Author Archives: April Dembosky

April Dembosky covers health care news and trends across California for KQED's local news and its statewide program The California Report. She has reported extensively on the economics of health care, the roll-out of the Affordable Care Act in California, and aging and end-of-life issues. Her work is regularly rebroadcast on NPR and has been recognized with awards from the Third Coast International Audio Festival, the Society for Professional Journalists, and the Association of Health Care Journalists.

Money a Huge Factor in Defeat of Proposition 46

The central fight in this complex initiative is whether to raise California’s 39-year-old cap on the amount of money that courts can award for pain and suffering to a victim of medical malpractice.  (Getty Images)

The central fight in this complex initiative is whether to raise California’s 39-year-old cap on the amount of money that courts can award for pain and suffering to a victim of medical malpractice. (Getty Images)

Update, 10:50 p.m.
By far the most expensive race in the state this election was Proposition 46. The three-part “patient safety measure” inspired close to $60 million in spending from the No side, seven times the spending on the Yes side. Medical malpractice insurers wanted to make sure this one went down – and early voter returns indicate that it will.

“It’s apparent that people are being influenced by biased advertising,” says Daniel G. Newman, president and co-founder of MapLight, a nonpartisan research organization that tracks the influence of money on politics. “These political ads have very little to do with the substance of the measure. They have very simple messaging that is often misleading.”

The key piece of Prop. 46 would have adjusted the cap on medical malpractice awards for inflation, from $250,000 – an amount set in 1975 – to $1.1 million. This would have applied only to pain and suffering awards. Victims of medical malpractice, and their lawyers, pushed to raise the cap because they say it limits victims’ ability to find representation, especially when that victim is elderly or a child and cannot claim lost wages or other economic damages. Insurers said this would drive up the costs of premiums. Continue reading

Five UC Hospitals Now Designated for Ebola Care

UCSF is one of the five centers designated. (Niall Kennedy/Flickr)

UCSF is one of the five centers designated. (Niall Kennedy/Flickr)

The five medical centers of the University of California will serve as designated Ebola treatment centers should a person in the state become ill from the virus.

While public health officials are calling on all hospitals in California to redouble preparations for screening and isolating patients at risk for Ebola, those who are confirmed to have the virus will be transferred to a UC medical center in San Francisco, Davis, Irvine, Los Angeles, or San Diego.

“As a public university, stepping up to a public health crisis, like a potential Ebola outbreak, is what we do,” says Brooke Converse, spokesperson for the UC Office of the President. “Our overall mission as the University of California is to serve Californians and serve the taxpayers and the public.” Continue reading

Genetic Variant Linked to Lower Breast Cancer Rates in Latinas

(Getty Images)

(Getty Images)

Researchers have long known that Latina women have lower rates of breast cancer compared to African-American and white women. They have mainly pointed to lifestyle and environmental factors to explain why –- Latinas tend to have more children, breast feed longer, and drink less alcohol, all factors that are associated with lower disease rates.

Now, an international study led by scientists at UC San Francisco shows that a genetic variant unique to Latina women with indigenous ancestry plays a significant role, too.

“When we were accounting for all the non-genetic risk factors in our analysis, it was not enough to explain that women with more indigenous American ancestry tended to have less breast cancer,” says lead author Prof. Laura Fejerman, a member of UCSF’s Institute of Human Genetics. Continue reading

California Hospitals Prepare for Ebola

Kaiser Permanente's newly opened medical center in Oakland. (Lisa Aliferis/KQED)

Kaiser’s new hospital in Oakland is one of two sites that Kaiser has chosen to treat any Ebola patient that might present in its system. (Lisa Aliferis/KQED)

Hospitals in California are adapting to evolving guidelines from the Centers for Disease Control on how to best prepare for a possible Ebola patient. There are no known — or suspected — cases of the virus in California, but the infection of two nurses in Texas has hospitals here revamping their protocols.

Responsibility ultimately falls on each individual hospital to incorporate CDC guidelines into its own Ebola response plan. The California Department of Public Health (CDPH) is providing guidance, but the state’s chief of communicable disease control, James Watt, says state help can only go so far.

“The reality is that every hospital situation is unique. The physical layout of the hospital is unique and needs to be taken into account. Also the equipment that (each) hospital has,” he said during a press briefing last week. “That’s why it’s really important for the training and the planning to be done at the facility level. That’s not something that can be one-size-fits-all.” Continue reading

Gov. Brown Meets with Nurses Over Ebola Preparedness

Gov. Jerry Brown and other state officials meet with California nurses to discuss Ebola preparedness. (Brad Alexander/Office of the Governor)

Gov. Jerry Brown and other state officials meet with California nurses to discuss Ebola preparedness. (Brad Alexander/Office of the Governor)

Gov. Jerry Brown met with top public health officials and nursing union leaders Tuesday to discuss efforts to prepare for Ebola. The meetings came on the heels of new guidance issued by the Centers for Disease Control and Prevention Monday night.

There are no known cases of Ebola in California. But after two nurses in Texas became infected after treating an Ebola patient there, the CDC is now recommending that hospitals provide better protective equipment for health workers, and hands-on training for how to put it on and take it off.

But the California Nurses Association (CNA) says the guidelines don’t go far enough. Continue reading

Ebola Now an Issue in Nurses’ Contract Bargaining

(Centers for Disease Control via Getty Images)

(Centers for Disease Control via Getty Images)

Nurses’ calls for better hospital preparation around Ebola have landed on the bargaining table. California’s powerful nurses’ union has been bargaining with Kaiser Permanente for months over a new contract, and is now adding to its list of demands better training, protection, and insurance coverage for nurses who may treat patients infected with Ebola.

Diane McClure, a nurse at Kaiser’s South Sacramento facility, says nurses still had no meaningful training more than a month after a patient was admitted to the hospital for a potential Ebola infection, though he later tested negative for the virus.

“Kaiser felt all they had to do was pull up some CDC flyers and put them on the lunchroom tables or up in the bathrooms,” she says. Continue reading

Prop. 45 Fight Worthy of Television Drama

Kevin Spacey stars as Frank Underwood in the Netflix series "House of Cards." (Kevin Winter/Getty Images)

Kevin Spacey stars as Frank Underwood in the Netflix series “House of Cards.” (Kevin Winter/Getty Images)

The power play behind Proposition 45 could be fodder for an episode of House of Cards:

Dave Jones might not like this comparison, but he’s the Frank Underwood in this fight.

“Power is a lot like real estate. It’s all about location, location, location. The closer you are to the source, the higher your property value,” so goes protagonist Frank Underwood, who plays the menacing House majority whip scheming to get closer to the president.

You’d never think there’d be such positioning over who gets to regulate health insurance.

But this is California. And no less than three state agencies want to have a say in this one. Continue reading

More Than Half of California’s Hospitals Dinged for Readmissions

Chinese Hospital in San Francisco received the second-highest fine of any hospital statewide. (m./Flickr)

Chinese Hospital in San Francisco received the second-highest fine of any hospital statewide. (m./Flickr)

The federal government is fining 64 percent of California hospitals for having too many Medicare patients return to the hospital within a month of being discharged, according to an analysis of Medicare data by Kaiser Health News.

Sutter Surgical Hospital North Valley in Yuba City was the only facility in the state that received the maximum 3 percent fine. Chinese Hospital in San Francisco received the second highest fine: 2.16 percent of all Medicare billings in the coming year.

“Any little bit hurts. We will definitely feel it,” says Peggy Cmiel, chief nursing officer at Chinese Hospital.

The fines are meant to encourage hospitals to do a better job of caring for patients after they’re released. In the past, many hospitals benefited if a patient returned after surgery – more treatment meant more money. Now, the Medicare program that pays for those treatments wants to reverse the trend by fining hospitals that don’t do a good enough job transitioning patients out of the hospital. Continue reading

Prop. 46, Inspired By Tragedy, Pits Doctors Against Lawyers

After Troy and Alana Pack were killed by an impaired driver, their father became an advocate for change, ultimately writing Prop. 46 on November's ballot. (Photo Courtesy: Bob Pack)

After Troy and Alana Pack were killed by an impaired driver, their father became an advocate for change, ultimately writing Prop. 46 on November’s ballot. (Photo Courtesyof Bob Pack)

Troy and Alana Pack had spent the day at their neighborhood Halloween party in Danville. Ten-year-old Troy went as a baseball player, and 7-year-old Alana was a good witch. In the afternoon, they changed out of their costumes and set out for a walk with their mother down Camino Tassajara. Destination: Baskin Robbins 31 Flavors.

“Alana, she liked anything with chocolate,” says their father, Bob Pack. “Troy, for sure, bubble gum ice cream, ’cause he liked counting the bubble gums that he would get.”

Bob Pack stayed home to rest. His family made it only half a mile down the road before his phone rang: “I received a call from a neighbor screaming there’d been an accident. And I raced down there,” he says.

An impaired driver had veered off the road and hit Troy and Alana head-on. Pack was doing CPR on Troy when the paramedics arrived. Continue reading

Drought May Be Driving Increase in West Nile

A security guard walks the perimeter of the Almaden Reservoir on January 28, 2014 in San Jose, California. Now in its third straight year of drought conditions, California is experiencing its driest year on record, dating back 119 years, and reservoirs throughout the state have low water levels. Santa Clara County reservoirs are at 3 percent of capacity or lower. California Gov. Jerry Brown officially declared a drought emergency to speed up assistance to local governments, streamline water transfers and potentially ease environmental protection requirements for dam releases. (Photo by Justin Sullivan/Getty Images)

A security guard walks the perimeter of the Almaden Reservoir in San Jose. (Justin Sullivan/Getty Images)

Public health experts say the state’s historic drought is partly to blame for the recent rise in West Nile virus infections. Cases this year have more than doubled to 311, compared to the same time last year.

West Nile virus is spread by mosquitoes. They contract the virus when they feed on infected birds, then spread it to other birds they bite next. A shortage of water can accelerate this cycle.

“When we have less water, birds and mosquitoes are seeking out the same water sources, and therefore are more likely to come in to closer proximity to one another, thus amplifying the virus,” said Vicki Kramer, chief of vector-borne diseases at the state department of public health.

Also, the water sources that do exist are more likely to stagnate. Stagnant water creates an excellent habitat for mosquitoes to breed. Continue reading