Gov. Terry Branstad’s comparison of medical co-pays to the cash bar at a wedding is insulting to uninsured Iowans. People often have no choice about encountering exorbitant medical expense.

It is wishful thinking to suggest that IowaCare will lead to a “healthy Iowa.” By definition, IowaCare provides “limited service,” with no mental health or ongoing prescription coverage. Hospitalization is available at two sites. Twenty-one counties must use the University of Iowa Hospitals and Clinics for primary care. Many of these patients own no car and most communities have no transportation to the university. Patients wait months for initial coverage, reinstatement when dropped from the program and primary care appointments. Many forms of specialty care remain out of reach.

In reality, much “Iowa care” is provided to these patients by free clinics in the form of medications, care during lapses in coverage and consultation as patients wait up to eight months to see IowaCare physicians. The true cost of IowaCare needs to include that money spent on enrolled patients in free clinics.

It is ironic that the governor favors IowaCare over Medicaid when the program is slated to end in December and the state has underfunded the university’s contribution for 2013 by $9 million. This is hardly a convincing commitment to Iowa health.

Dr. Mary Kemen

Cedar Rapids