Saturday, November 24, 2012

Governor Mead could have been a leader, but the feds won't answer his questions.

It’s unseemly when the Governor whines that he’s unable to make decisions because federal bureaucrats won’t answer his questions. It’s difficult to imagine many, if any, of Matt Mead’s predecessors failing to lead simply because their letters to the feds went unanswered.

His next campaign slogan could be, “I could have been a leader but the feds refused to answer my questions.”

This governor is yet to offer even one idea of his own to address the problems of the uninsured. That’s leadership? It certainly isn’t leadership when he uses the ruse that the feds won’t answer his questions as a pretext to turn his responsibilities over to the feds to create a health insurance exchange. It’s nothing more than a ploy he and his Republican colleagues mimic. Iowa’s GOP governor Terry Branstad sent 50 questions to the Department of Health and Human Services. Like Mead, Brandstad said that unless they were answered, Iowa might opt out.
In Idaho another Republican governor ignored recommendations of the advisory committee he appointed. They said an exchange created by the people of the state consistent with the needs of the state is preferable to one established by the feds.  The governor said, “I don’t want us buying a pig in a poke.”

As of last week 17 states, including conservative states such as Kentucky and Mississippi, are taking care of their own citizens rather than abdicating to the federal government. Those governors didn’t wait for the feds to answer questions. They took the lead, recognizing an opportunity to improve healthcare for their citizens. They answered their own questions.

Does it matter? Yes. Wyomingites are fond of the belief that we are unique. Sometimes it’s a myth but not when it comes to healthcare. The state’s rural nature has obligated state government and the private medical sector to create a delivery system quite different from those in larger states. Fewer people, longer distances, irregular resourcing, lack of doctors and other uniquely rural realities meant stringing together a healthcare delivery structure with which the federal government is unfamiliar.

The exchange will offer you a website to compare insurance plans and rates and to have questions answered in an objective manner rather than calling a dozen different insurance companies for information and misinformation. The answers found there will be considerably different and infinitely more useful if the website is created by Wyoming people who understand the state and are familiar with its people and their needs rather than by people along the Potomac.

If we don’t do it, the Obama administration will. Odd choice for Wyoming don’t you think? Wyoming doesn’t want the feds regulating wolves, education, agriculture, mining, oil and gas or much of anything. Why would we want them to take responsibility for creating a marketplace for our citizens to purchase health insurance? Does the governor support a Washington takeover of that responsibility?

Is the governor fearful that among his cabinet and other well-informed state employees there is insufficient expertise to answer his questions? Does he doubt they are capable of planning an insurance exchange consistent with Wyoming’s needs and resources? I’ve been there. I’ve been a part of the team at the Wyoming Department of Health. Those offices are filled with bright, committed people who understand these issues and have the knowledge required to do this job right. If the feds won’t answer Mead’s questions, these folks can and will. It’s insulting for the governor to say the answers can come only from Washington.

Some of us have watched events at the statehouse for a long time. It’s difficult to remember a time when a governor was so indecisive as Mead. It’s a problem not only on this issue but others as well, e.g. juvenile justice, Medicaid expansion, highway funding, to name a few. On this one, a critical deadline will soon pass, leaving his constituents at the whim of the federal government.

In Mead’s world, state’s rights apparently include the right to leave it to the federal government.

Monday, November 19, 2012

Yesterday's Thanksgiving Sermon at Highlands

“Two kinds of gratitude” - Highlands Presbyterian Church 
This is Thanksgiving week. It is the gateway to the celebration of Christmas. It’s a time to begin preparation for Advent. It’s a time of gratitude. Edwin Arlington Robinson was an American poet who wrote wonderful poems about life, the end of life, and the gratitude he felt about his life. He thought deeply about life and concluded, “ There are two kinds of gratitude:  The sudden kind we feel for what we are given and the larger kind we feel for what we give. 
It’s not that one kind is good and the other to be avoided as vain. Both are appropriate. Neither is separable.
I have a dear friend whose prayer each day is, “Remind me Lord what my life would be if I had today only that for which I gave thanks yesterday.” Profound, huh?
There’s an art to gratitude. And like all good art, it doesn’t come naturally and is never achieved without great thought and practice. It is counterintuitive in a world that seems to focus on that which troubles us, bedevils us, and distracts us. And so we set aside a day…one out of each 365 days…to give thanks. What if instead we set aside one day…one in every 365 days…Complaint-giving Day…one day to complain and gave thanks the other 364?
But it’s like most everything else Jesus said. If it were easy to give thanks, to love our neighbors, to turn the other cheek, if it were easy to give to all who ask and invite sinners to our table and be grateful…if any of it were easy…God would not have needed to send us a teacher.
But here he is. Jesus. Standing there…for at least one hour on one day out of every seven…with a message which today is, “do not worry about your life.” 
Please Jesus, there you go again. Life is defined by worry. Mine is…how about yours?
I worry about my sermons, my deadlines and timelines and hairlines. I worry about my children, my grandchildren. I worry about the high price of food, health insurance, and gasoline. I worry about tax time, dinnertime, quality time and bedtime. I wish I had been paid minimum wage for all the hours I spent worrying over the years. I wouldn’t have to worry about whether my money will run out before my life does.
And then here comes Jesus and blithely says, “Do not worry about your life.” Easier said than done, right? But why does scripture spend so much of its time speaking of worry? It seems that even God’s word worries about worrying. In Matthew Jesus asks whether our worries can add even one more moment to our lives. It cannot. Proverbs 12 speaks about how our worries weigh us down…oh yeah, my weight, there’s another worry.
The Apostle Paul told the church not to worry about anything but to pray about everything. So we worry about praying and we pray about our worries, literally about all of those things Jesus said God will provide… what we will eat or what we will drink, about our bodies, what we will wear…sometimes even where we will park.
Jesus asks whether our life is defined by the things about which we worry. Which is why he begins the teaching with the familiar admonition, “You cannot serve two masters.” Life, he says is about more than what you eat and what you wear. It’s about more than all the things about which you worry…and if you focus on your worries, you cannot focus on what life is really about.
Our worries are solely about what the poet Edwin Arlington Robinson referred to as the gratitude we feel for that which we are given. And it is important to give thanks for that which we eat, the clothes we wear, the warm home in which we lives, the things of life that make us secure and hopeful about the future.
I think what Jesus is saying this morning is that we must find our life’s energy not in the kind of gratitude that comes from what we take or receive but in what Robinson called, “the larger kind we feel for what we give.”
When Jesus says, “Is not life more than food, and the body more than clothing?” he is saying that “gratitude” is a verb…an action word…gratitude has something to do with how we respond to that with which we have been blessed. Life indeed is about what we eat and wear, whether we can afford food, healthcare, gasoline and more…but Jesus says…it’s also about something more.
On this Thanksgiving week as we begin to look forward to celebrating the birth of Jesus…as we prepare for a season our culture has made about what we receive…let’s think about gratitude and what life would be like if all we had today was that for which we gave thanks yesterday.
Let’s put the gratitude we claim to work as a way of actively giving thanks. You see our gratitude for our own good health shows in spending time with Alzheimer’s patients who have lost theirs…gratitude for having enough to eat is sharing food with those who do not, tilling the community garden, bringing food to this alter, bringing a meal to Family Promise…gratitude for having a warm home is spending time with those who do not, providing a hot cup of coffee for COMEA and conversation with families at Connections Corner…gratitude for your own recovery is helping others see the promise in their own lives…
…turning gratitude into action allows us to move beyond our worries…it allows us to notice the birds of the air who neither reap nor sow but are fed by our “heavenly Father.” It is what allows us to see and to smell the lilies of the field, how they grow; neither toiling nor spinning, yet even Solomon in all his glory was not clothed like one of these.
Let’s be honest. Despite Jesus’s teaching we will continue to worry about tomorrow even though, as he said, tomorrow will bring worries of its own.” Jesus said, “Today’s trouble is enough for today” but we know better. It is in our nature to worry but it is also in our nature to feel gratitude and to act gratefully.
So the next time I worry about the high price of food, I will remember those who can afford even less than I and will bring and extra can of vegetables to the alter. The next time I worry needlessly about my grandchildren I will remember those children who are not nearly so well loved, those who have fewer opportunities and far more challenges; when I worry about the high cost of my keeping up my home, I will send a few more dollars to COMEA, spend a few more hours with Family Promise.
As we are being grateful for what we have received, my Thanksgiving prayer is that we all feel the joy of the larger kind of gratitude we feel for what we give. AMEN.

Saturday, November 17, 2012

Despite unrequited hopes of Wyoming GOP, Obamacare is here to stay. Get over it and get with it.

It’s disappointing to see Wyoming legislators and the governor still playing partisan games with healthcare. They have been unable to develop a single effective strategy to provide care for the uninsured and are yet intent on fighting The Affordable care Act. This year’s presidential election was a referendum on the law. Called “the signature accomplishment” of Obama’s first term, Republicans never quit opposing the law. Governor Romney promised its repeal “on day one.” When the voters chose Barack Obama over Romney they were fully aware they were giving up on the last chance to avoid implementation the law.

The political and legal barricades are removed. As the political smoke clears, most people of good faith recognize the law provides enormous opportunities for improving health care for Wyoming children and families.

In the months following the law’s passage, Wyoming legislators placed their hopes in the US Supreme Court and coming elections. Key legislators including Senator Charles Scott blocked the implementation. Senator Leslie Nutting sponsored legislation making it a felony to implement it. Scott predicted 2010 elections would produce enough new Republican members of congress that the act would be repealed. When that didn’t happen, they counted on the Supreme Court to throw out the law. When that dream died, they put all their eggs in Romney’s basket…with equal success.

The clock didn’t stop. Key deadlines came and went. Others approached. Expectations the law would vanish created political paralysis. Now we’re beyond the unrequited hopes of Wyoming legislators. Like it or not, Obamacare is the law of the land. It will be implemented. Our political leaders must ask what they can do to make certain the law works effectively for Wyoming’s people.

The state dawdled on creating a health insurance exchange. It’s just as well. The exchange works best if state policy makers are sincere and piece it together with the full intention of making the law work. Until now, Wyoming’s head wasn’t there. Now perhaps?

The exchanges were actually a part of the law assuring there is no federal takeover of health insurance, as opponents often claimed. The exchange creates an online marketplace, personalized to each state’s needs and accessible to individuals and small businesses allowing them to make educated choices among private insurance plans meeting important criteria for both benefits and consumer protections.
A handful of states have already established exchanges. Wyoming has not. The state’s failure to act doesn’t mean the exchange won’t be created. Curiously or better yet, ironically, Wyoming politicians who never miss an opportunity to grandstand against federal interference are still dragging their right feet. They appear inexplicably willing to allow the feds to control the process. That’s partisan politics at it’s most bewildering. They’re intent on being “right” and wrong at the same time.
There are good reasons we should do it for ourselves. Exchanges must be established in a manner that carefully integrates other state health programs. Presumably we know better than the federal government the unique health needs among the people of our uniquely rural state.
It’s also time to decide whether to expand Medicaid under Obamacare. Prior to the election this issue was politically loaded. No Republican governor wanted to be seen cavorting with the new law. Now we can put politics aside and simply do what is best for the state. There’s little question that what is best is to take advantage of the opportunity the ACA affords by expanding Medicaid to provide insurance for some 30,000 Wyoming people who have no health insurance today.
Doing so, Wyoming reaps the windfall of the federal government paying nearly all the cost while millions in state tax dollars, now spent on programs to provide care for the uninsured, can be rechanneled or saved. Dollars coming into the state via Medicaid will not only assure better heath care for our citizens but will build Wyoming’s medical infrastructure.
Republican legislators need to get over it. Obamacare should no longer simply be a partisan, political issue. The issue should now be simply health care.

Saturday, November 10, 2012

In Wyoming children are not a priority

Last month the U.S. Supreme Court vacated a life-sentence for a Wyoming teenager convicted of a Sheridan murder. Wyoming policymakers might want to consider that as an omen. If the governor and the legislature can’t do something about our dysfunctional juvenile justice system the courts will do so just as they did in school funding.

Juvenile justice reform isn’t a priority for the governor or the legislature despite wasted money and wasted lives. There’s a steep cost for this system producing consistently failed outcomes. Tens of millions of your tax dollars fund this decayed system. You pay a lot now and even more later. If your child falls into the meat-grinder, long-term personal and psychological costs can be even higher. As a one-time member of Wyoming’s Parole Board, I know nearly all adults for whom you pay to house in a prison had a lengthy, unaddressed juvenile criminal record before being sentenced to an expensive prison cell.

More than 70,000 juveniles are held in jails across America. Wyoming does more than its fair share.  In 1971 the Columbia Research Center ranked Wyoming second in the nation for per capita rate of detained juveniles. Forty years later that remains unchanged. A lot of lives have been ruined over those four decades.
When lawmakers built the system decades ago, there was an excuse. There existed scant research informing lawmakers what works. There’s no excuse today. Now we know. Jails may be the place to put some children who commit violent crimes, i.e. children we are afraid of; jail is not for kids we are simply mad at. Today Wyoming children are jailed for crimes as menial as smoking cigarettes. The strategy doesn’t work. The earlier you start sending children to jail, the more likely they’ll be to spend adult years in prison. The failure to provide mental health and other services to youthful offenders will reap greater problems and higher costs in coming years.

Wyoming’s treatment of juvenile offenders is like bloodletting, a popular medical procedure used well into the 1800s for treating every ailment from acne to cancer, insanity, and other diseases. Centuries after science discredited the practice, stakeholders (usually barbers) continued to let blood. It didn’t work for patients, but it did work for barbers.

Wyoming’s juvenile justice system doesn’t work for children or their families. However, it works well for its gatekeepers. Wyoming has a feudal-lord system. Each of the 23 elected county attorneys is lord over their county. They have benefactors in the governor’s office and the legislature.

Under Governor Freudenthal, state grants provided an incentive for local communities to collaborate to improve services for juveniles believing schools, mental health providers, the medical community, and parents had something to offer and that prosecuting lawyers and judges should work with them collaboratively.

Communities were required to form a collaborative board, allowing interested entities to work together to improve services. Several county attorneys didn’t see any value in sharing the keys to their kingdoms. They waited patiently knowing they would outlast the governor who sought the reforms.

Soon after Governor Mead replaced Freudenthal the feudal-lords returned to power. This Governor reversed the progress, marginalizing those who supported a collaborative, research-based reform, replacing them with advisers who pleased the feudal-lords.

The grant program giving an incentive to make research-based reforms? Well, the prosecutors are now asking legislators to just give that money to them, no strings, allowing them to continue doing what they want whether it works or not.

All those studies demonstrating Wyoming is doing harm to children under the status quo? As the Geico-gekko would say, “Fugg-it-about-it.” Studies take time to read and put politicians in the uneasy position of saying no to a member of the club.

Yes, if you’re one of those children, the system is generously described as “dysfunctional.” It’s really an abomination by any justice measure. But it works for the feudal lords and their political allies. As long as they stand at the gate, not much will change. Hello voters!