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

Kaiser Mental Health Clinicians Authorize Strike

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

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

A union of 2,500 mental health clinicians at Kaiser have voted to authorize a strike, just one week after Kaiser’s nurses went on strike for two days.

In September, Kaiser agreed to pay a $4-million fine levied by state regulators. The Department of Managed Health Care found patients were subject to excessively long wait times to get a therapy appointment, or were shuttled into groups when they wanted individual therapy.

Psychiatric social worker Clement Papazian says various fixes, like after-hours appointments, still aren’t meeting demand. Continue reading

Covered California Patients Not Only Ones with Network Woes

(Getty Images)

(Getty Images)

Charlie Spiegel said he was “thrilled” when he learned that the Department of Managed Health Care was taking action against two major insurers that sell policies on the Covered California marketplace. The companies, DMHC says, had violated state law by listing doctors on their online directories who were not part of their network.

Spiegel, of San Francisco, is not a Covered California policy-holder, but he’s having significant problems of his own with the individual policy he bought from Anthem Blue Cross earlier this year.

Here’s the background: Spiegel, 56, says he enjoys good health, but had been postponing various preventive tests due to cost. Before the Affordable Care Act went into effect, he had a high deductible plan. Continue reading

Nurses to Resume Talks with Kaiser After Strike

Nurses carry signs as they strike outside of Kaiser Permanente hospital in San Francisco last week. (Justin Sullivan/Getty Images)

Nurses carry signs as they strike outside of Kaiser Permanente hospital in San Francisco last week. (Justin Sullivan/Getty Images)

Nurses are gearing up to return to the bargaining table with Kaiser, after walking off the job for a two-day strike.

Though the nurses emphasized the stalemate over more than 35 operational proposals in their call for the strike – over things like staffing levels and Ebola protections – several nurses on the picket lines expressed concerns about economic issues. Many of them wore pins that said “No TakeAways.”

Nurse Ama Jackson says they are afraid Kaiser will try to cut their pensions and health care benefits.

“They want to do takeaways, because they want to increase their profits,” she said, as hundreds of nurses marched up and down the sidewalk outside Kaiser’s hospital in Oakland last Tuesday. “But nurses are saying, ‘That’s not fair. That’s not fair to how hard we work.’” Continue reading

KQED’s #PriceCheck Project Shows Steep Variation in Prices Paid by Health Insurers

(Illustration: Andy Warner)

(Illustration: Andy Warner)

Since June, KQED has been crowdsourcing health care prices.

For starters, insurers paid from $128 to $694 for a screening mammogram.  

Why turn to crowdsourcing? Because health care prices are notoriously opaque. Negotiated rates between insurance companies and providers, both doctors and hospitals, are sealed tight, by contract. We know there’s variation, but comparing what one insurance company pays with another is virtually impossible.

So we asked you, the members of our community, to share what you paid.

Together with our collaborators KPCC in Los Angeles and ClearHealthCosts.com, a New York City startup dedicated to health cost transparency, we created a form to make it easy for people to share what they paid — and easy for consumers to see apples-to-apples comparisons of prices. Continue reading

Kaiser Nurses Plan 2-Day Strike: Premature Move or Strategic Step?

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

Kaiser’s Oakland Medical Center. (Lisa Aliferis/KQED)

As many as 18,000 Kaiser Permanente nurses are preparing for a two-day strike that will start Tuesday. Nurses plan to leave their posts at 7 a.m. and picket outside 21 medical centers and clinics across Northern California.

The placards nurses carry and the chants they repeat will say little about salaries or pensions. No economic proposals have even been put on the bargaining table yet.

“This seems awfully quick to go to a strike,” says Joanne Spetz, an economics professor at the UC San Francisco School of Nursing. “I can’t recall a situation where a strike has come up where there has not been some kind of disagreement about wages and benefits as part of the package.” Continue reading

‘Village’ Movement for Aging Seniors Faces Some Challenges

(Patrick/Flickr)

(Patrick/Flickr)

“It takes a village” is a common refrain.

Now “Villages” — yes, with a capital V — are sweeping the U.S., looking to redefine how people age in their communities.

The Village movement brings together older adults who want to age in their homes independently, but believe it will be too hard to do so, unless they have some support. These virtual villages link independent living seniors together. Members offer support to each other as they are able, and ask for support when they need it through an organized system.

Half of all villages in the U.S. started in the last three years. Because they are such a recent phenomenon, there have not been many studies about their outcomes. Continue reading

New State Funding Improves County Mental Health Services

(Getty Images)

(Getty Images)

By Elaine Korry

The Joslyn Center in Burbank is a place where older adults come for low-cost healthy meals and activities ranging from fitness and computer classes to music lessons.

But several times lately, the normally placid environment of the center has been disrupted. One client who uses the services was showing signs of mental illness. Renee Crawford coordinates social services at the Center.

“She gets very loud, very aggressive and very anxious,” Crawford said, in reference to the troubled client. “And then we have to go in and tell her, ‘Calm down, relax, you can’t be this loud,’ Then she gets very upset and very irate.”

The woman seemed to be suffering from paranoid delusions, and Crawford says the workers here aren’t trained to help her. Continue reading

Prop. 45 Defeated by Health Insurance Industry

The law would require health insurers to publicly disclose and justify their rates. (Getty Images)

The law would require health insurers to publicly disclose and justify their rates. (Getty Images)

Update, 12:30 a.m.
At first glance, Proposition 45 seemed like a no-brainer for consumers. The measure would have given the state’s insurance commissioner the authority to reject excessive rate hikes in health insurance sold on the individual and small-business markets.

Consumers who had seen their premiums go up by double digits year after year clung to Prop. 45 as the savior.

“I felt like a frog in hot water that got hotter and hotter until it was boiling,” says Josh Libresco, a market researcher who has bought health insurance for his family on the individual market for 20 years.

Continue reading

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

Berkeley Passes Soda Tax; San Francisco Effort Fails

(Getty Images)

(Getty Images)

Update: 2:30am 11/5/2014

Voters in Berkeley have passed the nation’s first soda tax with a resounding 75 percent of the vote. More than 30 cities and states across the country have attempted such a tax, but have failed, at least in part because of big spending by the soda industry to defeat these measures.

But across the bay in San Francisco, a similar proposal failed to get the two-thirds supermajority it needed.

Berkeley’s Measure D needed only a simple majority to pass. It will levy a penny-per-ounce tax on most sugar-sweetened beverages and is estimated to raise more than a million dollars per year. Proceeds will go to the general fund; Measure D calls for the creation of a health panel to advise Berkeley’s City Council on appropriate health programs to receive funding. Continue reading