to vote for the 20-week abortion ban, one of three House Democrats to vote for a constitutional amendment banning same-sex marriage, and one of nine House Democrats to vote for a bill banning secret recordings on Iowa farms. Hanson voted against all of those bills.

House File 45 heads to Governor Terry Branstad’s desk today after the Iowa House approved the “deappropriations” bill by a 95 to zero vote. The bill was the top legislative priority for House Republican leaders, but the Democratic-controlled Iowa Senate eliminated many of its controversial provisions last week. The full text of House File 45 is here, and the complete bill history is here. The Senate Journal for February 17 contains roll calls for votes on House File 45 and various amendments (pdf file). The final Senate version of House File 45 passed with 48 yes votes. First-term Republican Senator Mark Chelgren voted against the bill, and Republican Senator Sandy Greiner was absent.

Thanks to the Senate amendment, state funding for preschool, family planning, passenger rail, smoking cessation programs, and the core curriculum live to fight another day in the Iowa legislature. So do the Power Fund, the Office of Energy Independence, and the Grow Iowa Values Fund, all economic development programs long targeted by statehouse Republicans.

In addition, the Senate removed language from House File 45 that would have reduced funding for state universities, area education agencies, land acquisitions by the Department of Natural Resources and the Resource Enhancement and Protection fund.

The Senate’s version of House File 45 also did not include language creating a “tax relief fund” that would have collected surplus revenues after state reserve funds were filled.

After the jump I’ve posted an overview compiled by the Iowa House Democratic research staff on “major items eliminated” by the Senate amendment to House File 45. I’ve also listed some other significant points of divergence between the Senate and House versions of this bill, as well as key points on which the Senate left House File 45’s language intact.

Finally, I’ve posted the House Democratic research staff’s explanation of language that would create searchable databases on the state budget and tax rates.  

Iowa received the overall top ranking in a new report on the health care system in all 50 states and the District of Columbia. The Commonwealth Fund is a private foundation supporting research on health care issues and policies to achieve “better access, improved quality, and greater efficiency, particularly for society’s most vulnerable.” Researchers who compiled the 2011 state scorecard uncovered huge disparities in terms of access to care, health care quality, and health outcomes:

There is a twofold or greater spread between the best and worst states across important indicators of access and affordability, prevention and treatment, and potential to lead healthy lives (Exhibit 1). The performance gaps are particularly wide on indicators assessing developmental screening rates, provision of mental health care, hospitalizations because of asthma, prevalence of teen smoking, and mortality rates among infants and children. Lagging states would need to improve their performance by 60 percent on average to achieve benchmarks set by leading states.

If all states were to improve their performance to levels achieved by the best states, the cumulative effect would translate to thousands of children’s lives saved because of more accessible and improved delivery of high-quality care. In fact, improving performance to benchmark levels across the nation would mean: 5 million more children would have health insurance coverage, nearly 9 million children would have a medical home to help coordinate care, and some 600,000 more children would receive recommended vaccines by the age of 3 years.

Leading states-those in the top quartile-often do well on multiple indicators across dimensions of performance; public policies and state/local health systems make a difference. The 14 states at the top quartile of the overall performance rankings generally ranked high on multiple indicators and dimensions (Exhibit 2). In fact, the five top-ranked states-Iowa, Massachusetts, Vermont, Maine, and New Hampshire-performed in the top quartile on each of the four dimensions of performance. Many have been leaders in improving their health systems by taking steps to cover children or families, promote public health, and improve care delivery systems.

Iowa was the top-performing state in just one category: percentage of young children receiving all recommended doses of the six key vaccines. However, Iowa’s relatively high scores (among the top 5 states on nine indicators and in the top quartile for 14 indicators) made our state number one overall and in the “prevention and treatment” subgroup, number two in “potential to lead healthy lives” subgroup, and number six in the “access and affordability” subgroup. More detail on Iowa’s rankings can be found on this chart. To compare Iowa to other states, use this interactive map or download the full report here.

The new report’s executive summary highlights the benefits of the federal Children’s Health Insurance Program (generally known as SCHIP):

The Scorecard’s findings on children’s health insurance attest to the pivotal role of federal and state partnerships. Until the start of this decade, the number of uninsured children had been rising rapidly as the levels of employer-sponsored family coverage eroded for low- and middle-income families. This trend was reversed across the nation as a result of state-initiated Medicaid expansions and enactment and renewal of the Children’s Health Insurance Program (CHIP). Currently, Medicaid, CHIP, and other public programs fund health care for more than one-third of all children nationally. Children’s coverage has expanded in 35 states since the start of the last decade and held steady even in the middle of a severe recession. At the same time, coverage for parents-lacking similar protection-deteriorated in 41 states.

SCHIP used to be a favorite punching bag for Representative Steve King, who voted against funding what he called “Socialized Clinton style Hillarycare for Illegals and their Parents.” Fortunately, the majority in Congress recognized this program’s potential.

After the jump I’ve posted a sidebar from the general summary of the Commonwealth Fund’s report, called “Iowa’s Comprehensive Public Policies Make a Difference for Children’s Health.” I also included some methodological notes and listed the 20 indicators measured by researchers.

The Iowa House approved a major “deappropriations” bill, House File 45, on January 19 by a party-line vote of 60 to 40. Republican leaders fast-tracked what they call the Taxpayers First Act, which passed the House Appropriations Committee on the third day of the 2011 session. The bill would cut dozens of programs while increasing spending in a few areas. In addition, $327.4 million from this year’s surplus revenue would go into a new “Tax Relief Fund,” instead of being used to help close the projected budget gap for fiscal year 2012. This bill summary (pdf) lists the budget cuts and supplemental appropriations in House File 45. Click here for the full bill text.

Although the majority of speakers at a January 18 public hearing opposed the bill, and organizations lobbying against the bill outnumber those that have signed on in support, the House Republicans passed the bill with few significant changes. Democrats offered many amendments as floor debate went late into the evening on January 19, trying to save funds for the statewide voluntary preschool program, passenger rail, smoking cessation programs, and sustainable communities, among other things. Representatives rejected almost all those amendments on party-line votes. This page shows what amendments were filed, and the House Journal for January 19 contains the roll call votes.

House File 45 now moves to the Iowa Senate, which has a 26-24 Democratic majority. Democratic senators are likely to back increased expenditures for mental health services and indigent defense while opposing many of the spending cuts. After the jump I take a closer look at some of the most controversial provisions in House File 45.

The Iowa House Appropriations Committee passed House Study Bill 1 on January 12, by a party-line vote of 15 to 10. Republicans call the bill the “Taxpayers First Act” and claim it would save the state more than $500 million over three years, while refunding some money to taxpayers and allocating an extra $25 million for mental health services over the next 18 months. As Bleeding Heartland discussed here, the potential savings in the current budget year are far smaller. The Democratic-controlled Iowa Senate is unlikely to approve some of the big-ticket spending cuts, such as complete elimination of the voluntary preschool program for four-year-olds. The full text of the bill as introduced is here (pdf file). The Legislative Services Agency analysis of how much various provisions would cost or save is here (pdf file).

Looking through the lobbyist declarations on HSB 1, so far only Iowans for Tax Relief, the National Federation of Independent Business, and the Washington-based 501(c)4 group American Principles in Action have declared support for it. The bill’s opponents include the Greater Des Moines Partnership, the Iowa City Area Chamber of Commerce, the Iowa Association of School Boards, the Iowa chapter of the National Association of Social Workers, major labor unions (AFSCME and the Iowa State Education Association), the State Bar Association, and many organizations that advocate for public health and environmental causes. Numerous lobbyists haven’t taken a position on the bill; influential organizations still undecided include the Iowa Farm Bureau Federation, the Iowa Association of Business and Industry, the League of Cities, the State Association of Counties, the Iowa Medical Society, the Cedar Rapids Chamber of Commerce, the Iowa Chamber Alliance, and the American Association of Retired Persons.

UPDATE: The “deappropriations” bill was renamed House File 45. Click here for a bill summary.

During Governor Chet Culver’s final address to the Iowa legislature this morning, he mentioned that his administration

provided the legislature and the new administration with a detailed summary addressing the historic egg recall last summer. This includes five proposed changes in Iowa law that will help improve food safety and employee training standards in the wake of the salmonella outbreak last summer.

I’ve posted the full text of the Culver administration’s egg safety proposals after the jump. This passage summarizes the five areas that would require legislative action:

Although the new federal egg regulatory regime is aimed at the state’s largest producers, a new, mandatory Iowa [Salmonella enteriditis] detection and prevention program should be enacted under amendments to existing law and the creation of a new Iowa Code Section 196.15 to complement the federal government’s efforts to prevent SE contaminated shell eggs from entering into the nation’s food chain from all of Iowa’s egg producers.

There are at least five issues that are not covered by the recent federal egg regulatory reforms, that Iowa law does not currently address and that, therefore, unless corrected legislatively, may leave consumers of Iowa-produced eggs vulnerable to future SE poisoning.  First, federal egg safety laws pertain only to egg farms that host at least 3,000 hens and do not cover smaller operations.  Second, under federal law, producers have no legal obligation to report positive SE testing results to any federal or state agency.   Third, there are no accreditation or certification standards for laboratories that conduct SE testing.  Fourth, there are no legal criteria that establish the minimal level of training and competency for persons who are charged with the responsibility for implementing a new mandatory SE detection and prevention program.  And, fifth, there is no clearly-identified funding stream to support an effective expansion of state egg programs.

It would take heavy lifting to get these sensible ideas passed and signed into law. Even when Democrats controlled both chambers of the Iowa legislature, few new regulations on agriculture saw the light of day. The Iowa House now has a 60-40 Republican majority, which makes passing new food safety rules even more of an uphill battle. Governor-elect Terry Branstad has repeatedly criticized what he views as excessive regulations on farms, and the Iowa Farm Bureau Federation endorsed Branstad and almost a full slate of Republican legislative candidates last year.  

Best wishes for the new year to everyone in the Bleeding Heartland community. What’s on your mind this first weekend of 2011?

Improving personal health is a common new year’s resolution. I’ll be trying to eat less sugar and exercise more, partly to lose a few pounds and partly to reduce stress. Research suggests that exercising before breakfast is especially helpful, and you don’t have to do intense, long workouts every day to benefit.

Radio Iowa suggested a few ways people can prevent strokes, “the third leading cause of death in Iowa, killing more than 1,600 Iowans last year alone.” Here’s another idea for preventing strokes: reduce coal combustion. Physicians for Social Responsibility has found that 92 percent of Iowans “live within 30 miles of a coal plant.” Particulate matter and other pollutants generated by coal combustion have been proven to cause strokes, as well as heart disease and cancer, the two other leading causes of death in Iowa. Using renewable energy or natural gas to replace some of our coal-fired plants could measurably improve the health of Iowans.

According to State Climatologist Harry Hillaker, 44.66 inches of precipitation made 2010 the second-wettest year out of 138 years for which records are available. Here’s hoping for less rain in 2011, because Iowa isn’t implementing land-use practices that might allow the ground to absorb more rain. Governor-elect Terry Branstad has never been big on flood prevention and still has no plan for flood mitigation. The new Iowa Legislature is no more likely to enact wise floodplain management policies than the last one.

Those trying to reduce their carbon footprints in 2011 can find good ideas here, here and here. Staff charged with making institutions more energy efficient can get inspiration from Luther College in Decorah, one of only eight colleges nationwide “to earn an ‘A’ on The College Sustainability Report Card released Oct. 27 by the Sustainable Endowments Institute.”

Luther received an “A” in seven of the eight graded areas including: administration, climate change and energy, food and recycling, green building, student involvement, transportation, and investment priorities. The college received a “B” in endowment transparency. […]

Luther was among the first colleges in the country to sign the Presidents Climate Commitment, which encouraged institutions to reduce their carbon footprint, operate more efficiently, and make sustainability part of every student’s learning experience. […]

Luther has reduced greenhouse gas emissions by 20 percent since 2003 and is committed to a 50 percent reduction by 2012. Reducing greenhouse emissions is one of several goals in the college’s newest strategic plan, a section of which is dedicated to environmental sustainability.

Click here for the full report on how Luther achieved these outstanding results. The College Sustainability Report Card gave “B” grades to Grinnell College and Iowa State University, while the University of Iowa got a “C-“. Note to Luther staff: if you want more recognition next year, have someone return the Sierra Club’s “Cool Schools” survey.

This is an open thread.

Bleeding Heartland readers may recall that Senate Democrats imperiled the food safety bill, S510, by forgetting to put revenue-raising language in a bill that originated in the House of Representatives. Senate leaders tried to salvage the situation by adding the food safety language to the massive ominbus spending bill Congress was expected to approve last week. However, Senate Republicans torpedoed the omnibus bill, leaving few options for getting the food safety bill to President Barack Obama’s desk before the new Congress convenes.

According to Cox Radio reporter Jamie Dupree, the food safety bill came “back from the dead” on Sunday. The Senate took the food safety language from the continuing resolution on spending that had already passed the House and inserted it into a “Cash for Clunkers” bill the House had previously approved. (The food safety language replaced the Cash for Clunkers language.) The Senate then approved the new bill by unanimous consent. Amazingly, no Republican gummed up the works on that, not even the food safety bill’s deadly enemy Tom Coburn. The bill now goes back to the House, where Dupree says approval is expected this week. UPDATE: The Hill’s Alexander Bolton and Matthew Jaffe of ABC News report on the Senate maneuvering.

I had almost given up on this bill passing. It’s not perfect, but it’s a good step forward with bipartisan support in Congress. Both Tom Harkin and Chuck Grassley voted for the bill a few weeks ago in the Senate.  

Governor-elect Terry Branstad announced today that ophthalmologist Dr. Mariannette Miller-Meeks will run the Iowa Department of Public Health in his administration. A press release noted that Miller-Meeks “has served as the first woman President of the Iowa Medical Society and was the first [woman] on the faculty in the Department of Ophthalmology at the University of Iowa and councilor for Iowa to the American Academy of Ophthalmology.” Miller-Meeks was the Republican nominee in Iowa’s second Congressional district in 2008 and 2010. She worked hard during both campaigns but lost to Dave Loebsack in Iowa’s most Democratic-leaning Congressional district.

Also on December 9, Branstad announced that he will tap Chuck Palmer to head the Department of Human Services in his administration. Palmer did that job during Branstad’s previous time as governor from 1989 to 1999. Most recently he has been president of Iowans for Social and Economic Development, “an asset development organization with the mission of creating opportunities for low and moderate income Iowans to increase income and achieve financial stability.”

Branstad has pledged to reduce the size of state government by 15 percent, and keeping that promise would likely require significant cuts in the departments Miller-Meeks and Palmer will be running. The current budget (fiscal year 2011) allocated $935.5 million from the general fund to health and human services. That’s 17.7 percent of the general fund budget alone, or 15.9 percent of total state expenditures, including federal stimulus money and reserve funds as well as general fund spending. More than $200 million in federal stimulus money supported Iowa’s Medicaid budget in the current budget year, but similar support won’t be forthcoming in future years now that Republicans have a majority in the U.S. House of Representatives.

Branstad administration press releases on Miller-Meeks and Palmer are after the jump.

Republicans made huge gains in the Iowa House on November 2, defeating 13 Democratic incumbents and winning four Democratic-held open seats. Republicans fell just short in several other House races, and one that puzzled me was in district 7, covering Emmet and Palo Alto Counties and part of Kossuth in north-central Iowa.

Democrat Marcella Frevert retired after representing the district for 14 years in the Iowa House. The district leans a bit Democratic in voter registration, but open seats tend to be harder for parties to hold than districts where they have established incumbents. Clearly district 7 was winnable for the GOP; the certified results put Democrat John Wittneben just 32 votes ahead of Republican Lannie Miller.

For some reason, the Iowa GOP and allied groups didn’t invest nearly as much in Miller’s campaign as in other House Republican candidates. But why?

Some people hardly notice Veterans Day except for the lack of mail delivery. This day reminds others of their own or a loved one’s life-altering military service.

A few thoughts and links on the holiday are below.

Election news is keeping me busy, but several reports related to energy policy in Iowa caught my eye during the last week.

Links and excerpts are after the jump.  

Last week the federal departments of Health and Human Services, Labor, and Treasury “released interim final regulations implementing five of the insurance enrollee protections of the Patient Protection and Affordable Care Act” (the official name for the health insurance reform law adopted in March). Timothy Jost analyzed the regulations for the Health Affairs blog, and his whole post is worth reading. While a lot of uncertainty surrounds the new rules, the cost of compliance is expected to be low. Jost finds that “[r]elatively few people will directly benefit” from the health insurance reform, but there will be “[l]arge benefits for those who are affected.”

During the last presidential campaign and more than a year of health care debates on Capitol Hill, countless politicians swore they were committed to ending discrimination against Americans who have pre-existing medical conditions. After reviewing the interim regulations, Jost has good news and bad news for adults who lack health insurance because of a medical problem.

The ban on preexisting conditions exclusion found in the Affordable Care Act is much broader than the preexisting condition exclusion imposed by the Health Insurance Portability and Accountability Act [of 1996].  It prohibits any limitation or exclusion of benefits in a group or individual plan based on the prior existence of a medical condition.  The provision not only prohibits the exclusion of coverage of specific benefits based on a preexisting condition, but also the complete exclusion from the plan of a particular person if the exclusion is based on a preexisting condition.   The regulation does not, however, prohibit coverage exclusions that apply regardless of whether a condition is a preexisting condition or not.   The provision applies to enrollees under the age of 19 effective the first plan year beginning after September 23, 2010, but to adults only beginning in 2014.

In the summer of 2009, many progressives were disturbed to learn that the draft House health care bill delayed implementation of the pre-existing condition provision until 2013 (the date was pushed back to 2014 later in the legislative process). Why should Americans with previous or chronic medical problems continue to be denied health insurance for four more years? Don’t worry, we were told: new high-risk pools will be created to bridge the gap for people with pre-existing conditions.

We are now learning more about how the new Pre-Existing Condition Insurance Plan will operate. Eligible Iowans will be able to start applying for our state’s plan on July 15. But uh oh:

The new program, expected to start in a few weeks, will be financed with $35 million in federal money from the new health care reform law. That money will be enough to help only 975 Iowans, state administrators have concluded.

“$35 million doesn’t cover as many people as you’d hope,” said Susan Voss, Iowa’s insurance commissioner.

Another twist is that Iowans who participate in the state’s current high-risk insurance pool won’t be able to switch into the new pool, which will be significantly less expensive.

Federal experts have estimated that 34,500 Iowans could be eligible for the new pool.

The money is supposed to last until 2014, when private insurers will be banned from discriminating against people with pre-existing health conditions. At that point, such people should be able to buy their own insurance just like anyone else, health reform proponents say.

You see immediately what Jost was getting at: few Iowans with pre-existing conditions will benefit from the new high-risk pool (perhaps 3 percent of the eligible population). For those who get in, though, the benefits are immense: insurance for about the same price a healthy person would pay.

While helping 950 uninsurable Iowans obtain coverage is significant, it would have been better to implement the health insurance reform on a faster timetable. Because Congress lacked the political will to impose significant costs on insurance companies, 97 percent of Iowa adults with pre-existing conditions will have to wait until 2014 to reap the full benefit of the health reform.

That sounds like over-promising and under-delivering to me. But I can’t say I wasn’t warned a long time ago.

UPDATE: Democrats will talk up the health reform changes that take effect sooner, such as new Medicare reimbursement rates. Those are expected to increase payments to Iowa doctors and hospitals. But the public case for health care reform wasn’t built on wonky issues like Medicare reimbursement rates. It was a simple moral argument, and not letting insurers discriminate against people with a pre-existing condition was at its core.  

The Academy of Breastfeeding Medicine warns that recently updated “birth control guidelines released by the U.S. Centers for Disease Control and Prevention (CDC) could undermine mothers who want to breastfeed,” I learned from the ByMomsForMoms blog, sponsored by Lansinoh. From the Academy of Breastfeeding Medicine’s news release:

“The new guidelines ignore basic facts about how breastfeeding works,” says Dr. Gerald Calnen, President of the Academy of Breastfeeding Medicine (ABM). “Mothers start making milk due to the natural fall in progesterone after birth. An injection of artificial progesterone could completely derail this process.”

The CDC report, “U.S. Medical Eligibility Criteria for Contraceptive Use, 2010,” released in the May 28 issue of Morbidity & Mortality Weekly Report (MMWR), contains important changes in what constitutes acceptable contraceptive use by breastfeeding women. The criteria advise that by 1 month postpartum the benefits of progesterone contraception (in the form of progestin-only pills, depot medroxyprogesterone acetate (DPMA) injection, or implants), as well as the use of combined (progestin-estrogen) oral contraceptives outweigh the risk of reducing breastfeeding rates. Previously, progesterone birth control was not recommended for nursing mothers until at least 6 weeks after giving birth, and combined hormonal methods were not recommended before 6 months.

Based on clinical experience, breastfeeding support providers report a negative impact on breastfeeding when contraceptive methods are introduced too early. One preliminary study demonstrated dramatically lower breastfeeding rates at 6 months among mothers who underwent early insertion of progesterone-containing IUDs, compared with breastfeeding rates of mothers who underwent insertion at 6-8 weeks postpartum.

I have met women whose milk supply collapsed after they received a progesterone shot. One acquaintance had successfully nursed previous babies and was never informed by her health care provider that a birth control shot could impede her ability to produce enough milk for her infant.

It’s illogical for the CDC to give its blessing to early postpartum use of hormonal birth control when the federal government has supposedly been trying to promote breastfeeding for more than a decade. Earlier this year, the White House Task Force on Childhood Obesity set a goal of having half of U.S. babies breastfed for at least nine months by 2015, and recommended a number of specific policies to help reach that goal. But breastfeeding without a full milk supply is quite difficult no matter how educated the mother is or how supportive her environment. I hope the CDC will revise its guidelines and recommend non-hormonal forms of birth control for women in the early months of breastfeeding.  

In the aftermath of 9/11, we saw thousands of workers develop devastating respiratory conditions and other illnesses as a result of exposure to toxic dust that filled the air in the days and weeks after the twin towers fell. To this day, these peoples’ plight continues to add misery to the ongoing tragedy of 9/11. What makes it even worse is that these people were assured the air was safe.   As we all know now, it wasn’t.

Today, sadly, history may be repeating itself in the Gulf of Mexico.

(Thank you to Ligia Ercius-Dipaola, who posted this video on the NRDC Action Fund Facebook Page)

Amazingly, despite reports like this one, BP “continues to pretend that – just like an oil spill of this magnitude could never happen – there also could not possibly be a worker health concern.”  While the potential health hazards posed by chemical dispersants and oil itself are debatable, it is clear that significant risks existed.  

Already, we’ve seen evidence of the impact that spilled oil can have on human health. For starters, an increasing number of workers and residents in Gulf Coast areas have reported “suffering from nausea, vomiting, headaches and difficulty breathing.”  Considering that oil contains “petroleum hydrocarbons, which are toxic and irritating to the skin and airways”, as well as volatile chemicals “which can cause acute health effects such as headaches, dizziness and nausea” it’s no surprise that these symptoms are appearing.

(Thank you to Gary Chattem, who posted this on the NRDC Action Fund Facebook Wall)

So now, with the “60 exposure-related complaints filed with the Louisiana Department of Health and Hospitals”, not to mention the “overwhelming evidence that many of the compounds found in crude oil are dangerous,” shouldn’t BP be protecting the people who are cleaning up this mess? If they aren’t doing so, why aren’t they?

The bottom line is this: people along the Gulf Coast deserve to know the facts regarding the dangers they are facing and how to protect themselves.  It’s bad enough that their economic livelihoods are in danger of destruction in part due to BP’s greed and recklessness.  But if their lungs and other organs are damaged by oil and dispersant particles in the air, more than their economic livelihoods could be damaged.

None of us should ever forget that this disaster was brought on, at least in part, by BP cutting corners to save a few (million) bucks, and by the government’s failure to prevent the company from doing so.  As a result, the unthinkable has happened.  We must learn from those grave mistakes, not repeat them.  That means, in the long term, ridding ourselves of our dangerous, destructive addition to oil.  But what must happen now – right now – is for BP to stop cutting corners with the health of the people cleaning up the Gulf.

At the minimum, BP must switch its philosophy from “hope for the best” to “do whatever it takes, whatever the cost, to make sure people are safe.”  If BP won’t “make it right,” as the company’s ads like to say, then the government should force BP to do so.  In the words of one Venice, LA mother: “I’ve got the two most beautiful children in the world. If something were to happen to them, how could I look in those baby blues and say, Mommy didn’t know?”  It’s a great question.  What’s the answer, BP?

Remember last year when Republicans claimed health care reform would put government bureaucrats between patients and their doctors? It was a hypocritical talking point to begin with, given how often insurance companies overrule doctors’ orders, in some cases denying sick people access to life-saving medical care.

The hypocrisy is especially apparent now that Republicans are cheering two new laws passed in Oklahoma.

The Oklahoma Legislature voted Tuesday to override the governor’s vetoes of two abortion measures, one of which requires women to undergo an ultrasound and listen to a detailed description of the fetus before getting an abortion.

Though other states have passed similar measures requiring women to have ultrasounds, Oklahoma’s law goes further, mandating that a doctor or technician set up the monitor so the woman can see it and describe the heart, limbs and organs of the fetus. No exceptions are made for rape and incest victims.

A second measure passed into law on Tuesday prevents women who have had a disabled baby from suing a doctor for withholding information about birth defects while the child was in the womb.

To clarify: Republicans passed a law dictating the way doctors communicate with patients and how they must proceed with every woman seeking an abortion, regardless of her individual circumstances. According to the New York Times, the Center for Reproductive Rights has already filed suit to challenge the constitutionality of the ultrasound law, claiming it “violates the doctor’s freedom of speech, the woman’s right to equal protection and the woman’s right to privacy.”

The second law is in some ways more offensive, because the government is shielding doctors who deliberately do not level with their patients. I have close friends who have learned while pregnant that their future child has serious medical problems. To give doctors license to deceive women in that situation is unconscionable. Pregnant women must be able to make informed decisions regarding all medical care. Who’s to say that doctors will stop at “merely” hiding birth defects? Maybe some will decide it’s better not to tell women they have cancer or some other disease that might prompt them to terminate a pregnancy.

The new laws are similar to two anti-abortion laws the Oklahoma Supreme Court already struck down. Clearly Republicans won’t let a little thing like the state constitution get in the way of their desire to intimidate women and interfere with the information they receive from their doctors. I agree with Charles Lemos: this is a sign of how extreme today’s Republican Party has become.

Iowans who don’t take reproductive rights for granted may want to know that Arianna Huffington is coming to Des Moines next Tuesday to help raise money for Planned Parenthood of the Heartland (formerly Planned Parenthood of Greater Iowa). Click the link for event details.

Share any relevant thoughts in this thread. I recommend this post from the Ms. Magazine blog on the 10 worst myths about abortion in the United States.

Until this morning, I would have considered myself the blogger least likely to defend the right to smoke. Because of the many health risks associated with secondhand smoke, I strongly supported the Iowa Smokefree Air Act adopted in 2008, as well as the Iowa Department of Public Health’s decision to enforce that ban in all restaurants. I had no sympathy for smokers who whined about “Big Brother Democrats and Turncoat Republicans” and called the public smoking ban “Soviet” or “fascist.” I knew restaurant and bar owners who challenged the smoking ban in court were wasting their time and money.

However, Wellmark Blue Cross Blue Shield is going too far with its new personnel policy on tobacco use. Beginning on June 1,

The insurer will “require applicants to assert that they are tobacco-free in order to be considered for a position,” said Rob Schweers, spokesman for Wellmark, which employs approximately 1,600 people in Des Moines and another 200 throughout the rest of the state.

Wellmark is asking existing employees to stop using tobacco by Oct. 1. The new policy also prohibits any smoking during work hours, including scheduled breaks and during lunch.

The Des Moines Register quotes Schweers as saying the company wants to provide “incentive for people to quit [smoking], which will result in a healthier, more productive work force.” If Wellmark wants to pay for counseling or nicotine patches or other support for smokers trying to quit, I’m all for it. Nicotine is highly addictive, and many people need extra support to stop using it. But smoking is still legal in private homes and many outdoor spaces, and employers should not try to control how employees live when they’re not at work. Yes, smokers cost employers more in health care costs, but so do people who eat unhealthy diets or engage in other risky (but legal) behavior.

According to the Register, several other large employers in central Iowa ban smoking during working hours, including lunch breaks, but don’t prohibit their employees from smoking during private time. Wellmark has not yet threatened to fire employees who don’t quit smoking by October 1, but apparently, they would have the legal right to do so. Peggy Huppert of the American Cancer Society said violating that organization’s policy on tobacco use is grounds for termination.  

I’ve heard some strange arguments against marriage equality, but the latest from Iowa Family Policy Center President Chuck Hurley is a doozy. Reacting to a new report on HIV and syphilis rates among gay and bisexual men, Hurley asserted,

“The Iowa Legislature outlawed smoking [in some public places] in an effort to improve health and reduce the medical costs that are often passed on to the state,” Hurley said. “The secondhand impacts of certain homosexual acts are arguably more destructive, and potentially more costly to society than smoking.” […]

“Iowa lawmakers need to pay attention to hard facts and not be persuaded by emotion laden half-truths,” he said. “Because of their unwillingness to correct the error of last April’s Iowa Supreme Court opinion, the Iowa Legislature is responsible for sanctioning activities that will lead to dramatically higher rates of HIV and syphilis in Iowa.”

Where to begin? Smoking increases the risk of heart disease, cancer, stroke, and various respiratory ailments, causing an estimated 438,000 preventable deaths every year nationwide. In Iowa, smoking directly causes an estimated 4,400 deaths each year, and secondhand smoke claims another 440 lives. Smoking causes about $1 billion in health care costs every year in Iowa, of which about $301 million is covered by Medicaid.

AIDS is a serious health threat in the U.S., but not on the same scale as smoking. AIDS has caused fewer than 20,000 deaths nationwide per year in the past decade. The total number of AIDS deaths in this country since the epidemic began is estimated at just under 600,000. I was unable to find statistics showing how many Iowans have died of AIDS, but according to this report for the Iowa Department of Public Health, 114 Iowans were diagnosed with HIV in 2005, and 79 Iowans were diagnosed with AIDS the same year. The numbers may have increased somewhat since then, but AIDS is nowhere near as “destructive” and “costly” to Iowans as smoking. Iowa’s syphilis rate is far below the national average, and none of the states with the highest syphilis rates permit same-sex marriages. If Iowa legislators want to influence the syphilis rate, they should focus on providing adequate funding levels for STD testing and ensuring that young people have access to medically accurate sex education.

Hurley’s argument is not only fact-free, but also illogical on several levels. He seems to think that allowing same-gender couples to get married is going to encourage many more Iowans to experiment with gay sex. Do you know anyone who decided to become gay because they knew they’d be able to get married? Has homosexual activity diminished in New York and New Jersey since those states’ legislatures declined to legalize same-sex marriage? Did California’s Proposition 8 reduce the number of gays and lesbians having sex there?

If Hurley is worried about promiscuity and sexually-transmitted diseases, he should be happy to see gay couples settle down and get married.

Contrary to the strange fantasies of the Iowa Family Policy Center crowd, the Iowa Supreme Court didn’t make the sky fall last April. Fortunately, most Iowans understand that our state legislators have more important things to do than overturn same-sex marriage rights. They also sense that giving legal recognition to the relationships of committed same-sex couples does no harm to other people. More than 90 percent of respondents in a statewide poll conducted last September said gay marriage had caused “no real change” in their lives.

Hurley’s position on gay marriage is more coherent than, say, Terry Branstad’s, but it’s also more detached from reality. Maybe his latest comments aren’t the worst argument ever against gay marriage, but they are certainly a contender.

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.

Last Thursday, the Iowa Senate approved a bill that would improve the health and well-being of Iowa working mothers and their children. In addition, this bill would reduce many employers’ health care costs while lowering employee turnover and absenteeism. Unlike legislation that pits business interests against the needs of working families, this bill would be a win-win.

Nevertheless, almost the whole Republican caucus voted against Senate File 2270, which promotes workplace accommodations for employees who express breast milk.

Follow me after the jump for background on this bill and Republican opposition to it.

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.

Hey all, I haven’t posted in awhile, so this is pretty shameless, linking to the Ames Progressive again. But we just published our September issue with a 4500-word feature on the medical marijuana debate in Iowa (the first Board of Pharmacy hearing on the science behind its medical value was held last week).

I know the site’s been following this, so check this out if you’re interested in a comprehensive overview of what’s going on. Cheers!

http://amesprogressive.org/200…  

The Iowa Board of Pharmacy on Tuesday refused to reclassify marijuana as a medication doctors can prescribe, but voted to hold public hearings on the issue.

A bill introduced last year in the Iowa Senate would have allowed not-for-profit facilities called “compassion centers” to acquire, cultivate and deliver marijuana and related supplies to qualifying patients. The bill never got out of subcommittee, but its sponsor, Sen. Joe Bolkcom, said Tuesday that the Legislature could approve some sort of legalization.

The Iowa City Democrat applauded the plan to hold statewide hearings. “Like with any issue, there’s a certain education process that needs to go on,” he said.

Sen. Merlin Bartz, a Grafton Republican who served on the subcommittee, opposed Bolkcom’s bill because he thought it offered too few controls. However, Bartz said he believes more legislators would support a medical-marijuana bill with the same kinds of tight regulations already in place on prescription painkillers and other addictive drugs.

When the Iowa Board of Pharmacy announces dates and locations for these public hearings, I will include them on my event calendars at Bleeding Heartland.

Iowa should not have to reinvent the wheel on medical marijuana. Presumably our legislators could adapt model language from statutes approved elsewhere.

Tony Leys of the Des Moines Register reported that the Board of Pharmacy’s resolution denying the request to reclassify marijuana also attacked Carl Olsen, who heads Iowans for Medical Marijuana. It cited Olsen’s various arrests on marijuana-related charges during the 1970s and 1980s.

Des Moines Register columnist Marc Hansen described the Board of Pharmacy’s reaction to Olsen as “overblown.” What bothers me is that board members seem to think Olsen’s personal history is relevant to the issue of whether marijuana should be classified as a drug so dangerous that Iowa doctors cannot prescribe it.

The Board of Pharmacy’s actions on this matter should not be influenced by members’ opinions about Olsen or his motives. Their job is to evaluate the evidence on whether marijuana has valid medical uses. Under certain circumstances, Iowa doctors already can prescribe narcotics that are more addictive than marijuana and have more harmful side effects.

The RAGBRAI riders are enjoying some relatively cool weather this week, although last night’s rain may have been unpleasant for campers. If you’re riding and have any anecdotes to share, post them here.

Details on other events going on around the state are after the jump. As always, post a comment or send me an e-mail (desmoinesdem AT yahoo.com) if you know of something I’ve left out.

Occasionally I put a river clean-up on these event calendars, so I wanted to let the Bleeding Heartland community know about this opportunity:

The Iowa Whitewater Coalition today announced the Clean Rivers Team Stewardship Program (CRTSP) — a mini-grant program to help fund local river clean-up activities across Iowa.

Any community group or organization in Iowa is welcome to apply for a grant from the CRTSP for the purpose of paying expenses related to river clean-up activities. Grants are limited to a maximum of $500.

Details are available at www.iowawhitewater.org and a Letter of Application may be submitted at any time to Iowa Whitewater Coalition, PO Box 65453, West Des Moines, IA 50265. Questions can be addressed by Peter Komendowski at 319-269-8493.

UPDATE: Added details on the Iowa Politics forum for Republican gubernatorial candidates (July 22) after the jump.

I mentioned in this post that it’s been a full year since the Iowa Smokefree Air Act went into effect. The public smoking ban was one of the most controversial bills considered during the 2008 legislative session, and advocates praised the law’s success at a press conference this week.

According to a recent Iowa Department of Public Health survey, 14 percent of Iowans smoke. In 2007, IDPH research estimated the smoking rate at 19 percent. That’s a significant decline, suggesting that around one-quarter of Iowans who smoked in 2007 have since quit. The $1 a pack tax hike on cigarettes approved in 2007 was probably a major factor in this trend as well.

The overwhelming majority of Iowa businesses are complying with the smoking ban, according to a June 30 press release from the IDPH. A little more than 1 percent of Iowa businesses with employees (1,015 to be exact) have received a “Notice of Potential Violation” from the IDPH. Of those, approximately half are bars and restaurants. I’m not surprised, since bar and restaurant owners were the smoking ban’s most vocal opponents (despite research showing that smoking bans do not hurt businesses in the hospitality industry). For those who want more details on compliance with the Smokefree Air Act, I’ve posted the IDPH press release after the jump.

Although some Democrats were angry that the legislature took on this issue last year, I’m proud to have supported the smoking ban at this blog for all the reasons I listed here.  

Health and Human Services Secretary Kathleen Sebelius issued reports on Friday detailing the problems with the “health care status quo” across the country. You can find the reports at HealthReform.gov. The report for Iowa is here, and I’ve also posted it after the jump. Among other things, it shows the percent increase in family health insurance premiums since 2000 and the percentage of uninsured Iowans.

A couple of points jumped out at me:

• Choice of health insurance is limited in Iowa. Wellmark BC and BS alone constitutes 71 percent of the health insurance market share in Iowa, with the top two insurance providers accounting for 80 percent.11

Iowa is not unusual in this regard. Most insurance markets in the United States are dominated by one or two companies. My family’s Wellmark premiums went up 10 percent this year alone. Speaking of which, the annual salary of Wellmark’s CEO has “nearly doubled” in the past five years to about $2.5 million.

• Choice is even more limited for people with pre-existing conditions. In Iowa, premiums can vary, within limits, based on demographic factors and health status, and coverage can exclude pre-existing conditions or even be denied completely.

I know a family in Des Moines who were unable to purchase health insurance at any price because the mother has a thyroid condition. They are now covered through the father’s employer, but if he loses his job they will have no health insurance options.

Two more reasons why we cannot settle for health care reform without a public option, or with a fake public option. I was glad to see several House Democratic caucuses affirm that they will fight any health care bill lacking “a real and robust public option that lives up to our criteria”.

Click “there’s more” to read the whole report, with supporting footnotes.

Following up on yesterday’s post, I see that a brand-new New York Times/CBS nationwide poll shows widespread support for a real public health insurance option. The wording of the question was clear: “Would you favor or oppose the government’s offering everyone a government administered health insurance plan like Medicare that would compete with private insurance plans?”

Results: 72 percent of respondents favored the public option, including 87 percent of Democrats, 73 percent of independents, and 50 percent of Republicans.

Senator Chuck Grassley works overtime to snuff out a public option, urging President Obama to support a bipartisan bill in the Senate. But in the real world, a strong public option has bipartisan support. Even half of Republicans favor making a “government administered health insurance plan like Medicare” available to all Americans.

A public option would increase competition and give Americans more choices while driving down costs. A recent report found that one or two companies dominate the health insurance market in most parts of the country.

Obama will speak to ABC News about health care on Wednesday. I’ll be listening carefully to see whether he endorses a strong public option, which the House Democrats’ draft bill contains, or whether he remains open to a fake public option such as regional cooperatives or a “trigger”.

UPDATE: To be clear, the CBS/NYT poll is not an outlier. An NBC/Wall Street Journal poll released last week found, “Three in four people said a public [health insurance] plan is extremely or quite important.” A poll “bankrolled partly by previous opponents of health care reform” showed that “a majority (53%) strongly back the availability of a public plan, while another 30% ‘somewhat’ support it.”

In April the Iowa State Board of Education approved new nutrition standards:

A special task force drew up the standards, which set limits on calories, fat content, sugar and other nutritional measures. Carbonated beverages are banned. Caffeinated beverages and sports drinks are banned in elementary schools.

But the rules do not apply to food provided by school lunch or breakfast programs, items sold at concession stands or certain fundraisers or items provided by parents, teachers or others for class events.

Although I would have preferred tougher guidelines, these rules were a step in the right direction. To be more precise, they would have been a step in the right direction. After protests from some school officials, the State Board of Eduation “delayed most of the standards from going into effect until the 2010-11 school year.”

By that time, the regulations may have been relaxed, judging from what happened last week in the state legislature’s Administrative Rules Review Committee (unofficial motto: “Where good rules go to die”). The rest of the story is after the jump.