West of the Rotunda

The legislature was still in session, so the Capitol doctor still had to show up for office hours, though it didn’t seem like he was doing much good. Still, these part time retirement gigs kept his mind in the game, though he felt his heart fading from it a bit.

Doc Hasty shuffled up the steps of the domed building early. He hoped the morning hours would be brief and he’d make his 11AM tee reservation at the club. He unlocked his basement office door and flicked on the computer

It had been a weird session with all the pandemic brouhaha. He’d done his share of nose swabs. Prior sessions he mostly dealt with the worried well, the bad cold that hung on, the sore shoulder that wasn’t a heart attack. But there was real medicine to do sometimes. He once drained a painful purple fingernail with a red-hot paper clip. And there were nose bleeds and hemorrhoids, but this year had tested him.

First, he couldn’t get anybody to wear a mask except the Democrats, and that made the issue political, not common sense. He winced whenever he thought of it.

Then nobody would agree to get a vaccination, even though some of these guys were prime candidates for a ventilator, should they get the virus. That is, of course, except the Democrats, the dozen of so walking the halls with their “I Got the Shot” buttons. It was like they thought that might convince their counterparts across the aisle. Doc Hasty shook his head at the thought. Common sense ain’t common even here in the “Peoples House”.

But he was most bothered by the secret requests for hydroxychloroquine. Senators would lean in and whisper if he had any “Hydroxy”. The first time this happened last year, when the pandemic was still on the rise, he’d mistaken the request. He’d done enough ER shifts to know folks who wanted “hydros”, the short for hydrocodone, and “oxy” the short for oxycodone, both prescription narcotics with street value and narcotic effect. So, the whispered “hydroxy” request made his eyes bug out at the conservative Senator. With no answer, the Senator had filled in the “hydroxychloroquine”, but still whispering.

Now it was Doc Hasty’s turn to whisper, and he didn’t know quite where to go. He had read the studies, heard the news and knew the politics of the drug. And he also knew the risks. But he didn’t want to offend anyone for their beliefs either. He whispered back, “Hard to come by.” And shook his head. He hoped that would spread the word. The couple more times he got the ask he handled it the same. It faded and last session ended. Nobody had whispered such requests to him this session.

But there had been a few tough calls this session. Some folks had come in with bad colds, maybe a fever or a cough, so he’d swabbed their nose and told them to go home to await the results. It was awkward when he still saw them in the halls later that day sniffling or coughing. He’d glare at them, but he didn’t have any authority besides his professional advice. And he didn’t want to scare off folks from getting checked.

He shared this with his golf buddy one afternoon on the back nine. “Acting like a bunch of high school kids not wanting to miss the big game, huh?” had been Jack’s response.

Hasty chuckled. “Yeah, kinda, I guess.”

“How do you handle caring for all those prima donnas? It sure would drive me crazy.”

“Oh, they’re just normal people, like you and me.” Hasty offered.

Jack lined up his putt. “Well, if they’re normal, like you and me, I wish they’d act like it. I think getting elected has gone to their heads.”

“Oh?”

“You know Doc, what those guys need is a prescription for hydroxycommonsense. You got any of those pills?”

The Idaho legislature took a few days off back in March, did you notice? But they are set to get back together this Tuesday. I hope they got the studded tires off their rigs before they head to Boise, because I doubt they’ll be wanting to twirl a lug wrench in their suits and ties. Studs gotta come off here in Idaho by the end of April. Maybe they’ll be done with their lawmaking duties by then. But it isn’t going to snow in Boise in April; they should take them off now.

That’s the kind of thinking I want from a legislator; minimize the damage done to others. You see, while the studs make your traction better in ice and snow, they damage the roads. And we wear our roads out enough here in Idaho. Tire studs are regulated in Idaho law.

I bought some studs this year on Craigslist for my little two-wheel drive pickup. The old street tires were getting pretty bare. I was glad I had them with the snow and ice we had, but it’s time to take them off. Probably need a new set of street tires. If they are all-weather, I might be selling those studs on Craigslist next fall.

Some states ban studded tires, but they are like Hawaii and Florida and Texas. But get this, Minnesota also bans studded tires, and they get winter, I’ve heard. Washington state had a ban on studded tires until 1969 when the legislature allowed them. Every year since the Washington Department of Transportation has recommended reinstituting the ban, but their legislature hasn’t bit that bait. Washington does charge a $5 fee on every studded tire sold in the state. It goes into the highway repair fund, but they claim it doesn’t cover the damage done. Heck, in Wyoming they are legal all year. But they have oil.

So, past Idaho legislatures have decided to regulate some things, despite the tone of the current session. Maybe when they get back this Tuesday, they’ll take a look at that studded tire law and throw that one out.

They haven’t been too welcoming to regulations this year.

That is, unless it’s public art. They want to regulate how municipalities do art.

And historic names, like schools or parks, the legislature wants to put their hand on that scale.

Oh yes, and anything to do with “social justice” is facing hard times.

And they want to make it harder to turn in absentee ballots because, as House Majority leader Mike Moyle says, “Voting shouldn’t be easy.”

Maybe studded tires are next.

It really is about freedom, after all. There’s a guy down the street drives by my house all summer on his way to Arby’s with his studs on. I can hear him coming three blocks away. He’s celebrating his freedom to run studs in the summer while he ruts up the road in front of my house.

One person’s freedom is the next person’s rut in the road.

I don’t know about you but I’m looking forward to the legislature getting back together. I heard some got the Covid so that’s why they shut down suddenly. I really hope they are all better and nobody else gets sick. I hope they are ready to get back to work.

Maybe their perspective has changed in this little two-week break. We know the faces haven’t; the same butts will be in the same seats. And, despite the little Covid scare, most won’t be wearing masks.

But maybe they swapped to the summer tires. It would be the responsible, neighborly thing to do.

I listen to the radio when I’m working on that garage I’m building down the hill. Can’t hear it above the saw but it keeps me company. When I heard the ad for a “Health Care Sharing Ministry” I listened carefully, because I know what they are; and what they are not. But the ad sure didn’t help me know that.

Most HCSMs allow membership if applicants share the same religious beliefs. Some only ask that you have a “healthy lifestyle”. You are expected to pay a monthly fee, then when you have a medical cost, you apply for reimbursement.

I got my introduction to these when a fellow State Senator brought a bill before my committee back in the anti-Obamacare days. I’d never heard of them before. It turns out the ACA included an exception for these; folks so enrolled didn’t have to pay the Individual Mandate penalty. But the Obama compromise also limited these entities to ones in place before the year 2000. And that individual mandate penalty is now $0.

Back when the ACA compromises were being handed out, there were only about 100,000 people enrolled in these. Small potatoes to the insurance industry, and Obama, the great compromiser, thought this was a practice worth defending, so folks who participated got written out of the requirement for the Individual Mandate.

The bill before us that got me studying “just wanted to make sure” Idaho didn’t treat these entities like insurance. And they aren’t. But that radio ad I heard last week sure made them sound like it.

“Health insurance unaffordable? Try us!” was basically what it said.

Nowadays, HCSMs have over a million participants nationwide. And I guess radio ads are part of their marketing plan.

Remember, we (that is, Congress) have been doing nothing for the last ten years to keep health insurance affordable. I can see why folks are looking for a low-cost alternative. But HCSMs are not insurance.

Health insurance companies are regulated, both at the federal and state level. Health insurance companies cannot exclude you for a preexisting condition (thanks to the ACA). HCSMs can. Health insurance companies cannot kick you off for getting sick (expensive), also thanks to the ACA. HCSMs can. Health insurance companies must spend 80% of their revenue paying for health care (thanks ACA). And they get audited. HCSMs have no such obligation for transparency.

When I first heard about these long ago in committee, I thought they sounded like an informal mutual aid society, with a scriptural inspiration. The Apostle Paul said, “Bear one another’s burdens, and thus fulfill the law of Christ.” Galatians, Chapter 2 Verse 6. Why not let like-minded folks pool their resources and care for each other? My question is, why do they need to advertise on the radio?

It seems that some Idaho legislators might listen to these radio ads in their neck of the woods too. A bill was attempted to be introduced back in February to put some regulations on these actors. It was interesting to me that a Republican legislator carried it, and the committee rejected it. Now, as an Idaho Democrat, that’s familiar territory, but a Republican sponsor, and a member of the committee? He must have had a real stinker. Oh, that’s right, it had to do with regulations. We don’t need no regulations.

But another bill was introduced and printed, so we can read the suggestions. It is in a chairman’s drawer.

The bill proposes HCSMs have an annual audit that is made public, not exclude anyone based on their health risk, and not misrepresent itself as insurance.

I doubt the Idaho legislature will want to support such brazen regulations. We all just need to be careful when we are buying stuff, don’t we? We’re on our own here folks.

As the Idaho legislature plods through the ides of March, Governor Little should not be afraid they will stick around to override his veto. They will. They are in no hurry to leave. So, Brad, go ahead and veto the Initiative Killer Bill. It looks like they have the votes to override it. Then it will all be on them.

I understand the legislature’s twist about initiatives. It seems a lot of this session has been about their umbrage. After all, we elect them to make the laws, don’t we? And elect them, we do.

But there is this little thing called the Idaho Constitution. Article 3, Section 1 says:

The people reserve to themselves the power to propose laws, and enact the same at the polls independent of the legislature. This power is known as the initiative, and legal voters may, under such conditions and in such manner as may be provided by acts of the legislature, initiate any desired legislation and cause the same to be submitted to the vote of the people at a general election for their approval or rejection.

So, this proposed law (SB 1110) is well within the power of the legislature. But the details of the law will make the initiative process impossible, which is probably the legislature’s goal.

Twice in the last decade the people of Idaho have either over-rode the legislature (repeal of the Luna Laws) or taken up what the legislature refused (Medicaid Expansion). But then the voters returned the very same legislators they were disagreeing with to their places in the statehouse.

So, I can see why these elected folks feel pretty safe. Safe is not what our representatives should feel.

I’ll bet Governor Little doesn’t feel too safe. I hope that doesn’t keep him from doing the right thing.

Past judicial rulings (2001) have held that the county-based requirements for initiative passage violated the Equal Protection Clause of the US Constitution (14^th Amendment). But the legislature has fixed that by moving to legislative district requirements. Under current law in Idaho, to qualify an initiative for the ballot, signatures from 6% of the voters in 18 of the 35 legislative districts need to be submitted. If SB 1110 passes this week (and it will), this requirement jumps to 35/35 districts.

This will make an initiative or referendum impossible for the citizens of Idaho, despite what the Idaho Constitution guarantees.

Why doesn’t our legislature just propose changing the Idaho Constitution, getting rid of the process altogether? It would be harder, requiring 2/3rds vote in both bodies. It sure looks like they will have that margin. But then we’d have to vote on it, the people. A majority of us would have to say, at the next general election, sure, forget it, we don’t need no stinking initiatives. Given our tendency to elect these folks, we just might go along with them.

But then, twice in the last ten years we haven’t.

Two years ago, Governor Little vetoed a similar bill that had the purpose of making initiatives impossible. That time the legislature had adjourned, and it didn’t really look like they had the votes to override.

This time will be different. If Little vetoes, they’ll still be in town. And they probably will have 2/3rds in both bodies. I hope an override doesn’t deter him.

The Governor said in 2019 with his veto, he feared a Federal Judge would throw out the law. That argument has never stopped the legislature from their proposals.

I sure like having the power of the people proposing or rejecting laws here in Idaho. Believe me, it’s not easy now, and it shouldn’t be. Legislators point to the California or Washington State initiative boogey man. That’s not Idaho. And Brad knows it.

So, it’s been four years of a Republican administration and congress vowing to “Repeal and Replace” then “Repeal”, then “Let’s Beg the Courts to” deal with the great abomination they perceive the Affordable Care Act to be. But, I guess, elections have consequences. Now we have a Democratic administration and congress. Are they doing anything? Let’s look.

You remember I have written about the problems with the ACA before. When Nancy Pelosi said “We have to pass the law to find out what’s in it” she wasn’t kidding. There have been lots of quirks.

There is this thing called the “Subsidy Cliff”. It affects some people who purchase insurance on the exchanges (about 10% of Idahoans). Most Idahoans get health insurance through their employment (about 50%). Then there’s us Idaho geezers on Medicare (about 15%) and the poor or disabled on Medicaid (another 15%). Approximately 10% of Idahoans are uninsured (2019 numbers). You see, everybody is in a different boat. The single payer folks think this would be easier to fix if we were all in one boat. It would sure be a big boat.

But some of the folks in the Idaho Exchange boat are getting juiced. They face the subsidy cliff. Currently, if you make less than $50K and you buy your insurance on the Idaho Exchange, your premium comes to about 10% of your income. If you make $55K, the premium percentage jumps to about 20% of your income. It doesn’t make sense that a $5K raise would actually cost you $5K more in health insurance, but that’s how the current set up is.

And just like he promised, Joe Biden proposes to address this. He campaigned on fixing the problems with the ACA. Remember, lots of Democratic presidential candidates raised their hands to “Medicare for All”. But we got Joe.

The current $1.9 Trillion Covid relief budget reconciliation bill has “a fix” for this subsidy cliff. If it passes both houses (passed the Senate this weekend, maybe House on Tuesday), this cliff will disappear. Instead, folks buying insurance on the exchange will see gradual increases in the percentage they pay as their incomes go up, not the steep jump.

Here’s the catch. It’s only a two-year fix. Unless it is continued, in two years, the cliff comes back. What else happens in two years? Yup, mid term elections. The House will probably go back to the “Repeal” crowd and nothing will be done awaiting another presidential election.

It’s our fault folks. We don’t demand our elected officials address the health care mess in this country. We can’t stay focused on a problem longer that it takes to watch a Tick Tock or read a tweet. And if we can’t, we sure can’t expect our elected officials to have that discipline.

This fix has been in a lot of congressional drawers for four (maybe ten!) years getting no discussion, no traction. We, the splintered masses, have not asked for this simple fix with any sort of voice that could be heard.

It makes sense, given the many boats we are in. This problem probably affects about 1-2% of Idahoans, and about the same percent nationally. That’s not a large electorate, even for a simple fix. Especially when all you have to say is “Obamacare” and the AR15s come out.

Yes, it’s our fault. But it is a very complicated law, that ACA, Obamacare thing. There are lots of folks paying attention to it with ideas and suggestions. But we sure don’t want to hear any of that, do we?

Maybe, the scream and Tweet crowd would rather we have a simpler system, one where we are all in the same boat? If we don’t do the work to fix the many little boats we are in, we’ll all be swimming soon enough.

Courage isn’t something you think of when you’re talking about politicians. Indeed, if politicians are just supposed to be mouthpieces of their constituents, what courage is called for?

But some of our problems demand a greater perspective than a single constituency. There can be little incentive for a politician to take a broader view. Just keep the district happy and toe the party line seems to be their marching orders. Indeed, nowadays, most proposed solutions seem to gather support depending on your side of the aisle. Breaking rank may be political suicide.

So, when an elected representative does just that, voices dispute with his partisan colleagues, it gets noticed. And depending on the position taken, and the conviction of the speaker, it is judged foolish, petulant, disloyal, but rarely courageous.

I judge Idaho Representative Mike Simpson courageous.

He has proposed breaching the lower four Snake River dams in an attempt to restore a signature and endangered Idaho species: native salmon.

His proposal attempts to address the concerns of all parties. The port jobs in Lewiston and Clarkston, and further downriver will need support. The cheap transport costs area farmers have gotten will need support. Hydropower users will need support. He has a long and comprehensive list of the affected parties and how they need to be addressed. It is a very detailed proposal.

But judging from the immediate backlash from many of his fellow Republicans and conservative voices he’s catching a lot of heat. It takes some courage to get yelled at. And he knew he would. Despite that certitude, he has spent three years meeting with the affected players and crafting a solution. He stuck with his vision.

It’s not easy getting a controversial subject in front of a reluctant audience. I know from experience. And, indeed, my attempts to do such got me unelected. And this stance may do this for Representative Simpson. But what better use of public office than to take a principled public stand? That’s what I call courage.

I have been reading the criticisms of Simpson and his proposal. They run the gamut from partisan dismissive insults, to “hey, he’s not guaranteeing it will work”. The line of critics is long and predictable, from the Idaho Governor’s office down to the Farm Bureau, with many Republican legislators in the middle of the line. Most critics acknowledge that what has been done ($19B spent for “salmon recovery”) has not moved the needle. Some argue that hatchery stocks are just fine. Others point to native harvests, or ocean conditions as excuses to not take this action. But if any critic wants to be honest, they need to answer this question: does the survival of Native Idaho Salmon matter to you? I hear clearly that it does to Representative Simpson. I respect a clear, principled public statement.

We elect people to represent us, not lead us. I always cringed when someone referred to me as a “leader”. I just wanted to work on problems.

But we have lots of problems that most of us don’t want to do the work to solve. And many of the problems in this crowded, complicated world require more than a change in a single person’s behavior. Leaders help us see our problems and work on solutions.

I heard a man speak about the loss of Idaho salmon at our church some twenty years ago. Reed Burkholder held no elected office, but he sure wanted the runs of native salmon back. He proposed breaching the lower four Snake Dams back then. That’s about when I started seeing bumper stickers: “Save our Dams”. I asked local representative what they thought of the dwindling salmon runs. It seemed the Democratic candidates bemoaned the loss but couldn’t voice any solutions. The Republican candidates dismissed the problem and voiced support of the vital interests of their constituents: Palouse wheat farmers who needed cheap grain transport. The lines were drawn back then.

It takes courage to step across a line. Mike Simpson has courage.

The Idaho legislature spent no Idaho taxpayers’ money when it established a Maternal Mortality Review in 2019. The annual administrative cost was estimated to be $27K and “grant money” would fund it.

The legislature loves setting up panels and commissions and not having to pay for it. Still, this barely passed the House. All the representatives from my district supported it.

The guy who pushed for this spent some years on it, and he even approached me to sponsor it in 2016, my last year in the Senate. I warned him, a Democratic sponsor would be the kiss of death. Further, I just wasn’t sure the recommendations would be welcome, since at the time, the legislature wouldn’t even consider Medicaid Expansion. Maybe I was getting cynical. Shame on me.

It’s not like I don’t support this sort of activity. For years, as county coroner we reviewed childhood deaths in my jurisdiction. Examining cases can teach us a lot. I found the childhood fatality reviews very helpful as I considered public policy. Former Governor Otter finally made these reviews a statewide policy in an executive order in 2012.

This panel has also made recommendations the legislature has ignored.  Mainly, they suggested reviewing the “Religious Shield Laws” that prohibit prosecution of parents for neglect if a child dies from a treatable condition if the parents have religious beliefs blocking medical care. No such change has come before the legislature.

The MMR was directed to review deaths of women who were pregnant or had been pregnant within a year of their death and make recommendations for policy or procedural changes. The first report  for 2018 is out. I don’t think their recommendations will be welcome.

Idaho has few maternal mortalities; there were only ten found for 2018. Still, the review panel thought almost all could have been prevented.

One of their recommendations was for maternal Medicaid coverage to be extended to 12 months after birth. It’s cut off at 6 weeks now.

Can you imagine our legislature doing that? Think of what it would cost!

Again, I apologize for the cynicism.

But the legislature’s attitude is no secret. When asked about spending on Medicaid in the budget committee, Representative Caroline Troy (R-Genesee) said: “I’ve never believed that Medicaid accomplishes what we want- which is the health of our citizens. So, for many of us this (funding) is a bitter pill to swallow.”

I think that is a prevalent attitude amongst our elected representatives. Remember, she even voted for the Maternal Mortality Review.

There is overwhelming evidence that good prenatal care saves money and saves lives. Idaho generously extended Medicaid coverage to pregnant poor women decades ago. There must have been some support for this back then. Has it faded now?

I hope not.

But will the MMR recommendation to consider expanding coverage to 12 months after delivery even be considered? Apparently not from one of the representatives who voted to establish the review.

Don’t get me wrong, I understand this behavior. I see it every day. People make an appointment, come in a see me in the clinic, share a concern with me, then ignore my advice.

I’ve never carried a baby, it’s just not in my biology. I sure respect those who do. I did my share of prenatal care and deliveries. For many, this blessed event is a healthy and life growing experience. But, from my experience, not for all. I greatly appreciate the work this Maternal Mortality team has done, and I value their perspective and recommendations. I only wish our elected officials had the wisdom to at least consider, maybe act upon, the recommendations they wisely asked for.

It is true that the Idaho Legislature’s Constitutional mandate is to appropriate money. And it is true that the State of Idaho got a big check from the Federal Government this last summer. It came to around $1.25B dollars, from that CARES Act. And it is true that most of this big pot of Federal IOU’s got spent without any legislative action.

Keep in mind, the Idaho general fund annually spends about $4B of our state tax dollars. The legislature usually appropriates the $3.4B in Federal dollars we spend too.

Now, for the first few weeks of this legislative session, we have heard how the Idaho legislature is upset with our governor for his “unconstitutional” actions. But it seems their most pinched-face arguments have to do with restricting “freedoms”, not the money.

Will the legislature put this big pot of money received and spent on the books? Will it be part of the Joint Finance and Appropriations actions? I haven’t heard such rumblings.

Back when my hip didn’t hurt so much and those marble stairs to the third floor of the Capitol didn’t intimidate me, I served for a few years on that committee, JFAC. One Senator made a point that the Federal dollars for transportation were not in the budget request for the Department of Transportation. We were just voting on the Idaho dollars. He argued that the Federal dollars needed to be included in what was voted on. I agreed with him. We didn’t turn the money down, or quibble about it, we just made sure it was part of the accounting. I guess money for gravel and asphalt is good money.

It would be a lot of work to review, vote on and approve all those millions, about a billion, already out the door. But if the legislature wants to have a power play with the governor, this is where they have clear Constitutional standing. I don’t hear gripes about how this money was spent, though. They must trust the governor it went to the right places. Maybe they just trust that this was good money.

Likewise, we heard this last week that Idaho’s federal money for the Medicaid program will be boosted this year, so Governor Little told JFAC he was taking the proposed $30M in Medicaid cuts off the table for this year. I wonder if that is good money?

Idaho’s tax revenues have sure weathered the Covid storm. Every month for the last nine months we have beat predictions. Right now, it looks like the state will be sitting on a $600M surplus just for this fiscal year. And our reserve fund balances are about $500M.

But there’s one thing we know for sure, that Medicaid Expansion money was bad money. Idaho passed up on it for four years until an initiative passed. But it’s coming in the door now. So, it seems, some federal dollars are good, some are bad.

I can understand the reluctance about Medicaid money. There is a requirement that the state has to spend it’s share for every federal dollar we take. In regular Medicaid, the match is about 3:1; that is, 3 federal dollars require one Idaho dollar. For Medicaid expansion the match is 9:1. Nobody likes getting into long term obligations if you expect instability.

But I’m going to argue, the fact that Idaho expanded Medicaid eligibility right before we got hit with the pandemic helped stabilize our economy. Many studies in many states have shown such a benefit, so I’m not just making this up.

And all that money Brad sent out the door last summer has probably helped our tax revenues too. But if he would have been playing by the book, he should have called the legislature into session for the appropriation. But hey, it was good money, right?

I got my second Moderna immunization for Covid 19 this Friday. The first was pretty smooth, I noticed no side effects at all, not even a sore arm. The second one made my arm much sorer and I felt a little funky the day of the shot, but pretty much back to my usual stiff and sore old-man-self by the second day. So now I guess I’m pretty darn immune. I hope you all are soon.

Lots of folks are expressing hesitancy like I did a while back. They are waiting to see. Mostly it’s seniors and health care workers at the front of the lines. I’m both. And, that’s probably how it should be. Still, as a country we are slow to embrace this immunization. We all have our reasons.

I once visited Cuba and met with some of their health care providers. They had an immunization story to tell. Not that it’s a valid comparison, but it’s telling.

No need to tell you they are a communist country. Fidel was still alive when I visited back in the early 2000’s. Their health care system was pretty remarkable. Everybody had a doctor, and every doctor had a list of the patients they were responsible for. The public health bosses decided the country should be immunized against meningitis, the meningococcal variety. It is a rare but pretty lethal bacteria that can cause meningitis and sepsis (blood infection). They got the necessary doses, publicized their campaign, and got the local clinics ready.

This is an island about half the size of Idaho with about ten times as many people.

They were expecting the campaign to last a week, but when Monday rolled around, they found they had immunized the target population (folks under 20, about 3 million residents) by noon. I heard this story from the Cuban director of Public Health. He might have been bragging. I have not been able to verify the “by noon” statement, but multiple sources confirm the immunization program. Cuba has reduced mortality from meningococcus by >95% since 2002.

I’m not saying Brad Little needs to take lessons from Fidel Castro. But I would ask you to consider just what is the role of public health in this state.

Most of the time when we think of health it’s a pretty personal consideration. We choose whether to see the doctor, take the pill, get the test, lose weight and exercise. But public health crosses over into personal choice when one person’s actions affect others. Cuba, communist and all, puts a lot of emphasis on that crossover. Here in Idaho, we’re still pretty much thinking about ourselves.

When somebody is spreading a disease, they can be ordered to be isolated or quarantined by the Director of the Department of Health and Welfare. This was the authority for Governor Littles “stay at home” order last March. Boy, has that got some legislators twisted up. Maybe it did you too. It sure hit some businesses hard.

Public health districts serve regions of multiple counties. Their board members are appointed by the commissioners of the counties in the districts. They actually have little authority to issue orders, unless you have rats in your restaurant.

Now, there have been requests, even orders that people wear masks made by some municipalities.

Idaho is now seeing a significant decline in cases and deaths in the last couple months.  Our peak was in early December. Who knows if the first peak back in July, starting in June would have been higher without our “stay at home” time.  The immunizations are rolling out, slowly to be sure, but they are coming. You’re going to have to decide if you want one.

So just who, in this wild west state should have some authority about public health measures? If you were the Public Health boss, what would you do?