STAFF: The following is an unrehearsed interview with Iowa Senator Chuck Grassley. Participating in today's public affairs program are Eric Mandel, with KIFG Radio in Iowa Falls, and Jay Wilson with the Adams County Free Press in Corning.
The first question will be from Eric Mandel.
Senator Grassley, the Ellsworth Municipal Hospital in Iowa Falls recently voted to close its inpatient mental health unit and it's seen a declining average daily patient count over the past 18 months, but that will also mean 24 employees will lose their jobs.
Were you contacted at all about ways to get funding for this facility? And how can the system be fixed?
GRASSLEY: Well, I think the way that it needs to be fixed is to make sure that we get reimbursement for Medicare based on quality instead of quantity.
Presently, you know, Iowans don't get as sick as other people do, they don't go to the doctor at the drop of a hat. They -- generally doctors don't send everybody to a hospital at the drop of a hat. And consequently we do a very good job of delivering quality care. But we don't in the end do much in the way of abusing the system like they do in some states with over-utilization that brings in a lot of money.
And then, on top of it, we have a higher percentage of people that are on Medicare, and so, consequently, the government only pays 80 percent, so you don't have the income to the hospital. And then, when they have wards that you're talking about, that aren't used regularly, and by more often, or have the income to support it, and they have high overhead, then they have to become more efficient.
And so I think that the best thing I can do is keep pushing to get more fair reimbursement for -- or for Iowa hospitals, and our medical system, and do that by moving from reimbursement based on quantity to quality.
QUESTION: Thank you.
STAFF: And, Jay, go ahead.
QUESTION: All right. Thanks.
Senator Grassley, yesterday I saw a press release that came in that said that the Iowa Board of Pharmacy issues its recommendation for marijuana to move from Schedule I of Iowa Controlled Substance Act into Schedule II. And I was just kind of curious your thoughts on that issue.
GRASSLEY: Well, of course, so, basically what they're doing is approving the use of marijuana for medical purposes.
QUESTION: Right.
GRASSLEY: Is that right?
QUESTION: Right. That's as I understand it, yes.
GRASSLEY: Yes. Well, I know that they had a lot of hearings on it. They probably gave it a lot of deliberation.
Quite frankly, I would not support that move until I had indication from FDA, both from the standpoint of effectiveness and from the standpoint of safety, because I think when you talk about using certain products for health purposes, for medicinal purposes, I think the safety and efficacy standard set by the FDA is the one that ought to be used.
Now -- and also I think that I would need to have tests given that would -- you know, the same tests that any sort of medicine would go through to show that it was -- that it would work. And so far I have only had ad hoc instances and evidences of marijuana helping people with health problems. And I believe that you need to be very cautious as you move forward because I believe that marijuana's a gateway for harder drugs.
QUESTION: Thank you.
STAFF: Back to Eric.
QUESTION: Senator, in regards to the bonus pay for extended combat duty going to the Iowa National Guard soldiers who returned home from Iraq in 2007, why did this take so long to get completed? And what did you do to help it along?
GRASSLEY: Well, in the -- in the last question, I was the prime cosponsor of a bill in the Senate to do that. And then that bill didn't pass separately. It eventually became part of a defense authorization bill. So it doesn't come out as a separate bill, but part of a massive bill. But either way, it brings justice to these people, and I was glad to help it along.
But the one thing that you asked that's very difficult to answer, why did it take so long. All I can say is government red tape. I have no excuse for it. I'm embarrassed about it. And I said exactly that same thing in the press release that I put out yesterday.
These people should have had justice within six months. They should have had the money in their pocket within six months after the -- the screw-up was made public and made -- and made notice to me.
And I'm not even sure we should have had to pass a law to get the job done. I think when a bureaucracy screws up, they ought -- it ought to be self-correcting. But in this instance, we had to pass a bill.
STAFF: Back to Jay.
QUESTION: All right. Thanks. Just kind of piggy-backing, perhaps, somewhat on my previous question. I guess I've had the good fortune in my life to have worked in a number of different areas. And so, in a previous life for me, I worked in the social work field for about eight years. And in my time there, residential group homes and crisis intervention shelters, saw an awful lot of what I would consider abuse of legal drugs.
And what I noticed was you can't watch the evening news without seeing four or five or six or eight pharmaceutical commercials. You can't thumb through a magazine without seeing pretty extensive ads from pharmaceutical companies. And so what I've found is really that one of the biggest problems in our country is -- is the pharmaceuticals being able to -- to advertise in places, putting ideas in common people like myself's mind that, "Oh, hey, I'm, you know, I'm having a hard time sleeping. I tell my doctor this, I get what I want. And that appeases me."
So my concern is where pharmaceuticals are allowed to advertise. From my perspective, I don't believe that anybody but a medical doctor really needs to have some of these detailed informations. When they take a look at what my symptoms are, they can make a choice on how they should treat that, rather than me walking into a doctor's office and coming out with this prescription for Zoloft, which I could do quite easily from my experience.
GRASSLEY: Well, the only thing I can answer in contrast to what you said, not necessarily disagreeing with you, but it's kind of where we are.
Number one, the question of commercial free speech -- should anybody be denied the right of advertising a product? We didn't put any restrictions on -- on cars or -- or anything else. There's a few restrictions on cigarettes, there are a few restrictions on alcohol, but for reasons of -- of abuse, as opposed to just use.
And so you get into where the federal (inaudible) or the Supreme Court has been expanding First Amendment rights of individuals to corporations of what we call commercial free speech.
And then the other one is whether or not the doctor should have complete control over you as an individual, and if you -- and if you don't have a right to question your doctor. And one of the ways of bringing things to a doctor's attention is for you seeing something on television and you asking the doctor a simple question, "Well, what about this? Wouldn't it work for me?"
And so you get into the -- into what we're trying to do, is educate people about questioning the doctor.
STAFF: Back to Eric.
QUESTION: Senator, when you travel around Iowa, especially rural Iowa, what are you hearing about people -- or from people about not being able to make ends meet? And are you seeing any improvements thus far?
GRASSLEY: Well, I had town meetings this week in Anita and Stuart and Glenwood, Clarinda, Red Oak, Council Bluffs -- let's see -- Sidney. So I
had all of those town meetings so far.
And I have had people raise a lot of questions about getting the economy turned around, getting jobs created, questioning what we have done in the way of the stimulus bill that doesn't seem to be working. But I haven't had anybody bring to my attention specifically what about their own getting a job.
Now, I think I have had unemployed people come to my meetings, but it seems to me that they don't bring up their own personal problems of not getting a job. They bring up concern about the direction of the country and what Congress was doing in the way of the stimulus, and the fact that the president said it was supposed to keep unemployment under 8 percent and it doesn't. And they're mad about it and concerned about it.
STAFF: Thank you, Eric and Jay, for participating in today's public affairs program.
This has been Senator Chuck Grassley reporting to the people of Iowa.
END