Monthly Archives: September 2012

Analysis: Access to Health Care Starting to Resemble Access to Air Travel

By Michael L. Millenson, Kaiser Health News

Each one of these seats might have a different price, much like any health procedure. (Victor L. Antunez: Flickr)

Each one of these seats might have a different price, much like a health insurance policy. (Victor L. Antunez: Flickr)

The old axis of access ­in U.S. health care — insured or uninsured — is being replaced by the kind of gradations and complexity in determining who-gets-what-when-for-what-price for which the airline industry has become famous.

Some recent data and reactions to the provisions of the Affordable Care Act reinforce the trend. Here’s an overview:

Being able to afford any kind of seat. Sure, the number of Americans left standing at the gate because they can’t afford a health insurance “ticket” is declining. But, the scheduled takeoff in insurance coverage has run into mechanical difficulties. The Census Bureau announced this month that the number of uninsured dropped slightly in 2011 to 48.6 million, or 15.7 percent of the population. That slide is partly because parents can keep children on their insurance plans until age 26.

But prospects of adding another 30 million Americans starting in 2014 are now up in the air. While the Supreme Court upheld most of the federal health law, it struck down the penalty designed to compel states to expand Medicaid. That decision could void tickets to health insurance for an estimated three million people, says the Congressional Budget Office and Joint Committee on Taxation, and possibly a lot more, according to a critical analysis by two liberal legal experts. Continue reading

What’s In A Name? ‘Health Benefit Exchange’ Seeks New Brand

Editor’s Note: This story is part of a partnership that includes Capitol Public Radio, NPR and Kaiser Health News.

By Pauline Bartolone, Capital Public Radio

(Image: Kaiser Health News)

Don't worry -- "avocado" was rejected. (Image: Kaiser Health News)

As states work to comply with the federal health care law, many are designing their insurance exchanges, where people will be able to shop for coverage.

But just the word “exchange” sounds to many like off-putting government-speak, and some states are eager to come up with a more appealing name for these new marketplaces.

Peter Lee, who directs California’s Health Benefit Exchange, says it’s up for a new name, and he says they want it to sound fresh, dynamic and innovative.

“What we’re trying to figure out is what’s a name that’s going to stick, that’s going to grab hold, that all Californians are going to say ‘Boy, that’s where I go to find healthcare,’ ” Lee says.

The exchange will have a website where people can buy private health insurance, and many consumers will have government subsidies to help them purchase the insurance. Planners hope at least 3 million California customers will enroll for benefits starting in 2014. But that 3 million is a diverse bunch — so organizers want a name that will graball of them. Continue reading

Quick Read: Medicare Battle Heats Up California House Race

Redistricting brought new boundaries to northern California’s 7th congressional district — and an even split between Republicans and Democrats. Incumbent Dan Lungren and Dr. Ami Bera are battling to represent the district. They are “very effective stand ins for the two sides in the national debate” on Medicare says one analyst.

When Republican Rep. Dan Lungren faced a crowd of tea party supporters and Democratic detractors at a recent town hall meeting outside Sacramento in the town of Carmichael, the arguments showed how explosive the Medicare debate can get in the hottest races in the country.

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Quick Read: New York’s Soda Limits Could Boost Similar Efforts in California

Voters in Richmond and El Monte will decide on a penny-per-ounce “soda tax” in November. Health advocates are hoping that New York City’s approval to limit the sale of super-sized sugary beverages will help them gain traction for their efforts in California.

California health advocates hope their state will see some movement on limiting sugar-laced soda following action last week to cap serving sizes for sugary drinks in New York City. Starting in March, New York’s restaurants, food trucks and concession stands will be banned from selling sugary sodas in containers larger than 16 ounces.

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From Heartbreaking Miscomprehension Comes New Understanding

Lia Lee in 1988. (Photo: Anne Fadiman)

Lia Lee in 1988. (Photo: Anne Fadiman)

Today, it’s hard enough for doctors and patients to communicate effectively, even if they share the same primary language. But layer on not only language differences, but also a yawning cultural chasm, and a visit to western medicine might lead to a child being removed from the care of her parents.

That was the case for Lia Lee, a young Hmong refugee in Merced who suffered from epilepsy. As Anne Fadiman profiled in her riveting book, The Spirit Catches You and You Fall Down, Lia’s doctors grew frustrated by her parents’ unwillingness to follow their prescriptions for treatment, and the doctors ultimately had Lia legally removed from her parents’ care.

As the New York Times reports:

In traditional Hmong belief, qaug dab peg, [Hmong for epilepsy] like many illnesses, is spiritual in origin, caused when the soul becomes separated from the body. A traditional cure might entail visits from a shaman, who would attempt to reunite body and soul. Continue reading

Low-income Parents Brace for End of ‘Healthy Families’

By Mina Kim

Maria Garibay worries her daughters won't be able to stay with their current doctors when they switch from Healthy Families to Medi-Cal next year.(Mina Kim: KQED)

Maria Garibay worries her daughters won't be able to stay with their current doctors when they switch from Healthy Families to Medi-Cal next year.(Mina Kim: KQED)

Next January, the state will begin transferring hundreds of thousands of low-income kids from its popular Healthy Families insurance plan to Medi-Cal — which offers medical coverage to the state’s poorest residents.

Ending Healthy Families was one of Governor Jerry Brown’s budget-balancing priorities and now families are feeling the weight of that decision.

At Children’s Health Initiative in Napa, a nonprofit that helps get kids into affordable health plans, Maria Garibay has just gotten the news. Next year, her three girls will be moved from Healthy Families to Medi-Cal.

Speaking through an interpreter, Garibay says she’s worried her monthly premium will go up. That’s because last year Medi-Cal told her she’d need to start paying $1300 each month, per child, because of her income from a part-time restaurant job.

But then Garibay learned that she qualified for Healthy Families. The federally subsidized program is for families whose incomes are just above the federal poverty level. Under Healthy Families, Garibay pays a total premium of $14 a month. It’s a godsend for Garibay whose oldest daughter has a heart condition. Continue reading

Quick Read: Is A Faulty Stanford Study Putting Kids At Risk?

Stanford researchers whipped up quite a controversy 10 days ago with its study saying conventionally grown foods are (roughly) just as nutritious as organic. This article looks in critical detail not at the alleged conspiracy theories around funding, but the science itself.

It offered all the ingredients for a highly clickable news story: an elite university, a reputable scientific journal, surprising results and a conclusion that would be welcomed by many.

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Quick Read: Whooping Cough Vaccine’s Protection Fades Quickly

The whooping cough — or pertussis — vaccine used today is different from the one used as recently as the late 1990s. The older vaccine used whole pertussis cells, but it was shelved in favor of a vaccine with purified cells. The newer vaccine has fewer side effects, doctors have noted that its efficacy wanes more quickly. This new study reinforces prior reports.

To protect children against whooping cough, doctors recommend five shots of vaccine before they turn 7. But what happens after that? How long does the protection last? Researchers at the Kaiser Permanente Vaccine Study Center checked it out. They compared 277 kids who came down with whooping cough, or pertussis, to more than 3,000 children who tested negative for it.

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Long-Term Care A Big Worry in California

By Sarah Varney, Kaiser Health News

It turns out Republicans and Democrats do have something they can agree on this election season – they’re worried about how to pay for long-term care when they or a family member can no longer live at home.

A new poll released Wednesday by The SCAN Foundation and the UCLA Center for Health Policy Research found that half of California voters say they’ll need long-term care for a close family member in the next few years, but won’t be able to afford it.

Anxiety over the cost of long-term care, like the price tag of a nursing home stay, is going up. The percentage of California voters who said they couldn’t afford more than three months of nursing home care increased to 73 percent from 66 percent in 2011, and 46 percent said they didn’t have the money to cover a single month in a nursing home, about $6,800 in California. For Latinos, the prospect of paying for long-term care is even more grim: nine in 10 Latino voters said they couldn’t afford more than three months of nursing home care and 86 percent couldn’t afford more than three months of part-time care at home. Continue reading

State Watchdog to Investigate Another Health District Official

Katharine MieszkowskiThe Bay Citizen

California’s political watchdog agency is investigating a Fremont health care district official to determine whether he violated the state’s conflict-of-interest laws.

Michael Wallace, president of the Washington Township Health Care District board, is also the chairman of the board of Fremont Bank, which has received more than $1 million in fees from the taxpayer-funded district. Wallace declined to comment on the investigation.

The California Fair Political Practices Commission‘s decision to investigate Wallace, made public last week, is the latest in a series of probes it has initiated following a July report by The Bay Citizen that uncovered millions of dollars in questionable transactions involving companies and nonprofits with ties to health care district officials across the state.

Michael Wallace, president of the Washington Township Health Care District board, is also the chairman of the board of Fremont Bank. (Michael Short: California Watch)

Michael Wallace, president of the Washington Township Health Care District board, is also the chairman of the board of Fremont Bank. (Michael Short: California Watch)

Gerald Shefren and Arthur Faro, board members of the Sequoia Healthcare District in Redwood City, and Frank Burgess, a former board member of the San Gorgonio Memorial Healthcare District in Riverside County, also are under investigation for possibly violating state conflict-of-interest laws.

California’s more than 70 taxpayer-funded health care districts control multimillion-dollar budgets with little state oversight. While some operate hospitals or nursing homes, others manage real estate holdings and distribute community grants.

Since 1990, Wallace has served on the board of directors of the Washington Township Health Care District. Over the past decade, the district has paid Fremont Bank more than $1.2 million in fees. Continue reading