Douglas Burns is a fourth-generation Iowa journalist. He is the co-founder of the Western Iowa Journalism Foundation and a member of the Iowa Writers’ Collaborative, where this article first appeared on The Iowa Mercury newsletter. His family operated the Carroll Times Herald for 93 years in Carroll, Iowa where Burns resides.

About 2,000 nurses in four Des Moines area UnityPoint Health campuses will vote early this month on whether to unionize their ranks for what leaders of the movement say will bring more bargaining power for salaries, benefits and working conditions through a proposed affiliation with the Teamsters Union.

Nurses are expected to vote December 7 to 9 on unionization at four UnityPoint locations: Iowa Methodist Medical Center, Blank Children’s Hospital, Methodist West Hospital, and Iowa Lutheran Hospital.

An affirmative vote would be a groundbreaking one in Iowa health care—and the union movement—as the Teamsters would represent nurses in non-profit hospitals, with the potential for organizing other health-care workers across a span of UnityPoint facilities in Iowa—and other medical centers in which health-care workers could be inspired by the Des Moines vote.

“We are fed up with UnityPoint whittling away at the things nurses need at the bedside,” said Alex Wilken, 39, a critical care nurse at Iowa Methodist Medical Center with more than a decade of experience.

Wilken is on the organizing committee for unionization with his nursing peers at the four centers.

“It isn’t just about pay,” Wilken said, adding that patient-staff ratios and safer working conditions are a big part of the push for what he believes will be more effective advocacy.

“The method we have here in the United States is to unionize,” Wilken said in a phone interview.

UnityPoint leaders say unionization is not in the best interests of the health-care network. UnityPoint management denied a request this summer for voluntary union recognition in workplace negotiations.

“At UnityPoint Health, we believe that direct collaboration is the foundation for building the strongest and most supportive environment for both our team members and the patients we serve,” UnityPoint officials said in a statement sent to Iowa Mercury. “For this reason, we believe that representation by an outside party is not in the best interests of our patients, our nurses or our community.”

Iowa Methodist Medical Center in Des Moines (photo By Douglas Burns of The Iowa Mercury)

Union organizers held a news conference and rally on December 2 in front of Methodist Medical Center (across from 1320 Center Street) where they called for an investigation into how UnityPoint funded any opposition to unionization. In a flyer promoting the event, nurses and union officials allege that UnityPoint spent $6 million to fight the organizing drive.

UnityPoint did not respond directly to questions on funding sources for any activity related to the union vote.

Sammi Ladd, 36, a critical care nurse at Iowa Methodist, said health-care workers are concerned that staffing and security levels are not high enough to deal with patient violence. Ladd was attached by a patient while pregnant and kicked a few years later by another patient.

“I’ve seen my co-workers and friends get strangled by patients,” Ladd said.

Ladd expects the nurses to vote for unionization. The vote is managed by the National Labor Relations Board.

“I do truly think this is something that will go through,” Ladd said in an interview. “I do think this something that our community, Iowa, and nurses, deserve.”

Alano De La Rosa, the principal officer for Teamsters Local 90, which includes the Des Moines area and reaches into many other Iowa counties, said nurses will be able to negotiate with the full force of the Teamsters Union behind them. This includes a $400 million national strike fund, he said.

UnityPoint is clearly worried that the union effort with nurses at the four medical centers in the Des Moines could spread to their other facilities and staffing sectors, De La Rosa said.

“I believe it would have been considered by UnityPoint when they started cutting millions of dollars in checks to union busters,” De La Rosa said.

De La Rosa said the Teamsters Union has experience representing nurses and health-care workers.

“They are very big-hearted and they want to help everybody around them,” he said.

The vote is coming two months later than originally scheduled as as the federal government shutdown forced a postponement of a vote that had been set for early October.

Editor’s note from Laura Belin: Alex Wilken discussed the organizing drive on Julie Gammack’s Iowa Potluck podcast on December 1. The conversation is worth your time; several participants asked excellent questions, grounded in their experience with labor unions or working in the health care sector. You can watch that video here.

Richard Lindgren: A “Mars-on-Earth New City” project is far easier to do, much cheaper, and with much more immediate societal benefit if you pick a spot in America’s struggling heartland. -promoted by Laura Belin

So, I have watched the bizarre unpiloted, billion-dollar carnival ride that took Jeff Bezos into the barest edge of “space.” We are looking at spending more billions of dollars as a collective society to pursue a goal of living on the moon or Mars, for some just for the pursuit of scientific knowledge, but also because some fear that a future Earth may cease to be inhabitable.

Here is a simple brain game: What if we pretended that some place on Earth with challenges to daily habitability is a viable way-station for Mars, and spend our research dollars there instead? I nominate rural southern Iowa, where storm clouds hover over the future. I’m serious.

Rachel Bruns continues a series of posts addressing the quality of maternal health care in Iowa. -promoted by Laura Belin

My first post here addressed a number of outdated and non evidence based practices that continue in Iowa. My second post addressed how expanding access to midwives could help improve access to quality care, reduce the incidence of cesareans, and save lives.

This post will continue on those themes addressing additional practices of concern surrounding cesareans and vaginal birth after cesarean (VBAC).

Gwen Hope unpacks the economic and social possibilities that accompany legalizing cannabis, demystifying the oft-maligned psychoactive plant. -promoted by Laura Belin

Since the middle of the 20th century, cannabis has been a hot button issue, particularly since the Nixon Administration began the War on Drugs. Often political, the criminalization and demonization of the plant and substances derived from it has a complex, but living history in the United States.

A microcosm of the country incarnate, this issue is attached to almost every other issue and stance imaginable: from political party to patriotism, convention to community, race to religion, humanity to harm, morality to medicine, and everything in-between was and is attached to cannabis – the United States’s most popular illicit substance.

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.

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.

President Barack Obama has instructed the Health and Human Services department to develop new rules for hospitals that receive Medicare or Medicaid funding.

The memorandum from Obama to HHS Secretary Kathleen Sebelius, made public late Thursday night, orders new rules that would ensure hospitals “respect the rights of patients to designate visitors.”

Obama says the new rules should require that hospitals not deny visitation privileges on the basis of sexual orientation or gender identity.

“Every day, all across America, patients are denied the kindnesses and caring of a loved one at their sides whether in a sudden medical emergency or a prolonged hospital stay,” Obama says in the memo.

Affected, he said, are “gay and lesbian American who are often barred from the bedsides of the partners with whom they may have spent decades of their lives — unable to be there for the person they love, and unable to act as a legal surrogate if their partner is incapacitated.”

Cue conservatives to start whining about “special rights for homosexuals,” as if there is something extraordinary about visiting a loved one in the hospital or granting your life partner power of medical attorney. I’m glad the president took a stand on this issue.

I’m curious to see how the U.S. Conference of Catholic Bishops reacts to this executive order. I don’t know whether Catholic hospitals are more likely to have rules in place preventing visitation by gay or lesbian partners, but I would expect religious conservatives to complain about the government nullifying such rules. I wonder whether there is even grounds to challenge Obama’s order in court, if hospitals could demonstrate that their visitation bans are grounded in religious principles.  

The Iowa Legislature has been moving at an unusually fast pace during the shortened 2010 session. It’s time to catch up on what’s happened at the statehouse over the past three weeks. From here on out I will try to post a legislative roundup at the end of every week.

February 12 was the first “funnel” deadline. In order to have a chance of moving forward in 2010, all legislation except for tax and appropriations bills must have cleared at least one Iowa House or Senate committee by the end of last Friday.

After the jump I’ve included links on lots of bills that have passed or are still under consideration, as well as bills I took an interest in that failed to clear the funnel. I have grouped bills by subject area. This post is not an exhaustive list; way too many bills are under consideration for me to discuss them all. I recommend this funnel day roundup by Rod Boshart for the Mason City Globe-Gazette.

Note: the Iowa legislature’s second funnel deadline is coming up on March 5. To remain alive after that point, all bills except tax and appropriations bills must have been approved by either the full House or Senate and by a committee in the opposite chamber. Many bills that cleared the first funnel week will die in the second.  

I was going to comment on desmoinesdem's snow link story, but I decided to write my first diary instead…here she is:

Many on the left might be feeling depressed right now.  After all, this filibuster proof majority in the Senate is not really helping that much, and health care is seemingly being excessively watered down.

However, Democrats should not be overly depressed.  They have effectively shut down the voices of the Republican Party in Washington, save Olympia Snowe.  Isn't that what the supermajorities were all about?

Furthermore, according to President Obama, the public option is not everything.  I know many folks believe that it is, but there are many reforms in this bill that, if voted on by themselves, would easily receive over 80 votes in the Senate (i.e. they're popular and good policy).  Plus, if a bill does pass before the State of the Union address, even a sub-par one, President Obama can use that platform to boast, and tell us all about the wondrous portions of the health care reform that the Democrats alone passed through Congress.

I'm sure it'll be quite a speech.

As for the public option, moderate Democrats are quite the thorn in the side of the Democratic leadership.  It's kind of a Catch-22, though, as we can see in the following conversation:

Senator Lieberman: “The public option is a huge deal!”

President Obama:  “Look, Joe, the public option is only a small part of reform.  As such, if it's such a small portion of reform, why would you sink all of health care just to stop the public option?”

Lieberman: “Oh…it's only a small part of reform?”

Obama: “Yes…didn't you hear my speeches over the last 3 months?”

Lieberman: “Great…so if we get rid of the public option, it really won't harm reform that much…after all, it's only a small part of reform.”

Moderate Dems are probably thinking one of two things.

1.         If this PO is huge, then I’m justified in opposing it…more govt, more spending, my constituents don’t like it, yada yada yada

2.         If this PO is not huge, then I’m justified in opposing it…why are we fighting over something so small?

Some may disagree with their logic and/or facts, but the situation remains.

I'm willing to declare that the “public option” will be one of the following four options:

1.  The idea that was floated yesterday was of Medicare 55-65.  Although it could be problematic, politically.  thereisnospoon had a diary that speaks to that yesterday.  Interesting points.

http://www.dailykos.com/story/2009/12/7/811763/-Just-Forget-About-Me

2.  The good ole' Snowe trigger.  Many on the left believe that this is actually designed never to trigger.

3.  This OPM buy-in, so people can purchase federal insurance…although, many people are saying that it's not a real public option.

4.  Some sort of Opt-In public option…which probably would not be as robust as an Opt-Out, considering the nature of it.

Another big question is, if the final PO is one of these four options, is an individual mandate a political winner for the Democrats?  I’d have to say no.  desmoinesdem seemed concerned about it today too.  Why alienate younger voters?

The political play-out of this has been fascinating, and rarely do we have a time in American politics where we truly do NOT know the outcome.  We’ll see how it plays out.  Of these four options, or a fifth that I may have overlooked, what would be the best from a policy standpoint?  A political standpoint?

Something I just realized, from reading about the tightening results in NY-23 – prior to the two special elections, Pelosi had literally a one vote margin on the health care. From the article:

Before Owens was sworn in Friday, Rep. John Garamendi, a Democrat who won a special election in California, was sworn in Thursday. The two gave Pelosi the votes she needed to reach a majority of 218 and pass the historic health care reform legislation in the House.

The bill passed 220-215 late Saturday with the support of only one Republican. The Republican, Rep. Anh “Joseph” Cao of Louisiana, said he voted for the legislation only after seeing that Democrats had the 218 votes needed for passage.

This isn’t quite right; with both special election seats vacant, 217 would have provided a majority. If both seats had been claimed by opponents of health care, Pelosi could have held the vote before seating the new representatives. Without their two votes and without counting Cao, this would have left her with exactly 217 votes. Wow.

 (crossposted from Daily Kos) 

Yesterday, I saw our problem first hand. We are in a world of trouble, people.

Mobs are powerful and wholy beyond reason. Yet, they must be stopped, because they are extremely dangerous. There are a lot of very angry, very frightened people out there, and about 150 of them turned out on a Wednesday afternoon to harass Senator Tom Harkin, shout incoherent political slogans (the same ones that have been diaried to death here in the last week), and to let him know that they are very angry about the idea of government in general and government health care in particular. The total crowd was limited to about 210 by the fire code. 

Yesterday I posted information about some of the town-hall meetings that Iowans in Congress will hold during the next two weeks. You can also find Representative Steve King’s town-hall meeting schedule here and Representative Tom Latham’s schedule here.

If you attend any of these meetings, please take detailed notes and/or record the event if you can. Although local media will cover the story, journalists may not highlight every noteworthy comment. Senator Chuck Grassley’s infamous advice to a constituent seeking affordable health care was a sensation on YouTube and various political blogs before Iowa newspapers reported the story. I noticed that Daily Kos user clammyc used part of that clip in a video about the need for health care reform:

This diary by Daily Kos user ShadowSD contains lots of good links and talking points for you to use at town-hall meetings. Whether or not you get to ask a question, please consider posting a diary here with your impressions of the event. First-person accounts are usually a good read.

In general, I’d like to see more Bleeding Heartland readers writing diaries for this blog. Pieces with news or substantive analysis may be promoted to the front page.

Final note about this month’s town-halls: Rarely do I agree with Iowa GOP chairman Matt Strawn, but it is lame that Leonard Boswell hasn’t scheduled a health care public meeting in Polk County this month, or in any town that’s part of the Des Moines media market. If any Bleeding Heartland readers do attend Boswell’s scheduled “listening post” in Sigourney on August 13, please ask some specific questions about the kind of public health insurance option he supports. You might also want to note that rural Iowans would particularly benefit from a public option.

LATE UPDATE: I was wrong to criticize Boswell for not scheduling a health care event in the Des Moines area this month. On August 13 his office announced a town-hall on health care to be held on August 23 from 3 pm to 4 pm at the AIB College of Business Activities Center, 2280 Bell Avenue in Des Moines. RSVP by calling Congressman Boswell’s Des Moines office at 515-282-1909, or emailing boswellrsvp@mail.house.gov.  

Iowa Citizens for Community Improvement is holding its annual convention this Saturday, July 18, at the Hotel Fort Des Moines:

Iowa CCI’s statewide annual convention will feature workshops and plenary sessions on factory farming, campaign finance reform, immigration reform, and predatory lending. The convention will conclude with an exciting direct action targeting an undisclosed payday lender in a low-income community in  Des Moines.

More details on that and other events coming up soon are after the jump.

As always, please post a comment or send me an e-mail (desmoinesdem AT yahoo.com) if you know of another event I’ve left out.

To Bleeding Heartland readers who plan to do RAGBRAI next week: consider posting a diary about your experience or any candidates you encounter during the ride. I saw this at Bob Krause’s campaign site:

Eric Rysdam of  Fairfield, Iowa has agreed to ride across the state in  RAGBRAI, The Register’s Annual Great Bicycle Ride Across Iowa with a big Krause banner and shirt. Eric will be the core of an amorphous group participating and getting the word out about for us! Please wish Eric well with his training in anticipation of the July 19-25 event! Eric’s number is 319-293-6306 if you want to wish him well, or if you want to be on the ride with him.

There has been a lot of talk this week about the surprising move by Walmart to publically support President Obama’s health care reform plan, supposedly positioning themselves as a

leader in the fight to bring health care to all Americans. As we mentioned in a post on our blog

yesterday, this might be easier to swallow if Walmart had any history of leading by example. Instead, they usually do just the opposite.

Given

Walmart’s long record of trying to build a positive

reputation on ineffective work-arounds to health care coverage

for employee, the recent revelations about sacrificing quality for cheap perescription drugs, and their deceptive PR campaign that severely overstated their workers’ health

care coverage, it’s not hard to understand our skepticism. [get the details in the extended entry]

July 1, 2009 is a big day: the 4,800 residents of Windsor Heights are no longer divided by three zip codes. It couldn’t have happened without Congressman Leonard Boswell’s legislative efforts last year, and that probably wouldn’t have happened without Ed Fallon’s primary challenge. (Note: WHO’s Dave Price attended last night’s event celebrating our new zip code.)

Don’t feel left out if you’re among the 3 million Iowans who aren’t enjoying the good life in our state’s only inner-ring suburb. You too may be affected by one of the many laws that take effect today.

The Iowa House Democrats posted a partial list of these laws on their site, and Jason Hancock provided additional information at Iowa Independent, such as the margin by which these bills passed during the 2009 session. Many won unanimous approval or overwhelming bipartisan majorities in one or both chambers.

Most of the new laws are steps in the right direction for Iowa: increased foreclosure protections; $30 million in historic tax credits; expanded health care for children, low-income pregnant women and adult children under 25; broader eligibility for wind energy tax credits; more job protection for volunteer emergency providers, electronic logbooks to track pseudoephedrine sales. A few of the highlights on the House Democrats’ list deserve additional comment.

New rules for sex offenders: I’m glad that legislators replaced pointless sex offender residency restrictions that did nothing to protect children from predators, according to prosecutors as well as advocates for exploited children.  Too bad nobody listened to State Representative Ed Fallon, who was the only legislator to vote against the 2002 law and got bashed for that vote during his primary challenge against Boswell (see also here). Speaking of campaigns, Chris Rants was one of only three state representatives to vote against the new sex offender law. Will he make this an issue in the gubernatorial race?

Manure application during winter: On principle I think it’s a bad idea for legislators to interfere with the rulemaking process at the Department of Natural Resources. However, amendments greatly improved this bill from the version that passed the Iowa Senate. In fact, the new law includes tougher restrictions on liquid manure application than the rules that the DNR would have eventually produced. It’s important to note that these restrictions only apply to manure from hogs. Cattle farmers face no new limits on what to do with solid manure during winter.

Consumer fraud protections: Iowans rightly no longer need permission from the Attorney General’s Office to sue some types of businesses for fraud. Unfortunately, this law contains an embarrassingly long list of exemptions.

Nursing home rules: It’s pure chutzpah for House Democrats to write, “Nursing homes will face higher fines for incidents resulting in death or severe injury.” More like, nursing homes will no longer be fined for the violations most likely to result in death or severe injury, but are subject to higher fines for offenses regulators never charge anyone with.

Let’s end this post on a positive note. The septic tank inspection law approved during the 2008 session also takes effect today. Over time these inspections will reduce water pollution produced by unsewered communities in Iowa. Credit goes to the legislators who approved this bill last year and to Governor Chet Culver. He wisely used his line-item veto to block State Senator Joe Seng’s attempt to sneak a one-year delay of the septic tank inspections into an appropriations bill.

This thread is for any thoughts about Iowa’s brand-new laws. Probably none of them will be as controversial as the public smoking ban that took effect on July 1, 2008.

Walmart, in one of their worst ways of prioritizing prices above qualities to date, turns to a foreign drug supplier, Ranbaxy Laboratories, LTD, who has repeatedly been investigated by the FDA and the DoJ for “inadequate” safeguards against contamination, falsification of records and submitting false information to the FDA.  

On top of that, just eight months before the FDA inspected Ranbaxy's Paonta Sahib plant and found significant violations, Walmart awarded the company a “Supplier Award” for improving shipping times and performance.

In a new report on our website, we detail their multi-year spanning violations, DoJ investigation, Congressional Investigation, and list out all of the drugs made at the facility in questions.  Additionally, we detail their recent violations below.

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.”

I found some unintentional comedy in this AP story on Judge Sonia Sotomayor’s one-on-one meetings with senators:

Sotomayor has managed to disarm even senators who came prepared not to like her. Sen. Charles E. Grassley, an Iowa Republican, went in thinking “she would be aggressive and maybe even a little obnoxious.”

“I would classify her as kind of much friendlier … more reserved, less aggressive,” than he expected, Grassley told reporters later.

I wonder why Grassley thought Sotomayor would be “aggressive and maybe even a little obnoxious.” Would he expect that of any high-achieving Puerto Rican woman from New York, or only one who had been on the receiving end of a hatchet job in The New Republic? Or maybe he was taken in by right-wing commentators’ caricatures of Sotomayor.

Anyway, it’s safe to say that Sotomayor’s personality wasn’t the reason Grassley voted against her confirmation to the 2nd Circuit Court of Appeals. He’ll have to keep trying to remember why he cast that vote in 1998.

By the way, the Democrat who’s running against Grassley next year, Bob Krause, has his campaign website up and is on Twitter @KrauseForIowa. He plans to campaign hard against Grassley’s opposition to universal health care with a public option.

Congressman Leonard Boswell still supports a health care reform bill containing a public option that would go into effect immediately, Boswell’s spokesman Mark Daley confirmed today via e-mail.

Background and details are after the jump.

Senator Chuck Grassley didn’t take kindly to President Barack Obama’s weekly radio address about the need to accomplish health care reform this year. Early this morning, Grassley wrote on his Twitter feed,

Pres Obama you got nerve while u sightseeing in Paris to tell us”time to deliver” on health care. We still on skedul/even workinWKEND.

A little later, the senator Tweeted,

Pres Obama while u sightseeing in Paris u said ‘time to delivr on healthcare’ When you are a “hammer” u think evrything is NAIL I’m no NAIL

First of all, Obama recorded the weekly address before leaving for France. Second, it’s bizarre for Grassley to mock Obama’s “sightseeing in Paris,” as if that were the main purpose of his foreign visit. You can be sure that if Obama had not gone to France to commemorate the D-Day invasion, Republicans would be howling in protest.

Perhaps Grassley is venting because this week the president strongly affirmed his support for a public option in health care reform. Grassley has been working to forge a bipartisan consensus with no public option and published an op-ed in the Iowa City Press-Citizen on Friday warning against that approach. (Chase Martyn’s take on Grassley’s piece is worth reading.)

Or maybe Grassley’s just a little touchy lately. He wrote a letter to the editor of the Des Moines Register correcting a mistake from the Register’s vox-pop feature, “My 2-cents’ worth”:

In the Register’s Your 2 Cents’ Worth feature May 4, “Disgusted 50010 Woman” said I pay $40 a month for health insurance. In fact, I pay $356 a month for Blue Cross insurance coverage, a plan that is available to federal employees. This differs from health plans for state government employees in Iowa, where no portion of the premium is paid by the employee. There’s no basis for the assertion in her comments.

Fair enough, senator. But you have to admit, you’ve got a pretty good deal going. A couple half your age who purchase their own Blue Cross insurance plan could easily pay two or three times as much in premiums for comprehensive coverage. Even a bare-bones policy covering primarily catastrophic care could cost individuals more than $356 a month, and they’d have to pay out of pocket for most routine medical expenses and prescription drugs.

Natasha Chart recently looked into her health insurance options as a single 34-year-old woman. If she can afford it, she’ll pay $200 to $300 a month for less coverage than what members of Congress receive. I encourage Senator Grassley to read her post.

UPDATE: Greg Sargent received clarification from Grassley’s office about what the senator meant to convey in the hammer/NAIL tweet:

Senator Grassley has been urging the President to let the legislative process work so that health care reform legislation restructuring 17 percent of America’s economy will reflect broad consensus and garner bipartisan support from as many as 80 senators.

Still pushing the pipe dream of a large bipartisan majority for health care reform.

I got so busy this month that the event calendars fell by the wayside. After the jump I’ve posted details about lots of things going on this week and next.

As always, please post a comment or send an e-mail (desmoinesdem AT yahoo.com) if you know of something I’ve left out.

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.

Senator Chuck Grassley laid out his case against a “government-run” health care plan on the Senate floor yesterday. He used some of the same arguments he’s been making in conference calls with reporters and in his guest editorial at Politico.

I don’t know whether Grassley and the insurance lobby will be able to scare Senate Finance Committee Chairman Max Baucus away from supporting a public health insurance option.

However, after reading the highlights from recent opinion research that Richard Kirsch summarized at the Health Care for America Now blog, I am confident that the American public will not buy rehashed Republican talking points from 1993. For more on this point, follow me after the jump.

Iowa Independent posted a piece by Congressional correspondent Mike Lillis today: “Grassley leaves door open for government health care plan.” Lillis was on Grassley’s conference call with reporters today and heard the senator say this about a public health insurance option:

I think right now there’s a lot of people, including me – I’d prefer it not to be in [the bill]. Then there’s a lot of people that say, well, it’s got to be in or [there’ll be] no bill. And then there’s a dozen ways to look at possible compromises. And I think before I would write [it] off completely, I would want to look at what those possible compromises are.

I do not interpret this comment as a sign that Grassley is open to a government health plan. It sounds to me like he is working with Senate Finance Committee Chairman Max Baucus on a compromise that might be called a “public plan” but would not force private insurers to compete against a government plan like Medicare for All.

As Bleeding Heartland user ragbrai08 has noted, lots of things that could be characterized as a “public option” fall short of what we need.

Perhaps Americans would be allowed to buy into the health insurance program for federal employees, which is provided by various private insurance companies.

Lillis noted that during today’s conference call, Grassley suggested the federal government is not competent to “run a government-run health insurance plan in competition with the private sector […].” I read this to mean that Grassley is still working overtime to keep a public health insurance option out of the Senate’s health care legislation.

Here’s hoping Senate Democrats who understand the need for a public option are able to prevail with Baucus.

The White House is making a huge deal out of a commitment to introduce cost-saving measures from “the presidents of Pharma, Advamed (device manufacturers), the American Medical Association (doctors), the American Hospital Association, America’s Health Insurance Plans, and SEIU’s Health Care project.”

The White House arranged an urgent Sunday-afternoon conference call with reporters to break the news, and President Obama went on tv on Monday to talk about it. (Click here for the transcript of Obama’s televised remarks.)

Unlike the 1970s, when stakeholders’ promises to hold down costs derailed legislative action on health care, Obama made clear today that the current agreement on savings is “complementary to and is going to be completely compatible with a strong, aggressive effort to move health care reform through here in Washington [….]”

It’s too early to know how significant today’s announcement will be, so I’m laying out the cases for optimism and pessimism after the jump.

Congress is getting to work on the details of health care reform, and a major battleground will be whether to include a strong public health insurance option for all Americans.

Republicans like Senator Chuck Grassley are revving up their scare tactics about “government-run” health care. Coalitions of Democrats who back a public option are also taking shape in the House and the Senate.

The new Populist Caucus led by Congressman Bruce Braley (IA-01) has yet to weigh in on the specifics of health care reform. That needs to change soon if Braley is serious about turning this caucus into a voice for the middle class in the House.

More thoughts on this subject are after the jump.

As the ranking Republican on the Senate Finance Committee, Senator Chuck Grassley will influence the shape of health care reform. For that reason, he and Senate Finance Committee Chairman Max Baucus of Montana were invited to lunch at the White House on Wednesday with President Barack Obama and Vice President Joe Biden.

Grassley’s message to the president and vice president, as well as to every journalist who’ll listen, is that health care reform should be done through a bipartisan bill that can receive 70 or 80 votes in the Senate. (See also Grassley’s recent guest editorial at Politico.)

Many Democrats want to include a health care bill in the budget reconciliation process, which would prevent a Republican filibuster. Grassley warns that it would be a mistake to reform such a large part of the U.S. economy without broad support from members of Congress in both parties.

After the jump I’ll explain why Grassley is wrong, wrong, wrong about health care reform.

Congress will begin making important decisions on health care policy very soon. The Senate Finance Committee began drafting a health care bill a few days ago.

I was glad to see two Iowans among the representatives and senators who urged colleagues this week to include a strong public option in any health care reform plan.

After the jump I have more on where Congressman Dave Loebsack and Senator Tom Harkin stand on health care, as well as the benefits of creating a public health insurance option.

UPDATE: Thanks to Populista for reminding me that all Iowa Democrats in Congress (Bruce Braley, Dave Loebsack, Leonard Boswell and Tom Harkin) have signed on to support Health Care for America Now’s core principles for health care reform.

Iowa Independent reports that Senator Arlen Specter’s decision to become a Democrat leaves Iowa’s own Chuck Grassley with a difficult choice. He is currently the ranking member of the Senate Finance Committee, but with Specter’s departure he appears to be first in line to become ranking member of the Senate Judiciary Committee instead. According to Iowa Independent,

GOP conference rules forbid him from serving as ranking member of both panels at the same time, a Senate aide said Tuesday. Theoretically, he could get a waiver to serve on both, but that’s unlikely, the aide said.

So very shortly, Grassley has a tough choice to make: Either he can remain the senior Republican on Finance – a powerful spot this year with comprehensive health reforms looming, but also a position he’ll have to give up at the end of 2010 because of GOP term-limit rules – or he can accept the top GOP spot on Judiciary.

Judiciary will consider many important matters this year and next, possibly including a Supreme Court nominee. However, if I were Grassley I would stay at Finance for sure.

President Barack Obama wants health care reform to happen this year and is willing to use the budget reconciliation process to make it happen. The health care reform bill may become one of the most important pieces of legislation this decade. By all accounts Grassley has a strong working relationship with Senate Finance Committee Chairman Max Baucus.

I don’t think Judiciary will consider anything of comparable importance this year, and I doubt Grassley and Senate Judiciary Committee Chairman Pat Leahy would quickly develop the same kind of rapport Grassley has with Baucus.

At the end of 2010, Grassley’s term as ranking member of Finance will be up, and he can choose whether to become the ranking member of Judiciary or Budget. He has expressed a preference for Judiciary in the past.

If you were Grassley, would you take the chance to become the ranking member at Judiciary this year? If Grassley did give up his current position, it appears that Orrin Hatch would become the ranking member at Finance.

By the way, David Waldman reported yesterday at Congress Matters that Specter’s switch throws off the Judiciary Committee’s ratio of Democrats and Republicans. A new Senate organizing resolution will have to be adopted, and Democrats may use that opportunity to secure more seats on the Senate committees.

UPDATE: Grassley’s press secretary Beth Pellett Levine told me on Wednesday that the senator has not made any statement about whether he would consider becoming the ranking Republican on the Judiciary Committee.

I receive notices for many upcoming events I’m unable to attend, even though they would provide good material for a post at Bleeding Heartland.

Health Care for America Now has scheduled forums across the country this spring, including three in Iowa during the next month. The forums in Ottumwa and Sioux City will focus on rural health care reform and are co-hosted by the Center for Rural Affairs, Iowa Farmers Union, Iowa Citizen Action Network, Working Families Win, and Health Care for America Now Iowa.

The organizers are willing to accredit someone to cover each Iowa event for Bleeding Heartland. Please send me an e-mail (desmoinesdem AT yahoo.com) or post a comment in this thread if you are interested in attending one of these forums, taking notes and posting a diary about it later.

Wednesday, April 15 from 5:00 PM – 6:00 PM

Host: Charlie Wishman

Location: Ottumwa Public Library, 102 W 4th St in Ottumwa. Click here for more event information.

Wednesday, April 22 from 6:00 PM – 7:00 PM

Host: Charlie Wishman

Location: Western Iowa Tech, 4647 Stone Ave in Sioux City. Click here for more event information.

The Des Moines event is a longer symposium on what needs to be done to get health care reform passed in 2009. Co-sponsors include Health Care for America Now, the 1st Unitarian Church, RESULTS, AFSCME Council 61, and Every Child Matters.

Saturday, May 2 from 12:00 PM – 4:00 PM

Host: Charlie Wishman

Location: 1st Unitarian Church, 1800 Bell Ave in Des Moines. Click here for more information.

I’ll post a more detailed calendar of events this week later today or this evening.

This thread is for any comments about health care reform or good organizing work going on around Iowa.

This morning as you read this there are many so called godly Iowans sitting in the pews of their respective churches listening, and participating in, blame and judgment. Compounding fears of the demise of our state, country, and families, because the Iowa Supreme Court upheld rights for all Iowans, not just the ones that meet their criteria.

Hypocrite : a person who puts on a false appearance of virtue or religion

Pharisee:a self-righteous or sanctimonious person

According to the Holy Bible they  use to interpret the laws of our country Jesus would have deemed them Pharisees.

There are many Iowans who are religious and their actions convey their deep level of spirtuality.
Sadly, there were many Iowans this week who showed their hypocrisy and fear based drive to discriminate against one group of people.

A few days ago Chris Bowers reported welcome news from the progressive wing of the Democratic delegation in the U.S. House of Representatives. He posted a letter to House Speaker Nancy Pelosi from the co-chairs of the Progressive Caucus:

Dear Madam Speaker and Majority Leader,

Regarding the upcoming health care reform debate, we believe it is important for you to know that virtually the entire 77-Member Congressional Progressive Caucus (CPC) prefers a single-payer approach to healthcare reform.  Therefore, it will come as no surprise as you work to craft comprehensive health care reform legislation, that we urge the inclusion of a public plan option, at a minimum, in the final legislation.  We have polled CPC Members and a strong majority will not support legislation that does not include a public plan option that is supported on a level playing field with private health insurance plans.

We look forward to working with you to ensure inclusion of a public plan option and the successful passage of healthcare legislation that will provide a choice of  quality healthcare for all Americans

Sincerely,

Lynn Woolsey, Co-Chair, Congressional Progressive Caucus

Raul Grijalva, Co-Chair, Congressional Progressive Caucus

Many arguments lie ahead regarding what kind of public option would be acceptable as a compromise. Like most members of the Progressive Caucus, I would prefer an option for Americans to buy into an existing government-run program such as Medicare. Presumably corporate Democrats will be pushing for no public option or at best for allowing Americans to buy into the federal employees’ health insurance plan, which is provided by various private insurers.

I am glad to see progressive leaders warn that they will not support a Massachusetts-style health care reform, with a mandate for individuals to purchase private health insurance. There must be a public option.

Congressman Dave Loebsack is the only Iowan in the House Progressive Caucus and the only Iowan among the co-sponsors of HR 676, the single-payer health care bill. I am seeking comment from his office about whether he would reject any health care reform bill that does not include a public option.

Although Congressman Bruce Braley is not a co-sponsor of HR 676, I would think that fighting for a strong public option on health insurance would be a natural position for his Populist Caucus to take. I will seek comment from his office on this matter and write a follow-up post later this week.

The U.S. House of Representatives approved President Barack Obama’s proposed $3.55 trillion 2010 budget on Thursday by a vote of 233 to 196. As you can see from the roll call, all three Democrats representing Iowa voted for the budget: Bruce Braley (IA-01), Dave Loebsack (IA-02), and Leonard Boswell (IA-03). Every House Republican voted against Obama’s budget, including Tom Latham (IA-04) and Steve King (IA-05).

Twenty House Democrats joined Republicans in voting against the budget (Dennis Kucinich plus a minority of the Blue Dog caucus). But it’s notable that most Blue Dogs, like Boswell, supported this budget. Obama has met twice with the Blue Dog caucus this year, most recently on March 30.

House Republicans offered an alternative budget proposal with all kinds of crazy ideas in it, like privatizing Medicare, giving the wealthy more tax cuts, and freezing most non-defense discretionary federal spending. As you can see from the roll call, Tom Latham was among the 28 Republicans who joined House Democrats in voting down the GOP budget alternative. Steve King was among the 137 Republicans who voted yes.

White House officials were right to mock the GOP’s budget alternative as a “joke.” Freezing federal spending is a good way to turn a severe economic recession into a depression.

Soon after the House budget vote, I received press releases from the Democratic Congressional Campaign Committee slamming Latham and King for voting against a wide range of tax cuts contained in the budget resolution. I’ve posted those after the jump.

I suspect that the the DCCC is not putting out statements attacking the House Democrats who voted against the budget, and I’m seeking a comment from their communications staff about whether my hunch is correct. DCCC chair Chris Van Hollen warned on Thursday that liberal groups supporting primary challengers against unreliable House Democrats could cost the party seats in 2010. I wonder why we are supposed to look the other way when members of our own party take positions that the DCCC finds atrocious in House Republicans.

Meanwhile, the U.S. Senate approved a 2010 budget resolution late on Thursday after a nearly 12-hour marathon of votes on various amendments. David Waldman (formerly known as Kagro X) gives you the play-by-play from yesterday’s Senate action at Congress Matters. The final vote in the Senate was 55-43 (roll call here). Iowa’s Tom Harkin voted yes, along with all Senate Democrats except for Evan Bayh of Indiana and Ben Nelson of Nebraska, who voted with Republicans, and Robert Byrd of West Virginia, who did not vote. The 41 Senate Republicans, including Iowa’s Chuck Grassley, voted no.

CNN went over the key similarities and differences between the House and Senate budget resolutions. Most important difference, in my opinion:

[House Democrats] also included language that allows for the controversial procedure called “budget reconciliation” for health care, a tool that would limit debate on major policy legislation.

Senate Democrats did not include reconciliation in their version of the budget. The matter is guaranteed to be a major partisan sticking point when the two chambers meet to hammer out a final version of next year’s spending plan. If it passes, it would allow the Senate to pass Obama’s proposed health care reform without the threat of a Republican-led Senate filibuster.

Notably, both the House and Senate budget bills “do away with Obama’s request for an additional $250 billion, if needed, in financial-sector bailout money.” Thank goodness for that.

Any comments or speculation regarding federal tax or spending policies are welcome in this thread.

The phone rang early Tuesday evening, and the voice on the other end was an interviewer conducting a survey for Hill Research Consultants. I asked who commissioned the survey, but the interviewer said he didn’t know.

Judging from the type of questions and their wording, I assume this poll was commissioned either by a Republican considering a run for governor in 2010, a Republican interest group trying to decide what kind of candidate to support for 2010, or the Republican Party of Iowa itself.

As I always do whenever I am surveyed, I grabbed a something to write with and took as many notes as I could about the questions. However, it was a long poll and there was commotion in the background on my end, so I know I didn’t get all the questions down. If you have been a respondent in the same survey and can fill in some blanks, please post a comment in this thread or e-mail me (desmoinesdem AT yahoo.com).

My notes on the questions asked during this 15-20 minute survey are after the jump. These are paraphrased, but I tried to remember the wording as closely as I could. I don’t know whether the order of the suggested answers was the same for everyone, but since this sounded like a real poll, I assume the order of multiple-choice answers was rotated.

I haven’t had a chance to watch today’s White House regional forum on health care yet (the Des Moines Register made the video available here).

According to the Des Moines Register, Senator Tom Harkin promised that health care reform will not fail this time:

“This is not something that we’re going to kick the ball down the field,” he said. “This is going to happen this year.”

The Register noted that some people at the forum favored single-payer health care reform, while others would like to see only small incremental changes. Protesters supporting a single-payer system gathered outside the forum too. I agree that single-payer makes the most sense for all kinds of reasons, but President Barack Obama will not seek that change, and Congress will not pass it. I’m willing to settle for a compromise that includes a strong public-insurance option.

Obama’s representative at today’s forum expressed optimism about finding an acceptable compromise:

Nancy-Ann DeParle, the leader of Obama’s health-reform effort, said past health-reform debates saw too many people who were wedded to specific plans. They wouldn’t compromise if they couldn’t get everything they wanted, she said. “Their fall-back position was always the status quo.”

This time, she said, people seem more willing to listen to other people’s ideas and find compromises.

Prospects for passing universal health care reform will depend on large part on whether the bill is subject to a filibuster in the U.S. Senate (meaning it would need 60 votes to pass). Obama reportedly wants to include health care reform in the budget process, so that it could pass with only 51 votes.

Chris Peterson, president of the Iowa Farmers Union, talked about health insurance for rural Americans at today’s forum:

“Rural Iowans struggle with finding affordable insurance. Even solidly middle class farmers are feeling the pinch. Nearly one in eight Iowa farmers battle outstanding health debt,” Peterson said. “I am one of them.”

Peterson, who is 53, was kicked off his private insurance plan about two years ago for what the company said was a preexisting condition. Peterson and his wife, who has no private insurance either, have accumulated $14,000 in medical debts in the past two years. “The health care system in this country is dysfunctional and burdensome,” Peterson said of the private insurance industry. “…Personally, what I’ve been through, it seems at times it’s a ponzi scheme — they’re taking your money — or (it’s) just the robber barons pulling money out of your pockets.”

On this note, I highly recommend reading this article by Steph Larsen: “For healthy food and soil, we need affordable health care for farmers.”

Getting back to today’s events, @personaltxr was at the forum and tweeted that Senator Chuck Grassley was expected but didn’t turn up. Does anybody know why? Grassley has an important role to play as the ranking Republican on the Senate Finance Committee. UPDATE: The Des Moines Register reported that Grassley stayed in Washington because of ongoing Senate business.

If you saw the health care forum, either live or on video, let us know what you thought. Everyone else can use this thread for any comments related to our health care system and prospects for reform.

Happy Spring, Bleeding Heartland readers! There’s a lot happening this week, and I’ve posted the events after the jump.

Post a comment or send me an e-mail (desmoinesdem AT yahoo.com) if you know of something good happening that I’ve left out.

If you live within striking distance of Iowa City, there’s a benefit for the Iowa Renewable Energy Association tonight at the Mill (details below).

I haven’t written anything yet about Senator Chuck Grassley’s comments on the AIG bonuses. The whole episode was such an empty populist gesture. First he said the AIG no-goodniks should act like the Japanese and either offer a humble apology or kill themselves. Then he walked back his comments and said they should offer a sincere apology. That’s all? I’d like to see more strings attached to the Wall Street bailout program, which Grassley voted for.

The Twitterer for the Daily Iowan Opinion page had the best response to Grassley I’ve seen so far. After the senator explained that “I do want an attitude in corporate American that’s similar to what they have in corporate Japan,” DIOpinions commented, “Making failed American executives more like their Japanese counterparts would require massive pay cuts.” Don’t hold your breath until Grassley gets behind that.

Anyway, we’ll find out how much Grassley cares about getting taxpayers’ money back from AIG when the Senate votes on the bill the House of Representatives passed yesterday.

Follow me after the jump to read about Grassley’s recent comments on medical marijuana and health care reform.

Also, I can confirm that at least one Democrat is stepping forward to challenge Iowa’s senior senator in 2010. Details are below.