Washington Post WonkBlog reporter Sarah Kliff tweeted Friday morning that this piece is “fun with newspaper archives.” And indeed it is.
Kliff embedded and artfully linked together clips from newspapers past, clips that tell the story of the Medicare rollout.
It’s almost as if today’s Obamacare rollout news is ripped from yesterday’s headlines: “5,000 Aged To Be Hired in New Medicare Drive” or “Selling Elderly on Medicare is Not Easy.”
The first thing you need to know about the BRCA gene is that you have it.
Don’t panic. Everyone does. In fact, we all have two of them — the BRCA1 and 2 genes. They are normal genes that “have an important function in the cell. They are involved in repairing DNA damage,” explained Dr. Robert Nussbaum, a medical geneticist at UCSF. “When they’re functioning normally, they do a good job for us.”
We all have two copies of the BRCA genes. Men, too.
The problem is what happens when they don’t function normally. We’ll get to that in a minute. But first, in our call, Nussbaum gave me a helpful primer in basic genetics.
For starters, we all have two copies of each of the BRCA genes. Men, too. We get one copy from each parent. These genes are “like sentences,” Nussbaum said. ”They are made up of words.” When they’re spelled right, all is well.
But “you can have all kinds of misspellings,” Nussbaum said. “Red becomes reed. All kinds of things can happen that will alter the meaning of that sentence.” Continue reading
By Mina Kim
(Justin Sullivan/Getty Images)
Gov. Jerry Brown’s revised budget plan is a mixed bag for health advocates and some county officials.
Brown said the state would take the lead on a key provision of the federal health law — expanding Medi-Cal to more than one million Californians. Brown scrapped earlier plans to consider a more complicated, county-based system.
But Brown anticipates recouping more than $300 million from the counties next fiscal year – money that pays for public health programs and care for the uninsured. Brown’s rationale? With the full implementation of federal health reform next year, more people will enroll in Medi-Cal and fewer people will show up to county emergency rooms.
Farrah McDaid Ting with the California State Association of Counties says Brown’s proposal makes no sense. She says plenty of people will still rely on county services in 2014.
They are “people who qualify for Medi-Cal but don’t sign up, people who have a hard time signing up or staying on programs, the undocumented in our communities and those who are in between private health plans,” McDaid Ting said. “We need to retain enough funds to serve those people.” Continue reading
Covered California, the state’s health insurance exchange, announced the recipients of $37 million in education and outreach grants on Tuesday. It’s a critical step in the drive toward the full implementation of the federal health law on Jan. 1. “This program now belongs to California … and to Californians, and we have to make it work,” said Dr. Robert Ross, a Covered California board member.
The grants were awarded to 48 lead organizations, which will be supported by 226 community partner groups. They will focus on education and outreach to the 5.3 million Californians the exchange seeks to enroll, with an estimated 2.6 million of those people eligible for subsidies to help them afford insurance. Five of the recipients will target their outreach to small businesses.
Californians will be able to shop for insurance on the new marketplace starting Oct. 1, with coverage going into effect on Jan. 1. Most people must have insurance or pay a penalty. In 2014 the penalty is $95 per person or 1 percent of income (whichever is greater), and the penalty rises to $695 or 2.5 percent of income (again, whichever is greater) by 2016. Continue reading
(Foreign and Commonwealth Office/Flickr)
Angelina Jolie lit up social media Tuesday morning with her announcement that she recently had a preventive double mastectomy. She took this route, she says, because she carries a specific BRCA1 mutation — putting her at an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. You can read everything about her history in her New York Times piece, “My Medical Choice.”
But the key here is a specific BRCA1 mutation. There are many different mutations that can occur in the BRCA gene. Jolie is very careful to walk through all her personal decisions stemming from her unusually high risk, but emphasizes that “the risk is different in the case of each woman.”
About 10 percent of all breast cancers are due to those many BRCA mutations. Dr. Otis Brawley, chief medical officer with the American Cancer Society, explains in more detail what individual women should consider, in a response to Jolie’s piece:
This does not mean every woman needs a blood test to determine their genetic risk for breast and/or ovarian cancer. What it does mean is women should know their cancer family history and discuss it with their regular provider. If appropriate, they should be referred to and have the opportunity to discuss their risk and their options with a genetic specialist. Continue reading
It all started with a prescription from his doctor, but not for a drug.
“You should probably become a vegan,” New York Times food writer Mark Bittman says his doctor told him. That was six years ago. Then 57, Bittman says he was 40 pounds overweight, and his cholesterol and blood sugar which had always been normal, had moved into the “danger zone.”
Bittman had built his career around food, and being a vegan didn’t appeal to him, as he recounted this week on KQED’s Forum. “I wanted … something do-able, something I could stick with,” he said.
He hatched the idea of being vegan until dinner — “you’re only postponing gratitude” until then.
It seems to have worked. Today, he’s 35 pounds lighter and he says his blood sugar and cholesterol are back in the normal range.
Now he has recounted his experience in a new book, “VB6: Eat Vegan Before 6:00 to Restore Your Health and Lose Weight … for Good.” Continue reading
It’s nearly unbelievable to average consumers, but well known to wonks: health care prices are impossible to come by. Even calling and asking about a specific procedure, as researchers recently reported, led to an “I dunno” from the hospital itself more than half the time.
But now, a little bit of light is being shed on this dark area of health care. Wednesday morning, the federal government released a massive amount of data: the prices that hospitals across the country charge for 100 of the most common inpatient treatments.
Skipping over the wonk for now, let’s dive in to some numbers right here in the Bay Area. They cast a spotlight on how random and wildly variable health care prices are.
I picked one procedure, a hip or knee replacement (“lower extremity major joint replacement”) without major complications.
A joint replacement is generally a procedure you would schedule in advance, not a race-to-the-hospital-life-or-death-spare-no-cost situation. You might think the range of prices would be somewhat narrow.
You would be wrong. Continue reading
A soda tax failed at the ballot at two California cities last November. Before that, a statewide soda tax failed two years ago. But advocates and legislators are trying again. A bill that would require a penny-per-ounce tax on any sugary beverage is back in front of legislators and, so far, has passed out of two Senate committees.
The bill by Sen. Bill Monning (D-Carmel) has two explicit goals: to “discourage excessive consumption” by increasing the price of sugary drinks and to create a Children’s Health Promotion Fund.
“We’re in the midst of a public health crisis fueled by childhood obesity,” CaliforniaHealthline reports Monning said to the Senate Committee on Health last week. “This legislation sets an alternative path toward health and wellness.”
The health committee approved the bill. Next stop is the Senate appropriations committee.
While the soda industry is expected to be back in force for this bill, as it was for the other soda-tax efforts, this time there are new forces in play. Continue reading
For you wonks out there, Kaiser Health News has a fascinating Friday afternoon read for you.
In a piece titled “Bloggers See Own Reflections in Oregon Medicaid Study,” reporter Jordan Rau describes how this week’s news about Oregon’s Medicaid Experiment quickly became “a Rorschach test for how partisans and health policy wonks view the health care law.”
With no money for better food, no money for good shoes to go on walks, no rain gear, no walkman for listening to music as a distraction while walking, change is harder.
To quickly recap, in a New England Journal of Medicine study researchers analyzed how 10,000 people who won Medicaid coverage have fared since they gained insurance. The highlights were: no apparent affect on physical health; rates of depression 30 percent lower than those without coverage; catastrophic out-of-pocket medical expenses essentially eliminated.
In his piece, Rau publishes excerpts from seven blogs, each with a different take on the study’s highly nuanced results. But he closes with something I hadn’t seen elsewhere: a view of the experiment by someone who says he was one of the winners of the Medicaid coverage. Rau found the post on the blog Robert’s Stochastic thoughts.
Here’s the post in its entirety:
I am one of the winners in the Oregon lottery [winners could get Medicaid]. Going from no insurance to insurance is very confusing. When you have no money every health question starts with “would I rather live with this problem and have electricity, or treat this problem and keep my milk in a cooler for a month or so?” Stepping back into healthcare was like Continue reading
In what’s called the Oregon Experiment, 10,000 people in the state won Medicaid coverage in a lottery. Then researchers compared and contrasted the winners with the losers. As it turns out, the winners didn’t get any healthier — at least not physically. But there were other benefits. The people who won Medicaid were a whopping 30 percent less likely to be depressed. The researchers also correctly point out that health insurance is a financial product, intended to prevent financial calamity due to extraordinary medical bills. In the study, “Medicaid coverage almost completely eliminated catastrophic out-of-pocket medical expenditures.” That’s a big deal.
Let’s remember that health care does not equal health. Health comes from many places besides health care or health insurance: good schools, safe neighborhoods, and access to good jobs.