Sen. Ernst’s votes harm rural Iowa and our health care

Photograph of a nurse taking a blood sugar test from a patient

I take issue with the claims Senator Joni Ernst has recently made about her history of protecting Iowans’ health care. I do not think leaders like Senator Ernst appreciate the effect her actions have on patients, and she pays a lot more attention to what drug and insurance companies want. My experience in and journey to medicine has shown me that we need to do more for Iowans.

I made a conscious decision to practice Family Medicine. What touched me most about family medicine was the relationship between the provider and the patient—I saw that it was a lifetime commitment to one another. I do not see respect for that commitment in Joni Ernst’s votes and policy positions.

Physicians play such a crucial role in a person’s life; helping them find ways through disease management or the loss of a family member. I witnessed this powerful relationship working in healthcare planning and was so moved that at 32 years old, I went to medical school. I completed a rural family medicine residency with every intention of working in a rural community.

The Minden clinic, where I practice today, was built by Dr. Max Olson, in the 1950s. I quickly fell in love with the people and the location—it was exactly what I was called to do. I committed to turning it back into a full-time clinic. My wife and I bought land and built a house, and Minden has become our home.

We are a town of 600 people and our clinic is now open four days a week. Having a rural practice allows me to still do things that a lot of providers do not do. One day a week I do nursing home rounds, and the hospital-based procedures that I was trained to perform as a rural physician. As a solo practitioner, I get to practice the way I want to practice, but I also need to practice this way to keep the doors open. Unless we see everyone every day, we’re just not going to be able to make ends meet. The limits that come from turning back the clock, as Joni Ernst proposes, would devastate my community and my practice.

Some of my biggest concerns about repealing the Affordable Care Act (ACA) have to do with how it affected Medicaid. The Medicaid expansion provided coverage for people that otherwise were not able to get in the door, including many in the community I now serve. To see the expansion of Medicaid go away would be devastating. Most of my patients that come in for routine visits are being seen for diabetes, high blood pressure and cholesterol. Those are the kind of things that show up on exclusions because they’re expensive, lifelong. People would absolutely be excluded and we’d see them stop accessing care because it’s just too expensive. I fear for loss of life of my patients were the ACA be repealed.

That is why I’m involved in this fight and sharing my story with Stories From the Heartland: I see leaders like Senator Joni Ernst speak to my patients at town halls and hear her say that she truly cares about making sure people have good and affordable coverage, but her past votes tell a different story [Health Care Freedom Act “Skinny Repeal” – Senate Vote 179, 7/28/17; Obamacare Repeal Reconciliation Act – Senate Vote 169, 7/26/17]. Each of the plans I have seen Senator Ernst support would mean fewer people getting to see me in my clinic, which would mean fewer people being able to get the care they need, and would mean fewer small town clinics like mine could stay open.

Senator Ernst, your votes are not only bad for our health care system, but bad for our rural economies as well.

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