Policy

Actions by people in power – lawmakers, regulators and the like – can make a difference to your health, for better or for worse. We keep you informed

RECENT POSTS

Prisons Are Main Source of California’s Psychiatric Housing

(Photo/Gregory D. Cook)

(Photo/Gregory D. Cook)

By Hannah Guzik, HealthyCal

California’s jails and prisons hold far more people with severe psychiatric illnesses than state hospitals, according to a recent report from the Treatment Advocacy Center and the National Sheriffs’ Association.

“For a state with 38 million people — 1 in every 8 Americans lives in California — there are almost no public psychiatric beds available for individuals with serious mental illness,” the report says.

Four state hospitals — Metropolitan, Patton, Napa, and Atascadero — have just over 4,500 beds, but 88 percent of them are reserved for mentally ill individuals who have been charged with crimes, according to the report. Another state hospital at Coalinga is used almost exclusively for sexually violent predators. Continue reading

Two Different Reactions to Obamacare

The 2014 enrollment period for the Affordable Care Act closes tonight. For some people the new health law is a godsend. Others barely noticed its existence.

Donna Zeuli and her husband lost their insurance when he retired two years ago. Private insurers denied them both because of pre-existing conditions and the COBRA plan offered through his union was too expensive. So they decided to take their chances and wait for Obamacare to take effect.

Then, last fall, Zeuli had a mini stroke at her home in Magalia, Calif., in the foothills of Chico, and was rushed to the ER.

“You can’t believe the angst I had about not having insurance,” says Zeuli, 55. “The only thing I could think about was how much is this going to cost me. Do the minimum. But make sure I’m not gonna die.” Continue reading

Prescription: Take New Medicare Data With A Dose of Caution

The data details payments to individual doctors, but experts warn against drawing sweeping conclusions from the numbers.(Getty Images)

The data details payments to individual doctors, but experts warn against drawing sweeping conclusions from the numbers.   (Getty Images)

By Mark Memmott, NPR

The headlines about one of Wednesday’s big stories — the release of data from 2012 about Medicare payment to doctors around the nation — are certainly serious sounding:

— “Sliver of Medicare Doctors Get Big Share of Payouts.” (The New York Times)

— “Small Slice of Doctors Account for Big Chunk of Medicare Costs.” (The Wall Street Journal)

— “Release of Medicare doctor payments shows some huge payouts.” (Los Angeles Times)

Here’s how The Associated Press sums up the news: Continue reading

California ‘Death with Dignity’ Advocates Launch New Campaign

Jennifer Glass of San Mateo, undergoing chemotherapy last year for lung cancer. (Courtesy: Mary Thomas)

Jennifer Glass of San Mateo, undergoing chemotherapy last year for lung cancer. (Courtesy: Mary Thomas)

A new campaign is underway to legalize physician-assisted suicide in California. Advocates launched a series of online ads last week to begin raising awareness. Still, it could take years for the effort to yield any results.

“Having choice helps me feel I have some control.” 

Since the early 1990s, lawmakers and activists have tried and failed several times to pass a death with dignity law in California. Under such a law doctors could prescribe lethal medications to patients who are terminally ill. Oregon and Washington permit the practice.

“California is a large state. It’s a politically complicated state,” says Barbara Coombs Lee, president of Compassion and Choices. Her advocacy group is leading the effort to try again to pass a law through the legislature or ballot proposition that would make aid in dying accessible in California. Continue reading

Obama Signs Law to Fix Medicare Rate Gap in California

Under the new law San Diego, pictured above, will no longer be categorized as "rural." (vinhdicated/Flickr)

Under the new law San Diego, pictured above, will no longer be categorized as “rural.” (vinhdicated/Flickr)

A new federal law will change how doctors get paid in California, making it easier for patients in 14 California counties to find a doctor who accepts Medicare.

The law, signed by President Obama on Tuesday night, fixes an outdated Medicare formula that set rates based on urban or rural designations established in the 1960s, with places like San Diego, Sacramento, and Santa Cruz falling into the “rural” category.

So even as rent for office space and other costs of practicing medicine rose with the local economy in those places, doctors were still paid the same rates as doctors in remote, rural areas like Humboldt or Modoc. Continue reading

New Report Finds Dramatic Racial Disparities for California Kids

(Getty Images)

(Getty Images)

Many children of color in the state face different health and education opportunities from the earliest years.

That’s according to a new study from the Annie E. Casey Foundation.

The report looked at factors like birthweight, access to preschool and, later, reading and math proficiency. The researchers then created an index that weighted these and other social markers to measure a child’s opportunity to thrive later on.

The findings were stark. On a scale of 0 to 1000 (with 1000 being the highest), Asian and Pacific Islander children in California scored 768, Whites 748, American Indians 529, Latinos 405, and African American children 395.

“A multicultural state needs multicultural solutions,” Nadereh Pourat, UCLA Center for Health Policy Research

The report gives this analogy for thinking about the results. Think about a power grid that brings power to an area. A “prosperity grid” offers critical links to help kids succeed – in this case whether someone in their household has a high school diploma, their parents income, and achievement levels at their school.

“The inability of children of color to connect to this network through their neighborhoods clearly has significant consequences for their healthy development and well-being,” the authors wrote. Continue reading

Could Healthy San Francisco Help People Buy Obamacare Plans?

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(Deborah Svoboda/KQED)

A lot of San Franciscans are saying “no thanks” to the Affordable Care Act. As the cost of living rises in the city, even subsidized health insurance doesn’t feel affordable to many residents.

Supervisor David Campos says that, as a result, not enough people in the city are signing up for health insurance. He wants to change that.

“Without supplemental help, many people won’t get insurance,” he says. Continue reading

Higher Autism Numbers Announced as Feds Introduce Early Screening Program

(Getty Images)

(Getty Images)

Every two years, the federal government announces the rate of autism. This is what NPR’s shots blog had to say about today’s numbers, which show 1 in 68 children in the U.S. have an autism spectrum disorder.

That’s a remarkable jump from just two years ago, when the figure was 1 in 88 and an even bigger jump from 2007, when it was just 1 in 150.

But officials at the Centers for Disease Control and Prevention officials say the agency’s skyrocketing estimates don’t necessarily mean that kids are more likely to have autism now than they were 10 years ago.

“It may be that we’re getting better at identifying autism,” says Coleen Boyle, director of the CDC’s National Center on Birth Defects and Developmental disabilities.

For one thing, the prevalence seems to vary in different communities and among children of different races. The CDC found white children are far more likely to be identified with autism, even though scientists don’t believe the rates are truly different between whites, Hispanics or blacks.

“What we need to focus on is getting more people identified so they can get the supports they need,” Shannon Rosa, Bay Area parent advocate.

That means that the discrepancy lies in the diagnosis and services available in different communities. The shots blog points out the work of George Washington University anthropologist Roy Richard Grinker.

Along with other researchers, he studied autism prevalence in South Korea. They found that 1 in 38 children there met the criteria for autism spectrum disorder. Grinker thinks that the US number is likely closer to the one they saw in South Korea. Which means that in two years the CDC estimate will likely tick higher still.

Continue reading

New Bill Would Give Transgender People More Control Over Death Certificates

(Craig Miller/KQED)

(Craig Miller/KQED)

Regulations and laws have been expanding rapidly recently to give transgender people new rights. For example, transgender students can now use a school bathroom that corresponds with their gender identity. Athletes can compete in the Olympics — according to their gender identity. But when a transgender person passes away, the last record of the life they lived speaks to an identity they left behind.

Christopher Lee died in Oakland in 2012. His friends took great care to explain to the coroner that Lee was a female-to-male transgender person. They pointed to his driver’s license that showed the “sex” box marked with the letter “M,” for male. But when Lee’s best friend Chino Scott Chung went to pick up Lee’s ashes, the death certificate listed Christopher as Kristina. Sex: female.

“Christopher lived his life in all ways as a man and he changed his driver’s license and passport to reflect this,” said Scott-Chung. “Listing him as female on his death certificate is disrespectful to his memory and his legacy. It is deeply painful to me, to his chosen family, and to the community that he was so much a part of. Continue reading

California Gets an ‘F’ for Health Care Price Transparency

(Getty Images)

(Getty Images)

California — and 44 other states — received failing grades in a new analysis on transparency of health care prices. The report comes from Berkeley-based Catalyst for Payment Reform (CPR), and it shows that consumers remain pretty much in the dark if they want to figure out, in advance, what a treatment or procedure will cost.

“Very few states have done anything meaningful to help consumers understand what their health care costs were going to be,” said Suzanne Delbanco, executive director of the organization.

CPR looked primarily at laws and regulations around price transparency, as well as whether a state had a consumer-facing website where people could easily look up price information.

While California has taken “important symbolic steps” by passing price transparency laws, Delbanco said, “what hasn’t happened is turning that information into something that’s useful to consumers.” Continue reading