Scott Brown, the Republican newly elected to replace the late Sen. Edward Kennedy, D-Mass., has been surprisingly forthcoming about his vote in favor of the health reforms adopted by Massachusetts a few years back — reforms that include the same individual coverage mandate that many Republicans on Capitol Hill have declared unconstitutional.

And while many Republicans are spinning Brown’s victory as an indictment of the Democrats’ health reform push, The Washington Post’s Alec MacGillis today points out the inaccuracy of that argument.

Brown, he writes, “rode to victory on a message more nuanced than flat-out resistance to universal health coverage: Massachusetts residents, he said, already had insurance and should not have to pay for it elsewhere.”

“We have insurance here in Massachusetts,” he said in a campaign debate. “I’m not going to be subsidizing for the next three, five years, pick a number, subsidizing what other states have failed to do.”

What Brown failed to mention is the inconvenient fact that the Massachusetts reform plan (1) focused on coverage, not cost containment (not exactly an approach championed by the fiscally conservative), and (2) relies heavily on federal subsidies to fund an expansion of the state’s Medicaid and CHIP programs, among others. In October, the New England Journal of Medicine, using state data, reported that the federal government dedicated $688 million to Massachusetts health care in 2006, before the reforms took effect. In 2007, after the reforms were in place, that number jumped to $816 million. In 2008, it was $888 million. Last year, it was projected to approach $1.3 billion.

So while Brown says he’s not going to subsidize what other states failed to do, other states are busy subsidizing what Massachusetts has done. He should at least acknowledge that fact as he continues to oppose the Democrats’ proposals.

Mike Lillis covers Congress for The Washington Independent, a Center for Independent Media site. ]]> http://iowaindependent.com/26171/the-irony-of-scott-brown%e2%80%99s-opposition-to-health-care-reform/feed 0 http://iowaindependent.com/25783/lunchtime-links-17 http://iowaindependent.com/25783/lunchtime-links-17#comments Fri, 15 Jan 2010 18:30:30 +0000 Jason Hancock http://iowaindependent.com/?p=25783 Iowa Democrats skip the middle man and do the “journalism” themselves.

Grassley: Democrats want to “Europeanize” America’s economy.

Federal education grant summons ghost of labor bill past.

Vander Plaats renews pledge to issue unconstitutional executive order.

Steve King rarely strays from GOP.

Statehouse press corps taking Friday off.

The project would create a central location for people to store the college credits they have received from multiple institutions. Colleges and universities then essentially would bid for the opportunity to enroll students for the completion of their degrees.

The study is being funded by a $100,000 grant from the Bill and Melinda Gates Foundation.

Branstad, who has for months flirted with the notion of re-entering politics, will deliver a speech to students, faculty and staff of Des Moines University in a closed session, with a news conference to follow. He has served as president of the school for six years but is expected to announce his retirement during his speech.

The announcement comes as no surprise after Republican Party of Iowa Executive Director Jeff Boeyink quit his position with the party to run Branstad’s as of yet unannounced campaign earlier this week. It also follows Branstad forming a candidate committee with the Iowa Ethics and Campaign Disclosure Board last week. The four-term governor has repeatedly said he would make an announcement about his plans by mid-October, and the conventional wisdom was that his campaign was a foregone conclusion.

A state task force is preparing to tour the facilities and meet with local residents in an attempt to evaluate levels of care and cost effectiveness. Specifically, the task force will need to consider if the state would benefit from closing one of the facilities, a duty steeped as deeply in history as it is in state economics.

Kirkbride, a founding member of the organization that would later become the American Psychiatric Association, promoted standardizing not only care for those with mental health issues, but for the architectural design of the facilities in which such persons would be housed. Kirkbride believed that surroundings played a large role in the treatment of those described at the time to be “insane” or “feeble-minded.”

Kirkbride buildings were often sprawling structures that would allow patients to be segregated first by gender and then by degree and intensity of illness. In particular, the philosophy related to the architecture believed that nature — fresh air, sunlight — was an important element to treating mental illness, and many of the asylums based on his philosophy were constructed well outside of urban areas and on large lots where residents would be required to help not only with facility maintenance, but with ground-keeping, farming and other tasks.

The end result was state purchases of large tracts of rural land and construction of hulking brick and mortar facilities. Some of the structures closely resemble castles of Old Europe.

Mount Pleasant Mental Health Institute

The facility in Mount Pleasant was the first built by the state. (Photo courtesy of the IAGenWeb Project)

The Mount Pleasant facility is the oldest of the four state-run facilities that serve individuals affected by mental illness. The state made its first appropriation for the location and erection of the facility in 1855. Kirkbride himself recommended Boston architect Jonathan Preston to design the structure. The 50,000-square foot building formally opened as “The Iowa Lunatic Asylum, Mount Pleasant” on March 6, 1861.

“This is first permanent building erected in the state,” a reporter for the Burlington Hawkeye wrote at the time. “It is of large size. We have not the exact dimensions before us, but it is sufficient to say that when fully completed it will accommodate between 300 and 400 patients and will compare creditably with similar structures in other states…

“Before diminishing the subject, we think simple justice to the Directors and builder, and to all parties concerned, under the circumstances, renders it proper for us to say something further in regard to this building and the manner in which the public have been expended upon it. When we look at its extent, at its massive walls and firm foundations that nothing short of an earthquake could move, at its innumerable rooms and dormitories, all the partition walls being of brick — at its miles of iron pipe for heating purposes, hot and cold water and gas — at is pipes and flues in every part of the building for purposes of ventilation — at its engine and boilers, kitchen and laundry, et cetera, et cetera, our wonder was that so much had been done for the sums appropriated by the State. … We hope, now that it is open and receiving patients, that all citizens of the State who can make it convenient to do so, will visit the Asylum. They will find it a very pleasant place to spend an hour or two, and, notwithstanding its grated windows, and unfortunate inmates, having a cheerful, orderly and happy look.”

Within a year, however, The Hawkeye, began to publish articles on the overcrowded conditions within the asylum, violence and skyrocketing expenses. (According to the American Medical Association, the facility had 11 miles of iron pipes, 425 rooms above the basement, 900 doors, 1,100 windows, a 2,100-foot Artesian well and cost the state $600,000 to construct.) The facility had treated nearly 1,100 people, many of them from other states, during its first 21 months of operation.

In those early years, all of Iowa’s facilities were used for long-term care. Many patients who entered the wards likely never again lived outside an asylum.

According to the Department of Human Services, peak capacity was reached in 1946 at more than 1,500 patients. Since that time, however, and with the invention of better medications and different therapies, most patients’ stays are between 30 and 120 days.

For some time the grounds have been shared by the Mount Pleasant Correctional Facility, a medium-security prison designed to provide treatment to male offenders with character disorders and substance abuse issues. In 1999, a separate facility opened for women offenders who also had such specialized needs.

The Mount Pleasant facility currently provides inpatient treatment to adults, and it is the only dual-diagnosis program — psychiatric and substance abuse — run by the state. Although substance abuse patients throughout the state come to Mount Pleasant for treatment, it’s primary service area is limited to 15 counties in southeast Iowa.

Independence Mental Health Institute

The facility in Independence was Iowa's second asylum, and the structure continues to be used for the same purpose today. (Photo courtesy of KirkbrideBuildings.com)

The second of Iowa’s facilities began in 1868 with a state allocation for land and structure in Independence. The state hired S. Shipman of Madison, Wis., to serve as the architect and the building was given an Italian flair, complete with a mansard roof. It was built from limestone quarries in Epworth, Farley and Anamosa, which was considered to be quite an extravagance despite its local availability, and contained several fire-prevention amenities.

Construction began in 1869, and a portion of the building was opened in 1873, although the entire structure was not opened until 1884. Full cost for the structure, which contained 24 wards and could hold 600 patients, neared $1 million — nearly twice the cost of the Mount Pleasant facility.

Originally known as the “Iowa Hospital for the Insane, Independence,” it is now called the Independence Mental Health Institute, and, according to the Department of Human Services, it provides inpatient psychiatric treatment for adults, adolescents and children. The facility’s specialty, however, is its work with children and adolescents.

This facility currently serves 28 counties in eastern and northeastern Iowa, and children and adolescents from 43 counties primarily to the east of I-35.

Clarinda Mental Health Institute

The Clarinda facility was built by the state in the late 1800s to help alleviate crowded conditions in the other two state hospitals. (Photo courtesy of KirkbrideBuildings.com)

The facility in Clarinda, originally named the “Clarinda Asylum for the Insane,” was began with state appropriations (of $50,000, although many more appropriations followed) in 1884 primarily to relieve over-crowding at the other two facilities. Construction began in July 1885 with plans from Des Moines architects William Foster and Henry F. Liebbe, and patients were accepted beginning in 1888. In the beginning, Clarinda was a male-only facility that sat on 513 acres. By 1933, according to the Clarinda Chamber of Commerce, the complex occupied 1.055 acres.

Clarinda, just like all four of Iowa’s facilities, has also been mentioned in conjunction with American eugenics, which was comprised primarily of compulsory sterilization laws for those deemed “mentally deficient” or criminal. Roughly 1,900 people were sterilized in Iowa, and, although the law allowing the procedure was passed in 1911, most of those occurred between 1941 and 1953, after the 1929 creation of a State Eugenics Board. The 1929 legislation called on the superintendents of state institutions to submit quarterly reports to the eugenics board that listed viable candidates for sterilization, which included members of the general public who were provided free legal counsel, according to author Nancy Ordover.

In 1980 the Clarinda Correctional Facility, a medium-security, all-male prison serving primarily chemically dependent, mentally retarded and socially inadequate offenders, was established on the grounds.

Today, the facility at Clarinda offers a wide range of diagnostic and treatment services through is Acute Psychiatric Program. It is also well-known for its geropsychiatric work, providing nursing home beds for individuals with mental illnesses such as Alzheimer’s. The acute program serves 15 counties in southwestern Iowa. The geriatric program serves the entire state and is the only one of its kind at the state-run facilities.

Cherokee Mental Health Institute

During the mid-1940s the Cherokee facility housed about 1,700 patients. (Photo courtesy KirkbrideBuildings.com)

Just six years after Clarinda opened, the state asked architect Liebbe to plan another hospital in western Iowa. The “Cherokee State Hospital for the Insane” opened in 1902 and was the last of Iowa’s large state-run mental hospitals. Similar to the Mount Pleasant facility, the hospital in Cherokee had a peak population of roughly 1,700 patients in the mid-1940s.

The Cherokee facility, like nearly all state hospitals at that time, was host mid-century to infamous lobotomist Walter Freeman. The man had perfected the technique of completing a lobotomy with a device similar to an ice pick that could be pushed through the thin bone in an individual’s eye sockets and into the brain. Freeman felt that this type of procedure could be especially helpful in the state-run asylums because it did not require drilling holes into the skull or a surgeon.

Freeman, who enjoyed the attention of the media and often invited reporters to watch his surgeries, was performing one such lobotomy at the Cherokee facility when he stepped back to have his photo taken. As a result of Freeman’s camera mugging the patient died, the instrument plunging too far into the brain.

Today, the facility provides both inpatient and outpatient care to adults, adolescents and children. It serves adults in 41 northwestern Iowa counties, as well as children and teens in 55 counties primarily west of I-35. The vast majority of the patients admitted to Cherokee are there by order of the court. A correctional facility is also on the site.

Calling Iowa’s senior senator “cantankerous and quirky,” the magazine walks through the early stages of Grassley’s health care effort, where Grassley and the other members of the Senate Finance Committee worked behind closed doors to craft a bill that could garner widespread support.

No Republican received more TLC from Barack Obama, who has met with Grassley three times at the White House and called him three times more just to keep in touch. White House aides reckoned that if Grassley, with his conservative credentials, could find a health-care deal he liked, a significant number of other Republicans might be persuaded to climb aboard. “Health care not only is 16% of the gross national product, but it touches the quality of life of every household as few others do,” Grassley declared back in April. “I’m doing everything I can to make the reform effort in Congress a bipartisan one.”

That was then. And that was before he came back to Iowa and delivered the now infamous tall tale about an end-of-life provision in a version of the bill passed in the House.

When the Iowa Senator actually gave credence to the absurd notion that the House version of the legislation might allow the government to decide when, in his words, to “pull the plug on Grandma,” Democrats decided he was past the point of any hope. And then came Grassley’s late-August coup de grâce, a campaign fundraising letter. “The simple truth is that I am and always have been opposed to the Obama Administration’s plans to nationalize health care,” Grassley wrote. “Period.”

Time goes on to surmise that the rightward drift of the Republican Party in Iowa may have played a part in Grassley’s change of heart. There have been rumblings for months that a social conservative primary opponent could jump into the race against Grassley. Those rumblings grew louder when Grassley gave a lukewarm response to a question about the Iowa Supreme Court’s decision legalizing same-sex marriage.

Time also notes that if GOP leadership is upset with him he may not get the coveted spot as ranking Republican (or perhaps chair) of the Senate Judiciary Committee in 2011.

One Iowa and the Interfaith Alliance of Iowa filed the complaint Monday alleging that NOM, a New Jersey-based group that opposes same-sex marriage, violated Iowa campaign finance law in their Iowa House District 90 campaign.

“NOM has complete disregard of Iowa law as they engage in express advocacy in our state, while refusing to release the identity of their donors, as is legally required in Iowa law,” the complaint said. “NOM has a history of funneling secret money throughout the country to engage in similar activity.”

On Aug. 20, NOM reported making an independent expenditure of $86,060 to benefit Stephen Burgmeier, a candidate in Tuesday’s Iowa House District 90 special election. The complaint alleges the expenditure violates Iowa election laws requiring disclosure of political contributors. Similar complaints have been filed against NOM in California and Maine.

The Iowa complaint comes less than a week after Charlie Smithson, executive director of the Iowa Ethics and Campaign Disclosure Board, wrote a letter to NOM Executive Director Brian Brown saying that if his organization continues to engage in express advocacy in Iowa, the group would have to form a PAC and disclose its donors.

“We request a thorough investigation into their activities, including detailed accounting of any and all contributions and their sources, as Iowans clearly deserve to know who is funding last minute advertising to try and influence tomorrow’s election,” the complaint said.

NOM has said it will target target Iowa in the hopes of passing a state constitutional amendment reversing the unanimous ruling of the Iowa Supreme Court in April that the state’s Defense of Marriage Act was unconstitutional. The effort, called “The Reclaim Iowa Project,” leads many to believe the $90,000 spent on HD90 represents just a preview of the group’s future investment in Iowa politics.

In Maine, the state’s Commission on Governmental Ethics and Election Practices said in a letter to NOM that it will investigating their campaign practices at its Oct. 1 meeting. The group is trying to build support for a referendum to overturn a recently passed law legalizing same-sex marriage.

Fairness Fund PAC, which is associated with the state’s largest gay-rights advocacy group, One Iowa, is hoping a last-minute surge of money can help bring Democrat Curt Hanson to victory. The National Organization for Marriage (NOM), a New Jersey-based group that opposes same-sex marriage, spent nearly $90,000 on a television ad campaign for Republican candidate Steve Burgmeier.

“If Stephen Burgmeier wins this election, it will be spun as a victory for anti-gay marriage opponents in Iowa and across the country,” said Carolyn Jenison, executive director of One Iowa, in a post on the PAC’s blog. “We can’t let this happen.”

One Iowa has also started a petition drive hoping to force NOM to reveal its donors. Charlie Smithson, executive director of the Iowa Ethics and Campaign Disclosure Board, said in a letter to NOM Executive Director Brian Brown that if his organization continues to engage in express advocacy in Iowa, the group would have to form a PAC and disclose its donors.

NOM filed an independent expenditure Aug. 20 disclosing it was purchasing television advertising in support of Burgmeier. Smithson said in his letter that the independent expenditure process is “not a vehicle to shield political contributors.”

“It is a way for a group to disclose an expenditure it makes outside of a direct contribution to an Iowa committee,” he wrote. “However, if you are accepting more than $750 for political activities in Iowa, then you become a ‘permanent organization temporarily engaging in political activity’ and would be required to disclose donors to your Iowa activities under Iowa Code sections 68A.401(9) and 68A.102(18).”

The race to fill the southeastern Iowa district of Democrat John Whitaker has become the focus of the Republican Party of Iowa, the Iowa Democratic Party and activist groups of all political persuasions. Despite the fact that its outcome will have no bearing on control of the legislature, it is thought that the winning side will gain much needed momentum going into the 2010 elections.

Republican Steve Burgmeier raised $60,101. His campaign has spent more than $40,000 and has received in-kind donations, mostly direct mail pieces from the Republican Party of Iowa, totaling more than $77,000. His biggest contributors include $15,000 from the RPI, $10,000 from tax watchdog Iowans for Tax Relief and $10,000 from a political action committee associated with U.S. Sen. Chuck Grassley.

Democrat Curt Hanson has raised $42,881. His campaign has spent $27,651 and received nearly $129,000 of in-kind donations, mostly mailing paid for by the Iowa Democratic Party. His biggest donations came from numerous labor organizations.

Republicans were also assisted by the anti-gay marriage group National Organization for Marriage, which spent nearly $90,000 on a television advertising campaign. Gay-rights group One Iowa has also been highly involved in the race, although their financial commitment is not yet known.

Both candidates have said they support a vote on a constitutional ban of same-sex marriage.

Brian Brown, executive director of the conservative group that opposes same-sex marriage rights, has sent out notice of a new initiative: The Reclaim Iowa Project. The goal is to force Iowans to pass a state constitutional amendment reversing the unanimous ruling of the Iowa Supreme Court in April that the state’s Defense of Marriage Act was unconstitutional.

The force behind NOM’s interest in Iowa, according to Brown’s e-mail, is U.S. Rep. Steve King (R-Kiron).

Over the past several months, with the help of Congressman Steve King, NOM has laid the groundwork for its Reclaim Iowa Project, making over a million automated phone calls to Iowa families, and identifying 100,000 new supporters in Iowa.

As The Iowa Independent reported shortly after the court’s decision, King told Iowans at an anti-abortion rally in Cedar Rapids that “if we don’t save marriage, we can’t remain pro-life.” King also drew a direct line between homosexuality and incest. The Iowa Independent has also noted the automated phone calls into Iowa that feature King’s voice.

The e-mail from Brown makes a request of money to be used to target Iowa races. Specifically, NOM is seeking 100 new donors to join the organization as “Monthly Sustaining Partners.” No exact dollar amount is specified.

Iowans have become accustomed to special interest organizations like NOM entering the state every four years in hopes of spurring the national debate in conjunction  with the first-in-the-nation caucuses. It is unusual, however, for national special interest groups to target Iowans based on their own state politics.

Although NOM lists its executive offices in New Jersey, the disclosure related to the expenditures for the HD 90 race, filed with the Iowa Ethics and Campaign Disclosure Board, lists an address on H Street in Washington, D.C.  The same address has been used by The Coalition of Americans for Research Ethics, Capital City Partners, DeNukeIran.com, American Principles Project, Americans to Ban Cloning and American Principles in Action.

At the time when NOM opened its D.C. location, Brown completed a telephone interview with Lou Chibbaro Jr. of the Washington Blade. In that interview, Brown once again refused to release federal forms related to is finances, citing that the required Internal Revenue Service Form 990, filed in mid-August after an extension, was “processing.”

NOM, which spent millions to turn back a California decision for marriage equality, has come under fire from critics in that state who believe that much of the money spent in California stemmed directly from the Mormon Church.