Forget Public Health: The Politics of the California Vaccination Debate

(Craig Miller/KQED)

(Craig Miller/KQED)

Over on the KQED News Politics and Government Desk, John Myers hosts a terrific podcast on California politics. The most recent edition (published last Friday) took a hard look at the political debate in California over SB 277, a bill that would eliminate the state’s vaccine personal belief exemption.

Myers, KQED News’ Marisa Lagos and Anthony York of the Grizzly Bear talk about it starting at 11:20, and their discussion runs about 10 minutes:

We’ve written often (perhaps exhaustively) on State of Health about vaccines, but usually it’s been from a medical perspective or a public health perspective. But the debate around SB 277 has illuminated the politics around trying to change policy when a very loud, very vocal minority swamps the Capitol. Continue reading

San Pablo’s Doctors Medical Center to Close Tuesday

The emergency room at San Pablo's Doctors Medical Center will close permanently Tuesday at 7a.m., ending all patient care at the hospital. (Lisa Aliferis/KQED)

The emergency room at San Pablo’s Doctors Medical Center will close permanently Tuesday at 7 a.m., ending all patient care at the hospital. (Lisa Aliferis/KQED)

By Sara Hossaini

As Doctors Medical Center wellness director Tracy Taylor walks down the hospital’s long white halls, the first thing she mentions is just how strange it feels.

“It is very quiet, it feels very eerie and very different,” says Taylor.

DMC reluctantly closes its doors Tuesday after failing to find a solution to its financial woes.

The hospital began shutting things down — department by department — over the past couple of weeks after leaders said they had run out of viable options for bridging a stubborn $18-20 million annual deficit — something they blame on low Medi-Cal and Medicare reimbursement rates.
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California First in Care of Undocumented, But That’s Not Saying Much

(Getty Images)

(Getty Images)

By David Gorn, CaliforniaHealthline

Undocumented immigrants get better health care in California than the rest of the country — but that’s not saying much, according to a new report released Thursday by UCLA researchers.

“California is in the lead of a very sorry pack.”    

“California is in the lead of a very sorry pack,” said Steven Wallace, associate director of the UCLA Center for Health Policy Research and co-author of the report. “For California to stay in the lead, we need to keep innovating.”

It’s unclear how UCLA’s findings will affect SB 4 by Sen. Ricardo Lara (D-Bell Gardens), the bill to provide full-scope medical coverage to the undocumented, which cleared the Senate Committee on Health this week and now heads to Senate Appropriations. Continue reading

E-Cigarette Use Triples Among American Teenagers

Nicotine exposure at a young age 'may cause lasting harm to brain development,' warns Dr. Tom Frieden, chief of the Centers for Disease Control and Prevention. (Getty Images)

Nicotine exposure at a young age ‘may cause lasting harm to brain development,’ warns Dr. Tom Frieden, chief of the Centers for Disease Control and Prevention. (Getty Images)

By Rob Stein, NPR

A national survey confirms earlier indications that e-cigarettes are now more popular among teenage students than traditional cigarettes and other forms of tobacco, federal health officials reported Thursday.

450,000 middle school students now use e-cigarettes.
The findings prompted strong warnings from Dr. Tom Frieden, head of the Centers for Disease Control and Prevention, about the effects of any form of nicotine on young people.

“We want parents to know that nicotine is dangerous for kids at any age,” Frieden said.

“Adolescence is a critical time for brain development,” he added, in a written statement. “Nicotine exposure at a young age may cause lasting harm to brain development, promote addiction and lead to sustained tobacco use.” Continue reading

Disneyland Measles Outbreak to be Declared Over

The outbreak sickened 134 Californians. (Marsaili McGrath/Getty Images)

The outbreak sickened 134 Californians. (Marsaili McGrath/Getty Images)

By Alicia Chang, AP

The state’s measles outbreak that began at Disneyland and reignited debate about vaccinations is nearing an end.

The outbreak will be declared over in California on Friday if no new cases pop up, according to the California Department of Public Health.

Disease investigators worked for months to contain the highly contagious disease that originated at Disney theme parks in December and spread to several other states and countries. In all, 134 people in California were infected.

The outbreak cast a spotlight on the small but vocal anti-vaccine movement. Many who fell ill in the Disneyland outbreak were not immunized or had only one of the two recommended doses of the measles-mumps-rubella vaccine. Continue reading

Vaccine Exemption Bill Stalls in Sacramento; Vote Next Week

(Kevork Djansezian/Getty Images)

(Kevork Djansezian/Getty Images)

A bill that would eliminate the vaccine personal belief exemption stalled before the Senate Education Committee Wednesday in Sacramento. Lawmakers were deeply concerned that the bill would bar too many children from school. The bill’s co-author, Sen. Richard Pan (D-Sacramento), asked the committee to delay a vote until next Wednesday after the committee chairwoman warned him he did not have enough votes to pass.

Pan said he will use the time to address their concerns, possibly adding amendments to the bill.

Under the bill, SB277, California would no longer permit any vaccine exemptions except a medical one, meaning virtually all children would have to be vaccinated in order to attend public or private school. Even home-schoolers who group together would be affected under the current language, one of the committee’s complaints.

While several committee members expressed their support for vaccines, they were worried that the bill goes too far. “I’m looking for the compelling state interest in doing something (this) draconian,” said state Sen. Loni Hancock (D-Berkeley). “If I’m reading the bill correctly, there’s nothing you can do if you choose not to vaccinate your child,” except home-school and then only with your own children. Continue reading

Hidden Side Effect of Cancer Treatment: Big Bills

Anne Koller closes her eyes as an oncology nurse attaches a line for chemotherapy to a port in her chest. Koller typically spends 3 to 6 hours getting each treatment. (Sarah Jane Tribble/WCPN)

Anne Koller closes her eyes as an oncology nurse attaches a line for chemotherapy to a port in her chest. Koller typically spends 3 to 6 hours getting each treatment. (Sarah Jane Tribble/WCPN)

By Sarah Jane Tribble, Kaiser Health News

Anne Koller was diagnosed with late-stage colon cancer in 2011 and has been fighting it since.

“We talk about hair loss. Should we also talk about ‘chemotherapy is expensive?'”    

But it’s not just the cancer she’s fighting. It’s the bills.

“Think of those old horror flicks,” she says. “The swamp creature … comes out and is kind of oozy, and it oozes over everything.”

Koller, who just turned 65 years old, is petite, and sports a stylish auburn wig. When she was able to work, Koller was in the corporate world and safely middle-class, with health insurance and plenty of savings.

At first, she was too sick to deal with the bills. They piled up.

“You start looking at these bills,” Koller says, “and, as much as you know it’s expensive, the shock itself is like, ‘What?'” Continue reading

The Hidden Cost of Mammograms: More Testing and Overtreatment

Instead of having mammograms according to age, some doctors think screening should be based on a woman's overall risk for breast cancer. (Getty Images)

Instead of having mammograms according to age, some doctors think screening should be based on a woman’s overall risk for breast cancer. (Getty Images)

By Patti Neighmond, NPR

There’s no question mammograms can save lives by detecting breast cancer early. But they can also result in unnecessary testing and treatment that can be alarming and costly.

In fact, each year the U.S. spends $4 billion on follow-up tests and treatments that result from inaccurate mammograms, scientists report in the current issue of Health Affairs.

That’s a “stunning number,” says the study’s lead author, Dr. Kenneth Mandl, at Harvard Medical School’s Center for Biomedical Informatics.

Mandl and a colleague analyzed the insurance records of more than 700,000 women from 2011 to 2013. The women were between the ages of 40 and 59, and they all had routine mammograms to screen for breast cancer during that time period. Continue reading

Panel Votes To End Vaccine Exemption in California

By David Gorn, California Healthline

Lawmakers took step toward passage of a bill that would end the personal-belief exemption for childhood immunizations in California. (Centers for Disease Control and Prevention's Public Health Image Library)

Lawmakers took step toward passage of a bill that would end the personal-belief exemption for childhood immunizations in California. (Centers for Disease Control and Prevention’s Public Health Image Library)

On Wednesday, lawmakers took the first step toward passage of a bill that would end the personal-belief exemption for childhood immunizations in California.

The Senate Committee on Health on Wednesday voted to approve SB 277 by state Sen. Richard Pan (D-Sacramento). It would stop California parents from opting out of immunizations for their schoolchildren unless there is a medical reason to refuse vaccination.

“There is no scientific controversy about vaccine safety and vaccine effectiveness. This is not open to dispute among mainstream doctors and scientists.”

Pan, a pediatrician, said the recent outbreaks of measles and whooping cough could be prevented if a higher percentage of children were immunized against the diseases.

“I’ve personally witnessed the suffering caused by vaccine-preventable diseases,” Pan said. “All children deserve to be safe at school. The personal belief exemption is now putting other schoolchildren and people in our community in danger.”

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More Californians Visiting ER For Chronic Medical Conditions

Millions of Californians visit emergency departments for help with non-injury related  health problems -- and that number is rising.

Millions of Californians visit emergency departments for help with non-injury related health problems — and that number is rising.

Traditionally people think of a hospital emergency room as a place to go for injuries: someone gets in a car accident, has a heart attack, or falls out of a tree and breaks his leg. But the ER also plays a large role in treating medical patients.

Millions of Californians visit emergency departments for help with non-injury related health problems — and that number is rising, according to a study recently published in the April edition of Health Affairs.

“The study gives you kind of a bird’s eye view of what’s happening in the health care system overall.”

The study, led by the University of California, San Francisco, shows the rate of emergency room visits for non-injury related problems rose 13.4 percent in the state, from 10.1 million visits in 2005 to 11.9 million visits in 2011. The largest increase in non-injury related ER visits were for gastrointestinal diseases, abdominal pain and nervous system disorders.

Renee Hsia is a professor of Emergency Medicine and Health Policy Studies at UCSF, and the lead author of the study. She says hospital admissions rates are a window into California’s health care system.
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