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"content": "\u003cfigure id=\"attachment_19598\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/187909352.jpg\">\u003cimg class=\"size-large wp-image-19598\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/187909352-640x426.jpg\" alt=\"Covered California executive director Peter Lee, seen here at a November, 2013, press conference. (Max Whittaker/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Covered California executive director Peter Lee, seen here at a November, 2013, press conference. (Max Whittaker/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>UPDATE: June 20\u003c/strong>\u003c/p>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">KQED's April Dembosky attended the Covered California board meeting Thursday afternoon where the board expressed concern \u003cspan class=\"Apple-style-span\">that a voter initiative on the upcoming November ballot could compromise its authority. The initiative\u003c/span>\u003c/span> would give the state’s insurance commissioner the authority to reject excessive rate increases in health insurance premiums. But Covered California already negotiates rates with insurance plans. How would the initiative, if passed, affect Covered California?\u003c/p>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">Covered California board member Susan Kennedy called on agency staff to conduct an intensive analysis of the initiative’s potential impact Covered California's ability to operate -- and to get it done soon.\u003cbr>\n\u003c/span>\u003c!--more-->\u003c/p>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\"The impact from my perspective could be, really huge, and very negative on our ability to function. We ought to raise the alarm level on this and be much more aggressive,\" Kennedy said.\u003c/span>\u003c/p>\n\u003cp>The board also questioned its ability to meet federal Obamacare deadlines and effectively market plans if rates are caught up in a review process at the Department of Insurance. A coalition of health plans, hospitals and other health care organizations have organized to defeat the measure.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">Julianne Broyles of the California Association of Health Underwriters said it could be problematic if rates aren’t finalized by the time the marketplace opens in mid November.\u003c/span>\u003c/p>\n\u003cp>\"Anything that delays open enrollment, technological or rate review, will create chaos for consumers,\" Broyles said.\u003c/p>\n\u003cp>Proponents of the measure insist fears are overblown.\u003c/p>\n\u003cp>Jamie Court of the nonprofit Consumer Watchdog, which sponsored the initiative, said the ballot measure would bring the process of regulating rates into the public eye.\u003c/p>\n\u003cp>\"The difference between rate regulation and rate negotiation is transparency. And all negotiations for Covered California over rates are done in secret,\" Court said.\u003c/p>\n\u003cp>He said if voters pass the measure, health insurance companies would have to justify their rates to the public and swear under penalty of perjury what they say is true. And he says that will be key in preventing premiums from becoming increasingly unaffordable.\u003c/p>\n\u003cp>\u003cstrong>Original post:\u003c/strong>\u003c/p>\n\u003cp>Ahead of its \u003ca href=\"http://board.coveredca.com/meetings/2014/6-19/PDFs/Agenda%20(Open)%20-%20June%202014%20Board%20Meeting_Public.pdf\" target=\"_blank\">board meeting\u003c/a> Thursday, Covered California officials are raising questions -- literally -- about a November ballot initiative that some say could destabilize the state's health insurance marketplace.\u003c/p>\n\u003cp>If approved by voters the \u003ca href=\"http://www.sos.ca.gov/elections/ballot-measures/qualified-ballot-measures.htm\" target=\"_blank\">Insurance Rate Public Justification and Accountability Act\u003c/a> would give California's insurance commissioner the authority to reject excessive health insurance premium increases. While this idea likely sounds good to consumers, there are concerns that such authority could destabilize Covered California.\u003c/p>\n\u003cp>On Wednesday, Covered California released \u003ca href=\"http://board.coveredca.com/meetings/2014/6-19/PDFs/Insurance%20Rate%20Public%20Justification%20and%20Accountability%20Act%20-%20Operational%20Questions%20Outline.pdf\" target=\"_blank\">an outline of more than three dozen questions\u003c/a> it will analyze. Among the many unknowns: a rate challenge could mean open enrollment would start without finalized premiums.\u003c/p>\n\u003cp>In Covered California's \"\u003ca href=\"http://board.coveredca.com/meetings/2014/6-19/PDFs/Insurance%20Rate%20Public%20Justification%20and%20Accountability%20Act%20-%20Operational%20Questions%20Outline.pdf\" target=\"_blank\">Potential Operational Questions Outline\u003c/a>\" are references to the \"tightly choreographed sequence\" the agency must follow to meet the open enrollment deadline. \"Under the current timelines, there is very little flexibility in the event there are major delays\" -- delays presumably referring to challenges to rate increases.\u003c/p>\n\u003cp>Betsy Imholz is with Consumers Union in San Francisco. She noted that Consumers Union generally supports the kind of rate review proposed in the ballot initiative, but said the group has not yet taken a position on the California initiative.\u003c/p>\n\u003cp>\"The questions are fair,\" Imholz said. \"I think we all have to look at the questions and think about both the underlying policy issues and the operational issues. This is a unique situation we have here, and those questions have to be considered.\"\u003c/p>\n\u003cp>California already has a complicated regulatory health insurance environment, with two regulators governing health insurance products: the Department of Managed Health Care and the Department of Insurance.\u003c/p>\n\u003cp>In addition, the state law that governs Covered California mandates that the agency is an \"active purchaser.\" Covered California has \"statutory responsibility to negotiate with the (health) plans,\" Imholz said, \"to selectively choose the best plans and get the best rates for Californians ... and that makes analyzing (the ballot initiative) a little more complicated.\"\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"j00e1jF7KYyWzdH7BjJKFX9oTR3NYdYH\"]\u003c/p>\n\u003cp>Proponents of the initiative say concerns are overblown and that consumers would benefit if the insurance commissioner had veto power over health insurance rates. Proposition 103, passed by the voters in 1988, already gives the commissioner veto authority over auto, homeowner, property and casualty insurance. The November initiative would extend Prop. 103 to health insurance.\u003c/p>\n\u003cp>Dave Jones, California's insurance commissioner supports the initiative. When he was a state legislator, he tried more than once to pass a law giving the officeholder the authority to reject rates, and \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/05/27/insurance-commissioner-defends-health-insurance-initiative/\" target=\"_blank\">frequently points out\u003c/a> that 35 states give their insurance commissioners the authority to reject health insurance rate hikes, but not California.\u003c/p>\n\u003cp>Jamie Court, president of Consumer Watchdog, which sponsored the initiative, said that \"other states have health insurance exchanges and other states have health insurance rate regulations.\" He insisted that \"there shouldn't be any concerns about timing,\" that rate rejection authority can work smoothly with Covered California's timeline. Rates must be approved within 60 days, he said, and that over the many years that Prop. 103 has been in effect, there have only been 10-15 hearings in \"an industry with 6,000 filings a year,\" Court said.\u003c/p>\n\u003cp>Jones has previously stated that his office gets only about \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/05/27/insurance-commissioner-defends-health-insurance-initiative/\" target=\"_blank\">100 health insurance rate filings \u003c/a>a year.\u003c/p>\n\u003cp>Court said he had sent a letter to Covered California offering to meet with officials and address their concerns. But \"they demurred,\" he said. \"We're looking forward to answering (the questions) because we can answer all of them.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Covered California will take public comment on the ballot initiative at its board meeting Thursday afternoon.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">Julianne Broyles of the California Association of Health Underwriters said it could be problematic if rates aren’t finalized by the time the marketplace opens in mid November.\u003c/span>\u003c/p>\n\u003cp>\"Anything that delays open enrollment, technological or rate review, will create chaos for consumers,\" Broyles said.\u003c/p>\n\u003cp>Proponents of the measure insist fears are overblown.\u003c/p>\n\u003cp>Jamie Court of the nonprofit Consumer Watchdog, which sponsored the initiative, said the ballot measure would bring the process of regulating rates into the public eye.\u003c/p>\n\u003cp>\"The difference between rate regulation and rate negotiation is transparency. And all negotiations for Covered California over rates are done in secret,\" Court said.\u003c/p>\n\u003cp>He said if voters pass the measure, health insurance companies would have to justify their rates to the public and swear under penalty of perjury what they say is true. And he says that will be key in preventing premiums from becoming increasingly unaffordable.\u003c/p>\n\u003cp>\u003cstrong>Original post:\u003c/strong>\u003c/p>\n\u003cp>Ahead of its \u003ca href=\"http://board.coveredca.com/meetings/2014/6-19/PDFs/Agenda%20(Open)%20-%20June%202014%20Board%20Meeting_Public.pdf\" target=\"_blank\">board meeting\u003c/a> Thursday, Covered California officials are raising questions -- literally -- about a November ballot initiative that some say could destabilize the state's health insurance marketplace.\u003c/p>\n\u003cp>If approved by voters the \u003ca href=\"http://www.sos.ca.gov/elections/ballot-measures/qualified-ballot-measures.htm\" target=\"_blank\">Insurance Rate Public Justification and Accountability Act\u003c/a> would give California's insurance commissioner the authority to reject excessive health insurance premium increases. While this idea likely sounds good to consumers, there are concerns that such authority could destabilize Covered California.\u003c/p>\n\u003cp>On Wednesday, Covered California released \u003ca href=\"http://board.coveredca.com/meetings/2014/6-19/PDFs/Insurance%20Rate%20Public%20Justification%20and%20Accountability%20Act%20-%20Operational%20Questions%20Outline.pdf\" target=\"_blank\">an outline of more than three dozen questions\u003c/a> it will analyze. Among the many unknowns: a rate challenge could mean open enrollment would start without finalized premiums.\u003c/p>\n\u003cp>In Covered California's \"\u003ca href=\"http://board.coveredca.com/meetings/2014/6-19/PDFs/Insurance%20Rate%20Public%20Justification%20and%20Accountability%20Act%20-%20Operational%20Questions%20Outline.pdf\" target=\"_blank\">Potential Operational Questions Outline\u003c/a>\" are references to the \"tightly choreographed sequence\" the agency must follow to meet the open enrollment deadline. \"Under the current timelines, there is very little flexibility in the event there are major delays\" -- delays presumably referring to challenges to rate increases.\u003c/p>\n\u003cp>Betsy Imholz is with Consumers Union in San Francisco. She noted that Consumers Union generally supports the kind of rate review proposed in the ballot initiative, but said the group has not yet taken a position on the California initiative.\u003c/p>\n\u003cp>\"The questions are fair,\" Imholz said. \"I think we all have to look at the questions and think about both the underlying policy issues and the operational issues. This is a unique situation we have here, and those questions have to be considered.\"\u003c/p>\n\u003cp>California already has a complicated regulatory health insurance environment, with two regulators governing health insurance products: the Department of Managed Health Care and the Department of Insurance.\u003c/p>\n\u003cp>In addition, the state law that governs Covered California mandates that the agency is an \"active purchaser.\" Covered California has \"statutory responsibility to negotiate with the (health) plans,\" Imholz said, \"to selectively choose the best plans and get the best rates for Californians ... and that makes analyzing (the ballot initiative) a little more complicated.\"\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"j00e1jF7KYyWzdH7BjJKFX9oTR3NYdYH\"]\u003c/p>\n\u003cp>Proponents of the initiative say concerns are overblown and that consumers would benefit if the insurance commissioner had veto power over health insurance rates. Proposition 103, passed by the voters in 1988, already gives the commissioner veto authority over auto, homeowner, property and casualty insurance. The November initiative would extend Prop. 103 to health insurance.\u003c/p>\n\u003cp>Dave Jones, California's insurance commissioner supports the initiative. When he was a state legislator, he tried more than once to pass a law giving the officeholder the authority to reject rates, and \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/05/27/insurance-commissioner-defends-health-insurance-initiative/\" target=\"_blank\">frequently points out\u003c/a> that 35 states give their insurance commissioners the authority to reject health insurance rate hikes, but not California.\u003c/p>\n\u003cp>Jamie Court, president of Consumer Watchdog, which sponsored the initiative, said that \"other states have health insurance exchanges and other states have health insurance rate regulations.\" He insisted that \"there shouldn't be any concerns about timing,\" that rate rejection authority can work smoothly with Covered California's timeline. Rates must be approved within 60 days, he said, and that over the many years that Prop. 103 has been in effect, there have only been 10-15 hearings in \"an industry with 6,000 filings a year,\" Court said.\u003c/p>\n\u003cp>Jones has previously stated that his office gets only about \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/05/27/insurance-commissioner-defends-health-insurance-initiative/\" target=\"_blank\">100 health insurance rate filings \u003c/a>a year.\u003c/p>\n\u003cp>Court said he had sent a letter to Covered California offering to meet with officials and address their concerns. But \"they demurred,\" he said. \"We're looking forward to answering (the questions) because we can answer all of them.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Covered California will take public comment on the ballot initiative at its board meeting Thursday afternoon.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_19592\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Ginger-Hina.jpg\">\u003cimg class=\"size-large wp-image-19592\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Ginger-Hina-640x374.jpg\" alt=\"Plaintiff Ginger Rogers with one of her attorneys, Hina Shaw, reviewing the complaint that was filed today against Kindred Healthcare and affiliates. (Photo: Sara Feldman)\" width=\"640\" height=\"374\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Plaintiff Ginger Rogers (right) with one of her attorneys, Hina Shaw, reviewing the complaint that was filed today against Kindred Healthcare and affiliates. (Photo: Sara Feldman)\u003c/figcaption>\u003c/figure>\n\u003cp>Professional caregivers filed a class action lawsuit in California Wednesday on behalf of hundreds of workers throughout the state. They say their employer, Kindred Healthcare and its affiliates, shorted them on wages, overtime, and breaks.\u003c/p>\n\u003cp>Ginger Rogers, a caregiver with 25 years experience, says Kindred Healthcare hired her in 2012 to look after a patient at a skilled nursing facility in Castro Valley, outside San Francisco. She says she asked her supervisor if she could leave her patient's bedside to take a lunch break. The supervisor told her no, adding that coffee breaks weren't allowed either, according to the complaint filed in Alameda Superior Court today.\u003c/p>\n\u003cp>“That’s illegal,” says Hina Shah, co-director of the Women’s Employment Rights Clinic at Golden Gate University, who is representing Rogers and the other plaintiffs. “The law mandates two 10-minute breaks and a 30-minute meal break for every five hours of work. But more importantly, the type of work that these caregivers are doing is physically and mentally demanding, and to require someone to work 12-hour shifts without any kind of break is very detrimental to their health and is onerous.”\u003c!--more-->\u003c/p>\n\u003cp>The lawsuit also alleges the way these workers get paid violates the law, too. Shah says Kindred Healthcare pays its caregivers a flat sum for a 12-hour shift or a 24-hour shift. For some workers, that comes out to $5.83 an hour, “well below the minimum wage,” Shah says.\u003c/p>\n\u003cp>She added that these pay policies also denied workers overtime pay they were entitled to. Caregivers who work in nursing homes or assisted living facilities in California are entitled to time-and-a-half pay for every hour worked more than 8 in a day, and more than 40 in a week. But when Emma Delores Hawkins asked her supervisor for overtime pay, the supervisor responded, “We don’t have overtime.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Kindred Healthcare did not respond to requests for comment. The company is based in Kentucky and is one of the largest employers of direct care workers across the country. This is not the first labor lawsuit filed against the company –- nurses and other health workers have sued Kindred in the past for alleged wage and hour violations.\u003c/p>\n\u003cp>Wednesday’s lawsuit was filed on behalf of several hundred current and former caregivers who worked for Kindred Healthcare in California. They are represented by Shah’s clinic, the Legal Aid Society–Employment Law Center, and the Oakland law firm Lewis, Feinberg, Lee, Renaker & Jackson.\u003c/p>\n\u003cp>Shah says she and the other plaintiffs’ attorneys hope the lawsuit will set a new industry-wide standard for the way caregivers are compensated across the country.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We really hope this will send a signal,” she says.”Quality care really cannot come at the expense of these employees' basic rights to be paid for all hours worked.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19592\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Ginger-Hina.jpg\">\u003cimg class=\"size-large wp-image-19592\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Ginger-Hina-640x374.jpg\" alt=\"Plaintiff Ginger Rogers with one of her attorneys, Hina Shaw, reviewing the complaint that was filed today against Kindred Healthcare and affiliates. (Photo: Sara Feldman)\" width=\"640\" height=\"374\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Plaintiff Ginger Rogers (right) with one of her attorneys, Hina Shaw, reviewing the complaint that was filed today against Kindred Healthcare and affiliates. (Photo: Sara Feldman)\u003c/figcaption>\u003c/figure>\n\u003cp>Professional caregivers filed a class action lawsuit in California Wednesday on behalf of hundreds of workers throughout the state. They say their employer, Kindred Healthcare and its affiliates, shorted them on wages, overtime, and breaks.\u003c/p>\n\u003cp>Ginger Rogers, a caregiver with 25 years experience, says Kindred Healthcare hired her in 2012 to look after a patient at a skilled nursing facility in Castro Valley, outside San Francisco. She says she asked her supervisor if she could leave her patient's bedside to take a lunch break. The supervisor told her no, adding that coffee breaks weren't allowed either, according to the complaint filed in Alameda Superior Court today.\u003c/p>\n\u003cp>“That’s illegal,” says Hina Shah, co-director of the Women’s Employment Rights Clinic at Golden Gate University, who is representing Rogers and the other plaintiffs. “The law mandates two 10-minute breaks and a 30-minute meal break for every five hours of work. But more importantly, the type of work that these caregivers are doing is physically and mentally demanding, and to require someone to work 12-hour shifts without any kind of break is very detrimental to their health and is onerous.”\u003c!--more-->\u003c/p>\n\u003cp>The lawsuit also alleges the way these workers get paid violates the law, too. Shah says Kindred Healthcare pays its caregivers a flat sum for a 12-hour shift or a 24-hour shift. For some workers, that comes out to $5.83 an hour, “well below the minimum wage,” Shah says.\u003c/p>\n\u003cp>She added that these pay policies also denied workers overtime pay they were entitled to. Caregivers who work in nursing homes or assisted living facilities in California are entitled to time-and-a-half pay for every hour worked more than 8 in a day, and more than 40 in a week. But when Emma Delores Hawkins asked her supervisor for overtime pay, the supervisor responded, “We don’t have overtime.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Kindred Healthcare did not respond to requests for comment. The company is based in Kentucky and is one of the largest employers of direct care workers across the country. This is not the first labor lawsuit filed against the company –- nurses and other health workers have sued Kindred in the past for alleged wage and hour violations.\u003c/p>\n\u003cp>Wednesday’s lawsuit was filed on behalf of several hundred current and former caregivers who worked for Kindred Healthcare in California. They are represented by Shah’s clinic, the Legal Aid Society–Employment Law Center, and the Oakland law firm Lewis, Feinberg, Lee, Renaker & Jackson.\u003c/p>\n\u003cp>Shah says she and the other plaintiffs’ attorneys hope the lawsuit will set a new industry-wide standard for the way caregivers are compensated across the country.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We really hope this will send a signal,” she says.”Quality care really cannot come at the expense of these employees' basic rights to be paid for all hours worked.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_11293\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-e1398800357429.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11293\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-e1398800357429.jpg\" alt=\"(KJM-427/Flickr)\" width=\"640\" height=\"426\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-e1398800357429.jpg 640w, https://cdn.kqed.org/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-e1398800357429-400x266.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-e1398800357429-320x213.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(KJM-427/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Fenit Nirappil,\u003c/strong> Associated Press\u003c/p>\n\u003cp>A bill that would have made California the first state in the nation to require warning labels on sodas and other sugary drinks was effectively killed Tuesday.\u003c/p>\n\u003cp>Sen. Bill Monning’s SB1000 failed on a 7-8 vote as his fellow Democratic lawmakers doubted whether a label would change consumer behavior. It needed 10 votes to pass.\u003c/p>\n\u003cp>Certain sodas, energy drinks and fruit drinks would have included a label reading, “STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.”\u003c!--more-->\u003c/p>\n\u003cp>It was developed by public health advocates using cigarette and alcohol warnings as a model. Representatives of the beverage industry argued that the bill was unfair by not applying to other foods and drinks, including lattes and chocolate milk.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Monning, of Carmel, says warning labels would be the most efficacious tool for educating people about the dangers of sugary drinks.\u003c/p>\n\u003cp>“Changing behavior is the hardest challenge in the world of medicine,” Monning told lawmakers before the vote. “But you can’t start to even make a commitment to make behavior change if you don’t have the information.”\u003c/p>\n\u003cp>His bill had support from the California Medical Association, the California Center for Public Health Advocacy and groups devoted to improving the health of minorities. A similar bill introduced in Vermont stalled this year.\u003c/p>\n\u003cp>Democratic Assemblyman Jimmy Gomez noted that cigarette warning labels were accompanied by taxes and prohibitions on smoking in public places before tobacco use plunged.\u003c/p>\n\u003cp>“It wasn’t necessarily the labels that changed peoples’ habits, but it was the other requirements,” said Gomez, who represents Los Angeles.\u003c/p>\n\u003cp>CalBev, the California arm of the American Beverage Association, says it posts calorie counts on the front of many beverage containers as part of a voluntary campaign that started in 2010.\u003c/p>\n\u003cp>Industry groups also say warning labels may conflict with an upcoming overhaul of the nutritional information labels regulated by the U.S. Food and Drug Administration.\u003c/p>\n\u003cp>Sugary drinks have been a target of public health advocates who see them as one of the biggest drivers of preventable diseases. Former New York City Mayor Michael Bloomberg pushed a ban on large servings of soft drinks in 2012. A court later struck down the ban after it prompted lawsuits and an aggressive campaign from businesses.\u003c/p>\n\u003cp>Leaders in San Francisco and Berkeley are considering sending measures imposing a sugary drink tax to voters in November after nearby Richmond rejected such a tax in 2012.\u003c/p>\n\u003cp>A children’s health group recently launched a “Sugar Bites” ad campaign in the east San Francisco Bay Area and state capital depicting sugary drinks as snarling monsters with sharp teeth held by anxious children.\u003c/p>\n\u003cp>Monning, who previously called for a soda tax, said he would keep pushing for warning labels.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=”lvwJaSqeu72Up5IvAZnJf2lYszI5UcLK”]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_11293\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-e1398800357429.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11293\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-e1398800357429.jpg\" alt=\"(KJM-427/Flickr)\" width=\"640\" height=\"426\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-e1398800357429.jpg 640w, https://cdn.kqed.org/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-e1398800357429-400x266.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-e1398800357429-320x213.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(KJM-427/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Fenit Nirappil,\u003c/strong> Associated Press\u003c/p>\n\u003cp>A bill that would have made California the first state in the nation to require warning labels on sodas and other sugary drinks was effectively killed Tuesday.\u003c/p>\n\u003cp>Sen. Bill Monning’s SB1000 failed on a 7-8 vote as his fellow Democratic lawmakers doubted whether a label would change consumer behavior. It needed 10 votes to pass.\u003c/p>\n\u003cp>Certain sodas, energy drinks and fruit drinks would have included a label reading, “STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.”\u003c!--more-->\u003c/p>\n\u003cp>It was developed by public health advocates using cigarette and alcohol warnings as a model. Representatives of the beverage industry argued that the bill was unfair by not applying to other foods and drinks, including lattes and chocolate milk.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Monning, of Carmel, says warning labels would be the most efficacious tool for educating people about the dangers of sugary drinks.\u003c/p>\n\u003cp>“Changing behavior is the hardest challenge in the world of medicine,” Monning told lawmakers before the vote. “But you can’t start to even make a commitment to make behavior change if you don’t have the information.”\u003c/p>\n\u003cp>His bill had support from the California Medical Association, the California Center for Public Health Advocacy and groups devoted to improving the health of minorities. A similar bill introduced in Vermont stalled this year.\u003c/p>\n\u003cp>Democratic Assemblyman Jimmy Gomez noted that cigarette warning labels were accompanied by taxes and prohibitions on smoking in public places before tobacco use plunged.\u003c/p>\n\u003cp>“It wasn’t necessarily the labels that changed peoples’ habits, but it was the other requirements,” said Gomez, who represents Los Angeles.\u003c/p>\n\u003cp>CalBev, the California arm of the American Beverage Association, says it posts calorie counts on the front of many beverage containers as part of a voluntary campaign that started in 2010.\u003c/p>\n\u003cp>Industry groups also say warning labels may conflict with an upcoming overhaul of the nutritional information labels regulated by the U.S. Food and Drug Administration.\u003c/p>\n\u003cp>Sugary drinks have been a target of public health advocates who see them as one of the biggest drivers of preventable diseases. Former New York City Mayor Michael Bloomberg pushed a ban on large servings of soft drinks in 2012. A court later struck down the ban after it prompted lawsuits and an aggressive campaign from businesses.\u003c/p>\n\u003cp>Leaders in San Francisco and Berkeley are considering sending measures imposing a sugary drink tax to voters in November after nearby Richmond rejected such a tax in 2012.\u003c/p>\n\u003cp>A children’s health group recently launched a “Sugar Bites” ad campaign in the east San Francisco Bay Area and state capital depicting sugary drinks as snarling monsters with sharp teeth held by anxious children.\u003c/p>\n\u003cp>Monning, who previously called for a soda tax, said he would keep pushing for warning labels.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=”lvwJaSqeu72Up5IvAZnJf2lYszI5UcLK”]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_19562\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10646_016-hpf.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-19562\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10646_016-hpf.jpg\" alt=\"Araceli eats fruit during a break following an exercise on healthy eating during a Centering Pregnancy group in San Francisco. (Deborah Svoboda/The World)\" width=\"640\" height=\"427\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2014/06/RS10646_016-hpf.jpg 640w, https://cdn.kqed.org/wp-content/uploads/sites/27/2014/06/RS10646_016-hpf-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2014/06/RS10646_016-hpf-320x214.jpg 320w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">During a Centering Pregnancy group prenatal appointment in San Francisco, Araceli (left) eats fruit following an exercise on healthy eating. (Deborah Svoboda/The World)\u003c/figcaption>\u003c/figure>\n\u003cp>Once a month, Irma Vásquez goes for prenatal check-ups at a clinic in San Francisco’s Mission District. But her appointment looks nothing like a doctor’s appointment. Instead of getting one-on-one care, she meets with 12 other Latina immigrants for a group visit.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Studies show group prenatal care leads to better birth outcomes.\u003c/aside>\n\u003cp>The women meet at a community clinic and first take their own blood pressure, weigh themselves, and write down the results. Then they take turns seeing a midwife in a makeshift exam area in the corner of the room. The midwife checks each baby’s heart rate and talks privately with each woman.\u003c/p>\n\u003cp>Afterward they all sit in a circle and talk — in Spanish — about everything from eating healthy to dealing with domestic problems at home. Finally, there’s group meditation. Vásquez says this is her favorite part.\u003c/p>\n\u003cp>“It clears your mind of all the things that are going on around you, going on outside,” she says in Spanish. “It makes you more relaxed.”\u003c!--more-->\u003c/p>\n\u003cp>Vásquez, who is from Mexico, says she’s under a lot stress. She lives in a cramped apartment with her husband and his entire family. The group appointments help.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Vásquez and the other women are a part of a prenatal care program known as \u003ca href=\"http://www.centeringhealthcare.org/pages/centering-model/pregnancy-overview.php\" target=\"_blank\">Centering Pregnancy\u003c/a>. Women with similar gestational ages meet, learn about self-care, and have facilitated group discussions.\u003c/p>\n\u003cp>\u003cstrong>Better Outcomes — for Mom and Baby\u003c/strong>\u003c/p>\n\u003cp>Studies show group prenatal care leads to better birth outcomes when compared against standard care. Women who do Centering Pregnancy are more likely to \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23855366\" target=\"_blank\">breastfeed\u003c/a>, at least initially, and attend prenatal care appointments. They’re less likely to have \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23445830\" target=\"_blank\">postpartum depression\u003c/a> and \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2276878/\" target=\"_blank\">preterm births\u003c/a>.\u003c/p>\n\u003cp>And there’s another benefit — Centering Pregnancy is linked to fewer caesarean sections — and that saves taxpayer Medicaid dollars. For California births without complications, it cost nearly \u003ca href=\"http://transform.childbirthconnection.org/wp-content/uploads/2013/01/Cost-of-Having-a-Baby-Executive-Summary.pdf\" target=\"_blank\">twice as much for c-sections than it does for vaginal births.\u003c/a>\u003c/p>\n\u003cp>Midwife Margy Hutchison started Centering Pregnancy at\u003ca href=\"http://obgyn.medschool.ucsf.edu/sfgh/clinics/our_clinics/ob/_centering.aspx\" target=\"_blank\"> San Francisco General Hospital \u003c/a>15 years ago — for people like Irma Vásquez. Hutchison noticed that many of her Latina immigrant patients suffered from chronic stress or depression.\u003c/p>\n\u003cp>“It was really clear to me that many of them were really struggling,” Hutchison says. “And patients I continue to see are struggling with the impact of social isolation.”\u003c/p>\n\u003cp>Hutchison says she would see these Latina immigrants sitting alone and silent in the hospital’s waiting rooms. She wanted to connect them.\u003c/p>\n\u003cp>“Experience has shown me certainly that this group of people benefit tremendously from being in group prenatal care,” Hutchison says.\u003c/p>\n\u003cp>Hutchison says many of these women were suffering from stress, social isolation or depression — which are all linked to \u003ca href=\"http://www.google.com/url?q=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpubmed%2F21890014&sa=D&sntz=1&usg=AFQjCNHt2_6HbogfWvS07gsYcmq2kDyI_Q\" target=\"_blank\">preterm births\u003c/a>, \u003ca href=\"http://www.ajog.org/article/0002-9378(93)90016-C/abstract\" target=\"_blank\">low birth weight\u003c/a>, and damage to children’s \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/18049295\" target=\"_blank\">cognitive skills\u003c/a>. But it was hard to convince the women to do group prenatal care at first.\u003c/p>\n\u003cp>“If a woman’s depressed that may be the last thing she wants to do,” Hutchison says. “She wants to curl up in a ball and stay home.”\u003c/p>\n\u003cp>That was the case for Karent Novela, a Mexican immigrant who moved to San Francisco a year before she became pregnant. Novela didn’t speak English, and her only family here –her husband — works 12 hours a day. She was depressed and not in the mood to hang out with other women.\u003c/p>\n\u003cdiv>\u003ca class=\"embedly-card\" href=\"https://www.youtube.com/watch?v=3Mf3Oe45Uuk\">Centering Pregnancy: Outside-the-box prenatal care\u003c/a>\u003c/div>\n\u003cp>In addition, S.F. General’s Centering Pregnancy program is run by midwives, and that scared Novela. She had seen a midwife, one without medical credentials, back in Mexico a year earlier, and she had had a miscarriage. Now in the U.S., she wanted to see a doctor.\u003c/p>\n\u003cp>“When they told me about midwifes, my first thought was, ‘Midwives, that’s what we call in Mexico, parteras,’” says Novela. “Parteras are like the same in Mexico, but without any degrees or studies, just by their basic knowledge they deliver babies. So I just said, ‘No!’”\u003c/p>\n\u003cp>But the nurses at S.F. General were persistent. They assured her that their midwives are trained professionals.\u003c/p>\n\u003cp>“The nurse that was with me, she told me, ‘You might try it. If you like it, you can stay. If you don’t like it you can just keep coming to your appointments with your doctor. But you decide. It’s your decision.”\u003c/p>\n\u003cp>Novela signed up. She loved it.\u003c/p>\n\u003cp>“Having people who speak my language, and having people who are from my same background — like, they don’t have family — that changed me. It changed my life.”\u003c/p>\n\u003cp>\u003cstrong>Choosing Centering Pregnancy over Traditional Care\u003c/strong>\u003c/p>\n\u003cp>Novela isn’t alone. Most Latina midwifery patients at S.F. General are now choosing Centering Pregnancy over one-on-one care — and 95 percent of these women say they would do it again with future pregnancies. Internal hospital data show that Centering Pregnancy patients are more like to attend prenatal care appointments than midwifery patients who get traditional care.\u003c/p>\n\u003cp>Laurie Jurkiewicz is a midwife at S.F. General who runs Centering Pregnancy groups in Spanish. She says some U.S. hospitals hesitated at first to launch Centering Pregnancy programs — mostly because, like S.F. General, they weren’t set up for group prenatal care.\u003c/p>\n\u003cp>“It’s out-of-the box thinking, right?” says Jurkiewicz. “And so our struggle was we’d get a room, and we’d get kicked out of a room at the last minute, and the rooms weren’t very nice.”\u003c/p>\n\u003cp>S.F. General got the program off the ground by partnering with community clinics and using their space for these group appointments. Other hospitals are now doing the same or partnering with churches for meeting space.\u003c/p>\n\u003cfigure id=\"attachment_19572\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10640_010-hpf.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-19572\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10640_010-hpf-300x200.jpg\" alt=\"Laurie Jurkiewicz, a midwife from San Francisco General Hospital, monitors the baby's heartbeat during a Centering Pregnancy group appointment. (Deb Svoboda/The World)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Laurie Jurkiewicz, a midwife from San Francisco General Hospital, monitors the baby’s heartbeat during a Centering Pregnancy group appointment. (Deb Svoboda/The World)\u003c/figcaption>\u003c/figure>\n\u003cp>Jurkiewicz says the partnerships have allowed Centering Pregnancy to flourish at S.F. General. When they first created the program in 1999, it was the only one like it on the West Coast. Today, there are 21 Centering Pregnancy programs in California alone — mostly in California public hospitals where \u003ca href=\"http://caph.org/caphmemberhospitals/fastfacts/\" target=\"_blank\">nearly half the patients are Latino\u003c/a>. It’s also \u003ca href=\"https://centeringhealthcare.secure.force.com/WebPortal/LocateCenteringSitePage\" target=\"_blank\">growing nationwide\u003c/a>, especially among high-risk, low-income populations.\u003c/p>\n\u003cp>Karent Novela, the Mexican immigrant, says she’s built a community with the other Latina immigrants from her Centering Pregnancy group. They now call each other for support.\u003c/p>\n\u003cp>“They didn’t have family, they didn’t have friends, and most of them had their first baby like me,” says Novela. “So I just feel like, OK, I’m not the only one who is having these difficulties. I’m not the only one who is suffering for this. My way of seeing my situation changed. So I start to change.”\u003c/p>\n\u003cp>Novela says Centering Pregnancy shook things up in her life and pulled her out of her out of her depression. And that, she says, empowered her to be a better mom.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Clarification: The open in the radio piece above suggests that Centering Pregnancy was founded at S.F. General Hospital. But S.F. General was the first hospital on the west coast to offer the program.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19562\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10646_016-hpf.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-19562\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10646_016-hpf.jpg\" alt=\"Araceli eats fruit during a break following an exercise on healthy eating during a Centering Pregnancy group in San Francisco. (Deborah Svoboda/The World)\" width=\"640\" height=\"427\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2014/06/RS10646_016-hpf.jpg 640w, https://cdn.kqed.org/wp-content/uploads/sites/27/2014/06/RS10646_016-hpf-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2014/06/RS10646_016-hpf-320x214.jpg 320w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">During a Centering Pregnancy group prenatal appointment in San Francisco, Araceli (left) eats fruit following an exercise on healthy eating. (Deborah Svoboda/The World)\u003c/figcaption>\u003c/figure>\n\u003cp>Once a month, Irma Vásquez goes for prenatal check-ups at a clinic in San Francisco’s Mission District. But her appointment looks nothing like a doctor’s appointment. Instead of getting one-on-one care, she meets with 12 other Latina immigrants for a group visit.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Studies show group prenatal care leads to better birth outcomes.\u003c/aside>\n\u003cp>The women meet at a community clinic and first take their own blood pressure, weigh themselves, and write down the results. Then they take turns seeing a midwife in a makeshift exam area in the corner of the room. The midwife checks each baby’s heart rate and talks privately with each woman.\u003c/p>\n\u003cp>Afterward they all sit in a circle and talk — in Spanish — about everything from eating healthy to dealing with domestic problems at home. Finally, there’s group meditation. Vásquez says this is her favorite part.\u003c/p>\n\u003cp>“It clears your mind of all the things that are going on around you, going on outside,” she says in Spanish. “It makes you more relaxed.”\u003c!--more-->\u003c/p>\n\u003cp>Vásquez, who is from Mexico, says she’s under a lot stress. She lives in a cramped apartment with her husband and his entire family. The group appointments help.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Vásquez and the other women are a part of a prenatal care program known as \u003ca href=\"http://www.centeringhealthcare.org/pages/centering-model/pregnancy-overview.php\" target=\"_blank\">Centering Pregnancy\u003c/a>. Women with similar gestational ages meet, learn about self-care, and have facilitated group discussions.\u003c/p>\n\u003cp>\u003cstrong>Better Outcomes — for Mom and Baby\u003c/strong>\u003c/p>\n\u003cp>Studies show group prenatal care leads to better birth outcomes when compared against standard care. Women who do Centering Pregnancy are more likely to \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23855366\" target=\"_blank\">breastfeed\u003c/a>, at least initially, and attend prenatal care appointments. They’re less likely to have \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23445830\" target=\"_blank\">postpartum depression\u003c/a> and \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2276878/\" target=\"_blank\">preterm births\u003c/a>.\u003c/p>\n\u003cp>And there’s another benefit — Centering Pregnancy is linked to fewer caesarean sections — and that saves taxpayer Medicaid dollars. For California births without complications, it cost nearly \u003ca href=\"http://transform.childbirthconnection.org/wp-content/uploads/2013/01/Cost-of-Having-a-Baby-Executive-Summary.pdf\" target=\"_blank\">twice as much for c-sections than it does for vaginal births.\u003c/a>\u003c/p>\n\u003cp>Midwife Margy Hutchison started Centering Pregnancy at\u003ca href=\"http://obgyn.medschool.ucsf.edu/sfgh/clinics/our_clinics/ob/_centering.aspx\" target=\"_blank\"> San Francisco General Hospital \u003c/a>15 years ago — for people like Irma Vásquez. Hutchison noticed that many of her Latina immigrant patients suffered from chronic stress or depression.\u003c/p>\n\u003cp>“It was really clear to me that many of them were really struggling,” Hutchison says. “And patients I continue to see are struggling with the impact of social isolation.”\u003c/p>\n\u003cp>Hutchison says she would see these Latina immigrants sitting alone and silent in the hospital’s waiting rooms. She wanted to connect them.\u003c/p>\n\u003cp>“Experience has shown me certainly that this group of people benefit tremendously from being in group prenatal care,” Hutchison says.\u003c/p>\n\u003cp>Hutchison says many of these women were suffering from stress, social isolation or depression — which are all linked to \u003ca href=\"http://www.google.com/url?q=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpubmed%2F21890014&sa=D&sntz=1&usg=AFQjCNHt2_6HbogfWvS07gsYcmq2kDyI_Q\" target=\"_blank\">preterm births\u003c/a>, \u003ca href=\"http://www.ajog.org/article/0002-9378(93)90016-C/abstract\" target=\"_blank\">low birth weight\u003c/a>, and damage to children’s \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/18049295\" target=\"_blank\">cognitive skills\u003c/a>. But it was hard to convince the women to do group prenatal care at first.\u003c/p>\n\u003cp>“If a woman’s depressed that may be the last thing she wants to do,” Hutchison says. “She wants to curl up in a ball and stay home.”\u003c/p>\n\u003cp>That was the case for Karent Novela, a Mexican immigrant who moved to San Francisco a year before she became pregnant. Novela didn’t speak English, and her only family here –her husband — works 12 hours a day. She was depressed and not in the mood to hang out with other women.\u003c/p>\n\u003cdiv>\u003ca class=\"embedly-card\" href=\"https://www.youtube.com/watch?v=3Mf3Oe45Uuk\">Centering Pregnancy: Outside-the-box prenatal care\u003c/a>\u003c/div>\n\u003cp>In addition, S.F. General’s Centering Pregnancy program is run by midwives, and that scared Novela. She had seen a midwife, one without medical credentials, back in Mexico a year earlier, and she had had a miscarriage. Now in the U.S., she wanted to see a doctor.\u003c/p>\n\u003cp>“When they told me about midwifes, my first thought was, ‘Midwives, that’s what we call in Mexico, parteras,’” says Novela. “Parteras are like the same in Mexico, but without any degrees or studies, just by their basic knowledge they deliver babies. So I just said, ‘No!’”\u003c/p>\n\u003cp>But the nurses at S.F. General were persistent. They assured her that their midwives are trained professionals.\u003c/p>\n\u003cp>“The nurse that was with me, she told me, ‘You might try it. If you like it, you can stay. If you don’t like it you can just keep coming to your appointments with your doctor. But you decide. It’s your decision.”\u003c/p>\n\u003cp>Novela signed up. She loved it.\u003c/p>\n\u003cp>“Having people who speak my language, and having people who are from my same background — like, they don’t have family — that changed me. It changed my life.”\u003c/p>\n\u003cp>\u003cstrong>Choosing Centering Pregnancy over Traditional Care\u003c/strong>\u003c/p>\n\u003cp>Novela isn’t alone. Most Latina midwifery patients at S.F. General are now choosing Centering Pregnancy over one-on-one care — and 95 percent of these women say they would do it again with future pregnancies. Internal hospital data show that Centering Pregnancy patients are more like to attend prenatal care appointments than midwifery patients who get traditional care.\u003c/p>\n\u003cp>Laurie Jurkiewicz is a midwife at S.F. General who runs Centering Pregnancy groups in Spanish. She says some U.S. hospitals hesitated at first to launch Centering Pregnancy programs — mostly because, like S.F. General, they weren’t set up for group prenatal care.\u003c/p>\n\u003cp>“It’s out-of-the box thinking, right?” says Jurkiewicz. “And so our struggle was we’d get a room, and we’d get kicked out of a room at the last minute, and the rooms weren’t very nice.”\u003c/p>\n\u003cp>S.F. General got the program off the ground by partnering with community clinics and using their space for these group appointments. Other hospitals are now doing the same or partnering with churches for meeting space.\u003c/p>\n\u003cfigure id=\"attachment_19572\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10640_010-hpf.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-19572\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10640_010-hpf-300x200.jpg\" alt=\"Laurie Jurkiewicz, a midwife from San Francisco General Hospital, monitors the baby's heartbeat during a Centering Pregnancy group appointment. (Deb Svoboda/The World)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Laurie Jurkiewicz, a midwife from San Francisco General Hospital, monitors the baby’s heartbeat during a Centering Pregnancy group appointment. (Deb Svoboda/The World)\u003c/figcaption>\u003c/figure>\n\u003cp>Jurkiewicz says the partnerships have allowed Centering Pregnancy to flourish at S.F. General. When they first created the program in 1999, it was the only one like it on the West Coast. Today, there are 21 Centering Pregnancy programs in California alone — mostly in California public hospitals where \u003ca href=\"http://caph.org/caphmemberhospitals/fastfacts/\" target=\"_blank\">nearly half the patients are Latino\u003c/a>. It’s also \u003ca href=\"https://centeringhealthcare.secure.force.com/WebPortal/LocateCenteringSitePage\" target=\"_blank\">growing nationwide\u003c/a>, especially among high-risk, low-income populations.\u003c/p>\n\u003cp>Karent Novela, the Mexican immigrant, says she’s built a community with the other Latina immigrants from her Centering Pregnancy group. They now call each other for support.\u003c/p>\n\u003cp>“They didn’t have family, they didn’t have friends, and most of them had their first baby like me,” says Novela. “So I just feel like, OK, I’m not the only one who is having these difficulties. I’m not the only one who is suffering for this. My way of seeing my situation changed. So I start to change.”\u003c/p>\n\u003cp>Novela says Centering Pregnancy shook things up in her life and pulled her out of her out of her depression. And that, she says, empowered her to be a better mom.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Clarification: The open in the radio piece above suggests that Centering Pregnancy was founded at S.F. General Hospital. But S.F. General was the first hospital on the west coast to offer the program.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "6 Questions About Contraceptives, the ACA, and the Supreme Court",
"title": "6 Questions About Contraceptives, the ACA, and the Supreme Court",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_19539\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/480530545-2.jpg\">\u003cimg class=\"size-large wp-image-19539\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/480530545-2-640x411.jpg\" alt=\"Customers entering a Hobby Lobby store in the San Francisco Bay Area community of Antioch. (Justin Sullivan/Getty Images).\" width=\"640\" height=\"411\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Customers entering a Hobby Lobby store in the San Francisco Bay Area community of Antioch. The owners of the company are evangelical Christians and object, on religious grounds, to providing certain types of birth control. (Justin Sullivan/Getty Images).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Julie Rovner,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/June/13/Supreme-Court-Hobby-Lobby-contraception-birth-control.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>One of the \u003ca href=\"http://www.kaiserhealthnews.org/stories/2014/march/20/supreme-court-arguments-contraception-mandate.aspx\" target=\"_blank\">most watched issues\u003c/a> before the Supreme Court this term may turn on the question of religious freedom. But it will also likely determine how women will be able to access a key provision of the Affordable Care Act – one seeking to guarantee no-cost prescription contraception in most health insurance plans.\u003c/p>\n\u003cp>The justices' ruling on \u003ca href=\"http://www.scotusblog.com/case-files/cases/sebelius-v-hobby-lobby-stores-inc/\" target=\"_blank\">Sebelius v. Hobby Lobby Stores\u003c/a> and \u003ca href=\"http://www.scotusblog.com/case-files/cases/conestoga-wood-specialties-corp-v-sebelius/\" target=\"_blank\">Conestoga Wood Specialties Corp v. Sebelius\u003c/a>, two cases that are being considered together, is expected by the end of this month. The court will decide whether those companies, and potentially all other for-profit companies, must abide by the so-called contraceptive mandate. It's a complicated legal thicket, so here is some background.\u003c/p>\n\u003cp>\u003cstrong>1. What is the contraceptive mandate?\u003c/strong>\u003c/p>\n\u003cp>The health law requires that most insurance plans provide preventive care services without out-of-pocket expense to beneficiaries. The Obama administration included all contraceptives approved by the Food and Drug Administration as part of a package of \u003ca href=\"http://www.hrsa.gov/womensguidelines/\" target=\"_blank\">preventive services for women\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Interestingly, for many plans,\u003ca href=\"http://www.npr.org/blogs/health/2012/02/10/146662285/rules-requiring-contraceptive-coverage-have-been-in-force-for-years\" target=\"_blank\"> this wasn't new\u003c/a>. The Equal Employment Opportunity Commission ruled in 2000 that failure of employer health insurance plans to cover contraceptives was a violation of the 1978 Pregnancy Discrimination Act. But the new mandate extends that coverage to all plans, including those in the individual and small group markets, and it requires that the plans offer a specific array of contraceptive options for no cost.\u003c/p>\n\u003cp>More than half the states have their own \"\u003ca href=\"http://www.nwlc.org/resource/contraceptive-equity-laws-your-state-know-your-rights-use-your-rights-consumer-guide-0\" target=\"_blank\">contraceptive equity\u003c/a>\" laws on the books, many of which include religious exemptions that are similar to ones included in the federal regulation.\u003c/p>\n\u003cp>\u003cstrong>2. Who must comply with the mandate?\u003c/strong>\u003c/p>\n\u003cp>Most plans are covered by the mandate, but the federal regulation includes several exceptions. Churches and other strictly religious employers, who primarily employ those of the same faith and whose primary purpose is religious, are exempt from the requirement.\u003c/p>\n\u003cp>Nonprofit, religiously affiliated organizations, such as hospitals and universities, have a \u003ca href=\"http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/womens-preven-02012013.html\" target=\"_blank\">separate set\u003c/a> of rules. They do not have to provide the contraceptives directly, but must make them available to employees through a third party. Catholic Church officials as well as some others have objected to this requirement. There are at least \u003ca href=\"http://www.nwlc.org/status-lawsuits-challenging-affordable-care-acts-birth-control-coverage-benefit\" target=\"_blank\">three dozen court cases\u003c/a> challenging those rules still pending, according to the National Women's Law Center.\u003c/p>\n\u003cp>For-profit companies, however, including the plaintiffs in the cases before the Supreme Court now, aren't exempt.\u003c/p>\n\u003cp>\u003cstrong>3. The owners of Hobby Lobby and Conestoga Wood are not Catholic and say they have no problem offering birth control. So what is their challenge to the mandate?\u003c/strong>\u003c/p>\n\u003cp>Most forms of artificial contraception are contrary to Catholic teaching. But the Green family, which owns the nationwide craft chain Hobby Lobby, are evangelical Christians. And the Hahn family that owns Pennsylvania cabinet-maker Conestoga Wood Specialties are Mennonites. Both families already offer most forms of birth control as part of their health plans.\u003c/p>\n\u003cp>The owners say they are opposed to some forms of birth control — particularly emergency contraceptives \u003ca href=\"http://ec.princeton.edu/pills/plan-b.html\" target=\"_blank\">Plan B\u003c/a> and \u003ca href=\"http://ec.princeton.edu/pills/ella.html\" target=\"_blank\">Ella\u003c/a>, which can be used to prevent pregnancy if taken within 24 hours to as much as five days after unprotected sex — because these contraceptives prevent a fertilized egg from implanting in a woman's uterus. That, they say, is tantamount to a very early abortion, which violates their religion, they argue. The Greens – but not the Hahns – also object to two types of intrauterine devices for the same reasons.\u003c/p>\n\u003cp>\"These abortion-causing pills go against our faith, and our family is now being forced to choose between following the laws of the land that we love or maintaining the religious beliefs that have made our business successful and supported our family and thousands of our employees and their families,\" Hobby Lobby founder David Green told reporters on a conference call when the lawsuit was originally filed.\u003c/p>\n\u003cp>\u003cstrong>4. Do those drugs and devices actually cause abortions?\u003c/strong>\u003c/p>\n\u003cp>Not according to the vast majority of medical and scientific opinion.\u003c/p>\n\u003cp>\"Federal law and State law – which do preclude funding for abortions – don't consider these particular forms of contraception to be abortion,\" said U.S. Solicitor General Donald Verilli during the oral arguments in the case on behalf of the Obama administration. \"We've got about 2 million women who rely on the IUD as a method of birth control in this country. I don't think they are engaged in abortion in doing that.\"\u003c/p>\n\u003cp>\u003ca href=\"http://sblog.s3.amazonaws.com/wp-content/uploads/2013/10/13-354-BRIEF-OF-AMICI-CURIAE-PHYSICIANS-FOR-REPRODUCTIVE-HEALTH-et-al....pdf\" target=\"_blank\">The brief\u003c/a> filed by 10 medical groups led by the American College of Obstetricians and Gynecologists noted that \"there is a scientific distinction between a contraceptive and an abortifacient and the scientific record demonstrates that none of the FDA-approved contraceptives covered by the Mandate are abortifacients.\"\u003c/p>\n\u003cp>That's because the standard medical definition of the \u003ca href=\"http://www.kaiserhealthnews.org/stories/2011/june/01/npr-abortion-legislation.aspx\" target=\"_blank\">start of pregnancy\u003c/a> is when a fertilized egg implants in a woman's uterus, not when sperm and egg first unite.\u003c/p>\n\u003cp>But while blocking implantation of a fertilized egg does not fit the medical definition of pregnancy, it does qualify as ending a life for many religious people.\u003c/p>\n\u003cp>\"As far as the science goes, the FDA has said these four drugs and devices can terminate a human embryo,\" said Lori Windham, senior counsel for the Becket Fund for Religious Liberty, which has been representing Hobby Lobby. She noted that the labels for the emergency contraceptives and IUDs say they can prevent implantation.\u003c/p>\n\u003cp>In the case of one and perhaps both of the emergency contraceptive pills, however, new research suggests they may not work that way at all – they much more likely \u003ca href=\"http://www.nytimes.com/2012/06/06/health/research/morning-after-pills-dont-block-implantation-science-suggests.html?pagewanted=all&_r=0\" target=\"_blank\">simply prevent the fertilization of the egg\u003c/a> in the first place.\u003c/p>\n\u003cp>\u003cstrong>5. Does whether these products cause abortion matter for purposes of this case?\u003c/strong>\u003c/p>\n\u003cp>Probably not. At the heart of the case is what the company owners believe, and no one doubts the sincerity of their views. At issue is whether the owners can exercise those religious objections via their corporations under a 1993 law called the \u003ca href=\"http://www.scotusblog.com/2014/02/symposium-why-is-rfra-still-valid-against-the-federal-government/\" target=\"_blank\">Religious Freedom Restoration Act\u003c/a> (RFRA). It says the government may not impose a \"substantial burden\" on the free exercise of religion unless that burden is the narrowest possible way to further a compelling governmental interest.\u003c/p>\n\u003cp>The federal government and advocates for the mandate say that corporations cannot exercise religious rights, only individuals may.\u003c/p>\n\u003cp>The \u003ca href=\"http://sblog.s3.amazonaws.com/wp-content/uploads/2014/01/01.12.14_brief_for_petitioners_doj.pdf\" target=\"_blank\">government's brief\u003c/a> in the case said Hobby Lobby and a subsidiary Christian book store, \"for-profit corporations conducting commercial enterprises, are not persons exercising religion within the meaning of RFRA.\"\u003c/p>\n\u003cp>\u003cstrong>6. What would happen if the court extended religious standing to for-profit corporations?\u003c/strong>\u003c/p>\n\u003cp>Lots of bad things, say those who are siding with the government in the case.\u003c/p>\n\u003cp>For example, said Barry Lynn, executive director of Americans United for Separation of Church and State, in health care alone, \"Scientology-believing employers could insist upon non-coverage of its nemesis, psychiatry. And Jehovah's' Witness corporations could demand exclusion of surgical coverage, under the theory that so many of such procedures require the use of whole blood products, forbidden by their faith.\"\u003c/p>\n\u003cp>The potential for using religion to escape the reach of federal law doesn't end with health, said Lynn. Corporations could also claim that they don't need to abide by equal pay laws \"because of male dominance in their scriptural social order,\" he said, or, for those who offer public accommodations, \"you can hear them say we don't believe marriage equality is biblical, so you, (gay and lesbian) travelers, cannot stay in our hotel or eat in our restaurant.\"\u003c/p>\n\u003cp>Windham of the Becket Fund finds all those scenarios far-fetched. \"We've had this law on the books for 25 years and none of those cases have happened,\" she said.\u003c/p>\n\u003cp>During the \u003ca href=\"http://www.supremecourt.gov/oral_arguments/argument_transcripts/13-354_5436.pdf\" target=\"_blank\">arguments before the Supreme Court\u003c/a>, Justice Samuel Alito said much the same thing. \"In all the years RFRA has been on the books,\" he asked, \"has any of these claims involving minimum wage, for example, been brought and have they succeeded?\"\u003c/p>\n\u003cp>\"Very few of these claims have been brought,\" responded Paul Clement, the attorney who argued Hobby Lobby's case at the high court.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Justice Elena Kagan, however, said if the court upholds Hobby Lobby's claim, that might change. \"[T]hen you would see religious objectors come out of the woodwork with respect to these laws,\" she said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19539\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/480530545-2.jpg\">\u003cimg class=\"size-large wp-image-19539\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/480530545-2-640x411.jpg\" alt=\"Customers entering a Hobby Lobby store in the San Francisco Bay Area community of Antioch. (Justin Sullivan/Getty Images).\" width=\"640\" height=\"411\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Customers entering a Hobby Lobby store in the San Francisco Bay Area community of Antioch. The owners of the company are evangelical Christians and object, on religious grounds, to providing certain types of birth control. (Justin Sullivan/Getty Images).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Julie Rovner,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/June/13/Supreme-Court-Hobby-Lobby-contraception-birth-control.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>One of the \u003ca href=\"http://www.kaiserhealthnews.org/stories/2014/march/20/supreme-court-arguments-contraception-mandate.aspx\" target=\"_blank\">most watched issues\u003c/a> before the Supreme Court this term may turn on the question of religious freedom. But it will also likely determine how women will be able to access a key provision of the Affordable Care Act – one seeking to guarantee no-cost prescription contraception in most health insurance plans.\u003c/p>\n\u003cp>The justices' ruling on \u003ca href=\"http://www.scotusblog.com/case-files/cases/sebelius-v-hobby-lobby-stores-inc/\" target=\"_blank\">Sebelius v. Hobby Lobby Stores\u003c/a> and \u003ca href=\"http://www.scotusblog.com/case-files/cases/conestoga-wood-specialties-corp-v-sebelius/\" target=\"_blank\">Conestoga Wood Specialties Corp v. Sebelius\u003c/a>, two cases that are being considered together, is expected by the end of this month. The court will decide whether those companies, and potentially all other for-profit companies, must abide by the so-called contraceptive mandate. It's a complicated legal thicket, so here is some background.\u003c/p>\n\u003cp>\u003cstrong>1. What is the contraceptive mandate?\u003c/strong>\u003c/p>\n\u003cp>The health law requires that most insurance plans provide preventive care services without out-of-pocket expense to beneficiaries. The Obama administration included all contraceptives approved by the Food and Drug Administration as part of a package of \u003ca href=\"http://www.hrsa.gov/womensguidelines/\" target=\"_blank\">preventive services for women\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Interestingly, for many plans,\u003ca href=\"http://www.npr.org/blogs/health/2012/02/10/146662285/rules-requiring-contraceptive-coverage-have-been-in-force-for-years\" target=\"_blank\"> this wasn't new\u003c/a>. The Equal Employment Opportunity Commission ruled in 2000 that failure of employer health insurance plans to cover contraceptives was a violation of the 1978 Pregnancy Discrimination Act. But the new mandate extends that coverage to all plans, including those in the individual and small group markets, and it requires that the plans offer a specific array of contraceptive options for no cost.\u003c/p>\n\u003cp>More than half the states have their own \"\u003ca href=\"http://www.nwlc.org/resource/contraceptive-equity-laws-your-state-know-your-rights-use-your-rights-consumer-guide-0\" target=\"_blank\">contraceptive equity\u003c/a>\" laws on the books, many of which include religious exemptions that are similar to ones included in the federal regulation.\u003c/p>\n\u003cp>\u003cstrong>2. Who must comply with the mandate?\u003c/strong>\u003c/p>\n\u003cp>Most plans are covered by the mandate, but the federal regulation includes several exceptions. Churches and other strictly religious employers, who primarily employ those of the same faith and whose primary purpose is religious, are exempt from the requirement.\u003c/p>\n\u003cp>Nonprofit, religiously affiliated organizations, such as hospitals and universities, have a \u003ca href=\"http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/womens-preven-02012013.html\" target=\"_blank\">separate set\u003c/a> of rules. They do not have to provide the contraceptives directly, but must make them available to employees through a third party. Catholic Church officials as well as some others have objected to this requirement. There are at least \u003ca href=\"http://www.nwlc.org/status-lawsuits-challenging-affordable-care-acts-birth-control-coverage-benefit\" target=\"_blank\">three dozen court cases\u003c/a> challenging those rules still pending, according to the National Women's Law Center.\u003c/p>\n\u003cp>For-profit companies, however, including the plaintiffs in the cases before the Supreme Court now, aren't exempt.\u003c/p>\n\u003cp>\u003cstrong>3. The owners of Hobby Lobby and Conestoga Wood are not Catholic and say they have no problem offering birth control. So what is their challenge to the mandate?\u003c/strong>\u003c/p>\n\u003cp>Most forms of artificial contraception are contrary to Catholic teaching. But the Green family, which owns the nationwide craft chain Hobby Lobby, are evangelical Christians. And the Hahn family that owns Pennsylvania cabinet-maker Conestoga Wood Specialties are Mennonites. Both families already offer most forms of birth control as part of their health plans.\u003c/p>\n\u003cp>The owners say they are opposed to some forms of birth control — particularly emergency contraceptives \u003ca href=\"http://ec.princeton.edu/pills/plan-b.html\" target=\"_blank\">Plan B\u003c/a> and \u003ca href=\"http://ec.princeton.edu/pills/ella.html\" target=\"_blank\">Ella\u003c/a>, which can be used to prevent pregnancy if taken within 24 hours to as much as five days after unprotected sex — because these contraceptives prevent a fertilized egg from implanting in a woman's uterus. That, they say, is tantamount to a very early abortion, which violates their religion, they argue. The Greens – but not the Hahns – also object to two types of intrauterine devices for the same reasons.\u003c/p>\n\u003cp>\"These abortion-causing pills go against our faith, and our family is now being forced to choose between following the laws of the land that we love or maintaining the religious beliefs that have made our business successful and supported our family and thousands of our employees and their families,\" Hobby Lobby founder David Green told reporters on a conference call when the lawsuit was originally filed.\u003c/p>\n\u003cp>\u003cstrong>4. Do those drugs and devices actually cause abortions?\u003c/strong>\u003c/p>\n\u003cp>Not according to the vast majority of medical and scientific opinion.\u003c/p>\n\u003cp>\"Federal law and State law – which do preclude funding for abortions – don't consider these particular forms of contraception to be abortion,\" said U.S. Solicitor General Donald Verilli during the oral arguments in the case on behalf of the Obama administration. \"We've got about 2 million women who rely on the IUD as a method of birth control in this country. I don't think they are engaged in abortion in doing that.\"\u003c/p>\n\u003cp>\u003ca href=\"http://sblog.s3.amazonaws.com/wp-content/uploads/2013/10/13-354-BRIEF-OF-AMICI-CURIAE-PHYSICIANS-FOR-REPRODUCTIVE-HEALTH-et-al....pdf\" target=\"_blank\">The brief\u003c/a> filed by 10 medical groups led by the American College of Obstetricians and Gynecologists noted that \"there is a scientific distinction between a contraceptive and an abortifacient and the scientific record demonstrates that none of the FDA-approved contraceptives covered by the Mandate are abortifacients.\"\u003c/p>\n\u003cp>That's because the standard medical definition of the \u003ca href=\"http://www.kaiserhealthnews.org/stories/2011/june/01/npr-abortion-legislation.aspx\" target=\"_blank\">start of pregnancy\u003c/a> is when a fertilized egg implants in a woman's uterus, not when sperm and egg first unite.\u003c/p>\n\u003cp>But while blocking implantation of a fertilized egg does not fit the medical definition of pregnancy, it does qualify as ending a life for many religious people.\u003c/p>\n\u003cp>\"As far as the science goes, the FDA has said these four drugs and devices can terminate a human embryo,\" said Lori Windham, senior counsel for the Becket Fund for Religious Liberty, which has been representing Hobby Lobby. She noted that the labels for the emergency contraceptives and IUDs say they can prevent implantation.\u003c/p>\n\u003cp>In the case of one and perhaps both of the emergency contraceptive pills, however, new research suggests they may not work that way at all – they much more likely \u003ca href=\"http://www.nytimes.com/2012/06/06/health/research/morning-after-pills-dont-block-implantation-science-suggests.html?pagewanted=all&_r=0\" target=\"_blank\">simply prevent the fertilization of the egg\u003c/a> in the first place.\u003c/p>\n\u003cp>\u003cstrong>5. Does whether these products cause abortion matter for purposes of this case?\u003c/strong>\u003c/p>\n\u003cp>Probably not. At the heart of the case is what the company owners believe, and no one doubts the sincerity of their views. At issue is whether the owners can exercise those religious objections via their corporations under a 1993 law called the \u003ca href=\"http://www.scotusblog.com/2014/02/symposium-why-is-rfra-still-valid-against-the-federal-government/\" target=\"_blank\">Religious Freedom Restoration Act\u003c/a> (RFRA). It says the government may not impose a \"substantial burden\" on the free exercise of religion unless that burden is the narrowest possible way to further a compelling governmental interest.\u003c/p>\n\u003cp>The federal government and advocates for the mandate say that corporations cannot exercise religious rights, only individuals may.\u003c/p>\n\u003cp>The \u003ca href=\"http://sblog.s3.amazonaws.com/wp-content/uploads/2014/01/01.12.14_brief_for_petitioners_doj.pdf\" target=\"_blank\">government's brief\u003c/a> in the case said Hobby Lobby and a subsidiary Christian book store, \"for-profit corporations conducting commercial enterprises, are not persons exercising religion within the meaning of RFRA.\"\u003c/p>\n\u003cp>\u003cstrong>6. What would happen if the court extended religious standing to for-profit corporations?\u003c/strong>\u003c/p>\n\u003cp>Lots of bad things, say those who are siding with the government in the case.\u003c/p>\n\u003cp>For example, said Barry Lynn, executive director of Americans United for Separation of Church and State, in health care alone, \"Scientology-believing employers could insist upon non-coverage of its nemesis, psychiatry. And Jehovah's' Witness corporations could demand exclusion of surgical coverage, under the theory that so many of such procedures require the use of whole blood products, forbidden by their faith.\"\u003c/p>\n\u003cp>The potential for using religion to escape the reach of federal law doesn't end with health, said Lynn. Corporations could also claim that they don't need to abide by equal pay laws \"because of male dominance in their scriptural social order,\" he said, or, for those who offer public accommodations, \"you can hear them say we don't believe marriage equality is biblical, so you, (gay and lesbian) travelers, cannot stay in our hotel or eat in our restaurant.\"\u003c/p>\n\u003cp>Windham of the Becket Fund finds all those scenarios far-fetched. \"We've had this law on the books for 25 years and none of those cases have happened,\" she said.\u003c/p>\n\u003cp>During the \u003ca href=\"http://www.supremecourt.gov/oral_arguments/argument_transcripts/13-354_5436.pdf\" target=\"_blank\">arguments before the Supreme Court\u003c/a>, Justice Samuel Alito said much the same thing. \"In all the years RFRA has been on the books,\" he asked, \"has any of these claims involving minimum wage, for example, been brought and have they succeeded?\"\u003c/p>\n\u003cp>\"Very few of these claims have been brought,\" responded Paul Clement, the attorney who argued Hobby Lobby's case at the high court.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Justice Elena Kagan, however, said if the court upholds Hobby Lobby's claim, that might change. \"[T]hen you would see religious objectors come out of the woodwork with respect to these laws,\" she said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "School Lunch Debate: What's At Stake?",
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"content": "\u003cfigure id=\"attachment_15440\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122.jpg\">\u003cimg class=\"size-full wp-image-15440\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122.jpg\" alt=\"While 90 percent of schools have made the transition to new school lunch standards, some schools insist that the standards are unworkable. (Photo: USDA)\" width=\"640\" height=\"424\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122-400x265.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122-320x212.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">While 90 percent of schools have made the transition to new school lunch standards, some schools insist that the standards are unworkable. (Photo: USDA)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Allison Aubrey and Jessica Pupovac\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/thesalt/2014/06/11/320882341/school-lunch-debate-whats-at-stake\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>School lunches have never been known for culinary excellence. But to be fair, the National School Lunch Program — which provides free or reduced lunches to about 31 million kids every day — has never aimed to dazzle as much as to fill little bellies.\u003c/p>\n\u003cp>In 2010, Congress gave the Federal School Lunch Program a nutrition make-over. New regulations called for:\u003c/p>\n\u003cul>\n\u003cli>Increasing the amount of whole grains served in school cafeterias\u003c/li>\n\u003cli>Shifting to fat free or low-fat milks\u003c/li>\n\u003cli>Limiting the amount of calories that can come from saturated fats to 10 percent\u003c/li>\n\u003cli>Offering fruits and vegetables on a daily basis\u003c/li>\n\u003cli>Implementing caloric minimums and maximums for each meal\u003c/li>\n\u003c/ul>\n\u003cp>Those were just the first steps. By the school year starting this fall, schools are also required to:\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>Reduce the amount of sodium school cafeterias can serve to a maximum of 1,230 to 1,420 milligrams a day for lunch (depending on age group) and 540 to 640 milligrams a day for breakfast.\u003c/li>\n\u003cli>Shift to 100 percent \"whole grain-rich\" products, which means that they are mostly whole grain.\u003c/li>\n\u003c/ul>\n\u003cp>In the agriculture appropriations bill, which may come to a vote on Thursday, schools would also receive additional support for making the transition to a healthier menu, including provisions to help them purchase new equipment to prepare fresher foods.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"gJWHEusGINj4Z7JafteoUw4hYBsSxLZ4\"]Sam Kass, senior advisor for nutrition policy at the White House, says 90 percent of schools have already — or are in the process of — implementing the new standards.\u003c/p>\n\u003cp>Currently, half of all products served in the school lunch program must be \"whole-grain rich,\" which USDA defines as products made of at least 50 percent whole grain. According to the new standards, by the start of the next school year, schools must use only products that are whole-grain rich.\u003c/p>\n\u003cp>But GOP leaders, as well as the School Nutrition Association, which represents school food service directors and several companies that supply school cafeterias, say the upcoming requirements are unworkable. They claim that kids don't want the healthy options and, as a result, too much food is being wasted. They also say that the cost of reducing sodium and other preservatives are placing an undue burden on schools.\u003c/p>\n\u003cp>Alabama Republican Congressman Robert Aderholt introduced a provision that would give school districts a year-long waiver from both old and new standards if they can show that they are losing money.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003ca href=\"http://blogs.kqed.org/bayareabites/2014/06/11/lobbyists-loom-behind-the-scenes-of-school-nutrition-fight/\" target=\"_blank\">Related: Lobbyists Loom Behind the Scenes of School Nutrition Fight\u003c/a>]\u003c/p>\n\u003cp>First Lady Michelle Obama, who helped spearhead the new regulations, is vehemently opposed to delaying or softening the new regulations.\u003c/p>\n\u003cp>So is Agriculture Secretary Tom Vilsack. He says that kids will eat healthier foods if they are provided with them and claims that, overall, school food revenues around the country are up by about $200 million dollars since the changes took effect.\u003c/p>\n\u003cp>\"The facts just don't basically support the notion that somehow school district are financially strapped to be able comply,\" he said.\u003c/p>\n\u003cp>His advice for schools that are struggling: instead of asking to opt-out, ask for help.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The hearings over the waivers started on the House floor Wednesday.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15440\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122.jpg\">\u003cimg class=\"size-full wp-image-15440\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122.jpg\" alt=\"While 90 percent of schools have made the transition to new school lunch standards, some schools insist that the standards are unworkable. (Photo: USDA)\" width=\"640\" height=\"424\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122-400x265.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122-320x212.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">While 90 percent of schools have made the transition to new school lunch standards, some schools insist that the standards are unworkable. (Photo: USDA)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Allison Aubrey and Jessica Pupovac\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/thesalt/2014/06/11/320882341/school-lunch-debate-whats-at-stake\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>School lunches have never been known for culinary excellence. But to be fair, the National School Lunch Program — which provides free or reduced lunches to about 31 million kids every day — has never aimed to dazzle as much as to fill little bellies.\u003c/p>\n\u003cp>In 2010, Congress gave the Federal School Lunch Program a nutrition make-over. New regulations called for:\u003c/p>\n\u003cul>\n\u003cli>Increasing the amount of whole grains served in school cafeterias\u003c/li>\n\u003cli>Shifting to fat free or low-fat milks\u003c/li>\n\u003cli>Limiting the amount of calories that can come from saturated fats to 10 percent\u003c/li>\n\u003cli>Offering fruits and vegetables on a daily basis\u003c/li>\n\u003cli>Implementing caloric minimums and maximums for each meal\u003c/li>\n\u003c/ul>\n\u003cp>Those were just the first steps. By the school year starting this fall, schools are also required to:\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>Reduce the amount of sodium school cafeterias can serve to a maximum of 1,230 to 1,420 milligrams a day for lunch (depending on age group) and 540 to 640 milligrams a day for breakfast.\u003c/li>\n\u003cli>Shift to 100 percent \"whole grain-rich\" products, which means that they are mostly whole grain.\u003c/li>\n\u003c/ul>\n\u003cp>In the agriculture appropriations bill, which may come to a vote on Thursday, schools would also receive additional support for making the transition to a healthier menu, including provisions to help them purchase new equipment to prepare fresher foods.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"gJWHEusGINj4Z7JafteoUw4hYBsSxLZ4\"]Sam Kass, senior advisor for nutrition policy at the White House, says 90 percent of schools have already — or are in the process of — implementing the new standards.\u003c/p>\n\u003cp>Currently, half of all products served in the school lunch program must be \"whole-grain rich,\" which USDA defines as products made of at least 50 percent whole grain. According to the new standards, by the start of the next school year, schools must use only products that are whole-grain rich.\u003c/p>\n\u003cp>But GOP leaders, as well as the School Nutrition Association, which represents school food service directors and several companies that supply school cafeterias, say the upcoming requirements are unworkable. They claim that kids don't want the healthy options and, as a result, too much food is being wasted. They also say that the cost of reducing sodium and other preservatives are placing an undue burden on schools.\u003c/p>\n\u003cp>Alabama Republican Congressman Robert Aderholt introduced a provision that would give school districts a year-long waiver from both old and new standards if they can show that they are losing money.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003ca href=\"http://blogs.kqed.org/bayareabites/2014/06/11/lobbyists-loom-behind-the-scenes-of-school-nutrition-fight/\" target=\"_blank\">Related: Lobbyists Loom Behind the Scenes of School Nutrition Fight\u003c/a>]\u003c/p>\n\u003cp>First Lady Michelle Obama, who helped spearhead the new regulations, is vehemently opposed to delaying or softening the new regulations.\u003c/p>\n\u003cp>So is Agriculture Secretary Tom Vilsack. He says that kids will eat healthier foods if they are provided with them and claims that, overall, school food revenues around the country are up by about $200 million dollars since the changes took effect.\u003c/p>\n\u003cp>\"The facts just don't basically support the notion that somehow school district are financially strapped to be able comply,\" he said.\u003c/p>\n\u003cp>His advice for schools that are struggling: instead of asking to opt-out, ask for help.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The hearings over the waivers started on the House floor Wednesday.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Cross Country from D.C. to San Francisco, Complaints About Health Costs",
"title": "Cross Country from D.C. to San Francisco, Complaints About Health Costs",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_19468\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Gold-Road-Trip.jpg\">\u003cimg class=\"size-large wp-image-19468\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Gold-Road-Trip-640x480.jpg\" alt=\"Dudley Pratt (left) talks to reporter Jenny Gold at a gas station in Fenner, Calif. His complaint is health insurance paperwork. (Ilana Lipsett/Kaiser Health News)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dudley Pratt (left) talks to reporter Jenny Gold at a gas station in Fenner, Calif. His complaint is health insurance paperwork. (Ilana Lipsett/Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jenny Gold,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/June/09/health-care-cost-woes-coast-to-coast.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Recently, I moved from Washington, D.C., to San Francisco. I drove the Southern route and decided to conduct an informal survey.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I wish it would be cheaper mainly — more affordable.\" \u003c/aside>\n\u003cp>I asked folks I met along the way a question relevant to the health care reporting I've been doing for the past five years: What bugs you most about your medical care?\u003c/p>\n\u003cp>Few people I talked with — at gas stations, coffee shops, grocery stores, parking lots, bars and everywhere in between — even mentioned the Affordable Care Act or Obamacare by name. But I heard again and again how health policy issues I've been reporting on in Washington are affecting their lives.\u003c/p>\n\u003cp>What did I find out?\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>From coast to coast, people told me that their health coverage and care are too expensive. \"I wish it would be cheaper mainly — more affordable,\" Ruben Irigoyen of Springerville, Ariz., told me. \"That's mainly my concern. Everything is just very expensive, especially in these small communities.\"\u003c/p>\n\u003cp>A few people were able to buy more affordable insurance on the new marketplaces created by the health law. \"I'm not really happy with how much things cost. But I did get a plan through HealthCare.gov and that helped a lot,\" said Christa Sadler of Flagstaff, Ariz.\u003c/p>\n\u003cp>But the United States continues to spend more on health care than any other country in the world. And Angie Wilson of Nashville, Tenn., had experienced that firsthand. \"Of course the cost\" is the big problem, she told me. \"The cost! It's expensive. That's the main thing.\"\u003c/p>\n\u003cp>Hospitals across the country are seeking to improve medical care by getting primary care doctors, specialists, nurses and everyone in between to work together to coordinate the care of their patients. Under the health law, the government is penalizing hospitals if too many of their patients return quickly after being discharged. Those readmissions are an expensive symptom of uncoordinated care.\u003c/p>\n\u003cp>But care coordination is still a work in progress. \"I am very upset because my wife had major surgery last Thursday, and they made her leave the hospital on Friday at 7 o'clock at night, and now she's back in the hospital because she shouldn't have left so early,\" said Glenn Ferreri in Brandon, Miss. \"So I'm unhappy about the health care regulations going on that's pushing people out so that we have to take care of them at home where the care should be at the hospitals.\"\u003c/p>\n\u003cp>Right now, there's a big push to get computers and electronic health records in hospitals and doctors' offices across the country. Karen Greig of Menlo Park, Calif., says there are drawbacks for patients.\u003c/p>\n\u003cp>\"The way the computer in the examining room has come between me and the doctor. Half the time they don't even look you in the eye because they're busy typing away, looking at the computer and you're wondering are they even hearing what I'm saying?\" Greig told me in a Flagstaff, Ariz., coffee shop.\u003c/p>\n\u003cp>People I talked with were worried about who would take care of them. Will there be enough primary care doctors to meet demand from patients, especially as more Americans get insurance coverage under the health law. Hart Fortenbery in Lafayette, La., was particularly concerned about having to see a nurse practitioner instead of a doctor as more mid-level providers are taking on a bigger role in primary care.\u003c/p>\n\u003cp>\"What bugs me most about my medical care is the state of the doctors,\" he said. \"You can't see a doctor, and if you do they got to see 50 goddamn people a day. They're stressed, overworked, underpaid, and you end up with a nurse practitioner who's able to write prescriptions.\"\u003c/p>\n\u003cp>At a gas station in Fenner, Calif., just miles from the Arizona border, I met Dudley Pratt of Huntington Beach, Calif. He was riding his dirt bike across the Mojave Preserve.\u003c/p>\n\u003cp>He's said he's a free spirit, and it's all the paperwork about health insurance that drives him nuts. \"I can remember back in the '70s, you would have, like, Blue Cross Blue Shield, you go in and you hand them a card. There was no paperwork or copays,\" he said. \"You just went to the ER or whatever. Now it seems a lot more complicated.\"\u003c/p>\n\u003cp>And then were even a few people who – lo and behold – were actually happy with their medical care. I met Don Chalmers of San Diego, Calif., at the same gas station in Fenner. \"I will tell you I have always had good luck with my medical care,\" he said. \"Every time I went to the hospital I came out better than when I went in.\"\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"k2r4IPehcVuiLp590qsIiF0mCRlvpFXV\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19468\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Gold-Road-Trip.jpg\">\u003cimg class=\"size-large wp-image-19468\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Gold-Road-Trip-640x480.jpg\" alt=\"Dudley Pratt (left) talks to reporter Jenny Gold at a gas station in Fenner, Calif. His complaint is health insurance paperwork. (Ilana Lipsett/Kaiser Health News)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dudley Pratt (left) talks to reporter Jenny Gold at a gas station in Fenner, Calif. His complaint is health insurance paperwork. (Ilana Lipsett/Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jenny Gold,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/June/09/health-care-cost-woes-coast-to-coast.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Recently, I moved from Washington, D.C., to San Francisco. I drove the Southern route and decided to conduct an informal survey.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I wish it would be cheaper mainly — more affordable.\" \u003c/aside>\n\u003cp>I asked folks I met along the way a question relevant to the health care reporting I've been doing for the past five years: What bugs you most about your medical care?\u003c/p>\n\u003cp>Few people I talked with — at gas stations, coffee shops, grocery stores, parking lots, bars and everywhere in between — even mentioned the Affordable Care Act or Obamacare by name. But I heard again and again how health policy issues I've been reporting on in Washington are affecting their lives.\u003c/p>\n\u003cp>What did I find out?\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>From coast to coast, people told me that their health coverage and care are too expensive. \"I wish it would be cheaper mainly — more affordable,\" Ruben Irigoyen of Springerville, Ariz., told me. \"That's mainly my concern. Everything is just very expensive, especially in these small communities.\"\u003c/p>\n\u003cp>A few people were able to buy more affordable insurance on the new marketplaces created by the health law. \"I'm not really happy with how much things cost. But I did get a plan through HealthCare.gov and that helped a lot,\" said Christa Sadler of Flagstaff, Ariz.\u003c/p>\n\u003cp>But the United States continues to spend more on health care than any other country in the world. And Angie Wilson of Nashville, Tenn., had experienced that firsthand. \"Of course the cost\" is the big problem, she told me. \"The cost! It's expensive. That's the main thing.\"\u003c/p>\n\u003cp>Hospitals across the country are seeking to improve medical care by getting primary care doctors, specialists, nurses and everyone in between to work together to coordinate the care of their patients. Under the health law, the government is penalizing hospitals if too many of their patients return quickly after being discharged. Those readmissions are an expensive symptom of uncoordinated care.\u003c/p>\n\u003cp>But care coordination is still a work in progress. \"I am very upset because my wife had major surgery last Thursday, and they made her leave the hospital on Friday at 7 o'clock at night, and now she's back in the hospital because she shouldn't have left so early,\" said Glenn Ferreri in Brandon, Miss. \"So I'm unhappy about the health care regulations going on that's pushing people out so that we have to take care of them at home where the care should be at the hospitals.\"\u003c/p>\n\u003cp>Right now, there's a big push to get computers and electronic health records in hospitals and doctors' offices across the country. Karen Greig of Menlo Park, Calif., says there are drawbacks for patients.\u003c/p>\n\u003cp>\"The way the computer in the examining room has come between me and the doctor. Half the time they don't even look you in the eye because they're busy typing away, looking at the computer and you're wondering are they even hearing what I'm saying?\" Greig told me in a Flagstaff, Ariz., coffee shop.\u003c/p>\n\u003cp>People I talked with were worried about who would take care of them. Will there be enough primary care doctors to meet demand from patients, especially as more Americans get insurance coverage under the health law. Hart Fortenbery in Lafayette, La., was particularly concerned about having to see a nurse practitioner instead of a doctor as more mid-level providers are taking on a bigger role in primary care.\u003c/p>\n\u003cp>\"What bugs me most about my medical care is the state of the doctors,\" he said. \"You can't see a doctor, and if you do they got to see 50 goddamn people a day. They're stressed, overworked, underpaid, and you end up with a nurse practitioner who's able to write prescriptions.\"\u003c/p>\n\u003cp>At a gas station in Fenner, Calif., just miles from the Arizona border, I met Dudley Pratt of Huntington Beach, Calif. He was riding his dirt bike across the Mojave Preserve.\u003c/p>\n\u003cp>He's said he's a free spirit, and it's all the paperwork about health insurance that drives him nuts. \"I can remember back in the '70s, you would have, like, Blue Cross Blue Shield, you go in and you hand them a card. There was no paperwork or copays,\" he said. \"You just went to the ER or whatever. Now it seems a lot more complicated.\"\u003c/p>\n\u003cp>And then were even a few people who – lo and behold – were actually happy with their medical care. I met Don Chalmers of San Diego, Calif., at the same gas station in Fenner. \"I will tell you I have always had good luck with my medical care,\" he said. \"Every time I went to the hospital I came out better than when I went in.\"\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"k2r4IPehcVuiLp590qsIiF0mCRlvpFXV\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Resident Physicians at Children's Oakland Rally Over Contract Stalemate",
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"content": "\u003cfigure id=\"attachment_19461\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10682_IMG_6674-hpf.jpg\">\u003cimg class=\"size-full wp-image-19461\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10682_IMG_6674-hpf.jpg\" alt=\"Medical workers stage a protest in front of UCSF Benioff Children's Hospital Oakland. (Mark Andrew Boyer/KQED)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10682_IMG_6674-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10682_IMG_6674-hpf-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10682_IMG_6674-hpf-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Medical residents stage a protest in front of UCSF Benioff Children's Hospital Oakland. (Mark Andrew Boyer/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Resident physicians at UCSF Benioff Children’s Hospital Oakland say their salaries aren’t keeping up with the cost of living in the Bay Area. Theirs is one of the latest health care union battles to heat up in California between workers and hospital administration, and is drawing a new generation of members to union organizing.\u003c/p>\n\u003cp>“A lot of people think being a doctor is super glamorous and you make tons of money and everyone loves you,” said Alana Arnold, a second-year resident. “But in fact, residency is difficult. We’re here to learn and train. And we have to protect ourselves just like any other workforce.”\u003c/p>\n\u003cp>She and other pediatric medicine residents in Oakland have joined with SEIU’s Committee of Interns and Residents to fight for higher compensation, and a special fund for patients to cover bus tokens and other costs to help them get to appointments and maintain care. \u003c!--more-->\u003c/p>\n\u003cp>Residents are paid $52,000 a year and work up to 80 hours a week. The residents say they want a small $2,000 bonus over their three-year residency to help offset housing costs. But after more than a year of negotiating, there is no resolution. The latest talks with a federal mediator broke down.\u003c/p>\n\u003cp>“This contract bargaining has now become an issue of respect,” Arnold said at a demonstration outside the hospital last Friday. “The hospital administrators must see us as equal contributors and as professionals who provide critical medical services to patients of Children’s Hospital.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The hospital says it values the residents, but it also faces high costs of doing business in the Bay Area. Spokesperson Melinda Krigel says the hospital has to balance the residency program with a lot of competing needs, including patient care, research and community benefits.\u003c/p>\n\u003cp>“We have to look at all our costs and programs and decide where we have to put the money to sustain our mission,” Krigel said.\u003c/p>\n\u003cp>She said the residents’ demands come at the same time that federal grants for graduate medical training have been slashed 30 percent. The hospital plans to accept 28 residents in the next incoming class, compared to 30 in each of the last few years.\u003c/p>\n\u003cp>“Without that federal funding, our hands are tied,” Ms. Krigel said, adding that the residents do get various financial perks — including a stipend for books, and free food.\u003c/p>\n\u003cp>The residents say the hospital should tap into the $50 million philanthropic gift it recently received from Marc and Lynne Benioff, following the Oakland hospital’s affiliation with the UCSF Benioff Children’s Hospital earlier this year. The hospital says it hasn’t yet decided how it will spend the money.\u003c/p>\n\u003cp>The residents were joined by at least one member of another union at their march on Friday. Susan Segal is a nurse in the intensive care nursery at Children’s Hospital Oakland and a member of the California Nurses Association, a union that has often been at odds with SEIU, the union backing the residents.\u003c/p>\n\u003cp>“There are huge divides. And there have been historically huge feuds and coming together of SEIU and CNA,” Segal said. “But when it comes to this hospital, we stand together. Personally as a nurse and union member I’m committed to supporting every other union and their fights.”\u003c/p>\n\u003cp>Arnold says it’s important for people at all levels of the health care field, and of all ages, to get involved with their union.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Being a doctor is a privilege and an honor,” Arnold said. “But it is something that should not be abused by your employer. And that’s what’s going on with the hospital administration. So it’s just out of necessity that we need to organize and make sure that our working conditions are appropriate and necessary to carry out our duty, which is to provide the best care possible.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19461\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10682_IMG_6674-hpf.jpg\">\u003cimg class=\"size-full wp-image-19461\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10682_IMG_6674-hpf.jpg\" alt=\"Medical workers stage a protest in front of UCSF Benioff Children's Hospital Oakland. (Mark Andrew Boyer/KQED)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10682_IMG_6674-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10682_IMG_6674-hpf-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10682_IMG_6674-hpf-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Medical residents stage a protest in front of UCSF Benioff Children's Hospital Oakland. (Mark Andrew Boyer/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Resident physicians at UCSF Benioff Children’s Hospital Oakland say their salaries aren’t keeping up with the cost of living in the Bay Area. Theirs is one of the latest health care union battles to heat up in California between workers and hospital administration, and is drawing a new generation of members to union organizing.\u003c/p>\n\u003cp>“A lot of people think being a doctor is super glamorous and you make tons of money and everyone loves you,” said Alana Arnold, a second-year resident. “But in fact, residency is difficult. We’re here to learn and train. And we have to protect ourselves just like any other workforce.”\u003c/p>\n\u003cp>She and other pediatric medicine residents in Oakland have joined with SEIU’s Committee of Interns and Residents to fight for higher compensation, and a special fund for patients to cover bus tokens and other costs to help them get to appointments and maintain care. \u003c!--more-->\u003c/p>\n\u003cp>Residents are paid $52,000 a year and work up to 80 hours a week. The residents say they want a small $2,000 bonus over their three-year residency to help offset housing costs. But after more than a year of negotiating, there is no resolution. The latest talks with a federal mediator broke down.\u003c/p>\n\u003cp>“This contract bargaining has now become an issue of respect,” Arnold said at a demonstration outside the hospital last Friday. “The hospital administrators must see us as equal contributors and as professionals who provide critical medical services to patients of Children’s Hospital.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The hospital says it values the residents, but it also faces high costs of doing business in the Bay Area. Spokesperson Melinda Krigel says the hospital has to balance the residency program with a lot of competing needs, including patient care, research and community benefits.\u003c/p>\n\u003cp>“We have to look at all our costs and programs and decide where we have to put the money to sustain our mission,” Krigel said.\u003c/p>\n\u003cp>She said the residents’ demands come at the same time that federal grants for graduate medical training have been slashed 30 percent. The hospital plans to accept 28 residents in the next incoming class, compared to 30 in each of the last few years.\u003c/p>\n\u003cp>“Without that federal funding, our hands are tied,” Ms. Krigel said, adding that the residents do get various financial perks — including a stipend for books, and free food.\u003c/p>\n\u003cp>The residents say the hospital should tap into the $50 million philanthropic gift it recently received from Marc and Lynne Benioff, following the Oakland hospital’s affiliation with the UCSF Benioff Children’s Hospital earlier this year. The hospital says it hasn’t yet decided how it will spend the money.\u003c/p>\n\u003cp>The residents were joined by at least one member of another union at their march on Friday. Susan Segal is a nurse in the intensive care nursery at Children’s Hospital Oakland and a member of the California Nurses Association, a union that has often been at odds with SEIU, the union backing the residents.\u003c/p>\n\u003cp>“There are huge divides. And there have been historically huge feuds and coming together of SEIU and CNA,” Segal said. “But when it comes to this hospital, we stand together. Personally as a nurse and union member I’m committed to supporting every other union and their fights.”\u003c/p>\n\u003cp>Arnold says it’s important for people at all levels of the health care field, and of all ages, to get involved with their union.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Being a doctor is a privilege and an honor,” Arnold said. “But it is something that should not be abused by your employer. And that’s what’s going on with the hospital administration. So it’s just out of necessity that we need to organize and make sure that our working conditions are appropriate and necessary to carry out our duty, which is to provide the best care possible.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Privacy Law Frustrates Parents with Mentally Ill Adult Children",
"title": "Privacy Law Frustrates Parents with Mentally Ill Adult Children",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_19409\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/IMG_4052.jpg\">\u003cimg class=\"size-large wp-image-19409\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/IMG_4052-640x480.jpg\" alt=\"Mark, a minister who lives in the Bay Area, has not been able to communicate with doctors about his son, Scott, since Scott became an adult (Jenny Gold/ KHN).\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Mark, a minister who lives in the Bay Area, has not been able to communicate with doctors about his son, Scott, since Scott became an adult (Jenny Gold/ KHN).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jenny Gold\u003c/strong>, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/June/04/Parents-Of-Mentally-Ill-Adult-Children-Frustrated-By-Privacy-Law.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>The horrifying mass shooting in Isla Vista nearly two weeks ago brought up many questions: What -- if anything -- could parents have done to prevent the tragedy? And what did they actually know about their son's mental illness?\u003c/p>\n\u003caside class=\"pullquote alignleft\">'We were shut out of the conversation.' \u003c/aside>\n\u003cp>A privacy law called the \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/understanding/special/mhguidance.html\" target=\"_blank\">Health Insurance Portability and Accountability Act\u003c/a> was created in part to protect patients' information. But the law, called HIPAA for short, also presents a dilemma for families of people with serious mental illnesses like schizophrenia. HIPAA restricts what family members can find out directly, leaving them to wonder how they can help a loved one who won't share treatment details.\u003c/p>\n\u003cp>Mark, an ordained minister in Moraga, about 20 miles east of San Francisco, struggles with the problem almost every day. His son Scott, 24, has \u003ca href=\"http://www.mayoclinic.org/diseases-conditions/schizoaffective-disorder/basics/definition/con-20029221\" target=\"_blank\">schizoaffective disorder\u003c/a> and has been hospitalized a dozen times for the hallucinations, mania and depression that it brings. (Kaiser Health News and KQED aren't publishing the family's last name to protect Scott's identity.)\u003c!--more-->\u003c/p>\n\u003cp>Mark first noticed a change in his son just before his high school graduation. \"There was a deep aggressiveness that started to emerge,\" he recalls. \"We just thought, well, it was frustration with life or circumstances, things weren't going well in school.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And it got worse. In the middle of a standoff one day, Scott threw a small table at his mother. Scott was taken to a psychiatric hospital by the police. He was 18. Because he was still in high school, he was treated as a minor by the hospital. Mark and his wife met with Scott's doctors and set up a treatment plan.\u003c/p>\n\u003cp>\"We saw, OK, this is kind of the way it works,\" says Mark, adding, \"That was pretty much the last time we had that opportunity\" to talk to any medical professionals about Scott.\u003c/p>\n\u003cp>The next time their son was hospitalized, he was out of high school. The doctors told the family that because of HIPAA, they couldn't be part of the treatment discussion unless Scott granted permission, which he refused to do.\u003c/p>\n\u003cp>\"We were shut out of the conversation,\" says Mark. \"And I think that was the first time we really started feeling hopeless. As long as we could feel we were in a conversation with them, we had a sense of hope. All of a sudden there was a wall that went up, and that was gone.\"\u003c/p>\n\u003cp>What little information Mark and his wife get about Scott's treatment comes from their insurance company, since Scott is still on their plan. The family hasn't spoken to any of Scott's doctors since that first hospitalization, even though one of their most pressing questions is whether it's even safe for Scott to come back home. Mark still has scars on his head from an altercation with Scott the last time he was home.\u003c/p>\n\u003cp>Mark is a gentle and deliberate man with round glasses and a rosy complexion. His tidy suburban home is filled with photos of his children and piles of books about faith. But, he wonders, \"Why am I, as the one who is a primary caregiver, protector, provider, whatever — I've watched this kid grow up — and yet I'm out of the circle?\"\u003c/p>\n\u003cp>That's something E. Fuller Torrey, a psychiatrist and founder of the Treatment Advocacy Center, a mental health advocacy group, hears all the time. He says the problem is that HIPAA wasn't written with mental illness in mind.\u003c/p>\n\u003cp>\"When someone has cancer, you can make the assumption that their brain is working normally so that they can make an informed decision as to whether or not they want their loved ones to know exactly what the details of the cancer is,\" he says. \"You can't make that assumption about people with schizophrenia or bipolar disorder.\"\u003c/p>\n\u003cp>Often, he says, sharing information with the family can be crucial to a patient's care, helping to ensure that they stick with a treatment plan, and can minimize the need for readmission to the hospital. Torrey supports\u003ca href=\"http://murphy.house.gov/helpingfamiliesinmentalhealthcrisisact\" target=\"_blank\"> a bill in Congress\u003c/a> that would alter HIPAA to make it easier for families to access information about patients with severe illness. That's particularly important for parents who \"still continue to provide the primary care for many, many of the people who are severely mentally ill,\" he says.\u003c/p>\n\u003cp>Opponents of \u003ca href=\"http://www.npr.org/2014/05/30/317274857/rep-murphy-aims-for-mental-health-bill-to-pass-before-next-shooting\" target=\"_blank\">the bill\u003c/a>, including Jennifer Mathis, director of programs at the Bazelon Center for Mental Health Law, says that weakening privacy protections would make patients less willing to seek treatment. \"They need to know that it's going to be kept confidential,\" Mathis says.\u003c/p>\n\u003cp>There are already exceptions in HIPAA that allow providers to talk to family or caregivers when the patient is a danger to themselves or others, she says. But those exceptions often are not used. Sometimes, Mathis says, providers may be \"hiding behind HIPAA,\" so that they don't have to deal with families, or because they are afraid of being sued.\u003c/p>\n\u003cp>Others problems include plain misunderstanding about what the law requires and allows.\u003c/p>\n\u003cp>But even for doctors who thoroughly understand HIPAA, the safety exemption can be too narrow. \"The vast majority of situations families find themselves in are not life and death,\" says Carolyn Wolf, who directs the mental health practice at New York law firm Abrams Fensterman.\u003c/p>\n\u003cp>The exemptions and possible changes to the law don't help Pastor Mark much. \"It has been a very arduous journey, and it continues,\" he says. \"It's had its moments of extreme anguish, a lot of tears shed, a lot of prayers prayed, a lot of just absolute puzzlement at life itself.\"\u003c/p>\n\u003cp>For now, as a father and as a minister, he's relying on faith.\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"fukx5RCuMuJHuX7DW0Vj3qKaf12HD0WS\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19409\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/IMG_4052.jpg\">\u003cimg class=\"size-large wp-image-19409\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/IMG_4052-640x480.jpg\" alt=\"Mark, a minister who lives in the Bay Area, has not been able to communicate with doctors about his son, Scott, since Scott became an adult (Jenny Gold/ KHN).\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Mark, a minister who lives in the Bay Area, has not been able to communicate with doctors about his son, Scott, since Scott became an adult (Jenny Gold/ KHN).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jenny Gold\u003c/strong>, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/June/04/Parents-Of-Mentally-Ill-Adult-Children-Frustrated-By-Privacy-Law.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>The horrifying mass shooting in Isla Vista nearly two weeks ago brought up many questions: What -- if anything -- could parents have done to prevent the tragedy? And what did they actually know about their son's mental illness?\u003c/p>\n\u003caside class=\"pullquote alignleft\">'We were shut out of the conversation.' \u003c/aside>\n\u003cp>A privacy law called the \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/understanding/special/mhguidance.html\" target=\"_blank\">Health Insurance Portability and Accountability Act\u003c/a> was created in part to protect patients' information. But the law, called HIPAA for short, also presents a dilemma for families of people with serious mental illnesses like schizophrenia. HIPAA restricts what family members can find out directly, leaving them to wonder how they can help a loved one who won't share treatment details.\u003c/p>\n\u003cp>Mark, an ordained minister in Moraga, about 20 miles east of San Francisco, struggles with the problem almost every day. His son Scott, 24, has \u003ca href=\"http://www.mayoclinic.org/diseases-conditions/schizoaffective-disorder/basics/definition/con-20029221\" target=\"_blank\">schizoaffective disorder\u003c/a> and has been hospitalized a dozen times for the hallucinations, mania and depression that it brings. (Kaiser Health News and KQED aren't publishing the family's last name to protect Scott's identity.)\u003c!--more-->\u003c/p>\n\u003cp>Mark first noticed a change in his son just before his high school graduation. \"There was a deep aggressiveness that started to emerge,\" he recalls. \"We just thought, well, it was frustration with life or circumstances, things weren't going well in school.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And it got worse. In the middle of a standoff one day, Scott threw a small table at his mother. Scott was taken to a psychiatric hospital by the police. He was 18. Because he was still in high school, he was treated as a minor by the hospital. Mark and his wife met with Scott's doctors and set up a treatment plan.\u003c/p>\n\u003cp>\"We saw, OK, this is kind of the way it works,\" says Mark, adding, \"That was pretty much the last time we had that opportunity\" to talk to any medical professionals about Scott.\u003c/p>\n\u003cp>The next time their son was hospitalized, he was out of high school. The doctors told the family that because of HIPAA, they couldn't be part of the treatment discussion unless Scott granted permission, which he refused to do.\u003c/p>\n\u003cp>\"We were shut out of the conversation,\" says Mark. \"And I think that was the first time we really started feeling hopeless. As long as we could feel we were in a conversation with them, we had a sense of hope. All of a sudden there was a wall that went up, and that was gone.\"\u003c/p>\n\u003cp>What little information Mark and his wife get about Scott's treatment comes from their insurance company, since Scott is still on their plan. The family hasn't spoken to any of Scott's doctors since that first hospitalization, even though one of their most pressing questions is whether it's even safe for Scott to come back home. Mark still has scars on his head from an altercation with Scott the last time he was home.\u003c/p>\n\u003cp>Mark is a gentle and deliberate man with round glasses and a rosy complexion. His tidy suburban home is filled with photos of his children and piles of books about faith. But, he wonders, \"Why am I, as the one who is a primary caregiver, protector, provider, whatever — I've watched this kid grow up — and yet I'm out of the circle?\"\u003c/p>\n\u003cp>That's something E. Fuller Torrey, a psychiatrist and founder of the Treatment Advocacy Center, a mental health advocacy group, hears all the time. He says the problem is that HIPAA wasn't written with mental illness in mind.\u003c/p>\n\u003cp>\"When someone has cancer, you can make the assumption that their brain is working normally so that they can make an informed decision as to whether or not they want their loved ones to know exactly what the details of the cancer is,\" he says. \"You can't make that assumption about people with schizophrenia or bipolar disorder.\"\u003c/p>\n\u003cp>Often, he says, sharing information with the family can be crucial to a patient's care, helping to ensure that they stick with a treatment plan, and can minimize the need for readmission to the hospital. Torrey supports\u003ca href=\"http://murphy.house.gov/helpingfamiliesinmentalhealthcrisisact\" target=\"_blank\"> a bill in Congress\u003c/a> that would alter HIPAA to make it easier for families to access information about patients with severe illness. That's particularly important for parents who \"still continue to provide the primary care for many, many of the people who are severely mentally ill,\" he says.\u003c/p>\n\u003cp>Opponents of \u003ca href=\"http://www.npr.org/2014/05/30/317274857/rep-murphy-aims-for-mental-health-bill-to-pass-before-next-shooting\" target=\"_blank\">the bill\u003c/a>, including Jennifer Mathis, director of programs at the Bazelon Center for Mental Health Law, says that weakening privacy protections would make patients less willing to seek treatment. \"They need to know that it's going to be kept confidential,\" Mathis says.\u003c/p>\n\u003cp>There are already exceptions in HIPAA that allow providers to talk to family or caregivers when the patient is a danger to themselves or others, she says. But those exceptions often are not used. Sometimes, Mathis says, providers may be \"hiding behind HIPAA,\" so that they don't have to deal with families, or because they are afraid of being sued.\u003c/p>\n\u003cp>Others problems include plain misunderstanding about what the law requires and allows.\u003c/p>\n\u003cp>But even for doctors who thoroughly understand HIPAA, the safety exemption can be too narrow. \"The vast majority of situations families find themselves in are not life and death,\" says Carolyn Wolf, who directs the mental health practice at New York law firm Abrams Fensterman.\u003c/p>\n\u003cp>The exemptions and possible changes to the law don't help Pastor Mark much. \"It has been a very arduous journey, and it continues,\" he says. \"It's had its moments of extreme anguish, a lot of tears shed, a lot of prayers prayed, a lot of just absolute puzzlement at life itself.\"\u003c/p>\n\u003cp>For now, as a father and as a minister, he's relying on faith.\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "State Leaders in Budget Fight over In-Home Health Services",
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"content": "\u003cfigure id=\"attachment_19395\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/179063219.jpg\">\u003cimg class=\"size-large wp-image-19395\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/179063219-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The State Capitol Building in Sacramento. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The primary is over, and now it’s crunch time to come up with a state budget. A key fiscal battle is pitting legislative Democrats against the governor in overtime pay for in-home care workers.\u003c/p>\n\u003cp>Last fall, the federal government changed the overtime rules for caregivers who cook, bathe and provide other help for elderly or disabled people who live in their own homes. Starting next January, caregivers are entitled to overtime pay for any hours they work exceeding 40 in each week.\u003c/p>\n\u003cp>Gov. Jerry Brown says California can’t afford the overtime pay. He wants to cap workers’ hours to avoid triggering the overtime rules. The budget proposals he released in January and May reflect this cap, as well as rate cuts for in-home health care providers.\u003c!--more-->\u003c/p>\n\u003cp>“Whether it’s the overtime or the provider rates or the courts or any of the other items, we have to squeeze it out of the current budget,” Brown said at a press conference about his latest budget proposal last month. “This is one cut on how to do it. Others will see differently, but at the end of the day we have to live within the revenue.”\u003c/p>\n\u003cp>Families and disability rights advocates are terrified of the consequences. They say a cap on hours will force people to hire strangers to perform intimate care duties they only trust their regular caregiver to do.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s not like, 'I’ll take Pepsi instead of Coke.' They’re not interchangeable,” said Deborah Doctor, a disability rights lobbyist.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/152988718&color=ff5500&auto_play=false&hide_related=false&show_artwork=true&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>She says it's hard enough to find a suitable home worker as it is. The pay is low -- an average of $10 an hour -- and the work is messy and grueling. Doctor says few are willing to take on the kinds of tasks one caregiver provides for a disabled woman in Los Angeles.\u003c/p>\n\u003cp>“She does bowel extraction every week. So we think there’s going to be someone just dying to do this?” she says.\u003c/p>\n\u003cp>The state estimates it will cost around $186 million from the general fund to cover the overtime costs of in-home workers. Legislative Democrats argue the state can cover these costs now that its finances are in better shape -- both the Senate and Assembly budget committees have proposed allocating money for the overtime pay.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But Brown has been advocating for fiscal restraint and bolstering the state’s rainy day fund. It remains to be seen what the governor will sign into law.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19395\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/179063219.jpg\">\u003cimg class=\"size-large wp-image-19395\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/179063219-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The State Capitol Building in Sacramento. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The primary is over, and now it’s crunch time to come up with a state budget. A key fiscal battle is pitting legislative Democrats against the governor in overtime pay for in-home care workers.\u003c/p>\n\u003cp>Last fall, the federal government changed the overtime rules for caregivers who cook, bathe and provide other help for elderly or disabled people who live in their own homes. Starting next January, caregivers are entitled to overtime pay for any hours they work exceeding 40 in each week.\u003c/p>\n\u003cp>Gov. Jerry Brown says California can’t afford the overtime pay. He wants to cap workers’ hours to avoid triggering the overtime rules. The budget proposals he released in January and May reflect this cap, as well as rate cuts for in-home health care providers.\u003c!--more-->\u003c/p>\n\u003cp>“Whether it’s the overtime or the provider rates or the courts or any of the other items, we have to squeeze it out of the current budget,” Brown said at a press conference about his latest budget proposal last month. “This is one cut on how to do it. Others will see differently, but at the end of the day we have to live within the revenue.”\u003c/p>\n\u003cp>Families and disability rights advocates are terrified of the consequences. They say a cap on hours will force people to hire strangers to perform intimate care duties they only trust their regular caregiver to do.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s not like, 'I’ll take Pepsi instead of Coke.' They’re not interchangeable,” said Deborah Doctor, a disability rights lobbyist.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/152988718&color=ff5500&auto_play=false&hide_related=false&show_artwork=true&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>She says it's hard enough to find a suitable home worker as it is. The pay is low -- an average of $10 an hour -- and the work is messy and grueling. Doctor says few are willing to take on the kinds of tasks one caregiver provides for a disabled woman in Los Angeles.\u003c/p>\n\u003cp>“She does bowel extraction every week. So we think there’s going to be someone just dying to do this?” she says.\u003c/p>\n\u003cp>The state estimates it will cost around $186 million from the general fund to cover the overtime costs of in-home workers. Legislative Democrats argue the state can cover these costs now that its finances are in better shape -- both the Senate and Assembly budget committees have proposed allocating money for the overtime pay.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But Brown has been advocating for fiscal restraint and bolstering the state’s rainy day fund. It remains to be seen what the governor will sign into law.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_15832\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/56292361-e1382588779517.jpg\">\u003cimg class=\"size-full wp-image-15832\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/56292361-e1382588779517.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"417\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/56292361-e1382588779517.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/56292361-e1382588779517-400x261.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/56292361-e1382588779517-320x209.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>A bill by state Sen. Mark Leno aimed at raising the minimum wage passed the California Senate and is moving on to the Assembly.\u003c/p>\n\u003cp>But what does this have to do with health?\u003c/p>\n\u003caside class=\"pullquote alignleft\">A \"powerful intervention\" for public health. \u003c/aside>\n\u003cp>Generally, advocates of raising the minimum wage try to sway public opinion by using economic arguments. But there’s an increasing move to tie health outcomes and health costs directly to the minimum wage, just as health advocates have\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/04/17/smoking-or-schools-which-is-more-important-to-your-health/\" target=\"_blank\"> long tied\u003c/a> socioeconomic status generally to health status.\u003c/p>\n\u003cp>\u003ca href=\"http://www.humanimpact.org/news/the-health-impacts-of-raising-the-minimum-wage/\" target=\"_blank\">A new study\u003c/a> finds that raising the state minimum wage could prevent hundreds of premature deaths in California each year and save millions in health costs.\u003c/p>\n\u003cp>Human Impact Partners, or HIP, conducted a \"\u003ca href=\"http://www.humanimpact.org/news/the-health-impacts-of-raising-the-minimum-wage/\" target=\"_blank\">rapid health analysis\u003c/a>\" of Leno's proposed \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB935\" target=\"_blank\">SB935\u003c/a>, which would raise the current $8-an-hour minimum wage to $13 an hour by 2017.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>They found that the higher wage would prevent the premature deaths of nearly 400 lower-income Californians per year.\u003c/p>\n\u003cp>“Giving working families a decent standard of living … is one of the most powerful interventions we can make for public health,” says HIP co-director Jonathan Heller.\u003c/p>\n\u003cp>\u003cstrong>Raising the Minimum Wage Can Also Raise Health Status ...\u003c/strong>\u003c/p>\n\u003cp>Higher pay reduces people's risk of all kinds of health problems, ranging from obesity to depression to smoking.\u003c/p>\n\u003cp>The report also found that adults and families who live in poverty are more than twice as likely to face serious psychological distress than those families who make three times the poverty level.\u003c/p>\n\u003cp>Heller says studies have tied the physical problems to the accumulated effects of chronic stress, less access to health care and the quality of neighborhoods in which people can afford to live.\u003c/p>\n\u003cp>While HIP's study looked specifically at the impact of a minimum wage increase in California, other researchers have looked more broadly. Paul Leigh is a professor of economics at UC Davis Medical School. He and research partner DaeHwan Kim \u003ca href=\"http://www.epi.org/blog/raising-minimum-wage-improve-public-health/\" target=\"_blank\">crunched numbers \u003c/a>from a multistate health study that lasted from 1999-2007. In some of the states, the minimum wage went up during that time.\u003c/p>\n\u003cp>In one case, they looked at the effect of the wage increase on rates of high blood pressure. “We found a higher minimum wage was associated with fewer cases of hypertension, especially at lower income levels,\" Leigh said.\u003c/p>\n\u003cp>The researchers used the same data set to look at weight. “We found low-wage workers had higher rates of obesity, and when wages went up there was a reduction in prevalence of obesity,” Leigh said.\u003c/p>\n\u003cp>\u003cstrong>… Could Lead to Health Cost Savings\u003c/strong>\u003c/p>\n\u003cp>Leigh says he would like to do research linking health care cost savings with raising the minimum wage.\u003c/p>\n\u003cp>According to the Harvard School of Public Health, the United States spent $190 billion a year on obesity-related costs in 2005. The Centers for Disease Control and Prevention says smoking drains more than $289 billion a year from the economy in both medical care costs and lost productivity.\u003c/p>\n\u003cp>“Obesity, hypertension, smoking are very costly for U.S. economy, so anything you can do to reduce them will have positive effect in reducing overall medical costs,” said Leigh.\u003c/p>\n\u003cp>That would give advocates of raising the minimum wage a new tool for making their argument.\u003c/p>\n\u003cp>Rajiv Bhatia authored the study by Health Impact Partners, which looked at how SB935 could impact the health of California’s low-income workers.\u003c/p>\n\u003cp>He says it’s important to understand the nuanced way that wages affect health.\u003c/p>\n\u003cp>“It’s not like, ‘OK, I get more money in my pocket and my blood pressure changes and health improves,'” says Bhatia. “Income is working through many pathways. And not every pathway is working on every individual.”\u003c/p>\n\u003cp>Still, he says, people at the bottom 20 percent of income are four times as likely to rate their health as poor as those at the top. “Low income is associated with exposures that cause diseases,” says Bhatia. “But it also causes your disease outcomes to be worse.”\u003c/p>\n\u003cp>He says there is a precedent for public health departments getting involved in a policy fight to raise the minimum wage. In Minnesota the commissioner of health \u003ca href=\"http://www.minnpost.com/community-voices/2014/03/wages-are-public-health-issue\" target=\"_blank\">publicly advocated \u003c/a>for an increase, after a study there showed the health benefits of raising the state's minimum wage.\u003c/p>\n\u003cp>Bhatia says that, long term, he would like to create something like an online calculator, “so somebody in any state could look at their state wage and plug in an alternative minimum wage. Then they would get as an output how would self-rated health improve, how would health insurance options change, how would education outcomes change.”\u003c/p>\n\u003cp>Bhatia says that is in the works. In the meantime, he is hopeful that more people arguing for the minimum wage will take up the health mantle.\u003c/p>\n\u003cp>He says the current paradigm by many advocating for a minimum wage increase is that this is an economic trade-off issue, between what is right and fair versus something that is economically feasible.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But, he says, by putting it in a health frame, it humanizes and adds another dimension. Factoring in health improvements — and estimated health costs savings — is a dimension Bhatia hopes will resonate with the public.\u003c/p>\n\n",
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"excerpt": "Study finds raising minimum wage to $13/hour avoids 400 premature deaths annually, lowers other risks.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15832\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/56292361-e1382588779517.jpg\">\u003cimg class=\"size-full wp-image-15832\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/56292361-e1382588779517.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"417\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/56292361-e1382588779517.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/56292361-e1382588779517-400x261.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/56292361-e1382588779517-320x209.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>A bill by state Sen. Mark Leno aimed at raising the minimum wage passed the California Senate and is moving on to the Assembly.\u003c/p>\n\u003cp>But what does this have to do with health?\u003c/p>\n\u003caside class=\"pullquote alignleft\">A \"powerful intervention\" for public health. \u003c/aside>\n\u003cp>Generally, advocates of raising the minimum wage try to sway public opinion by using economic arguments. But there’s an increasing move to tie health outcomes and health costs directly to the minimum wage, just as health advocates have\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/04/17/smoking-or-schools-which-is-more-important-to-your-health/\" target=\"_blank\"> long tied\u003c/a> socioeconomic status generally to health status.\u003c/p>\n\u003cp>\u003ca href=\"http://www.humanimpact.org/news/the-health-impacts-of-raising-the-minimum-wage/\" target=\"_blank\">A new study\u003c/a> finds that raising the state minimum wage could prevent hundreds of premature deaths in California each year and save millions in health costs.\u003c/p>\n\u003cp>Human Impact Partners, or HIP, conducted a \"\u003ca href=\"http://www.humanimpact.org/news/the-health-impacts-of-raising-the-minimum-wage/\" target=\"_blank\">rapid health analysis\u003c/a>\" of Leno's proposed \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB935\" target=\"_blank\">SB935\u003c/a>, which would raise the current $8-an-hour minimum wage to $13 an hour by 2017.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>They found that the higher wage would prevent the premature deaths of nearly 400 lower-income Californians per year.\u003c/p>\n\u003cp>“Giving working families a decent standard of living … is one of the most powerful interventions we can make for public health,” says HIP co-director Jonathan Heller.\u003c/p>\n\u003cp>\u003cstrong>Raising the Minimum Wage Can Also Raise Health Status ...\u003c/strong>\u003c/p>\n\u003cp>Higher pay reduces people's risk of all kinds of health problems, ranging from obesity to depression to smoking.\u003c/p>\n\u003cp>The report also found that adults and families who live in poverty are more than twice as likely to face serious psychological distress than those families who make three times the poverty level.\u003c/p>\n\u003cp>Heller says studies have tied the physical problems to the accumulated effects of chronic stress, less access to health care and the quality of neighborhoods in which people can afford to live.\u003c/p>\n\u003cp>While HIP's study looked specifically at the impact of a minimum wage increase in California, other researchers have looked more broadly. Paul Leigh is a professor of economics at UC Davis Medical School. He and research partner DaeHwan Kim \u003ca href=\"http://www.epi.org/blog/raising-minimum-wage-improve-public-health/\" target=\"_blank\">crunched numbers \u003c/a>from a multistate health study that lasted from 1999-2007. In some of the states, the minimum wage went up during that time.\u003c/p>\n\u003cp>In one case, they looked at the effect of the wage increase on rates of high blood pressure. “We found a higher minimum wage was associated with fewer cases of hypertension, especially at lower income levels,\" Leigh said.\u003c/p>\n\u003cp>The researchers used the same data set to look at weight. “We found low-wage workers had higher rates of obesity, and when wages went up there was a reduction in prevalence of obesity,” Leigh said.\u003c/p>\n\u003cp>\u003cstrong>… Could Lead to Health Cost Savings\u003c/strong>\u003c/p>\n\u003cp>Leigh says he would like to do research linking health care cost savings with raising the minimum wage.\u003c/p>\n\u003cp>According to the Harvard School of Public Health, the United States spent $190 billion a year on obesity-related costs in 2005. The Centers for Disease Control and Prevention says smoking drains more than $289 billion a year from the economy in both medical care costs and lost productivity.\u003c/p>\n\u003cp>“Obesity, hypertension, smoking are very costly for U.S. economy, so anything you can do to reduce them will have positive effect in reducing overall medical costs,” said Leigh.\u003c/p>\n\u003cp>That would give advocates of raising the minimum wage a new tool for making their argument.\u003c/p>\n\u003cp>Rajiv Bhatia authored the study by Health Impact Partners, which looked at how SB935 could impact the health of California’s low-income workers.\u003c/p>\n\u003cp>He says it’s important to understand the nuanced way that wages affect health.\u003c/p>\n\u003cp>“It’s not like, ‘OK, I get more money in my pocket and my blood pressure changes and health improves,'” says Bhatia. “Income is working through many pathways. And not every pathway is working on every individual.”\u003c/p>\n\u003cp>Still, he says, people at the bottom 20 percent of income are four times as likely to rate their health as poor as those at the top. “Low income is associated with exposures that cause diseases,” says Bhatia. “But it also causes your disease outcomes to be worse.”\u003c/p>\n\u003cp>He says there is a precedent for public health departments getting involved in a policy fight to raise the minimum wage. In Minnesota the commissioner of health \u003ca href=\"http://www.minnpost.com/community-voices/2014/03/wages-are-public-health-issue\" target=\"_blank\">publicly advocated \u003c/a>for an increase, after a study there showed the health benefits of raising the state's minimum wage.\u003c/p>\n\u003cp>Bhatia says that, long term, he would like to create something like an online calculator, “so somebody in any state could look at their state wage and plug in an alternative minimum wage. Then they would get as an output how would self-rated health improve, how would health insurance options change, how would education outcomes change.”\u003c/p>\n\u003cp>Bhatia says that is in the works. In the meantime, he is hopeful that more people arguing for the minimum wage will take up the health mantle.\u003c/p>\n\u003cp>He says the current paradigm by many advocating for a minimum wage increase is that this is an economic trade-off issue, between what is right and fair versus something that is economically feasible.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But, he says, by putting it in a health frame, it humanizes and adds another dimension. Factoring in health improvements — and estimated health costs savings — is a dimension Bhatia hopes will resonate with the public.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Should There Be a Ban on Using Food Stamps to Buy Soda?",
"title": "Should There Be a Ban on Using Food Stamps to Buy Soda?",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_17715\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\">\u003cimg class=\"size-full wp-image-17715\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"400\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-400x250.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-320x200.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Banning the use of food stamps to purchase sodas and other sugary drinks could reduce both obesity and Type 2 diabetes rates, according to new research from the Stanford University School of Medicine.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'Shift in policy could prevent 400,000 cases of obesity.' \u003c/aside>\n\u003cp>About one in seven Americans — more than 46 million people — currently receive food stamps, now called the Supplemental Nutrition Assistance Program, or SNAP.\u003ca href=\"http://www.cdc.gov/nchs/nhanes/nhanes.htm\" target=\"_blank\"> Government surveys\u003c/a> show that the average SNAP recipient drinks the equivalent of a little more than a can of soda a day.\u003c/p>\n\u003cp>Stanford researchers used two data sets, one on diet and another on price data for food, and then used simulations to estimate the effect of a ban on using SNAP funds to buy sugary beverages, including sodas and sports drinks, but excluding 100 percent fruit juices.\u003c!--more-->\u003c/p>\n\u003cp>Over a 10-year period, the simulation indicated that such a ban would amount to a 2.4 percent drop in obesity prevalence and a 1.7 percent decline in Type 2 diabetes among SNAP recipients.\u003c/p>\n\u003cp>While those percentage changes sound small, lead author Dr. Sanjay Basu, a professor of medicine at Stanford, says the real impact across a population would be impressive.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"This shift in policy would be preventing around 400,000 cases of obesity in the next decade and nearly 250,000 cases of Type 2 diabetes,\" Basu said.\u003c/p>\n\u003cp>The study was published in the journal \u003ca href=\"http://content.healthaffairs.org/content/33/6/1032.abstract\" target=\"_blank\">Health Affairs\u003c/a>.\u003c/p>\n\u003cp>[contextly_sidebar id=\"79b7f787c8ba45e85d9e5bfa25bc392d\"]\u003c/p>\n\u003cp>The American Beverage Association criticized the idea of a ban. In a statement, the group said a ban would be an \"expensive and unnecessary restriction that (has) negligible benefits.\" The association called instead for heath education and healthy incentives.\u003c/p>\n\u003cp>But Harold Goldstein, executive director of the California Center for Public Health Advocacy, was intrigued by the analysis. \"I look at these federal dollars as a subsidy to Coke and Pepsi,\" he said. \"Here's a strategy that could have a significant impact on low-income folks who have among the highest diabetes rates in the country.\" Goldstein was not involved in the research.\u003c/p>\n\u003cp>Another federal program, Women, Infants and Children, already does not allow the purchase of sugar-sweetened beverages.\u003c/p>\n\u003cp>The researchers also looked at the impact of giving 30 cents back to SNAP participants for each dollar they might spend on fruits and vegetables. While such a reward doubled the number of people eating the recommended requirements of fruits and vegetables, obesity and diabetes indicators \"did not improve considerably,\" Basu said.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/152651570&color=ff5500&auto_play=false&hide_related=false&show_artwork=true&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Last June, a bipartisan group of mayors \u003ca href=\"http://s3.documentcloud.org/documents/716748/mayors-request-house-limit-snap-access-to-soda.pdf\" target=\"_blank\">sent a letter\u003c/a> to House Speaker John Boehner and House Minority Leader Nancy Pelosi advocating improvements to the SNAP program, saying it was time to consider limiting subsidies for sugar-sweetened beverages.\u003c/p>\n\u003cp>Monday's study comes against a backdrop of renewed calls in California cities for a soda tax — and just days after the California Senate \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2014/5/senate-approves-soda-warning-bill\" target=\"_blank\">passed a bill \u003c/a>that would require a health warning label on sodas and other sugary beverages.\u003c/p>\n\u003cp>Doctors and other public health professionals are growing increasingly concerned about the health impact of sugary beverages, or what Goldstein referred to as \"liquid sugar.\"\u003c/p>\n\u003cp>\"We know that there is overwhelming science that the liquid sugar in these beverages is a unique driver in today's skyrocketing obesity epidemic,\" he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated to clarify the American Beverage Association's opposition to a policy on banning food stamps for purchase of sugar-sweetened beverages.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17715\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\">\u003cimg class=\"size-full wp-image-17715\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"400\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-400x250.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-320x200.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Banning the use of food stamps to purchase sodas and other sugary drinks could reduce both obesity and Type 2 diabetes rates, according to new research from the Stanford University School of Medicine.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'Shift in policy could prevent 400,000 cases of obesity.' \u003c/aside>\n\u003cp>About one in seven Americans — more than 46 million people — currently receive food stamps, now called the Supplemental Nutrition Assistance Program, or SNAP.\u003ca href=\"http://www.cdc.gov/nchs/nhanes/nhanes.htm\" target=\"_blank\"> Government surveys\u003c/a> show that the average SNAP recipient drinks the equivalent of a little more than a can of soda a day.\u003c/p>\n\u003cp>Stanford researchers used two data sets, one on diet and another on price data for food, and then used simulations to estimate the effect of a ban on using SNAP funds to buy sugary beverages, including sodas and sports drinks, but excluding 100 percent fruit juices.\u003c!--more-->\u003c/p>\n\u003cp>Over a 10-year period, the simulation indicated that such a ban would amount to a 2.4 percent drop in obesity prevalence and a 1.7 percent decline in Type 2 diabetes among SNAP recipients.\u003c/p>\n\u003cp>While those percentage changes sound small, lead author Dr. Sanjay Basu, a professor of medicine at Stanford, says the real impact across a population would be impressive.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"This shift in policy would be preventing around 400,000 cases of obesity in the next decade and nearly 250,000 cases of Type 2 diabetes,\" Basu said.\u003c/p>\n\u003cp>The study was published in the journal \u003ca href=\"http://content.healthaffairs.org/content/33/6/1032.abstract\" target=\"_blank\">Health Affairs\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The American Beverage Association criticized the idea of a ban. In a statement, the group said a ban would be an \"expensive and unnecessary restriction that (has) negligible benefits.\" The association called instead for heath education and healthy incentives.\u003c/p>\n\u003cp>But Harold Goldstein, executive director of the California Center for Public Health Advocacy, was intrigued by the analysis. \"I look at these federal dollars as a subsidy to Coke and Pepsi,\" he said. \"Here's a strategy that could have a significant impact on low-income folks who have among the highest diabetes rates in the country.\" Goldstein was not involved in the research.\u003c/p>\n\u003cp>Another federal program, Women, Infants and Children, already does not allow the purchase of sugar-sweetened beverages.\u003c/p>\n\u003cp>The researchers also looked at the impact of giving 30 cents back to SNAP participants for each dollar they might spend on fruits and vegetables. While such a reward doubled the number of people eating the recommended requirements of fruits and vegetables, obesity and diabetes indicators \"did not improve considerably,\" Basu said.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/152651570&color=ff5500&auto_play=false&hide_related=false&show_artwork=true&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Last June, a bipartisan group of mayors \u003ca href=\"http://s3.documentcloud.org/documents/716748/mayors-request-house-limit-snap-access-to-soda.pdf\" target=\"_blank\">sent a letter\u003c/a> to House Speaker John Boehner and House Minority Leader Nancy Pelosi advocating improvements to the SNAP program, saying it was time to consider limiting subsidies for sugar-sweetened beverages.\u003c/p>\n\u003cp>Monday's study comes against a backdrop of renewed calls in California cities for a soda tax — and just days after the California Senate \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2014/5/senate-approves-soda-warning-bill\" target=\"_blank\">passed a bill \u003c/a>that would require a health warning label on sodas and other sugary beverages.\u003c/p>\n\u003cp>Doctors and other public health professionals are growing increasingly concerned about the health impact of sugary beverages, or what Goldstein referred to as \"liquid sugar.\"\u003c/p>\n\u003cp>\"We know that there is overwhelming science that the liquid sugar in these beverages is a unique driver in today's skyrocketing obesity epidemic,\" he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated to clarify the American Beverage Association's opposition to a policy on banning food stamps for purchase of sugar-sweetened beverages.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"radiolab": {
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},
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"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
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