Monthly Archives: February 2013

Health Care Overhaul’s Consumer Protections Pass California Legislature



Reforms to the individual health insurance market passed out of the Assembly and Senate in Sacramento on Thursday. Included in the bills were popular consumer provisions including: guaranteed issue, requiring insurers to cover all who apply; and rate setting rules that will make it illegal to charge people with pre-existing conditions more than anyone else or redline those conditions.

From here, the Assembly bill, AB 1X 2, will be heard in the Senate. The Senate’s bill, SB 1X 2, heads to the Assembly.

The bills are moving through a special session of the legislature. The Legislature is working to pass bills to bring the state in line with the requirements of the federal health care overhaul, the Affordable Care Act.

Assemblymember Richard Pan (D-Sacramento), chair of the Assembly Health committee, authored AB 1X 2. “I’m certainly happy it passed,” Pan said in an interview. “It showed the legislature understands the nature of these historic reforms that we’re putting place for California.” Continue reading

Study: Sugar — Independent of Obesity — Causes Diabetes

SugarBowl_Judy_FlickrFor years, doctors have debated sugar’s role in causing diabetes. The prevailing medical opinion has been that eating more sugar means eating more calories, and it’s the resulting weight gain that leads to diabetes. But a major new study shows a direct link between sugar and diabetes — a link that’s independent of a person’s weight.

KQED’s Stephanie Martin interviewed one of the study’s authors, Dr. Robert Lustig from UCSF. Lustig is an expert on childhood obesity and has been vocal about the health hazards of sugar for years. His video “Sugar: The Bitter Truth” has more than three million views on YouTube.

“This is the same level of proof that was available to us when we implicated cigarettes as the cause of lung cancer back in the 1960′s.”

Lustig told Martin that the study was very carefully done — researchers looked at sugar consumption in 175 countries over a decade and controlled for just about everything including obesity, poverty, and physical activity. They found that the more sugar in the food supply, the higher the rates of diabetes in that country, no matter what the obesity rates were.

In the study, sugar was 11 times stronger than total calories in explaining diabetes rates around the world. “Those countries where sugar went up showed increases in [diabetes] rates. Those countries where sugar availability went down, showed decreases in rate.” Continue reading

Quick Read: Working Women Blues

This essay may — at first glance — appear to be a bit off the health beat. But employment equity is important to health status, for women and their children. Edgar effectively points out the difference between the challenges “narrow, elite women at the top” face (such as Marissa Mayer and Sheryl Sandberg) — and the fear women at lower rungs of the economy deal with every day: the potential of losing a job because a child is ill and needs care, or because the babysitter called in sick.

There’s been a lot of talk in the media lately about women in the workplace. From Anne-Marie Slaughter’s complaining about not “having it all,” to Facebook COO Sheryl Sandberg exhorting women to “lean in” to their careers (translation: suck it up) and not let little things like babies disrupt their rise to the top, to Yahoo CEO Marissa Meyer

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Video: Anti-Tobacco Advocate Debi Austin, Appeared in ‘Voicebox’ Commercial, Dies at 62

I remembered the commercial instantly:

Debi Austin appeared in the ad in 1996. In a raspy voice, she described starting smoking at age 13. Then declaring, “They say nicotine isn’t addictive,” she took a drag from her cigarette through a stoma, a hole in her throat which permitted her to breathe. “How can they say that?” she concluded.

For years, she worked to keep kids from smoking. She died last week after fighting various cancers for more than 20 years.

From a release from the California Department of Public Health:

“We are saddened by Debi’s death. She exemplified the real toll tobacco takes on a person’s body,” said CDPH Director and State Public Health Officer Dr. Ron Chapman. “Debi was a pioneer in the fight against tobacco and showed tremendous courage by sharing her story to educate Californians on the dangers of smoking. She was an inspiration for Californians to quit smoking and also influenced countless others not to start. We trust she will continue to touch those that hear her story, particularly teens and young adults. She will be greatly missed.”

Tobacco Free California says this about Austin on its website (where you can also watch a video about her):

Debi Austin started smoking at the age of 13. She continued to smoke through a stoma in her throat even after being diagnosed with cancer and having her larynx removed at the age of 42. But, Debi fought back. She starred in an iconic television ad for the California Tobacco Control Program, quit smoking and has made anti-tobacco education not only her mission in life, but her passion.

Obama Administration Files Brief in Support of Medi-Cal Provider Cuts

In a move that is expected to have repercussions across the country, the Obama Administration on Monday filed a brief in the Ninth Circuit Court in support of Gov. Jerry Brown’s proposed 10 percent payment cuts to Medi-Cal providers.

Some background: The provider cuts were approved by CMS back in 2011, but then immediately challenged by the California Medical Association (and others) in federal court. A federal judge blocked the cuts. The state of California appealed to the Ninth Circuit. A three-judge panel approved the cuts. The CMA asked for an en banc review by all of the judges.

And that’s where we are today, with the Obama Administration’s brief.

The timing is interesting, as it comes when the National Governors Association is meeting in Washington, and the Obama Administration is trying to convince states to implement the Medicaid expansion portion of the health care overhaul. As the New York Times reports, the Administration seems to be in support of giving states flexibility: Continue reading

Bill for Statewide Soda Tax Introduced

By Mina Kim



Richmond voters may have crushed an effort to pass a soda tax last fall, but that’s not stopping one lawmaker from trying to tax sodas statewide.

State Senator Bill Monning (D-Carmel) tried to pass a statewide soda tax two years ago that failed, but with Democrats expected to hang on to supermajorities in both houses, Monning thinks this time is different.

“The political train has changed in 2012, but it’s still not going to be automatic by any means,” Monning says. “Any tax is going to be an uphill fight.”

Monning’s bill would slap distributors of sugary drinks with an excise tax of a penny-per-ounce, the same amount that was proposed in Richmond and El Monte, in southern California. The bill would further create a Children’s Health Promotion Fund which would then split all revenue between the State Department of Public Health and Superintendent of Public Instruction.

A recent Field Poll showed support for a tax if the money went to children’s nutrition and physical education. Continue reading

Quick Read: Mediterranean Diet Can Cut Heart Disease, Study Finds

This was a huge study. More than 7,000 people were randomly assigned to one of three diets. Often in diet studies, researchers will look at changes in blood pressure or cholesterol, but what’s significant here is that instead they looked at numbers of heart attacks, stroke and deaths among participants. “At the end of the day, that is what really matters,” says a spokesperson for the American Heart Association.

About 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to a Mediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables, and even drink wine with meals, a large and rigorous new study found.

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New Approach to Medical Residency May Ease Doctor Shortage in Central Valley

By Rebecca Plevin, Valley Public Radio

Dr. Peter Broderick examines a patient's x-ray while family practice medical residents look on. (Rebecca Plevin/KVPR)

Dr. Peter Broderick examines a patient’s x-ray while family practice medical residents look on. (Rebecca Plevin/KVPR)

The Central Valley suffers from an acute shortage of doctors — especially primary care doctors — but a new type of residency program aims to bring relief. These new “teaching health centers” are funded by the Affordable Care Act.

This new approach contrasts with traditional medical residency programs, which are often based at university medical centers in large cities and encourage specialty training.

With the recognition that medical residents often stay where they are trained, the idea behind this new approach is to place these young doctors not in large hospitals but in community health centers where they will focus on primary care.

“The hope is that more of the graduates from these programs will stay in these underserved settings, will work in these community health clinics, and hopefully address some of the shortages that we have with that population,” said Dr. Peter Broderick, the CEO of Modesto’s Valley Consortium of Medical Education.

In 2010 Broderick’s group opened the state’s first “teaching health center” — the Valley Family Medical Residency Program. It has trained 12 doctors a year since then. Continue reading

When Artificial Hips Go Bad: Thousands Sue over ASR XL by Johnson & Johnson Subsidiary

Michael Kelly, attorney for plaintiff Loren Kransky, holds up an ASR XL hip implant made by Johnson & Johnson during his opening statement to the jury at the trial of Kransky v. DePuy, at California Superior Court in Los Angeles, on Friday, Jan. 25, 2013. (Credit: Patrick T. Fallon/Bloomberg)

Michael Kelly, attorney for plaintiff Loren Kransky, holds up an ASR XL hip implant made by Johnson & Johnson during his opening statement to the jury at the trial of Kransky v. DePuy, at California Superior Court in Los Angeles, on Friday, Jan. 25, 2013. (Credit: Patrick T. Fallon/Bloomberg)

In recent weeks, a jury in Los Angeles Superior Court has been diving deep into the world of artificial hips. They’re hearing the case of a Montana man whose hip implant went bad –- but they’re also laying the legal groundwork for what’s expected to be a massive settlement between the maker of the hip and more than 10,000 Americans.

De Puy, a subsidiary of Johnson and Johnson, stands accused of producing a defective design, failing to warn doctors and patients when word first came trickling back the hip was failing at high rates, and then moving too slowly to recall the product.

The ASR hip went to market in Europe in 2003; in the US, in 2005. Within a year or two of when it was first sold in Europe, concerns about the ASR began filtering back to J&J through surgeons. Continue reading

Just Say No: Doctors’ Groups Define More Unnecessary Tests, Procedures

CT scan 13 of Clubs_Flickr

One new recommendation: Don’t automatically do a CT scan to check a child’s minor head injury. (13 of Clubs/Flickr)

One of the rallying cries against fee-for-service medicine is this: since doctors are paid to do things to patients (tests, procedures), they are then incentivized to do more things to patients (tests, procedures) than the patient might actually need.

On Thursday, a wide swath of medical groups joined a campaign to list tests and procedures which are commonly done but risk causing patients more harm than benefit.

This “Choosing Wisely” campaign is from a coalition of doctors’ groups — ranging from the American Academy of Pediatrics to the Society of Thoracic Surgeons — in conjunction with Consumer Reports. Last year, the campaign named 45 tests and procedures patients should look at carefully. This year, 17 doctors’ organizations representing 350,000 physicians released 90 additional tests and procedures. Continue reading