Treating Type 2 Diabetes With A Dose Of History

San Francisco poet Erica McMath has seen the devastating effects of type-2 diabetes first hand (Jeremy Raff/KQED)

Erica Sheppard McMath has seen the devastating effects of Type 2 diabetes first hand (Jeremy Raff/KQED)

The diabetes epidemic is not abstract to Erica Sheppard McMath. As a girl, she watched her uncle deteriorate each time she saw him at family events. His eyes yellowed before he went blind. Then, his foot was amputated. Finally, he died from diabetes-related complications.

“It’s like seeing someone literally fall apart limb by limb because of what they’re putting in their mouth,” said McMath.

Growing up, diabetes was everywhere. In just a few years, one aunt was blind at 32, another was on dialysis, and a 9-year-old cousin started insulin treatment.
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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

How a Florida Decision on HIV Medications May Affect California

Truvada is an anti-retroviral pill used to treat HIV infection. It can also help reduce the risk new infections. (Justin Sullivan/Getty Images)

Truvada is an anti-retroviral pill used to treat HIV infection. It can also help reduce the risk of new infections. (Justin Sullivan/Getty Images)

By David Gorn, California Healthline

A health insurer in Florida agreed last week to lower the price of some HIV medications, moving them from a specialty tier to a generic medication tier.

The change will reduce out-of-pocket copayments from roughly $1,000 a month for some medications to anywhere from $5 to $100, according to advocates. The change goes into effect in Florida on June 1.

The move by Aetna was prompted, in part, by a lawsuit filed by the National Health Law Program (NHLP). Wayne Turner, staff attorney at NHLP, says the Florida news has ramifications in California — for HIV/AIDS patients, and possibly for others with conditions requiring specialty medications. 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

Posthumous Brittany Maynard Video Supports Calif. ‘Death with Dignity’ Bill

State senators heard testimony today on a proposed bill that would allow doctors to prescribe lethal medication to terminally ill patients who request it. The testimony included a video from Brittany Maynard recorded 19 days before she took life-ending drugs.

 

In the video, Maynard implored California lawmakers to legalize “aid in dying.” Maynard, who had been diagnosed with terminal brain cancer, took lethal medication last year in Oregon, where the practice is legal.

“The decision about how I end my dying process should be up to me and my family under a doctor’s care. How dare the government make decisions or limit options for terminally ill people like me. Unfortunately, California law prevented me from getting the end-of life-option I deserved,” said Maynard, who died Nov. 1 at age 29. Continue reading

Frontline ‘Vaccine War’ Live Chat; Wednesday 3/25, Noon PT

A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)

A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)

Frontline aired an updated version of its 2008 documentary The Vaccine War on Tuesday night. The film dives deep into the debate over vaccines. While the overwhelming majority of parents vaccinate their children, a small but growing minority either under-vaccinate their children or refuse vaccines altogether.

The debate has taken a new turn in the wake of the measles outbreak which started in Disneyland in December. Public health officials believe a still-unknown person infected with measles visited the park and spread it to others. As the outbreak took hold, a new front in the debate grew: that of people who are immune-compromised.

State of Health first told the story of Carl Krawitt the father of 7-year-old Rhett who was diagnosed with leukemia when he was two and a half. Because of the treatments Rhett underwent to fight his disease, prior vaccine protection was wiped out, and he had to wait until he had been in remission for a year before his vaccines could begin again. The Krawitt family has been arguing that those unvaccinated by choice should not be able to attend public school.

Frontline producers told the story of Rhett’s family in The Vaccine War.

Now, it’s your turn. On Wednesday (March 25) at noon PT, Frontline is hosting a live chat, and I’m honored to be the moderator. ‘Vaccine War’ producer and director Kate McMahon will take your questions, along with Carl Krawitt, and Dr. Arthur Reingold, Head of Epidemiology at the UC Berkeley School of Public Health.

Feel free to leave a question now and please join us at noon for the chat!

On Medi-Cal Now, Lose Your House Later?

(Erik Soderstrom via Flickr)

(Erik Soderstrom via Flickr)

Catherine Jarett ran into a nasty surprise after she sent a form to Medi-Cal on behalf of her clients. An estate attorney, Jarett was hired by the sons of an elderly Vallejo woman who had died. The woman had been enrolled in Medi-Cal, the state’s insurance program for the poor, for more than 20 years.

Many on Medi-Cal learning that the state can file a claim against their estate after they die.

After Jarett filed the form with Medi-Cal — a death notice as required — the state sent a bill for a hefty $76,349. Jarett was stunned. It was for the cost of “health insurance, vision insurance, dental insurance,” she said.

The bill was part of Medi-Cal’s “estate recovery program.” Under a federal law not widely known to consumers, states can seize assets of Medi-Cal beneficiaries after they die. “I was never aware of this wrinkle that they could recover for health insurance,” Jarett said. Continue reading