Author Archives: state of health

Uninsured? Here Are Alternative Options for Medical Care

By Emily Bazar, CHCF Center for Health Reporting

Millions of still Californians remain uninsured, either by choice or immigration status. (Getty Images)

Millions of still Californians remain uninsured, either by choice or immigration status. (Getty Images)

About 5 million Californians have new health coverage as a result of the Affordable Care Act (ACA), both through the Covered California health insurance exchange and the expansion of Medi-Cal, California’s Medicaid program for low-income residents.

But millions of others remain uninsured – by circumstance or by choice.

Up to half of California’s uninsured population is made up of immigrants who are not in the country legally, and therefore are excluded from health insurance exchanges, tax credits and most Medi-Cal coverage. Others can’t afford coverage (even if it’s subsidized), choose not to buy insurance, or are unaware that they qualify for free or subsidized insurance.

No matter who they are or what their circumstances, they get sick, too.

Q: I’m uninsured but need medical care. What are my options?

A: It’s hard to pin down exactly how many Californians remain uninsured, but Anthony Wright, executive director of Health Access California, believes there are roughly 3 million of you.

The good news is that more than a third of you are actually eligible for coverage, either Medi-Cal or subsidized insurance through Covered California, says Laurel Lucia, an ACA expert at UC Berkeley’s Center for Labor Research and Education.

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Planning On Getting An Annual Physical Exam? Maybe You Shouldn’t

By Jenny Gold, Kaiser Health News

The Society for General Internal Medicine even put annual physicals on a list of things doctors should avoid for healthy adults. (Joe Raedle/Getty Images)

The Society for General Internal Medicine put annual physicals on a list of things doctors should avoid for healthy adults. (Joe Raedle/Getty Images)

It’s a warm afternoon in Miami, and 35-year-old Emanuel Vega has come to Baptist Health Primary Care in Miami.

Vega, a strapping man with a thick black beard, is feeling good, but he came to see the doctor today because his wife thought he should – she even made the appointment. It is free to him under his insurance policy with no co-pay, as most preventive care is under the Affordable Care Act.

“I would argue that we should move forward with the elimination of the annual physical.”

Vega is one of more than 44 million Americans who is taking part in a medical ritual: visiting the doctor for an annual physical exam. But there’s little evidence that those visits actually do any good for healthy adults.

Caruso listens to Vega’s heart and lungs, checks his pulse in his ankles and feels around his lymph nodes. He also asks Vega about his exercise and sleeping schedule and orders blood and urine tests. As long as everything checks out, Caruso asks Vega to return for another exam in a year. Vega says he definitely will.

It was a positive experience for both doctor and patient, and they’re not alone; 92 percent of Americans say it is important to get an annual head-to-toe physical exam, according to a Kaiser Family Foundation poll (KHN is an editorially independent program of the foundation). And 62 percent of those polled said they went to the doctor every year for their exam.

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Learn How Your Health Insurance Could Impact Your Tax Bill (Video)

Are you still getting your taxes done ahead of the April 15 deadline? Don’t forget that your 2014 tax bill could be affected by your health insurance.

The federal health law requires that most people have health coverage. If you were insured through work, bought a plan on the new insurance marketplaces or enrolled in Medicare Part A, Medicaid or Tricare you likely met the requirement and can simply check that box off on your tax form. Continue reading

Is Pollution From Asia Making the Central Valley’s Bad Air Even Worse?

(David McNew/Getty Images)

Advocates say the San Joaquin Valley Air District should focus on sources it can control, like farming machinery. (David McNew/Getty Images)

By Alice Daniel

California’s Central Valley grapples with some of the dirtiest air in the nation. The culprits range from its vast agriculture industry to trucks on Highway 99. But one local air district is tagging a source far away: Asia.

“The world in so many ways is getting smaller in respect to what we always thought was our own backyard issue: ozone,” says David Lighthall, the health science advisor for the San Joaquin Valley Air Pollution Control District.

Lighthall is one of the organizers of an ozone pollution conference starting Tuesday where scientists from California, China, Colorado and other places will discuss trends in global ozone.

Scientists say pollutants from fast-growing Asian countries like China are blowing across the Pacific Ocean and increasing ozone levels in vulnerable areas that include parts of California. But how much of a difference that foreign — or “transboundary” — ozone makes in the Central Valley is debatable. Continue reading

Doctors with Cancer Join California Movement for ‘Aid in Dying’

Dan Swangard, a 48-year-old physician from San Francisco, was diagnosed in 2013 with a rare form of metastatic cancer. (Anna Gorman/KHN)

Dan Swangard, a 48-year-old physician from San Francisco, was diagnosed in 2013 with a rare form of metastatic cancer. (Anna Gorman/KHN)

By Anna Gorman, Kaiser Health News

Dan Swangard knows what death looks like.

As a physician, he has seen patients die in hospitals, hooked to morphine drips and overcome with anxiety. He has watched dying drag on for weeks or months as terrified relatives stand by helplessly.

“It’s very real for me. This could be my own issue a year from now.”

Recently, however, his thoughts about how seriously ill people die have become personal. Swangard was diagnosed in 2013 with a rare form of metastatic cancer.

To remove the cancer, surgeons took out parts of his pancreas and liver, as well as his entire spleen and gallbladder. The operation was successful but Swangard, 48, knows there’s a strong chance the disease will return. And if he gets to a point where there’s nothing more medicine can do, he wants to be able to control when and how his life ends.

“It’s very real for me,” said Swangard, who lives in Bolinas, Calif. “This could be my own issue a year from now.” Continue reading

Doctors Medical Center to Close in April, Barring Miracle

Stephen Scotty, who works at Doctors Medical Center's cardiac catheter lab addresses the board. (Andrew Stelzer/KQED)

Stephen Scotty, of Doctors Medical Center’s cardiac catheter lab, addressed the West Contra Costa County Healthcare District board Thursday night. (Andrew Stelzer/KQED)

By Andrew Stelzer

Doctors Medical Center in San Pablo will begin shutting its doors next month, barring an angel donor who can make up the hospital’s $18 million deficit.

The West Contra Costa County healthcare district voted Thursday night to begin giving employees two-weeks notice on April 7th, meaning operations would start winding down April 21st, and continue through June.

The hospital, which serves  the largely low-income residents of West Contra Costa County, has been in dire financial straits for almost 20 years. Voters approved parcel taxes in 2004 and 2011 to keep it afloat, but a third proposed tax in 2014 failed to gain the two-thirds majority needed.

Financial advisor Harold Emahiser said the problem is that 80 percent of the hospital’s patients are on Medicare or Medi-cal, which doesn’t pay enough for services rendered. Continue reading

Do High-Deductible Health Plans Cut Costs Now, But Backfire in Long Run?

(Getty Images)

(Getty Images)

By Jay Hancock, Kaiser Health News

Got a high-deductible health plan? The kind that doesn’t pay most medical bills until they exceed several thousand dollars? You’re a foot soldier who’s been drafted in the war against high health costs.

People with high deductible plans are foot soldiers in the war against high health costs.  

Companies that switch workers into high-deductible plans can reap enormous savings, consultants will tell you — and not just by making employees pay more. Total costs paid by everybody — employer, employee and insurance company — tend to fall in the first year or rise more slowly when consumers have more at stake at the health-care checkout counter whether or not they’re making medically wise choices.

Consumers with high deductibles sometimes skip procedures, think harder about getting treatment and shop for lower prices when they do seek care.

What nobody knows is whether such plans, also sold to individuals and families through the health law’s online exchanges, will backfire. If people choose not to have important preventive care and end up needing an expensive hospital stay years later as a result, everybody is worse off. Continue reading

Millions Need to Be On Alert for Medi-Cal Renewal

(Screen shot of California's Department of Health Care Services website)

(Screen shot of California’s Department of Health Care Services website)

By Emily Bazar, CHCF Center for Health Reporting

I spend the majority of my time (and space) writing about the new state health insurance exchange, Covered California.

But the behemoth in California’s Affordable Care Act implementation is Medi-Cal, the state’s decades-old version of the federal Medicaid program, which provides publicly funded insurance to low-income residents.

About 12 million Californians are in Medi-Cal now. That’s roughly one in three state residents. By comparison, about 1.4 million Californians are enrolled in Covered California.

Given its size, Medi-Cal’s annual renewal process is now one of its greatest challenges. Continue reading

Depression Takes Growing Toll on American Workplace

(Getty Images)

(Getty Images)

By Lisa Gillespie, Kaiser Health News

For every dollar spent on treating depression, nearly five dollars more is spent on related medical conditions like back and chest pain, sleep disorders and migraines. Depression can also lead to lost productivity, placing a greater financial burden on businesses and the health care system, according to new research measuring the economic impact of depression.

Average worker with major depression loses the productivity of 32 days a year.

“The fact that they’re finding such greater costs with all these different [related conditions] underscores how the fragmented system is not helpful for our economy because people with mental illness are not getting the rounded health care they need,” said Lynn Bufka, with the American Psychological Association, who was not affiliated with the study.

The total cost to the U.S. economy of major depressive disorder rose to $210 billion in 2010, up more than 20 percent from $173 billion in 2008. Continue reading

California Needs More Primary Care Docs, But Residency Slots Threatened

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

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

By David Gorn, California Healthline

Today is a huge day for graduating medical students. It’s Match Day — the day they find out where they’re going for residency programs — the training years between medical school and practice.

In California, there are 140 residency slots every year in the family practice specialty. That number may diminish, given the pending loss of four funding sources designed to encourage California medical students to join family-practice residencies, particularly in underserved areas of the state.

According to Del Morris, president of the California Academy of Family Physicians, California faces a loss of $50 million from the end of these four programs: Continue reading