Monthly Archives: April 2013

What President Obama Wants You To Know About Obamacare

The president talks up the health care overhaul at Tuesday’s press conference

President Obama Takes Questions From The Press During News Conference.

The health care overhaul is “a big complicated piece of business,” President Obama told reporters during Tuesday’s news conference. (Alex Wong/Getty Images)

If you’re one of the millions of people confused about Obamacare, the president took a few minutes on Tuesday to reiterate his main messages about the federal health law.

“For the 85 to 90 percent of Americans who already have health insurance, they’re already experiencing most of the benefits of the Affordable Care Act even if they don’t know it,” the president said.

He called insurance “stronger, better, more secure,” for people than before the law’s passage. “Full stop. That’s it. Now they don’t have to worry about anything else.”

President Obama specifically mentioned three benefits of the ACA already in place:

  • Children can stay on their parents’ plan until age 26
  • Your insurance company cannot drop you if you get sick
  • You get free preventive care with no co-pay and no deductible (including many cancer screening tests)

The law also has banned lifetime caps on coverage. For people who have employer-based insurance or Medicare, most of the changes required by the law are already in place.

For people who do not have insurance — or who buy insurance for themselves or their families — “implementation issues” remain, the president said. Continue reading

School-Based Health Centers Serve More Than Just Students

By Chris Richard

At the Manual Arts High School Wellness Center in Los Angeles, pediatric nurse practitioner Jennie Lien gives 15-month-old Andrew Baptist a medical examination. Andrew's great-grandmother, Yvonne Lee (right) says Andrew's entire family relies on the center for medical care.(Photo/Chris Richard)

At the Manual Arts High School Wellness Center in Los Angeles, pediatric nurse practitioner Jennie Lien gives 15-month-old Andrew Baptist a medical examination. Andrew’s great-grandmother, Yvonne Lee (right) says Andrew’s entire family relies on the center for medical care.(Photo/Chris Richard)

When Compton’s Dominguez High School celebrated the opening of a new campus wellness center last month, it was a timeless moment.

The marching band blared and thundered. Drill teams members pranced and whirled, just as they’ve been dancing and high-kicking on high school campuses for generations.

But the scene in the wellness center itself offered a glimpse of what the future could be for school medical services in California.

There was a student in for routine blood work. In the next cubicle, a mother had brought her young son, who had the flu. And neighborhood resident Jonetta Stewart, 76, had come seeking relief from frequent vertigo and headaches.

Physician’s assistant Rachel Damicali checked Stewart’s blood pressure. It was very high.

Some campus-based wellness centers offer free and low-cost services not just to students, but to entire neighborhoods, to people of any age.
Dimacali says she sees a lot of variety in her fast-paced days.

“My last patient was a 4-year-old kid, and now I’m seeing Jonetta for her blood pressure management,” she said. “So, we see a whole range: from chronic disease to urgent care visits to just physical exams.”

Just in time for the implementation of President Obama’s health care overhaul coming Jan. 1, a handful of California schools are starting to open campus-based wellness centers like the one at Dominguez, offering free and low-cost services not just to students, but to entire neighborhoods, to people of any age. Continue reading

Berkeley Journalist Takes On The ‘Feel-Good War on Breast Cancer’

The article asks: (Photo/Getty Images)

(Photo/Getty Images)

I first saw the article Thursday night on Facebook, then stayed up until midnight reading it. In a helluva story, Peggy Orenstein addresses The Feel-Good War on Breast Cancer in this Sunday’s New York Times Magazine.

Orenstein is uniquely situated to write an article she hopes will “help change the national conversation.” She’s been treated for breast cancer twice in the last 15 years, including a mastectomy last fall, and the Times Magazine — for which she writes regularly — is one of the most powerful publications in the world.

Orenstein was first diagnosed with breast cancer in 1997 after her doctor sent her for a screening mammography. “I used to believe a mammogram saved my life,” she writes as the opening line of her piece. Today, she’s not so sure.

As she writes in the Times:

Sixteen years later, my thinking has changed. As study after study revealed the limits of screening — and the dangers of overtreatment — a thought niggled at my consciousness. How much had my mammogram really mattered? Would the outcome have been the same Continue reading

Doctors Fear HIV Patients Will Fall Through Cracks As Obamacare Rolls Out

Public health implications as people who stop taking HIV medications can quickly become infectious

Dr. Kathleen Clanon talks to patient Andrew Solis about keeping his HIV under control. Clanon worries her patients will have disruptions in their care if they don't navigate the changes coming under federal health reform. (Mina Kim/KQED)

Dr. Kathleen Clanon talks to patient Andrew Solis about keeping his HIV under control. Clanon worries her patients will have disruptions in their care if they don’t navigate the changes coming under federal health reform. (Mina Kim/KQED)

A major goal of the federal health care law is that millions of people who currently do not have health insurance will have improved access to care. But the massive overhaul is also expected to be widely disruptive, and doctors worry that many people with chronic illness could suffer during the changeover, as KQED’s Mina Kim details today on The California Report.

Kim tells the story of 33-year-old Andrew Solis who stopped taking HIV medications more than a year ago after becoming addicted to methamphetamine while in a “rocky relationship.” He resumed treatment at the Oakland Highland Hospital HIV clinic last October after ending the relationship.

Solis has been able to get back in to treatment fairly easily, Kiim reports. But changes coming under the Affordable Care Act could complicate care for clinic patients, says Kathleen Clanon, chief medical officer at Highland Hospital. Continue reading

Boston ER Doctor Finds Marathon Memories Hard to Shake

By Leana Wen, for NPR

(Jim Rogash/Getty Images)

(Jim Rogash/Getty Images)

I have a recurring nightmare where I am performing CPR on a patient who turns out to be my husband.

Last Monday, my nightmare nearly came true.

It was 2:50 p.m., and the Massachusetts General Hospital ER was filled to capacity.

In the section where I was working, my patients were critically ill, with strokes, heart attacks and overwhelming infections. Even the hallways were packed with patients receiving emergency treatments.

A call over the loudspeakers announced that there had been two explosions. Many people were injured. That’s all we knew.

Screams mixed with ambulance sirens. The loudspeaker sounded again and again, announcing that more patients were on their way.
Doctors, nurses and transporters disconnected monitors and rushed to send every patient to other areas of the hospital.

As we cleared the emergency room, there was a second call. These were bombings. There were fatalities and dozens, maybe hundreds, of injured. How many were coming to Mass General? Nobody knew.

Three minutes later, the doors flew open. Stretchers came, one after the other. Some victims had no pulse and weren’t breathing. Others had legs blown to shreds. All were covered with blood and soot.

The ER smelled of burnt flesh, and each stretcher left behind a fresh trail of blood. Continue reading

Are Minority Kids Being Missed In ADHD Diagnosis?

(Getty Images)

(Getty Images)

For years, doctors, teachers and parents have fretted that attention deficit hyperactivity disorder (ADHD) is overdiagnosed and that children are overprescribed the stimulants that treat the brain disorder too often.

But, as EdSource Today reports, that’s not the case in California. According to new data from the National Survey of Children’s Health, California ranks 5th lowest in the country in diagnosis. The national average of children with ADHD is 7.9 percent, but in California, the rate is 5.2 percent.

That 5.2 percent rate may be a low one nationally. But globally, rates vary between 3 and 9 percent, “with the average closer to 5,” Prof. Joshua Israel told EdSource Today.

Still, within ethnic groups in California, the diagnosis rates drop dramatically. Kaiser researchers published data earlier this year which showed white children had a 5.6 percent rate — well in line with global averages. But other groups had much lower ADHD diagnosis rates as follows:

  • Black children: 4.1 percent
  • Latino children:  2.5 percent
  • Asian American children: 1.9 percent Continue reading

‘Cal Enviroscreen’ Ranks Zip Codes Statewide By Pollution

New Screening Tool Provides Broad Snapshot of Total Environmental Burden

Factory in West Fresno. (Sasha Khokha/KQED)

A factory in West Fresno. (Sasha Khokha/KQED)

It’s the first environmental health screening tool of its kind in the country.

California’s Environmental Protection Agency is rolling out “Cal Enviroscreen” which helps pinpoint communities that may be particularly vulnerable to pollution. And it’s not just for wonks. You can look up your own community. Cal Enviroscreen measures a broad range of pollutants and health indicators in every zip code across the state.

The most vulnerable community in the state? West Fresno, one of Fresno’s poorest areas. Other zip codes in the top ten include Bakersfield, Stockton and the Los Angeles-area communities of Vernon, Baldwin Park, and Boyle Heights.

Toxicologist Dr. George Alexeeff heads the state’s Office of Environmental Health Hazard Assessment. He says California regulators have done a pretty good job of targeting individual pollution problems, like reducing diesel exhaust, or eliminating particular chemicals in drinking water.

But that kind of regulation doesn’t give a broad snapshot of the total environmental burden some communities face. Continue reading

Sacramento Native and Her Husband Face Amputation, Rehab Together After Boston Bombings

Patrick and Jessica Kensky Downes, newlyweds, who each lost their lower left leg in the Boston bombings. (Photo from Jessica's Facebook page)

Patrick and Jessica Kensky Downes, newlyweds, who each lost their lower left leg in the Boston bombings. (Photo from Jessica’s Facebook page)

A week after the Boston Marathon bombing, only the most seriously injured are still hospitalized. Sacramento native Jessica Kensky Downes and her husband Patrick are among them. As Martha Bebinger of WBUR reports, the couple were at the finish line when the explosions ripped through the crowd. Patrick and Jessica both each lost the lower part of their left legs.

From WBUR:

Friends are having a hard time reconciling this news with memories of the joyful pair who married just last August.  Smiles in photos of Jessica and Patrick jump off the screen.

“But that’s not just a photograph,” says Leslie Kelly, who watched Jessica grow up just outside Sacramento, Calif.  “Those two are the happiest, most optimistic, wonderful people,” continues Kelly, which provides “a real good foundation for both of them going forward.” Continue reading

Native American Woman Finds Strength in Spiritual Ceremony

Editor’s Note: In a world where random violence seems to be a constant threat, it can feel like we’re on our own, unprotected and unsupported. As part of our occasional series “What’s Your Story,” Sheila Jumping Bull of Oakland describes how she found strength and solace from a spiritual ceremony called “Wiping of the Tears.”

By Sheila Jumping Bull

Shiela Jumping-Bull records her commentary in a KQED studio as part of the "What's Your Story?" series.

Shiela Jumping-Bull records her commentary in a KQED studio as part of the “What’s Your Story?” series. (Shuka Kalantari/KQED)

Two years ago I was shot in my leg while waiting for the bus. I was in the wrong place at the wrong time. After being shot, I was told that I would never walk again, or that if I did, I’d have to walk with a cane. Being that I had to stay in bed for three months straight, not being able to walk or hold my own baby or do anything for myself, I became depressed. I didn’t want anything to do with life. Mentally, I was not here. I couldn’t believe what was going on. I was angry, confused and hurt.

We have a medicine man that comes to our Native community, once a month. He does ceremonies, sweat lodges, talking circles. He did a ceremony called Wiping of the Tears. I didn’t want to participate in this ceremony, but a lot of people from the Native American community told me that I should because it would help me.

As I prayed and as these songs were being sung, I could feel my spirit coming back.
A Wiping of the Tears ceremony is where you call upon your ancestors and those who have passed before you to come and help heal you — and take away your pain. As the medicine man sings these songs, these sacred songs, these ceremonial songs, you pray, and you ask for their guidance, their strength, their love, and their help. Continue reading

6 Factors That Help Save Lives In A Disaster

From Olympic Park to the Boston Marathon to Texas

The New Yorker’s Atul Gawande writes often and well about medicine. This week, he described how disaster planning and training in hospitals saves lives. This morning he added a series of tweets:

Continue reading