In school we often hear or say that we can learn from our mistakes. And currently we see Olympic athletes doing just that, like when they have a second run on the ski slopes, for instance. But Iowa Republicans and Gov. Kim Reynolds doesn’t seem to have heard that advice. Or maybe they need to make many mistakes before the learning begins.

Medicaid privatization was former Governor Branstad’s initiative. Republicans argued that the service would be better and costs would be lower. In fact, since privatization began in April 2016, just the opposite has happened: service has declined precipitously and costs are higher. But the only recognition that things have gone awry is Governor Reynolds’ statement that “mistakes were made” while offering no real path to correct them.

Privatization began with three companies taking over the administration of Medicaid, a program that covers about 600,000 Iowans. Within 18 months one company withdrew, saying it could not make a profit and arguing it had too many patients with severe medical problems. Those patients existed prior to privatization and were being cared for much better under state administration. The patients, for whom available services had already been curtailed when privatization occurred, had to deal with more disruption in their medical care. In late 2017, the state had to assume responsibility for over 10,000 patients temporarily because the other two private companies could not take on the patients stranded by the third company’s departure. 

To satisfy the two remaining companies, an increase of $182.8 million was agreed upon. But as is true of Medicaid generally, the bulk of that ($147 million dollars) was to be covered by the Federal government, so Iowa officials could shrug it off.

Meanwhile, complaints by patients about denial of care and by medical personnel about lack of reimbursement continue unabated. Most recently, the Des Moines Register reported that the private administrators’ failure to pay would result in the likely closing of a very successful addiction treatment program at the Polk County jail. When opioid addiction is one of our country’s leading killers, the state of Iowa watches a successful treatment program languish because private Medicaid administrators won’t make the required reimbursements to care providers.

When will Republicans stop reflexively arguing that private business runs every program more efficiently than the government does? How much evidence must accumulate before they start to learn from their mistakes?