Ada County Commission Chair Rick Yzaguirre and I returned last Wednesday after having spent five days in Portland, Oregon, at a meeting of the National Association of Counties. Having the opportunity to interact with other county elected officials from around the nation was valuable and the amazing talk given to the “Women of NACo” by mountain climber extraordinaire, Alison Levine, was priceless. Frankly, it’s too bad she wasn’t scheduled to speak to the general assembly, as her presentation was the best of the entire conference! This was the first time I have ever attended a NACo meeting. There are a number of ways in which I believe this annual meeting could be dramatically improved.
The conference was organized into general sessions and breakout sessions. The breakout sessions were more useful, but the format left a lot to be desired. For the most part, a panel of speakers would talk at us, and at the end – if we were lucky enough to have time – we could ask a question. A more interactive format, allowing for a greater exchange of information or even some brainstorming to take place, would have been far more meaningful and useful.
Too much of the conference was spent promoting “sponsors.” Given the level of fees that were already charged for participation in the conference, I am unsure why paid sponsors were even necessary. Speaking of cost, the Portland area, although easily accessible from Boise due to its relatively close proximity, was a pricey one in which to hold a conference of elected government officials. I would hope some thought goes into the affordability factor of the area, for a conference such as this one.
The conference content was clearly biased. All of the incoming NACo officers are Democrats, and a strong bias was clearly demonstrated with the choice of speakers. We heard lengthy political speeches from three members of the Obama administration; yet, there was no counterbalance of speakers from the other side (or even the middle) of the political spectrum. The fact that NACo espouses to be non-partisan appears to be largely lip service, with little basis in reality. For the record, I would have the same concern about the lack of nonpartisanship, or bipartisanship, had all of the speakers been chosen from the Republican side of the political spectrum.
One of the primary reasons I attended the NACo conference was to find out why the group has chosen to support the Affordable Care Act, President Obama’s well-meaning but way-off-target health care reform measure. I attended every session on health care that I could. NACo’s incoming Second Vice President was one of the speakers at the three-hour Health Steering Committee meeting. During her talk, she indicated that the best policies come from the local level, not the national level.
It was at the end of this talk that I took the opportunity to ask my burning question: Given her statement that public policy is best driven from the local level, rather than by the federal government, why would NACo support President Obama’s Affordable Care Act? I was absolutely floored by the response I received. The incoming NACo Second Vice President said that we had a tight schedule so there wasn’t time to answer my question. She indicated I could see her later, to discuss my question privately.
I never did manage to have that private conversation, although it seems that a private discussion on public policy is a bit of an oxymoron. It would be nice to know why NACo supports such a misguided policy, in which individuals are legally required to purchase health insurance from private companies.
On the flip side, many beneficial changes that could be made to public health policy were not discussed. For example, there was no discussion about the fact that it is currently not legal to purchase or sell health insurance across state lines, which severely limits competition, driving the high cost of insurance even higher. There was no discussion about personal responsibility for one’s own health. There was no discussion about the fact that educated consumers make better decisions and wiser choices about their medical care. There was no discussion about Medical Savings Accounts, which would cause consumers to pay more attention to the costs and quality of medical service they and their families are receiving. There was no discussion about reducing the number of unnecessary procedures that are being performed.
On two occasions, I did manage to bring up Ada County’s pilot health care project, in which we are working with Idaho State University, the Idaho Department of Health and Welfare and the Central District Health Department to provide free preventive health care screenings to low income and uninsured individuals. Health sciences students from ISU perform the screenings, and patients are then referred on for additional medical care, when it is warranted. In our program, prevention and personal responsibility for taking care of one’s own health are stressed. It is our hope to reduce the number of claims, and dollars paid out, for medical services for indigent patients – something we are statutorily mandated to pay. As an example, treating diabetes is more cost effective than treating a patient in a diabetic coma, or one with kidney failure resulting from untreated diabetes. I’d like to see programs such as ours, using free health sciences students’ labor to provide free preventive health care screenings, spread far and wide to save money for taxpayers across the nation.
In a similar vein, I will be attending the annual meeting of the National Association of Local Boards of Health (NALBOH) in Coeur d’Alene in September. It is my hope to spread the word on our cost-effective way of providing medical screenings, and learn more on how other communities are working to cut the cost of providing medical care to low income and uninsured individuals, since under Idaho law, county and the state taxpayers are mandated to pay the medical bills of people who are unable to pay for their own necessary medical care. I expect the NALBOH meeting in Idaho will prove to be more beneficial and productive than was the NACo meeting in Portland.