Wishing and hoping are not the same as having and doing. They really are not.

I know it's been a while since you've heard from me. To be honest, it's becoming difficult to believe there's any point to my constant drum-beating. But leave it to Iowa's leadership to re-ignite the flame.

The Reynolds administration has just announced its monumental "Healthy Hometowns" initiative, a plan to get one billion dollars from the U.S. Dept. of Health & Human Services to "transform" rural health care in Iowa. It is certainly an attention-getter. Here's what I have to say:

Seeking funds is dramatically different from having funds, or committing funds. Legislative and administrative leadership was singing this same tune when they passed House File 972 last spring. It promised 460 additional rural hospital residencies. At the time, Kelly Garcia, Director of the Iowa Dept. of Health & Human Services, said her agency was "aiming to launch new residencies by July 1," failing to mention that the funds had not yet even been applied for. Perhaps someone should be asking Kelly, "July 1 of what year?" Oh no, wait, Kelly no longer works here.

I have to wonder, so I have to ask, "Why did that $150 million rural health care solution require so much legislative brouhaha but not this ask for a billion dollars?" I mean, it couldn't have been just so lawmakers looked like they were doing something about this crisis, could it?

Please just tell us now and get it over with: At what point will leadership admit that Iowa's life-threatening shortage of health care workers—urban as well as rural—is not really a priority at all? Take the hint from our goobernatorial candidates: They aren't even pretending that health care access is an issue.

Iowa health care consumers are not stupid. They face the challenges of accessing health care and caregiving resources every single day. That means they recognize exactly what is at risk and what needs to happen, and they also see that leadership—and wannabes—clearly do not.

[Prior to the January 2026 start of the new legislative session, I will be sharing a review of lawmakers' past "No, no, this is the one!" solutions to Iowa's critical shortage of health care workers and resources. And I, for one, cannot wait to see what's next!]

Where will you be when the music stops?

Jo has a fix for health care's supply chain crisis. If your organization wants to host a thought-provoking and informative program on the demographics of health care and strategies for self-preservation in this perfect storm, click here. Then contact Jo at JoKline@msn.com to explore the possibilities.