The news and the Idaho Department of Health and Welfare are trumpeting the billion-dollar, five-year grant to our state. This fiasco was shoe-horned into the One Big Beautiful Boondoggle that cut taxes and exploded our debt.
Our federal “Gang of Four” want credit for bringing the dollars home, while they cut Medicaid funding and ballooned our debt. Go ahead, slap them on the back.
Vote for them again. After all, they are Republican and Trump lackeys.
This grant required states to propose projects that would “qualify” in a narrow three-month window. How’s that for thoughtful expenditure of our tax dollars?
The projects had to be sustained beyond the five-year grant period by the state. Do you think the Idaho legislature is going to come up with $200M/year for Idaho healthcare when the grant runs out?
Most of the grant money will be for technology improvements. I have seen this before. Who gets that money? Not local communities. The big tech bros who sat behind Trump at the inaugural catch this effluent downstream. It will just wash through our depleted state.
The ACA (Obamacare for you Republicans) did the same thing. I was working on the IDHW budgets in those years. I asked my analyst (Hey Tater!) what the heck this money was doing. Indeed, it was all Federal money, from our federal income taxes. It was supposed to be moving clinics and hospitals to more electronic medical records. I asked him to look into it. He told me the money was helping. I shrugged and it got appropriated. That was stupid.
I had been through this in real life. I was in the first large clinic in Idaho to adopt electronic medical records. We were on the cutting edge. And we made the investment without any federal or state grants. We spent our own money. Why?
I learned we had different reasons for this investment. I believed that having our medical records in a searchable database we could study our practices and find out the best treatments, the best way to deal with the common problems we saw daily.
My partners had different reasons. We had five people working in our medical records department at the time. They were low wage but had benefits and retirement. After the million-dollar investment we had one medical records employee.
Three years into the “experiment”, long before Obamacare, I proposed leveraging this investment to my partners. Let’s do studies on our data. Let’s find out what our best treatment for a urinary tract infection is. We could find out how we are treating high blood pressure. We could improve our practice.
It was an impassioned speech. The group around the table was quiet. Don’t you want to learn how to treat your patients better, I asked. They were all quiet. I looked at the guy next to me. Don’t you? I asked directly.
He looked up at me, squarely in the eyes, and honestly said, “No.”
The allure of data, analysis, technology in medical care is a sham if there is no commitment from the professionals pulling the levers.
So we need to be asking ourselves some painful questions.
Why does Idaho need more doctors if they are just here to make themselves richer?
Do doctors really improve the health of a community?
What do you people want from healthcare?
We don’t have to answer these tough questions (though we should), but big money is asking and answering them while we pay the taxes, and the taxpayer funded grants go out the door.
The billion-dollar grant to Idaho will go to big tech companies who sell kiosks and apps to connect to a provider. The call you make will go to Islamabad, or more likely AI, and you might get the reassurance you need or not.
Will your community be better off?
I am sorry I shrugged with the ACA money for electronic records. It didn’t cost Idaho taxpayers. But it cost us all. We should be expecting more and getting more for the way too much we pay for this horrible health care system. This needs to change.
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