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"content": "\u003cfigure id=\"attachment_9250\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Sacramento_Capital_seliaymiwell_flickr-e1370983947930.jpg\">\u003cimg class=\"size-large wp-image-9250\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Sacramento_Capital_seliaymiwell_flickr-620x413.jpg\" alt=\"(seliaymiwell/flickr)\" width=\"620\" height=\"413\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(seliaymiwell/flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>California lawmakers announced a series of budget proposals Wednesday calling for more training of law enforcement officers on how to handle people with mental illness. While lawmakers have been working on the proposals for weeks, there is renewed emphasis on them in the aftermath of a gun rampage that left seven people dead near UC Santa Barbara last weekend.\u003c/p>\n\u003cp>“How do we stop this before it happens?” said Sen. Hannah-Beth Jackson (D-Santa Barbara).\u003c/p>\n\u003cp>Jackson said police officers who visited the shooter before the violence erupted failed to investigate him thoroughly and failed to recognize warning signs of mental health problems. “This is a young man whose mental illness was right out there on YouTube, right out there on Facebook, and in screeds that he posted on blogs,” Jackson said. “And yet no one did or was able to recognize the potential for violence that resulted in this mass set of murders.”\u003c/p>\n\u003cp>Sen. Loni Hancock (D-Berkeley) says the problem continues inside the state’s jails and prisons, where nearly half the inmates suffer from mental illness. She cited incidents where mentally ill inmates were improperly pepper sprayed.\u003c!--more-->\u003c/p>\n\u003cp>“You can be a correctional officer right out of high school,” Hancock said. “Nobody tells you about the demographics of the prison population, how to treat mentally ill people, how to de-escalate situations.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Senate Democrats want to see more money invested in training law enforcement and prison personnel in how to deal with mentally ill offenders. It’s just one of a series of policy and budget proposals the caucus has been working on.\u003c/p>\n\u003cp>But now they say their efforts have taken on even greater importance after \u003ca href=\"http://ww2.kqed.org/news/2014/05/26/amid-multiple-warning-signs-alleged-isla-vista-killer-slipped-through-system/\" target=\"_blank\">what happened in Isla Vista.\u003c/a>\u003c/p>\n\u003cp>“These proposals, finalized earlier this month, are now cast under a different light than any of us had every planned,” said Darrell Steinberg, Senate president pro tem. “It’s a cruel and sad coincidence.” Steinberg also stressed that most people with mental illness are not violent.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/151876934&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\">\u003c/iframe>\u003c/p>\n\u003cp>He and his allies want to spend $132 million on efforts aimed at reducing the number of people with mental illness who are incarcerated, and lowering recidivism rates of people who are released from prison, then re-offend because they could not get proper mental health treatment.\u003c/p>\n\u003cp>They draw their suggestions from \u003ca href=\"http://www.law.stanford.edu/sites/default/files/organization/149642/doc/slspublic/Report_v10.pdf\" target=\"_blank\">a report\u003c/a> released Wednesday by the Stanford Law School Three Strikes Project. It highlights how the population of mentally ill people in prison has ballooned in recent decades and outlines three key areas for change:\u003c/p>\n\u003col>\n\u003cli>Reform the way people with mental illness are sentenced, in part, by establishing more mental health courts that take a person’s mental health into account when judging a crime, and consider alternatives to incarceration for non-violent offenders.\u003c/li>\n\u003cli>Provide more meaningful treatment for the mentally ill, both while they are incarcerated and particularly, when they are released.\u003c/li>\n\u003cli>Establish a process and criteria for humane releases. People with mental illness are denied parole more often than other offenders, according to the Stanford report. Lawmakers suggest providing more case managers and services for parolees with mental illness.\u003c/li>\n\u003c/ol>\n\u003cp>A final budget is due next month. 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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Senate Democrats want to see more money invested in training law enforcement and prison personnel in how to deal with mentally ill offenders. It’s just one of a series of policy and budget proposals the caucus has been working on.\u003c/p>\n\u003cp>But now they say their efforts have taken on even greater importance after \u003ca href=\"http://ww2.kqed.org/news/2014/05/26/amid-multiple-warning-signs-alleged-isla-vista-killer-slipped-through-system/\" target=\"_blank\">what happened in Isla Vista.\u003c/a>\u003c/p>\n\u003cp>“These proposals, finalized earlier this month, are now cast under a different light than any of us had every planned,” said Darrell Steinberg, Senate president pro tem. “It’s a cruel and sad coincidence.” Steinberg also stressed that most people with mental illness are not violent.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/151876934&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\">\u003c/iframe>\u003c/p>\n\u003cp>He and his allies want to spend $132 million on efforts aimed at reducing the number of people with mental illness who are incarcerated, and lowering recidivism rates of people who are released from prison, then re-offend because they could not get proper mental health treatment.\u003c/p>\n\u003cp>They draw their suggestions from \u003ca href=\"http://www.law.stanford.edu/sites/default/files/organization/149642/doc/slspublic/Report_v10.pdf\" target=\"_blank\">a report\u003c/a> released Wednesday by the Stanford Law School Three Strikes Project. It highlights how the population of mentally ill people in prison has ballooned in recent decades and outlines three key areas for change:\u003c/p>\n\u003col>\n\u003cli>Reform the way people with mental illness are sentenced, in part, by establishing more mental health courts that take a person’s mental health into account when judging a crime, and consider alternatives to incarceration for non-violent offenders.\u003c/li>\n\u003cli>Provide more meaningful treatment for the mentally ill, both while they are incarcerated and particularly, when they are released.\u003c/li>\n\u003cli>Establish a process and criteria for humane releases. People with mental illness are denied parole more often than other offenders, according to the Stanford report. Lawmakers suggest providing more case managers and services for parolees with mental illness.\u003c/li>\n\u003c/ol>\n\u003cp>A final budget is due next month. The Senate must first get the state Assembly and the governor to agree to these proposals before they become an official line item.\u003c/p>\n\u003cp>They’re unlikely to face opposition from law enforcement advocates who agree with the goals of the proposals.\u003c/p>\n\u003cp>“We need more training and better resources,” said Craig Brown, a lobbyist with the California Correctional Peace Officers Association. “We know we’ve been accumulating more and more inmates with mental illness. The Los Angeles County Jail has been saying for years that they’re the biggest mental health institution in the state.”\u003c/p>\n\u003cp>He says law enforcement is equally interested in reducing recidivism as lawmakers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We haven’t seen the details, and that’s where the devil is,” Brown said. “But nobody’s fighting over the goal.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Insurance Commissioner Defends Health Insurance Initiative",
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"content": "\u003cfigure id=\"attachment_19280\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/CDJOfficialPhoto.jpg\">\u003cimg class=\"size-large wp-image-19280\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/CDJOfficialPhoto-640x581.jpg\" alt=\"Dave Jones leads the California Department of Insurance. (Courtesy: Department of Insurance)\" width=\"640\" height=\"581\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dave Jones leads the California Department of Insurance. (Courtesy: Department of Insurance)\u003c/figcaption>\u003c/figure>\n\u003cp>In this lull between the end of the first open enrollment for Covered California and the release of rates for next year — expected to be made public in July — San Francisco's Commonwealth Club invited the state's Commissioner of Insurance Dave Jones to talk about the state of the health care overhaul in California.\u003c/p>\n\u003cp>The commissioner closed his remarks by pitching for the rate review \u003ca href=\"http://www.sos.ca.gov/elections/ballot-measures/qualified-ballot-measures.htm\" target=\"_blank\">ballot initiative\u003c/a> coming up in November. As moderator of the discussion following, I fielded several questions from the audience about the upcoming initiative. To recap the basics: If passed, the initiative would give the insurance commissioner the authority to reject excessive health insurance rate increases.\u003c/p>\n\u003cp>The insurance commissioner already has that authority over auto, homeowner, property and casualty insurance — via voter-passed Proposition 103 back in 1988. Many voters are surprised, Jones said, to find out he cannot also reject health insurance premium increases. He called this lack of explicit authority a \"major missing piece of the Affordable Care Act.\"\u003c!--more-->\u003c/p>\n\u003cp>\"Californians have suffered from repeated health insurance rate hikes year after year,\" Jones said. \"On average (health insurance) rates in the last 10 years have gone up over 150 percent. That's five times the rate of inflation.\"\u003c/p>\n\u003cp>Jones also noted that 35 states have given their insurance commissioners \"the authority to reject health insurance rate hikes, but not California.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It's a measure that likely sounds appealing to plenty of voters, but\u003ca href=\"http://www.stophighercosts.com/reports/impact-on-covered-california\" target=\"_blank\"> a report\u003c/a> earlier this month determined that, if passed, the initiative could destabilize Covered California, the state's Obamacare exchange. The report was written by consultant Jon Kingsdale, the former head of the Massachusetts health exchange who has also been an advisor to the Obama administration on the Affordable Care Act. It was funded by \u003ca href=\"http://www.stophighercosts.com/about-us\" target=\"_blank\">Californians Against Higher Health Care Costs,\u003c/a> which includes the California Association of Health Plans.\u003c/p>\n\u003cp>Under state law, Covered California can negotiate with insurers and can reject plans from participating in the exchange. This leverage may have helped to moderate rates in the exchange's first year. Still, Covered California must submit accepted plans to the state's regulators for certification.\u003c/p>\n\u003cp>And here's where we get into the weeds of certifying insurance rates and what this initiative would do.\u003c/p>\n\u003cp>Under Prop. 103, consumer \"\u003ca href=\"http://www.insurance.ca.gov/0100-consumers/0285-p103/info.cfm\" target=\"_blank\">intervenors\u003c/a>\" can file challenges to rate hikes. They can recover \"reasonable costs and fees\" under certain circumstances for mounting a challenge. Intervenors do this now, on occasion, with the other types of insurance covered by Prop. 103.\u003c/p>\n\u003cp>But under the ACA, the individual market for health insurance is now sold only during an open enrollment period — just several weeks out of the year, not year-round like auto or homeowners insurance is.\u003c/p>\n\u003cp>Larry Levitt, senior vice president at the Kaiser Family Foundation, called the intervenor process \"a real wild card\" if approved for health insurance rates. \"\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">There is the potential for some real messiness here if rates are challenged and not finalized before open enrollment begins.\"\u003c/span>\u003c/span>\u003c/p>\n\u003cp>That messiness would extend beyond just the premium. Under the ACA, subsidies are set according to the cost of the second lowest-cost premium. \"Worst case,\" Levitt said, \"you enter open enrollment without final rates, for at least some plans, so you don't know what the second lowest-cost silver plan is, so you're not certain of the benchmark for the premium subsidies.\" In other words, you could have people picking plans at rates that might change down the line.\u003c/p>\n\u003cp>Jones insisted that worry was overblown, pointing out that his department has about 7,000 rate filings annually for property and casualty insurance. Only about 12 of those filings are challenged by intervenors, \"so .2 percent of all the rate filings have an intervenor,\" Jones said.\u003c/p>\n\u003cp>His department gets about 100 health insurance filings a year. \"I'm confident that we can review those and accommodate public input … to meet the timelines of the exchange,\" he said.\u003c/p>\n\u003cp>Covered California is expected to release its analysis of the initiatives impact in the next several weeks.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"eIAnY5A7JQrFZId6BPNFSsF4Ohn7xK19\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19280\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/CDJOfficialPhoto.jpg\">\u003cimg class=\"size-large wp-image-19280\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/CDJOfficialPhoto-640x581.jpg\" alt=\"Dave Jones leads the California Department of Insurance. (Courtesy: Department of Insurance)\" width=\"640\" height=\"581\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dave Jones leads the California Department of Insurance. (Courtesy: Department of Insurance)\u003c/figcaption>\u003c/figure>\n\u003cp>In this lull between the end of the first open enrollment for Covered California and the release of rates for next year — expected to be made public in July — San Francisco's Commonwealth Club invited the state's Commissioner of Insurance Dave Jones to talk about the state of the health care overhaul in California.\u003c/p>\n\u003cp>The commissioner closed his remarks by pitching for the rate review \u003ca href=\"http://www.sos.ca.gov/elections/ballot-measures/qualified-ballot-measures.htm\" target=\"_blank\">ballot initiative\u003c/a> coming up in November. As moderator of the discussion following, I fielded several questions from the audience about the upcoming initiative. To recap the basics: If passed, the initiative would give the insurance commissioner the authority to reject excessive health insurance rate increases.\u003c/p>\n\u003cp>The insurance commissioner already has that authority over auto, homeowner, property and casualty insurance — via voter-passed Proposition 103 back in 1988. Many voters are surprised, Jones said, to find out he cannot also reject health insurance premium increases. He called this lack of explicit authority a \"major missing piece of the Affordable Care Act.\"\u003c!--more-->\u003c/p>\n\u003cp>\"Californians have suffered from repeated health insurance rate hikes year after year,\" Jones said. \"On average (health insurance) rates in the last 10 years have gone up over 150 percent. That's five times the rate of inflation.\"\u003c/p>\n\u003cp>Jones also noted that 35 states have given their insurance commissioners \"the authority to reject health insurance rate hikes, but not California.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It's a measure that likely sounds appealing to plenty of voters, but\u003ca href=\"http://www.stophighercosts.com/reports/impact-on-covered-california\" target=\"_blank\"> a report\u003c/a> earlier this month determined that, if passed, the initiative could destabilize Covered California, the state's Obamacare exchange. The report was written by consultant Jon Kingsdale, the former head of the Massachusetts health exchange who has also been an advisor to the Obama administration on the Affordable Care Act. It was funded by \u003ca href=\"http://www.stophighercosts.com/about-us\" target=\"_blank\">Californians Against Higher Health Care Costs,\u003c/a> which includes the California Association of Health Plans.\u003c/p>\n\u003cp>Under state law, Covered California can negotiate with insurers and can reject plans from participating in the exchange. This leverage may have helped to moderate rates in the exchange's first year. Still, Covered California must submit accepted plans to the state's regulators for certification.\u003c/p>\n\u003cp>And here's where we get into the weeds of certifying insurance rates and what this initiative would do.\u003c/p>\n\u003cp>Under Prop. 103, consumer \"\u003ca href=\"http://www.insurance.ca.gov/0100-consumers/0285-p103/info.cfm\" target=\"_blank\">intervenors\u003c/a>\" can file challenges to rate hikes. They can recover \"reasonable costs and fees\" under certain circumstances for mounting a challenge. Intervenors do this now, on occasion, with the other types of insurance covered by Prop. 103.\u003c/p>\n\u003cp>But under the ACA, the individual market for health insurance is now sold only during an open enrollment period — just several weeks out of the year, not year-round like auto or homeowners insurance is.\u003c/p>\n\u003cp>Larry Levitt, senior vice president at the Kaiser Family Foundation, called the intervenor process \"a real wild card\" if approved for health insurance rates. \"\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">There is the potential for some real messiness here if rates are challenged and not finalized before open enrollment begins.\"\u003c/span>\u003c/span>\u003c/p>\n\u003cp>That messiness would extend beyond just the premium. Under the ACA, subsidies are set according to the cost of the second lowest-cost premium. \"Worst case,\" Levitt said, \"you enter open enrollment without final rates, for at least some plans, so you don't know what the second lowest-cost silver plan is, so you're not certain of the benchmark for the premium subsidies.\" In other words, you could have people picking plans at rates that might change down the line.\u003c/p>\n\u003cp>Jones insisted that worry was overblown, pointing out that his department has about 7,000 rate filings annually for property and casualty insurance. Only about 12 of those filings are challenged by intervenors, \"so .2 percent of all the rate filings have an intervenor,\" Jones said.\u003c/p>\n\u003cp>His department gets about 100 health insurance filings a year. \"I'm confident that we can review those and accommodate public input … to meet the timelines of the exchange,\" he said.\u003c/p>\n\u003cp>Covered California is expected to release its analysis of the initiatives impact in the next several weeks.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"eIAnY5A7JQrFZId6BPNFSsF4Ohn7xK19\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Patent Reform Plunged Into Deep Freeze ",
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"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_19227\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/RS3437_dccapitol0223-scr.jpg\">\u003cimg class=\"size-large wp-image-19227\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/RS3437_dccapitol0223-scr-640x410.jpg\" alt=\"(Saul Loeb/AFP/Getty Images)\" width=\"640\" height=\"410\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Saul Loeb/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">Patent reform is a big deal in California, and not just to Silicon Valley tech companies. Any company that makes money off a patented idea or technology is keenly interested in what happens at the federal level – or doesn’t. \u003c/span>\u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"This news is devastating to the welfare of startups who will continue to face the threat of patent trolls.\" \u003c/aside>\n\u003cp>Senator Patrick Leahy, the Vermont Democrat who chairs the Judiciary Committee, has taken the patent reform bill off the agenda, lamenting in a \u003ca href=\"http://www.leahy.senate.gov/press/comment-of-senator-patrick-leahy-d-vt_chairman-senate-judiciary-committee-on-patent-legislation\" target=\"_blank\">statement \u003c/a>the various industries that rely on patents could not come to terms “on how to combat the scourge of patent trolls.”\u003c/p>\n\u003cp>\"I have said all along that we needed broad bipartisan support to get a bill through the Senate. Regrettably, competing companies on both sides of this issue refused to come to agreement on how to achieve that goal.\"\u003c!--more-->\u003c/p>\n\u003cp>The bill was intended to stymie trolls -- companies that exist solely to buy up patents, threaten infringement lawsuits, and then offer to settle for a tidy sum. A recent report issued by the \u003ca href=\"http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CCcQFjAA&url=http%3A%2F%2Fwww.whitehouse.gov%2Fsites%2Fdefault%2Ffiles%2Fdocs%2Fpatent_report.pdf&ei=ZUd-U-udJ4umyATF24GoAg&usg=AFQjCNGjo7m0fnd7ncG3tbeP76LATX8bwQ&sig2=rs5ii3fjv55Q5bK9kpqZDg&bvm=bv.67720277,d.aWw\" target=\"_blank\">White House\u003c/a> quoted one estimate that trolls extracted $29 billion dollars from their hapless targets in 2011, a 400 percent increase from 2005. Trouble is, your attitude about what parts of the system need reforming -- and how -- differs depending on whether you work in software, biotech, a research university, or even a law firm.\u003c/p>\n\u003cp>So who scuttled the bill on its way to markup? The Washington Post \u003ca href=\"http://www.washingtonpost.com/blogs/the-switch/wp/2014/05/21/whos-behind-the-last-minute-push-to-thwart-patent-reform/?utm_source=govdelivery\" target=\"_blank\">reports \u003c/a>it was a coalition of trial lawyers, universities, pharmaceutical firms and biotech companies.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We believe the measures in the legislation … go far beyond what is necessary or desirable to combat abusive patent litigation, and would do serious damage to the patent system,\" reads \u003ca href=\"http://www.washingtonpost.com/blogs/the-switch/files/2014/05/BIO-letter-copy.pdf\" target=\"_blank\">one letter\u003c/a> sent to Leahy on May 20. \"Many of the provisions would have the effect of treating every patent holder as a patent troll.\"\u003c/p>\n\u003cp>\"They couldn’t reach consensus on elements of the House Bill and finally just gave up,\" Congresswoman Zoe Lofgren (D-San Jose) told KQED. Lofgren co-sponsored the House patent reform bill that \u003ca href=\"http://www.cnet.com/news/house-passes-bill-aimed-at-curbing-patent-troll-lawsuits/\" target=\"_blank\">passed in December\u003c/a> with bi-partisan support, a rare feat these days in Washington DC.\u003c/p>\n\u003cp>Lofgren says the need for patent reform is urgent, especially for small businesses and entrepreneurs. \"Nobody likes to be sued, but at least the big companies have the revenue to be able to fight this stuff. The little guys can just be crushed.\"\u003c/p>\n\u003cp>The Silicon Valley lobbying outfit Engine was quick to voice its disappointment. In a press release, Engine \u003ca href=\"http://engine.is/issues/patent-reform-off-the-table-for-now-whats-next/3885\" target=\"_blank\">said\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>This news is devastating to the welfare of startups who will continue to face the threat of patent trolls. That no agreement could be reached, especially in light of the efforts being made across the committee to find common ground, is also bad news for the economy where \u003ca href=\"http://venturebeat.com/2014/04/24/waiting-for-patent-reform-is-costing-us-billions-here-are-the-numbers/\" target=\"_blank\">annual losses from patent troll litigation are billions of dollars\u003c/a>.\u003c/p>\u003c/blockquote>\n\u003cp>In recent years, it’s become increasingly difficult to get legislation through Congress. Individually and through groups, tech titans have \u003ca href=\"http://ww2.kqed.org/news/2014/03/31/silicon-valley-big-bucks-lobbying-force-in-washington-dc/?__utma=34673459.1355619827.1376932905.1400771684.1400783799.180&__utmb=34673459.5.10.1400783800&__utmc=34673459&__utmx=-&__utmz=34673459.1400783800.180.102.utmcsr=google%7Cutmccn=%28organic%29%7Cutmcmd=organic%7Cutmctr=%28not%20provided%29&__utmv=-&__utmk=148613557\" target=\"_blank\">spent a lot of money\u003c/a> trying to get comprehensive immigration reform passed -– to no avail.\u003c/p>\n\u003cp>While retail, software and IT firms have born the brunt of troll attacks so far, biopharmaceutical firms are fat targets, too, and \u003ca href=\"http://thehill.com/blogs/congress-blog/judicial/201945-next-patent-troll-victims-pharma-and-bio\" target=\"_blank\">word is\u003c/a> that industry will face increasing pressure to seek protection from changes in the law.\u003c/p>\n\u003cp>But after weeks of frustrating negotiations, it looks like patent reform may have to wait for the next legislative session.\u003c/p>\n\u003cp>Or maybe not. Congresswoman Anna Eshoo (D-Palto Alto) had a different read.\u003c/p>\n\u003cp>\"Senator Leahy has pushed the pause button,\" she told KQED, noting there has been no vote killing the bill. \"I always welcome in negotiations a time out. Their responsibility is to reach consensus, for the sake of the country.\"\u003c/p>\n\u003cp>Like Lofgren, Eshoo wants to see legislative action now, not next year.\u003c/p>\n\u003cp>\"It really is a racket,\" Eshoo says of the patent troll industry. \"It's a hold up, and it places an economic gun at the head of companies. There's too much of a cost to our national economy. We can't afford this.\"\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"N65cwOqaTvWZV0oMuRMrKL7NhN4JZaB9\"]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19227\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/RS3437_dccapitol0223-scr.jpg\">\u003cimg class=\"size-large wp-image-19227\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/RS3437_dccapitol0223-scr-640x410.jpg\" alt=\"(Saul Loeb/AFP/Getty Images)\" width=\"640\" height=\"410\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Saul Loeb/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">Patent reform is a big deal in California, and not just to Silicon Valley tech companies. Any company that makes money off a patented idea or technology is keenly interested in what happens at the federal level – or doesn’t. \u003c/span>\u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"This news is devastating to the welfare of startups who will continue to face the threat of patent trolls.\" \u003c/aside>\n\u003cp>Senator Patrick Leahy, the Vermont Democrat who chairs the Judiciary Committee, has taken the patent reform bill off the agenda, lamenting in a \u003ca href=\"http://www.leahy.senate.gov/press/comment-of-senator-patrick-leahy-d-vt_chairman-senate-judiciary-committee-on-patent-legislation\" target=\"_blank\">statement \u003c/a>the various industries that rely on patents could not come to terms “on how to combat the scourge of patent trolls.”\u003c/p>\n\u003cp>\"I have said all along that we needed broad bipartisan support to get a bill through the Senate. Regrettably, competing companies on both sides of this issue refused to come to agreement on how to achieve that goal.\"\u003c!--more-->\u003c/p>\n\u003cp>The bill was intended to stymie trolls -- companies that exist solely to buy up patents, threaten infringement lawsuits, and then offer to settle for a tidy sum. A recent report issued by the \u003ca href=\"http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CCcQFjAA&url=http%3A%2F%2Fwww.whitehouse.gov%2Fsites%2Fdefault%2Ffiles%2Fdocs%2Fpatent_report.pdf&ei=ZUd-U-udJ4umyATF24GoAg&usg=AFQjCNGjo7m0fnd7ncG3tbeP76LATX8bwQ&sig2=rs5ii3fjv55Q5bK9kpqZDg&bvm=bv.67720277,d.aWw\" target=\"_blank\">White House\u003c/a> quoted one estimate that trolls extracted $29 billion dollars from their hapless targets in 2011, a 400 percent increase from 2005. Trouble is, your attitude about what parts of the system need reforming -- and how -- differs depending on whether you work in software, biotech, a research university, or even a law firm.\u003c/p>\n\u003cp>So who scuttled the bill on its way to markup? The Washington Post \u003ca href=\"http://www.washingtonpost.com/blogs/the-switch/wp/2014/05/21/whos-behind-the-last-minute-push-to-thwart-patent-reform/?utm_source=govdelivery\" target=\"_blank\">reports \u003c/a>it was a coalition of trial lawyers, universities, pharmaceutical firms and biotech companies.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We believe the measures in the legislation … go far beyond what is necessary or desirable to combat abusive patent litigation, and would do serious damage to the patent system,\" reads \u003ca href=\"http://www.washingtonpost.com/blogs/the-switch/files/2014/05/BIO-letter-copy.pdf\" target=\"_blank\">one letter\u003c/a> sent to Leahy on May 20. \"Many of the provisions would have the effect of treating every patent holder as a patent troll.\"\u003c/p>\n\u003cp>\"They couldn’t reach consensus on elements of the House Bill and finally just gave up,\" Congresswoman Zoe Lofgren (D-San Jose) told KQED. Lofgren co-sponsored the House patent reform bill that \u003ca href=\"http://www.cnet.com/news/house-passes-bill-aimed-at-curbing-patent-troll-lawsuits/\" target=\"_blank\">passed in December\u003c/a> with bi-partisan support, a rare feat these days in Washington DC.\u003c/p>\n\u003cp>Lofgren says the need for patent reform is urgent, especially for small businesses and entrepreneurs. \"Nobody likes to be sued, but at least the big companies have the revenue to be able to fight this stuff. The little guys can just be crushed.\"\u003c/p>\n\u003cp>The Silicon Valley lobbying outfit Engine was quick to voice its disappointment. In a press release, Engine \u003ca href=\"http://engine.is/issues/patent-reform-off-the-table-for-now-whats-next/3885\" target=\"_blank\">said\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>This news is devastating to the welfare of startups who will continue to face the threat of patent trolls. That no agreement could be reached, especially in light of the efforts being made across the committee to find common ground, is also bad news for the economy where \u003ca href=\"http://venturebeat.com/2014/04/24/waiting-for-patent-reform-is-costing-us-billions-here-are-the-numbers/\" target=\"_blank\">annual losses from patent troll litigation are billions of dollars\u003c/a>.\u003c/p>\u003c/blockquote>\n\u003cp>In recent years, it’s become increasingly difficult to get legislation through Congress. Individually and through groups, tech titans have \u003ca href=\"http://ww2.kqed.org/news/2014/03/31/silicon-valley-big-bucks-lobbying-force-in-washington-dc/?__utma=34673459.1355619827.1376932905.1400771684.1400783799.180&__utmb=34673459.5.10.1400783800&__utmc=34673459&__utmx=-&__utmz=34673459.1400783800.180.102.utmcsr=google%7Cutmccn=%28organic%29%7Cutmcmd=organic%7Cutmctr=%28not%20provided%29&__utmv=-&__utmk=148613557\" target=\"_blank\">spent a lot of money\u003c/a> trying to get comprehensive immigration reform passed -– to no avail.\u003c/p>\n\u003cp>While retail, software and IT firms have born the brunt of troll attacks so far, biopharmaceutical firms are fat targets, too, and \u003ca href=\"http://thehill.com/blogs/congress-blog/judicial/201945-next-patent-troll-victims-pharma-and-bio\" target=\"_blank\">word is\u003c/a> that industry will face increasing pressure to seek protection from changes in the law.\u003c/p>\n\u003cp>But after weeks of frustrating negotiations, it looks like patent reform may have to wait for the next legislative session.\u003c/p>\n\u003cp>Or maybe not. Congresswoman Anna Eshoo (D-Palto Alto) had a different read.\u003c/p>\n\u003cp>\"Senator Leahy has pushed the pause button,\" she told KQED, noting there has been no vote killing the bill. \"I always welcome in negotiations a time out. Their responsibility is to reach consensus, for the sake of the country.\"\u003c/p>\n\u003cp>Like Lofgren, Eshoo wants to see legislative action now, not next year.\u003c/p>\n\u003cp>\"It really is a racket,\" Eshoo says of the patent troll industry. \"It's a hold up, and it places an economic gun at the head of companies. There's too much of a cost to our national economy. We can't afford this.\"\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"N65cwOqaTvWZV0oMuRMrKL7NhN4JZaB9\"]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Study: Steps to Save Lives in a Flu Pandemic",
"title": "Study: Steps to Save Lives in a Flu Pandemic",
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"content": "\u003cfigure id=\"attachment_19193\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682.jpg\">\u003cimg class=\"size-large wp-image-19193\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682-640x368.jpg\" alt=\"A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\" width=\"640\" height=\"368\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brian Lau\u003c/strong>\u003c/p>\n\u003cp>In a new analysis, Stanford researchers, in collaboration with others across the country, suggest changes policy makers could address now to save thousands of lives and billions of dollars in the event of a pandemic, such as the one the world saw in 2009 when H1N1 swept around the world.\u003c/p>\n\u003cp>A new bird flu strain -- H7N9 -- emerged in March, 2013, World Health Organization \u003ca href=\"http://wwwnc.cdc.gov/travel/notices/watch/avian-flu-h7n9-china\" target=\"_blank\">report\u003c/a> 400 deaths since last April, most of them in Asia.\u003c/p>\n\u003cp>Researchers used data from the 2009 pandemic and the virus characteristics of the H7N9 bird flu in a model to estimate the health and economic consequences. They studied the effect of both vaccination programs and public health initiatives, using different time points during the first 12 months of a simulated severe pandemic in a densely populated metropolitan area.\u003c/p>\n\u003cp>In 2009, a vaccine was developed and became available 9 months into the pandemic. Researchers found that a shorter time to vaccination -- 6 months instead of 9 -- would avert nearly 6,000 deaths and save $1.9 billion in treatment costs. The study was published in the \u003ca href=\"http://annals.org/article.aspx?articleID=1872847\" target=\"_blank\">Annals of Internal Medicine\u003c/a> this week.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Influenza is a virus that changes its structure frequently. These subtle changes allow the virus to evade the human immune system and result in repetitive flu outbreaks. This is why each year we have to get a new flu shot.\u003c/p>\n\u003cp>Occasionally, the flu virus undergoes a major shift in its structure, allowing a strain that normally infects only animals to make the jump to humans. These major changes make the virus so unique that our immune systems cannot recognize and fight the virus -- meaning higher rates of infection and potentially causing a large regional or global pandemic.\u003c/p>\n\u003cp>The backbone of the U.S. Centers of Disease Control and Prevention’s response to an influenza pandemic is to develop and distribute an appropriate vaccine. Currently, flu vaccines are egg-based and require months for manufacturers to optimize growth conditions and produce vaccines.\u003c/p>\n\u003cp>\u003cspan>“Best-case scenario: egg-based vaccine delivery is completed in 5 months”, said Dr. Nayer Khazeni, lead author and assistant professor of medicine at the Stanford University School of Medicine. Moving toward new technologies \"can decrease this time by 2-3 months.\" \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Public Health Measures Can Save Lives in Pandemic\u003c/strong>\u003c/p>\n\u003cp>Still, regardless of the method of vaccine development, there will be a delay from the time a virus appears to delivery of a vaccine. During this time period, public health officials can limit the spread of the virus, the researchers said, possibly through school and childcare closures or even voluntary isolation. But, isolating the population until vaccines are delivered may not be practical or safe. The economic fallout alone could be detrimental.\u003c/p>\n\u003cp>The study found that a 33 percent decrease in contacts with infected individuals would save as many lives and reduce cost similar to vaccinating the population at 4 months into a pandemic. This could result in saving over 11,400 deaths and about $3.8 billion in health care costs compared to vaccinating at 9 months as in the 2009 flu pandemic.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"Apple-style-span\" style=\"font-style: inherit;color: #000000\">Brian Lau is a freelance writer and an orthopedic surgery resident at UCSF medical center. Follow him \u003ca style=\"font-weight: bold;color: #114999\" href=\"https://twitter.com/blauMD\" target=\"_blank\">on Twitter\u003c/a>. \u003c/span>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19193\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682.jpg\">\u003cimg class=\"size-large wp-image-19193\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682-640x368.jpg\" alt=\"A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\" width=\"640\" height=\"368\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brian Lau\u003c/strong>\u003c/p>\n\u003cp>In a new analysis, Stanford researchers, in collaboration with others across the country, suggest changes policy makers could address now to save thousands of lives and billions of dollars in the event of a pandemic, such as the one the world saw in 2009 when H1N1 swept around the world.\u003c/p>\n\u003cp>A new bird flu strain -- H7N9 -- emerged in March, 2013, World Health Organization \u003ca href=\"http://wwwnc.cdc.gov/travel/notices/watch/avian-flu-h7n9-china\" target=\"_blank\">report\u003c/a> 400 deaths since last April, most of them in Asia.\u003c/p>\n\u003cp>Researchers used data from the 2009 pandemic and the virus characteristics of the H7N9 bird flu in a model to estimate the health and economic consequences. They studied the effect of both vaccination programs and public health initiatives, using different time points during the first 12 months of a simulated severe pandemic in a densely populated metropolitan area.\u003c/p>\n\u003cp>In 2009, a vaccine was developed and became available 9 months into the pandemic. Researchers found that a shorter time to vaccination -- 6 months instead of 9 -- would avert nearly 6,000 deaths and save $1.9 billion in treatment costs. The study was published in the \u003ca href=\"http://annals.org/article.aspx?articleID=1872847\" target=\"_blank\">Annals of Internal Medicine\u003c/a> this week.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Influenza is a virus that changes its structure frequently. These subtle changes allow the virus to evade the human immune system and result in repetitive flu outbreaks. This is why each year we have to get a new flu shot.\u003c/p>\n\u003cp>Occasionally, the flu virus undergoes a major shift in its structure, allowing a strain that normally infects only animals to make the jump to humans. These major changes make the virus so unique that our immune systems cannot recognize and fight the virus -- meaning higher rates of infection and potentially causing a large regional or global pandemic.\u003c/p>\n\u003cp>The backbone of the U.S. Centers of Disease Control and Prevention’s response to an influenza pandemic is to develop and distribute an appropriate vaccine. Currently, flu vaccines are egg-based and require months for manufacturers to optimize growth conditions and produce vaccines.\u003c/p>\n\u003cp>\u003cspan>“Best-case scenario: egg-based vaccine delivery is completed in 5 months”, said Dr. Nayer Khazeni, lead author and assistant professor of medicine at the Stanford University School of Medicine. Moving toward new technologies \"can decrease this time by 2-3 months.\" \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Public Health Measures Can Save Lives in Pandemic\u003c/strong>\u003c/p>\n\u003cp>Still, regardless of the method of vaccine development, there will be a delay from the time a virus appears to delivery of a vaccine. During this time period, public health officials can limit the spread of the virus, the researchers said, possibly through school and childcare closures or even voluntary isolation. But, isolating the population until vaccines are delivered may not be practical or safe. The economic fallout alone could be detrimental.\u003c/p>\n\u003cp>The study found that a 33 percent decrease in contacts with infected individuals would save as many lives and reduce cost similar to vaccinating the population at 4 months into a pandemic. This could result in saving over 11,400 deaths and about $3.8 billion in health care costs compared to vaccinating at 9 months as in the 2009 flu pandemic.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"Apple-style-span\" style=\"font-style: inherit;color: #000000\">Brian Lau is a freelance writer and an orthopedic surgery resident at UCSF medical center. Follow him \u003ca style=\"font-weight: bold;color: #114999\" href=\"https://twitter.com/blauMD\" target=\"_blank\">on Twitter\u003c/a>. \u003c/span>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "SEIU Teams Up with California Hospitals, Withdraws Ballot Initiatives",
"title": "SEIU Teams Up with California Hospitals, Withdraws Ballot Initiatives",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_19051\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/sb10069454g-001-e1399421017698.jpg\">\u003cimg class=\"size-large wp-image-19051\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/sb10069454g-001-640x480.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The California Hospital Association and Service Employees International Union say they have reached a \"unique agreement\" that will \"change the face of healthcare in California.\"\u003c/p>\n\u003cp>And in the process, the two ballot initiatives SEIU backed -- that would have put dramatic limits on both\u003ca href=\"http://www.sos.ca.gov/admin/press-releases/2014/db14-002.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+NewsUpdatesFromCaliforniaSecretaryOfStateDebraBowen+(News+Updates+from+California+Secretary+of+State+Debra+Bowen)\" target=\"_blank\"> hospital charges\u003c/a> and \u003ca href=\"http://www.sos.ca.gov/admin/press-releases/2014/db14-001.htm\" target=\"_blank\">CEO compensation\u003c/a> -- are being withdrawn.\u003c/p>\n\u003cp>The partnership was announced Tuesday morning, is effective immediately, and runs through December 31, 2017. In a long call with reporters, both sides emphasized what they called the centerpiece of the deal: a $100 million \"joint advocacy fund.\"\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Major Goal is Raising Medi-Cal Rates\u003c/strong>\u003c/p>\n\u003cp>CHA president Duane Dauner said the parties \"will undertake the task of making sure that we fundamentally reform California's Medi-Cal program over the coming two years.\" Medi-Cal is the federal-state health program for people who are low income.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Specifically, both SEIU and the CHA seek to increase Medi-Cal reimbursement rates to providers, currently 49th in the country, a move that was good news to advocates.\u003c/p>\n\u003cp>\"We certainly support increasing Medi-Cal rates, because that improves access to care for the 8-plus million Californians in Medi-Cal right now,\" said Anthony Wright, executive director of Health Access. He noted that some 9 million Californians are now enrolled in Medi-Cal, in the wake of the expansion under the Affordable Care Act. \"All those folks need access to primary care providers and hospitals, to get the care they need, but that means paying a decent rate to providers.\"\u003c/p>\n\u003cp>But some people are curious what the union is getting out of this move. The details of the agreement will not be made public. Instead, the deal was summarized in a one-page press release. To Glenn Melnick, a health economist at USC, the potential overhaul of Medi-Cal is not where focus should lie.\u003c/p>\n\u003cp>\"The big news is that they're pulling those items off the ballot,\" he said. \"That's the big news. Why? I can't tell from this release.\"\u003c/p>\n\u003cp>Melnick called the initiative that would have regulated nonprofit hospital prices \"the nuclear option … it was tying hospital pricing to cost. That's a tremendously powerful threat.\"\u003c/p>\n\u003cp>But he noted that if such a measure would have passed, then hospitals would have had less revenue -- meaning they would have had less money to spend on wages and salaries of their employees.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/148382927&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Dave Regan, president and CEO of SEIU-United Healthcare Workers West, said that working to overhaul Medi-Cal might ensure a more stable future for workers. \"What do we get out of (the deal)? We get the opportunity to built the best health care system in America. We get to do it in collaboration with hospital providers, we get to offer our younger members an opportunity to help create a future that will offer them stable employment to retirement and then hopefully a secure retirement beyond that, and frankly, we don't have that right now.\"\u003c/p>\n\u003cp>Melnick did agree that higher Medi-Cal payments would potentially give hospitals more money to spend on their workforce. \"Sixty percent of budget is wages and salaries in a hospital,\" he said. \"If they have more, they'll spend it, because they're good at that.\"\u003c/p>\n\u003cp>In addition to SEIU and the California Hospital Association, other hospitals and health systems are parties to the deal which covers a majority of hospital beds in the state.\u003c/p>\n\u003cp>A spokesman with the state's Department of Health Care Services said they were reviewing the agreement and declined comment.\u003c/p>\n\u003cp>\u003cstrong>Harsh Criticism\u003c/strong>\u003c/p>\n\u003cp>In a joint release, three powerful unions in California harshly criticized the agreement, calling it \"an act of treason.\"\u003c/p>\n\u003cp>\"This agreement will undermine the rights of workers and will eliminate the union's watchdog role on behalf of patients,\" read the statement from the California Nurses Association, the National Union of Healthcare Workers and the AFL-CIO. It noted that it appeared that \"SEIU agreed to become a company union\" and chastised SEIU for refusing to release the details of the deal.\u003c/p>\n\u003cp>In the joint agreement, both the CHA and SEIU say they will seek \"legislation, regulations or voluntary compliance to address the issues raised in SEIU-UHW's two hospital ballot initiatives, which will not be pursued. This includes modernizing the hospital pricing system.\"\u003c/p>\n\u003cp>Wright, of Health Access, said hospital bills are often \"outrageous\" and might have \"no relationship to what insurers or government programs pay.\"\u003c/p>\n\u003cp>\"It's impossible to make apples-to-apples comparisons, it's impossible to get a handle on hospitals' pricing, the rhyme or reason of it.\"\u003c/p>\n\u003cp>The CHA's Dauner defended hospital price transparency, and insisted that \"anyone that wants to see what hospitals charge for anything is immediately available on the state's website.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California recently\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/03/25/california-gets-an-f-for-health-care-price-transparency/\" target=\"_blank\"> received an \"F\"\u003c/a> in health care price transparency from the nonprofit Catalyst for Payment Reform.\u003c/p>\n\n",
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"excerpt": "The union and hospital association say they will create a $100 million \"joint advocacy fund\" to overhaul Medi-Cal.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19051\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/sb10069454g-001-e1399421017698.jpg\">\u003cimg class=\"size-large wp-image-19051\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/sb10069454g-001-640x480.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The California Hospital Association and Service Employees International Union say they have reached a \"unique agreement\" that will \"change the face of healthcare in California.\"\u003c/p>\n\u003cp>And in the process, the two ballot initiatives SEIU backed -- that would have put dramatic limits on both\u003ca href=\"http://www.sos.ca.gov/admin/press-releases/2014/db14-002.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+NewsUpdatesFromCaliforniaSecretaryOfStateDebraBowen+(News+Updates+from+California+Secretary+of+State+Debra+Bowen)\" target=\"_blank\"> hospital charges\u003c/a> and \u003ca href=\"http://www.sos.ca.gov/admin/press-releases/2014/db14-001.htm\" target=\"_blank\">CEO compensation\u003c/a> -- are being withdrawn.\u003c/p>\n\u003cp>The partnership was announced Tuesday morning, is effective immediately, and runs through December 31, 2017. In a long call with reporters, both sides emphasized what they called the centerpiece of the deal: a $100 million \"joint advocacy fund.\"\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Major Goal is Raising Medi-Cal Rates\u003c/strong>\u003c/p>\n\u003cp>CHA president Duane Dauner said the parties \"will undertake the task of making sure that we fundamentally reform California's Medi-Cal program over the coming two years.\" Medi-Cal is the federal-state health program for people who are low income.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Specifically, both SEIU and the CHA seek to increase Medi-Cal reimbursement rates to providers, currently 49th in the country, a move that was good news to advocates.\u003c/p>\n\u003cp>\"We certainly support increasing Medi-Cal rates, because that improves access to care for the 8-plus million Californians in Medi-Cal right now,\" said Anthony Wright, executive director of Health Access. He noted that some 9 million Californians are now enrolled in Medi-Cal, in the wake of the expansion under the Affordable Care Act. \"All those folks need access to primary care providers and hospitals, to get the care they need, but that means paying a decent rate to providers.\"\u003c/p>\n\u003cp>But some people are curious what the union is getting out of this move. The details of the agreement will not be made public. Instead, the deal was summarized in a one-page press release. To Glenn Melnick, a health economist at USC, the potential overhaul of Medi-Cal is not where focus should lie.\u003c/p>\n\u003cp>\"The big news is that they're pulling those items off the ballot,\" he said. \"That's the big news. Why? I can't tell from this release.\"\u003c/p>\n\u003cp>Melnick called the initiative that would have regulated nonprofit hospital prices \"the nuclear option … it was tying hospital pricing to cost. That's a tremendously powerful threat.\"\u003c/p>\n\u003cp>But he noted that if such a measure would have passed, then hospitals would have had less revenue -- meaning they would have had less money to spend on wages and salaries of their employees.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/148382927&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Dave Regan, president and CEO of SEIU-United Healthcare Workers West, said that working to overhaul Medi-Cal might ensure a more stable future for workers. \"What do we get out of (the deal)? We get the opportunity to built the best health care system in America. We get to do it in collaboration with hospital providers, we get to offer our younger members an opportunity to help create a future that will offer them stable employment to retirement and then hopefully a secure retirement beyond that, and frankly, we don't have that right now.\"\u003c/p>\n\u003cp>Melnick did agree that higher Medi-Cal payments would potentially give hospitals more money to spend on their workforce. \"Sixty percent of budget is wages and salaries in a hospital,\" he said. \"If they have more, they'll spend it, because they're good at that.\"\u003c/p>\n\u003cp>In addition to SEIU and the California Hospital Association, other hospitals and health systems are parties to the deal which covers a majority of hospital beds in the state.\u003c/p>\n\u003cp>A spokesman with the state's Department of Health Care Services said they were reviewing the agreement and declined comment.\u003c/p>\n\u003cp>\u003cstrong>Harsh Criticism\u003c/strong>\u003c/p>\n\u003cp>In a joint release, three powerful unions in California harshly criticized the agreement, calling it \"an act of treason.\"\u003c/p>\n\u003cp>\"This agreement will undermine the rights of workers and will eliminate the union's watchdog role on behalf of patients,\" read the statement from the California Nurses Association, the National Union of Healthcare Workers and the AFL-CIO. It noted that it appeared that \"SEIU agreed to become a company union\" and chastised SEIU for refusing to release the details of the deal.\u003c/p>\n\u003cp>In the joint agreement, both the CHA and SEIU say they will seek \"legislation, regulations or voluntary compliance to address the issues raised in SEIU-UHW's two hospital ballot initiatives, which will not be pursued. This includes modernizing the hospital pricing system.\"\u003c/p>\n\u003cp>Wright, of Health Access, said hospital bills are often \"outrageous\" and might have \"no relationship to what insurers or government programs pay.\"\u003c/p>\n\u003cp>\"It's impossible to make apples-to-apples comparisons, it's impossible to get a handle on hospitals' pricing, the rhyme or reason of it.\"\u003c/p>\n\u003cp>The CHA's Dauner defended hospital price transparency, and insisted that \"anyone that wants to see what hospitals charge for anything is immediately available on the state's website.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California recently\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/03/25/california-gets-an-f-for-health-care-price-transparency/\" target=\"_blank\"> received an \"F\"\u003c/a> in health care price transparency from the nonprofit Catalyst for Payment Reform.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Obamacare in Jail: How San Francisco Policy Helps Inmates",
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"content": "\u003cfigure id=\"attachment_18958\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/thomashawk/3396042806/in/photolist-hKr7ZG-NyYN7-Q4Sue-8BJVgU-NyYVm-efaaEg-effU5b-efa9kz-efaafp-effSPE-effS5L-NzrB4-NyZ2o-6b6Bdb-ba34VP-ba35eF-o4dSz-YteKt-9PtxFt-516wLR-51aJB5-kEtxz-6mvNzB-6Gh5QT-51aLt1-5GCTEz-fNW3uU-6GkWYj-6GkUN7-6Gm7rd-itxXGM-8rRNtd-6Gh31B-8rNHLR-er2Fr7-8rNHgH-8rRNyN-8rRPuY-8rNJdD-8rRNom-8rNHBn-8rRNJq-8rNHuB-8rRNgY-eZbpkD-6Gm3BC-6GgYiz-arK7kf-ba3aYt-97TLvP\">\u003cimg class=\"size-large wp-image-18958\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/3396042806_104f70f704_b-640x376.jpg\" alt=\"A new law permits San Francisco Sheriff Department staff to enroll people into health plans. (Thomas Hawk/Flickr)\" width=\"640\" height=\"376\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A new law permits San Francisco Sheriff Department staff to enroll people into health plans. (Thomas Hawk/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The San Francisco Sheriff's Department is implementing a new city law allowing its staff to enroll inmates into health insurance under the Affordable Care Act. Sheriff Ross Mirkarimi believes that making sure people have health coverage when they're released will help prevent them from committing another crime and coming back.\u003c/p>\n\u003cp>“I believe that will go a long way to helping us improve public safety by using a public health strategy,” he said.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Health insurance sign-ups available to all inmates at the San Francisco county jail.\u003c/aside>\n\u003cp>He estimates this will help save taxpayers millions of dollars.\u003c/p>\n\u003cp>One inmate – Sophia – recently requested help signing up for health insurance. Sophia, who asked that her last name not be used, was caught driving a stolen car in January and sentenced to three months in the county jail. She says that was because she stopped getting treatment for her substance abuse and mental health problems when her health insurance expired.\u003c!--more-->\u003c/p>\n\u003cp>“It stopped in December. And I didn’t get it reinstated. So I didn’t address any of my issues and I guess that’s why I found myself in a car, driving around,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>She thought she might not do that again if she could get back on a health plan. She asked the jail if they could help her find one. Tanya Mara, the director of the health division of jail reentry services, came to walk her through the process of applying for health insurance.\u003c/p>\n\u003cp>“Prior to your arrest, did you have an income?\" Mara asked Sophia. \"Does your income change from month to month? What do you expect your income to be for 2014?”\u003c/p>\n\u003cp>Mara quickly identified a program for Sophia.\u003c/p>\n\u003cp>“You would likely qualify for Medi-Cal,” she says. “With the Affordable Care Act, you can now qualify for Medi-Cal based on income.” Medi-Cal is California's version of Medicaid, health insurance for people who are low income.\u003c/p>\n\u003cp>Obamacare has changed two key things for the formerly incarcerated. First, it expanded Medicaid to include childless adults. That means most prisoners will now qualify for the free government health coverage when they get out. Second, all plans must now cover treatment for mental health and substance use disorders –- problems that affect more than half the people in prison or jail, according to a report by the U.S. Department of Justice.\u003c/p>\n\u003cp>\u003cstrong>\"Captive Audience\" for Enrollment\u003c/strong>\u003c/p>\n\u003cp>Pretty soon, health insurance sign-ups like Sophia’s will happen for all inmates at the San Francisco county jail -- whether they request it or not. And they’ll happen right when most new arrivals get booked into custody.\u003c/p>\n\u003cp>“You have a captive audience,” Sheriff Mirkarimi said. He wants to make sure the 30,000 prisoners who come through the jail system every year are covered on the day they’re released.\u003c/p>\n\u003cp>The sheriff was behind the new city law. It authorizes his staff to enroll people into health care plans under the Affordable Care Act, 24 hours a day, 7 days a week. Other counties and states are exploring similar efforts for people exiting jail or prison.\u003c/p>\n\u003cp>But Mirkarimi acknowledges that getting coverage is just one small step. Just because someone has a newly minted Medi-Cal card doesn't mean they'll know how to use it.\u003c/p>\n\u003cp>“No, they’re going to have to demonstrate the wherewithal and resourcefulness to use that Medi-Cal card,” he said. “We, and our staff, help them get ready. But ultimately, it’s on them.”\u003c/p>\n\u003cp>That’s not how Wanda Fain sees it. She was just released from state prison after 21 years behind bars. Everything is new to her. Getting on and off escalators is weird. Mobile phones are a new concept. She says she needs a friend just to help her ride the bus.\u003c/p>\n\u003cp>“They tell me what bus we on, they tell me what stops to get off,” she said, “what specific things to look for so I won’t miss a stop.”\u003c/p>\n\u003cp>Don’t even get her started on housing.\u003c/p>\n\u003cp>“Us parolees, we can’t leave San Francisco. But at the same token, we can’t afford to stay in San Francisco,” she said. “Cause it’s, what ,$4,000 for a one bedroom? Who coming out of prison got that money?”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/147255043&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Navigating the health care system is even more confusing. Fain has seizures, lymphoma, and bipolar disorder. In prison, the guards regulated all of her care for her. She wasn't allowed to eat a meal until she took her meds. But on the outside, it's up to her to find the right doctor, the right pharmacy –- and to figure out which four buses she needs to take to get there.\u003c/p>\n\u003cp>“It's little things like that that people think are so easy,\" she said, shaking her head. “They are so overwhelming.”\u003c/p>\n\u003cp>If Sheriff Mirkarimi's plan is going to work, people getting out of jail are going to need help on the other side.\u003c/p>\n\u003cp>\u003cstrong>Clinic Helps Former Prisoners Navigate Health Care System\u003c/strong>\u003c/p>\n\u003cp>Most inmates leaving jail or prison are like Fain and have several chronic conditions. And most are so focused on other things that they rarely get medical help until things are so bad that they end up in the Emergency Room.\u003c/p>\n\u003cp>“These are really some of the sickest patients we see in our system,” said Shira Shavit, a family doctor in San Francisco. “They have high rates of hospitalization, very high rates of using the emergency room, and also very high rates of death.”\u003c/p>\n\u003cp>Dr. Shavit is trying to shift those trends. She’s the director of The Transitions Clinic, a specialized program designed for former prisoners, where doctors, psychiatrists, and social workers all consult together on the same patients. But its key staff are community health workers who have all spent time behind bars, too; people like Juanita Alvarado who help patients with all the tasks that would otherwise get in the way of caring for their health -- applying for housing, social security, finding a job, printing out paperwork or bus maps.\u003c/p>\n\u003cp>“Basically holding their hands in the first few weeks after they’re out,” Alvarado said.\u003c/p>\n\u003cp>She keeps the bookshelf behind her desk stocked with soup, breakfast bars, peanut butter, and tuna fish. A lot of their patients are denied food stamps because of drug convictions and have trouble finding affordable groceries.\u003c/p>\n\u003cp>“So I hook them up with a little bag,” Alvarado said.\u003c/p>\n\u003cp>The one-stop-shop approach works. Transition program patients show up for their appointments at higher rates than other patients, and, Dr. Shavit says ER use among their patients has dropped by 50 percent.\u003c/p>\n\u003cp>That caught the attention of the federal government, which foots a lot of those ER bills with taxpayer dollars. It gave the clinic a special $6.8 million \u003ca href=\"http://innovation.cms.gov/initiatives/Health-Care-Innovation-Awards/California.html\" target=\"_blank\">innovation grant\u003c/a> created under the Affordable Care Act to expand the concept beyond San Francisco. The team is using the money to help 11 clinics in six states and Puerto Rico hire and train former prisoners to staff similar programs. Federal health officials believe this will ultimately save $8 million.\u003c/p>\n\u003cp>The even broader goal – for both Mirkarimi’s plan and the Transitions Clinic – is that health care will help keep people from going back to jail or prison. Recidivism rates have dipped in recent years, but they are still high – 61 percent of people who leave a California prison return within three years. For people on parole or probation in San Francisco, the rate is even higher.\u003c/p>\n\u003cp>Wanda Fain feels like she’s just skirting those statistics. She lives a short walk away from the Transitions Clinic and comes often to get help with a range of tasks and health issues.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“If I didn't have Juanita Alvarado, or Dr. Shavit, or any of them, I’d be in – I don’t know where I’d be,” she said. “Probably on my way back.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18958\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/thomashawk/3396042806/in/photolist-hKr7ZG-NyYN7-Q4Sue-8BJVgU-NyYVm-efaaEg-effU5b-efa9kz-efaafp-effSPE-effS5L-NzrB4-NyZ2o-6b6Bdb-ba34VP-ba35eF-o4dSz-YteKt-9PtxFt-516wLR-51aJB5-kEtxz-6mvNzB-6Gh5QT-51aLt1-5GCTEz-fNW3uU-6GkWYj-6GkUN7-6Gm7rd-itxXGM-8rRNtd-6Gh31B-8rNHLR-er2Fr7-8rNHgH-8rRNyN-8rRPuY-8rNJdD-8rRNom-8rNHBn-8rRNJq-8rNHuB-8rRNgY-eZbpkD-6Gm3BC-6GgYiz-arK7kf-ba3aYt-97TLvP\">\u003cimg class=\"size-large wp-image-18958\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/3396042806_104f70f704_b-640x376.jpg\" alt=\"A new law permits San Francisco Sheriff Department staff to enroll people into health plans. (Thomas Hawk/Flickr)\" width=\"640\" height=\"376\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A new law permits San Francisco Sheriff Department staff to enroll people into health plans. (Thomas Hawk/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The San Francisco Sheriff's Department is implementing a new city law allowing its staff to enroll inmates into health insurance under the Affordable Care Act. Sheriff Ross Mirkarimi believes that making sure people have health coverage when they're released will help prevent them from committing another crime and coming back.\u003c/p>\n\u003cp>“I believe that will go a long way to helping us improve public safety by using a public health strategy,” he said.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Health insurance sign-ups available to all inmates at the San Francisco county jail.\u003c/aside>\n\u003cp>He estimates this will help save taxpayers millions of dollars.\u003c/p>\n\u003cp>One inmate – Sophia – recently requested help signing up for health insurance. Sophia, who asked that her last name not be used, was caught driving a stolen car in January and sentenced to three months in the county jail. She says that was because she stopped getting treatment for her substance abuse and mental health problems when her health insurance expired.\u003c!--more-->\u003c/p>\n\u003cp>“It stopped in December. And I didn’t get it reinstated. So I didn’t address any of my issues and I guess that’s why I found myself in a car, driving around,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She thought she might not do that again if she could get back on a health plan. She asked the jail if they could help her find one. Tanya Mara, the director of the health division of jail reentry services, came to walk her through the process of applying for health insurance.\u003c/p>\n\u003cp>“Prior to your arrest, did you have an income?\" Mara asked Sophia. \"Does your income change from month to month? What do you expect your income to be for 2014?”\u003c/p>\n\u003cp>Mara quickly identified a program for Sophia.\u003c/p>\n\u003cp>“You would likely qualify for Medi-Cal,” she says. “With the Affordable Care Act, you can now qualify for Medi-Cal based on income.” Medi-Cal is California's version of Medicaid, health insurance for people who are low income.\u003c/p>\n\u003cp>Obamacare has changed two key things for the formerly incarcerated. First, it expanded Medicaid to include childless adults. That means most prisoners will now qualify for the free government health coverage when they get out. Second, all plans must now cover treatment for mental health and substance use disorders –- problems that affect more than half the people in prison or jail, according to a report by the U.S. Department of Justice.\u003c/p>\n\u003cp>\u003cstrong>\"Captive Audience\" for Enrollment\u003c/strong>\u003c/p>\n\u003cp>Pretty soon, health insurance sign-ups like Sophia’s will happen for all inmates at the San Francisco county jail -- whether they request it or not. And they’ll happen right when most new arrivals get booked into custody.\u003c/p>\n\u003cp>“You have a captive audience,” Sheriff Mirkarimi said. He wants to make sure the 30,000 prisoners who come through the jail system every year are covered on the day they’re released.\u003c/p>\n\u003cp>The sheriff was behind the new city law. It authorizes his staff to enroll people into health care plans under the Affordable Care Act, 24 hours a day, 7 days a week. Other counties and states are exploring similar efforts for people exiting jail or prison.\u003c/p>\n\u003cp>But Mirkarimi acknowledges that getting coverage is just one small step. Just because someone has a newly minted Medi-Cal card doesn't mean they'll know how to use it.\u003c/p>\n\u003cp>“No, they’re going to have to demonstrate the wherewithal and resourcefulness to use that Medi-Cal card,” he said. “We, and our staff, help them get ready. But ultimately, it’s on them.”\u003c/p>\n\u003cp>That’s not how Wanda Fain sees it. She was just released from state prison after 21 years behind bars. Everything is new to her. Getting on and off escalators is weird. Mobile phones are a new concept. She says she needs a friend just to help her ride the bus.\u003c/p>\n\u003cp>“They tell me what bus we on, they tell me what stops to get off,” she said, “what specific things to look for so I won’t miss a stop.”\u003c/p>\n\u003cp>Don’t even get her started on housing.\u003c/p>\n\u003cp>“Us parolees, we can’t leave San Francisco. But at the same token, we can’t afford to stay in San Francisco,” she said. “Cause it’s, what ,$4,000 for a one bedroom? Who coming out of prison got that money?”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/147255043&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Navigating the health care system is even more confusing. Fain has seizures, lymphoma, and bipolar disorder. In prison, the guards regulated all of her care for her. She wasn't allowed to eat a meal until she took her meds. But on the outside, it's up to her to find the right doctor, the right pharmacy –- and to figure out which four buses she needs to take to get there.\u003c/p>\n\u003cp>“It's little things like that that people think are so easy,\" she said, shaking her head. “They are so overwhelming.”\u003c/p>\n\u003cp>If Sheriff Mirkarimi's plan is going to work, people getting out of jail are going to need help on the other side.\u003c/p>\n\u003cp>\u003cstrong>Clinic Helps Former Prisoners Navigate Health Care System\u003c/strong>\u003c/p>\n\u003cp>Most inmates leaving jail or prison are like Fain and have several chronic conditions. And most are so focused on other things that they rarely get medical help until things are so bad that they end up in the Emergency Room.\u003c/p>\n\u003cp>“These are really some of the sickest patients we see in our system,” said Shira Shavit, a family doctor in San Francisco. “They have high rates of hospitalization, very high rates of using the emergency room, and also very high rates of death.”\u003c/p>\n\u003cp>Dr. Shavit is trying to shift those trends. She’s the director of The Transitions Clinic, a specialized program designed for former prisoners, where doctors, psychiatrists, and social workers all consult together on the same patients. But its key staff are community health workers who have all spent time behind bars, too; people like Juanita Alvarado who help patients with all the tasks that would otherwise get in the way of caring for their health -- applying for housing, social security, finding a job, printing out paperwork or bus maps.\u003c/p>\n\u003cp>“Basically holding their hands in the first few weeks after they’re out,” Alvarado said.\u003c/p>\n\u003cp>She keeps the bookshelf behind her desk stocked with soup, breakfast bars, peanut butter, and tuna fish. A lot of their patients are denied food stamps because of drug convictions and have trouble finding affordable groceries.\u003c/p>\n\u003cp>“So I hook them up with a little bag,” Alvarado said.\u003c/p>\n\u003cp>The one-stop-shop approach works. Transition program patients show up for their appointments at higher rates than other patients, and, Dr. Shavit says ER use among their patients has dropped by 50 percent.\u003c/p>\n\u003cp>That caught the attention of the federal government, which foots a lot of those ER bills with taxpayer dollars. It gave the clinic a special $6.8 million \u003ca href=\"http://innovation.cms.gov/initiatives/Health-Care-Innovation-Awards/California.html\" target=\"_blank\">innovation grant\u003c/a> created under the Affordable Care Act to expand the concept beyond San Francisco. The team is using the money to help 11 clinics in six states and Puerto Rico hire and train former prisoners to staff similar programs. Federal health officials believe this will ultimately save $8 million.\u003c/p>\n\u003cp>The even broader goal – for both Mirkarimi’s plan and the Transitions Clinic – is that health care will help keep people from going back to jail or prison. Recidivism rates have dipped in recent years, but they are still high – 61 percent of people who leave a California prison return within three years. For people on parole or probation in San Francisco, the rate is even higher.\u003c/p>\n\u003cp>Wanda Fain feels like she’s just skirting those statistics. She lives a short walk away from the Transitions Clinic and comes often to get help with a range of tasks and health issues.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“If I didn't have Juanita Alvarado, or Dr. Shavit, or any of them, I’d be in – I don’t know where I’d be,” she said. “Probably on my way back.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_18948\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/hongiiv/3129766406/in/photolist-5LySvL-5weVaD-4tHu8p-5LyQXU-5LyQDm-5LuCbn-5LuAcv-5LuC58-5wjffw-5LyPSC-hKsNWb-6Fg42Y-4bG9Qy-9tLWy1-5wjfcw-5LyQds-5LuBmK-5LuBDr-5weV7r-5LuB7Z-5LuBPc-5PbrNx-5LyR5A-4tHu98-5LyQQw-4tHu7T-5PfFv7-5weV8g-5LuAi6-5wjfdy-5LuBui-4fYr81-5HDkKA-8mM5aA-5nLnEy-9yFvui-4nQTup-2wGsW7-4nVtjy-4T1jMh-iEassb-4pdB6y-4oDoyx-CS7Rc-4m61oD-4Yqs7k-czsfKw-d6MJns-5kDcJH-4mzerB\">\u003cimg class=\"size-large wp-image-18948\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/3129766406_3f62c12d6a_o-640x426.jpg\" alt=\"The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Christina Farr\u003c/strong>\u003c/p>\n\u003cp>Health care entrepreneurs are a different breed than most entrepreneurs. Rather than hunkering down to build a cool product, they need to think about regulation and red tape -- right from the start.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Ignoring the FDA and pushing ahead with a product is not a viable option. \u003c/aside>\n\u003cp>As boring as it may sound, health-tech founders need to develop a relationship with the U.S. Food and Drug Administration (FDA). This process might drag on for some time, as this authority has the unenviable job of overseeing an explosion of \u003ca href=\"http://mobihealthnews.com/28361/rock-health-1-97b-invested-in-digital-health-startups-in-2013/\" target=\"_blank\">new medical technology\u003c/a>, whether it’s a new electronic health record or a device that turns your smartphone into an ear scope.\u003c/p>\n\u003cp>As the recent \u003ca href=\"http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2013/ucm376296.htm\" target=\"_blank\">enforcement action\u003c/a> against genetic testing firm 23andMe demonstrated, ignoring the FDA and pushing ahead with a product is \u003ca href=\"http://venturebeat.com/2014/03/12/23andme-ceo-we-need-to-return-to-delivering-health-information/\" target=\"_blank\">not a viable option\u003c/a>.\u003c/p>\n\u003cp>In recent years, Silicon Valley's entrepreneurs have become increasingly critical, attacking the agency's antiquated processes in a string of interviews and \u003ca href=\"http://www.usatoday.com/story/opinion/2014/02/15/fischer-king-health-information-technology/5464693/\" target=\"_blank\">op-eds\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“There is this perceived myth that the FDA will change its mind on a dime,” said Ellie Cachette, an entrepreneur and health advocate who has served on a number of committee boards for the National Institutes of Health.\u003c/p>\n\u003cp>The crux of the problem is a mismatch of priorities.\u003c/p>\n\u003cp>The FDA's chief mandate is to \u003ca href=\"http://www.fda.gov/aboutfda/transparency/basics/ucm194877.htm\" target=\"_blank\">protect public health\u003c/a>, but some (perhaps many) entrepreneurs fear that it’s under-resourced, overwhelmed, and a roadblock to life-saving innovation. Life sciences-focused venture capitalists say the FDA is prone to delays and abrupt policy changes, making health care a precarious bet.\u003c/p>\n\u003cp>“The first cause of death for our startups is a lack of capital, and if investors aren’t confident that they can scale the FDA hurdles, they simply won’t invest,” said Kyra Davis, a program manager at the Entrepreneurship Center at UCSF, who works closely with budding health-tech entrepreneurs.\u003c/p>\n\u003cp>Life sciences startups are in a particularly tough spot, with investment in a downward spiral. (Note: The picture looked a bit rosier in the first quarter of 2014, in part due to a few successful \u003ca href=\"http://medcitynews.com/2014/04/biotech-attracts-1b-in-venture-capital-funding-medical-device-deal-size-trends-higher/\" target=\"_blank\">recent biotech IPOs\u003c/a>.)\u003c/p>\n\u003cp>Whether it’s justified or not, the FDA is often cited by health investors as the reason for this decline.\u003c/p>\n\u003cp>“We have been pushing the FDA on how difficult it is to get products approved,” said Michael Carusi, a general partner at \u003ca href=\"http://www.atvcapital.com/\">ATV Capital\u003c/a>, in an interview for a series I wrote in April, 2013 for \u003cem>VentureBeat\u003c/em> on Silicon Valley’s perceptions of the FDA.\u003c/p>\n\u003cp>\u003ca href=\"http://venturebeat.com/2013/04/30/stifled-by-regulation-entrepreneurs-take-life-saving-devices-overseas/\">For that article,\u003c/a> the FDA responded that it is doing its best with entrepreneurs and VCs to “develop smart regulation that balance patient safety and innovation.”\u003c/p>\n\u003cp>\u003cstrong>Tension Between Protecting Public Health and Regulating Innovation\u003c/strong>\u003c/p>\n\u003cp>The FDA’s crack down on 23andMe last November prompted health entrepreneurs to quake in their boots and angry Internet commentators to rail against \"Big Government.\" In February, Senators Angus King (I-Maine) and Deb Fischer (R-Nebraska) \u003ca href=\"http://venturebeat.com/2014/02/26/new-digital-health-bill-proposes-to-undermine-the-fda-draws-mixed-reactions/\" target=\"_blank\">proposed a bill \u003c/a>in Congress to prevent the agency from regulating “low risk” health IT altogether.\u003c/p>\n\u003cp>But the FDA has stepped up in one important regard. After demurring for several months, it released its \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm369431.htm\" target=\"_blank\">final guidance\u003c/a> on how it plans to regulate the explosion in mobile medical technology, a particularly trendy space. Most mobile medical apps do not require federal regulation, the FDA found, so developers and investors could breathe a bit easier.\u003c/p>\n\u003cp>According to John Wilson, a health policy expert and advisor to the \u003ca href=\"http://www.newmeaccelerator.com/\" target=\"_blank\">NewMe startup accelerator\u003c/a>, the FDA is doing its job and doesn’t deserve the bad rep.\u003c/p>\n\u003cp>“Entrepreneurs have a tendency to over-promise and under-deliver. But in health care, people’s lives are at stake,” he explained.\u003c/p>\n\u003cp>“When the company doesn’t work out, the FDA is often blamed. Startups are looking for a fall guy.\"\u003c/p>\n\u003cp>While Wilson believes in a “checks and balancing” body like the FDA, he does admit that the agency has plenty of work to do.\u003c/p>\n\u003cp>It’s a boom time for technology, and some of it is genuinely breaking new ground. It will take some time to determine whether this new tech is potentially harmful, and how it should be classified. For instance, it’s a matter of ongoing debate among geneticists and lawyers whether 23andMe should have been treated as a medical device. This field of consumer genetic reporting is nascent, making it a particularly problematic area for the FDA.\u003c/p>\n\u003cp>Meanwhile, Silicon Valley expects to move quickly -- and doesn’t respond well to hesitation and delays.\u003c/p>\n\u003cp>“The pendulum swings with the FDA -- or at least it has in my 25 years,” added Joe Kiani, chief executive of California-based Masimo Corp., a medical technology company that was founded in 1989 and went public in 2007.\u003c/p>\n\u003cp>“Sometimes, the agency can be very difficult, and other times it’s easy and formulaic. Right now, it’s one of those difficult periods.”\u003c/p>\n\u003cp>\u003cstrong>\"Don't View the FDA As This Scary Thing\"\u003c/strong>\u003c/p>\n\u003cp>Even those who are sympathetic to the FDA would admit that the regulatory processes are no small matter.\u003c/p>\n\u003cp>Amy Sheng, founder of a company that develops a low-risk medical device, estimates that it required \"hundreds of thousands of dollars\" and a “truck-load” of paperwork to implement a full quality system.\u003c/p>\n\u003cp>Sheng hired several consultants to navigate legislation, as well as a few key employees. She advises health-tech entrepreneurs to raise significant funding at the outset -- and bring the right set of legal and quality assurance experts on board.\u003c/p>\n\u003cp>\"I've been speaking the medical device language my whole career, so I don't view the FDA as this scary thing,\" said Sheng. \"Just keep in mind that the agency's mission is to protect patients and make sure your product is safe and accurate.\"\u003c/p>\n\u003cp>Meanwhile, Malay Gandhi, chief strategy officer at digital health accelerator \u003ca href=\"http://rockhealth.com/\">Rock Health\u003c/a>, would advise entrepreneurs to take a deep breath and relax. He has a far more optimistic view about regulatory processes, and doesn’t believe that the FDA is \"out to get” health entrepreneurs.\u003c/p>\n\u003cp>“There is some level of fear but the process is well defined and you can get through it,” he said. “There are countless numbers of people who have done it already.”\u003c/p>\n\u003cp>According to Gandhi, the entrepreneurs in Rock Health will often approach the FDA for clarification and typically receive a response within a few weeks. In the past few years, none of the founders were publicly admonished in a similar manner to 23andMe.\u003c/p>\n\u003cp>“At the end of the day, there aren’t that many health companies that are anything like 23andMe,” he added.\u003c/p>\n\u003cp>For those who don’t have the requisite funding, another good option is to take the business overseas.\u003c/p>\n\u003cp>Kiani often advises newcomers to launch their products in Europe first, where regulation is far more predictable. It can take years (and those hundreds of thousands of dollars) for U.S.-based entrepreneurs to gain approval from the FDA -- and in that time, many founders will find success in international markets.\u003c/p>\n\u003cp>“China and Japan and Brazil have their own regulatory difficulties, Japan is a predictable process, but Europe is probably best,” said Kiani. “It’s the fastest way to market.”\u003c/p>\n\u003cp>Ultimately, the experts stress that the FDA is unlikely to pay attention unless something is seriously wrong. Pass the regulatory checks, file the paperwork, do the research, and avoid making overblown statements in marketing to patients.\u003c/p>\n\u003cp>For health entrepreneurs, getting in the FDA’s good graces is money and time well-spent, Walter de Brouwer, founder of Scanadu, a hand-held medical device, told \u003cem>Fast Company.\u003c/em> Despite the efforts of politicians like Senators King and Fisher, the agency is not going anywhere anytime soon, so de Brouwer advises getting in its good graces.\u003c/p>\n\u003cp>“Trying to do something medical and avoiding the FDA, that is a lost battle. It’s like asking the Vatican to become atheist.”\u003c/p>\n\u003cp>\u003cem style=\"color: #1f1f1f\">Christina Farr is a San Francisco-based journalist covering health technology. She previously wrote for Venture Beat, The Bay Citizen and SFGate.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"CNmeBBlBPPwQslZMYMxjOTuOuvmvqRlu\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18948\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/hongiiv/3129766406/in/photolist-5LySvL-5weVaD-4tHu8p-5LyQXU-5LyQDm-5LuCbn-5LuAcv-5LuC58-5wjffw-5LyPSC-hKsNWb-6Fg42Y-4bG9Qy-9tLWy1-5wjfcw-5LyQds-5LuBmK-5LuBDr-5weV7r-5LuB7Z-5LuBPc-5PbrNx-5LyR5A-4tHu98-5LyQQw-4tHu7T-5PfFv7-5weV8g-5LuAi6-5wjfdy-5LuBui-4fYr81-5HDkKA-8mM5aA-5nLnEy-9yFvui-4nQTup-2wGsW7-4nVtjy-4T1jMh-iEassb-4pdB6y-4oDoyx-CS7Rc-4m61oD-4Yqs7k-czsfKw-d6MJns-5kDcJH-4mzerB\">\u003cimg class=\"size-large wp-image-18948\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/3129766406_3f62c12d6a_o-640x426.jpg\" alt=\"The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Christina Farr\u003c/strong>\u003c/p>\n\u003cp>Health care entrepreneurs are a different breed than most entrepreneurs. Rather than hunkering down to build a cool product, they need to think about regulation and red tape -- right from the start.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Ignoring the FDA and pushing ahead with a product is not a viable option. \u003c/aside>\n\u003cp>As boring as it may sound, health-tech founders need to develop a relationship with the U.S. Food and Drug Administration (FDA). This process might drag on for some time, as this authority has the unenviable job of overseeing an explosion of \u003ca href=\"http://mobihealthnews.com/28361/rock-health-1-97b-invested-in-digital-health-startups-in-2013/\" target=\"_blank\">new medical technology\u003c/a>, whether it’s a new electronic health record or a device that turns your smartphone into an ear scope.\u003c/p>\n\u003cp>As the recent \u003ca href=\"http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2013/ucm376296.htm\" target=\"_blank\">enforcement action\u003c/a> against genetic testing firm 23andMe demonstrated, ignoring the FDA and pushing ahead with a product is \u003ca href=\"http://venturebeat.com/2014/03/12/23andme-ceo-we-need-to-return-to-delivering-health-information/\" target=\"_blank\">not a viable option\u003c/a>.\u003c/p>\n\u003cp>In recent years, Silicon Valley's entrepreneurs have become increasingly critical, attacking the agency's antiquated processes in a string of interviews and \u003ca href=\"http://www.usatoday.com/story/opinion/2014/02/15/fischer-king-health-information-technology/5464693/\" target=\"_blank\">op-eds\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>“There is this perceived myth that the FDA will change its mind on a dime,” said Ellie Cachette, an entrepreneur and health advocate who has served on a number of committee boards for the National Institutes of Health.\u003c/p>\n\u003cp>The crux of the problem is a mismatch of priorities.\u003c/p>\n\u003cp>The FDA's chief mandate is to \u003ca href=\"http://www.fda.gov/aboutfda/transparency/basics/ucm194877.htm\" target=\"_blank\">protect public health\u003c/a>, but some (perhaps many) entrepreneurs fear that it’s under-resourced, overwhelmed, and a roadblock to life-saving innovation. Life sciences-focused venture capitalists say the FDA is prone to delays and abrupt policy changes, making health care a precarious bet.\u003c/p>\n\u003cp>“The first cause of death for our startups is a lack of capital, and if investors aren’t confident that they can scale the FDA hurdles, they simply won’t invest,” said Kyra Davis, a program manager at the Entrepreneurship Center at UCSF, who works closely with budding health-tech entrepreneurs.\u003c/p>\n\u003cp>Life sciences startups are in a particularly tough spot, with investment in a downward spiral. (Note: The picture looked a bit rosier in the first quarter of 2014, in part due to a few successful \u003ca href=\"http://medcitynews.com/2014/04/biotech-attracts-1b-in-venture-capital-funding-medical-device-deal-size-trends-higher/\" target=\"_blank\">recent biotech IPOs\u003c/a>.)\u003c/p>\n\u003cp>Whether it’s justified or not, the FDA is often cited by health investors as the reason for this decline.\u003c/p>\n\u003cp>“We have been pushing the FDA on how difficult it is to get products approved,” said Michael Carusi, a general partner at \u003ca href=\"http://www.atvcapital.com/\">ATV Capital\u003c/a>, in an interview for a series I wrote in April, 2013 for \u003cem>VentureBeat\u003c/em> on Silicon Valley’s perceptions of the FDA.\u003c/p>\n\u003cp>\u003ca href=\"http://venturebeat.com/2013/04/30/stifled-by-regulation-entrepreneurs-take-life-saving-devices-overseas/\">For that article,\u003c/a> the FDA responded that it is doing its best with entrepreneurs and VCs to “develop smart regulation that balance patient safety and innovation.”\u003c/p>\n\u003cp>\u003cstrong>Tension Between Protecting Public Health and Regulating Innovation\u003c/strong>\u003c/p>\n\u003cp>The FDA’s crack down on 23andMe last November prompted health entrepreneurs to quake in their boots and angry Internet commentators to rail against \"Big Government.\" In February, Senators Angus King (I-Maine) and Deb Fischer (R-Nebraska) \u003ca href=\"http://venturebeat.com/2014/02/26/new-digital-health-bill-proposes-to-undermine-the-fda-draws-mixed-reactions/\" target=\"_blank\">proposed a bill \u003c/a>in Congress to prevent the agency from regulating “low risk” health IT altogether.\u003c/p>\n\u003cp>But the FDA has stepped up in one important regard. After demurring for several months, it released its \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm369431.htm\" target=\"_blank\">final guidance\u003c/a> on how it plans to regulate the explosion in mobile medical technology, a particularly trendy space. Most mobile medical apps do not require federal regulation, the FDA found, so developers and investors could breathe a bit easier.\u003c/p>\n\u003cp>According to John Wilson, a health policy expert and advisor to the \u003ca href=\"http://www.newmeaccelerator.com/\" target=\"_blank\">NewMe startup accelerator\u003c/a>, the FDA is doing its job and doesn’t deserve the bad rep.\u003c/p>\n\u003cp>“Entrepreneurs have a tendency to over-promise and under-deliver. But in health care, people’s lives are at stake,” he explained.\u003c/p>\n\u003cp>“When the company doesn’t work out, the FDA is often blamed. Startups are looking for a fall guy.\"\u003c/p>\n\u003cp>While Wilson believes in a “checks and balancing” body like the FDA, he does admit that the agency has plenty of work to do.\u003c/p>\n\u003cp>It’s a boom time for technology, and some of it is genuinely breaking new ground. It will take some time to determine whether this new tech is potentially harmful, and how it should be classified. For instance, it’s a matter of ongoing debate among geneticists and lawyers whether 23andMe should have been treated as a medical device. This field of consumer genetic reporting is nascent, making it a particularly problematic area for the FDA.\u003c/p>\n\u003cp>Meanwhile, Silicon Valley expects to move quickly -- and doesn’t respond well to hesitation and delays.\u003c/p>\n\u003cp>“The pendulum swings with the FDA -- or at least it has in my 25 years,” added Joe Kiani, chief executive of California-based Masimo Corp., a medical technology company that was founded in 1989 and went public in 2007.\u003c/p>\n\u003cp>“Sometimes, the agency can be very difficult, and other times it’s easy and formulaic. Right now, it’s one of those difficult periods.”\u003c/p>\n\u003cp>\u003cstrong>\"Don't View the FDA As This Scary Thing\"\u003c/strong>\u003c/p>\n\u003cp>Even those who are sympathetic to the FDA would admit that the regulatory processes are no small matter.\u003c/p>\n\u003cp>Amy Sheng, founder of a company that develops a low-risk medical device, estimates that it required \"hundreds of thousands of dollars\" and a “truck-load” of paperwork to implement a full quality system.\u003c/p>\n\u003cp>Sheng hired several consultants to navigate legislation, as well as a few key employees. She advises health-tech entrepreneurs to raise significant funding at the outset -- and bring the right set of legal and quality assurance experts on board.\u003c/p>\n\u003cp>\"I've been speaking the medical device language my whole career, so I don't view the FDA as this scary thing,\" said Sheng. \"Just keep in mind that the agency's mission is to protect patients and make sure your product is safe and accurate.\"\u003c/p>\n\u003cp>Meanwhile, Malay Gandhi, chief strategy officer at digital health accelerator \u003ca href=\"http://rockhealth.com/\">Rock Health\u003c/a>, would advise entrepreneurs to take a deep breath and relax. He has a far more optimistic view about regulatory processes, and doesn’t believe that the FDA is \"out to get” health entrepreneurs.\u003c/p>\n\u003cp>“There is some level of fear but the process is well defined and you can get through it,” he said. “There are countless numbers of people who have done it already.”\u003c/p>\n\u003cp>According to Gandhi, the entrepreneurs in Rock Health will often approach the FDA for clarification and typically receive a response within a few weeks. In the past few years, none of the founders were publicly admonished in a similar manner to 23andMe.\u003c/p>\n\u003cp>“At the end of the day, there aren’t that many health companies that are anything like 23andMe,” he added.\u003c/p>\n\u003cp>For those who don’t have the requisite funding, another good option is to take the business overseas.\u003c/p>\n\u003cp>Kiani often advises newcomers to launch their products in Europe first, where regulation is far more predictable. It can take years (and those hundreds of thousands of dollars) for U.S.-based entrepreneurs to gain approval from the FDA -- and in that time, many founders will find success in international markets.\u003c/p>\n\u003cp>“China and Japan and Brazil have their own regulatory difficulties, Japan is a predictable process, but Europe is probably best,” said Kiani. “It’s the fastest way to market.”\u003c/p>\n\u003cp>Ultimately, the experts stress that the FDA is unlikely to pay attention unless something is seriously wrong. Pass the regulatory checks, file the paperwork, do the research, and avoid making overblown statements in marketing to patients.\u003c/p>\n\u003cp>For health entrepreneurs, getting in the FDA’s good graces is money and time well-spent, Walter de Brouwer, founder of Scanadu, a hand-held medical device, told \u003cem>Fast Company.\u003c/em> Despite the efforts of politicians like Senators King and Fisher, the agency is not going anywhere anytime soon, so de Brouwer advises getting in its good graces.\u003c/p>\n\u003cp>“Trying to do something medical and avoiding the FDA, that is a lost battle. It’s like asking the Vatican to become atheist.”\u003c/p>\n\u003cp>\u003cem style=\"color: #1f1f1f\">Christina Farr is a San Francisco-based journalist covering health technology. She previously wrote for Venture Beat, The Bay Citizen and SFGate.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "California Senate Holds Soda-Labeling Bill Over Costs",
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"content": "\u003cfigure id=\"attachment_11293\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-e1398800357429.jpg\">\u003cimg class=\"size-large wp-image-11293\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-620x412.jpg\" alt=\"(KJM-427/Flickr)\" width=\"620\" height=\"412\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(KJM-427/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A bill to put warning labels on sodas and other sugary drinks in California is on hold for now. After clearing one committee vote \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2014/4/panel-oks-sugary-drink-warning-label-bill\" target=\"_blank\">earlier this month\u003c/a>, the Senate Appropriations Committee suspended the \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201320140SB1000\" target=\"_blank\">SB 1000\u003c/a> Monday, over the cost of enforcing the measure.\u003c/p>\n\u003cp>The proposed labels would warn people that \"drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay,\" and would apply to all sugary drinks that have more than 75 calories per 12 ounces.\u003c/p>\n\u003cp>KQED News host Mina Kim spoke with Senator Bill Monning (D-Carmel) Monday afternoon about the committee's decision.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/146974620&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>The appropriations committee made the move largely over the estimated $390,000 in enforcement costs that the state will face if the bill becomes law. While Monning said that the committee's decision to move the bill to the so-called suspense file is \"common procedure,\" the Los Angeles Times reported that Monning \u003ca href=\"http://www.latimes.com/local/political/la-me-pc-calif-soda-labeling-bill-sidelined-over-costs-20140428,0,7811941.story#axzz30H41whbE\" target=\"_blank\">intends to rework the bill \u003c/a>to reduce those costs before reintroducing it for another vote later this spring.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Times reported that the bill faces opposition from businesses. From its report:\u003c/p>\n\u003cblockquote>\n\u003cp style=\"color: #000000\">Ralph Simoni of the California Nevada Soft Drink Assn. said the record-keeping required for selling hundreds of drinks would be a “very onerous burden,” and is unnecessary. “The beverage industry has voluntarily listed calories on the front of every package,” he said.\u003c/p>\n\u003cp style=\"color: #000000\">John Latimer, a lobbyist for the California Retailers Assn., opposed the bill, saying putting labels on one product “disproportionately” blames soda for a health issue that involves many other products and issues.\u003c/p>\n\u003c/blockquote>\n\u003cp>\u003cspan style=\"color: #000000\">But Monning called the concerns a \"red herring\" and said most of the requirements of the bill would be borne by manufacturers at the time of production, not retailers. \"I really see this as a consumer right-to-know bill,\" Monning said. \"People say, 'well the calories are already posted on these sugar-sweetened beverages,' but what's not known is that all calories are not created equally, and the calories in sugar-sweetened beverages are for the most part empty and actually damaging to the liver and pancreas that convert sugar to fat more rapidly than sugar in foods.\"\u003c/span>\u003c/p>\n\u003cp>The bigger question is whether a warning label will have any effect on consumption. \"It's a fair question,\" Monning said, \"and I don't think we have data we can project.\" He said that warning labels need to be part of a broader public education campaign.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"nagBXLmTyyhQIwQ4iJssbswbSzk7Ypz3\"]\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: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-e1398800357429.jpg\">\u003cimg class=\"size-large wp-image-11293\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-620x412.jpg\" alt=\"(KJM-427/Flickr)\" width=\"620\" height=\"412\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(KJM-427/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A bill to put warning labels on sodas and other sugary drinks in California is on hold for now. After clearing one committee vote \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2014/4/panel-oks-sugary-drink-warning-label-bill\" target=\"_blank\">earlier this month\u003c/a>, the Senate Appropriations Committee suspended the \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201320140SB1000\" target=\"_blank\">SB 1000\u003c/a> Monday, over the cost of enforcing the measure.\u003c/p>\n\u003cp>The proposed labels would warn people that \"drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay,\" and would apply to all sugary drinks that have more than 75 calories per 12 ounces.\u003c/p>\n\u003cp>KQED News host Mina Kim spoke with Senator Bill Monning (D-Carmel) Monday afternoon about the committee's decision.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/146974620&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>The appropriations committee made the move largely over the estimated $390,000 in enforcement costs that the state will face if the bill becomes law. While Monning said that the committee's decision to move the bill to the so-called suspense file is \"common procedure,\" the Los Angeles Times reported that Monning \u003ca href=\"http://www.latimes.com/local/political/la-me-pc-calif-soda-labeling-bill-sidelined-over-costs-20140428,0,7811941.story#axzz30H41whbE\" target=\"_blank\">intends to rework the bill \u003c/a>to reduce those costs before reintroducing it for another vote later this spring.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Times reported that the bill faces opposition from businesses. From its report:\u003c/p>\n\u003cblockquote>\n\u003cp style=\"color: #000000\">Ralph Simoni of the California Nevada Soft Drink Assn. said the record-keeping required for selling hundreds of drinks would be a “very onerous burden,” and is unnecessary. “The beverage industry has voluntarily listed calories on the front of every package,” he said.\u003c/p>\n\u003cp style=\"color: #000000\">John Latimer, a lobbyist for the California Retailers Assn., opposed the bill, saying putting labels on one product “disproportionately” blames soda for a health issue that involves many other products and issues.\u003c/p>\n\u003c/blockquote>\n\u003cp>\u003cspan style=\"color: #000000\">But Monning called the concerns a \"red herring\" and said most of the requirements of the bill would be borne by manufacturers at the time of production, not retailers. \"I really see this as a consumer right-to-know bill,\" Monning said. \"People say, 'well the calories are already posted on these sugar-sweetened beverages,' but what's not known is that all calories are not created equally, and the calories in sugar-sweetened beverages are for the most part empty and actually damaging to the liver and pancreas that convert sugar to fat more rapidly than sugar in foods.\"\u003c/span>\u003c/p>\n\u003cp>The bigger question is whether a warning label will have any effect on consumption. \"It's a fair question,\" Monning said, \"and I don't think we have data we can project.\" He said that warning labels need to be part of a broader public education campaign.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"nagBXLmTyyhQIwQ4iJssbswbSzk7Ypz3\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "State's Walk and Bike Infrastructure Poised for Healthy Update",
"title": "State's Walk and Bike Infrastructure Poised for Healthy Update",
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"content": "\u003cfigure id=\"attachment_18867\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/bike-path-pic.jpg\">\u003cimg class=\"size-large wp-image-18867\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/bike-path-pic-640x428.jpg\" alt=\"(Getty images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty images)\u003c/figcaption>\u003c/figure>\n\u003cp>Far more Californians are choosing biking or walking to get around these days. Over the last 10 years, the number of trips Californians made on foot and by bike doubled, according to the latest California Household Travel Survey.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Every $1 million invested in bikeways, returns between $1.2 million and $3.8 million in health care savings.\u003c/aside>\n\u003cp>Now the state has launched the \u003ca href=\"http://www.catc.ca.gov/programs/ATP.htm\" target=\"_blank\">Active Transportation Program\u003c/a> (ATP). Caltrans funds, combined with other regional and federal grants will create a $360 million pot of money that will be awarded to program applicants this August.\u003c/p>\n\u003cp>The money will be targeted at projects like bike lanes and safer intersections for pedestrians, but also non-infrastructure programs like bike-to-work events and community engagement.\u003c/p>\n\u003cp>Jeanie Ward-Waller is the California advocacy organizer for the \u003ca href=\"http://saferoutespartnership.org/\" target=\"_blank\">Safe Routes to School National Partnership\u003c/a>. She said this is the most money by far that has been offered to improve walk/bike routes.\u003c!--more-->\u003c/p>\n\u003cp>But she said that it is also unique because the priorities for awarding the money are not just about transportation. Part of the decision about awarding the money will be based on potential boosts to public health. Some money is earmarked for projects in disadvantaged communities.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s watershed in terms of supporting walking and biking, but it’s also a watershed in how it is being targeted,\" Ward-Waller said. \"I think it’s a new standard about how we are approaching transportation and prioritizing things like public health and sustainability and making sure equity is a lens.”\u003c/p>\n\u003cp>There are plenty of studies linking improved health to walking or biking.\u003c/p>\n\u003cp>According to \u003ca href=\"http://everybodywalk.org/\" target=\"_blank\">Every Body Walk\u003c/a>, walking 20 to 25 minutes a week can extend life by several years. A 45-minute daily walk halves the odds of catching a cold. Walking also leads to improved outcomes with depression, arthritis and dementia.\u003c/p>\n\u003cp>In financial terms, the \u003ca href=\"http://calbike.org/\" target=\"_blank\">California Bicycle Coalition\u003c/a> says every $1 million invested in bikeways returns between $1.2 million and $3.8 million in health care savings.\u003c/p>\n\u003cp>Dave Snyder, executive director of the coalition, said because the amount of money for bike/walk programs is so much higher than what Sacramento has offered in the past, it is drawing welcome attention. Before, he said, the programs for walking and biking were funded from small, discreet pots of money and could almost be written off as \"cute ideas.\"\u003c/p>\n\u003cp>\"Now it’s a line item in the transportation budget, and we hope people will say 'That’s a good program why are we just giving this amount?'” Snyder said.\u003c/p>\n\u003cp>Snyder said if you look closer, it amounts to only 1 percent of the state's overall transportation budget.\u003c/p>\n\u003cp>He said his group is especially excited to see so-called \"first and last mile\" projects funded. These funds would help get people easily and safely from their homes or offices to mass transit or major bike paths.\u003c/p>\n\u003cp>\"Often between two points there are two transit stops that is quick and easy, but there is a half mile missing on either side. So it’s practically not a useful transit system. If we can solve that last mile problem and make it much easier to get to your stop, then transit becomes much easier and more viable,\" Snyder said.\u003c/p>\n\u003cp>Initial proposals for the program are due at the end of May. Snyder said there has been so much enthusiasm about ATP he expects the funding to be oversubscribed by a factor of 10.\u003c/p>\n\u003cp>For Tony Dang, deputy director of \u003ca href=\"http://californiawalks.org/\" target=\"_blank\">California Walks\u003c/a>, the public health benefits are not just the mental and physical benefits that come from moving. Dang says by getting cars off the road, that also decreases asthma rates.\u003c/p>\n\u003cp>He said he's excited to see the funding going to unexpected populations.\u003c/p>\n\u003cp>\"I think walking and biking may seem very sexy these days and it skews younger, but our organization would like to see programs for seniors,\" Dang said. \"We’re going to see more and more people age and we’d like them to age in place with dignity. And when people get older and can’t drive, we’d like them to still be able to see their family and get to their friends and the store.\"\u003c/p>\n\u003cp>One of the ways that can happen is by doing audits of infrastructure near senior centers. It may also involve programs that create senior walking groups.\u003c/p>\n\u003cp>ATP also promises to help health by addressing pedestrian safety issues, Dang said. 2013 was a particularly bad year for pedestrian fatalities in the Bay Area.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"San Francisco and San Jose had record highs last year. We need to invest in streets in a way that not just benefits car drivers,\" Dang said. \"We need street to be safer for everyone, whether on foot, bike or in a car.\"\u003c/p>\n\n",
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"excerpt": "California will award $360 million for programs promoting walking and biking, with an emphasis on health.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18867\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/bike-path-pic.jpg\">\u003cimg class=\"size-large wp-image-18867\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/bike-path-pic-640x428.jpg\" alt=\"(Getty images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty images)\u003c/figcaption>\u003c/figure>\n\u003cp>Far more Californians are choosing biking or walking to get around these days. Over the last 10 years, the number of trips Californians made on foot and by bike doubled, according to the latest California Household Travel Survey.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Every $1 million invested in bikeways, returns between $1.2 million and $3.8 million in health care savings.\u003c/aside>\n\u003cp>Now the state has launched the \u003ca href=\"http://www.catc.ca.gov/programs/ATP.htm\" target=\"_blank\">Active Transportation Program\u003c/a> (ATP). Caltrans funds, combined with other regional and federal grants will create a $360 million pot of money that will be awarded to program applicants this August.\u003c/p>\n\u003cp>The money will be targeted at projects like bike lanes and safer intersections for pedestrians, but also non-infrastructure programs like bike-to-work events and community engagement.\u003c/p>\n\u003cp>Jeanie Ward-Waller is the California advocacy organizer for the \u003ca href=\"http://saferoutespartnership.org/\" target=\"_blank\">Safe Routes to School National Partnership\u003c/a>. She said this is the most money by far that has been offered to improve walk/bike routes.\u003c!--more-->\u003c/p>\n\u003cp>But she said that it is also unique because the priorities for awarding the money are not just about transportation. Part of the decision about awarding the money will be based on potential boosts to public health. Some money is earmarked for projects in disadvantaged communities.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s watershed in terms of supporting walking and biking, but it’s also a watershed in how it is being targeted,\" Ward-Waller said. \"I think it’s a new standard about how we are approaching transportation and prioritizing things like public health and sustainability and making sure equity is a lens.”\u003c/p>\n\u003cp>There are plenty of studies linking improved health to walking or biking.\u003c/p>\n\u003cp>According to \u003ca href=\"http://everybodywalk.org/\" target=\"_blank\">Every Body Walk\u003c/a>, walking 20 to 25 minutes a week can extend life by several years. A 45-minute daily walk halves the odds of catching a cold. Walking also leads to improved outcomes with depression, arthritis and dementia.\u003c/p>\n\u003cp>In financial terms, the \u003ca href=\"http://calbike.org/\" target=\"_blank\">California Bicycle Coalition\u003c/a> says every $1 million invested in bikeways returns between $1.2 million and $3.8 million in health care savings.\u003c/p>\n\u003cp>Dave Snyder, executive director of the coalition, said because the amount of money for bike/walk programs is so much higher than what Sacramento has offered in the past, it is drawing welcome attention. Before, he said, the programs for walking and biking were funded from small, discreet pots of money and could almost be written off as \"cute ideas.\"\u003c/p>\n\u003cp>\"Now it’s a line item in the transportation budget, and we hope people will say 'That’s a good program why are we just giving this amount?'” Snyder said.\u003c/p>\n\u003cp>Snyder said if you look closer, it amounts to only 1 percent of the state's overall transportation budget.\u003c/p>\n\u003cp>He said his group is especially excited to see so-called \"first and last mile\" projects funded. These funds would help get people easily and safely from their homes or offices to mass transit or major bike paths.\u003c/p>\n\u003cp>\"Often between two points there are two transit stops that is quick and easy, but there is a half mile missing on either side. So it’s practically not a useful transit system. If we can solve that last mile problem and make it much easier to get to your stop, then transit becomes much easier and more viable,\" Snyder said.\u003c/p>\n\u003cp>Initial proposals for the program are due at the end of May. Snyder said there has been so much enthusiasm about ATP he expects the funding to be oversubscribed by a factor of 10.\u003c/p>\n\u003cp>For Tony Dang, deputy director of \u003ca href=\"http://californiawalks.org/\" target=\"_blank\">California Walks\u003c/a>, the public health benefits are not just the mental and physical benefits that come from moving. Dang says by getting cars off the road, that also decreases asthma rates.\u003c/p>\n\u003cp>He said he's excited to see the funding going to unexpected populations.\u003c/p>\n\u003cp>\"I think walking and biking may seem very sexy these days and it skews younger, but our organization would like to see programs for seniors,\" Dang said. \"We’re going to see more and more people age and we’d like them to age in place with dignity. And when people get older and can’t drive, we’d like them to still be able to see their family and get to their friends and the store.\"\u003c/p>\n\u003cp>One of the ways that can happen is by doing audits of infrastructure near senior centers. It may also involve programs that create senior walking groups.\u003c/p>\n\u003cp>ATP also promises to help health by addressing pedestrian safety issues, Dang said. 2013 was a particularly bad year for pedestrian fatalities in the Bay Area.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"San Francisco and San Jose had record highs last year. We need to invest in streets in a way that not just benefits car drivers,\" Dang said. \"We need street to be safer for everyone, whether on foot, bike or in a car.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "FDA Proposes First Regulations for E-Cigarettes",
"title": "FDA Proposes First Regulations for E-Cigarettes",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_18878\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/e-cigs.jpg\">\u003cimg class=\"size-large wp-image-18878\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/e-cigs-640x498.jpg\" alt=\"The FDA is proposing regulations that would rein in the e-cigarette industry. (Getty Images)\" width=\"640\" height=\"498\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The FDA is proposing regulations that would rein in the e-cigarette industry. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Rob Stein (\u003ca href=\"http://www.npr.org/blogs/health/2014/04/24/306228616/the-fda-moves-to-regulate-increasingly-popular-e-cigarettes\" target=\"_blank\">NPR\u003c/a>) and Rachel Dornhelm\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The Food and Drug Administration Thursday proposed regulating e-cigarettes for the first time.\u003c/p>\n\u003cp>The agency unveiled a long-awaited \u003ca href=\"https://www.federalregister.gov/articles/2014/04/25/2014-09491/sale-and-distribution-of-tobacco-products-and-required-warning-statements-for-tobacco-products\" target=\"_blank\">rule\u003c/a> that would give it power to oversee the increasingly popular devices, much in the way that it regulates traditional cigarettes.\u003c/p>\n\u003cp>\"It's a huge change,\" FDA Commissioner Margaret Hamburg told reporters in a briefing before the official announcement of the agency's plans. \"We will have the authority as a science-based regulatory agency to take critical actions to promote and protect the health of the public.\"\u003c/p>\n\u003cp>The proposal will be subject to public comment and further review by the agency before becoming final. But once that happens the rule would impose new restrictions, including:\u003c/p>\n\u003cul>\n\u003cli>A ban on the sale of e-cigarettes to minors\u003c/li>\n\u003cli>A prohibition on distributing free samples\u003c/li>\n\u003cli>A ban on selling e-cigarettes in vending machines unless they are in places that never admit young people\u003c/li>\n\u003cli>A requirement that e-cigarettes carry warnings that they contain nicotine, which is addictive\u003c/li>\n\u003cli>E-cigarette manufacturers would be required to disclose the ingredients in their products\u003c/li>\n\u003c/ul>\n\u003caside class=\"pullquote alignleft\">\"This announcement starts the process that will give us the authority to actually get out there and regulate e-cigarettes.\"\u003c/aside>\n\u003cp>U.S. Rep. Jackie Speier (D-San Mateo), who has asked for congressional hearings on the topic, called the regulations today \"long overdue.\" In a statement she said she wants to see wider governmental control of the $2 billion industry, especially provisions that govern advertising to minors and former smokers.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Although the proposed rule does make long awaited changes such as restricting the sale of e-cigarettes to minors, there are important pieces missing — such as child-proof packaging. Too many children have ended up poisoned by the devices,” Speier said.\u003c/p>\n\u003cp>Sen. Barbara Boxer (D-Calif.) also immediately responded to the FDA's move and called for further action.\u003c!--more-->\u003c/p>\n\u003cp>\"Now it is time for the Administration to take the next important step by banning the outrageous marketing of e-cigarettes to our kids, including the use of candy flavors and cartoon advertisements that are shamelessly designed to lure and addict them,\" Boxer wrote in an email statement.\u003c/p>\n\u003cp>E-cigarettes are plastic or metal tubes about the size of a traditional cigarette that heat a liquid solution containing nicotine. That creates a vapor that users inhale. Their popularity has soared in recent years.\u003c/p>\n\u003cp>This has led some cities in California to regulate their use in public. Richmond, Long Beach and Los Angeles all have some form of a public ban of e-cigarettes.\u003c/p>\n\u003cp>San Francisco passed its own ordinance in March that takes effect this Saturday. It treats electronic cigarettes as regular cigarettes, effectively banning them at bars, restaurants and businesses. Sellers will also have to secure a special permit, and e-cigarettes can’t be sold at pharmacies and other businesses where tobacco sales are banned.\u003c/p>\n\u003cp>Some have welcomed the e-cigarette trend as a way to prevent people from smoking traditional cigarettes, which are far more dangerous, and to help smokers quit.\u003c/p>\n\u003cp>Others fear the devices will addict nonsmokers to nicotine and eventually lead to more people smoking. That has fueled calls for the FDA to assert its authority over the devices. Although e-cigarettes are generally considered much safer than traditional cigarettes, some fear that not enough research has been done to know what risks they may have.\u003c/p>\n\u003cp>\"We call the current marketplace for e-cigarettes the Wild, Wild West,\" said Mitchell Zeller, who heads the FDA's Center for Tobacco Products. \"We will be in a position to ensure that the products are as safe as they could possibly be.\"\u003c/p>\n\u003cp>The FDA had previously attempted to regulate e-cigarettes, but that effort was thwarted in court. The agency recently signaled, however, that it planned to try again. Thursday's announcement will make that official.\u003c/p>\n\u003cp>The proposal would also require any new e-cigarettes to get FDA approval before being sold, and demand that current products provide a justification for remaining on the market.\u003c/p>\n\u003cp>The announcement stopped short of more aggressive regulation that some critics had called for, including restricting or banning fruit flavors and other sweeteners that may appeal to young people.\u003c/p>\n\u003cp>It also won't restrict television advertising and online sales, as some had hoped. But Zeller and Hamburg said Thursday's move is the first step that could lead to such measures if the agency determines that those are needed.\u003c/p>\n\u003cp>\"This announcement starts the process that will give us the authority to actually get out there and regulate e-cigarettes,\" Hamburg said.\u003c/p>\n\u003cp>The FDA also is proposing regulation of a variety of other tobacco-related products, including cigars, nicotine gels, pipe tobacco and water pipes.\u003c/p>\n\u003cp>E-cigarette companies and anti-smoking advocates had just started to review the FDA's proposal. But at least initially the industry welcomed the FDA's plans, apparently relieved the agency had not gone further.\u003c/p>\n\u003cp>\"We are extremely relieved that all e-cigarette companies will be regulated, and forced to achieve and maintain the same high standards that Vapor Corp. and several of our responsible competitors, have been imposing on ourselves for years,\" Jeffrey Holman, president and director of the Dania, Fla., company, said in an email to Shots (health news from NPR).\u003c/p>\n\u003cp>Public health advocates generally welcomed the move as an important first step, but expressed disappointment that the agency had failed to regulate the devices more aggressively right away.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This action is long overdue,\" said Matthew Myers, president of the Campaign for Tobacco-Free Kids. \"It is inexcusable that it has taken the FDA and the administration so long to act. This delay has had serious health consequences, as these unregulated tobacco products have been marketed using tactics and sweet flavors that appeal to kids.\"\u003c/p>\n\n",
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"excerpt": "The new rules would ban sales to minors and require warnings on products.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18878\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/e-cigs.jpg\">\u003cimg class=\"size-large wp-image-18878\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/e-cigs-640x498.jpg\" alt=\"The FDA is proposing regulations that would rein in the e-cigarette industry. (Getty Images)\" width=\"640\" height=\"498\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The FDA is proposing regulations that would rein in the e-cigarette industry. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Rob Stein (\u003ca href=\"http://www.npr.org/blogs/health/2014/04/24/306228616/the-fda-moves-to-regulate-increasingly-popular-e-cigarettes\" target=\"_blank\">NPR\u003c/a>) and Rachel Dornhelm\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The Food and Drug Administration Thursday proposed regulating e-cigarettes for the first time.\u003c/p>\n\u003cp>The agency unveiled a long-awaited \u003ca href=\"https://www.federalregister.gov/articles/2014/04/25/2014-09491/sale-and-distribution-of-tobacco-products-and-required-warning-statements-for-tobacco-products\" target=\"_blank\">rule\u003c/a> that would give it power to oversee the increasingly popular devices, much in the way that it regulates traditional cigarettes.\u003c/p>\n\u003cp>\"It's a huge change,\" FDA Commissioner Margaret Hamburg told reporters in a briefing before the official announcement of the agency's plans. \"We will have the authority as a science-based regulatory agency to take critical actions to promote and protect the health of the public.\"\u003c/p>\n\u003cp>The proposal will be subject to public comment and further review by the agency before becoming final. But once that happens the rule would impose new restrictions, including:\u003c/p>\n\u003cul>\n\u003cli>A ban on the sale of e-cigarettes to minors\u003c/li>\n\u003cli>A prohibition on distributing free samples\u003c/li>\n\u003cli>A ban on selling e-cigarettes in vending machines unless they are in places that never admit young people\u003c/li>\n\u003cli>A requirement that e-cigarettes carry warnings that they contain nicotine, which is addictive\u003c/li>\n\u003cli>E-cigarette manufacturers would be required to disclose the ingredients in their products\u003c/li>\n\u003c/ul>\n\u003caside class=\"pullquote alignleft\">\"This announcement starts the process that will give us the authority to actually get out there and regulate e-cigarettes.\"\u003c/aside>\n\u003cp>U.S. Rep. Jackie Speier (D-San Mateo), who has asked for congressional hearings on the topic, called the regulations today \"long overdue.\" In a statement she said she wants to see wider governmental control of the $2 billion industry, especially provisions that govern advertising to minors and former smokers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Although the proposed rule does make long awaited changes such as restricting the sale of e-cigarettes to minors, there are important pieces missing — such as child-proof packaging. Too many children have ended up poisoned by the devices,” Speier said.\u003c/p>\n\u003cp>Sen. Barbara Boxer (D-Calif.) also immediately responded to the FDA's move and called for further action.\u003c!--more-->\u003c/p>\n\u003cp>\"Now it is time for the Administration to take the next important step by banning the outrageous marketing of e-cigarettes to our kids, including the use of candy flavors and cartoon advertisements that are shamelessly designed to lure and addict them,\" Boxer wrote in an email statement.\u003c/p>\n\u003cp>E-cigarettes are plastic or metal tubes about the size of a traditional cigarette that heat a liquid solution containing nicotine. That creates a vapor that users inhale. Their popularity has soared in recent years.\u003c/p>\n\u003cp>This has led some cities in California to regulate their use in public. Richmond, Long Beach and Los Angeles all have some form of a public ban of e-cigarettes.\u003c/p>\n\u003cp>San Francisco passed its own ordinance in March that takes effect this Saturday. It treats electronic cigarettes as regular cigarettes, effectively banning them at bars, restaurants and businesses. Sellers will also have to secure a special permit, and e-cigarettes can’t be sold at pharmacies and other businesses where tobacco sales are banned.\u003c/p>\n\u003cp>Some have welcomed the e-cigarette trend as a way to prevent people from smoking traditional cigarettes, which are far more dangerous, and to help smokers quit.\u003c/p>\n\u003cp>Others fear the devices will addict nonsmokers to nicotine and eventually lead to more people smoking. That has fueled calls for the FDA to assert its authority over the devices. Although e-cigarettes are generally considered much safer than traditional cigarettes, some fear that not enough research has been done to know what risks they may have.\u003c/p>\n\u003cp>\"We call the current marketplace for e-cigarettes the Wild, Wild West,\" said Mitchell Zeller, who heads the FDA's Center for Tobacco Products. \"We will be in a position to ensure that the products are as safe as they could possibly be.\"\u003c/p>\n\u003cp>The FDA had previously attempted to regulate e-cigarettes, but that effort was thwarted in court. The agency recently signaled, however, that it planned to try again. Thursday's announcement will make that official.\u003c/p>\n\u003cp>The proposal would also require any new e-cigarettes to get FDA approval before being sold, and demand that current products provide a justification for remaining on the market.\u003c/p>\n\u003cp>The announcement stopped short of more aggressive regulation that some critics had called for, including restricting or banning fruit flavors and other sweeteners that may appeal to young people.\u003c/p>\n\u003cp>It also won't restrict television advertising and online sales, as some had hoped. But Zeller and Hamburg said Thursday's move is the first step that could lead to such measures if the agency determines that those are needed.\u003c/p>\n\u003cp>\"This announcement starts the process that will give us the authority to actually get out there and regulate e-cigarettes,\" Hamburg said.\u003c/p>\n\u003cp>The FDA also is proposing regulation of a variety of other tobacco-related products, including cigars, nicotine gels, pipe tobacco and water pipes.\u003c/p>\n\u003cp>E-cigarette companies and anti-smoking advocates had just started to review the FDA's proposal. But at least initially the industry welcomed the FDA's plans, apparently relieved the agency had not gone further.\u003c/p>\n\u003cp>\"We are extremely relieved that all e-cigarette companies will be regulated, and forced to achieve and maintain the same high standards that Vapor Corp. and several of our responsible competitors, have been imposing on ourselves for years,\" Jeffrey Holman, president and director of the Dania, Fla., company, said in an email to Shots (health news from NPR).\u003c/p>\n\u003cp>Public health advocates generally welcomed the move as an important first step, but expressed disappointment that the agency had failed to regulate the devices more aggressively right away.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This action is long overdue,\" said Matthew Myers, president of the Campaign for Tobacco-Free Kids. \"It is inexcusable that it has taken the FDA and the administration so long to act. This delay has had serious health consequences, as these unregulated tobacco products have been marketed using tactics and sweet flavors that appeal to kids.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_18823\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/teresa.jpg\">\u003cimg class=\"size-large wp-image-18823\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/teresa-640x516.jpg\" alt=\"Teresa Martinez, 62, works as a hairdresser at a Koreatown hair salon. She earns about $10,000 per year and cannot afford to buy private health coverage (Photo by Heidi de Marco/KHN).\" width=\"640\" height=\"516\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Teresa Martinez, 62, works as a hairdresser at a Koreatown hair salon. She earns about $10,000 per year and cannot afford to buy private health coverage (Photo by Heidi de Marco/KHN).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>by Anna Gorman, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/April/21/Teresa-the-hairdresser.aspx\" target=\"_blank\">KHN\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>For most of Teresa Martinez’s life, buying health insurance has been out of the question. She works at a Koreatown hair salon, earning about $10 per cut – not nearly enough to afford private coverage.\u003c/p>\n\u003cp>With a long list of ailments including dizziness, blurry vision and leg pain, she eagerly applied last year for a county program that would cover her for free until Obamacare set in.\u003c/p>\n\u003cp>“I thought at long last, I would be able to go to the doctor and get what I need,” said Martinez, 62, who lives in East Los Angeles. “I was so excited. But that was short lived.”\u003c/p>\n\u003caside class=\"pullquote alignleft\">The state has 45 days to process the Medi-Cal applications but it often takes longer and the waiting period varies -- sometimes widely -- by county.\u003c/aside>\n\u003cp>Without any explanation, Martinez received a denial letter from the Healthy Way Los Angeles, a temporary coverage program for low-income people. Later she applied for Medicaid -- known as Medi-Cal in California -- which was expanded under the Affordable Care Act to include people like Martinez without dependent children.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But a health clinic worker told her she may have to wait months for approval -- and to hold off on appointments until she has her official card.\u003c/p>\n\u003cp>Nearly 2 million Californians have gained coverage with the expansion of the Medi-Cal program for poor and disabled people, including those who transitioned from temporary programs like Healthy Way LA.\u003c!--more-->\u003c/p>\n\u003cp>But roughly 800,000 more applications are pending from people presumed to be eligible for the program. While hospitals are required to accept patients with emergencies, private doctors, health clinics, pharmacies and specialists have discretion over whether to treat patients for non-urgent health needs while they await acceptance into the program.\u003c/p>\n\u003cp>“If they don’t have final determination of their eligibility, they are probably not able to get care,” said Catherine Teare, senior program officer at the California HealthCare Foundation. That can be frustrating for people who, like Martinez, have long put off for treatment for lack of coverage.\u003c/p>\n\u003cp>The state has 45 days to process the Medi-Cal applications but it often takes longer and the waiting period varies -- sometimes widely -- by county. Medi-Cal will pay providers retroactively for care provided to eligible candidates during the waiting period.\u003c/p>\n\u003cp>The sheer volume of applications is slowing the process, said Norman Williams, spokesman for the California Department of Health Care Services. Adding to the delays are new requirements on verifying income, and the number of incomplete or duplicate applications.\u003c/p>\n\u003cp>“It is just a big number that has a lot of moving parts,” he said. “We are working very quickly and very diligently to get these people into coverage.”\u003c/p>\n\u003cp>The delays in confirming eligibility aren’t unique to California. “In practically every state, there are backlogs,” said Matt Salo, executive director of the National Association of Medicaid Directors.\u003cs> \u003c/s>\u003c/p>\n\u003cp>The number of Medicaid applicants nationwide who are in limbo is unclear, said Judith Solomon, vice president for health policy at the Center on Budget and Policy Priorities. Solomon ascribed much of the problem to inadequacies in technology. Many of the uninsured are seeking coverage through subsidized insurance marketplace websites. When they are deemed eligible for free coverage under Medicaid, their information is not always transferred seamlessly.\u003c/p>\n\u003cp>The system still is playing “catchup,” Solomon said.\u003c/p>\n\u003cp>\u003cstrong>Living ‘Day to Day’\u003c/strong>\u003c/p>\n\u003cp>At Chela’s Hair Fashions in Koreatown, customers trickle in, some from the neighborhood and others from across town. Friendly and upbeat, Martinez chats with them, affectionately calling them, “mi hija, mi hijo” -- my daughter, my son.\u003c/p>\n\u003cp>After giving the owner a commission, Martinez said she earns just enough to pay her bills – about $10,000 a year. She relies on her boyfriend to pay the rent on their apartment. “I live day to day,” she said.\u003c/p>\n\u003cp>Originally from Mexico, Martinez said that she fled an abusive husband when she was 17 and crossed the border with a false identification. She became a U.S. citizen under the 1986 amnesty law and learned English while working -- as a babysitter, a waitress, a receptionist and eventually a hair stylist. She briefly had insurance while working for a bank.\u003c/p>\n\u003cp>In her youth, Martinez said, the last thing on her mind was going to the doctor. She went years without a mammogram and a physical and can’t remember the last time she saw a dentist. When she was in pain, she applied Menthol or used herbal remedies.\u003c/p>\n\u003cp>“I have always self-diagnosed and self-medicated,” she said. “I pray for everything, especially my good health.”\u003c/p>\n\u003cp>But Martinez said now that she is getting older, she needs to see a doctor. A fall caused lingering ankle and hip pain. She feared she might have diabetes – a doctor in Mexico once told her she was on the borderline.\u003c/p>\n\u003cp>In December, she went to a community clinic in Hollywood run by QueensCare Health Centers to get a long-awaited physical. At the suggestion of a health center employee, she applied for the free county coverage program while she was there. After helping her complete the application, an enrollment counselor told her she would likely qualify and Martinez said she felt great. “What a difference a day could make.”\u003c/p>\n\u003cp>A few hours later in a spacious exam room, nurse practitioner Wendy Davidson introduced herself. “What concerns you about your health?” she asked as she conducted a brief exam.\u003c/p>\n\u003cp>Martinez told her she hadn’t seen a doctor in at least 10 years. Her mouth was dry and her right eye blurry. She had swelling in her knee and frequent headaches.\u003c/p>\n\u003cp>“Do you have any chronic diseases?” Davidson asked.\u003c/p>\n\u003cp>“Not that I know,” she said. Davidson ordered blood work and encouraged her to make a follow-up appointment.\u003c/p>\n\u003cp>\u003cstrong>Going back to ‘herbal stuff’\u003c/strong>\u003c/p>\n\u003cp>About a month later, Martinez returned for her lab results. Her blood sugar was a little high.\u003c/p>\n\u003cp>“We want to make sure you don’t get diabetes,” Davidson said. “With extra weight and high blood sugar, you’re at risk.”\u003c/p>\n\u003cp>The nurse practitioner urged her to exercise and watch what she ate. “Let’s see if the dry mouth and the dizziness get better with a little bit of exercise,” she said. “I can tell you’re motivated.”\u003c/p>\n\u003cp>Martinez left with follow-up appointments, including for a mammogram and an eye exam. But then in February, she received the denial letter from Healthy Way Los Angeles and social worker told her to cancel the appointments until she had Medi-Cal.\u003c/p>\n\u003cp>QueensCare is continuing to see longtime patients awaiting approval but is asking new patients to come back when they have an official card, said spokeswoman Bianca Rodas.\u003c/p>\n\u003cp>Martinez is frustrated that she still doesn’t have health insurance, nearly four months after her first application. She also fears her blood sugar levels are getting worse.\u003c/p>\n\u003cp>“I’m really worried,” she said. 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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18823\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/teresa.jpg\">\u003cimg class=\"size-large wp-image-18823\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/teresa-640x516.jpg\" alt=\"Teresa Martinez, 62, works as a hairdresser at a Koreatown hair salon. She earns about $10,000 per year and cannot afford to buy private health coverage (Photo by Heidi de Marco/KHN).\" width=\"640\" height=\"516\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Teresa Martinez, 62, works as a hairdresser at a Koreatown hair salon. She earns about $10,000 per year and cannot afford to buy private health coverage (Photo by Heidi de Marco/KHN).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>by Anna Gorman, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/April/21/Teresa-the-hairdresser.aspx\" target=\"_blank\">KHN\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>For most of Teresa Martinez’s life, buying health insurance has been out of the question. She works at a Koreatown hair salon, earning about $10 per cut – not nearly enough to afford private coverage.\u003c/p>\n\u003cp>With a long list of ailments including dizziness, blurry vision and leg pain, she eagerly applied last year for a county program that would cover her for free until Obamacare set in.\u003c/p>\n\u003cp>“I thought at long last, I would be able to go to the doctor and get what I need,” said Martinez, 62, who lives in East Los Angeles. “I was so excited. But that was short lived.”\u003c/p>\n\u003caside class=\"pullquote alignleft\">The state has 45 days to process the Medi-Cal applications but it often takes longer and the waiting period varies -- sometimes widely -- by county.\u003c/aside>\n\u003cp>Without any explanation, Martinez received a denial letter from the Healthy Way Los Angeles, a temporary coverage program for low-income people. Later she applied for Medicaid -- known as Medi-Cal in California -- which was expanded under the Affordable Care Act to include people like Martinez without dependent children.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But a health clinic worker told her she may have to wait months for approval -- and to hold off on appointments until she has her official card.\u003c/p>\n\u003cp>Nearly 2 million Californians have gained coverage with the expansion of the Medi-Cal program for poor and disabled people, including those who transitioned from temporary programs like Healthy Way LA.\u003c!--more-->\u003c/p>\n\u003cp>But roughly 800,000 more applications are pending from people presumed to be eligible for the program. While hospitals are required to accept patients with emergencies, private doctors, health clinics, pharmacies and specialists have discretion over whether to treat patients for non-urgent health needs while they await acceptance into the program.\u003c/p>\n\u003cp>“If they don’t have final determination of their eligibility, they are probably not able to get care,” said Catherine Teare, senior program officer at the California HealthCare Foundation. That can be frustrating for people who, like Martinez, have long put off for treatment for lack of coverage.\u003c/p>\n\u003cp>The state has 45 days to process the Medi-Cal applications but it often takes longer and the waiting period varies -- sometimes widely -- by county. Medi-Cal will pay providers retroactively for care provided to eligible candidates during the waiting period.\u003c/p>\n\u003cp>The sheer volume of applications is slowing the process, said Norman Williams, spokesman for the California Department of Health Care Services. Adding to the delays are new requirements on verifying income, and the number of incomplete or duplicate applications.\u003c/p>\n\u003cp>“It is just a big number that has a lot of moving parts,” he said. “We are working very quickly and very diligently to get these people into coverage.”\u003c/p>\n\u003cp>The delays in confirming eligibility aren’t unique to California. “In practically every state, there are backlogs,” said Matt Salo, executive director of the National Association of Medicaid Directors.\u003cs> \u003c/s>\u003c/p>\n\u003cp>The number of Medicaid applicants nationwide who are in limbo is unclear, said Judith Solomon, vice president for health policy at the Center on Budget and Policy Priorities. Solomon ascribed much of the problem to inadequacies in technology. Many of the uninsured are seeking coverage through subsidized insurance marketplace websites. When they are deemed eligible for free coverage under Medicaid, their information is not always transferred seamlessly.\u003c/p>\n\u003cp>The system still is playing “catchup,” Solomon said.\u003c/p>\n\u003cp>\u003cstrong>Living ‘Day to Day’\u003c/strong>\u003c/p>\n\u003cp>At Chela’s Hair Fashions in Koreatown, customers trickle in, some from the neighborhood and others from across town. Friendly and upbeat, Martinez chats with them, affectionately calling them, “mi hija, mi hijo” -- my daughter, my son.\u003c/p>\n\u003cp>After giving the owner a commission, Martinez said she earns just enough to pay her bills – about $10,000 a year. She relies on her boyfriend to pay the rent on their apartment. “I live day to day,” she said.\u003c/p>\n\u003cp>Originally from Mexico, Martinez said that she fled an abusive husband when she was 17 and crossed the border with a false identification. She became a U.S. citizen under the 1986 amnesty law and learned English while working -- as a babysitter, a waitress, a receptionist and eventually a hair stylist. She briefly had insurance while working for a bank.\u003c/p>\n\u003cp>In her youth, Martinez said, the last thing on her mind was going to the doctor. She went years without a mammogram and a physical and can’t remember the last time she saw a dentist. When she was in pain, she applied Menthol or used herbal remedies.\u003c/p>\n\u003cp>“I have always self-diagnosed and self-medicated,” she said. “I pray for everything, especially my good health.”\u003c/p>\n\u003cp>But Martinez said now that she is getting older, she needs to see a doctor. A fall caused lingering ankle and hip pain. She feared she might have diabetes – a doctor in Mexico once told her she was on the borderline.\u003c/p>\n\u003cp>In December, she went to a community clinic in Hollywood run by QueensCare Health Centers to get a long-awaited physical. At the suggestion of a health center employee, she applied for the free county coverage program while she was there. After helping her complete the application, an enrollment counselor told her she would likely qualify and Martinez said she felt great. “What a difference a day could make.”\u003c/p>\n\u003cp>A few hours later in a spacious exam room, nurse practitioner Wendy Davidson introduced herself. “What concerns you about your health?” she asked as she conducted a brief exam.\u003c/p>\n\u003cp>Martinez told her she hadn’t seen a doctor in at least 10 years. Her mouth was dry and her right eye blurry. She had swelling in her knee and frequent headaches.\u003c/p>\n\u003cp>“Do you have any chronic diseases?” Davidson asked.\u003c/p>\n\u003cp>“Not that I know,” she said. Davidson ordered blood work and encouraged her to make a follow-up appointment.\u003c/p>\n\u003cp>\u003cstrong>Going back to ‘herbal stuff’\u003c/strong>\u003c/p>\n\u003cp>About a month later, Martinez returned for her lab results. Her blood sugar was a little high.\u003c/p>\n\u003cp>“We want to make sure you don’t get diabetes,” Davidson said. “With extra weight and high blood sugar, you’re at risk.”\u003c/p>\n\u003cp>The nurse practitioner urged her to exercise and watch what she ate. “Let’s see if the dry mouth and the dizziness get better with a little bit of exercise,” she said. “I can tell you’re motivated.”\u003c/p>\n\u003cp>Martinez left with follow-up appointments, including for a mammogram and an eye exam. 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"disqusTitle": "California Legislature To Consider Antibiotic Ban in Animals",
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"content": "\u003cfigure id=\"attachment_18838\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/ab1437edit.jpg\">\u003cimg class=\"size-large wp-image-18838 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/ab1437edit-640x557.jpg\" alt=\"Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).\" width=\"640\" height=\"557\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Joe Rubin\u003c/strong>\u003c/p>\n\u003cp>A new bill in the California Legislature could give California the distinction of going where the federal government hasn’t — more strictly regulating the way that livestock are given antibiotics.\u003c/p>\n\u003cp>But freshman state Assemblyman Kevin Mullin (D-South San Francisco), who is introducing state Assembly Bill 1437, says getting it through the agricultural committee is a bit of long shot.\u003c/p>\n\u003cp>More than 70 percent of all antibiotics in the U.S. are given to animals, often to healthy livestock. Until very recently drug companies marketed the growth-promoting benefits of antibiotics. And many meat producers, keen for additional profits and assured by pharmaceutical companies that the practice was safe for people and animals, would routinely add antibiotics to feed.\u003c/p>\n\u003cp>In December, the Food and Drug Administration, after years of debate on the issue, asked drug companies to voluntarily stop marketing the growth-promoting benefits of antibiotics out of concerns for public health. The companies are largely complying. But critics like the Natural Resources Defense Council and New York Times food writer \u003ca href=\"http://www.nytimes.com/2013/12/18/opinion/bittman-the-fdas-not-really-such-good-news.html?pagewanted=all&_r=0\" target=\"_blank\">Mark Bittman\u003c/a> have criticized the FDA’s approach as lax and unlikely to lead to any real change.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->There is reason critics are skeptical about how much change is actually happening. The European Union took a similar step banning the use of antibiotics for animal growth promotion back in 2006. A \u003ca href=\"http://www.wageningenur.nl/en/Research-Results/Projects-and-programmes/MARAN-Antibiotic-usage/Trends-in-use-per-species/Antibiotic-usage-in-broilers.htm\" target=\"_blank\">study\u003c/a> of antibiotic use in the Netherlands found that usage actually went up in chickens in the ensuing years. It seems as if chicken ranches and feed lots continued to use antimicrobials at the same rate, but for disease prevention instead of overtly for growth promotion. It wasn’t until 2009 that rates began to tumble when bans on most of those prophylactic uses of antibiotics started to take effect.\u003c/p>\n\u003cp>Like a similar bill that U.S. Sen. Dianne Feinstein (D-Calif.) has been floating for several years, Mullin’s bill seeks to mirror those tougher European standards.\u003c/p>\n\u003cp>On Tuesday, Dr. David Relman, an infectious disease specialist from Stanford University, spoke at a Sacramento press conference in favor of AB 1437. He said he is treating more and more patients who have contracted so-called superbugs. He recalled one case last year that haunts him, a woman with an infection in her bloodstream that was resistant to every known antibiotic. He couldn’t save her.\u003c/p>\n\u003cp>When asked if the prolific use of antibiotics in livestock were really partly to blame for her death, Relman said, “To that particular woman, we can't say. But to many, many woman and men like her, we would have to say the burden of evidence says yes.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/146153547&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>That burden of evidence includes some studies that are showing more conclusive evidence of resistant pathogens in animals jumping to people. A recent Johns Hopkins School of Medicine \u003ca href=\"http://www.nature.com/news/pig-manure-fertilizer-linked-to-human-mrsa-infections-1.13752\" target=\"_blank\">examination\u003c/a> found that residents living near a pig farm in Pennsylvania were more likely to become infected with methicillin-resistant Staphylococcus aureus (MRSA) bacteria.\u003c/p>\n\u003cp>The real worry is the unknown. As Relman described it, antimicrobial resistance is a bit like climate change. Every bit of antibiotic overuse can add up to a bigger problem.\u003c/p>\n\u003cp>But Bill Mattos, president of the California Poultry Association, says the health concerns over the use of antibiotics in livestock are being overblown.\u003c/p>\n\u003cp>“Most of the problem comes from doctors overmedicating their patients,\" Mattos said. \"That’s where the problem is because everybody wants antibiotics when they get sick.\"\u003c/p>\n\u003cp>Mattos said he is confident that AB 1437 won’t survive its committee hearing next week because the bill doesn’t have enough supporters. The Poultry Association is backing a competing and more modest bill in the State Senate authored by Jerry Hill (D-San Mateo). Hill’s bill essentially makes the recent FDA’s recommendations mandatory, rather than voluntary in California.\u003c/p>\n\u003cp>Mattos said every year California produces 300 million chickens. Those chickens employ and feed a lot of people.\u003c/p>\n\u003cp>“If you want an antibiotic free product, you can buy it. It says it on the label. Ten to 15 percent of people are looking for antibiotic free, 80 percent don’t care,” Mattos said.\u003c/p>\n\u003cp>On Tuesday, in his assembly office, Mullin — who represents cities in San Mateo County just south of San Francisco — was sounding like a man about to possibly lose a battle.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There is no question that in this building, we are in an uphill fight to get this public health issue heard and to have action taken on the bill,\" Mullin said. \"But we remain optimistic and hopeful that as the general public becomes more aware of these concerns, that that will change the political calculus at the state capital.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->There is reason critics are skeptical about how much change is actually happening. The European Union took a similar step banning the use of antibiotics for animal growth promotion back in 2006. A \u003ca href=\"http://www.wageningenur.nl/en/Research-Results/Projects-and-programmes/MARAN-Antibiotic-usage/Trends-in-use-per-species/Antibiotic-usage-in-broilers.htm\" target=\"_blank\">study\u003c/a> of antibiotic use in the Netherlands found that usage actually went up in chickens in the ensuing years. It seems as if chicken ranches and feed lots continued to use antimicrobials at the same rate, but for disease prevention instead of overtly for growth promotion. It wasn’t until 2009 that rates began to tumble when bans on most of those prophylactic uses of antibiotics started to take effect.\u003c/p>\n\u003cp>Like a similar bill that U.S. Sen. Dianne Feinstein (D-Calif.) has been floating for several years, Mullin’s bill seeks to mirror those tougher European standards.\u003c/p>\n\u003cp>On Tuesday, Dr. David Relman, an infectious disease specialist from Stanford University, spoke at a Sacramento press conference in favor of AB 1437. He said he is treating more and more patients who have contracted so-called superbugs. He recalled one case last year that haunts him, a woman with an infection in her bloodstream that was resistant to every known antibiotic. He couldn’t save her.\u003c/p>\n\u003cp>When asked if the prolific use of antibiotics in livestock were really partly to blame for her death, Relman said, “To that particular woman, we can't say. But to many, many woman and men like her, we would have to say the burden of evidence says yes.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/146153547&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>That burden of evidence includes some studies that are showing more conclusive evidence of resistant pathogens in animals jumping to people. A recent Johns Hopkins School of Medicine \u003ca href=\"http://www.nature.com/news/pig-manure-fertilizer-linked-to-human-mrsa-infections-1.13752\" target=\"_blank\">examination\u003c/a> found that residents living near a pig farm in Pennsylvania were more likely to become infected with methicillin-resistant Staphylococcus aureus (MRSA) bacteria.\u003c/p>\n\u003cp>The real worry is the unknown. As Relman described it, antimicrobial resistance is a bit like climate change. Every bit of antibiotic overuse can add up to a bigger problem.\u003c/p>\n\u003cp>But Bill Mattos, president of the California Poultry Association, says the health concerns over the use of antibiotics in livestock are being overblown.\u003c/p>\n\u003cp>“Most of the problem comes from doctors overmedicating their patients,\" Mattos said. \"That’s where the problem is because everybody wants antibiotics when they get sick.\"\u003c/p>\n\u003cp>Mattos said he is confident that AB 1437 won’t survive its committee hearing next week because the bill doesn’t have enough supporters. The Poultry Association is backing a competing and more modest bill in the State Senate authored by Jerry Hill (D-San Mateo). Hill’s bill essentially makes the recent FDA’s recommendations mandatory, rather than voluntary in California.\u003c/p>\n\u003cp>Mattos said every year California produces 300 million chickens. Those chickens employ and feed a lot of people.\u003c/p>\n\u003cp>“If you want an antibiotic free product, you can buy it. It says it on the label. Ten to 15 percent of people are looking for antibiotic free, 80 percent don’t care,” Mattos said.\u003c/p>\n\u003cp>On Tuesday, in his assembly office, Mullin — who represents cities in San Mateo County just south of San Francisco — was sounding like a man about to possibly lose a battle.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There is no question that in this building, we are in an uphill fight to get this public health issue heard and to have action taken on the bill,\" Mullin said. \"But we remain optimistic and hopeful that as the general public becomes more aware of these concerns, that that will change the political calculus at the state capital.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"order": 1
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"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
"site": "radio",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
"title": "Freakonomics Radio",
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"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"meta": {
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"link": "/radio/program/fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
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"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"apple": "https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"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?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"stitcher": "https://www.stitcher.com/show/on-our-watch",
"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
"site": "news",
"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
"meta": {
"site": "news",
"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
"imageAlt": "KQED Perspectives",
"officialWebsiteLink": "/perspectives/",
"meta": {
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/id73801135",
"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"
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},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/M4f5",
"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
"tuneIn": "https://tunein.com/podcasts/Business--Economics-Podcasts/Planet-Money-p164680/",
"rss": "https://feeds.npr.org/510289/podcast.xml"
}
},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
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