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"content": "\u003cp>\u003cstrong>By Sarah Varney\u003c/strong>,\u003ca title=\"http://www.kaiserhealthnews.org/Stories/2012/October/08/Medicare-decision-retirement.aspx\" href=\"http://www.kaiserhealthnews.org/Stories/2012/October/08/Medicare-decision-retirement.aspx\" target=\"_blank\"> Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_8587\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/Screen-Shot-2012-10-08-at-7.47.23-AM.png\">\u003cimg class=\"size-medium wp-image-8587\" title=\"(Image: Kaiser Health News)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/Screen-Shot-2012-10-08-at-7.47.23-AM-300x197.png\" alt=\"(Image: Kaiser Health News)\" width=\"300\" height=\"197\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Image: Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>Bruce Osterweil is a lucky man to live just a short walk from where San Francisco’s Golden Gate meets the cold, rough waters of the Pacific Ocean. He is also a lucky man to have married his wife, Patricia Furlong, who has long provided the family’s health insurance through her job at a small financial consulting firm.\u003c/p>\n\u003cp>But last month, Osterweil’s wife turned 65 and decided to retire, and although she may walk away with a crystal bowl or a golden watch for all those years of service, she will also walk away from her company’s generous health insurance benefits. That means Osterweil, who is 59 and a self-employed benefits consultant, is shopping for his own health insurance.\u003c/p>\n\u003cp>\"I’m really surprised at how hard it could be for just the average person who isn’t an actuary or benefits consultant to figure any of this out. It’s astonishing,\" he says.\u003c/p>\n\u003cp>When a spouse or parent signs up for Medicare, it is often perplexing – and unnerving – for the rest of the family who may have grown used to cushy employer-sponsored coverage. For example, young adults up to age 26, who were covered under their parent’s insurance, are no longer covered when their parent moves to Medicare.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Medicare doesn’t cover dependents,\" according to Joe Baker, president of the \u003ca href=\"http://www.medicarerights.org/\" target=\"_blank\">Medicare Rights Center\u003c/a>, a patient education group with a busy hotline for those with Medicare questions. \"However, if you’re a dependent of someone who is losing coverage because they’re retiring and going into Medicare, you can continue your coverage for 3 years under COBRA.\"\u003c/p>\n\u003cp>COBRA is a federal law that allows someone to pay full price to stay on their employer’s group plan. They can also shop around for an individual plan. For healthy young adults, Baker says families should look to see if they can find less expensive coverage.\u003c/p>\n\u003cp>But buying an individual plan can be daunting for older adults in their late 50s or early 60s who are more likely to have some health problems. They are at the mercy of the private insurance market. “We do frequently get calls from folks,” says Baker, \"who cannot find insurance policies in the state in which they live either because they have pre-existing conditions or the policy is so expensive they really can’t afford it.\"\u003c/p>\n\u003cp>The younger spouses of Medicare beneficiaries who have been denied coverage – and have been uninsured for six months – can apply for coverage through their state’s so-called high risk pool. Baker notes that there should be better options for older adults starting in 2014, when a key provision of the federal health law will prohibit insurance companies from denying adults coverage because of a pre-existing condition.\u003c/p>\n\u003cp>Another confounding question is what to do when someone turns 65 and decides to keep working. Should they keep their insurance or sign up for Medicare coverage?\u003c/p>\n\u003cp>The answer hinges on just how big of a company you work for. \"The [federal] rules are quite clear,\" says Baker. \"If you’re working at an employer with more than 20 employees and you have coverage through that employer -- or through a spouse working at company with more than 20 employees -- you can continue to keep that coverage. That means you don’t really need to enroll in Medicare.\"\u003c/p>\n\u003cp>Baker says many people will still enroll in Part A of Medicare -- which covers inpatient hospital care -- because there is no premium, and it may pay some of the costs not covered by your group health plan. But most don’t enroll in Part B, which covers doctor’s visits, because it costs about $100 a month and is often largely redundant.\u003c/p>\n\u003cp>It is a different story if you work at a small company with fewer than 20 employees. In that case, Baker says, the federal rule is: You need to enroll in Medicare.\u003c/p>\n\u003cp>\"Employers think they’re doing people a favor, saying, 'Oh don’t worry, you can stay on our plan. Don’t worry about Medicare.' If they’re under 20 full time employees, they risk the insurance company finding out you’re Medicare eligible and saying, 'You’re off the plan and by the way everything we paid after you turned 65 and were eligible for Medicare, you need to pay us back.'\"\u003c/p>\n\u003cp>To avoid any foul ups, Baker recommends that as people near their 65th birthday, they should start talking to their human resources department or call Social Security.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced in collaboration with\u003c/em> \u003ca href=\"http://www.npr.org/\" target=\"_blank\">\u003cimg src=\"http://www.kaiserhealthnews.org/~/media/Images/KHN%20Partners/logo_npr.jpg\" alt=\"NPR\" width=\"45\" height=\"15\">\u003c/a>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Sarah Varney\u003c/strong>,\u003ca title=\"http://www.kaiserhealthnews.org/Stories/2012/October/08/Medicare-decision-retirement.aspx\" href=\"http://www.kaiserhealthnews.org/Stories/2012/October/08/Medicare-decision-retirement.aspx\" target=\"_blank\"> Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_8587\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/Screen-Shot-2012-10-08-at-7.47.23-AM.png\">\u003cimg class=\"size-medium wp-image-8587\" title=\"(Image: Kaiser Health News)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/Screen-Shot-2012-10-08-at-7.47.23-AM-300x197.png\" alt=\"(Image: Kaiser Health News)\" width=\"300\" height=\"197\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Image: Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>Bruce Osterweil is a lucky man to live just a short walk from where San Francisco’s Golden Gate meets the cold, rough waters of the Pacific Ocean. He is also a lucky man to have married his wife, Patricia Furlong, who has long provided the family’s health insurance through her job at a small financial consulting firm.\u003c/p>\n\u003cp>But last month, Osterweil’s wife turned 65 and decided to retire, and although she may walk away with a crystal bowl or a golden watch for all those years of service, she will also walk away from her company’s generous health insurance benefits. That means Osterweil, who is 59 and a self-employed benefits consultant, is shopping for his own health insurance.\u003c/p>\n\u003cp>\"I’m really surprised at how hard it could be for just the average person who isn’t an actuary or benefits consultant to figure any of this out. It’s astonishing,\" he says.\u003c/p>\n\u003cp>When a spouse or parent signs up for Medicare, it is often perplexing – and unnerving – for the rest of the family who may have grown used to cushy employer-sponsored coverage. For example, young adults up to age 26, who were covered under their parent’s insurance, are no longer covered when their parent moves to Medicare.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Medicare doesn’t cover dependents,\" according to Joe Baker, president of the \u003ca href=\"http://www.medicarerights.org/\" target=\"_blank\">Medicare Rights Center\u003c/a>, a patient education group with a busy hotline for those with Medicare questions. \"However, if you’re a dependent of someone who is losing coverage because they’re retiring and going into Medicare, you can continue your coverage for 3 years under COBRA.\"\u003c/p>\n\u003cp>COBRA is a federal law that allows someone to pay full price to stay on their employer’s group plan. They can also shop around for an individual plan. For healthy young adults, Baker says families should look to see if they can find less expensive coverage.\u003c/p>\n\u003cp>But buying an individual plan can be daunting for older adults in their late 50s or early 60s who are more likely to have some health problems. They are at the mercy of the private insurance market. “We do frequently get calls from folks,” says Baker, \"who cannot find insurance policies in the state in which they live either because they have pre-existing conditions or the policy is so expensive they really can’t afford it.\"\u003c/p>\n\u003cp>The younger spouses of Medicare beneficiaries who have been denied coverage – and have been uninsured for six months – can apply for coverage through their state’s so-called high risk pool. Baker notes that there should be better options for older adults starting in 2014, when a key provision of the federal health law will prohibit insurance companies from denying adults coverage because of a pre-existing condition.\u003c/p>\n\u003cp>Another confounding question is what to do when someone turns 65 and decides to keep working. Should they keep their insurance or sign up for Medicare coverage?\u003c/p>\n\u003cp>The answer hinges on just how big of a company you work for. \"The [federal] rules are quite clear,\" says Baker. \"If you’re working at an employer with more than 20 employees and you have coverage through that employer -- or through a spouse working at company with more than 20 employees -- you can continue to keep that coverage. That means you don’t really need to enroll in Medicare.\"\u003c/p>\n\u003cp>Baker says many people will still enroll in Part A of Medicare -- which covers inpatient hospital care -- because there is no premium, and it may pay some of the costs not covered by your group health plan. But most don’t enroll in Part B, which covers doctor’s visits, because it costs about $100 a month and is often largely redundant.\u003c/p>\n\u003cp>It is a different story if you work at a small company with fewer than 20 employees. In that case, Baker says, the federal rule is: You need to enroll in Medicare.\u003c/p>\n\u003cp>\"Employers think they’re doing people a favor, saying, 'Oh don’t worry, you can stay on our plan. Don’t worry about Medicare.' If they’re under 20 full time employees, they risk the insurance company finding out you’re Medicare eligible and saying, 'You’re off the plan and by the way everything we paid after you turned 65 and were eligible for Medicare, you need to pay us back.'\"\u003c/p>\n\u003cp>To avoid any foul ups, Baker recommends that as people near their 65th birthday, they should start talking to their human resources department or call Social Security.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced in collaboration with\u003c/em> \u003ca href=\"http://www.npr.org/\" target=\"_blank\">\u003cimg src=\"http://www.kaiserhealthnews.org/~/media/Images/KHN%20Partners/logo_npr.jpg\" alt=\"NPR\" width=\"45\" height=\"15\">\u003c/a>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Fact checkers wasted no time today in pointing out flaws in both candidates' statements during the presidential debate.\u003c/p>\n\u003cp>\u003ca title=\"http://www.politico.com/news/stories/1012/82003.html\" href=\"http://www.politico.com/news/stories/1012/82003.html\" target=\"_blank\">Politico\u003c/a> --Analyzing Health Care Statements\u003c/p>\n\u003cblockquote>\u003cp>President Barack Obama and Mitt Romney had at it out over health care Wednesday night — providing some of the toughest, and wonkiest, moments of the night.\u003c/p>\n\u003cp>Both candidates also showed they had done their research, citing studies to back their claims about Obama's health care law and how the other would cut Medicare spending — but they both managed to stretch the truth.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003c/blockquote>\n\u003cp>\u003ca title=\"http://www.latimes.com/news/politics/la-pn-fact-check-romney-healthcare-20121003,0,5148610.story\" href=\"http://www.latimes.com/news/politics/la-pn-fact-check-romney-healthcare-20121003,0,5148610.story\" target=\"_blank\">Los Angeles Times\u003c/a> -- Romney Repeats Erroneous Claims on Health Care\u003c/p>\n\u003cblockquote>\u003cp>\u003ca id=\"PEPLT007376\" title=\"Mitt Romney\" href=\"http://www.latimes.com/topic/politics/government/mitt-romney-PEPLT007376.topic\">Mitt Romney\u003c/a> repeated a number of erroneous claims during Wednesday’s debate about \u003ca id=\"PEPLT007408\" title=\"Barack Obama\" href=\"http://www.latimes.com/topic/politics/government/barack-obama-PEPLT007408.topic\">President Obama\u003c/a>’s healthcare law, including that it relies on a board that will decide \"what kind of treatment” patients can get.\u003c/p>\n\u003cp>This is a myth advanced repeatedly by critics of the \u003ca id=\"EVGAP00039\" title=\"Patient Protection and Affordable Care Act\" href=\"http://www.latimes.com/topic/health/healthcare-laws/patient-protection-affordable-care-act-EVGAP00039.topic\">Affordable Care Act\u003c/a> and debunked consistently by independent fact-checkers.\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca title=\"http://www.washingtonpost.com/blogs/election-2012/wp/2012/10/03/fact-check-the-700b-medicare-cut/\" href=\"http://www.washingtonpost.com/blogs/election-2012/wp/2012/10/03/fact-check-the-700b-medicare-cut/\"> Washington Post\u003c/a> -- The $700 Billion Medicare Cut\u003c/p>\n\u003cblockquote>\u003cp>Romney accused Obama of taking $716 billion from Medicare. This $700 billion figure comes from the difference over 10 years (2013-2022) between anticipated Medicare spending (what is known as “the baseline”) and the changes that the law makes to reduce spending. The savings mostly are wrung from health-care providers, not Medicare beneficiaries — who, as a result of the health-care law, ended up with new benefits for preventive care and prescription drugs.\u003c/p>\u003c/blockquote>\n\u003cp> \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Fact checkers wasted no time today in pointing out flaws in both candidates' statements during the presidential debate.\u003c/p>\n\u003cp>\u003ca title=\"http://www.politico.com/news/stories/1012/82003.html\" href=\"http://www.politico.com/news/stories/1012/82003.html\" target=\"_blank\">Politico\u003c/a> --Analyzing Health Care Statements\u003c/p>\n\u003cblockquote>\u003cp>President Barack Obama and Mitt Romney had at it out over health care Wednesday night — providing some of the toughest, and wonkiest, moments of the night.\u003c/p>\n\u003cp>Both candidates also showed they had done their research, citing studies to back their claims about Obama's health care law and how the other would cut Medicare spending — but they both managed to stretch the truth.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003c/blockquote>\n\u003cp>\u003ca title=\"http://www.latimes.com/news/politics/la-pn-fact-check-romney-healthcare-20121003,0,5148610.story\" href=\"http://www.latimes.com/news/politics/la-pn-fact-check-romney-healthcare-20121003,0,5148610.story\" target=\"_blank\">Los Angeles Times\u003c/a> -- Romney Repeats Erroneous Claims on Health Care\u003c/p>\n\u003cblockquote>\u003cp>\u003ca id=\"PEPLT007376\" title=\"Mitt Romney\" href=\"http://www.latimes.com/topic/politics/government/mitt-romney-PEPLT007376.topic\">Mitt Romney\u003c/a> repeated a number of erroneous claims during Wednesday’s debate about \u003ca id=\"PEPLT007408\" title=\"Barack Obama\" href=\"http://www.latimes.com/topic/politics/government/barack-obama-PEPLT007408.topic\">President Obama\u003c/a>’s healthcare law, including that it relies on a board that will decide \"what kind of treatment” patients can get.\u003c/p>\n\u003cp>This is a myth advanced repeatedly by critics of the \u003ca id=\"EVGAP00039\" title=\"Patient Protection and Affordable Care Act\" href=\"http://www.latimes.com/topic/health/healthcare-laws/patient-protection-affordable-care-act-EVGAP00039.topic\">Affordable Care Act\u003c/a> and debunked consistently by independent fact-checkers.\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca title=\"http://www.washingtonpost.com/blogs/election-2012/wp/2012/10/03/fact-check-the-700b-medicare-cut/\" href=\"http://www.washingtonpost.com/blogs/election-2012/wp/2012/10/03/fact-check-the-700b-medicare-cut/\"> Washington Post\u003c/a> -- The $700 Billion Medicare Cut\u003c/p>\n\u003cblockquote>\u003cp>Romney accused Obama of taking $716 billion from Medicare. This $700 billion figure comes from the difference over 10 years (2013-2022) between anticipated Medicare spending (what is known as “the baseline”) and the changes that the law makes to reduce spending. The savings mostly are wrung from health-care providers, not Medicare beneficiaries — who, as a result of the health-care law, ended up with new benefits for preventive care and prescription drugs.\u003c/p>\u003c/blockquote>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Portable Solar Panels Bring Light, Save Lives in Developing World",
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"content": "\u003cp>\u003cstrong>By Andrew Stelzer\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_8547\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/JulietteAlyek_solar_AndrewStelzer.jpg\">\u003cimg class=\"size-medium wp-image-8547\" title=\"Dr. Juliette Alyek, a pediatrician from Uganda, learns to install a solar panel with We Care Solar, a Berkeley nonprofit. (Photo: Andrew Stelzer)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/JulietteAlyek_solar_AndrewStelzer-300x225.jpg\" alt=\"Dr. Juliette Alyek, a pediatrician from Uganda, learns to install a solar panel with We Care Solar, a Berkeley nonprofit. (Photo: Andrew Stelzer)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Juliette Alyek, a pediatrician from Uganda, learns to install a solar panel with We Care Solar, a Berkeley nonprofit. (Photo: Andrew Stelzer)\u003c/figcaption>\u003c/figure>\n\u003cp>Juliette Alyek came here all the way from Uganda to learn how to drill holes in a corrugated tin roof.\u003cstrong>\u003c/strong>\u003c/p>\n\u003cp>Over the sound of drilling, I hear laughter, mixed with frustration. \"Let's try it again,\" Alyek says, then \"Got it, bingo. Just right!\"\u003c/p>\n\u003cp>Alyek is a pediatrician, who -- along with 13 other women from around the world -- has travelled to Berkeley for a week-long training to become a special kind of ambassador. Back in Uganda, her home city is big enough to have consistent electricity. But she says only about five percent of Ugandans are connected to the grid. That’s a big problem if a woman is giving birth at night.\u003c/p>\n\u003cp>“These facilities are using kerosene lamps, or they’re using torches, or they don’t have anything at all,\" she says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Berkeley obstetrician Laura Stachel saw the same problem when she traveled to Nigeria four years ago to study ways to reduce maternal mortality in state hospitals. At the time, Nigeria had one of the highest maternal mortality rates in the world. Tens of thousands of women died during childbirth every year.\u003c!--more-->\u003c/p>\n\u003cp>At the hospital Stachel visited on that trip, she saw first-hand a major contributing factor -- sporadic electricity. She saw a Cesarean section conducted by flashlight, critically ill patients waiting until dawn, or later, for urgent surgical procedures.\u003c/p>\n\u003cp>“And because they haven’t had that experience of 24-hour electricity,\" Stachel says, \"they don’t expect 24-hour electricity.”\u003c/p>\n\u003cp>Together, Stachel and her husband, Hal Aronson, hatched an idea -- create a small kit with everything needed to bring enough power and light for doctors and health workers to safely deliver babies. Aronson is a solar energy educator, and he designed the prototype, now called a solar suitcase.\u003c/p>\n\u003cp>Together the couple then created a nonprofit organization, \u003ca title=\"http://wecaresolar.org\" href=\"http://wecaresolar.org\" target=\"_blank\">We Care Solar\u003c/a>. Over the last four years, they have installed more than 200 of solar suitcases in 11 countries. But the first hospital to get one was the NIgerian hospital Stachel had visited in 2008. At that hospital, maternal mortality has dropped 70 percent.\u003c/p>\n\u003cp>At a cost of only $1,500 dollars, there’s been interest from all types of groups, including the United Nations and the World Health Organization.\u003cstrong> \u003c/strong>The solar suitcase charges cellular phones and walkie-talkies, used for in-facility communication in many places.\u003c/p>\n\u003cp>We Care Solar hopes to deploy as many as 10,000 solar suitcases in the next five years.\u003c/p>\n\u003cp>Aronson created a mock-clinic in his backyard, so the 14 women here this week from India, Africa and Mexico could be trained to install the solar suitcase's panel. In addition, the women will take classes in maternal health and solar energy.\u003c/p>\n\u003cp>Once they go home, these women will be the newest \"We Care Solar Ambassadors,\" helping in the organization's solar programs around the world.\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>\u003cem>\u003ca title=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/solarsuitcase20121003.mp3\" href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/solarsuitcase20121003.mp3\" target=\"_blank\">Listen to Andrew Stelzer's story\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003cem>Watch the \"Solar Suitcase\" story on PBS' NewsHour:\u003c/em>\u003c/p>\n\u003cp>\u003cobject width=\"514\" height=\"290\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"width=514&height=290&video=http://video.pbs.org/videoPlayerInfo/2219530722/?player=PBS_Partner_Player_v1&start=0&end=0&balance=true&player=viral&end=0&lr_admap=in:warnings:0;in:pbs:0\">\u003cparam name=\"allowFullScreen\" value=\"true\">\u003cparam name=\"allowscriptaccess\" value=\"always\">\u003cparam name=\"wmode\" value=\"transparent\">\u003cparam name=\"src\" value=\"http://dgjigvacl6ipj.cloudfront.net/media/swf/PBSPlayer.swf\">\u003cparam name=\"allowfullscreen\" value=\"true\">\u003cembed width=\"514\" height=\"290\" type=\"application/x-shockwave-flash\" src=\"http://dgjigvacl6ipj.cloudfront.net/media/swf/PBSPlayer.swf\" flashvars=\"width=514&height=290&video=http://video.pbs.org/videoPlayerInfo/2219530722/?player=PBS_Partner_Player_v1&start=0&end=0&balance=true&player=viral&end=0&lr_admap=in:warnings:0;in:pbs:0\" allowfullscreen=\"true\" allowscriptaccess=\"always\" wmode=\"transparent\">\u003c/embed>\u003c/object>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp style=\"font-size: 11px;font-family: Arial, Helvetica, sans-serif;color: #808080;margin-top: 5px;background: transparent;text-align: center;width: 512px\">Watch \u003ca href=\"http://video.pbs.org/video/2219530722\" target=\"_blank\">'Solar Suitcase' Sheds Light on Darkened Delivery Rooms\u003c/a> on PBS. See more from \u003ca href=\"http://www.pbs.org/newshour/\" target=\"_blank\">PBS NewsHour.\u003c/a>\u003c/p>\n\n",
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"excerpt": "Juliette Alyek came here all the way from Uganda to learn how to drill holes in a corrugated tin roof.\r\n\r\nOver the sound of drilling, I hear laughter, mixed with frustration. \"Let's try it again,\" Alyek says, then \"Got it, bingo. Just right!\"\r\n\r\nAlyek is a pediatrician, who -- along with 13 other women from around the world -- has travelled to Berkeley for a week-long training to become a special kind of ambassador. Back in Uganda, her home city is big enough to have consistent electricity",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Andrew Stelzer\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_8547\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/JulietteAlyek_solar_AndrewStelzer.jpg\">\u003cimg class=\"size-medium wp-image-8547\" title=\"Dr. Juliette Alyek, a pediatrician from Uganda, learns to install a solar panel with We Care Solar, a Berkeley nonprofit. (Photo: Andrew Stelzer)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/JulietteAlyek_solar_AndrewStelzer-300x225.jpg\" alt=\"Dr. Juliette Alyek, a pediatrician from Uganda, learns to install a solar panel with We Care Solar, a Berkeley nonprofit. (Photo: Andrew Stelzer)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Juliette Alyek, a pediatrician from Uganda, learns to install a solar panel with We Care Solar, a Berkeley nonprofit. (Photo: Andrew Stelzer)\u003c/figcaption>\u003c/figure>\n\u003cp>Juliette Alyek came here all the way from Uganda to learn how to drill holes in a corrugated tin roof.\u003cstrong>\u003c/strong>\u003c/p>\n\u003cp>Over the sound of drilling, I hear laughter, mixed with frustration. \"Let's try it again,\" Alyek says, then \"Got it, bingo. Just right!\"\u003c/p>\n\u003cp>Alyek is a pediatrician, who -- along with 13 other women from around the world -- has travelled to Berkeley for a week-long training to become a special kind of ambassador. Back in Uganda, her home city is big enough to have consistent electricity. But she says only about five percent of Ugandans are connected to the grid. That’s a big problem if a woman is giving birth at night.\u003c/p>\n\u003cp>“These facilities are using kerosene lamps, or they’re using torches, or they don’t have anything at all,\" she says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Berkeley obstetrician Laura Stachel saw the same problem when she traveled to Nigeria four years ago to study ways to reduce maternal mortality in state hospitals. At the time, Nigeria had one of the highest maternal mortality rates in the world. Tens of thousands of women died during childbirth every year.\u003c!--more-->\u003c/p>\n\u003cp>At the hospital Stachel visited on that trip, she saw first-hand a major contributing factor -- sporadic electricity. She saw a Cesarean section conducted by flashlight, critically ill patients waiting until dawn, or later, for urgent surgical procedures.\u003c/p>\n\u003cp>“And because they haven’t had that experience of 24-hour electricity,\" Stachel says, \"they don’t expect 24-hour electricity.”\u003c/p>\n\u003cp>Together, Stachel and her husband, Hal Aronson, hatched an idea -- create a small kit with everything needed to bring enough power and light for doctors and health workers to safely deliver babies. Aronson is a solar energy educator, and he designed the prototype, now called a solar suitcase.\u003c/p>\n\u003cp>Together the couple then created a nonprofit organization, \u003ca title=\"http://wecaresolar.org\" href=\"http://wecaresolar.org\" target=\"_blank\">We Care Solar\u003c/a>. Over the last four years, they have installed more than 200 of solar suitcases in 11 countries. But the first hospital to get one was the NIgerian hospital Stachel had visited in 2008. At that hospital, maternal mortality has dropped 70 percent.\u003c/p>\n\u003cp>At a cost of only $1,500 dollars, there’s been interest from all types of groups, including the United Nations and the World Health Organization.\u003cstrong> \u003c/strong>The solar suitcase charges cellular phones and walkie-talkies, used for in-facility communication in many places.\u003c/p>\n\u003cp>We Care Solar hopes to deploy as many as 10,000 solar suitcases in the next five years.\u003c/p>\n\u003cp>Aronson created a mock-clinic in his backyard, so the 14 women here this week from India, Africa and Mexico could be trained to install the solar suitcase's panel. In addition, the women will take classes in maternal health and solar energy.\u003c/p>\n\u003cp>Once they go home, these women will be the newest \"We Care Solar Ambassadors,\" helping in the organization's solar programs around the world.\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>\u003cem>\u003ca title=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/solarsuitcase20121003.mp3\" href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/solarsuitcase20121003.mp3\" target=\"_blank\">Listen to Andrew Stelzer's story\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003cem>Watch the \"Solar Suitcase\" story on PBS' NewsHour:\u003c/em>\u003c/p>\n\u003cp>\u003cobject width=\"514\" height=\"290\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"width=514&height=290&video=http://video.pbs.org/videoPlayerInfo/2219530722/?player=PBS_Partner_Player_v1&start=0&end=0&balance=true&player=viral&end=0&lr_admap=in:warnings:0;in:pbs:0\">\u003cparam name=\"allowFullScreen\" value=\"true\">\u003cparam name=\"allowscriptaccess\" value=\"always\">\u003cparam name=\"wmode\" value=\"transparent\">\u003cparam name=\"src\" value=\"http://dgjigvacl6ipj.cloudfront.net/media/swf/PBSPlayer.swf\">\u003cparam name=\"allowfullscreen\" value=\"true\">\u003cembed width=\"514\" height=\"290\" type=\"application/x-shockwave-flash\" src=\"http://dgjigvacl6ipj.cloudfront.net/media/swf/PBSPlayer.swf\" flashvars=\"width=514&height=290&video=http://video.pbs.org/videoPlayerInfo/2219530722/?player=PBS_Partner_Player_v1&start=0&end=0&balance=true&player=viral&end=0&lr_admap=in:warnings:0;in:pbs:0\" allowfullscreen=\"true\" allowscriptaccess=\"always\" wmode=\"transparent\">\u003c/embed>\u003c/object>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp style=\"font-size: 11px;font-family: Arial, Helvetica, sans-serif;color: #808080;margin-top: 5px;background: transparent;text-align: center;width: 512px\">Watch \u003ca href=\"http://video.pbs.org/video/2219530722\" target=\"_blank\">'Solar Suitcase' Sheds Light on Darkened Delivery Rooms\u003c/a> on PBS. See more from \u003ca href=\"http://www.pbs.org/newshour/\" target=\"_blank\">PBS NewsHour.\u003c/a>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Analysis: Access to Health Care Starting to Resemble Access to Air Travel",
"title": "Analysis: Access to Health Care Starting to Resemble Access to Air Travel",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>By Michael L. Millenson, \u003ca title=\"http://www.kaiserhealthnews.org/Stories/2012/September/26/millenson-health-care-and-airlines.aspx\" href=\"http://www.kaiserhealthnews.org/Stories/2012/September/26/millenson-health-care-and-airlines.aspx\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_8528\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/AirplaneSeats_Victor_L_Antunez_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-8528 \" title=\"Each one of these seats might have a different price, much like any health procedure. (Victor L. Antunez: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/AirplaneSeats_Victor_L_Antunez_Flickr-300x225.jpg\" alt=\"Each one of these seats might have a different price, much like any health procedure. (Victor L. Antunez: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Each one of these seats might have a different price, much like a health insurance policy. (Victor L. Antunez: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The old axis of access in U.S. health care -- insured or uninsured -- is being replaced by the kind of gradations and complexity in determining who-gets-what-when-for-what-price for which the airline industry has become famous.\u003c/p>\n\u003cp>Some recent data and reactions to the provisions of the Affordable Care Act reinforce the trend. Here's an overview:\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Being able to afford any kind of seat\u003c/em>.\u003c/strong> Sure, the number of Americans left standing at the gate because they can't afford a health insurance \"ticket\" is declining. But, the scheduled takeoff in insurance coverage has run into mechanical difficulties. The Census Bureau announced this month \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2012/September/12/census-number-of-uninsured-drops.aspx\">that the number of uninsured\u003c/a> dropped slightly in 2011 to 48.6 million, or 15.7 percent of the population. That slide is partly because parents can keep children on their insurance plans until age 26.\u003c/p>\n\u003cp>But prospects of adding another 30 million Americans starting in 2014 are now up in the air. While the Supreme Court \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/06/28/supreme-court-health-care-decision/\" href=\"http://ww2.kqed.org/stateofhealth/2012/06/28/supreme-court-health-care-decision/\" target=\"_blank\">upheld most of the federal health law\u003c/a>, it struck down the penalty designed to compel states to expand Medicaid. That decision could void tickets to health insurance for an estimated three million people, says the \u003ca href=\"http://www.cbo.gov/publication/43472\">Congressional Budget Office and Joint Committee on Taxation\u003c/a>, and possibly a lot more, according to a \u003ca href=\"http://healthaffairs.org/blog/2012/07/31/cbos-updated-affordable-care-act-estimates-resting-on-shaky-assumptions/\">critical analysis\u003c/a> by two liberal legal experts.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>\u003cem>A ticket isn't the same as a seat\u003c/em>.\u003c/strong> As airline passengers have learned, having a ticket isn't the same as having a confirmed seat. In 2011\u003cstrong>, \u003c/strong>\u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22869644\">nearly one-third of physicians said\u003c/a> they wouldn't accept new Medicaid patients because of payment issues; a smaller number of doctors have said the same thing about Medicare patients. Even with some private plans, you may be on permanent standby because the doctor of your choice does not accept your health plan.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Your private jet is ready\u003c/em>.\u003c/strong> Of course, when money is no object, there are those who rate the equivalent of a private jet. That group would include individuals paying \u003ca href=\"http://www.nytimes.com/2011/04/30/your-money/30wealth.html?pagewanted=all\">a reported $6,000 to $27,000 a month\u003c/a> for \"boutique\" services like Guardian 24/7 (whose one-page public\u003cstrong> \u003c/strong>\u003ca href=\"http://www.guardian247.com/\">website\u003c/a> simply says, \"By Invitation Only\"), \u003ca href=\"http://www.worldclinic.com/\">World Clinic\u003c/a> and \u003ca href=\"http://www.pinnaclecare.com/\">PinnacleCare Private Health Advisory\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Business class\u003c/em>\u003c/strong>. Unlike Medicaid \"recipients,\" Medicare \"beneficiaries\" start off with a generous benefit at a modest price and can easily upgrade. They can choose a Medicare Advantage plan in which the average enrollee receives additional benefits and reduced cost-sharing. In addition\u003cstrong>, \u003c/strong>\u003ca href=\"http://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html\">Medigap\u003c/a> plans provide wrap-around coverage to pay costs traditional Medicare doesn't.\u003c/p>\n\u003cp>Also traveling business class are those participants in the fast-dwindling number of health plans provided by unions, \u003ca href=\"http://www.daytondailynews.com/news/news/township-employees-pay-least-for-health-care-cover/nR485/\">municipal employers\u003c/a> or private companies where the worker contribution is minimal and benefits are generous.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Coach, but some people get better seats and prices\u003c/em>.\u003c/strong> Patients with traditional Medicare coverage, \u003ca href=\"http://content.healthaffairs.org/content/31/8/1866.short\">a recent study found\u003c/a>, are more likely than those with private health insurance to get needed care, to avoid access problems due to cost, and to be satisfied with their coverage. Medicare even \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21841296\">reduces racial and ethnic disparities\u003c/a> in access and drug expenditures.\u003c/p>\n\u003cp>But being a high-wage worker with a good employer-sponsored plan also is a great way to get a good ticket. A new \u003ca href=\"http://content.healthaffairs.org/content/early/2012/09/07/hlthaff.2012.0708.full\">Kaiser Family Foundation survey\u003c/a> found that workers at businesses with more low-wage employees paid an average of nearly $1,000 more for their share of premiums than workers in a high-wage environment.\u003c/p>\n\u003cp>Workers at small firms face higher cost sharing, including higher copayments and higher deductibles, and may face a greater premium contribution, the KFF survey found. Think of it as a high-cost ticket and maybe a middle seat, to boot.\u003cem> \u003c/em>In that same vein, the health overhaul's ban on insurers using pre-existing condition information to refuse coverage or raise prices doesn't take effect until 2014, which affects today's self-employed workers who are older and have families. Those workers can find themselves paying much more than the \u003ca href=\"http://content.healthaffairs.org/content/early/2012/09/07/hlthaff.2012.0708.full\" target=\"_blank\">$15,745 average premium cost for family coverage\u003c/a> under an employer plan. State plans for high-risk individuals who are otherwise uninsurable typically are high priced and full of restrictions.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Sorry, your flight has been delayed\u003c/em>.\u003c/strong> Of course, even sitting in first class doesn't mean your flight won't have mechanical problems or a rough landing. Similarly, the most comprehensive insurance is no guarantee of high-quality, safe and appropriate care.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>A new ticketing system?\u003c/em>\u003c/strong> For all the inconveniences of the current health insurance system, it is at least familiar. However, both the public and private sectors have plans to shake up the shopping-for-insurance process as has happened in the era of deregulated airlines.\u003c/p>\n\u003cp>Unlike with airline tickets, however, consumer choices in health care can lead to consequences that truly are non-changeable and non-refundable. Whether the industry turmoil leads to more Americans getting a better \"seat\" at a better price remains to be seen.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Michael L. Millenson is a Highland Park, Illinois-based consultant, a visiting scholar at the Kellogg School of Management and the author of \u003c/em>\u003ca href=\"http://www.press.uchicago.edu/Misc/Chicago/525872.html\" target=\"_blank\">\u003cem>Demanding Medical Excellence: Doctors and Accountability in the Information Age\u003c/em>\u003c/a>\u003cem>. \u003c/em>\u003c/p>\n\n",
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"excerpt": "The old axis of access in U.S. health care -- insured or uninsured -- is being replaced by the kind of gradations and complexity in determining who-gets-what-when-for-what-price for which the airline industry has become famous.\r\n\r\nSome recent data and reactions to the provisions of the Affordable Care Act reinforce the trend. Here's an overview:\r\n\r\nBeing able to afford any kind of seat. Sure, the number of Americans left standing at the gate because they can't afford a health insurance \"ticket\" is declining. But, the scheduled takeoff in insurance coverage has run into mechanical difficulties. The Census Bureau announced this month that the number of uninsured dropped slightly in 2011 to 48.6 million, or 15.7 percent of the population. That slide is partly because parents can keep children on their insurance plans until age 26.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Michael L. Millenson, \u003ca title=\"http://www.kaiserhealthnews.org/Stories/2012/September/26/millenson-health-care-and-airlines.aspx\" href=\"http://www.kaiserhealthnews.org/Stories/2012/September/26/millenson-health-care-and-airlines.aspx\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_8528\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/AirplaneSeats_Victor_L_Antunez_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-8528 \" title=\"Each one of these seats might have a different price, much like any health procedure. (Victor L. Antunez: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/AirplaneSeats_Victor_L_Antunez_Flickr-300x225.jpg\" alt=\"Each one of these seats might have a different price, much like any health procedure. (Victor L. Antunez: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Each one of these seats might have a different price, much like a health insurance policy. (Victor L. Antunez: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The old axis of access in U.S. health care -- insured or uninsured -- is being replaced by the kind of gradations and complexity in determining who-gets-what-when-for-what-price for which the airline industry has become famous.\u003c/p>\n\u003cp>Some recent data and reactions to the provisions of the Affordable Care Act reinforce the trend. Here's an overview:\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Being able to afford any kind of seat\u003c/em>.\u003c/strong> Sure, the number of Americans left standing at the gate because they can't afford a health insurance \"ticket\" is declining. But, the scheduled takeoff in insurance coverage has run into mechanical difficulties. The Census Bureau announced this month \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2012/September/12/census-number-of-uninsured-drops.aspx\">that the number of uninsured\u003c/a> dropped slightly in 2011 to 48.6 million, or 15.7 percent of the population. That slide is partly because parents can keep children on their insurance plans until age 26.\u003c/p>\n\u003cp>But prospects of adding another 30 million Americans starting in 2014 are now up in the air. While the Supreme Court \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/06/28/supreme-court-health-care-decision/\" href=\"http://ww2.kqed.org/stateofhealth/2012/06/28/supreme-court-health-care-decision/\" target=\"_blank\">upheld most of the federal health law\u003c/a>, it struck down the penalty designed to compel states to expand Medicaid. That decision could void tickets to health insurance for an estimated three million people, says the \u003ca href=\"http://www.cbo.gov/publication/43472\">Congressional Budget Office and Joint Committee on Taxation\u003c/a>, and possibly a lot more, according to a \u003ca href=\"http://healthaffairs.org/blog/2012/07/31/cbos-updated-affordable-care-act-estimates-resting-on-shaky-assumptions/\">critical analysis\u003c/a> by two liberal legal experts.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003cem>A ticket isn't the same as a seat\u003c/em>.\u003c/strong> As airline passengers have learned, having a ticket isn't the same as having a confirmed seat. In 2011\u003cstrong>, \u003c/strong>\u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22869644\">nearly one-third of physicians said\u003c/a> they wouldn't accept new Medicaid patients because of payment issues; a smaller number of doctors have said the same thing about Medicare patients. Even with some private plans, you may be on permanent standby because the doctor of your choice does not accept your health plan.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Your private jet is ready\u003c/em>.\u003c/strong> Of course, when money is no object, there are those who rate the equivalent of a private jet. That group would include individuals paying \u003ca href=\"http://www.nytimes.com/2011/04/30/your-money/30wealth.html?pagewanted=all\">a reported $6,000 to $27,000 a month\u003c/a> for \"boutique\" services like Guardian 24/7 (whose one-page public\u003cstrong> \u003c/strong>\u003ca href=\"http://www.guardian247.com/\">website\u003c/a> simply says, \"By Invitation Only\"), \u003ca href=\"http://www.worldclinic.com/\">World Clinic\u003c/a> and \u003ca href=\"http://www.pinnaclecare.com/\">PinnacleCare Private Health Advisory\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Business class\u003c/em>\u003c/strong>. Unlike Medicaid \"recipients,\" Medicare \"beneficiaries\" start off with a generous benefit at a modest price and can easily upgrade. They can choose a Medicare Advantage plan in which the average enrollee receives additional benefits and reduced cost-sharing. In addition\u003cstrong>, \u003c/strong>\u003ca href=\"http://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html\">Medigap\u003c/a> plans provide wrap-around coverage to pay costs traditional Medicare doesn't.\u003c/p>\n\u003cp>Also traveling business class are those participants in the fast-dwindling number of health plans provided by unions, \u003ca href=\"http://www.daytondailynews.com/news/news/township-employees-pay-least-for-health-care-cover/nR485/\">municipal employers\u003c/a> or private companies where the worker contribution is minimal and benefits are generous.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Coach, but some people get better seats and prices\u003c/em>.\u003c/strong> Patients with traditional Medicare coverage, \u003ca href=\"http://content.healthaffairs.org/content/31/8/1866.short\">a recent study found\u003c/a>, are more likely than those with private health insurance to get needed care, to avoid access problems due to cost, and to be satisfied with their coverage. Medicare even \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21841296\">reduces racial and ethnic disparities\u003c/a> in access and drug expenditures.\u003c/p>\n\u003cp>But being a high-wage worker with a good employer-sponsored plan also is a great way to get a good ticket. A new \u003ca href=\"http://content.healthaffairs.org/content/early/2012/09/07/hlthaff.2012.0708.full\">Kaiser Family Foundation survey\u003c/a> found that workers at businesses with more low-wage employees paid an average of nearly $1,000 more for their share of premiums than workers in a high-wage environment.\u003c/p>\n\u003cp>Workers at small firms face higher cost sharing, including higher copayments and higher deductibles, and may face a greater premium contribution, the KFF survey found. Think of it as a high-cost ticket and maybe a middle seat, to boot.\u003cem> \u003c/em>In that same vein, the health overhaul's ban on insurers using pre-existing condition information to refuse coverage or raise prices doesn't take effect until 2014, which affects today's self-employed workers who are older and have families. Those workers can find themselves paying much more than the \u003ca href=\"http://content.healthaffairs.org/content/early/2012/09/07/hlthaff.2012.0708.full\" target=\"_blank\">$15,745 average premium cost for family coverage\u003c/a> under an employer plan. State plans for high-risk individuals who are otherwise uninsurable typically are high priced and full of restrictions.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Sorry, your flight has been delayed\u003c/em>.\u003c/strong> Of course, even sitting in first class doesn't mean your flight won't have mechanical problems or a rough landing. Similarly, the most comprehensive insurance is no guarantee of high-quality, safe and appropriate care.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>A new ticketing system?\u003c/em>\u003c/strong> For all the inconveniences of the current health insurance system, it is at least familiar. However, both the public and private sectors have plans to shake up the shopping-for-insurance process as has happened in the era of deregulated airlines.\u003c/p>\n\u003cp>Unlike with airline tickets, however, consumer choices in health care can lead to consequences that truly are non-changeable and non-refundable. Whether the industry turmoil leads to more Americans getting a better \"seat\" at a better price remains to be seen.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Michael L. Millenson is a Highland Park, Illinois-based consultant, a visiting scholar at the Kellogg School of Management and the author of \u003c/em>\u003ca href=\"http://www.press.uchicago.edu/Misc/Chicago/525872.html\" target=\"_blank\">\u003cem>Demanding Medical Excellence: Doctors and Accountability in the Information Age\u003c/em>\u003c/a>\u003cem>. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "From Heartbreaking Miscomprehension Comes New Understanding",
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"content": "\u003cfigure id=\"attachment_8488\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/Screen-Shot-2012-09-17-at-2.57.55-PM.png\">\u003cimg class=\"size-medium wp-image-8488\" title=\"Lia Lee in 1988. (Photo: Anne Fadiman)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/Screen-Shot-2012-09-17-at-2.57.55-PM-300x252.png\" alt=\"Lia Lee in 1988. (Photo: Anne Fadiman)\" width=\"300\" height=\"252\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lia Lee in 1988. (Photo: Anne Fadiman)\u003c/figcaption>\u003c/figure>\n\u003cp>Today, it's \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/07/02/the-perils-of-medical-jargon/\" href=\"http://ww2.kqed.org/stateofhealth/2012/07/02/the-perils-of-medical-jargon/\" target=\"_blank\">hard enough for doctors and patients to communicate \u003c/a>effectively, even if they share the same primary language. But layer on not only language differences, but also a yawning cultural chasm, and a visit to western medicine might lead to a child being removed from the care of her parents.\u003c/p>\n\u003cp>That was the case for Lia Lee, a young Hmong refugee in Merced who suffered from epilepsy. As \u003ca title=\"http://english.yale.edu/faculty-staff/anne-fadiman\" href=\"http://english.yale.edu/faculty-staff/anne-fadiman\" target=\"_blank\">Anne Fadiman\u003c/a> profiled in her riveting book, \u003cem>The Spirit Catches You and You Fall Down\u003c/em>, Lia's doctors grew frustrated by her parents' unwillingness to follow their prescriptions for treatment, and the doctors ultimately had Lia legally removed from her parents' care.\u003c/p>\n\u003cp>As the \u003cem>New York Times\u003c/em> reports:\u003c/p>\n\u003cblockquote>\u003cp>In traditional Hmong belief, qaug dab peg, [Hmong for epilepsy] like many illnesses, is spiritual in origin, caused when the soul becomes separated from the body. A traditional cure might entail visits from a shaman, who would attempt to reunite body and soul.\u003c!--more-->\u003c/p>\n\u003cp>A work of narrative nonfiction, Ms. Fadiman’s book is a cautionary tale about the cultural chasm between Lia’s family, with its generations-old animist beliefs, and her rationalist American doctors.\u003c/p>\n\u003cp>“In some sense, I was trying to provide a way of controlling her \u003ca title=\"In-depth reference and news articles about Seizures.\" href=\"http://health.nytimes.com/health/guides/symptoms/seizures/overview.html?inline=nyt-classifier\">seizures\u003c/a> with Western methods and Western medicines,” said Dr. Neil Ernst, who with his wife, Dr. Peggy Philp, was one of the pediatricians who treated Lia early on. “And in some sense, the Lees were giving up control of their child to a system that they didn’t understand.”\u003c/p>\u003c/blockquote>\n\u003cdiv>The gulf between the western doctors and Lia's family may have contributed to a catastrophic seizure that led to severe brain damage. No one thought Lia would survive. She slipped into a persistent vegetative state. Her parents remained utterly devoted to her.\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>Again, from \u003cem>The Times:\u003c/em>\u003c/div>\n\u003cdiv>\n\u003cblockquote>\u003cp>For 26 years, her days varied little: her parents bathed her, fed her, flexed her stiffened limbs, kissed, caressed and tenderly talked to her. There were visits to doctors in Merced and later in Sacramento, where the family moved in 1996. There were periodic visits from a shaman, intended not so much to cure Lia as to ease her suffering.\u003c/p>\n\u003cp>“Everything that my parents had done for her is all manual labor,” Mai Lee said on Wednesday. “Carrying her from place to place, transporting her to appointments here and there, it was all done manually. They did that for a very long time.”\u003c/p>\u003c/blockquote>\n\u003cdiv>Lia died on August 31. She was 30 years old. But during those years after she suffered great brain damage, Lia had a tremendous impact on the practice of health and medicine.\u003c/div>\n\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>Three years after Fadiman's book was published, \u003ca title=\"http://www.healthyhousemerced.org\" href=\"http://www.healthyhousemerced.org\" target=\"_blank\">Healthy House Merced\u003c/a> embarked on an innovative cross-cultural program to teach Hmong shamans and western doctors about each other. As Shuka Kalantari described for \u003cem>State of Health\u003c/em> earlier this year:\u003c/div>\n\u003cdiv>\n\u003cblockquote>\u003cp>The shaman training program, \u003ca href=\"http://healthyhousemerced.org/Trainings.aspx\" target=\"_blank\">Partners in Healing\u003c/a>, is now in its twelfth year and has trained over 100 shamans throughout the Central Valley. The program also teaches shamans when to refer their patients to a doctor.\u003c/p>\n\u003cp>“It’s pretty much the shaman that do the referral,” said (Hmong shaman May) Yang. “Because if patient call me … more of the time I would tell them, ‘You have disease, you have virus, or you have infection. You need to go to the doctor right away.’ And the patient will listen and say, ‘OK, if you say so. I’ll go see my doctor right away.’ If the doctor cannot find anything then they will come to me and I will do the ceremony for them.”\u003c/p>\n\u003cp>\u003ca href=\"http://blogs.kqed.org/ourxperience/author/johndoe/\" target=\"_blank\">Changvang Her\u003c/a> is an interpreter with Healthy House who interprets for shamans and the hospital’s Hmong patients. He also acts as a cultural broker between the shamans and medical staff. Her says the key is to explain things like CAT Scans in a way that’s sensitive to how shamans see the world.\u003c/p>\n\u003cp>“In order to make the shamans understand about the image here, I explain, ‘The shaman they can see spirits, whereas the doctor use CT, x-ray, and microscope to see disease or illness.’ So we make that comparison so they understand about the equipment.” ...\u003c/p>\n\u003cp>Doctors also attend traditional Hmong ceremonies where they get to spend time with shamans outside of the hospital setting and learn more about their healing traditions. Now physicians in cities with large Hmong populations, like Sacramento and Fresno, are looking to Mery Medical Center as a model. “It’s bridged that gap, from our physicians, our staff, to the Hmong culture.”\u003c/p>\u003c/blockquote>\n\u003cp>Learn More:\u003c/p>\n\u003cp>\u003ca title=\"http://blogs.kqed.org/ourxperience/2012/02/24/hmong-shamans-teach-doctors-vice-versa/\" href=\"http://blogs.kqed.org/ourxperience/2012/02/24/hmong-shamans-teach-doctors-vice-versa/\" target=\"_blank\">Hmong Shamans Teach Doctors (& Vice Versa)\u003c/a>\u003c/p>\n\u003c/div>\n\u003cdiv>\u003ca title=\"http://blogs.kqed.org/ourxperience/2012/02/28/supporting-hmong-and-mein-health-in-merced/\" href=\"http://blogs.kqed.org/ourxperience/2012/02/28/supporting-hmong-and-mein-health-in-merced/\" target=\"_blank\">Supporting Hmong and Mien Health in Merced\u003c/a>\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cp> \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_8488\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/Screen-Shot-2012-09-17-at-2.57.55-PM.png\">\u003cimg class=\"size-medium wp-image-8488\" title=\"Lia Lee in 1988. (Photo: Anne Fadiman)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/Screen-Shot-2012-09-17-at-2.57.55-PM-300x252.png\" alt=\"Lia Lee in 1988. (Photo: Anne Fadiman)\" width=\"300\" height=\"252\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lia Lee in 1988. (Photo: Anne Fadiman)\u003c/figcaption>\u003c/figure>\n\u003cp>Today, it's \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/07/02/the-perils-of-medical-jargon/\" href=\"http://ww2.kqed.org/stateofhealth/2012/07/02/the-perils-of-medical-jargon/\" target=\"_blank\">hard enough for doctors and patients to communicate \u003c/a>effectively, even if they share the same primary language. But layer on not only language differences, but also a yawning cultural chasm, and a visit to western medicine might lead to a child being removed from the care of her parents.\u003c/p>\n\u003cp>That was the case for Lia Lee, a young Hmong refugee in Merced who suffered from epilepsy. As \u003ca title=\"http://english.yale.edu/faculty-staff/anne-fadiman\" href=\"http://english.yale.edu/faculty-staff/anne-fadiman\" target=\"_blank\">Anne Fadiman\u003c/a> profiled in her riveting book, \u003cem>The Spirit Catches You and You Fall Down\u003c/em>, Lia's doctors grew frustrated by her parents' unwillingness to follow their prescriptions for treatment, and the doctors ultimately had Lia legally removed from her parents' care.\u003c/p>\n\u003cp>As the \u003cem>New York Times\u003c/em> reports:\u003c/p>\n\u003cblockquote>\u003cp>In traditional Hmong belief, qaug dab peg, [Hmong for epilepsy] like many illnesses, is spiritual in origin, caused when the soul becomes separated from the body. A traditional cure might entail visits from a shaman, who would attempt to reunite body and soul.\u003c!--more-->\u003c/p>\n\u003cp>A work of narrative nonfiction, Ms. Fadiman’s book is a cautionary tale about the cultural chasm between Lia’s family, with its generations-old animist beliefs, and her rationalist American doctors.\u003c/p>\n\u003cp>“In some sense, I was trying to provide a way of controlling her \u003ca title=\"In-depth reference and news articles about Seizures.\" href=\"http://health.nytimes.com/health/guides/symptoms/seizures/overview.html?inline=nyt-classifier\">seizures\u003c/a> with Western methods and Western medicines,” said Dr. Neil Ernst, who with his wife, Dr. Peggy Philp, was one of the pediatricians who treated Lia early on. “And in some sense, the Lees were giving up control of their child to a system that they didn’t understand.”\u003c/p>\u003c/blockquote>\n\u003cdiv>The gulf between the western doctors and Lia's family may have contributed to a catastrophic seizure that led to severe brain damage. No one thought Lia would survive. She slipped into a persistent vegetative state. Her parents remained utterly devoted to her.\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>Again, from \u003cem>The Times:\u003c/em>\u003c/div>\n\u003cdiv>\n\u003cblockquote>\u003cp>For 26 years, her days varied little: her parents bathed her, fed her, flexed her stiffened limbs, kissed, caressed and tenderly talked to her. There were visits to doctors in Merced and later in Sacramento, where the family moved in 1996. There were periodic visits from a shaman, intended not so much to cure Lia as to ease her suffering.\u003c/p>\n\u003cp>“Everything that my parents had done for her is all manual labor,” Mai Lee said on Wednesday. “Carrying her from place to place, transporting her to appointments here and there, it was all done manually. They did that for a very long time.”\u003c/p>\u003c/blockquote>\n\u003cdiv>Lia died on August 31. She was 30 years old. But during those years after she suffered great brain damage, Lia had a tremendous impact on the practice of health and medicine.\u003c/div>\n\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>Three years after Fadiman's book was published, \u003ca title=\"http://www.healthyhousemerced.org\" href=\"http://www.healthyhousemerced.org\" target=\"_blank\">Healthy House Merced\u003c/a> embarked on an innovative cross-cultural program to teach Hmong shamans and western doctors about each other. As Shuka Kalantari described for \u003cem>State of Health\u003c/em> earlier this year:\u003c/div>\n\u003cdiv>\n\u003cblockquote>\u003cp>The shaman training program, \u003ca href=\"http://healthyhousemerced.org/Trainings.aspx\" target=\"_blank\">Partners in Healing\u003c/a>, is now in its twelfth year and has trained over 100 shamans throughout the Central Valley. The program also teaches shamans when to refer their patients to a doctor.\u003c/p>\n\u003cp>“It’s pretty much the shaman that do the referral,” said (Hmong shaman May) Yang. “Because if patient call me … more of the time I would tell them, ‘You have disease, you have virus, or you have infection. You need to go to the doctor right away.’ And the patient will listen and say, ‘OK, if you say so. I’ll go see my doctor right away.’ If the doctor cannot find anything then they will come to me and I will do the ceremony for them.”\u003c/p>\n\u003cp>\u003ca href=\"http://blogs.kqed.org/ourxperience/author/johndoe/\" target=\"_blank\">Changvang Her\u003c/a> is an interpreter with Healthy House who interprets for shamans and the hospital’s Hmong patients. He also acts as a cultural broker between the shamans and medical staff. Her says the key is to explain things like CAT Scans in a way that’s sensitive to how shamans see the world.\u003c/p>\n\u003cp>“In order to make the shamans understand about the image here, I explain, ‘The shaman they can see spirits, whereas the doctor use CT, x-ray, and microscope to see disease or illness.’ So we make that comparison so they understand about the equipment.” ...\u003c/p>\n\u003cp>Doctors also attend traditional Hmong ceremonies where they get to spend time with shamans outside of the hospital setting and learn more about their healing traditions. Now physicians in cities with large Hmong populations, like Sacramento and Fresno, are looking to Mery Medical Center as a model. “It’s bridged that gap, from our physicians, our staff, to the Hmong culture.”\u003c/p>\u003c/blockquote>\n\u003cp>Learn More:\u003c/p>\n\u003cp>\u003ca title=\"http://blogs.kqed.org/ourxperience/2012/02/24/hmong-shamans-teach-doctors-vice-versa/\" href=\"http://blogs.kqed.org/ourxperience/2012/02/24/hmong-shamans-teach-doctors-vice-versa/\" target=\"_blank\">Hmong Shamans Teach Doctors (& Vice Versa)\u003c/a>\u003c/p>\n\u003c/div>\n\u003cdiv>\u003ca title=\"http://blogs.kqed.org/ourxperience/2012/02/28/supporting-hmong-and-mein-health-in-merced/\" href=\"http://blogs.kqed.org/ourxperience/2012/02/28/supporting-hmong-and-mein-health-in-merced/\" target=\"_blank\">Supporting Hmong and Mien Health in Merced\u003c/a>\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Low-income Parents Brace for End of 'Healthy Families'",
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"content": "\u003cp>\u003cstrong>By Mina Kim\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_8472\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/MinaPhoto.jpg\">\u003cimg class=\"size-medium wp-image-8472\" title=\"Maria Garibay worries her daughters won't be able to stay with their current doctors when they switch from Healthy Families to Medi-Cal next year.(Mina Kim: KQED)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/MinaPhoto-300x225.jpg\" alt=\"Maria Garibay worries her daughters won't be able to stay with their current doctors when they switch from Healthy Families to Medi-Cal next year.(Mina Kim: KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Maria Garibay worries her daughters won't be able to stay with their current doctors when they switch from Healthy Families to Medi-Cal next year.(Mina Kim: KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Next January, the state will begin transferring hundreds of thousands of low-income kids from its popular \u003ca title=\"http://www.healthyfamilies.ca.gov/Home/default.aspx\" href=\"http://www.healthyfamilies.ca.gov/Home/default.aspx\" target=\"_blank\">Healthy Families\u003c/a> insurance plan to Medi-Cal -- which offers medical coverage to the state's poorest residents.\u003c/p>\n\u003cp>Ending Healthy Families was one of Governor Jerry Brown’s budget-balancing priorities and now families are feeling the weight of that decision.\u003c/p>\n\u003cp>At \u003ca title=\"http://www.napachi.org\" href=\"http://www.napachi.org\" target=\"_blank\">Children’s Health Initiative\u003c/a> in Napa, a nonprofit that helps get kids into affordable health plans, Maria Garibay has just gotten the news. Next year, her three girls will be moved from Healthy Families to Medi-Cal.\u003c/p>\n\u003cp>Speaking through an interpreter, Garibay says she's worried her monthly premium will go up. That's because last year Medi-Cal told her she'd need to start paying $1300 each month, per child, because of her income from a part-time restaurant job.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But then Garibay learned that she qualified for Healthy Families. The federally subsidized program is for families whose incomes are just above the federal poverty level. Under Healthy Families, Garibay pays a total premium of $14 a month. It's a godsend for Garibay whose oldest daughter has a heart condition.\u003c!--more-->\u003c/p>\n\u003cp>Garibay, through the interpreter, says \"My daughter's been seeing the same cardiologist since she was three years old. Will she be able to see her same cardiologist when she switches to Medi-Cal?\"\u003c/p>\n\u003cp>Children's Health Initiative manager Elba Gonzalez-Mares says she just doesn't know. Medi-Cal reimburses doctors at a lower rate than Healthy Families, so some doctors limit the number of Medi-Cal patients they take, or refuse to see them altogether.\u003c/p>\n\u003cp>Gonzales-Mares says she's been reassuring parents that their payments will be similar when the plan changes. But she hasn't been able to guarantee that their kids will be able to see the same doctors.\u003c/p>\n\u003cp>\"The reaction is very upsetting,\" Gonzales-Mares says of the families. \"They're concerned.\"\u003c/p>\n\u003cp>The state is ending Healthy Families as part of a budget deal between Governor Brown and Democratic lawmakers. It's designed to cut costs and save other health programs. Moving the nearly 900,000 kids in the Healthy Families program to Medi-Cal is expected to save $72 million a year by 2015.\u003c/p>\n\u003cp>Latino children make up nearly half the Healthy Families enrollees, and Gonzales-Mares worries they'll suffer the greatest disruptions in care. She says a survey of families the agency sees raises concerns about whether they'll understand that Healthy Families is ending.\u003c/p>\n\u003cp>\"The Latino family, yes, they speak Spanish. But their literacy levels are very low, a third grade level,\" she says, \"even in Spanish.\"\u003c/p>\n\u003cp>But Medi-Cal officials say the program is equipped to deal with the needs of Spanish speakers. \u003ca title=\"http://www.dhcs.ca.gov/Pages/DirectorsBiography.aspx\" href=\"http://www.dhcs.ca.gov/Pages/DirectorsBiography.aspx\" target=\"_blank\">Toby Douglas\u003c/a> leads the state's Department of Health Care Services, which oversees Medi-Cal.\u003c/p>\n\u003cp>\"Our proportion of individuals on the Medi-Cal program that are Spanish speaking or Latino descent are the same as those on Healthy Families,\" Douglas explains. \"So it’s an essential component of our Medi-Cal program today.\"\u003c/p>\n\u003cp>Douglas says his office is working hard to make sure there will be enough doctors and specialists to treat these kids. \"Close to 90 percent of the providers who participate in Healthy Families participate in the Medi-Cal program, and we believe that these providers will continue to see these children when they transition.\"\u003c/p>\n\u003cp>Douglas says under the \u003ca title=\"http://www.healthcare.gov/law/index.html\" href=\"http://www.healthcare.gov/law/index.html\" target=\"_blank\">federal health care overhaul\u003c/a>, Medi-Cal reimbursement rates will rise significantly for two years, beginning this January.\u003c/p>\n\u003cp>But some pediatricians, like Napa pediatrician Victoria Morgese, are skeptical the state will maintain the higher rates when those federal funds go away. \"The way I was raised, you can't get blood out of a turnip,\" she says. \"If the money's not there, the money's not there.\"\u003c/p>\n\u003cp>Morgese is one of thousands of California doctors now forced to decide whether to keep her Healthy Families patients once they switch over to Medi-Cal. \"My mentality is to take care of these people, to be a care provider,\" she says. \"And yet, I have to take everything into consideration because I have to run a business!\"\u003c/p>\n\u003cp>Morgese has more than 500 Healthy Families patients. She limits the number of Medi-Cal recipients to 10 percent of her patient load. Morgese says at current Medi-Cal reimbursement rates, she'd need to see three times the number of patients to keep the lights on.\u003c/p>\n\u003cp>\"That means that the model of practice that we have set up here,\" she explains, \"which is to spend a long time with our patients, to have a lower than average volume of patients per day in our office ... I wouldn't be able to do that.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Some children's health advocates are pushing for a delay to the transition. The four phase, year-long transfer is scheduled to begin in January.\u003c/p>\n\n",
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"excerpt": "Next January, the state will begin transferring hundreds of thousands of low-income kids from its popular Healthy Families insurance plan to Medi-Cal -- which offers medical coverage to the state's poorest residents.\r\n\r\nEnding Healthy Families was one of Governor Jerry Brown’s budget-balancing priorities and now families are feeling the weight of that decision.\r\n\r\nAt Children’s Health Initiative in Napa, a nonprofit that helps get kids into affordable health plans, Maria Garibay has just gotten the news. Next year, her three girls will be moved from Healthy Families to Medi-Cal.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Mina Kim\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_8472\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/MinaPhoto.jpg\">\u003cimg class=\"size-medium wp-image-8472\" title=\"Maria Garibay worries her daughters won't be able to stay with their current doctors when they switch from Healthy Families to Medi-Cal next year.(Mina Kim: KQED)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/MinaPhoto-300x225.jpg\" alt=\"Maria Garibay worries her daughters won't be able to stay with their current doctors when they switch from Healthy Families to Medi-Cal next year.(Mina Kim: KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Maria Garibay worries her daughters won't be able to stay with their current doctors when they switch from Healthy Families to Medi-Cal next year.(Mina Kim: KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Next January, the state will begin transferring hundreds of thousands of low-income kids from its popular \u003ca title=\"http://www.healthyfamilies.ca.gov/Home/default.aspx\" href=\"http://www.healthyfamilies.ca.gov/Home/default.aspx\" target=\"_blank\">Healthy Families\u003c/a> insurance plan to Medi-Cal -- which offers medical coverage to the state's poorest residents.\u003c/p>\n\u003cp>Ending Healthy Families was one of Governor Jerry Brown’s budget-balancing priorities and now families are feeling the weight of that decision.\u003c/p>\n\u003cp>At \u003ca title=\"http://www.napachi.org\" href=\"http://www.napachi.org\" target=\"_blank\">Children’s Health Initiative\u003c/a> in Napa, a nonprofit that helps get kids into affordable health plans, Maria Garibay has just gotten the news. Next year, her three girls will be moved from Healthy Families to Medi-Cal.\u003c/p>\n\u003cp>Speaking through an interpreter, Garibay says she's worried her monthly premium will go up. That's because last year Medi-Cal told her she'd need to start paying $1300 each month, per child, because of her income from a part-time restaurant job.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But then Garibay learned that she qualified for Healthy Families. The federally subsidized program is for families whose incomes are just above the federal poverty level. Under Healthy Families, Garibay pays a total premium of $14 a month. It's a godsend for Garibay whose oldest daughter has a heart condition.\u003c!--more-->\u003c/p>\n\u003cp>Garibay, through the interpreter, says \"My daughter's been seeing the same cardiologist since she was three years old. Will she be able to see her same cardiologist when she switches to Medi-Cal?\"\u003c/p>\n\u003cp>Children's Health Initiative manager Elba Gonzalez-Mares says she just doesn't know. Medi-Cal reimburses doctors at a lower rate than Healthy Families, so some doctors limit the number of Medi-Cal patients they take, or refuse to see them altogether.\u003c/p>\n\u003cp>Gonzales-Mares says she's been reassuring parents that their payments will be similar when the plan changes. But she hasn't been able to guarantee that their kids will be able to see the same doctors.\u003c/p>\n\u003cp>\"The reaction is very upsetting,\" Gonzales-Mares says of the families. \"They're concerned.\"\u003c/p>\n\u003cp>The state is ending Healthy Families as part of a budget deal between Governor Brown and Democratic lawmakers. It's designed to cut costs and save other health programs. Moving the nearly 900,000 kids in the Healthy Families program to Medi-Cal is expected to save $72 million a year by 2015.\u003c/p>\n\u003cp>Latino children make up nearly half the Healthy Families enrollees, and Gonzales-Mares worries they'll suffer the greatest disruptions in care. She says a survey of families the agency sees raises concerns about whether they'll understand that Healthy Families is ending.\u003c/p>\n\u003cp>\"The Latino family, yes, they speak Spanish. But their literacy levels are very low, a third grade level,\" she says, \"even in Spanish.\"\u003c/p>\n\u003cp>But Medi-Cal officials say the program is equipped to deal with the needs of Spanish speakers. \u003ca title=\"http://www.dhcs.ca.gov/Pages/DirectorsBiography.aspx\" href=\"http://www.dhcs.ca.gov/Pages/DirectorsBiography.aspx\" target=\"_blank\">Toby Douglas\u003c/a> leads the state's Department of Health Care Services, which oversees Medi-Cal.\u003c/p>\n\u003cp>\"Our proportion of individuals on the Medi-Cal program that are Spanish speaking or Latino descent are the same as those on Healthy Families,\" Douglas explains. \"So it’s an essential component of our Medi-Cal program today.\"\u003c/p>\n\u003cp>Douglas says his office is working hard to make sure there will be enough doctors and specialists to treat these kids. \"Close to 90 percent of the providers who participate in Healthy Families participate in the Medi-Cal program, and we believe that these providers will continue to see these children when they transition.\"\u003c/p>\n\u003cp>Douglas says under the \u003ca title=\"http://www.healthcare.gov/law/index.html\" href=\"http://www.healthcare.gov/law/index.html\" target=\"_blank\">federal health care overhaul\u003c/a>, Medi-Cal reimbursement rates will rise significantly for two years, beginning this January.\u003c/p>\n\u003cp>But some pediatricians, like Napa pediatrician Victoria Morgese, are skeptical the state will maintain the higher rates when those federal funds go away. \"The way I was raised, you can't get blood out of a turnip,\" she says. \"If the money's not there, the money's not there.\"\u003c/p>\n\u003cp>Morgese is one of thousands of California doctors now forced to decide whether to keep her Healthy Families patients once they switch over to Medi-Cal. \"My mentality is to take care of these people, to be a care provider,\" she says. \"And yet, I have to take everything into consideration because I have to run a business!\"\u003c/p>\n\u003cp>Morgese has more than 500 Healthy Families patients. She limits the number of Medi-Cal recipients to 10 percent of her patient load. Morgese says at current Medi-Cal reimbursement rates, she'd need to see three times the number of patients to keep the lights on.\u003c/p>\n\u003cp>\"That means that the model of practice that we have set up here,\" she explains, \"which is to spend a long time with our patients, to have a lower than average volume of patients per day in our office ... I wouldn't be able to do that.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Some children's health advocates are pushing for a delay to the transition. The four phase, year-long transfer is scheduled to begin in January.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>By Sarah Varney\u003c/strong>, \u003ca title=\"http://capsules.kaiserhealthnews.org/index.php/2012/09/long-term-care-a-big-time-worry-in-california-study-finds/\" href=\"http://capsules.kaiserhealthnews.org/index.php/2012/09/long-term-care-a-big-time-worry-in-california-study-finds/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/longtern-300.jpg\">\u003cimg class=\"alignleft size-full wp-image-8451\" title=\"longtern-300\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/longtern-300.jpg\" alt=\"\" width=\"300\" height=\"199\">\u003c/a>It turns out Republicans and Democrats do have something they can agree on this election season – they’re worried about how to pay for long-term care when they or a family member can no longer live at home.\u003c/p>\n\u003cp>A new \u003ca href=\"http://www.thescanfoundation.org/poll-finds-nearly-half-california-voters-40-and-older-likely-need-long-term-care-next-five-years\">poll\u003c/a> released Wednesday by The SCAN Foundation and the UCLA Center for Health Policy Research found that half of California voters say they’ll need long-term care for a close family member in the next few years, but won’t be able to afford it.\u003c/p>\n\u003cp>Anxiety over the cost of long-term care, like the price tag of a nursing home stay, is going up. The percentage of California voters who said they couldn’t afford more than three months of nursing home care increased to 73 percent from 66 percent in 2011, and 46 percent said they didn’t have the money to cover a single month in a nursing home, about $6,800 in California. For Latinos, the prospect of paying for long-term care is even more grim: nine in 10 Latino voters said they couldn’t afford more than three months of nursing home care and 86 percent couldn’t afford more than three months of part-time care at home.\u003c!--more-->\u003c/p>\n\u003cp>Long-term care costs can surprise many families who expect Medicare to cover their needs. After a hospital stay, Medicare will pay for 100 days of nursing home care, but after that, families are on their own or are forced to spend down their assets to become poor enough to qualify for Medicaid. Latino voters in California, the poll found, were the most confused about Medicare: 31 percent assumed the federal program would pay for long-term, nursing home care – more than twice as many as white voters.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>What is certain is that there will be many more people spending their golden years in the Golden State. Over the next two decades, the population of seniors aged 65 and older is projected to double to 8 million. And Californians want their state government in Sacramento to find a solution. The vast majority of Republicans (81 percent), Democrats (94 percent) and independents (85 percent), the poll found, said that despite the fiscal calamities in California, figuring out affordable options for long-term care should be a top priority.\u003c/p>\n\u003cp>The poll surveyed 1,667 registered California voters age 40 and older and was conducted by Lake Research Partners and Chesapeake Beach Consulting between Aug. 15-22, 2012.\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca title=\"http://www.theatlantic.com/business/archive/2012/09/live-long-and-pay-for-it-americas-real-long-term-cost-crisis/262247/\" href=\"http://www.theatlantic.com/business/archive/2012/09/live-long-and-pay-for-it-americas-real-long-term-cost-crisis/262247/\" target=\"_blank\">Live Long and Pay for It: America's Real Long-Term Care Cost Crisis\u003c/a> (The Atlantic)\u003c/p>\n\n",
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"excerpt": "It turns out Republicans and Democrats do have something they can agree on this election season – they’re worried about how to pay for long-term care when they or a family member can no longer live at home.\r\n\r\nA new poll released Wednesday by The SCAN Foundation and the UCLA Center for Health Policy Research found that half of California voters say they’ll need long-term care for a close family member in the next few years, but won’t be able to afford it.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Sarah Varney\u003c/strong>, \u003ca title=\"http://capsules.kaiserhealthnews.org/index.php/2012/09/long-term-care-a-big-time-worry-in-california-study-finds/\" href=\"http://capsules.kaiserhealthnews.org/index.php/2012/09/long-term-care-a-big-time-worry-in-california-study-finds/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/longtern-300.jpg\">\u003cimg class=\"alignleft size-full wp-image-8451\" title=\"longtern-300\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/longtern-300.jpg\" alt=\"\" width=\"300\" height=\"199\">\u003c/a>It turns out Republicans and Democrats do have something they can agree on this election season – they’re worried about how to pay for long-term care when they or a family member can no longer live at home.\u003c/p>\n\u003cp>A new \u003ca href=\"http://www.thescanfoundation.org/poll-finds-nearly-half-california-voters-40-and-older-likely-need-long-term-care-next-five-years\">poll\u003c/a> released Wednesday by The SCAN Foundation and the UCLA Center for Health Policy Research found that half of California voters say they’ll need long-term care for a close family member in the next few years, but won’t be able to afford it.\u003c/p>\n\u003cp>Anxiety over the cost of long-term care, like the price tag of a nursing home stay, is going up. The percentage of California voters who said they couldn’t afford more than three months of nursing home care increased to 73 percent from 66 percent in 2011, and 46 percent said they didn’t have the money to cover a single month in a nursing home, about $6,800 in California. For Latinos, the prospect of paying for long-term care is even more grim: nine in 10 Latino voters said they couldn’t afford more than three months of nursing home care and 86 percent couldn’t afford more than three months of part-time care at home.\u003c!--more-->\u003c/p>\n\u003cp>Long-term care costs can surprise many families who expect Medicare to cover their needs. After a hospital stay, Medicare will pay for 100 days of nursing home care, but after that, families are on their own or are forced to spend down their assets to become poor enough to qualify for Medicaid. Latino voters in California, the poll found, were the most confused about Medicare: 31 percent assumed the federal program would pay for long-term, nursing home care – more than twice as many as white voters.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>What is certain is that there will be many more people spending their golden years in the Golden State. Over the next two decades, the population of seniors aged 65 and older is projected to double to 8 million. And Californians want their state government in Sacramento to find a solution. The vast majority of Republicans (81 percent), Democrats (94 percent) and independents (85 percent), the poll found, said that despite the fiscal calamities in California, figuring out affordable options for long-term care should be a top priority.\u003c/p>\n\u003cp>The poll surveyed 1,667 registered California voters age 40 and older and was conducted by Lake Research Partners and Chesapeake Beach Consulting between Aug. 15-22, 2012.\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca title=\"http://www.theatlantic.com/business/archive/2012/09/live-long-and-pay-for-it-americas-real-long-term-cost-crisis/262247/\" href=\"http://www.theatlantic.com/business/archive/2012/09/live-long-and-pay-for-it-americas-real-long-term-cost-crisis/262247/\" target=\"_blank\">Live Long and Pay for It: America's Real Long-Term Care Cost Crisis\u003c/a> (The Atlantic)\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003ca title=\"View user profile.\" href=\"http://californiawatch.org/user/katharine-mieszkowski\">Katharine Mieszkowski\u003c/a>, \u003ca href=\"http://www.baycitizen.org/\" target=\"_blank\">The Bay Citizen\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/BayCitizenLogo1.png\">\u003cimg class=\"alignright size-full wp-image-8441\" title=\"BayCitizenLogo1\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/BayCitizenLogo1.png\" alt=\"\" width=\"218\" height=\"74\">\u003c/a>California's political watchdog agency is investigating a Fremont health care district official to determine whether he violated the state’s conflict-of-interest laws.\u003c/p>\n\u003cp>Michael Wallace, president of the Washington Township Health Care District board, is also the chairman of the board of Fremont Bank, which has received more than $1 million in fees from the taxpayer-funded district. Wallace declined to comment on the investigation.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.fppc.ca.gov/\" target=\"_blank\">California Fair Political Practices Commission\u003c/a>'s decision to investigate Wallace, made public last week, is the \u003ca href=\"http://www.baycitizen.org/government/story/states-political-watchdog-investigate/\" target=\"_blank\">latest in a series of probes\u003c/a> it has initiated following \u003ca href=\"http://www.baycitizen.org/health/story/millions-health-care-district-deals/\" target=\"_blank\">a July report\u003c/a> by The Bay Citizen that uncovered millions of dollars in questionable transactions involving companies and nonprofits with ties to health care district officials across the state.\u003c/p>\n\u003cfigure id=\"attachment_8439\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/WashingtonHospital_MichaelShort_CalWatch1.jpg\">\u003cimg class=\"size-medium wp-image-8439\" title=\"Michael Wallace, president of the Washington Township Health Care District board, is also the chairman of the board of Fremont Bank. (Michael Short: California Watch)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/WashingtonHospital_MichaelShort_CalWatch1-300x199.jpg\" alt=\"Michael Wallace, president of the Washington Township Health Care District board, is also the chairman of the board of Fremont Bank. (Michael Short: California Watch)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Michael Wallace, president of the Washington Township Health Care District board, is also the chairman of the board of Fremont Bank. (Michael Short: California Watch)\u003c/figcaption>\u003c/figure>\n\u003cp>Gerald Shefren and Arthur Faro, board members of the \u003ca href=\"http://www.sequoiahealthcaredistrict.com/\" target=\"_blank\">Sequoia Healthcare District\u003c/a> in Redwood City, and Frank Burgess, a former board member of the \u003ca href=\"http://www.sgmh.org/getpage.php?name=hboard\" target=\"_blank\">San Gorgonio Memorial Healthcare District\u003c/a> in Riverside County, also are under investigation for possibly violating state conflict-of-interest laws.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>California’s more than 70 taxpayer-funded health care districts control multimillion-dollar budgets with little state oversight. While some operate hospitals or nursing homes, others manage real estate holdings and distribute community grants.\u003c/p>\n\u003cp>Since 1990, Wallace has served on the board of directors of the Washington Township Health Care District. Over the past decade, the district has paid Fremont Bank more than $1.2 million in fees.\u003c!--more-->\u003c/p>\n\u003cp>During the same period, Wallace held a variety of leadership roles at the bank, where he is now board chairman. As recently as last year, his salary was more than $100,000, while he held more than $1 million of stock in the bank’s parent company.\u003c/p>\n\u003cp>In a statement issued to The Bay Citizen in July, Wallace defended his actions, saying, “I did not participate in the district’s selection of Fremont Bank in 2001 and abstained from the board’s vote.\u003c/p>\n\u003cp>But state conflict-of-interest laws generally prohibit public boards and commissions from entering into a contract that could benefit any member financially, even if the member does not participate in the contracting decisions. Punishments for conflict-of-interest violations can range from warning letters to fines.\u003c/p>\n\u003cp>The commission decided not to investigate Nancy Farber, CEO of the Washington Hospital Healthcare System. As CEO, Farber reports to the Washington Township district’s board, which oversees Washington Hospital and various outpatient clinics that serve residents primarily in southern Alameda County. The hospital district board approved two grants worth a total of $350,000 to the George Mark Children's House, a nonprofit where Farber’s husband, Peter Farber-Szekrenyi, served as an unpaid board member.\u003c/p>\n\u003cp>Farber did not vote on either grant because she does not sit on the district board, but she did participate in a discussion about one of the grants. Less than a month after the district approved the second grant, her husband became a paid consultant for the nonprofit, earning $12,800 a month. In April 2011, Farber-Szekrenyi became its CEO, earning $208,000 a year. Under state law, public officials cannot participate in a decision in which they have a financial interest.\u003c/p>\n\u003cp>The commission determined that because Farber's husband was a volunteer when the grants were approved, there was no conflict of interest, according to Gary Winuk, chief of the commission’s enforcement division: “He was volunteering there, and not an employee at the time the decision was made, so there is no conflict if there is no pay.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Farber declined to comment on the agency's decision. A district spokeswoman would not reveal how much the district has spent in legal fees to represent Wallace and Farber in the commission's inquiries.\u003c/p>\n\n",
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"excerpt": "California's political watchdog agency is investigating a Fremont health care district official to determine whether he violated the state’s conflict-of-interest laws.\r\n\r\nMichael Wallace, president of the Washington Township Health Care District board, is also the chairman of the board of Fremont Bank, which has received more than $1 million in fees from the taxpayer-funded district. Wallace declined to comment on the investigation.\r\n\r\nThe California Fair Political Practices Commission's decision to investigate Wallace, made public last week, is the latest in a series of probes it has initiated following a July report by The Bay Citizen that uncovered millions of dollars in questionable transactions involving companies and nonprofits with ties to health care district officials across the state.",
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"description": "California's political watchdog agency is investigating a Fremont health care district official to determine whether he violated the state’s conflict-of-interest laws.\r\n\r\nMichael Wallace, president of the Washington Township Health Care District board, is also the chairman of the board of Fremont Bank, which has received more than $1 million in fees from the taxpayer-funded district. Wallace declined to comment on the investigation.\r\n\r\nThe California Fair Political Practices Commission's decision to investigate Wallace, made public last week, is the latest in a series of probes it has initiated following a July report by The Bay Citizen that uncovered millions of dollars in questionable transactions involving companies and nonprofits with ties to health care district officials across the state.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca title=\"View user profile.\" href=\"http://californiawatch.org/user/katharine-mieszkowski\">Katharine Mieszkowski\u003c/a>, \u003ca href=\"http://www.baycitizen.org/\" target=\"_blank\">The Bay Citizen\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/BayCitizenLogo1.png\">\u003cimg class=\"alignright size-full wp-image-8441\" title=\"BayCitizenLogo1\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/BayCitizenLogo1.png\" alt=\"\" width=\"218\" height=\"74\">\u003c/a>California's political watchdog agency is investigating a Fremont health care district official to determine whether he violated the state’s conflict-of-interest laws.\u003c/p>\n\u003cp>Michael Wallace, president of the Washington Township Health Care District board, is also the chairman of the board of Fremont Bank, which has received more than $1 million in fees from the taxpayer-funded district. Wallace declined to comment on the investigation.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.fppc.ca.gov/\" target=\"_blank\">California Fair Political Practices Commission\u003c/a>'s decision to investigate Wallace, made public last week, is the \u003ca href=\"http://www.baycitizen.org/government/story/states-political-watchdog-investigate/\" target=\"_blank\">latest in a series of probes\u003c/a> it has initiated following \u003ca href=\"http://www.baycitizen.org/health/story/millions-health-care-district-deals/\" target=\"_blank\">a July report\u003c/a> by The Bay Citizen that uncovered millions of dollars in questionable transactions involving companies and nonprofits with ties to health care district officials across the state.\u003c/p>\n\u003cfigure id=\"attachment_8439\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/WashingtonHospital_MichaelShort_CalWatch1.jpg\">\u003cimg class=\"size-medium wp-image-8439\" title=\"Michael Wallace, president of the Washington Township Health Care District board, is also the chairman of the board of Fremont Bank. (Michael Short: California Watch)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/WashingtonHospital_MichaelShort_CalWatch1-300x199.jpg\" alt=\"Michael Wallace, president of the Washington Township Health Care District board, is also the chairman of the board of Fremont Bank. (Michael Short: California Watch)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Michael Wallace, president of the Washington Township Health Care District board, is also the chairman of the board of Fremont Bank. (Michael Short: California Watch)\u003c/figcaption>\u003c/figure>\n\u003cp>Gerald Shefren and Arthur Faro, board members of the \u003ca href=\"http://www.sequoiahealthcaredistrict.com/\" target=\"_blank\">Sequoia Healthcare District\u003c/a> in Redwood City, and Frank Burgess, a former board member of the \u003ca href=\"http://www.sgmh.org/getpage.php?name=hboard\" target=\"_blank\">San Gorgonio Memorial Healthcare District\u003c/a> in Riverside County, also are under investigation for possibly violating state conflict-of-interest laws.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>California’s more than 70 taxpayer-funded health care districts control multimillion-dollar budgets with little state oversight. While some operate hospitals or nursing homes, others manage real estate holdings and distribute community grants.\u003c/p>\n\u003cp>Since 1990, Wallace has served on the board of directors of the Washington Township Health Care District. Over the past decade, the district has paid Fremont Bank more than $1.2 million in fees.\u003c!--more-->\u003c/p>\n\u003cp>During the same period, Wallace held a variety of leadership roles at the bank, where he is now board chairman. As recently as last year, his salary was more than $100,000, while he held more than $1 million of stock in the bank’s parent company.\u003c/p>\n\u003cp>In a statement issued to The Bay Citizen in July, Wallace defended his actions, saying, “I did not participate in the district’s selection of Fremont Bank in 2001 and abstained from the board’s vote.\u003c/p>\n\u003cp>But state conflict-of-interest laws generally prohibit public boards and commissions from entering into a contract that could benefit any member financially, even if the member does not participate in the contracting decisions. Punishments for conflict-of-interest violations can range from warning letters to fines.\u003c/p>\n\u003cp>The commission decided not to investigate Nancy Farber, CEO of the Washington Hospital Healthcare System. As CEO, Farber reports to the Washington Township district’s board, which oversees Washington Hospital and various outpatient clinics that serve residents primarily in southern Alameda County. The hospital district board approved two grants worth a total of $350,000 to the George Mark Children's House, a nonprofit where Farber’s husband, Peter Farber-Szekrenyi, served as an unpaid board member.\u003c/p>\n\u003cp>Farber did not vote on either grant because she does not sit on the district board, but she did participate in a discussion about one of the grants. Less than a month after the district approved the second grant, her husband became a paid consultant for the nonprofit, earning $12,800 a month. In April 2011, Farber-Szekrenyi became its CEO, earning $208,000 a year. Under state law, public officials cannot participate in a decision in which they have a financial interest.\u003c/p>\n\u003cp>The commission determined that because Farber's husband was a volunteer when the grants were approved, there was no conflict of interest, according to Gary Winuk, chief of the commission’s enforcement division: “He was volunteering there, and not an employee at the time the decision was made, so there is no conflict if there is no pay.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Farber declined to comment on the agency's decision. A district spokeswoman would not reveal how much the district has spent in legal fees to represent Wallace and Farber in the commission's inquiries.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>By Richard Kipling, \u003ca title=\"http://centerforhealthreporting.org/blog/nurse-led-clinics-may-not-be-new-they-may-be-future972\" href=\"http://centerforhealthreporting.org/blog/nurse-led-clinics-may-not-be-new-they-may-be-future972\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_8353\" class=\"wp-caption alignleft\" style=\"max-width: 185px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM.png\">\u003cimg class=\"size-full wp-image-8353\" title=\"Screen Shot 2012-09-06 at 1.44.03 PM\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM.png\" alt=\"\" width=\"185\" height=\"182\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM.png 185w, https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM-32x32.png 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM-64x64.png 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM-75x75.png 75w\" sizes=\"(max-width: 185px) 100vw, 185px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: Glide Health Services)\u003c/figcaption>\u003c/figure>\n\u003cp>Who doesn’t remember running to the school nurse’s office with a nosebleed or ear ache? But how many among us have gone to a nurse-managed clinic for our \u003cem>adult\u003c/em> health care?\u003c/p>\n\u003cp>In this era of experimentation in health delivery, the nurse-led clinic is part of the conversation about how best to medically serve us, particularly the poor and uninsured populations.\u003c/p>\n\u003cp>These safety net clinics fly pretty far beneath the general public’s radar, despite the fact most have been around for a decade or more. In California, there are now at least seven of them, mostly in the Bay Area.\u003c/p>\n\u003cp>To find out more about what they do and how they differ from a typical health clinic, I got in touch with Patricia Dennehy, director of \u003ca href=\"http://glide.org/health\" target=\"_blank\">Glide Health Services\u003c/a>, a pioneering nurse-led health center in San Francisco that promises “compassionate healthcare.” The clinic, located in the Tenderloin area of downtown, addresses such issues as hunger and housing as well as providing medical support. It partners with Saint Francis Memorial Hospital, which offers pharmacy and lab services at no cost.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Glide Health resembles other community-based health centers, she told me, “except the leadership is a nurse – typically a nurse practitioner -- instead of a physician or other health professional.”\u003c/p>\n\u003cp>The more important difference, though, is Glide’s “nursing model” approach, which contrasts with the “medical model” that governs most clinics, said Dennehy, who is also a \u003ca href=\"http://nursing.ucsf.edu/faculty/patricia-dennehy\" target=\"_blank\">clinical professor in the school of nursing at UCSF\u003c/a>.\u003c/p>\n\u003cp>“The nursing model puts the \u003cem>person\u003c/em> in the center instead of the disease,” Dennehy said. “In the nurse-led model, the patient is more than, say, a diabetic. It’s about all the social determinants of your health. Are you a victim of trauma? Depressed? We take time to get to know you. It’s less prescriptive and more of a partnership.”\u003c/p>\n\u003cp>Nurse-led centers developed out of “the service mission of schools of nursing,” she said. “The faculty wanted to provide service and educate their students.” The National Nursing Centers Consortium lists \u003ca href=\"http://www.nncc.us/site/index.php/about-nncc/member-clinics\" target=\"_blank\">128 nurse-led center members\u003c/a> across the country, and \u003ca href=\"http://www.phmc.org/site/index.php?option=com_content&view=article&id=451:health-care-reform-package-includes-unprecedented-investment-in-nurse-led-health-clinics&catid=29&Itemid=1575\" target=\"_blank\">more than 85 schools of nursing run such clinics\u003c/a>, which function as training centers as well.\u003c/p>\n\u003cp>In many cases, it’s a “marriage between the school, the community and a community hospital,” said Dennehy. “That’s not unusual and it’s the perfect triangle.”\u003c/p>\n\u003cp>The clinics may be nurse-run, but that doesn’t mean there isn’t a doctor in the house. Many of the clinics recruit doctors to come in on appointed days as part of their professional team. “We have a wonderful internist, a psychiatrist and a pharmacist for parts of the week,” she said.\u003c/p>\n\u003cp>How does all this play with patients? Is there a lot of explaining to do when a doctor is \u003cem>not\u003c/em> around? “If any patient wants to see a doctor, we give them a referral to our doctor or to another place,” said Dennehy. “It doesn’t happen with great frequency, but it does happen.”\u003c/p>\n\u003cp>The clinic’s bottom line, she said, is that “We think that everyone has the right to choose their care. We’ll do everything we can to help you find another place.”\u003c/p>\n\u003cp>Is there new momentum for more nurse-led clinics because of the Affordable Care Act?\u003c/p>\n\u003cp>“It’s very clear that we cannot doctor-up to meet the country’s primary care needs,” said Dennehy.\u003c/p>\n\u003cp>People are searching for different models, she said, particularly when the ACA is bringing so many new people into full insurance coverage.\u003c/p>\n\u003cp>Many more medical professionals will have to practice “at the full scope of their competency and their training,” she said.\u003c/p>\n\u003cp>So what about nurse-led clinics’ prospects?\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There are plenty of new buds on the vine that are trying to get up and going,” Dennehy said. “I think there are going to be more.”\u003c/p>\n\n",
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"excerpt": "Who doesn’t remember running to the school nurse’s office with a nosebleed or ear ache? But how many among us have gone to a nurse-managed clinic for ouradult health care?\r\n\r\nIn this era of experimentation in health delivery, the nurse-led clinic is part of the conversation about how best to medically serve us, particularly the poor and uninsured populations.\r\n\r\nThese safety net clinics fly pretty far beneath the general public’s radar, despite the fact most have been around for a decade or more. In California, there are now at least seven of them, mostly in the Bay Area.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Richard Kipling, \u003ca title=\"http://centerforhealthreporting.org/blog/nurse-led-clinics-may-not-be-new-they-may-be-future972\" href=\"http://centerforhealthreporting.org/blog/nurse-led-clinics-may-not-be-new-they-may-be-future972\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_8353\" class=\"wp-caption alignleft\" style=\"max-width: 185px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM.png\">\u003cimg class=\"size-full wp-image-8353\" title=\"Screen Shot 2012-09-06 at 1.44.03 PM\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM.png\" alt=\"\" width=\"185\" height=\"182\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM.png 185w, https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM-32x32.png 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM-64x64.png 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM-75x75.png 75w\" sizes=\"(max-width: 185px) 100vw, 185px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: Glide Health Services)\u003c/figcaption>\u003c/figure>\n\u003cp>Who doesn’t remember running to the school nurse’s office with a nosebleed or ear ache? But how many among us have gone to a nurse-managed clinic for our \u003cem>adult\u003c/em> health care?\u003c/p>\n\u003cp>In this era of experimentation in health delivery, the nurse-led clinic is part of the conversation about how best to medically serve us, particularly the poor and uninsured populations.\u003c/p>\n\u003cp>These safety net clinics fly pretty far beneath the general public’s radar, despite the fact most have been around for a decade or more. In California, there are now at least seven of them, mostly in the Bay Area.\u003c/p>\n\u003cp>To find out more about what they do and how they differ from a typical health clinic, I got in touch with Patricia Dennehy, director of \u003ca href=\"http://glide.org/health\" target=\"_blank\">Glide Health Services\u003c/a>, a pioneering nurse-led health center in San Francisco that promises “compassionate healthcare.” The clinic, located in the Tenderloin area of downtown, addresses such issues as hunger and housing as well as providing medical support. It partners with Saint Francis Memorial Hospital, which offers pharmacy and lab services at no cost.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Glide Health resembles other community-based health centers, she told me, “except the leadership is a nurse – typically a nurse practitioner -- instead of a physician or other health professional.”\u003c/p>\n\u003cp>The more important difference, though, is Glide’s “nursing model” approach, which contrasts with the “medical model” that governs most clinics, said Dennehy, who is also a \u003ca href=\"http://nursing.ucsf.edu/faculty/patricia-dennehy\" target=\"_blank\">clinical professor in the school of nursing at UCSF\u003c/a>.\u003c/p>\n\u003cp>“The nursing model puts the \u003cem>person\u003c/em> in the center instead of the disease,” Dennehy said. “In the nurse-led model, the patient is more than, say, a diabetic. It’s about all the social determinants of your health. Are you a victim of trauma? Depressed? We take time to get to know you. It’s less prescriptive and more of a partnership.”\u003c/p>\n\u003cp>Nurse-led centers developed out of “the service mission of schools of nursing,” she said. “The faculty wanted to provide service and educate their students.” The National Nursing Centers Consortium lists \u003ca href=\"http://www.nncc.us/site/index.php/about-nncc/member-clinics\" target=\"_blank\">128 nurse-led center members\u003c/a> across the country, and \u003ca href=\"http://www.phmc.org/site/index.php?option=com_content&view=article&id=451:health-care-reform-package-includes-unprecedented-investment-in-nurse-led-health-clinics&catid=29&Itemid=1575\" target=\"_blank\">more than 85 schools of nursing run such clinics\u003c/a>, which function as training centers as well.\u003c/p>\n\u003cp>In many cases, it’s a “marriage between the school, the community and a community hospital,” said Dennehy. “That’s not unusual and it’s the perfect triangle.”\u003c/p>\n\u003cp>The clinics may be nurse-run, but that doesn’t mean there isn’t a doctor in the house. Many of the clinics recruit doctors to come in on appointed days as part of their professional team. “We have a wonderful internist, a psychiatrist and a pharmacist for parts of the week,” she said.\u003c/p>\n\u003cp>How does all this play with patients? Is there a lot of explaining to do when a doctor is \u003cem>not\u003c/em> around? “If any patient wants to see a doctor, we give them a referral to our doctor or to another place,” said Dennehy. “It doesn’t happen with great frequency, but it does happen.”\u003c/p>\n\u003cp>The clinic’s bottom line, she said, is that “We think that everyone has the right to choose their care. We’ll do everything we can to help you find another place.”\u003c/p>\n\u003cp>Is there new momentum for more nurse-led clinics because of the Affordable Care Act?\u003c/p>\n\u003cp>“It’s very clear that we cannot doctor-up to meet the country’s primary care needs,” said Dennehy.\u003c/p>\n\u003cp>People are searching for different models, she said, particularly when the ACA is bringing so many new people into full insurance coverage.\u003c/p>\n\u003cp>Many more medical professionals will have to practice “at the full scope of their competency and their training,” she said.\u003c/p>\n\u003cp>So what about nurse-led clinics’ prospects?\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There are plenty of new buds on the vine that are trying to get up and going,” Dennehy said. “I think there are going to be more.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Hantavirus Investigation at Yosemite Continues",
"title": "Hantavirus Investigation at Yosemite Continues",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>By \u003cstrong>Lauren Sommer\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_8278\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/CurryVillage_Yosemite_JunSeita_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-8278\" title=\"Curry Village tent cabins at Yosemite National Park. (Jun Seita: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/CurryVillage_Yosemite_JunSeita_Flickr-300x225.jpg\" alt=\"Curry Village tent cabins at Yosemite National Park. (Jun Seita: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Curry Village tent cabins at Yosemite National Park. (Jun Seita: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>State public health officials are warning 1,700 people who stayed in \u003ca title=\"http://www.nps.gov/yose/index.htm\" href=\"http://www.nps.gov/yose/index.htm\" target=\"_blank\">Yosemite National Park\u003c/a>'s Curry Village tent cabins since mid-June about \u003ca title=\"http://www.cdc.gov/hantavirus/\" href=\"http://www.cdc.gov/hantavirus/\" target=\"_blank\">hantavirus\u003c/a>. Three people who stayed in the tent cabins this summer have contracted the illness and two people have died. There may be a fourth case as well.\u003c/p>\n\u003cp>A group of the tent cabins are closed as public health officials investigate the cases. The state health department had previously warned the park about the risk.\u003c/p>\n\u003cp>Hantavirus is a serious illness which causes flu-like symptoms. It can progress rapidly and has a 38 percent mortality rate, according to the Centers for Disease Control. There is no known treatment, although prompt admission to the ICU and oxygen therapy can be helpful.\u003c/p>\n\u003cp>The virus is spread through mouse droppings, says Vicki Kramer, Ph.D., Chief of the Vector-Borne Disease Section of the California Department of Public Health.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"If rodents do invade an area, it’s important not to sweep, not to vacuum because that causes the virus to become airborne,\" she said.\u003c/p>\n\u003cp>Hantavirus is rare. There have been only 60 cases in the last two decades in California. Kramer’s department has been working with the park since two previous hantavirus cases in 2000 and 2010.\u003c!--more-->\u003c/p>\n\u003cp>Two years ago, it was recommended park staff be trained in cleaning standards -- which Kramer says the park did. Health officials also recommended putting up warning signs in the tent cabins. But the park didn't follow that recommendation.\u003c/p>\n\u003cp>\"We certainly want to put signs up in places,\" said Yosemite National Park spokesman Scott Gediman. \"But we’ve learned over the years that to sit there and have a sign everywhere listing every potential danger is both impractical and something we have to balance.\"\u003c/p>\n\u003cp>Gediman says there are signs up now. Tent cabins are being inspected and retrofitted to prevent mice from getting in.\u003c/p>\n\u003cp>The \u003ca title=\"http://www.latimes.com/news/local/la-me-yosemite-20120829,0,304568.story\" href=\"http://www.latimes.com/news/local/la-me-yosemite-20120829,0,304568.story\" target=\"_blank\">Los Angeles Times\u003c/a> reports that officials are testing deer mice across the park in an effort to learn what is causing the outbreak. Park ranger Jana McCabe told the \u003cem>Times\u003c/em> they are \"pretty confident that it's not a cleanliness issue.\"\u003c/p>\n\u003cp>McCabe continues:\u003c/p>\n\u003cblockquote>\u003cp>\"We've reviewed the cases; we've reviewed the cleaning methods,\" she said. \"It makes you start wondering, what has changed? What is going on in the environment? That's really the question.\"\u003c/p>\n\u003cp>After confirming the first two infections earlier this month, Yosemite officials began catching deer mice and disinfecting the Curry Village cabins. They also contacted health authorities.\u003c/p>\n\u003cp>... The California Department of Public Health said Tuesday afternoon that it had recommended a closure of affected cabins \"due to the level of mouse activity and presence of the hantavirus.\" Gediman said the closure was part of the cleaning and repair process already underway.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>More:\u003c/strong>\u003cbr>\n\u003cem>California Watch: \u003c/em>\u003ca title=\"http://californiawatch.org/dailyreport/calif-scientists-calls-warn-yosemite-visitors-virus-went-unheeded-17784\" href=\"http://californiawatch.org/dailyreport/calif-scientists-calls-warn-yosemite-visitors-virus-went-unheeded-17784\" target=\"_blank\">Scientists Calls to Warn Yosemite Visitors Went Unheeded\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Listen to Lauren Sommer's report:\u003c/em>\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201208300850b.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201208300850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "State public health officials are warning 1,700 people who stayed in Yosemite National Park's Curry Village tent cabins since mid-June about hantavirus. Three people who stayed in the tent cabins this summer have contracted the illness and two people have died. There may be a fourth case as well.\r\n\r\nA group of the tent cabins are closed as public health officials investigate the cases. The state health department had previously warned the park about the risk.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By \u003cstrong>Lauren Sommer\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_8278\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/CurryVillage_Yosemite_JunSeita_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-8278\" title=\"Curry Village tent cabins at Yosemite National Park. (Jun Seita: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/CurryVillage_Yosemite_JunSeita_Flickr-300x225.jpg\" alt=\"Curry Village tent cabins at Yosemite National Park. (Jun Seita: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Curry Village tent cabins at Yosemite National Park. (Jun Seita: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>State public health officials are warning 1,700 people who stayed in \u003ca title=\"http://www.nps.gov/yose/index.htm\" href=\"http://www.nps.gov/yose/index.htm\" target=\"_blank\">Yosemite National Park\u003c/a>'s Curry Village tent cabins since mid-June about \u003ca title=\"http://www.cdc.gov/hantavirus/\" href=\"http://www.cdc.gov/hantavirus/\" target=\"_blank\">hantavirus\u003c/a>. Three people who stayed in the tent cabins this summer have contracted the illness and two people have died. There may be a fourth case as well.\u003c/p>\n\u003cp>A group of the tent cabins are closed as public health officials investigate the cases. The state health department had previously warned the park about the risk.\u003c/p>\n\u003cp>Hantavirus is a serious illness which causes flu-like symptoms. It can progress rapidly and has a 38 percent mortality rate, according to the Centers for Disease Control. There is no known treatment, although prompt admission to the ICU and oxygen therapy can be helpful.\u003c/p>\n\u003cp>The virus is spread through mouse droppings, says Vicki Kramer, Ph.D., Chief of the Vector-Borne Disease Section of the California Department of Public Health.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"If rodents do invade an area, it’s important not to sweep, not to vacuum because that causes the virus to become airborne,\" she said.\u003c/p>\n\u003cp>Hantavirus is rare. There have been only 60 cases in the last two decades in California. Kramer’s department has been working with the park since two previous hantavirus cases in 2000 and 2010.\u003c!--more-->\u003c/p>\n\u003cp>Two years ago, it was recommended park staff be trained in cleaning standards -- which Kramer says the park did. Health officials also recommended putting up warning signs in the tent cabins. But the park didn't follow that recommendation.\u003c/p>\n\u003cp>\"We certainly want to put signs up in places,\" said Yosemite National Park spokesman Scott Gediman. \"But we’ve learned over the years that to sit there and have a sign everywhere listing every potential danger is both impractical and something we have to balance.\"\u003c/p>\n\u003cp>Gediman says there are signs up now. Tent cabins are being inspected and retrofitted to prevent mice from getting in.\u003c/p>\n\u003cp>The \u003ca title=\"http://www.latimes.com/news/local/la-me-yosemite-20120829,0,304568.story\" href=\"http://www.latimes.com/news/local/la-me-yosemite-20120829,0,304568.story\" target=\"_blank\">Los Angeles Times\u003c/a> reports that officials are testing deer mice across the park in an effort to learn what is causing the outbreak. Park ranger Jana McCabe told the \u003cem>Times\u003c/em> they are \"pretty confident that it's not a cleanliness issue.\"\u003c/p>\n\u003cp>McCabe continues:\u003c/p>\n\u003cblockquote>\u003cp>\"We've reviewed the cases; we've reviewed the cleaning methods,\" she said. \"It makes you start wondering, what has changed? What is going on in the environment? That's really the question.\"\u003c/p>\n\u003cp>After confirming the first two infections earlier this month, Yosemite officials began catching deer mice and disinfecting the Curry Village cabins. They also contacted health authorities.\u003c/p>\n\u003cp>... The California Department of Public Health said Tuesday afternoon that it had recommended a closure of affected cabins \"due to the level of mouse activity and presence of the hantavirus.\" Gediman said the closure was part of the cleaning and repair process already underway.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>More:\u003c/strong>\u003cbr>\n\u003cem>California Watch: \u003c/em>\u003ca title=\"http://californiawatch.org/dailyreport/calif-scientists-calls-warn-yosemite-visitors-virus-went-unheeded-17784\" href=\"http://californiawatch.org/dailyreport/calif-scientists-calls-warn-yosemite-visitors-virus-went-unheeded-17784\" target=\"_blank\">Scientists Calls to Warn Yosemite Visitors Went Unheeded\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Listen to Lauren Sommer's report:\u003c/em>\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201208300850b.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201208300850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Sick and Aging Prison Inmates; Current Care, Possible Changes",
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"content": "\u003cfigure id=\"attachment_8263\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Screen-Shot-2012-08-28-at-2.22.25-PM.png\">\u003cimg class=\"size-medium wp-image-8263 \" title=\"Screen Shot 2012-08-28 at 2.22.25 PM\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Screen-Shot-2012-08-28-at-2.22.25-PM-300x230.png\" alt=\"\" width=\"300\" height=\"230\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Inmate Sean Reese, a Vacaville prison hospice volunteer, helps a patient in the documentary \"Life in Prison\" by Lonny Shavelson.\u003c/figcaption>\u003c/figure>\n\u003cp>The state Assembly is expected to vote by this Friday on \u003ca title=\"http://info.sen.ca.gov/cgi-bin/postquery?bill_number=sb_1462&sess=CUR&house=B&site=sen\" href=\"http://info.sen.ca.gov/cgi-bin/postquery?bill_number=sb_1462&sess=CUR&house=B&site=sen\" target=\"_blank\">a bill\u003c/a> that would permit medical probation for county jail inmates. Under medical probation, inmates who are terminally ill or so physically incapacitated that they require 24-hour care would be released from jail.\u003c/p>\n\u003cp>A 2010 law already permits medical probation for prison inmates. If passed, this new law would extend medical probation to inmates at county jails. As the \u003ca title=\"http://www.baycitizen.org/blogs/pulse-of-the-bay/vote-medical-probation-expected-aug-31/\" href=\"http://www.baycitizen.org/blogs/pulse-of-the-bay/vote-medical-probation-expected-aug-31/\" target=\"_blank\">Bay Citizen\u003c/a> reports:\u003c/p>\n\u003cblockquote>\u003cp>The bill comes as the state's new policy known as realignment brings tens of thousands of low-level felons who would have served time in state prison to county jails, burdening the county with costs of caring for very sick inmates.\u003c/p>\n\u003cp>Many of the prisoners who receive medical parole are bedridden, and officials say they pose no threat to others.\u003c/p>\n\u003cp>Since the (2010) law went into effect, according to Joyce Hayhoe, legislative director for California Correctional Health Care Services, 42 inmates have been approved for medical parole and seven have been denied of a total of 49 who have had hearings.\u003c/p>\u003c/blockquote>\n\u003cp>Journalist Lonny Shavelson gained rare access to the Vacaville prison hospice -- the first prison hospice in the country -- and produced this short, powerful \u003ca title=\"http://www.youtube.com/watch?v=SUPQlXMdZHQ&feature=youtu.be\" href=\"http://www.youtube.com/watch?v=SUPQlXMdZHQ&feature=youtu.be\" target=\"_blank\">documentary \u003c/a>for the Center for Investigative Reporting.\u003cbr>\n[youtube http://www.youtube.com/watch?v=SUPQlXMdZHQ]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "The state Assembly is expected to vote by this Friday on a bill that would permit \"medical probation\" for county jail inmates. Under medical probation, inmates who are terminally ill or so physically incapacitated that they require 24-hour care would be released from jail. The practice is already allowed in the state's prison system.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_8263\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Screen-Shot-2012-08-28-at-2.22.25-PM.png\">\u003cimg class=\"size-medium wp-image-8263 \" title=\"Screen Shot 2012-08-28 at 2.22.25 PM\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Screen-Shot-2012-08-28-at-2.22.25-PM-300x230.png\" alt=\"\" width=\"300\" height=\"230\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Inmate Sean Reese, a Vacaville prison hospice volunteer, helps a patient in the documentary \"Life in Prison\" by Lonny Shavelson.\u003c/figcaption>\u003c/figure>\n\u003cp>The state Assembly is expected to vote by this Friday on \u003ca title=\"http://info.sen.ca.gov/cgi-bin/postquery?bill_number=sb_1462&sess=CUR&house=B&site=sen\" href=\"http://info.sen.ca.gov/cgi-bin/postquery?bill_number=sb_1462&sess=CUR&house=B&site=sen\" target=\"_blank\">a bill\u003c/a> that would permit medical probation for county jail inmates. Under medical probation, inmates who are terminally ill or so physically incapacitated that they require 24-hour care would be released from jail.\u003c/p>\n\u003cp>A 2010 law already permits medical probation for prison inmates. If passed, this new law would extend medical probation to inmates at county jails. As the \u003ca title=\"http://www.baycitizen.org/blogs/pulse-of-the-bay/vote-medical-probation-expected-aug-31/\" href=\"http://www.baycitizen.org/blogs/pulse-of-the-bay/vote-medical-probation-expected-aug-31/\" target=\"_blank\">Bay Citizen\u003c/a> reports:\u003c/p>\n\u003cblockquote>\u003cp>The bill comes as the state's new policy known as realignment brings tens of thousands of low-level felons who would have served time in state prison to county jails, burdening the county with costs of caring for very sick inmates.\u003c/p>\n\u003cp>Many of the prisoners who receive medical parole are bedridden, and officials say they pose no threat to others.\u003c/p>\n\u003cp>Since the (2010) law went into effect, according to Joyce Hayhoe, legislative director for California Correctional Health Care Services, 42 inmates have been approved for medical parole and seven have been denied of a total of 49 who have had hearings.\u003c/p>\u003c/blockquote>\n\u003cp>Journalist Lonny Shavelson gained rare access to the Vacaville prison hospice -- the first prison hospice in the country -- and produced this short, powerful \u003ca title=\"http://www.youtube.com/watch?v=SUPQlXMdZHQ&feature=youtu.be\" href=\"http://www.youtube.com/watch?v=SUPQlXMdZHQ&feature=youtu.be\" target=\"_blank\">documentary \u003c/a>for the Center for Investigative Reporting.\u003cbr>\n\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/SUPQlXMdZHQ'\n title='//www.youtube.com/embed/SUPQlXMdZHQ'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "New Requirement for Vaccine Exemption Passed by Senate",
"title": "New Requirement for Vaccine Exemption Passed by Senate",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_8239\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Vaccine_Baby_DanHatton_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-8239\" title=\"Baby cries after receiving a vaccine. (Dan Hatton: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Vaccine_Baby_DanHatton_Flickr-300x200.jpg\" alt=\"Baby cries after receiving a vaccine. (Dan Hatton: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Baby cries after receiving a vaccine. (Dan Hatton: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>\u003cem>Update: Gov. Jerry Brown\u003ca href=\"http://gov.ca.gov/docs/AB_2109_Signing_Message.pdf\" target=\"_blank\"> signed this bill\u003c/a> into law on Sept. 30, 2012. \u003c/em>\u003c/strong>\u003c/p>\n\u003cp>California has one of the more lenient approaches for parents who wish to opt out of vaccinations for their school-age children. While state law requires that children must be vaccinated against various illnesses (think polio, measles, tetanus) to enroll in school, California parents can opt out of vaccines simply by filing a short statement stating that immunizations are contrary to their beliefs. It's known as a personal belief exemption.\u003c/p>\n\u003cp>This week in Sacramento, the Senate passed\u003ca title=\"http://www.aroundthecapitol.com/billtrack/text.html?bvid=20110AB210996AMD\" href=\"http://www.aroundthecapitol.com/billtrack/text.html?bvid=20110AB210996AMD\" target=\"_blank\"> AB 2109\u003c/a>, a bill to make this exemption a little tougher. Under the bill, parents who don't wish to have their children vaccinated must meet with a health care provider to talk about risks and benefits of vaccines. The provider can be a doctor, nurse practitioner, physician assistant, osteopathic physician, naturopathic doctor or a credentialed school nurse. The provider must sign a form and the parent must still provide a written statement.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"This bill does not take away the parent’s right to make a decision.\"\u003c/aside>\n\u003cp>\u003ca title=\"http://asmdc.org/members/a05/\" href=\"http://asmdc.org/members/a05/\" target=\"_blank\">Assemblyman Richard Pan\u003c/a> of Sacramento, a pediatrician himself, sponsored the bill. He pointed to misinformation as a driver of parents opting out of vaccines. \"Parents become uncertain. They're not sure what they should do,\" he told me today in an interview. \"They’re being told their children should be immunized but at the same time, they’re seeing scary stuff out on the internet.\"\u003c!--more-->\u003c/p>\n\u003cp>Pan noted that the bill does not mandate vaccination of all children. \"This bill does not take away the parent’s right to make a decision about whether to get their child immunized or not. We just want to make sure it’s an informed decision.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Critics counter that parents who opt out are already informed. They say that this bill adds to health care costs by requiring extra medical appointments to discuss vaccines.\u003c/p>\n\u003cp>A similar bill passed 18 months ago in Washington state. After it took effect, the opt-out rate there dropped by about 25 percent. So at least some people are making a different decision after meeting with a health care provider. Public health officials expect the opt out rate will go down further this year.\u003c/p>\n\u003cp>The personal belief exemption rate in California is much lower than Washington's -- 2.3 percent for the 2010-2011 school year. But it's not an even distribution statewide. In Los Angeles county, for example, the rate is 1.58 percent. But several counties in northern California -- Trinity, Nevada, Siskiyou -- have opt-out rates exceeding 12 percent. Public health officials say when more than 10 percent of children are not vaccinated, it puts a community at risk. Of special concern are people with weakened immune systems, such as cancer patients or people with HIV. Another group at strong risk are newborn babies.\u003c/p>\n\u003cp>Babies cannot be vaccinated against some illnesses until they are six months old. In 2010, California had a\u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/01/25/no-whooping-cough-deaths-last-year-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2012/01/25/no-whooping-cough-deaths-last-year-in-california/\" target=\"_blank\"> whooping cough epidemic\u003c/a>. There were 9.000 reported cases and 10 babies died.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>AB 2109 heads back to the Assembly for a final vote, which must happen before the end of the legislative session next Friday. From there, the governor will have 30 days to sign or veto the bill.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_8239\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Vaccine_Baby_DanHatton_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-8239\" title=\"Baby cries after receiving a vaccine. (Dan Hatton: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Vaccine_Baby_DanHatton_Flickr-300x200.jpg\" alt=\"Baby cries after receiving a vaccine. (Dan Hatton: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Baby cries after receiving a vaccine. (Dan Hatton: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>\u003cem>Update: Gov. Jerry Brown\u003ca href=\"http://gov.ca.gov/docs/AB_2109_Signing_Message.pdf\" target=\"_blank\"> signed this bill\u003c/a> into law on Sept. 30, 2012. \u003c/em>\u003c/strong>\u003c/p>\n\u003cp>California has one of the more lenient approaches for parents who wish to opt out of vaccinations for their school-age children. While state law requires that children must be vaccinated against various illnesses (think polio, measles, tetanus) to enroll in school, California parents can opt out of vaccines simply by filing a short statement stating that immunizations are contrary to their beliefs. It's known as a personal belief exemption.\u003c/p>\n\u003cp>This week in Sacramento, the Senate passed\u003ca title=\"http://www.aroundthecapitol.com/billtrack/text.html?bvid=20110AB210996AMD\" href=\"http://www.aroundthecapitol.com/billtrack/text.html?bvid=20110AB210996AMD\" target=\"_blank\"> AB 2109\u003c/a>, a bill to make this exemption a little tougher. Under the bill, parents who don't wish to have their children vaccinated must meet with a health care provider to talk about risks and benefits of vaccines. The provider can be a doctor, nurse practitioner, physician assistant, osteopathic physician, naturopathic doctor or a credentialed school nurse. The provider must sign a form and the parent must still provide a written statement.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"This bill does not take away the parent’s right to make a decision.\"\u003c/aside>\n\u003cp>\u003ca title=\"http://asmdc.org/members/a05/\" href=\"http://asmdc.org/members/a05/\" target=\"_blank\">Assemblyman Richard Pan\u003c/a> of Sacramento, a pediatrician himself, sponsored the bill. He pointed to misinformation as a driver of parents opting out of vaccines. \"Parents become uncertain. They're not sure what they should do,\" he told me today in an interview. \"They’re being told their children should be immunized but at the same time, they’re seeing scary stuff out on the internet.\"\u003c!--more-->\u003c/p>\n\u003cp>Pan noted that the bill does not mandate vaccination of all children. \"This bill does not take away the parent’s right to make a decision about whether to get their child immunized or not. We just want to make sure it’s an informed decision.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Critics counter that parents who opt out are already informed. They say that this bill adds to health care costs by requiring extra medical appointments to discuss vaccines.\u003c/p>\n\u003cp>A similar bill passed 18 months ago in Washington state. After it took effect, the opt-out rate there dropped by about 25 percent. So at least some people are making a different decision after meeting with a health care provider. Public health officials expect the opt out rate will go down further this year.\u003c/p>\n\u003cp>The personal belief exemption rate in California is much lower than Washington's -- 2.3 percent for the 2010-2011 school year. But it's not an even distribution statewide. In Los Angeles county, for example, the rate is 1.58 percent. But several counties in northern California -- Trinity, Nevada, Siskiyou -- have opt-out rates exceeding 12 percent. Public health officials say when more than 10 percent of children are not vaccinated, it puts a community at risk. Of special concern are people with weakened immune systems, such as cancer patients or people with HIV. Another group at strong risk are newborn babies.\u003c/p>\n\u003cp>Babies cannot be vaccinated against some illnesses until they are six months old. In 2010, California had a\u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/01/25/no-whooping-cough-deaths-last-year-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2012/01/25/no-whooping-cough-deaths-last-year-in-california/\" target=\"_blank\"> whooping cough epidemic\u003c/a>. There were 9.000 reported cases and 10 babies died.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>AB 2109 heads back to the Assembly for a final vote, which must happen before the end of the legislative session next Friday. From there, the governor will have 30 days to sign or veto the bill.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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