Reform

How the Washington rollout of health care reform is changing the landscape of health care in California

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May 21, 2012 | 11:39 AM | By

Poll: What’s It’s Like To Be Sick In America

By Richard Knox and Joe Neel, NPR News and Kaiser Health News

In the lull between the Supreme Court arguments over the federal health overhaul law and the decision expected in June, we thought we’d ask Americans who actually use the health system quite a bit how they view the quality of care and its cost.

Most surveys don’t break it down this way.

Source: NPR/Robert Wood Johnson Foundation/Harvard School of Public Health Poll. Credit: Alyson Hurt/Nelson Hsu, NPR

Source: NPR/Robert Wood Johnson Foundation/Harvard School of Public Health Poll. (Image: Alyson Hurt/Nelson Hsu, NPR)

When the results came back, we found that people who have a serious medical condition or who’ve been in the hospital in the past year tended to have more concerns about costs and quality than people who aren’t sick. No big surprise there.

But what was notable: 3 of 4 people who were sick said cost is a very serious problem, and half said quality is a very serious problem.

Nearly half of those with recent serious illness say they felt burdened by what they had to pay out of their own pocket for care.

The recently ill are more likely to say the cost and quality of care have worsened over the past five years, compared to people who weren’t sick.

Among people who’ve recently required a lot of care, significant proportions say their treatment was poorly managed, with nearly a third complaining of poor communication among their caregivers. One in eight believe they got the wrong diagnosis, treatment or test. Continue reading →

FILED UNDER: Policy, Reform
May 17, 2012 | 11:20 AM | By

Bridge to Health Reform “Undoable” in San Luis Obsipo

By John Gonzales, Center for Health Reporting

San Luis Obispo County. (Steve Wilson: Flickr)

San Luis Obispo County. (Steve Wilson: Flickr)

California’s “Bridge to Reform” program is intended to do exactly that: provide a bridge to the 2014 roll-out of the Affordable Care Act. Right now, 47 of California’s 58 counties have already provided health care to more than 335,000 people. San Luis Obispo is a case study in one county that is not participating.

We have reported on the Bridge to Reform, also known as the Low Income Health Program, since its early phases. I was the reporter on our first piece, which looked at Kern County’s efforts to build the bridge. A follow-up examined the challenges of implementing the program in the far corners of Humboldt and Del Norte counties.

In San Luis Obispo, Health Agency Director Jeff Hamm said he made the decision to withdraw from participation reluctantly. For years, the county has slashed its health budget and outsourced its medical safety net.

It reached the point, Hamm said, of not having the start-up funds, or medical infrastructure, needed to implement the Bridge to Reform.

“We understood it would be good for a lot of people. We didn’t have the money,” said Hamm, whose county joins Fresno as a non-participant. “It was a big paradigm shift, a really big shift in terms of infrastructure, requirements for data collection, and processing. … We’re talking a 150-page contract with the State of California. … It became undoable for us.” Continue reading →

FILED UNDER: Policy, Reform, Affordable Care Act, Bridge to Reform
April 20, 2012 | 1:10 PM | By

California Prison Medical Costs Higher Than Average

By KQED Staff and Wires

California spends three times the national average on inmate medical care. (Getty Images)

As the state prepares to resume control of inmate medical care, it must find ways to reduce costs that are triple the national average, the nonpartisan Legislative Analyst’s Office said Thursday.

The federal receivership that has been in place since 2006 has greatly improved the medical care of state prison inmates but also has caused costs to soar, according to the report. California spends $16,000 per inmate for health care services, compared to an average of $5,000 in other states.

The analysis was released less than two weeks before the state and attorneys representing inmates must report to a federal judge with recommendations on when the receivership should end and whether it should maintain some oversight role.

The Legislature should create an independent board to monitor prison medical care to make sure conditions do not deteriorate once the state retakes control, the report said. It also recommends that the state experiment with contracting for medical services to cut costs. Continue reading →

FILED UNDER: Policy, Reform, California
April 4, 2012 | 10:25 AM | By

Opposition to the Federal Health Law: Tea Party, Republicans and … the Green Party

Green Party Backs A Single-Payer System

The Green Party opposes the federal health law, but for different reasons than you might think. (Mark Wilson: Getty Images)

The Green Party opposes the federal health law, because it doesn't go far enough. (Mark Wilson: Getty Images)

The platform of California’s third largest political party — the Green Party — includes legalizing marijuana, ending the death penalty and offering free, community bicycles. Now, add this to the Party’s list of solemn commitments:

“We’re hoping the individual mandate will be struck down,” says Barry Hermanson, the Green Party’s candidate for California’s 12th Congressional District. ”It is extraordinary that now Congress is saying individuals must purchase a product from a private company. There’s no precedent for this.”

For Hermanson, and other Greens, being compelled to buy a product from an industry they find repugnant is a bit like a school requiring kids to hand over their lunch money to the playground bullies.

“I have no trust they have my best interest and the general populace interest in mind,” he said. Continue reading →

FILED UNDER: Policy, Reform, Health Care Overhaul, Single Payer System
March 30, 2012 | 1:18 PM | By

Just in Time for the Weekend! Background on Health Care in California

(alycat: Flickr)

(alycat: Flickr)

Admit it. The Supreme Court’s scrutiny of the health care overhaul has piqued your interest. You’ve read or heard stories about the oral arguments. But you feel guilty. You haven’t been able to keep up on how the federal health care law is playing out in the Golden State. State of Health is here to help.

We’ve rounded up four stories — filed by KQED Health Reporter Sarah Varney over the last 10 months — to help give you an overview. These stories all have to do with how California is moving forward in implementing the Affordable Care Act. Yes, the Supreme Court might overturn the ACA, but then again, it might not. Presuming the law goes forward, California is in a better position than most states to meet the 2014 full implementation.

In just under 22 minutes, you can get up to speed on where California stands. So put on your headphones and listen to the following stories: Continue reading →

FILED UNDER: Policy, Reform, Health Care Overhaul, Health Insurance Exchange, Medi-Cal
March 29, 2012 | 5:52 PM | By

Politics in the High Court — Right, Left or Not at All?

(Mark Wilson: Getty Images)

(Mark Wilson: Getty Images)

Every news organization in the country is busy parsing the Supreme Court today and State of Health is no exception. But if you’re tired of arcane discussions of the Commerce Clause, the individual mandate and (heaven forbid) the 1867 Tax Anti-Injunction Act, read on.

In a “Health Law Hearings Wrap Up” this morning on KQED’s Forum, I perked up when the guests got going on how much to read into the justices’ questions. These are not the first legal experts to focus on Justice Kennedy, the perceived swing vote, who asked many tough questions of the attorney defending the government’s position on the constitutionality of the health care law.

But Vikram Amar, professor at the UC Davis School of Law urged caution in trying to analyze the questions too closely. “Justice Kennedy at some points in the past asked very tough questions of the government and ended up not striking down the law in question,” he said. Continue reading →

FILED UNDER: Reform, Health Care and the Supreme Court
March 29, 2012 | 10:26 AM | By

Full Audio & Transcripts: Supreme Court’s Oral Arguments on the Health Law

(Jessica Marcy: KHN)

(Jessica Marcy: KHN)

The Supreme Court’s historic hearings of the Affordable Care Act have wrapped up. The Court addressed four issues over the last three days and held a total of six hours of oral arguments.

Below is complete audio and transcripts from each set of arguments.

First, the court heard arguments about whether it can even consider the case now. Under the new law, the first penalties would be assessed in 2015 for those who do not purchase health insurance. An arcane 1867 law says people can’t sue over a tax until they pay a tax. Must the court wait until 2015 to decide whether the health law is constitutional?

You can listen to the 90 minutes of oral arguments here:

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Or read on for the complete transcript as well as audio and transcripts from the other arguments:
Continue reading →

FILED UNDER: Reform, Affordable Care Act, Health Care and the Supreme Court
March 28, 2012 | 3:56 PM | By

Legal Levity: Moments of Humor During Historic Hearings

Supreme Court Justice Antonin Scalia was one of the justices making the occasional joke today. (Courtesy: U.S. Supreme Court)

Supreme Court Justice Antonin Scalia was one of the justices making the occasional joke today. (Courtesy: U.S. Supreme Court)

It was the hottest ticket inside the Beltway–the Supreme Court’s hearings on the federal health care law. Kaiser Health News reporter Phil Galewitz was determined to get in, but didn’t have a press pass (and no member of Congress gave him one, either). Instead–just by standing in line–he got in.

There were two sets of arguments today. For the earlier arguments, Galewitz only snagged a “three-minute pass” then parlayed it into a full six minutes. But for the second hearing about the Medicaid expansion, he got a special “gray” ticket for the full, one-hour session.

Galewitz picks up his story from there–and it turns out the Justices can be funny: Continue reading →

FILED UNDER: Reform, Affordable Care Act, Health Care and the Supreme Court
March 28, 2012 | 3:15 PM | By

Court Considers Whether Entire Health Care Law Should Be Struck Down

By: KQED News Staff and Wires

(Jessica Marcy: KHN)

(Jessica Marcy: Kaiser Health News)

The Supreme Court signaled Wednesday that it could throw out other key parts of the Affordable Care Act if it first finds the individual insurance requirement unconstitutional.

On the third and last day of arguments, the justices appeared to accept the administration’s argument that at least two important insurance changes are so closely tied to the insurance requirement that they could not survive without it. Those two changes are the popular provisions that both require insurers to offer insurance to applicants with pre-existing conditions and also requires insurers to charge the same rates to people who are roughly the same age, regardless of their health.

Those changes should go, the Obama Administration argued, because without the individual mandate, people might wait until they’re sick before they signed up for coverage. Not enough people would be in the health insurance pool to spread risk. Ruin could come to the insurance market.

In short the Court faces three scenarios if it strikes down the individual mandate: Continue reading →

FILED UNDER: Reform, Health Care and the Supreme Court