West of the Rotunda

North Idaho is different.

The vast majority of my years in Idaho have been spent in the state’s Pacific time zone. Why do we operate an hour different? Obviously, because we are north of the earlier Mountain Time folks down south, and time knows latitude, doesn’t it?

I’ve heard our Governor insists we up here be called “Northern Idaho”, not “North Idaho”, lest we start getting ideas of independence. I’m sorry, but that ship has sailed.

The Salmon River is the border for our special craziness. Come on up. But pack your colander or tin foil hat and put it on your head as you cross Time Zone Bridge. You’ll fit right in.

We had a strong antigovernment streak before statehood. Florence (north of the Salmon River) was a booming mining town in 1862. A Federal judge ventured over from Walla Walla to offer justice. He convened a grand jury and asked for indictments. The miners obliged, calling President Lincoln, cabinet members, Union generals and the judge up for trial. The judge rode his horse back to Walla Walla post haste and resigned. We can discourage authority.

We proudly know our history. I’m not sure the 1890’s miners insurrection in the Silver Valley was crazy. The wealthy mine bosses lived in lavish Spokane mansions while miners starved and slaved. But the strikers crossed the government line when they blew up a mill. The means of production cannot be damaged. That got US government troops called in from Denver. Some have argued lily white North Idaho’s racism was founded on the fact that it was black US Army “Buffalo Soldiers” who rounded up strikers and stood guard with rifles over them in open pens.

The coda to this episode didn’t end with the former governor’s assassination or the famous trial of the Union mine bosses who might have ordered the hit, nor with their acquittal. Our special crazy up here might have grown out of that convoluted spectacle of injustice.

I have no idea if Richard Butler and the Aryan Nations knew this history when they came to Hayden, Idaho near Coeur d Alene. But they added to the aura we exude. We are still known for their wacko ideas, even though they are long gone. We’ve moved on to prepping for the apocalypse and wrapping ourselves in Confederate flags.

The 1990’s Ruby Ridge standoff put us back on the crazy map. Randy Weaver died this month. He survived the siege of federal gunmen on his isolated North Idaho compound, though his wife and son were killed. He too was acquitted of all charges except “failing to appear in court”. Government hasn’t learned how to handle us. Maybe we just don’t like authority.

My home, Moscow, Idaho has its own crazy streak. Indeed, one State Senator we elected to represent us called us a “cesspool of liberalism”. It wasn’t me.

I like the crazy creative twist some of our residents can exhibit.

One day over coffee at the Co-op, one of these artistic types told me of an old State Patrol car he had purchased at auction back in the day. It still had the spotlights and the black and white paint, but all the fun sirens and bubble gum lights had been stripped and it wouldn’t do 120 mph anymore. But it sure looked official. He sported a bushy head of hair and a big scruffy beard. He appreciated the odd looks he got pulling up next to a fellow citizen at an intersection.

But apparently, he went too far when he designed and installed insignia badges on the front doors. They looked too official. A real state trooper pulled him over and told him to take them off.

They were a gold shield with black lettering: “North Idaho” on top; underneath “A State of Mind”.

I took a break from posting this last two weeks. I thank my employer for the time off, I thank the editor for the respite, and I thank my wife for the adventurous time we shared.

By the time you read this the nail-biting Idaho primary election will be over. I’m not going to make any predictions about the outcome of the races. Such would be foolish. But I can confidently predict the direction Idaho will be headed in the coming few years. We will continue in about the same direction. Our state will continue to grow with lots of folks moving in, looking for their own Private Idaho.

And these transplants will want more “freedoms” and less taxes. Don’t we all?

And they will look longingly at our public lands, thinking private ownership is the answer. I respectfully disagree.

You see, that was the adventure we took these last couple weeks. We explored some western public lands.

I’ve fixed up a 1985 Volkswagen camper. It climbs the grades at a modest pace. But it sleeps us warm, keeps the beer cold, and makes good coffee in the morning.

Our first stop was on Idaho’s beautiful Salmon River. Then we stayed in a Forest Service campground on Brownlee Creek amid some old growth red firs. Then, while visiting our daughter in Caldwell the first weekend we toured the Owyhees. There was a chill wind and snow on the peaks, but it’s an arid land. The ranches there are pretty far apart.

But our goal was to visit the Malheur Wildlife Refuge in southeast Oregon, outside Burns. We had been there before, but this time we took binoculars and the bird book.

The natives found the place friendly, with food and water enough to support their small population. But with white settlement the natural corrals of the Blitzen valley walls were recognized by an enterprising cattleman in the 1850’s. By the late 19^th century, it became the largest cattle ranch in the US, 160,000 acres. The cattle baron acquired some land by federal programs, some by purchase and some through legal battles. There must have been some bitterness since the ranch manager got shot by a disgruntled evicted homesteader.

The water flowing into marshes was key to the millions of migrating birds, but private property demands productivity, and water was diverted for fields and pasture. The marshes dried up and ducks died. And the surrounding farms were barely sustained.

Teddy Roosevelt was persuaded to make the area a wildlife refuge in 1908. Water rights were finally purchased for the Refuge in 1934.

Ammon Bundy chose to make a stand here a few years back. He called for the privatization of the federal lands and expected local ranchers to rise up in support. Like Putin misread the Ukrainians, Bundy got no groundswell of local support. His Sagebrush Rebellion fizzled.

But it’s still a stump speech dog whistle in this public land dominated state.

Martha and I enjoyed the birds; some we have never seen before. A quiet morning walk along the riverbank was memorable.

On the trip back up to the Palouse we passed through three National Forests. We pulled off a forest road and dispersal camped by the North Fork of the John Day River.

It’s a beautiful place up here in this sparsely populated corner of our country.

I own land. I do my best to maintain it and improve it. I expect the same for our publicly owned land. I don’t mind paying the fee for USFS or BLM campgrounds, and I appreciate that you can camp, hike, fish, or hunt on public lands. I can’t imagine the West without them.

I got a new cap to an old tooth last week. As the dentist was grinding down my old weak molar the assistant produced the new gold cap and offered it to the dentist. “Wow, that’s heavy!” he commented before cementing it into my mouth.

Wealth in my mouth.

I imagined an invading soldier shooting me in my wife’s garden as I held my hands up. Then he flipped me on my back and pulled out his Leatherman and opened my dead jaws, looking to pry out my dental wealth.

Twenty first century justice, despite the accoutrements of shoulder-fired missiles and remote-controlled drones is not too distant from the Vikings or the Huns. We take what we can. Might makes right. The school yard bully cowers us.

Russia is taking what it wants from Ukraine. She will want more. We wring our hands, dreading the nuclear arsenal we know they harbor.

What if the bullied playground colleagues thought to play differently? Bullies need to be confronted, and the nuclear end game is what they use to hold us hostage. There is a corollary to their gambit.

What would Russia do if Norway and Finland sent a column of tanks to Murmansk right now? It’s only a hundred miles or so and there’s a good road. I’m sure most of Russia’s military is looking toward Ukraine. That’s less than the distance from Kharkiv in northeast Ukraine to Mariupol, close to the Black Sea. It’s the same as a drive from Moscow, Idaho to Grangeville. It’s very doable.

The Scandinavians could easily argue the residents want their governance. Maybe their news media could dun up support.

And Turkey and Iran, with the support of Armenia and Azerbaijan might move into Georgia, in south central Russia to “free” the oppressed Georgians.

Then, over on Russia’s east Pacific coast, let’s say Japan and China decided the residents of Vladivostok wanted their assistance to dissolve the oppression of Moscow.

We should not be sheep. If the playground rules are to just take what you want, then let’s encourage our allies to go get it.

The possibilities are endless.

I’m sure Finland and Estonia see value in St. Petersburg. It’s only a hundred miles from their borders. Fifty tanks could make it in a day easily. Think of all the cruise ship passengers who want to dock and tour The Hermitage. It’s a cash cow.

Comrade Putin has opened up the game. We just have to play it like he does.

It’s too bad here on our continent we are just looking at Toronto, Ottawa, and Monterrey. If Biden sees some value there, let’s get our tanks rolling. I’m sure he could convince Fox News and Facebook to sell it to us. Would we buy it?

But the game is in Europe right now. It might come to the Western Hemisphere in another generation.

This limited warfare game of taking what you want and keeping the big stick of nuclear weapons in your back pocket begets bullies. Do we want such a system for ourselves? Did we invade Iran on such a pretext? Did we and the world look the other way because of our arsenal, our economic position?

Any meaningful global response to nuclear powered bullies is crippled. Any significant worldwide sanctions through the UN or the World Court requires the consent of the nuclear empowered bullies.

The Romans had their legions, and that worked against the Gauls and the Huns. Ballistic megaton missiles up the ante.

It is hard to consider global justice from north central Idaho. But seeing the painful pictures of dead civilians in Ukraine makes my jaw ache.

Have you ever wondered about the bill you get from the doctor’s office? Why did that visit just cost $135.75? And why is my insurance only paying $89.45? But the bill says the fee is “contractually reduced” to $110.91, so I only have to pay $21.46. But then I paid a $20 copay, so now I only owe $1.46. Seems like I you got a great deal, huh?

Isn’t this American healthcare system wonderful?

The providers are free to set their charges wherever they choose. It’s a free marketplace. But if providers want to work with insurance companies, they have to negotiate the “contractual” allowable rate with that insurance company, thus the reduced rate. The insurance company is fighting for you, aren’t they? But the more they pay to providers, and the more they collect in premiums, the more they grow their company. But the lower their rates, the more people sign up with them. Keep in mind, it’s usually an employer who makes the decision which insurance company to contract with for their employees. It’s not a simple marketplace.

About half the insured lives in Idaho have government insurance, either Medicare or Medicaid. The rates they pay to providers isn’t really negotiated. Medicare sets their rates annually through a very complex process that does accept input from doctors and hospitals. Then providers can either decide to “participate” with Medicare and accept their reduced “allowable” charges, and then whatever payments are offered. Providers face the difficult choice: participate and accept the reduced rate or try to collect on your own from the patient.

Idaho Medicaid bases most of what they pay on Medicare rates. But many Medicaid services (obstetrics, newborn care) have no Medicare rates. So, then Idaho Medicaid has to set its own rates. And it turns out they are not doing this very well.

I respect any legislator that asks a difficult question publicly. Most of the time I tried to do this in private, not wanting to embarrass state agencies. But Senator Abby Lee asked this question, and the painful answer is available for you to read. She got the Office of Performance Evaluation (OPE) to answer: “How does Idaho Medicaid set its provider rates?” You can read the study. It’s public, without a FOIA request on the legislative website under “performance evaluations”.

Like all OPE studies, it’s fair and honest. It’s a testament to the Idaho legislature that they keep this painfully candid group around and ask for their input. Honestly, much of the recommendations they provide go unheeded. But the legislature hasn’t abolished their input, though they could with the stroke of a JFAC budget.

The Idaho Medicaid budget has been pared to bare bones over the last twenty years. It turns out there is almost no capacity in this organization to analyze and alter payments based on some meaningful rationale. The Division of Medicaid has consistently asked for the smallest budget it could afford, and the legislature has often undercut their requests.

I will admit to some responsibility in this. Some ten years ago I helped write the DHW and Medicaid budgets when I served on JFAC. I cut them to the bones. Maybe this was short sighted. I don’t remember any requests for an analysis of rates. Maybe they knew my knife was sharp.

But setting rates can influence behavior, and that’s how we can change some of our costly practices.

I remember when a Washington insurance company said they would pay the same for obstetric care whether the baby was born vaginally or by C-section. They wanted no financial incentive to the doctor to give up on a natural delivery and take the woman to the operating room.

Thank you to Senator Lee for asking this question. I hope my acknowledgement (from an Idaho Democrat) doesn’t hurt you in your Republican Primary.

We can all do better. Let us do so.

This article inspired this post. The paywall might block your reading of it, but I paste the text below the post. I saw similar problems in the 15 years I worked as the “jail doctor” in Latah County, so the story didn’t surprise me. We can’t always find a clear border between criminality and insanity. Justice demands we provide for all whom we have deprived their freedom.

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Imagine yourself in a brutal domestic argument. Your spouse, maybe a relative threatens you and you respond with violence. You are arrested and charged for your crime.

Now imagine further you have deep personal demons. Maybe you’ve struggled with them your whole life, managed them the best you could. Maybe such turmoil contributed to your domestic conflict, maybe it bounced you from job to job and kept you on a financial cliff. Your car is broken down and the boss fired you a few weeks back. Now, though, those problems sit with you in the county jail. They accompany just you to your arraignment where your right to freedom is removed. They do not testify on your behalf. Instead, they mock and deride you from inside your skull. The courtroom may be the picture of order, the bailiff stands, and the judge sits and the lawyers for the state and for you, banter about bail and risk. You are sent back to jail to await your trial.

The trial is speedy and definitive. You must serve time in the custody of the Idaho Department of Corrections. You have lost your freedom in this country where we say we respect “the rule of law”.

But the demons begin to win inside your small hard skull. You find no meaning to this life you have struggled through for maybe too long. Your brain stops telling you what to do. The jail deputy notices you don’t get up for breakfast. You have soiled yourself. You do not respond to the deputy’s speech. You stop responding to everything. The demons murmur or screech and you have retreated as far away as you can go.

The jail deputies ask for help. You are examined by professionals and deemed unable to care for yourself, indeed a risk to yourself and maybe a risk to others, given the history of violence presented at your trial. The county jail and the county sheriff ask for help.

Professionals have determined you need medical and psychiatric assistance. The Idaho Department of Corrections asks the Idaho Department of Health and Welfare to help. They do their evaluation. They determine you need care that the DOC cannot provide, but you are too great a risk to go to a state mental hospital.

Meanwhile, the days go by in the county lockup, your freedom long gone, and your mind possessed of demons and doubt.

This movie you have obligingly created in your mind at my request is not over. In fact, this is just episode one of the first season. It is an ongoing series. Idaho could make this a Netflix drama with little production cost. This happens every month in a different county in this wonderful state. Idaho Justice would be an excellent title, don’t you think?

This is not justice for the convicted and the severely mentally ill. This is not justice for the sheriff or deputies who swear to protect the convicted, now denied their freedom, but in their charge. This is not justice for the officers of the court, the judge and the lawyers who swear to serve. This is not justice for you and me who should know that this travesty is happening in our counties, in our state.

If you doubt that this is not just a mental Netflix series, ask to have a conversation with your local elected county sheriff. Ask them if such a scenario has occurred under their watch. See if they shift and deflect. It is a painful truth we all do not want to face.

For how we each define justice, for ourselves, and for those we have allowed “the rule of law” to deprive of their freedom is a telling definition. Please search your soul. I believe we can do better.

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Lewiston Tribune article, April 9, 2022

The plight of an inmate who has languished at the Idaho County Jail for months highlights the critical lack of mental health treatment options on the Camas Prairie.

A group of about 36 county and state officials met Thursday at the Soltman Center in Grange-ville to discuss taking the first steps toward establishing mental health services for Idaho and Lewis counties. A recovery, crisis or outreach center likely would be modeled after such facilities currently operating in Lewiston, Moscow and Orofino.

That future plan, however, doesn’t help an inmate currently being held at the Idaho County Jail. The man was convicted in January during a court trial of multiple felonies, including attempted strangulation. Shortly after the conviction but before sentencing, the inmate became suddenly incapacitated, or “catatonic,” meaning he stopped eating, drinking, moving voluntarily, speaking and taking care of personal hygiene functions.

The ongoing care of the inmate, along with what sheriff’s officials believe is stonewalling by the Idaho Department of Health and Welfare to find a mental health facility where the inmate can be treated, has created what Idaho County Sheriff Doug Ulmer believes is a dangerous situation.

“Our job is to protect the community and protect the people in our jail,” Ulmer said during an interview at his office Thursday.

“This person needs help. He had a bed (in a mental health facility) to go to in Boise. Health and Welfare did their interview and said he did not meet their criteria.

“The roadblocks are being thrown up, in my opinion, by the Health and Welfare mental health group and their process. We are not set up to deal with his situation at all. It takes 24 hours a day, seven days a week checking on this person. It’s a constant pull and there’s no light at the end of the tunnel. We just keep getting this runaround from Health and Welfare. … This person shouldn’t be in our facility; he should be in a hospital and getting the help he needs.”

Michael Wraith, program manager for Health and Welfare’s Regions 1 and 2 Behavioral Health program at Coeur d’Alene, said he couldn’t comment on the specifics of any case.

Speaking in general about the department’s policies, however, Wraith said “there are a lot of nuances that come into every case that’s committed to us. Medical complications are one of the primary issues. … Sometimes, if a person is dangerously mentally ill, it slows down the process.”

Although the Idaho County inmate was evaluated by a licensed psychologist following a court order, Wraith said his department has to have additional evaluations if there are complications to a case, such as medical problems or someone who is dangerously mentally ill.

That, apparently, is what has happened in the Idaho County case.

Brian Hewson, chief deputy for the Idaho County Sheriff’s Office, said shortly after the court-ordered evaluation of the inmate, he made contact with the Idaho Department of Correction in Boise to let people there know Idaho County would be sending down the inmate.

“I told (the person he contacted), ‘We’re getting ready to load him up and we’re getting ready to transport him to you, like the court order states,’ ” Hewson said. “He says, ‘Hold your brakes, it doesn’t work that way. We have the ability to not go by a judge’s order.’ He said, ‘Judges don’t like it, but that’s the way it is.’ I go, ‘OK, that’s a new one to me, right?’ ”

Hewson continued: “He said, ‘What we need is, we need Health and Welfare to evaluate him because we go by Health and Welfare’s determination.’ (The inmate) had already been evaluated by doctors, psychologists, but that’s not good enough.”

Two workers from Health and Welfare showed up at the Idaho County Jail a couple of days later, Hewson said, and spent 10 to 15 minutes with the inmate. There was no interaction with him at all, and the workers left and filed a report for the Department of Correction.

“The Department of Correction says he does not meet their criteria because he’s not a dangerous individual,” Hewson said, pointing out that the inmate had been convicted of attempted strangulation and assault.

“We have concerns. He’s been convicted, so if he goes to a state hospital with lower security, my concern is that he is now a flight risk because he has not been sentenced yet. … We have had him at St. Joe’s several days. He was evaluated and they said he should be hospitalized but they didn’t have a bed for him.

“We don’t know where to turn,” Hewson said. “I’ve never seen roadblocks like this.”

Wraith said his department tries to have transparent communication with other agencies, but sheriff’s officers said that has not happened in this case.

“Our commitment process in general is a complicated system,” Wraith said. “So it’s not something (where) we’re intentionally creating barriers.

“Any patient that is committed to us gets placed into an appropriate facility as soon as possible,” he added.

Ulmer acknowledged that even if a recovery or crisis center was available in Idaho County it probably wouldn’t have helped out in this particular case.

But there are other examples of why the Camas Prairie needs places for people who are having behavioral health crises.

“We have people we deal with all the time,” Ulmer said. “How many times a deputy or a policeman opens his billfold to buy somebody lunch that can’t (afford it). These people are just wandering and they have issues. They’re hungry and they need food (and shelter).

“We work with these people all the time,” Ulmer said. “So if there was an avenue we could take these people to, to get them help, that would be huge.”

Hewson added, “There’s people out there wandering around who don’t meet that criteria of being a danger to the public or themselves. And the services that we were talking about (in the resource and crisis center meeting), that would work for them if there were contacts that we could call or steer them in that direction.”

Ulmer said his office supports the idea of a behavioral health resource or crisis center in Idaho County, “but if it comes with the red tape Health and Welfare has made, we don’t want to be involved.

“We try to help people out and it kind of feels like you’re failing miserably because you keep running into this wall,” the sheriff said. “This person (the inmate) remains in our facility that we are not in any way, shape or form able to deal with. We deal with his needs because we have to, because the people who should be dealing with him aren’t. It’s aggravating.”

When I first got elected to the Idaho State Senate way back 2010, I woke up on the morning after the election to a phone call from Mountain Time Zone. I just was having coffee when the Senate Pro Tem at the time, Senator Bob Geddes, called me on my land line to welcome me to the Idaho Senate. He was very gracious. I was aware, and so, I’m sure was he, that I had won a seat formerly held by a respected Idaho Republican for 14 years. And I was an Idaho Democrat.  That Senator had been beaten in the primary by a Tea Party candidate. Then I had beaten the radical in the general election. So, Idaho Democrats gained a legislative Senate seat. I had been working so hard to knock doors in my district, I had little perspective on the statewide political landscape. But I appreciated his welcoming generosity.

The second call I got that November morning was from a guy I knew who had followed and supported my campaign. He was living out of state at the time to make big money, but his heart was in this wonderful state. I remember a question he asked me after the initial congratulatory exchange. “So, Dan, have you ever considered running as a Republican?”

I had stayed up late and wasn’t real sharp, even with that first cup of coffee. “No, I haven’t.” I answered. “The voters wouldn’t trust such a flip.” I threw out, not really being an expert on Idaho voters at that point in my political career.

But my caller knew Idaho very well. He was 25 years younger than me, and he knew the tides of this era while I harbored memories of the olden times, when Democrats could get elected to either the legislature or statewide in this leftover state. I was only thinking of my district, my election, and indeed, my service. Why should the party label matter?

But I soon learned that it did.

I was assigned to the Agriculture Committee in my first year in the Idaho Senate. An issue came before us that I needed to understand, so when I saw a senior senator not on the committee, but a rancher and I assumed more familiar with the subject I approached him. He stopped and heard my question, but then he started backing up as he answered. I followed, bending in to listen, but soon realized we were in an alcove, out of sight. He didn’t want to be seen talking to an Idaho Democrat in the halls. But his counsel was wise, and I appreciated his wisdom. I learned that good conversations must be combined with discretion. And that labels matter.

Many elected people have had to play this ugly partisan game here in Idaho. I’m not a good enough historian to make the list complete. But I think of John Peavey, former Idaho State Senator. He was first appointed to fill his mom’s seat when she got picked to run the US Mint by President Nixon. So, he served for a while as a Republican as she was, but then switched parties and got elected as a Democrat in his central Idaho district. He’s really known for his wise and provocative stand on water rights, since he was part of the lawsuit that forced the Snake River adjudication. We owe him some gratitude.

Indeed, Branden Durst, a current candidate for State Superintendent of Public Instruction sat next to me on the floor of the Idaho Senate as a Democrat. But he runs now as a far-right Republican.

Other elected officials I have served with have told me they first ran for office as a Democrat. But they understood the Idaho climate.

Some Idaho Republicans want to purify their ranks, killing RHINOS (Republicans In Name Only). I just wish we could elect folks who want our communities to thrive.

It’s always something when Idaho makes the national news. But these pinko slanted reporters just seem to cherry pick the awards we get. So, when I read about our Lieutenant Governor getting the coveted “Black Hole” award, I had to look further beyond just the Fake News.

Janice McGeachin did indeed get this ignominious press award for hiding public information from the us, the public, and then losing her lawsuit, and trying to get us taxpayers to pay for her shenanigans. But I was sure there was more going on in this backwater state, so I Googled my hind end off and tried to find what else might be going on.

It turns out there’s more awards you should know about.

The Sheepherders Association has a small offshoot that deals with domestic feline custodial practices, and it turns out our Governor, Brad Little, got awarded the Cat Herder of the Year award for 2021. He was recognized for his ability to deal with craziness, crapitude, and criticism in public office. Brad was well known to the Sheepherders Association, so I wondered if this award was kind of an inside joke, but he didn’t miss an opportunity for public pleas. His acceptance speech was brief at the Elko, Nevada convention. “Thank you for this.” He said. “Now I need to get you all to register for the Republican Primary in Idaho.”

Why didn’t this make the news? It’s just another example of the “Fake News” we all have to deal with.

I had to get to the third page of Google searching for “Idaho Awards” to find the Anadromous Award. It’s pretty obscure. They say they want to acknowledge the efforts of individuals who exemplify the upstream work of salmon and steelhead, battling against predators and dams, current and gill nets, fishermen and waterfalls, to return to their spawning grounds to lay their eggs, have them fertilized to create offspring who can then face such obstacles. Can you imagine the award ceremony? Tears were dropping from the ten people in the room before the winner was announced.

No wonder the Fake News didn’t cover this. Representative Mike Simpson got the award last year, so they had to look elsewhere. Their glance didn’t stray far.

They awarded the 2021 Anadromous Award to Lawrence Wasden, Idaho Attorney General. They recognized that he hadn’t specifically done anything for steelhead or salmon in this land-locked state, but that he had exemplified the nature of their struggle. He had tried, unceasingly to tell the truth to people who did not want to hear it. How more upstream can you fight? The applause was strong, though he was not present to accept the award. It seems he had other engagements.

A corollary to the Black Hole Award came from the Conservative Political Action Convention. They acknowledge folks who successfully hide their funding but accomplish significant change. This was the coveted Dark Money Award, given in the past to such notables as Paul Manafort. He got it while serving his foreshortened federal sentence, right before he was pardoned by our former President. They recognized the Idaho Freedom Foundation this year for their unprecedented success here in Idaho. Kudos to the Freedom Index.

But lest you think only Republicans win awards in Idaho, the National Association for Dramatic Public Mistakes found an Idaho Democrat (well, maybe) to recognize in our small state. They gave their Bonehead Award to Idaho Democratic Gubernatorial Candidate, Shelby Rognstad. When he announced and started raising money to run against whoever the Republicans chose, he didn’t realize he was a registered Republican. The Idaho Secretary of State pointed this faux pas out to him, but since he had waited to the last minute to file, he had no time to change his registration. He now will run as a write-in. The last Democrat in Idaho has to learn to spell “Rognstad”.

Fake news be damned.

The Idaho legislature wants to make Idaho medical students whose education is supported by taxpayer dollars serve some time in Idaho when they grow up and become practicing physicians. Seems like a win-win, doesn’t it? Idaho needs doctors, the students want to become doctors. Why not require them to spend some time helping out this beautiful state in return for the taxpayer support they receive?

You need to know I have some history here. I was supported in my medical education by Idaho taxpayers some 40 years ago. I was an Idaho WAMI. It had just one “W” back then, before Wyoming joined Washington, Alaska, Montana, and Idaho in the medical school collaboration.

It’s not the first time Idaho has tried to incentivize WWAMI students to return to our dear state. The first attempt was a carrot, not a stick. WWAMI students who returned to Idaho and practiced in an underserved area could be eligible for support to repay medical school loan debt. This was from a fund garnered from assessments on students in the program, and later, taxpayer funds were added.

But the current law is a stick. If you are a WWAMI student and don’t come back to Idaho to practice within a year of finishing your residency or getting a license, and then stay for four years, you owe the state of Idaho the full amount of what the taxpayers doled out to support you: about $160,000.

Alaska, Wyoming, and Montana have all instituted such requirements of their state supported students in the last few years. None of these states has seen a dramatic drop in applicants for their programs.

The University of Washington School of Medicine and the WWAMI multistate collaborative program are recognized for their excellence in training and preparation of medical students to serve both primary care and rural populations.

I’ve watched the UW/ University of Idaho WWAMI faculty try to avoid this for the last ten years and I really haven’t understood their reluctance. Taxpayers deserve some return for their investment. But carrots and sticks? Why not make Idaho a place doctors want to work and where people want to be well?

One of the most critical decisions a young highly trained professional in any field faces is where to locate and put their services to use. Market forces often focus on the quantifiable salary, but for many, there are greater considerations.

Where can my spouse be happy?

Will my children thrive in this town?

Will I continue to learn and grow in my profession?

Can we find a place to live that will suit us?

Will our family feel welcome?

I know these are their questions because I had them myself, and I addressed them in the colleagues I recruited.

The best way to serve our state in its health care professional needs may not be with carrots or sticks but instead to look at the bigger picture. We need to make our state sustainably desirable to live in, to work in, to serve in.

I moved from Hells Canyon to Council, Idaho to McCall, to Moscow where I started my family. We walked the streets before the Farmers Market and looked at the big old homes. We fell in love with the Palouse.

Each of our little towns, and even the big ones need to be supported as they struggle to serve their needs. Carrots and sticks are the tools of petty tyrants. We need vision and wisdom in the leaders we elect.

I cannot oppose this requirement that medical students return to the state that supported their wonderful education. They should have a deep sense of service to the health of their community. Idaho leaders need to build strong communities for them to serve.

We held our Idaho State Democratic convention at Mingles Pool Hall on ladies’ night, thinking it wouldn’t be too crowded. There were just three of us left in this vast state; two in the North End of Boise and me up in Moscow. They agreed to come the 300 miles north for the beautiful drive.

I checked with the bouncer, and he said we could use a corner booth if we didn’t get too loud. “Why don’t you get a pool table? Number two is open. That’s your favorite.” He knew my habits.

Thinking a couple games of cutthroat might pass the time while we approved the minutes of our last meeting, I got the rack of balls and picked out a cue. The other two Idaho Democrats came through the swinging doors right on time. Matt had his Idaho State sweatshirt on, and Priscilla was wearing her Paulette Jordan sweatshirt. We always try to fit in.

They ambled my way reluctantly. Matt grinned and nodded toward the rack of balls. “Are we going to play for who gets to be the last?”

You see, we had to decide who amongst us was going to keep the banner, since there was such a strong desire to register Republican to participate in the closed Republican Primary election this May.

“You know how to play cutthroat?” I asked them. Their headshakes got me started on the explanation of the rules, but they got distracted.

Priscilla asked the waitress is they had organic herbal tea. Matt wanted an artisanal IPA. They settled for whatever and I got Jim Beam on the rocks.

“Cutthroat, huh?” Matt asked. “Sounds like an appropriate game for Democrats.”

Priscila frowned. “Just because you didn’t vote for Paulette, I wouldn’t cut your throat.” She chalked her cue fiercely.

“So, the rules are, the last one of us with any balls on the table gets to be the last Democrat in Idaho.”

“That’s sure sexist.” Priscilla frowned again. “How do I know which are my balls and which are yours?” She grinned and glared with her emphasis.

“Whatever balls you don’t sink, that’s what you are.”

Matt grimaced. “Another Democrat rule if I’ve ever heard one.”

“So, I’ll break. If I drop the One Ball and the Fifteen Ball, I’m the middles, six through ten. We each have five balls and you want to drop the other guys. Make a shot, even your own ball, and you get to keep shooting. Winner is the last one with their balls up.”

Matt racked. “Move to approve the minutes.”

“Second,” Priscilla offered, “and I’ll go next.”

Sure enough, I dropped a couple on the break, the ten and the twelve, so that meant I was the low balls. I made a couple more, then missed.

Priscilla dropped the fifteen. “So now you are the middles, six through ten.” I explained. She lined up on the nine-ball. “You know that’s yours.” I offered. She sank it in the corner, looked at me and smiled. “Now you only have two left.” She smiled again and kept shooting. She dropped one of Matt’s and one of mine, then another of hers, then missed.

Matt studied the table and I spoke to Priscilla as she chalked her cue softly. “You only have one left. Why’re you doing that?”

She whispered, “I’m moving to Portland. I can’t be the last Democrat in Idaho.”

Matt sank two of his, leaving him with just one also, then he missed. “Are you moving too?” I asked him.

He was honest. “I need to vote for Brad in the primary. I have the paperwork in the car.

I dropped their remaining balls, leaving me, the last Democrat in Idaho with three balls on the table.