Gov. Kim Reynolds’ failure to reappoint David Hudson to the Medical Assistance Advisory Council was a mistake.
Hudson, a Windsor Heights resident, served as co-chair of the council, which advises the governor and director of the Iowa Department of Human Services on the budget, policy and administration of the Medicaid program.
As co-chair, Hudson did what he was supposed to do. He raised questions, expressed concerns and challenged data about costs and quality of services. He spoke up — as a leader, and as a parent of a 30-year-old son with a disability.
He apparently frustrated those in state government who would have us believe the Medicaid program is working fine.
For the sake of argument, put yourself in Reynolds’ shoes. She’s running for election to an office that she was promoted to when Gov. Terry Branstad departed. She didn’t create the managed care program, but she stood by Branstad’s side as he did.
She knows Medicaid and managed care is a big deal. It affects about 600,000 Iowans. In 2008, it expended $2.6 billion in tax revenues. In 2017, it spent $4.4 billion. The trends are scary, and unsustainable.
She also knows bad stories have emerged. Managed care is reducing services to people with disabilities living independently, with massive impact on their quality of life. People in nursing homes are being inadequately served. Iowans, especially in rural areas, have trouble accessing services they need.
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Too many people are suffering, and suffering does not make a good campaign ad (except for the opposition). Given a chance to minimize criticism by not reappointing someone upsetting the apple cart, what do you do?
Reynolds chose to eject Hudson. She could have made the choice to listen to him, and use his story, and the stories of hundreds of other Iowans, to make needed improvements to the program.
Instead, she chose politics and shot the messenger.
Medicaid and managed care may be the Achilles heel of the Reynolds administration. It’s a perpetual weak spot, continually churning out a narrative that this governor and legislature, while cutting taxes and services to help wealthy and corporate interests, just doesn’t care much about the less fortunate.
Whether that perception is reality can and will be debated. But its presence is why we need more people like Hudson.
We need people asking questions, suggesting alternatives, pushing and prodding. We need people inside government making it better, rather than being on the outside with voices unheard. We need department directors, chairs of councils and committees, members of the dozens of boards and commissions, etc. who want to be servants of the public, not of the Governor.
But to get that, we need a governor willing to appoint such people to leadership and advisory positions. It takes strong leadership to fill positions with those willing to disagree, to say what needs to be said rather than what the leader wants to hear.
But collaborative and self-confident leaders do that.
Look no further than the musical Hamilton. The main story was about Alexander Hamilton, but it also detailed George Washington and the fierce and frequent debates among his cabinet. Encouraging ideas, debate and dissent made him a better President.
There’s a lesson there for Gov. Reynolds, or a potential Gov. Hubbell.
• John Hale is co-owner of The Hale Group, an Ankeny-based consulting, advocacy and communication firm, and a registered No Party voter. Comments: firstname.lastname@example.org, @indieiniowa