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"content": "\u003cfigure id=\"attachment_24996\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS13438_IMG_4138.jpg\">\u003cimg class=\"size-large wp-image-24996\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS13438_IMG_4138-640x480.jpg\" alt=\"The emergency room at San Pablo's Doctors Medical Center will close permanently Tuesday at 7a.m., ending all patient care at the hospital. (Lisa Aliferis/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The emergency room at San Pablo's Doctors Medical Center will close permanently Tuesday at 7 a.m., ending all patient care at the hospital. (Lisa Aliferis/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Sara Hossaini\u003c/strong>\u003c/p>\n\u003cp>As Doctors Medical Center wellness director Tracy Taylor walks down the hospital's long white halls, the first thing she mentions is just how strange it feels.\u003c/p>\n\u003cp>\"It is very quiet, it feels very eerie and very different,\" says Taylor.\u003c/p>\n\u003cp>DMC reluctantly closes its doors Tuesday after failing to find a solution to its financial woes.\u003c/p>\n\u003cp>The hospital began shutting things down -- department by department -- over the past couple of weeks after leaders said they had run out of viable options for bridging a stubborn $18-20 million annual deficit -- something they blame on low Medi-Cal and Medicare reimbursement rates.\u003cbr>\n\u003c!--more-->\u003cbr>\nThe emergency room, which began diverting ambulances last August, will close completely at 7 a.m. Tuesday, permanently shutting down all patient care at the hospital. Some business functions, \u003ca title=\"http://doctorsmedicalcenter.org/medicalrecords\" href=\"http://doctorsmedicalcenter.org/medicalrecords\" target=\"_blank\">including \u003c/a>\u003ca title=\"http://doctorsmedicalcenter.org/medicalrecords\" href=\"http://doctorsmedicalcenter.org/medicalrecords\" target=\"_blank\">medical records\u003c/a>, will stay open for a few more weeks.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Taylor points to one of the last open units.\u003c/p>\n\u003cp>\"So this is our HBO area -- and that's not to watch television, but it's hyperbaric medicine,\" she says.\u003c/p>\n\u003cp>Patients with diabetes or who are recovering from cancer treatment come here to get oxygen therapy.\u003c/p>\n\u003cp>Cheri Fraga has been coming every day for a few weeks to treat complications from a bone infection.\u003c/p>\n\u003cp>\"I think it's sad\" the hospital is closing, Fraga says.\u003c/p>\n\u003cp>As Fraga wraps up her final treatment at the center, she said she's not sure where she'll go if she ever needs help again.\u003c/p>\n\u003cp>\"I have asthma, emphysema, I've had to come to emergency multiple times,\" says Fraga, \"And if they weren't here, I don't know what I would have done. Probably would have died.\"\u003c/p>\n\u003cp>Her nurse, 27-year veteran Bary Green, says the contractor that runs his department hopes to reestablish locally, but without the hospital to anchor it, that could prove difficult.\u003c/p>\n\u003cp>\"This is going to become a medical desert very quickly because if the physicians don't have the support services of a local hospital, they're not gonna stay,\" says Green.\u003c/p>\n\u003cp>Both Green and Taylor are worried about patients that they say often can't leave.\u003c/p>\n\u003cp>\"It worries me because I live in this community,\" says Taylor, \"that come rush hour if I had an emergency, it's a long ride to another emergency room.\"\u003c/p>\n\u003cp>To help fill the void, LifeLong Medical Care is \u003ca title=\"http://www.lifelongmedical.org/locations/our-locations/urgent-care-san-pablo.html\" href=\"http://www.lifelongmedical.org/locations/our-locations/urgent-care-san-pablo.html\" target=\"_blank\">adding urgent care services\u003c/a> to its Brookside Health Center in San Pablo. It opens Monday and will serve people with conditions like asthma, broken bones and infections.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>West Contra Costa County has a \u003ca title=\"http://cchealth.org/dmc/west-county-resources.php\" href=\"http://cchealth.org/dmc/west-county-resources.php\" target=\"_blank\">health care resource list \u003c/a>in English and Spanish for displaced local residents.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Taylor points to one of the last open units.\u003c/p>\n\u003cp>\"So this is our HBO area -- and that's not to watch television, but it's hyperbaric medicine,\" she says.\u003c/p>\n\u003cp>Patients with diabetes or who are recovering from cancer treatment come here to get oxygen therapy.\u003c/p>\n\u003cp>Cheri Fraga has been coming every day for a few weeks to treat complications from a bone infection.\u003c/p>\n\u003cp>\"I think it's sad\" the hospital is closing, Fraga says.\u003c/p>\n\u003cp>As Fraga wraps up her final treatment at the center, she said she's not sure where she'll go if she ever needs help again.\u003c/p>\n\u003cp>\"I have asthma, emphysema, I've had to come to emergency multiple times,\" says Fraga, \"And if they weren't here, I don't know what I would have done. Probably would have died.\"\u003c/p>\n\u003cp>Her nurse, 27-year veteran Bary Green, says the contractor that runs his department hopes to reestablish locally, but without the hospital to anchor it, that could prove difficult.\u003c/p>\n\u003cp>\"This is going to become a medical desert very quickly because if the physicians don't have the support services of a local hospital, they're not gonna stay,\" says Green.\u003c/p>\n\u003cp>Both Green and Taylor are worried about patients that they say often can't leave.\u003c/p>\n\u003cp>\"It worries me because I live in this community,\" says Taylor, \"that come rush hour if I had an emergency, it's a long ride to another emergency room.\"\u003c/p>\n\u003cp>To help fill the void, LifeLong Medical Care is \u003ca title=\"http://www.lifelongmedical.org/locations/our-locations/urgent-care-san-pablo.html\" href=\"http://www.lifelongmedical.org/locations/our-locations/urgent-care-san-pablo.html\" target=\"_blank\">adding urgent care services\u003c/a> to its Brookside Health Center in San Pablo. It opens Monday and will serve people with conditions like asthma, broken bones and infections.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>West Contra Costa County has a \u003ca title=\"http://cchealth.org/dmc/west-county-resources.php\" href=\"http://cchealth.org/dmc/west-county-resources.php\" target=\"_blank\">health care resource list \u003c/a>in English and Spanish for displaced local residents.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California First in Care of Undocumented, But That's Not Saying Much",
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"content": "\u003cfigure id=\"attachment_24988\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000001219161_Large-e1429296584291.jpg\">\u003cimg class=\"size-large wp-image-24988\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000001219161_Large-640x427.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title=\"http://www.californiahealthline.org/capitol-desk/2015/4/california-first-in-care-for-undocumented-ucla-researchers-say\" href=\"http://www.californiahealthline.org/capitol-desk/2015/4/california-first-in-care-for-undocumented-ucla-researchers-say\" target=\"_blank\">CaliforniaHealthline\u003c/a>\u003c/p>\n\u003cp>Undocumented immigrants get better health care in California than the rest of the country -- but that's not saying much, according to a \u003ca href=\"http://healthpolicy.ucla.edu/publications/Documents/PDF/2015/immigrantreport-apr2015.pdf\" target=\"_blank\">new report\u003c/a> released Thursday by UCLA researchers.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"California is in the lead of a very sorry pack.\" \u003c/aside>\n\u003cp>\"California is in the lead of a very sorry pack,\" said Steven Wallace, associate director of the UCLA Center for Health Policy Research and co-author of the report. \"For California to stay in the lead, we need to keep innovating.\"\u003c/p>\n\u003cp>It's unclear how UCLA's findings will affect \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB4\" target=\"_blank\">SB 4\u003c/a> by Sen. Ricardo Lara (D-Bell Gardens), the bill to provide full-scope medical coverage to the undocumented, which cleared the Senate Committee on Health this week and now heads to Senate Appropriations.\u003c!--more-->\u003c/p>\n\u003cp>\"You could spin this either way,\" Wallace said -- that California is leading the nation so it doesn't need to do more; or that coverage in all states, including California, is inadequate. \"We weren't interested in influencing policy,\" Wallace said, \"we wanted to know how the states are doing across the nation.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Wallace said he thinks the strides California has made in addressing some of the needs of the undocumented community augurs well for passage of SB 4.\u003c/p>\n\u003cp>\"If California appears to be ahead nationally, that shows both a willingness and awareness to do that,\" Wallace said. And many of the concerns about those incremental advances, he said, have been proven false. \"Nothing bad has happened by doing a number of these things,\" he said.\u003c/p>\n\u003cp>The report was a joint effort by the UCLA Center for Health Policy Research, the UC Global Health Institute and the UCLA Blum Center on Poverty and Health in Latin America.\u003c/p>\n\u003cp>\"Most states have restrictive policies,\" the report said, \"and even among the few [states] with higher scores, there are more opportunities for policymakers to strengthen state laws that improve the legal, social and economic environments that foster the health of undocumented immigrants.\"\u003c/p>\n\u003cp>\"It is frustrating that so many states have policies that ignore or exclude a group of people who work hard and contribute so much to our society,\" Wallace said. \"The neglect or outright discrimination of the undocumented does not just hurt workers and their families. It hurts the communities that rely on them for the basic labor that makes our society function.\"\u003c/p>\n\u003cp>The report's recommendation: State lawmakers, including those in California, need to do more to limit the federal laws restricting access to health care for the undocumented.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"None of these policies pass easily,\" Wallace said. \"We have come a long way from the '90s, we have changed the political culture in the state. But it's clear that California needs to keep its momentum in providing services for all members of the state.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24988\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000001219161_Large-e1429296584291.jpg\">\u003cimg class=\"size-large wp-image-24988\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000001219161_Large-640x427.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title=\"http://www.californiahealthline.org/capitol-desk/2015/4/california-first-in-care-for-undocumented-ucla-researchers-say\" href=\"http://www.californiahealthline.org/capitol-desk/2015/4/california-first-in-care-for-undocumented-ucla-researchers-say\" target=\"_blank\">CaliforniaHealthline\u003c/a>\u003c/p>\n\u003cp>Undocumented immigrants get better health care in California than the rest of the country -- but that's not saying much, according to a \u003ca href=\"http://healthpolicy.ucla.edu/publications/Documents/PDF/2015/immigrantreport-apr2015.pdf\" target=\"_blank\">new report\u003c/a> released Thursday by UCLA researchers.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"California is in the lead of a very sorry pack.\" \u003c/aside>\n\u003cp>\"California is in the lead of a very sorry pack,\" said Steven Wallace, associate director of the UCLA Center for Health Policy Research and co-author of the report. \"For California to stay in the lead, we need to keep innovating.\"\u003c/p>\n\u003cp>It's unclear how UCLA's findings will affect \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB4\" target=\"_blank\">SB 4\u003c/a> by Sen. Ricardo Lara (D-Bell Gardens), the bill to provide full-scope medical coverage to the undocumented, which cleared the Senate Committee on Health this week and now heads to Senate Appropriations.\u003c!--more-->\u003c/p>\n\u003cp>\"You could spin this either way,\" Wallace said -- that California is leading the nation so it doesn't need to do more; or that coverage in all states, including California, is inadequate. \"We weren't interested in influencing policy,\" Wallace said, \"we wanted to know how the states are doing across the nation.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Wallace said he thinks the strides California has made in addressing some of the needs of the undocumented community augurs well for passage of SB 4.\u003c/p>\n\u003cp>\"If California appears to be ahead nationally, that shows both a willingness and awareness to do that,\" Wallace said. And many of the concerns about those incremental advances, he said, have been proven false. \"Nothing bad has happened by doing a number of these things,\" he said.\u003c/p>\n\u003cp>The report was a joint effort by the UCLA Center for Health Policy Research, the UC Global Health Institute and the UCLA Blum Center on Poverty and Health in Latin America.\u003c/p>\n\u003cp>\"Most states have restrictive policies,\" the report said, \"and even among the few [states] with higher scores, there are more opportunities for policymakers to strengthen state laws that improve the legal, social and economic environments that foster the health of undocumented immigrants.\"\u003c/p>\n\u003cp>\"It is frustrating that so many states have policies that ignore or exclude a group of people who work hard and contribute so much to our society,\" Wallace said. \"The neglect or outright discrimination of the undocumented does not just hurt workers and their families. It hurts the communities that rely on them for the basic labor that makes our society function.\"\u003c/p>\n\u003cp>The report's recommendation: State lawmakers, including those in California, need to do more to limit the federal laws restricting access to health care for the undocumented.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"None of these policies pass easily,\" Wallace said. \"We have come a long way from the '90s, we have changed the political culture in the state. But it's clear that California needs to keep its momentum in providing services for all members of the state.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "E-Cigarette Use Triples Among American Teenagers",
"title": "E-Cigarette Use Triples Among American Teenagers",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_24977\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000024865885_Large.jpg\">\u003cimg class=\"wp-image-24977 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000024865885_Large-640x409.jpg\" alt=\"Nicotine exposure at a young age 'may cause lasting harm to brain development,' warns Dr. Tom Frieden, chief of the Centers for Disease Control and Prevention. (Getty Images)\" width=\"640\" height=\"409\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Nicotine exposure at a young age 'may cause lasting harm to brain development,' warns Dr. Tom Frieden, chief of the Centers for Disease Control and Prevention. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Rob Stein,\u003c/strong>\u003ca title=\"http://www.npr.org/blogs/health/2015/04/16/400144741/use-of-e-cigarettes-triples-among-u-s-teens\" href=\"http://www.npr.org/blogs/health/2015/04/16/400144741/use-of-e-cigarettes-triples-among-u-s-teens\" target=\"_blank\"> NPR\u003c/a>\u003c/p>\n\u003cp>A national survey confirms earlier indications that e-cigarettes are now more popular among teenage students than traditional cigarettes and other forms of tobacco, federal health officials reported Thursday.\u003c/p>\n\u003caside class=\"pullquote alignleft\">450,000 middle school students now use e-cigarettes. \u003c/aside>\n\u003cp>The findings prompted strong warnings from \u003ca href=\"http://www.cdc.gov/about/leadership/director.htm\">Dr. Tom Frieden\u003c/a>, head of the Centers for Disease Control and Prevention, about the effects of any form of nicotine on young people.\u003c/p>\n\u003cp>\"We want parents to know that nicotine is dangerous for kids at any age,\" Frieden said.\u003c/p>\n\u003cp>\"Adolescence is a critical time for brain development,\" he added, in a written statement. \"Nicotine exposure at a young age may cause lasting harm to brain development, promote addiction and lead to sustained tobacco use.\"\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The statistical findings, \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6414a3.htm?s_cid=mm6414a3_w\" target=\"_blank\">published\u003c/a> in this week's issue of \u003cem>Morbidity and Mortality Weekly Report\u003c/em>, come from the CDC's National Youth Tobacco Survey. The latest survey found that the use of e-cigarettes increased from 1.1 percent in 2013 to 3.9 percent in 2014 among middle school students, and from 4.5 percent to 13.4 percent among high school students. That translates to a total of 450,000 middle school students now using e-cigs, alongside 2 million high school students.\u003c/p>\n\u003cp>The findings are similar to those from a study \u003ca href=\"http://www.npr.org/2014/12/16/371253640/teens-now-reach-for-e-cigarettes-over-regular-ones\" target=\"_blank\">reported in December\u003c/a>.\u003c/p>\n\u003cp>The CDC survey also found that hookah use doubled among middle schoolers and high school students, while use of traditional cigarettes fell for high school students and remained the same for middle school students.\u003c/p>\n\u003cp>The new evidence comes as the Food and Drug Administration is deciding how strictly to regulate e-cigarettes.\u003c/p>\n\u003cp>The devices heat a nicotine-laced fluid, which then becomes a vapor that users inhale. While many doctors say the vapor of e-cigarettes is likely less damaging than the smoke of burnt tobacco leaves, there is intense debate about how safe e-cigarettes are. Some public health researchers say the electronic devices may be useful for helping some smokers give up traditional cigarettes. But many also fear the devices may hook a new generation on nicotine and lead to them starting to smoke traditional cigarettes.\u003c/p>\n\u003cp>\"The release of this survey couldn't be better timed,\" said \u003ca href=\"http://www.heart.org/HEARTORG/General/About-Us%E2%80%94-American-Heart-Association_UCM_305422_SubHomePage.jsp\" target=\"_blank\">Nancy Brown\u003c/a> of the American Heart Association in a written statement. \"The take-away message is loud and clear: Tobacco regulations need to be finalized now. We cannot stand by while more and more youth put themselves at risk for heart disease, stroke or even an early death.\"\u003c/p>\n\u003cp>But the makers of e-cigarettes argue that the devices may be helping drive down the rate of regular cigarette use among teens.\u003c/p>\n\u003cp>\"While the use of vapor products by teens should be discouraged, the data is clear that as teen experimentation with vaping has grown over the last three years, youth smoking has experienced the largest decline in the history of the ... survey,\" Gregory Conley, of the American Vaping Association, told Shots in an email.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This dramatic fall in teen smoking should be part of the discussion,\" Conley said, \"but the CDC deemed this finding to not be worthy of a single line in their press release. That is not surprising, as it would interfere with the CDC's evidence-free attempts to paint e-cigarettes as a potential gateway to traditional cigarettes.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24977\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000024865885_Large.jpg\">\u003cimg class=\"wp-image-24977 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000024865885_Large-640x409.jpg\" alt=\"Nicotine exposure at a young age 'may cause lasting harm to brain development,' warns Dr. Tom Frieden, chief of the Centers for Disease Control and Prevention. (Getty Images)\" width=\"640\" height=\"409\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Nicotine exposure at a young age 'may cause lasting harm to brain development,' warns Dr. Tom Frieden, chief of the Centers for Disease Control and Prevention. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Rob Stein,\u003c/strong>\u003ca title=\"http://www.npr.org/blogs/health/2015/04/16/400144741/use-of-e-cigarettes-triples-among-u-s-teens\" href=\"http://www.npr.org/blogs/health/2015/04/16/400144741/use-of-e-cigarettes-triples-among-u-s-teens\" target=\"_blank\"> NPR\u003c/a>\u003c/p>\n\u003cp>A national survey confirms earlier indications that e-cigarettes are now more popular among teenage students than traditional cigarettes and other forms of tobacco, federal health officials reported Thursday.\u003c/p>\n\u003caside class=\"pullquote alignleft\">450,000 middle school students now use e-cigarettes. \u003c/aside>\n\u003cp>The findings prompted strong warnings from \u003ca href=\"http://www.cdc.gov/about/leadership/director.htm\">Dr. Tom Frieden\u003c/a>, head of the Centers for Disease Control and Prevention, about the effects of any form of nicotine on young people.\u003c/p>\n\u003cp>\"We want parents to know that nicotine is dangerous for kids at any age,\" Frieden said.\u003c/p>\n\u003cp>\"Adolescence is a critical time for brain development,\" he added, in a written statement. \"Nicotine exposure at a young age may cause lasting harm to brain development, promote addiction and lead to sustained tobacco use.\"\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The statistical findings, \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6414a3.htm?s_cid=mm6414a3_w\" target=\"_blank\">published\u003c/a> in this week's issue of \u003cem>Morbidity and Mortality Weekly Report\u003c/em>, come from the CDC's National Youth Tobacco Survey. The latest survey found that the use of e-cigarettes increased from 1.1 percent in 2013 to 3.9 percent in 2014 among middle school students, and from 4.5 percent to 13.4 percent among high school students. That translates to a total of 450,000 middle school students now using e-cigs, alongside 2 million high school students.\u003c/p>\n\u003cp>The findings are similar to those from a study \u003ca href=\"http://www.npr.org/2014/12/16/371253640/teens-now-reach-for-e-cigarettes-over-regular-ones\" target=\"_blank\">reported in December\u003c/a>.\u003c/p>\n\u003cp>The CDC survey also found that hookah use doubled among middle schoolers and high school students, while use of traditional cigarettes fell for high school students and remained the same for middle school students.\u003c/p>\n\u003cp>The new evidence comes as the Food and Drug Administration is deciding how strictly to regulate e-cigarettes.\u003c/p>\n\u003cp>The devices heat a nicotine-laced fluid, which then becomes a vapor that users inhale. While many doctors say the vapor of e-cigarettes is likely less damaging than the smoke of burnt tobacco leaves, there is intense debate about how safe e-cigarettes are. Some public health researchers say the electronic devices may be useful for helping some smokers give up traditional cigarettes. But many also fear the devices may hook a new generation on nicotine and lead to them starting to smoke traditional cigarettes.\u003c/p>\n\u003cp>\"The release of this survey couldn't be better timed,\" said \u003ca href=\"http://www.heart.org/HEARTORG/General/About-Us%E2%80%94-American-Heart-Association_UCM_305422_SubHomePage.jsp\" target=\"_blank\">Nancy Brown\u003c/a> of the American Heart Association in a written statement. \"The take-away message is loud and clear: Tobacco regulations need to be finalized now. We cannot stand by while more and more youth put themselves at risk for heart disease, stroke or even an early death.\"\u003c/p>\n\u003cp>But the makers of e-cigarettes argue that the devices may be helping drive down the rate of regular cigarette use among teens.\u003c/p>\n\u003cp>\"While the use of vapor products by teens should be discouraged, the data is clear that as teen experimentation with vaping has grown over the last three years, youth smoking has experienced the largest decline in the history of the ... survey,\" Gregory Conley, of the American Vaping Association, told Shots in an email.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This dramatic fall in teen smoking should be part of the discussion,\" Conley said, \"but the CDC deemed this finding to not be worthy of a single line in their press release. That is not surprising, as it would interfere with the CDC's evidence-free attempts to paint e-cigarettes as a potential gateway to traditional cigarettes.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Disneyland Measles Outbreak to be Declared Over",
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"content": "\u003cfigure id=\"attachment_24968\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS13944_53249939.jpg\">\u003cimg class=\"size-large wp-image-24968\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS13944_53249939-640x427.jpg\" alt=\"The outbreak sickened 134 Californians. (Marsaili McGrath/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The outbreak sickened more than 130 Californians. (Marsaili McGrath/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alicia Chang, AP\u003c/strong>\u003c/p>\n\u003cp>The state's measles outbreak that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">began at Disneyland \u003c/a>and reignited debate about vaccinations is nearing an end.\u003c/p>\n\u003cp>The outbreak will be declared over in California on Friday if no new cases pop up, according to the California Department of Public Health.\u003c/p>\n\u003cp>Disease investigators worked for months to contain the highly contagious disease that originated at Disney theme parks in December and spread to several other states and countries. More than 130 people in California were infected.\u003c/p>\n\u003cp>The outbreak cast a spotlight on the small but vocal anti-vaccine movement. Many who fell ill in the Disneyland outbreak were not immunized or had only one of the two recommended doses of the measles-mumps-rubella vaccine.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Public health officials have said vaccinations rates must be high to protect a population from infection. While measles has been declared eliminated from the U.S. for years, outbreaks still occur because the virus can be imported from overseas and spread among people who skip shots for personal reasons or who are too young to be immunized.\u003c/p>\n\u003cp>The Disneyland outbreak \"reminds us that we are part of a global medical community\" and the U.S. should help tame measles raging in many parts of the world, said Dr. Richard Wenzel, an infectious disease expert at Virginia Commonwealth University.\u003c/p>\n\u003cp>The U.S. has experienced measles outbreaks in recent years, including a 2014 episode that sickened 383 people in Ohio's Amish country.\u003c/p>\n\u003cp>Symptoms can appear up to two weeks after exposure and include fever, cough and watery eyes followed by a telltale rash. A measles outbreak is considered over when 42 days — or two incubation periods — have passed since the last onset of the rash. The most recent confirmed measles case in California had \u003ca title=\"http://www.cdph.ca.gov/programs/immunize/Documents/Measles_Update_4-10-2015_public.pdf\" href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Measles_Update_4-10-2015_public.pdf\" target=\"_blank\">rash onset on March 2\u003c/a>, according to state data.\u003c/p>\n\u003cp>As one of the world's international destinations, Disneyland was the perfect place to launch a widespread measles outbreak, health experts said. The theme parks attract tens of thousands of visitors from around the globe, who could then return home with the virus.\u003c/p>\n\u003cp>Forty people were exposed to measles while visiting or working at Disney theme parks in December. They then spread the virus to 30 family members. The rest caught measles in the community or from an unknown source, according to state health officials.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Disease detectives have said they likely may never find patient zero — or the person who triggered the outbreak — but believe it's someone who brought measles into the country.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24968\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS13944_53249939.jpg\">\u003cimg class=\"size-large wp-image-24968\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS13944_53249939-640x427.jpg\" alt=\"The outbreak sickened 134 Californians. (Marsaili McGrath/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The outbreak sickened more than 130 Californians. (Marsaili McGrath/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alicia Chang, AP\u003c/strong>\u003c/p>\n\u003cp>The state's measles outbreak that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">began at Disneyland \u003c/a>and reignited debate about vaccinations is nearing an end.\u003c/p>\n\u003cp>The outbreak will be declared over in California on Friday if no new cases pop up, according to the California Department of Public Health.\u003c/p>\n\u003cp>Disease investigators worked for months to contain the highly contagious disease that originated at Disney theme parks in December and spread to several other states and countries. More than 130 people in California were infected.\u003c/p>\n\u003cp>The outbreak cast a spotlight on the small but vocal anti-vaccine movement. Many who fell ill in the Disneyland outbreak were not immunized or had only one of the two recommended doses of the measles-mumps-rubella vaccine.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Public health officials have said vaccinations rates must be high to protect a population from infection. While measles has been declared eliminated from the U.S. for years, outbreaks still occur because the virus can be imported from overseas and spread among people who skip shots for personal reasons or who are too young to be immunized.\u003c/p>\n\u003cp>The Disneyland outbreak \"reminds us that we are part of a global medical community\" and the U.S. should help tame measles raging in many parts of the world, said Dr. Richard Wenzel, an infectious disease expert at Virginia Commonwealth University.\u003c/p>\n\u003cp>The U.S. has experienced measles outbreaks in recent years, including a 2014 episode that sickened 383 people in Ohio's Amish country.\u003c/p>\n\u003cp>Symptoms can appear up to two weeks after exposure and include fever, cough and watery eyes followed by a telltale rash. A measles outbreak is considered over when 42 days — or two incubation periods — have passed since the last onset of the rash. The most recent confirmed measles case in California had \u003ca title=\"http://www.cdph.ca.gov/programs/immunize/Documents/Measles_Update_4-10-2015_public.pdf\" href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Measles_Update_4-10-2015_public.pdf\" target=\"_blank\">rash onset on March 2\u003c/a>, according to state data.\u003c/p>\n\u003cp>As one of the world's international destinations, Disneyland was the perfect place to launch a widespread measles outbreak, health experts said. The theme parks attract tens of thousands of visitors from around the globe, who could then return home with the virus.\u003c/p>\n\u003cp>Forty people were exposed to measles while visiting or working at Disney theme parks in December. They then spread the virus to 30 family members. The rest caught measles in the community or from an unknown source, according to state health officials.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Disease detectives have said they likely may never find patient zero — or the person who triggered the outbreak — but believe it's someone who brought measles into the country.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Cow’s Milk Found in Breast Milk Sold Online",
"title": "Cow’s Milk Found in Breast Milk Sold Online",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_24882\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/cows.jpg\">\u003cimg class=\"size-large wp-image-24882\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/cows-640x411.jpg\" alt=\"A recent study shows 10 percent of human breast milk purchased online is contaminated with traces of cow’s milk.\" width=\"640\" height=\"411\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A new study shows 10 percent of human breast milk purchased online is contaminated with cow’s milk. (Justin Sullivan/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Most doctors agree that 'breast is best.' Breastfed babies have \u003ca href=\"http://www.womenshealth.gov/breastfeeding/breastfeeding-benefits.html\" target=\"_blank\">lower rates of respiratory infections\u003c/a>, ear infections, asthma, digestive problems, childhood obesity, asthma and Sudden Infant Death Syndrome (SIDS). The public health message is being heard: in 2011 almost \u003ca href=\"http://www.cdc.gov/breastfeeding/pdf/2014breastfeedingreportcard.pdf\" target=\"_blank\">80 percent of newborn U.S. infants\u003c/a> were initially breastfed.\u003c/p>\n\u003cp>But sometimes mothers can’t breastfeed. They may not have sufficient milk production, or maybe their child is allergic to the ingredients in infant formula, so they seek an alternative: buying breast milk on the Internet.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“For an infant who is allergic to cow’s milk or failing to thrive because of formula, this is a huge public health problem.”\u003c/aside>\n\u003cp>The \u003ca href=\"http://www.fda.gov/ScienceResearch/SpecialTopics/PediatricTherapeuticsResearch/ucm235203.htm\" target=\"_blank\">FDA doesn’t approve\u003c/a>. Breast milk purchased online isn’t always properly screened for infectious diseases, and it has a chance of being contaminated -- with things like cow’s milk.\u003c/p>\n\u003cp>\u003ca href=\"http://pediatrics.aappublications.org/content/early/2015/03/31/peds.2014-3554.full.pdf+html\" target=\"_blank\">A study\u003c/a> published Monday in the journal \u003cem>Pediatrics\u003c/em> reveals 10 percent of breast milk purchased online is contaminated with cow’s milk. A team at The Research Institute at Nationwide Children’s Hospital in Ohio anonymously purchased 102 samples of milk advertised as breast milk online. They found 10 percent of bovine DNA in 10 of the samples.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The study says one out four people searching for human milk online do so because their baby has a preexisting medical condition, like an intolerance to infant formula.\u003c/p>\n\u003cp>“For an infant who is allergic to cow’s milk or failing to thrive because of formula, this is a huge public health problem,” says Pauline Sakamoto, the Executive Director of \u003ca href=\"http://www.mothersmilk.org/\" target=\"_blank\">Mother’s Milk Bank,\u003c/a> a San Jose non-profit that provides donated milk to families in need.\u003c/p>\n\u003cp>Sakamoto says there are no regulatory bodies checking the safety of online human breast milk transactions. In a previous study, the same researchers at the Nationwide Children’s Hospital found 74 percent of \u003ca href=\"http://pediatrics.aappublications.org/content/early/2013/10/16/peds.2013-1687.abstract\" target=\"_blank\">breast milk purchased online contains bacteria\u003c/a>, making it unsuitable for human consumption.\u003c/p>\n\u003cp>Sakamoto says Mother’s Milk Bank only takes donated milk because selling one's own breast milk promotes unsafe practices. She says they charge $3.75 per ounce because that's how much it costs to pasteurize the donated milk while keeping its nutritional value, test the milk for contaminants and screen both mother and child. Sakamoto says those precationary steps usually aren't taken with breast milk purchased online.\u003c/p>\n\u003cp>“The other problem with buying milk is justice. It’s unequal access to ill or unhealthy infants. Nonprofit milk banks in the U.S. distribute milk to infants that are preterm or have a medical necessity for donor milk. When you have online selling of milk, that in some ways may deplete the volume of milk available for those who are critically in need.”\u003c/p>\n\u003caside class=\"pullquote alignleft\">“I think these studies show that if moms are paid for their breast milk, these are the kind of problems we will see.”\u003c/aside>\n\u003cp>Mother’s Milk Bank is one of 16 milk banks in the U.S. that is approved by the U.S. Food and Drug Administration. These milk banks, plus two in Canada, received at total of 3.7 million ounces of donated milk in 2014.\u003c/p>\n\u003cp>But it's not enough to supply the growing demand for breast milk in North American. Brazil has over 200 milk banks, Sakamoto says, because their human milk banking system is funded by the Brazilian government. That's contributed to a drastic \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1766344/\" target=\"_blank\">drop in the country's infant mortality rates\u003c/a>. Sakamoto says U.S. milk banks don’t get government or insurance funding.\u003c/p>\n\u003cp>“It’s shameful that insurance companies still won’t cover donor milk for moms for even two weeks after she has a baby. For the moms out there looking to buy milk for their babies, why can’t they get donor milk through their insurance companies if they have medical reasons? They should be able to it. Their children should get milk until their gastrointestinal tracts are mature enough to take formula. It’s a good fix, and it's cheaper in the long run for the health insurance industry.”\u003c/p>\n\u003cp>Sakamoto says the key to curbing the sale of contaminated human breast milk online is to provide desperate mothers with more milk banks, and ask more lactating mothers to donate milk. She says we also need to take money out of the equation.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I think these studies show that if moms are paid for their breast milk, these are the kind of problems we will see.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24882\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/cows.jpg\">\u003cimg class=\"size-large wp-image-24882\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/cows-640x411.jpg\" alt=\"A recent study shows 10 percent of human breast milk purchased online is contaminated with traces of cow’s milk.\" width=\"640\" height=\"411\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A new study shows 10 percent of human breast milk purchased online is contaminated with cow’s milk. (Justin Sullivan/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Most doctors agree that 'breast is best.' Breastfed babies have \u003ca href=\"http://www.womenshealth.gov/breastfeeding/breastfeeding-benefits.html\" target=\"_blank\">lower rates of respiratory infections\u003c/a>, ear infections, asthma, digestive problems, childhood obesity, asthma and Sudden Infant Death Syndrome (SIDS). The public health message is being heard: in 2011 almost \u003ca href=\"http://www.cdc.gov/breastfeeding/pdf/2014breastfeedingreportcard.pdf\" target=\"_blank\">80 percent of newborn U.S. infants\u003c/a> were initially breastfed.\u003c/p>\n\u003cp>But sometimes mothers can’t breastfeed. They may not have sufficient milk production, or maybe their child is allergic to the ingredients in infant formula, so they seek an alternative: buying breast milk on the Internet.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“For an infant who is allergic to cow’s milk or failing to thrive because of formula, this is a huge public health problem.”\u003c/aside>\n\u003cp>The \u003ca href=\"http://www.fda.gov/ScienceResearch/SpecialTopics/PediatricTherapeuticsResearch/ucm235203.htm\" target=\"_blank\">FDA doesn’t approve\u003c/a>. Breast milk purchased online isn’t always properly screened for infectious diseases, and it has a chance of being contaminated -- with things like cow’s milk.\u003c/p>\n\u003cp>\u003ca href=\"http://pediatrics.aappublications.org/content/early/2015/03/31/peds.2014-3554.full.pdf+html\" target=\"_blank\">A study\u003c/a> published Monday in the journal \u003cem>Pediatrics\u003c/em> reveals 10 percent of breast milk purchased online is contaminated with cow’s milk. A team at The Research Institute at Nationwide Children’s Hospital in Ohio anonymously purchased 102 samples of milk advertised as breast milk online. They found 10 percent of bovine DNA in 10 of the samples.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The study says one out four people searching for human milk online do so because their baby has a preexisting medical condition, like an intolerance to infant formula.\u003c/p>\n\u003cp>“For an infant who is allergic to cow’s milk or failing to thrive because of formula, this is a huge public health problem,” says Pauline Sakamoto, the Executive Director of \u003ca href=\"http://www.mothersmilk.org/\" target=\"_blank\">Mother’s Milk Bank,\u003c/a> a San Jose non-profit that provides donated milk to families in need.\u003c/p>\n\u003cp>Sakamoto says there are no regulatory bodies checking the safety of online human breast milk transactions. In a previous study, the same researchers at the Nationwide Children’s Hospital found 74 percent of \u003ca href=\"http://pediatrics.aappublications.org/content/early/2013/10/16/peds.2013-1687.abstract\" target=\"_blank\">breast milk purchased online contains bacteria\u003c/a>, making it unsuitable for human consumption.\u003c/p>\n\u003cp>Sakamoto says Mother’s Milk Bank only takes donated milk because selling one's own breast milk promotes unsafe practices. She says they charge $3.75 per ounce because that's how much it costs to pasteurize the donated milk while keeping its nutritional value, test the milk for contaminants and screen both mother and child. Sakamoto says those precationary steps usually aren't taken with breast milk purchased online.\u003c/p>\n\u003cp>“The other problem with buying milk is justice. It’s unequal access to ill or unhealthy infants. Nonprofit milk banks in the U.S. distribute milk to infants that are preterm or have a medical necessity for donor milk. When you have online selling of milk, that in some ways may deplete the volume of milk available for those who are critically in need.”\u003c/p>\n\u003caside class=\"pullquote alignleft\">“I think these studies show that if moms are paid for their breast milk, these are the kind of problems we will see.”\u003c/aside>\n\u003cp>Mother’s Milk Bank is one of 16 milk banks in the U.S. that is approved by the U.S. Food and Drug Administration. These milk banks, plus two in Canada, received at total of 3.7 million ounces of donated milk in 2014.\u003c/p>\n\u003cp>But it's not enough to supply the growing demand for breast milk in North American. Brazil has over 200 milk banks, Sakamoto says, because their human milk banking system is funded by the Brazilian government. That's contributed to a drastic \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1766344/\" target=\"_blank\">drop in the country's infant mortality rates\u003c/a>. Sakamoto says U.S. milk banks don’t get government or insurance funding.\u003c/p>\n\u003cp>“It’s shameful that insurance companies still won’t cover donor milk for moms for even two weeks after she has a baby. For the moms out there looking to buy milk for their babies, why can’t they get donor milk through their insurance companies if they have medical reasons? They should be able to it. Their children should get milk until their gastrointestinal tracts are mature enough to take formula. It’s a good fix, and it's cheaper in the long run for the health insurance industry.”\u003c/p>\n\u003cp>Sakamoto says the key to curbing the sale of contaminated human breast milk online is to provide desperate mothers with more milk banks, and ask more lactating mothers to donate milk. She says we also need to take money out of the equation.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I think these studies show that if moms are paid for their breast milk, these are the kind of problems we will see.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Treating Type 2 Diabetes With A Dose Of History",
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"content": "\u003cfigure id=\"attachment_24795\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Erica-McMath-Photo.jpg\">\u003cimg class=\"size-large wp-image-24795\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Erica-McMath-Photo-640x427.jpg\" alt=\"San Francisco poet Erica McMath has seen the devastating effects of type-2 diabetes first hand (Jeremy Raff/KQED)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Erica Sheppard McMath has seen the devastating effects of Type 2 diabetes first hand (Jeremy Raff/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>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.\u003c/p>\n\u003cp>“It’s like seeing someone literally fall apart limb by limb because of what they’re putting in their mouth,” said McMath.\u003c/p>\n\u003cp>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.\u003cbr>\n\u003c!--more-->\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/198906613\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Her own health suffered as her home life descended into chaos. A fight with her mother’s boyfriend, who was an alcoholic, landed her in foster care at age 15.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I was dealing with the pain of living in a group home, with the pain of sexual abuse,” she says. “I dealt with my pain through food because that was the only thing that could calm me down.”\u003c/p>\n\u003cp>She gained a lot of weight, increasing her risk for developing diabetes. She knew that her source of comfort was the same thing that was killing her family members.\u003c/p>\n\u003cp>That tension became the subject of her slam poem \"Death Recipe,\" which she performed on \u003ca href=\"http://www.hbo.com/russell-simmons-presents-brave-new-voices/cast-and-crew/team-bay-area/article/untitled-by-erica-mcmath-sheppard.html#/\" target=\"_blank\">HBO's Brave New Voices in 2010.\u003c/a>\u003c/p>\n\u003cp>In it, she criticizes herself, her community, and above all, the unequal society McMath says contributed to her family's health crises. The poem begins, “We eat like we still slaves/ cause back in the days we got what whites didn’t want.”\u003c/p>\n\u003cp>She says that \"things like chitlins or pig's feet -- in slavery times you ate whatever was available to you.\"\u003c/p>\n\u003cp>McMath sees a connection to today. \"If you don’t have enough money to consider other options, your focus is just staying alive. It is a poor man’s appetite, and it’s absolutely killing us.”\u003c/p>\n\u003cp>\u003cstrong>Prescription for Diabetes: A History Lesson\u003c/strong>\u003c/p>\n\u003cp>“You cannot find a McDonald's in San Francisco, except for in communities of color,” says Zea Malawa, a pediatrician in San Francisco’s Bayview neighborhood, where \u003ca title=\"http://www.sfhip.org/index.php?module=htmlpages&func=display&pid=57\" href=\"http://www.sfhip.org/index.php?module=htmlpages&func=display&pid=57\" target=\"_blank\">life expectancy is 14 years less\u003c/a> than in a nearby affluent neighborhood.\u003c/p>\n\u003cp>She says fast food and sodas “are like the modern iteration of pig’s feet -- the garbage falling down on disenfranchised communities.”\u003c/p>\n\u003cp>This perspective, says Malawa, is an important part of her medical practice.\u003c/p>\n\u003cp>“One thing I often talk about with families around cooking is (that) this food comes from a time when we spent 10-hour days in the field in the South,\" she says. \"That makes sense when you’re burning incredible calories, but now, we’re sedentary.”\u003c/p>\n\u003cp>Malawa says she re-frames nutrition advice this way because too often in the doctor's office, “people feel patronized, like our culture is negated or wrong -- like you’re saying their grandmother did it all wrong.”\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It’s important to ask, how is structural racism playing into this?\"\u003c/aside>\n\u003cp>Grandmothers weren't all wrong for expressing their culture and their love through food, says Malawa, even though an excess of those foods can contribute to obesity and diabetes.\u003c/p>\n\u003cp>Instead, she says, “it’s important to ask, how is structural racism playing into this? How is this is an all-of-us problem?”\u003c/p>\n\u003cp>Malawa says this conversation helps parents feel empowered instead of marginalized, which opens the door to healthier eating for both parents and kids.\u003c/p>\n\u003cp>\u003cstrong>Food Industry To Blame\u003c/strong>\u003c/p>\n\u003cp>McMath says that her uncle who ultimately died of diabetes complications did drink soda, but adds that, \"a factory made that soda and sold it at a very affordable price.\"\u003c/p>\n\u003cp>UCSF endocrinologist Robert Lustig puts it in more stark terms. He compares the added sugar in processed foods to alcohol and tobacco -- an addictive, disease-causing substance that needs to be regulated. \"The food industry cannot be given carte blanche. They're allowed to make money, but they're not allowed to make money by making people sick,\" \u003ca href=\"http://www.theguardian.com/lifeandstyle/2014/aug/24/robert-lustig-sugar-poison\" target=\"_blank\">Lustig told The Guardian.\u003c/a>\u003c/p>\n\u003cp>Advocates say food and soda companies aggressively market sugary drinks and unhealthy food to children of color. For example, black children and teens saw more than twice as many ads for sugary drinks and energy drinks on TV compared with white children and teens in 2013, \u003ca href=\"http://www.sugarydrinkfacts.org/resources/SugaryDrinkFACTS_Report.pdf\" target=\"_blank\">according to Yale’s Rudd Center for Food Policy and Obesity.\u003c/a>\u003c/p>\n\u003cp>\"I call it food addiction,\" said McMath, \"it's an everyday struggle.\"\u003c/p>\n\u003cp>\u003cstrong>Obligated to Do Something\u003c/strong>\u003c/p>\n\u003cp>McMath handles stress differently now and eats more fresh food. She's lost 85 pounds. She's a sociology major, and will graduate from San Francisco State University in a few months.\u003c/p>\n\u003cp>Her life is a lot better than when she wrote the poem, but she’s dismayed to see her family’s health problems reflected in the elementary school students she works with.\u003c/p>\n\u003cp>“I was eating a regular salad with tomatoes and onions, and a 7-year-old boy asked me, ‘What’s that?’ Students who have never seen an eggplant or fresh tomato turn into adults who barely know what those vegetables look like,” she says.\u003c/p>\n\u003cp>She wants to turn that frustration into action now that she’s graduating. She says that her \"goal is to focus on food and justice, to bridge this gap between the wealthy and the unwealthy.\"\u003c/p>\n\u003cp>“We’re living in this epidemic of death,\" she says. \"Death from food, homicide, mental death, incarceration. My people are passing away at numbers that are crazy, and I feel obligated to do something about it.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Watch McMath perform her poem \"Death Recipe\" in this video:\u003cbr>\n[youtube http://www.youtube.com/watch?v=Xe69WNbNS0g&w=560&h=315]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24795\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Erica-McMath-Photo.jpg\">\u003cimg class=\"size-large wp-image-24795\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Erica-McMath-Photo-640x427.jpg\" alt=\"San Francisco poet Erica McMath has seen the devastating effects of type-2 diabetes first hand (Jeremy Raff/KQED)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Erica Sheppard McMath has seen the devastating effects of Type 2 diabetes first hand (Jeremy Raff/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>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.\u003c/p>\n\u003cp>“It’s like seeing someone literally fall apart limb by limb because of what they’re putting in their mouth,” said McMath.\u003c/p>\n\u003cp>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.\u003cbr>\n\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/198906613&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/198906613'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Her own health suffered as her home life descended into chaos. A fight with her mother’s boyfriend, who was an alcoholic, landed her in foster care at age 15.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I was dealing with the pain of living in a group home, with the pain of sexual abuse,” she says. “I dealt with my pain through food because that was the only thing that could calm me down.”\u003c/p>\n\u003cp>She gained a lot of weight, increasing her risk for developing diabetes. She knew that her source of comfort was the same thing that was killing her family members.\u003c/p>\n\u003cp>That tension became the subject of her slam poem \"Death Recipe,\" which she performed on \u003ca href=\"http://www.hbo.com/russell-simmons-presents-brave-new-voices/cast-and-crew/team-bay-area/article/untitled-by-erica-mcmath-sheppard.html#/\" target=\"_blank\">HBO's Brave New Voices in 2010.\u003c/a>\u003c/p>\n\u003cp>In it, she criticizes herself, her community, and above all, the unequal society McMath says contributed to her family's health crises. The poem begins, “We eat like we still slaves/ cause back in the days we got what whites didn’t want.”\u003c/p>\n\u003cp>She says that \"things like chitlins or pig's feet -- in slavery times you ate whatever was available to you.\"\u003c/p>\n\u003cp>McMath sees a connection to today. \"If you don’t have enough money to consider other options, your focus is just staying alive. It is a poor man’s appetite, and it’s absolutely killing us.”\u003c/p>\n\u003cp>\u003cstrong>Prescription for Diabetes: A History Lesson\u003c/strong>\u003c/p>\n\u003cp>“You cannot find a McDonald's in San Francisco, except for in communities of color,” says Zea Malawa, a pediatrician in San Francisco’s Bayview neighborhood, where \u003ca title=\"http://www.sfhip.org/index.php?module=htmlpages&func=display&pid=57\" href=\"http://www.sfhip.org/index.php?module=htmlpages&func=display&pid=57\" target=\"_blank\">life expectancy is 14 years less\u003c/a> than in a nearby affluent neighborhood.\u003c/p>\n\u003cp>She says fast food and sodas “are like the modern iteration of pig’s feet -- the garbage falling down on disenfranchised communities.”\u003c/p>\n\u003cp>This perspective, says Malawa, is an important part of her medical practice.\u003c/p>\n\u003cp>“One thing I often talk about with families around cooking is (that) this food comes from a time when we spent 10-hour days in the field in the South,\" she says. \"That makes sense when you’re burning incredible calories, but now, we’re sedentary.”\u003c/p>\n\u003cp>Malawa says she re-frames nutrition advice this way because too often in the doctor's office, “people feel patronized, like our culture is negated or wrong -- like you’re saying their grandmother did it all wrong.”\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It’s important to ask, how is structural racism playing into this?\"\u003c/aside>\n\u003cp>Grandmothers weren't all wrong for expressing their culture and their love through food, says Malawa, even though an excess of those foods can contribute to obesity and diabetes.\u003c/p>\n\u003cp>Instead, she says, “it’s important to ask, how is structural racism playing into this? How is this is an all-of-us problem?”\u003c/p>\n\u003cp>Malawa says this conversation helps parents feel empowered instead of marginalized, which opens the door to healthier eating for both parents and kids.\u003c/p>\n\u003cp>\u003cstrong>Food Industry To Blame\u003c/strong>\u003c/p>\n\u003cp>McMath says that her uncle who ultimately died of diabetes complications did drink soda, but adds that, \"a factory made that soda and sold it at a very affordable price.\"\u003c/p>\n\u003cp>UCSF endocrinologist Robert Lustig puts it in more stark terms. He compares the added sugar in processed foods to alcohol and tobacco -- an addictive, disease-causing substance that needs to be regulated. \"The food industry cannot be given carte blanche. They're allowed to make money, but they're not allowed to make money by making people sick,\" \u003ca href=\"http://www.theguardian.com/lifeandstyle/2014/aug/24/robert-lustig-sugar-poison\" target=\"_blank\">Lustig told The Guardian.\u003c/a>\u003c/p>\n\u003cp>Advocates say food and soda companies aggressively market sugary drinks and unhealthy food to children of color. For example, black children and teens saw more than twice as many ads for sugary drinks and energy drinks on TV compared with white children and teens in 2013, \u003ca href=\"http://www.sugarydrinkfacts.org/resources/SugaryDrinkFACTS_Report.pdf\" target=\"_blank\">according to Yale’s Rudd Center for Food Policy and Obesity.\u003c/a>\u003c/p>\n\u003cp>\"I call it food addiction,\" said McMath, \"it's an everyday struggle.\"\u003c/p>\n\u003cp>\u003cstrong>Obligated to Do Something\u003c/strong>\u003c/p>\n\u003cp>McMath handles stress differently now and eats more fresh food. She's lost 85 pounds. She's a sociology major, and will graduate from San Francisco State University in a few months.\u003c/p>\n\u003cp>Her life is a lot better than when she wrote the poem, but she’s dismayed to see her family’s health problems reflected in the elementary school students she works with.\u003c/p>\n\u003cp>“I was eating a regular salad with tomatoes and onions, and a 7-year-old boy asked me, ‘What’s that?’ Students who have never seen an eggplant or fresh tomato turn into adults who barely know what those vegetables look like,” she says.\u003c/p>\n\u003cp>She wants to turn that frustration into action now that she’s graduating. She says that her \"goal is to focus on food and justice, to bridge this gap between the wealthy and the unwealthy.\"\u003c/p>\n\u003cp>“We’re living in this epidemic of death,\" she says. \"Death from food, homicide, mental death, incarceration. My people are passing away at numbers that are crazy, and I feel obligated to do something about it.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Watch McMath perform her poem \"Death Recipe\" in this video:\u003cbr>\n\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/Xe69WNbNS0g'\n title='//www.youtube.com/embed/Xe69WNbNS0g'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_24805\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/107091586-e1427918866261.jpg\">\u003cimg class=\"size-large wp-image-24805\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/107091586-640x415.jpg\" alt=\"Truvada is an anti-retroviral pill used to treat HIV infection. It can also help reduce the risk new infections. (Justin Sullivan/Getty Images)\" width=\"640\" height=\"415\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">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)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title=\"http://www.californiahealthline.org/capitol-desk/2015/4/hiv-medication-decision-in-florida-may-have-implications-in-california\" href=\"http://www.californiahealthline.org/capitol-desk/2015/4/hiv-medication-decision-in-florida-may-have-implications-in-california\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>A health insurer in Florida agreed last week to\u003ca title=\"http://www.bloomberg.com/news/articles/2015-03-27/aetna-to-cut-co-payments-for-most-aids-drugs-after-complaint\" href=\"http://www.bloomberg.com/news/articles/2015-03-27/aetna-to-cut-co-payments-for-most-aids-drugs-after-complaint\" target=\"_blank\"> lower the price of some HIV medications\u003c/a>, moving them from a specialty tier to a generic medication tier.\u003c/p>\n\u003cp>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.\u003c/p>\n\u003cp>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.\u003c!--more-->\u003c/p>\n\u003cp>\"The formularies in California have been more balanced than other parts of the country, so it's not the same as Florida,\" Turner said. \"But there definitely are implications for California. This will have direct impact for HIV/AIDS patients in California.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Other advocates say the change will certainly help the effort to end adverse price-tiering in California, but aren't so sure of the direct impact. Anne Donnelly is director of public policy for the San Francisco-based Project Inform. Project Inform published \u003ca href=\"http://www.projectinform.org/pdf/CCformularies.pdf\" target=\"_blank\">an analysis\u003c/a> of the medication formularies used by plans in Covered California and has participated in outreach efforts held by exchange officials to address the issue.\u003c/p>\n\u003cp>\"Whether or not it will have a direct effect is a bit of a question, just because there's a lot of work already going on here in California, and a lot of progress being made, particularly with Covered California,\" Donnelly said. \"We're thrilled [NHLP] won that lawsuit, and it will help. ... It's that 'tipping point' idea. It will start to tip insurers in that direction.\"\u003c/p>\n\u003cp>The next step, NHLP attorney Turner says, is to apply that shift from specialty to generic tier to other conditions with expensive treatment costs.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Aetna's announcement protects people living with HIV/AIDS, but not those managing other serious or disabling medical conditions requiring costly medications that are often placed in similarly high cost-sharing tiers,\" Turner said. \"[We] will continue our efforts so that all low-income individuals can … access the care they need.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24805\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/107091586-e1427918866261.jpg\">\u003cimg class=\"size-large wp-image-24805\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/107091586-640x415.jpg\" alt=\"Truvada is an anti-retroviral pill used to treat HIV infection. It can also help reduce the risk new infections. (Justin Sullivan/Getty Images)\" width=\"640\" height=\"415\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">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)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title=\"http://www.californiahealthline.org/capitol-desk/2015/4/hiv-medication-decision-in-florida-may-have-implications-in-california\" href=\"http://www.californiahealthline.org/capitol-desk/2015/4/hiv-medication-decision-in-florida-may-have-implications-in-california\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>A health insurer in Florida agreed last week to\u003ca title=\"http://www.bloomberg.com/news/articles/2015-03-27/aetna-to-cut-co-payments-for-most-aids-drugs-after-complaint\" href=\"http://www.bloomberg.com/news/articles/2015-03-27/aetna-to-cut-co-payments-for-most-aids-drugs-after-complaint\" target=\"_blank\"> lower the price of some HIV medications\u003c/a>, moving them from a specialty tier to a generic medication tier.\u003c/p>\n\u003cp>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.\u003c/p>\n\u003cp>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.\u003c!--more-->\u003c/p>\n\u003cp>\"The formularies in California have been more balanced than other parts of the country, so it's not the same as Florida,\" Turner said. \"But there definitely are implications for California. This will have direct impact for HIV/AIDS patients in California.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Other advocates say the change will certainly help the effort to end adverse price-tiering in California, but aren't so sure of the direct impact. Anne Donnelly is director of public policy for the San Francisco-based Project Inform. Project Inform published \u003ca href=\"http://www.projectinform.org/pdf/CCformularies.pdf\" target=\"_blank\">an analysis\u003c/a> of the medication formularies used by plans in Covered California and has participated in outreach efforts held by exchange officials to address the issue.\u003c/p>\n\u003cp>\"Whether or not it will have a direct effect is a bit of a question, just because there's a lot of work already going on here in California, and a lot of progress being made, particularly with Covered California,\" Donnelly said. \"We're thrilled [NHLP] won that lawsuit, and it will help. ... It's that 'tipping point' idea. It will start to tip insurers in that direction.\"\u003c/p>\n\u003cp>The next step, NHLP attorney Turner says, is to apply that shift from specialty to generic tier to other conditions with expensive treatment costs.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Aetna's announcement protects people living with HIV/AIDS, but not those managing other serious or disabling medical conditions requiring costly medications that are often placed in similarly high cost-sharing tiers,\" Turner said. \"[We] will continue our efforts so that all low-income individuals can … access the care they need.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Is Pollution From Asia Making the Central Valley's Bad Air Even Worse?",
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"content": "\u003cfigure id=\"attachment_24787\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS729_farms0613-21-e1427821121824.jpg\">\u003cimg class=\"size-large wp-image-24787\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS729_farms0613-21-640x428.jpg\" alt=\"(David McNew/Getty Images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Advocates say the San Joaquin Valley Air District should focus on sources it can control, like farming machinery. (David McNew/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alice Daniel\u003c/strong>\u003c/p>\n\u003cp>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.\u003c/p>\n\u003cp>“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.\u003c/p>\n\u003cp>Lighthall is one of the organizers of an \u003ca title=\"http://www.valleyair.org/topc/\" href=\"http://www.valleyair.org/topc/\" target=\"_blank\">ozone pollution conference\u003c/a> starting Tuesday where scientists from California, China, Colorado and other places will discuss trends in global ozone.\u003c/p>\n\u003cp>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.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Lighthall says that on some days this additional pollution is enough to prevent the district from meeting federal clean air health standards. The Valley's bowl-shaped geography traps pollutants, sometimes for days at a time -- and that includes pollutants from other places, Lighthall says.\u003c/p>\n\u003cp>He says there's an \"upward trend\" in transboundary ozone and the ozone is now \"mixing down and really making a difference on certain days as to whether we actually meet the standard ... or whether we don’t meet it,” Lighthall says.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/198583646\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>But the EPA disagrees. It says that on the Valley’s worst air days, most ozone pollution comes from local sources. In fact, last year the air district unsuccessfully petitioned the EPA to exempt it from penalties for violating a health standard blaming it on smog from Asia.\u003c/p>\n\u003cp>Some local health advocates say the air district is straying too far from home.\u003c/p>\n\u003cp>“The air district is famous for looking for loopholes,” says Delores Weller, director of the Central Valley Air Quality Coalition, an advocacy group.\u003c/p>\n\u003cp>She says the district is focusing on sources it can’t control and should do everything it can first to tackle homegrown pollution.\u003c/p>\n\u003cp>“It would be great to see an agriculture, farming operations and air pollution conference based here in the Valley as opposed to a trans-boundary ozone conference,” Weller says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But the air district says it must research all sources of air pollution to know exactly what it’s dealing with and how best to mitigate. It’s even \u003ca title=\"http://www.latimes.com/science/la-me-pacific-smog-20150201-story.html#page=1\" href=\"http://www.latimes.com/science/la-me-pacific-smog-20150201-story.html#page=1\" target=\"_blank\">funding research at U.C. Davis \u003c/a>to assess the effects of ozone from Asia.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24787\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS729_farms0613-21-e1427821121824.jpg\">\u003cimg class=\"size-large wp-image-24787\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS729_farms0613-21-640x428.jpg\" alt=\"(David McNew/Getty Images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Advocates say the San Joaquin Valley Air District should focus on sources it can control, like farming machinery. (David McNew/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alice Daniel\u003c/strong>\u003c/p>\n\u003cp>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.\u003c/p>\n\u003cp>“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.\u003c/p>\n\u003cp>Lighthall is one of the organizers of an \u003ca title=\"http://www.valleyair.org/topc/\" href=\"http://www.valleyair.org/topc/\" target=\"_blank\">ozone pollution conference\u003c/a> starting Tuesday where scientists from California, China, Colorado and other places will discuss trends in global ozone.\u003c/p>\n\u003cp>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.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Lighthall says that on some days this additional pollution is enough to prevent the district from meeting federal clean air health standards. The Valley's bowl-shaped geography traps pollutants, sometimes for days at a time -- and that includes pollutants from other places, Lighthall says.\u003c/p>\n\u003cp>He says there's an \"upward trend\" in transboundary ozone and the ozone is now \"mixing down and really making a difference on certain days as to whether we actually meet the standard ... or whether we don’t meet it,” Lighthall says.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/198583646&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/198583646'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But the EPA disagrees. It says that on the Valley’s worst air days, most ozone pollution comes from local sources. In fact, last year the air district unsuccessfully petitioned the EPA to exempt it from penalties for violating a health standard blaming it on smog from Asia.\u003c/p>\n\u003cp>Some local health advocates say the air district is straying too far from home.\u003c/p>\n\u003cp>“The air district is famous for looking for loopholes,” says Delores Weller, director of the Central Valley Air Quality Coalition, an advocacy group.\u003c/p>\n\u003cp>She says the district is focusing on sources it can’t control and should do everything it can first to tackle homegrown pollution.\u003c/p>\n\u003cp>“It would be great to see an agriculture, farming operations and air pollution conference based here in the Valley as opposed to a trans-boundary ozone conference,” Weller says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But the air district says it must research all sources of air pollution to know exactly what it’s dealing with and how best to mitigate. It’s even \u003ca title=\"http://www.latimes.com/science/la-me-pacific-smog-20150201-story.html#page=1\" href=\"http://www.latimes.com/science/la-me-pacific-smog-20150201-story.html#page=1\" target=\"_blank\">funding research at U.C. Davis \u003c/a>to assess the effects of ozone from Asia.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Doctors with Cancer Join California Movement for 'Aid in Dying'",
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"content": "\u003cfigure id=\"attachment_24761\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0305-e1427734238891.jpg\">\u003cimg class=\"size-large wp-image-24761\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0305-640x480.jpg\" alt=\"Dan Swangard, a 48-year-old physician from San Francisco, was diagnosed in 2013 with a rare form of metastatic cancer. (Anna Gorman/KHN)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dan Swangard, a 48-year-old physician from San Francisco, was diagnosed in 2013 with a rare form of metastatic cancer. (Anna Gorman/KHN)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman,\u003c/strong> \u003ca title=\"http://kaiserhealthnews.org/news/hoping-to-live-these-doctors-want-a-choice-in-how-they-die/\" href=\"http://kaiserhealthnews.org/news/hoping-to-live-these-doctors-want-a-choice-in-how-they-die/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Dan Swangard knows what death looks like.\u003c/p>\n\u003cp>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.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“It’s very real for me. This could be my own issue a year from now.”\u003c/aside>\n\u003cp>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.\u003c/p>\n\u003cp>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.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s very real for me,” said Swangard, who lives in Bolinas, Calif. “This could be my own issue a year from now.”\u003c!--more-->\u003c/p>\n\u003cp>That’s one of the reasons Swangard joined a California lawsuit last month seeking to let doctors prescribe lethal medications to certain patients who want to hasten death. If he were given only months to live, Swangard said, he can’t say for certain whether he would take them.\u003c/p>\n\u003cp>“But I want to be able to make that choice,” he said.\u003c/p>\n\u003cp>The right-to-die movement has gained renewed momentum in California and around the nation following the highly publicized death of an East Bay woman with brain cancer. Brittany Maynard, 29, moved to Oregon to take advantage of its “Death with Dignity” law and died in November after taking a fatal dose of barbiturates prescribed by her doctor.\u003c/p>\n\u003cp>The California lawsuit asks the court to protect physicians from liability if they prescribe lethal medications to patients who are both terminally ill and mentally competent to decide their fate.\u003c/p>\n\u003cp>[contextly_sidebar id=\"haIJdBeaTK2L2aNSQP1MdhGr9HxMuMq1\"]\u003c/p>\n\u003cp>The lawsuit argues that while it is against the law in California for anyone to assist in another’s suicide, these cases are not suicides. Rather, the suit argues, they are choices by a dying person on how his or her life should end and decisions about one’s own body protected under the state constitution.\u003c/p>\n\u003cp>Separately, two California state senators have proposed a bill that would allow doctors to prescribe lethal medication to certain terminally ill adults.\u003c/p>\n\u003cp>Three states — Oregon, Washington and Vermont — already have laws allowing physician-assisted deaths. Courts in New Mexico and Montana also have ruled that aid in dying is legal, and a suit was also recently filed in New York.\u003c/p>\n\u003cp>Legislation is pending in several other states. Kathryn Tucker, an attorney on several of the court cases, is also spearheading the California lawsuit. This time, she and her legal team decided to include among the plaintiffs two doctors with life-threatening illnesses, Swangard and a retired San Francisco obstetrician.\u003c/p>\n\u003cp>Physicians “have a very deep and broad understanding about what the journey to death can be like,” said Tucker, executive director of the Disability Rights Legal Center. “The curtain is pulled back. For lay people, death is much more mysterious.”\u003c/p>\n\u003cp>But a recent survey of 21,000 doctors in the U.S. and Europe shows views may be shifting. According to Medscape, the organization that did the survey, 54 percent of American doctors support assisted suicide, up from 46 percent four years earlier. Historically, doctors have been some of the most vocal critics of assisted suicide, also called aid-in-dying. The American Medical Association still says that “physician-assisted suicide is fundamentally incompatible with the physician’s role as healer.” Similarly, the California Medical Association takes the view that helping patients die conflicts with doctors’ commitment to do no harm. “It is the physicians’ job to take care of the patient and that is amplified when that patient is most sick,” said spokeswoman Molly Weedn.\u003c/p>\n\u003cp>Swangard is among those who believe that taking care of patients means letting them choose how their lives should end. That’s not the same as killing patients or facilitating suicide, he said.\u003c/p>\n\u003cp>Swangard completed his medical residency in San Francisco in the middle of the AIDS crisis; young men were dying all around him. Throughout his career as an internal medicine doctor, a hospice volunteer and now an anesthesiologist, he has become frustrated with how the medical system handles death. Doctors spend so much time trying to extend life that few focus on what patients want in their last days, he said.\u003c/p>\n\u003cp>“I don’t think we know how to die,” he said. “We fight tooth and nail to keep that from happening.”\u003c/p>\n\u003cp>[contextly_sidebar id=\"ILqrwTkVsGGtAYwEnHms9CvV1Pn6Ubfl\"]\u003c/p>\n\u003cp>Swangard’s own illness was discovered in early 2013 during a long-overdue checkup. He hadn’t been worried about his health — he was obsessed with fitness, swimming regularly and seeing a trainer twice a week. But when the doctor pressed on Swangard’s stomach, he felt a mango-sized mass.\u003c/p>\n\u003cp>He had a visceral feeling, he said, “something bad was happening.”\u003c/p>\n\u003cp>Within a week, a surgeon found a neuroendocrine tumor in the pancreas and metastasis in the liver. It was the same cancer that took Steve Jobs’ life — one that doesn’t generally respond to chemotherapy or radiation. “My fears became real,” he said.\u003c/p>\n\u003cp>The doctors told him they believed they got all the cancerous cells. But Swangard was tormented by questions: Am I going to be alive in a year? Is my cancer going to come back?\u003c/p>\n\u003cp>“I wasn’t sleeping, I wasn’t exercising, I was marinating in my own sadness and fear of what this all meant,” he said. “I thought, ‘This is going to kill me.’”\u003c/p>\n\u003cp>Since his diagnosis, Swangard said he has had a greater understanding of his patients’ struggles. Occasionally, he holds their hands and tells them he has been where they are.\u003c/p>\n\u003cp>Earlier this year, a physician friend asked him if he’d be willing to join the California case. Swangard didn’t hesitate. He didn’t go into medicine to help dying people linger and wants to help change that approach — for his patients and for himself.\u003c/p>\n\u003cp>When he dies, Swangard said, he wants to be surrounded by people he loves. He doesn’t want to be in a drug-induced haze, nor consumed by worry about what’s next. He wants to be able to say goodbye.\u003c/p>\n\u003cp>“It is a little bit of a blessing to know how I might die,” he said. “I don’t think a lot of patients have insight into what to expect.”\u003c/p>\n\u003cp>These days, he wears a Buddhist prayer bracelet, a reminder to focus on the present. He cut his work hours, swims as often as he can and meditates regularly. At home, he stares out at the ocean, often watching dolphins pass by. He makes every effort to stay calm and healthy.\u003c/p>\n\u003cp>He is in remission but he knows that what happens with the cancer is largely outside his control. An MRI last year showed a small lesion in his liver, which doctors are watching closely.\u003c/p>\n\u003cp>“It’s this big unknown,” he said.\u003c/p>\n\u003cfigure id=\"attachment_24772\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0347-e1427736893164.jpg\">\u003cimg class=\"size-medium wp-image-24772\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0347-300x225.jpg\" alt=\"Retired San Francisco obstetrician Robert Liner, 70, is a plaintiff in a California lawsuit seeking to let doctors prescribe lethal medications to certain patients who want to die. (Anna Gorman/KHN)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Retired San Francisco obstetrician Robert Liner, 70, is a plaintiff in a California lawsuit seeking to let doctors prescribe lethal medications to certain patients who want to die. (Anna Gorman/KHN)\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Robert Liner, a fellow plaintiff who only recently met Swangard, lives with the same uncertainty.\u003c/p>\n\u003cp>On his 69th birthday in May 2013, the retired obstetrician had a bad cough. He felt tired and short of breath. His wife took him to the hospital, where doctors discovered malignant masses on his kidneys — advanced-stage lymphoma.\u003c/p>\n\u003cp>After radiation and chemotherapy, the tumors shrank. He also is in remission. But if the cancer comes back, he said, “the prospects are not going to be good.”\u003c/p>\n\u003cp>He often thinks of a former patient, a 25-year-old woman with metastatic ovarian cancer. She wanted to die while she still was able to communicate. Liner wasn’t able to help ease her death because the law wouldn’t let him. “I felt like I’d failed her,” he said.\u003c/p>\n\u003cp>Years before his diagnosis, Liner, now 70, became involved with Compassion & Choices, an organization that promotes aid-in-dying. He has a shelf of books in his San Francisco home devoted to the subject: Being Mortal, Dying Right, Knocking on Heaven’s Door.\u003c/p>\n\u003cp>He keeps a stack of notecards with quotes about the end of life, which he often recites in speeches to church groups or senior centers. One reads, “The best preparation for death is a life well-lived.”\u003c/p>\n\u003cp>He believes having medication to hasten death helps terminally ill people live fully in their last weeks or months without being immobilized by fear. “If you are riddled with anxiety, you are not free to concentrate on what’s most meaningful to you,” he said.\u003c/p>\n\u003cp>Like Swangard, Liner doesn’t know if he would take the medication. He recently married the woman he calls his “beloved” and said he has lots of plans for his retirement years, including writing a screenplay and improving his piano playing.\u003c/p>\n\u003cp>“My wife says I’d be hanging on to life by my fingernails,” he said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>But that decision should be his to make, with his family and his doctor, he said. “I want the comfort of knowing it’s up to me when enough is enough,” he said.\u003c/p>\n\n",
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"excerpt": "Dr. Dan Swangard has metastatic cancer. He joined a lawsuit to change California law to allow physician-assisted suicide.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24761\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0305-e1427734238891.jpg\">\u003cimg class=\"size-large wp-image-24761\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0305-640x480.jpg\" alt=\"Dan Swangard, a 48-year-old physician from San Francisco, was diagnosed in 2013 with a rare form of metastatic cancer. (Anna Gorman/KHN)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dan Swangard, a 48-year-old physician from San Francisco, was diagnosed in 2013 with a rare form of metastatic cancer. (Anna Gorman/KHN)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman,\u003c/strong> \u003ca title=\"http://kaiserhealthnews.org/news/hoping-to-live-these-doctors-want-a-choice-in-how-they-die/\" href=\"http://kaiserhealthnews.org/news/hoping-to-live-these-doctors-want-a-choice-in-how-they-die/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Dan Swangard knows what death looks like.\u003c/p>\n\u003cp>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.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“It’s very real for me. This could be my own issue a year from now.”\u003c/aside>\n\u003cp>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.\u003c/p>\n\u003cp>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.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s very real for me,” said Swangard, who lives in Bolinas, Calif. “This could be my own issue a year from now.”\u003c!--more-->\u003c/p>\n\u003cp>That’s one of the reasons Swangard joined a California lawsuit last month seeking to let doctors prescribe lethal medications to certain patients who want to hasten death. If he were given only months to live, Swangard said, he can’t say for certain whether he would take them.\u003c/p>\n\u003cp>“But I want to be able to make that choice,” he said.\u003c/p>\n\u003cp>The right-to-die movement has gained renewed momentum in California and around the nation following the highly publicized death of an East Bay woman with brain cancer. Brittany Maynard, 29, moved to Oregon to take advantage of its “Death with Dignity” law and died in November after taking a fatal dose of barbiturates prescribed by her doctor.\u003c/p>\n\u003cp>The California lawsuit asks the court to protect physicians from liability if they prescribe lethal medications to patients who are both terminally ill and mentally competent to decide their fate.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The lawsuit argues that while it is against the law in California for anyone to assist in another’s suicide, these cases are not suicides. Rather, the suit argues, they are choices by a dying person on how his or her life should end and decisions about one’s own body protected under the state constitution.\u003c/p>\n\u003cp>Separately, two California state senators have proposed a bill that would allow doctors to prescribe lethal medication to certain terminally ill adults.\u003c/p>\n\u003cp>Three states — Oregon, Washington and Vermont — already have laws allowing physician-assisted deaths. Courts in New Mexico and Montana also have ruled that aid in dying is legal, and a suit was also recently filed in New York.\u003c/p>\n\u003cp>Legislation is pending in several other states. Kathryn Tucker, an attorney on several of the court cases, is also spearheading the California lawsuit. This time, she and her legal team decided to include among the plaintiffs two doctors with life-threatening illnesses, Swangard and a retired San Francisco obstetrician.\u003c/p>\n\u003cp>Physicians “have a very deep and broad understanding about what the journey to death can be like,” said Tucker, executive director of the Disability Rights Legal Center. “The curtain is pulled back. For lay people, death is much more mysterious.”\u003c/p>\n\u003cp>But a recent survey of 21,000 doctors in the U.S. and Europe shows views may be shifting. According to Medscape, the organization that did the survey, 54 percent of American doctors support assisted suicide, up from 46 percent four years earlier. Historically, doctors have been some of the most vocal critics of assisted suicide, also called aid-in-dying. The American Medical Association still says that “physician-assisted suicide is fundamentally incompatible with the physician’s role as healer.” Similarly, the California Medical Association takes the view that helping patients die conflicts with doctors’ commitment to do no harm. “It is the physicians’ job to take care of the patient and that is amplified when that patient is most sick,” said spokeswoman Molly Weedn.\u003c/p>\n\u003cp>Swangard is among those who believe that taking care of patients means letting them choose how their lives should end. That’s not the same as killing patients or facilitating suicide, he said.\u003c/p>\n\u003cp>Swangard completed his medical residency in San Francisco in the middle of the AIDS crisis; young men were dying all around him. Throughout his career as an internal medicine doctor, a hospice volunteer and now an anesthesiologist, he has become frustrated with how the medical system handles death. Doctors spend so much time trying to extend life that few focus on what patients want in their last days, he said.\u003c/p>\n\u003cp>“I don’t think we know how to die,” he said. “We fight tooth and nail to keep that from happening.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Swangard’s own illness was discovered in early 2013 during a long-overdue checkup. He hadn’t been worried about his health — he was obsessed with fitness, swimming regularly and seeing a trainer twice a week. But when the doctor pressed on Swangard’s stomach, he felt a mango-sized mass.\u003c/p>\n\u003cp>He had a visceral feeling, he said, “something bad was happening.”\u003c/p>\n\u003cp>Within a week, a surgeon found a neuroendocrine tumor in the pancreas and metastasis in the liver. It was the same cancer that took Steve Jobs’ life — one that doesn’t generally respond to chemotherapy or radiation. “My fears became real,” he said.\u003c/p>\n\u003cp>The doctors told him they believed they got all the cancerous cells. But Swangard was tormented by questions: Am I going to be alive in a year? Is my cancer going to come back?\u003c/p>\n\u003cp>“I wasn’t sleeping, I wasn’t exercising, I was marinating in my own sadness and fear of what this all meant,” he said. “I thought, ‘This is going to kill me.’”\u003c/p>\n\u003cp>Since his diagnosis, Swangard said he has had a greater understanding of his patients’ struggles. Occasionally, he holds their hands and tells them he has been where they are.\u003c/p>\n\u003cp>Earlier this year, a physician friend asked him if he’d be willing to join the California case. Swangard didn’t hesitate. He didn’t go into medicine to help dying people linger and wants to help change that approach — for his patients and for himself.\u003c/p>\n\u003cp>When he dies, Swangard said, he wants to be surrounded by people he loves. He doesn’t want to be in a drug-induced haze, nor consumed by worry about what’s next. He wants to be able to say goodbye.\u003c/p>\n\u003cp>“It is a little bit of a blessing to know how I might die,” he said. “I don’t think a lot of patients have insight into what to expect.”\u003c/p>\n\u003cp>These days, he wears a Buddhist prayer bracelet, a reminder to focus on the present. He cut his work hours, swims as often as he can and meditates regularly. At home, he stares out at the ocean, often watching dolphins pass by. He makes every effort to stay calm and healthy.\u003c/p>\n\u003cp>He is in remission but he knows that what happens with the cancer is largely outside his control. An MRI last year showed a small lesion in his liver, which doctors are watching closely.\u003c/p>\n\u003cp>“It’s this big unknown,” he said.\u003c/p>\n\u003cfigure id=\"attachment_24772\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0347-e1427736893164.jpg\">\u003cimg class=\"size-medium wp-image-24772\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0347-300x225.jpg\" alt=\"Retired San Francisco obstetrician Robert Liner, 70, is a plaintiff in a California lawsuit seeking to let doctors prescribe lethal medications to certain patients who want to die. (Anna Gorman/KHN)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Retired San Francisco obstetrician Robert Liner, 70, is a plaintiff in a California lawsuit seeking to let doctors prescribe lethal medications to certain patients who want to die. (Anna Gorman/KHN)\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Robert Liner, a fellow plaintiff who only recently met Swangard, lives with the same uncertainty.\u003c/p>\n\u003cp>On his 69th birthday in May 2013, the retired obstetrician had a bad cough. He felt tired and short of breath. His wife took him to the hospital, where doctors discovered malignant masses on his kidneys — advanced-stage lymphoma.\u003c/p>\n\u003cp>After radiation and chemotherapy, the tumors shrank. He also is in remission. But if the cancer comes back, he said, “the prospects are not going to be good.”\u003c/p>\n\u003cp>He often thinks of a former patient, a 25-year-old woman with metastatic ovarian cancer. She wanted to die while she still was able to communicate. Liner wasn’t able to help ease her death because the law wouldn’t let him. “I felt like I’d failed her,” he said.\u003c/p>\n\u003cp>Years before his diagnosis, Liner, now 70, became involved with Compassion & Choices, an organization that promotes aid-in-dying. He has a shelf of books in his San Francisco home devoted to the subject: Being Mortal, Dying Right, Knocking on Heaven’s Door.\u003c/p>\n\u003cp>He keeps a stack of notecards with quotes about the end of life, which he often recites in speeches to church groups or senior centers. One reads, “The best preparation for death is a life well-lived.”\u003c/p>\n\u003cp>He believes having medication to hasten death helps terminally ill people live fully in their last weeks or months without being immobilized by fear. “If you are riddled with anxiety, you are not free to concentrate on what’s most meaningful to you,” he said.\u003c/p>\n\u003cp>Like Swangard, Liner doesn’t know if he would take the medication. He recently married the woman he calls his “beloved” and said he has lots of plans for his retirement years, including writing a screenplay and improving his piano playing.\u003c/p>\n\u003cp>“My wife says I’d be hanging on to life by my fingernails,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But that decision should be his to make, with his family and his doctor, he said. “I want the comfort of knowing it’s up to me when enough is enough,” he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_24751\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS14652_IMG_20150326_174348916-e1427474277469.jpg\">\u003cimg class=\"wp-image-24751 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS14652_IMG_20150326_174348916-640x360.jpg\" alt=\"Stephen Scotty, who works at Doctors Medical Center's cardiac catheter lab addresses the board. (Andrew Stelzer/KQED)\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Stephen Scotty, of Doctors Medical Center's cardiac catheter lab, addressed the West Contra Costa County Healthcare District board Thursday night. (Andrew Stelzer/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Andrew Stelzer\u003c/strong>\u003c/p>\n\u003cp>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.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.wcchd.ca.gov/\" target=\"_blank\">West Contra Costa County healthcare district\u003c/a> voted Thursday night to begin giving employees two-weeks notice on April 7\u003cspan style=\"font-size: 12px;line-height: 0px\">th, \u003c/span>meaning operations would start winding down April 21st, and continue through June.\u003c/p>\n\u003cp>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 \u003ca href=\"http://www.contracostatimes.com/contra-costa-times/ci_25711650/san-pablo-voters-reject-tax-fund-doctors-medical\" target=\"_blank\">failed to gain the two-thirds majority needed.\u003c/a>\u003c/p>\n\u003cp>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.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“The issue here isn’t if the hospital was only run better,\" Emahiser said, \"It was not run inefficiently.\"\u003c/p>\n\u003cp>\"When you look at the cost per patient day compared to other (East Bay) hospitals, it was 24 percent lower. It's not a cost issue. It’s a revenue issue. It's reimbursement.” he added.\u003c/p>\n\u003cp>“Basically this hospital has to go down because it serves too many poor people. That’s not right,” said Michael Parker with the \u003ca href=\"http://richmondprogressivealliance.net/\" target=\"_blank\">Richmond Progressive Alliance\u003c/a>, one of many western Contra Costa residents who lamented the loss of a critical resource.\u003c/p>\n\u003cfigure id=\"attachment_10467535\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2015/03/Maria-Sahagun.jpg\">\u003cimg class=\"size-thumbnail wp-image-10467535\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2015/03/Maria-Sahagun-400x225.jpg\" alt=\"Nurse Maria Sahagun pleads with the Doctors Medical Center's board to close the hospital unless there is a viable financial solution\" width=\"400\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Nurse Maria Sahagun pleads with the Doctors Medical Center's board to close the hospital unless there is a viable financial solution\u003c/figcaption>\u003c/figure>\n\u003cp>\"Without this hospital, the residents of West Contra Costa will be deprived of meaningful health care anywhere near their homes,\" said Dr. Sharon Drager, who works at the hospital and serves on its governing body.\u003c/p>\n\u003cp>“As soon as the hospital closes they’ll lose an emergency room, an advanced cardiovascular unit, a cancer center, an advanced wound center, as well as medical and surgical inpatient and outpatient services. State of the art care for heart attacks will no longer be nearby but many miles away on crowded freeways. As soon as the hospital closes, the medical community will disappear. A hospital is an ecosystem. It's not a building.\"\u003c/p>\n\u003cp>But despite many dire predictions, virtually none of the 200 people at the meeting called for a significant delay.\u003c/p>\n\u003cp>“We've been closing for 10 years. Please set the date, Let us close with dignity,\" said Steven Scotty, who works in the cardiac catheter lab.\u003c/p>\n\u003cp>The board pushed back the closure date by one week, too see if a last minute proposal by San Diego entrepreneur Larry Anderson to buy the hospital can get off the ground. Anderson has received praise for the turnaround of \u003ca href=\"http://www.tricitymed.org/\" target=\"_blank\">Tri-City Medical Center in Oceanside,\u003c/a> but \u003ca href=\"http://www.utsandiego.com/news/2013/oct/17/tri-city-fires-anderson/\" target=\"_blank\">was later fired from his job as CEO\u003c/a>.\u003c/p>\n\u003cp>Anderson's proposal was only seen by Doctors Medical Center's lawyer Thursday morning. It includes a Chinese investor and $3 million contributed by the hospital's doctors. West Contra Costa County Healthcare District Board Vice-Chair John Gioia reluctantly supported the delay, to give the proposal a chance to come together.\u003c/p>\n\u003cp>“We can't go on faith when we decide our fiduciary obligations of whether to keep spending $2 million a month of taxpayer money in the hopes that somebody says they can turn something around,\" said Gioia.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>At a cost of $500,000 a week, the hospital could keep running through July in hopes of a financial rescue, but then might not have enough money to pay what’s owed to employees and vendors.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24751\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS14652_IMG_20150326_174348916-e1427474277469.jpg\">\u003cimg class=\"wp-image-24751 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS14652_IMG_20150326_174348916-640x360.jpg\" alt=\"Stephen Scotty, who works at Doctors Medical Center's cardiac catheter lab addresses the board. (Andrew Stelzer/KQED)\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Stephen Scotty, of Doctors Medical Center's cardiac catheter lab, addressed the West Contra Costa County Healthcare District board Thursday night. (Andrew Stelzer/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Andrew Stelzer\u003c/strong>\u003c/p>\n\u003cp>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.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.wcchd.ca.gov/\" target=\"_blank\">West Contra Costa County healthcare district\u003c/a> voted Thursday night to begin giving employees two-weeks notice on April 7\u003cspan style=\"font-size: 12px;line-height: 0px\">th, \u003c/span>meaning operations would start winding down April 21st, and continue through June.\u003c/p>\n\u003cp>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 \u003ca href=\"http://www.contracostatimes.com/contra-costa-times/ci_25711650/san-pablo-voters-reject-tax-fund-doctors-medical\" target=\"_blank\">failed to gain the two-thirds majority needed.\u003c/a>\u003c/p>\n\u003cp>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.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The issue here isn’t if the hospital was only run better,\" Emahiser said, \"It was not run inefficiently.\"\u003c/p>\n\u003cp>\"When you look at the cost per patient day compared to other (East Bay) hospitals, it was 24 percent lower. It's not a cost issue. It’s a revenue issue. It's reimbursement.” he added.\u003c/p>\n\u003cp>“Basically this hospital has to go down because it serves too many poor people. That’s not right,” said Michael Parker with the \u003ca href=\"http://richmondprogressivealliance.net/\" target=\"_blank\">Richmond Progressive Alliance\u003c/a>, one of many western Contra Costa residents who lamented the loss of a critical resource.\u003c/p>\n\u003cfigure id=\"attachment_10467535\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2015/03/Maria-Sahagun.jpg\">\u003cimg class=\"size-thumbnail wp-image-10467535\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2015/03/Maria-Sahagun-400x225.jpg\" alt=\"Nurse Maria Sahagun pleads with the Doctors Medical Center's board to close the hospital unless there is a viable financial solution\" width=\"400\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Nurse Maria Sahagun pleads with the Doctors Medical Center's board to close the hospital unless there is a viable financial solution\u003c/figcaption>\u003c/figure>\n\u003cp>\"Without this hospital, the residents of West Contra Costa will be deprived of meaningful health care anywhere near their homes,\" said Dr. Sharon Drager, who works at the hospital and serves on its governing body.\u003c/p>\n\u003cp>“As soon as the hospital closes they’ll lose an emergency room, an advanced cardiovascular unit, a cancer center, an advanced wound center, as well as medical and surgical inpatient and outpatient services. State of the art care for heart attacks will no longer be nearby but many miles away on crowded freeways. As soon as the hospital closes, the medical community will disappear. A hospital is an ecosystem. It's not a building.\"\u003c/p>\n\u003cp>But despite many dire predictions, virtually none of the 200 people at the meeting called for a significant delay.\u003c/p>\n\u003cp>“We've been closing for 10 years. Please set the date, Let us close with dignity,\" said Steven Scotty, who works in the cardiac catheter lab.\u003c/p>\n\u003cp>The board pushed back the closure date by one week, too see if a last minute proposal by San Diego entrepreneur Larry Anderson to buy the hospital can get off the ground. Anderson has received praise for the turnaround of \u003ca href=\"http://www.tricitymed.org/\" target=\"_blank\">Tri-City Medical Center in Oceanside,\u003c/a> but \u003ca href=\"http://www.utsandiego.com/news/2013/oct/17/tri-city-fires-anderson/\" target=\"_blank\">was later fired from his job as CEO\u003c/a>.\u003c/p>\n\u003cp>Anderson's proposal was only seen by Doctors Medical Center's lawyer Thursday morning. It includes a Chinese investor and $3 million contributed by the hospital's doctors. West Contra Costa County Healthcare District Board Vice-Chair John Gioia reluctantly supported the delay, to give the proposal a chance to come together.\u003c/p>\n\u003cp>“We can't go on faith when we decide our fiduciary obligations of whether to keep spending $2 million a month of taxpayer money in the hopes that somebody says they can turn something around,\" said Gioia.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>At a cost of $500,000 a week, the hospital could keep running through July in hopes of a financial rescue, but then might not have enough money to pay what’s owed to employees and vendors.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_23614\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-e1422076915312.jpg\">\u003cimg class=\"size-large wp-image-23614\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-640x456.jpg\" alt=\"A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\" width=\"640\" height=\"456\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Frontline aired an updated version of its 2008 documentary \u003ca title=\"http://www.pbs.org/wgbh/pages/frontline/\" href=\"http://www.pbs.org/wgbh/pages/frontline/\" target=\"_blank\">The Vaccine War\u003c/a> 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.\u003c/p>\n\u003cp>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.\u003c/p>\n\u003cp>State of Health \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">first told the story of Carl Krawitt\u003c/a> 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 \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" target=\"_blank\">before his vaccines could begin again\u003c/a>. The Krawitt family has been arguing that those unvaccinated by choice should not be able to attend public school.\u003c/p>\n\u003cp>Frontline producers told the story of Rhett's family in The Vaccine War.\u003c/p>\n\u003cp>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.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Feel free to leave a question now and please join us at noon for the chat!\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ciframe src=\"http://wwwssl.coveritlive.com/embed.html?altcastCode=0fc95ef8b6&srcdom=www.coveritlive.com&srcdomsec=wwwssl.coveritlive.com&height=550&entryLoc=top&commentLoc=top&titlePage=off&replayContentOrder=chronological&embedType=stream&titleImage=%2Ftemplates%2Fcoveritlive%2Fimages%2FbuildPage%2FNewsImage.jpg\" style=\"width:100%;height:550px\" height=\"550px\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23614\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-e1422076915312.jpg\">\u003cimg class=\"size-large wp-image-23614\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-640x456.jpg\" alt=\"A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\" width=\"640\" height=\"456\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Frontline aired an updated version of its 2008 documentary \u003ca title=\"http://www.pbs.org/wgbh/pages/frontline/\" href=\"http://www.pbs.org/wgbh/pages/frontline/\" target=\"_blank\">The Vaccine War\u003c/a> 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.\u003c/p>\n\u003cp>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.\u003c/p>\n\u003cp>State of Health \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">first told the story of Carl Krawitt\u003c/a> 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 \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" target=\"_blank\">before his vaccines could begin again\u003c/a>. The Krawitt family has been arguing that those unvaccinated by choice should not be able to attend public school.\u003c/p>\n\u003cp>Frontline producers told the story of Rhett's family in The Vaccine War.\u003c/p>\n\u003cp>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.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Feel free to leave a question now and please join us at noon for the chat!\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ciframe src=\"http://wwwssl.coveritlive.com/embed.html?altcastCode=0fc95ef8b6&srcdom=www.coveritlive.com&srcdomsec=wwwssl.coveritlive.com&height=550&entryLoc=top&commentLoc=top&titlePage=off&replayContentOrder=chronological&embedType=stream&titleImage=%2Ftemplates%2Fcoveritlive%2Fimages%2FbuildPage%2FNewsImage.jpg\" style=\"width:100%;height:550px\" height=\"550px\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "On Medi-Cal Now, Lose Your House Later?",
"title": "On Medi-Cal Now, Lose Your House Later?",
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"content": "\u003cfigure id=\"attachment_24679\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/3917552574_e407cd25e0_o-e1427240331570.jpg\">\u003cimg class=\"size-large wp-image-24679\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/3917552574_e407cd25e0_o-640x489.jpg\" alt=\"(Erik Soderstrom via Flickr)\" width=\"640\" height=\"489\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Erik Soderstrom via Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>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.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Many on Medi-Cal learning that the state can file a claim against their estate after they die.\u003c/aside>\n\u003cp>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.\u003c/p>\n\u003cp>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.\u003c!--more-->\u003c/p>\n\u003cp>Jarett's clients did not want to speak to reporters, but Jarett said they insisted their mother had not been to the doctor in years and had even died at home. Jarett said the charges included a breakdown by month of the state's payments to a managed care plan as part of Medi-Cal.\u003c/p>\n\u003cp>While federal law mandates that states recover for nursing home care, the law makes it optional that states recover for medical services -- doctor visits, hospital stays and the like -- for people 55 and over. Advocates say most states do not do this optional recovery, but California does.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It's an awful system, and it needs to be changed. It absolutely needs to be changed,\" said Pat McGinnis, executive director of California Advocates for Nursing Home Reform. Her group is sponsoring a bill, \u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0001-0050/sb_33_bill_20141201_introduced.html\" target=\"_blank\">SB33\u003c/a>, introduced by state Sen. Ed Hernandez (D-West Covina), that would abolish this optional recovery. The bill will be heard by the Senate Health Committee on Wednesday.\u003c/p>\n\u003cp>Last year, a similar bill \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/25/for-some-medi-cal-might-mean-ultimately-losing-their-homes-estate-recovery/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/25/for-some-medi-cal-might-mean-ultimately-losing-their-homes-estate-recovery/\" target=\"_blank\">sailed through the Legislature\u003c/a>, but was ultimately vetoed by Gov. Jerry Brown. Still, in a statement last September when he vetoed the bill, Brown left an opening. He said estate protection might be a \"reasonable policy goal,\" but that the cost \"needs to considered alongside other worthwhile policy changes.\"\u003c/p>\n\u003cp>Figuring out that cost is a challenge. In 2013-14, the state recovered $61 million in 3,900 cases, said Carol Sloan with the Department of Health Care Services. But the state does not break down how much of that $61 million is for nursing home care and how much of it is for medical services.\u003c/p>\n\u003cp>For perspective, $17.8 billion in state general fund dollars went to Medi-Cal last year. The total budget for Medi-Cal is significantly more than that after adding in federal dollars, various taxes and more -- $85.7 billion.\u003c/p>\n\u003cp>\u003cstrong>'Leery' of Medi-Cal\u003c/strong>\u003c/p>\n\u003cp>Like the attorney Jarett, Anne-Louise Vernon, 60, of Campbell, had never heard of estate recovery. She had been \"so looking forward,\" she says, to signing up for insurance under the Affordable Care Act. Her income was so low that she did not qualify for subsidies to purchase insurance on the Covered California marketplace. Instead, she qualified for Medi-Cal.\u003c/p>\n\u003cp>Vernon said she was \"leery,\" and asked if there were strings attached. \"I was told, 'No, no, it's completely free.'\" She said it was some time later, when she was looking around online, that she found a reference on an FAQ page about assets being seized. She was furious.\u003c/p>\n\u003cp>\"So you're breaking the law if you don't have health insurance,\" Vernon said, in reference to Obamacare's \"individual mandate\" that everyone have health insurance, and then she was \"force(d) into Medi-Cal; they don't tell people it's a loan.\"\u003c/p>\n\u003cp>Vernon held onto her home years ago after a divorce, but said she was \"involuntarily retired\" and has been living on savings. She knows she could shelter her home but doesn't want to take that step. \"I'm 60! I'm not going to sign my house over to my kids at this age.\"\u003c/p>\n\u003cp>For other people, attorneys' fees to take the legal steps to shelter a property are a big issue. \"People who end up on Medi-Cal are poor people,\" said McGinnis. \"They usually have pretty poor houses, and they're the ones that usually cannot afford to pay an attorney $300-400 an hour.\"\u003c/p>\n\u003cp>\u003cstrong>'Collection Agency for the Feds'\u003c/strong>\u003c/p>\n\u003cp>Estate recovery has become a much bigger issue since the rollout of Obamacare started more than a year ago. Under the expansion of Medicaid, people earning up to 138 percent of the federal poverty level are eligible (in states like California that are participating in the expansion). But for those people, 100 percent of the cost of their health coverage is borne by the federal government for the first three years, drifting down to 90 percent after that, and any recovered money would be returned to the federal government.\u003c/p>\n\u003cp>\"What are we? A collection agency for the feds?\" asked McGinnis, who also says CANHR is hearing from consumers who will disenroll from Medi-Cal if the policy has not changed. Other advocates believe the policy is a barrier to enrollment for some people.\u003c/p>\n\u003cp>For now, Vernon is staying on Medi-Cal. Like 80 percent of Medi-Cal beneficiaries in California, she is enrolled in a managed care plan. When she wanted to know what her Medi-Cal coverage cost, she spent \"hours and hours on the phone\" calling both her managed care plan and the state, she says, and got the runaround from both of them. No one could tell her what her coverage cost.\u003c/p>\n\u003cp>Finally, an advocate sent her a link to the exact page on a state website where she could find out how to file a request for information -- with a $25 fee. She finally got an answer: $578.71 a month. If she stays on Medi-Cal for another five years until she's 65, when she becomes eligible for Medicare, the state will have paid almost $35,000 for her managed care premium. After she dies, the state could bill her estate for that amount -- or more, if she continues on Medi-Cal.\u003c/p>\n\u003cp>Ironically, if Vernon, and others like her, earned just a bit more money, they would qualify for heavily subsidized private insurance through the Covered California exchange. The state estimates that the \"per member per month\" premium for those\u003ca href=\"http://www.dhcs.ca.gov/dataandstats/reports/mcestimates/Documents/2014_May_Estimate/M1407_Regular_PC_Tab.pdf\" target=\"_blank\"> newly eligible for Medi-Cal is $620.98\u003c/a>, or nearly $75,000 over 10 years.\u003c/p>\n\u003cp>Vernon plugged her age and Zip code into the Covered California insurance calculator, but increased her income to $17,000 to see what would happen.\u003c/p>\n\u003cp>She found she could get a plan for as little as $31 a month, \"estate recovery free,\" she noted. These plans come with a $2,250 out-of-pocket limit, but even if a 55-year-old maxed that out every year, the 10-year total of deductible plus premium is $26,220 -- about $50,000 less than what would be accrued on average on Medi-Cal, with no estate recovery.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Sally Schilling, a student at the UC Berkeley Graduate School of Journalism produced this piece about estate recovery which aired Tuesday on PBS NewsHour:\u003c/em>\u003c/p>\n\u003cdiv>\u003ca class=\"embedly-card\" href=\"https://www.youtube.com/watch?v=WsARJYhzmKE\">The Medicaid bill that doesn't go away when you die\u003c/a>\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>\u003cem>\u003cstrong>Update:\u003c/strong> This post has been updated to reflect the amount for the average newly-eligible person to Medi-Cal. It is $620.98 per month. \u003c/em>\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24679\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/3917552574_e407cd25e0_o-e1427240331570.jpg\">\u003cimg class=\"size-large wp-image-24679\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/3917552574_e407cd25e0_o-640x489.jpg\" alt=\"(Erik Soderstrom via Flickr)\" width=\"640\" height=\"489\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Erik Soderstrom via Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>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.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Many on Medi-Cal learning that the state can file a claim against their estate after they die.\u003c/aside>\n\u003cp>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.\u003c/p>\n\u003cp>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.\u003c!--more-->\u003c/p>\n\u003cp>Jarett's clients did not want to speak to reporters, but Jarett said they insisted their mother had not been to the doctor in years and had even died at home. Jarett said the charges included a breakdown by month of the state's payments to a managed care plan as part of Medi-Cal.\u003c/p>\n\u003cp>While federal law mandates that states recover for nursing home care, the law makes it optional that states recover for medical services -- doctor visits, hospital stays and the like -- for people 55 and over. Advocates say most states do not do this optional recovery, but California does.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It's an awful system, and it needs to be changed. It absolutely needs to be changed,\" said Pat McGinnis, executive director of California Advocates for Nursing Home Reform. Her group is sponsoring a bill, \u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0001-0050/sb_33_bill_20141201_introduced.html\" target=\"_blank\">SB33\u003c/a>, introduced by state Sen. Ed Hernandez (D-West Covina), that would abolish this optional recovery. The bill will be heard by the Senate Health Committee on Wednesday.\u003c/p>\n\u003cp>Last year, a similar bill \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/25/for-some-medi-cal-might-mean-ultimately-losing-their-homes-estate-recovery/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/25/for-some-medi-cal-might-mean-ultimately-losing-their-homes-estate-recovery/\" target=\"_blank\">sailed through the Legislature\u003c/a>, but was ultimately vetoed by Gov. Jerry Brown. Still, in a statement last September when he vetoed the bill, Brown left an opening. He said estate protection might be a \"reasonable policy goal,\" but that the cost \"needs to considered alongside other worthwhile policy changes.\"\u003c/p>\n\u003cp>Figuring out that cost is a challenge. In 2013-14, the state recovered $61 million in 3,900 cases, said Carol Sloan with the Department of Health Care Services. But the state does not break down how much of that $61 million is for nursing home care and how much of it is for medical services.\u003c/p>\n\u003cp>For perspective, $17.8 billion in state general fund dollars went to Medi-Cal last year. The total budget for Medi-Cal is significantly more than that after adding in federal dollars, various taxes and more -- $85.7 billion.\u003c/p>\n\u003cp>\u003cstrong>'Leery' of Medi-Cal\u003c/strong>\u003c/p>\n\u003cp>Like the attorney Jarett, Anne-Louise Vernon, 60, of Campbell, had never heard of estate recovery. She had been \"so looking forward,\" she says, to signing up for insurance under the Affordable Care Act. Her income was so low that she did not qualify for subsidies to purchase insurance on the Covered California marketplace. Instead, she qualified for Medi-Cal.\u003c/p>\n\u003cp>Vernon said she was \"leery,\" and asked if there were strings attached. \"I was told, 'No, no, it's completely free.'\" She said it was some time later, when she was looking around online, that she found a reference on an FAQ page about assets being seized. She was furious.\u003c/p>\n\u003cp>\"So you're breaking the law if you don't have health insurance,\" Vernon said, in reference to Obamacare's \"individual mandate\" that everyone have health insurance, and then she was \"force(d) into Medi-Cal; they don't tell people it's a loan.\"\u003c/p>\n\u003cp>Vernon held onto her home years ago after a divorce, but said she was \"involuntarily retired\" and has been living on savings. She knows she could shelter her home but doesn't want to take that step. \"I'm 60! I'm not going to sign my house over to my kids at this age.\"\u003c/p>\n\u003cp>For other people, attorneys' fees to take the legal steps to shelter a property are a big issue. \"People who end up on Medi-Cal are poor people,\" said McGinnis. \"They usually have pretty poor houses, and they're the ones that usually cannot afford to pay an attorney $300-400 an hour.\"\u003c/p>\n\u003cp>\u003cstrong>'Collection Agency for the Feds'\u003c/strong>\u003c/p>\n\u003cp>Estate recovery has become a much bigger issue since the rollout of Obamacare started more than a year ago. Under the expansion of Medicaid, people earning up to 138 percent of the federal poverty level are eligible (in states like California that are participating in the expansion). But for those people, 100 percent of the cost of their health coverage is borne by the federal government for the first three years, drifting down to 90 percent after that, and any recovered money would be returned to the federal government.\u003c/p>\n\u003cp>\"What are we? A collection agency for the feds?\" asked McGinnis, who also says CANHR is hearing from consumers who will disenroll from Medi-Cal if the policy has not changed. Other advocates believe the policy is a barrier to enrollment for some people.\u003c/p>\n\u003cp>For now, Vernon is staying on Medi-Cal. Like 80 percent of Medi-Cal beneficiaries in California, she is enrolled in a managed care plan. When she wanted to know what her Medi-Cal coverage cost, she spent \"hours and hours on the phone\" calling both her managed care plan and the state, she says, and got the runaround from both of them. No one could tell her what her coverage cost.\u003c/p>\n\u003cp>Finally, an advocate sent her a link to the exact page on a state website where she could find out how to file a request for information -- with a $25 fee. She finally got an answer: $578.71 a month. If she stays on Medi-Cal for another five years until she's 65, when she becomes eligible for Medicare, the state will have paid almost $35,000 for her managed care premium. After she dies, the state could bill her estate for that amount -- or more, if she continues on Medi-Cal.\u003c/p>\n\u003cp>Ironically, if Vernon, and others like her, earned just a bit more money, they would qualify for heavily subsidized private insurance through the Covered California exchange. The state estimates that the \"per member per month\" premium for those\u003ca href=\"http://www.dhcs.ca.gov/dataandstats/reports/mcestimates/Documents/2014_May_Estimate/M1407_Regular_PC_Tab.pdf\" target=\"_blank\"> newly eligible for Medi-Cal is $620.98\u003c/a>, or nearly $75,000 over 10 years.\u003c/p>\n\u003cp>Vernon plugged her age and Zip code into the Covered California insurance calculator, but increased her income to $17,000 to see what would happen.\u003c/p>\n\u003cp>She found she could get a plan for as little as $31 a month, \"estate recovery free,\" she noted. These plans come with a $2,250 out-of-pocket limit, but even if a 55-year-old maxed that out every year, the 10-year total of deductible plus premium is $26,220 -- about $50,000 less than what would be accrued on average on Medi-Cal, with no estate recovery.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Sally Schilling, a student at the UC Berkeley Graduate School of Journalism produced this piece about estate recovery which aired Tuesday on PBS NewsHour:\u003c/em>\u003c/p>\n\u003cdiv>\u003ca class=\"embedly-card\" href=\"https://www.youtube.com/watch?v=WsARJYhzmKE\">The Medicaid bill that doesn't go away when you die\u003c/a>\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>\u003cem>\u003cstrong>Update:\u003c/strong> This post has been updated to reflect the amount for the average newly-eligible person to Medi-Cal. It is $620.98 per month. \u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"tagline": "The flip side of gentrification, told through one town",
"info": "Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?",
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"tagline": "Exploring the Bay Area, one question at a time",
"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
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"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
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"order": 8
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},
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"source": "Commonwealth Club of California"
},
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"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
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"order": 9
},
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"hidden-brain": {
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"airtime": "SUN 7:30pm-8pm",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"order": 18
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"id": "latino-usa",
"title": "Latino USA",
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"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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