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"disqusTitle": "Congress Delays Guidelines to Limit Junk Food Marketing to Children",
"title": "Congress Delays Guidelines to Limit Junk Food Marketing to Children",
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"content": "\u003cfigure id=\"attachment_1491\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Screen-Shot-2011-12-16-at-4.11.08-PM.png\">\u003cimg class=\"size-medium wp-image-1491 \" title=\"One of the 29,000 public comments in response to food marketing guideline proposal submitted to the federal government. \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Screen-Shot-2011-12-16-at-4.11.08-PM-300x261.png\" alt=\"One of the 29,000 public comments in response to food marketing guideline proposal submitted to the federal government. \" width=\"300\" height=\"261\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Scan of one of the 29,000 public comments in response to food marketing guideline proposal submitted to the federal government.\u003c/figcaption>\u003c/figure>\n\u003cp>Score another round for junk food marketing. Just weeks after Congress turned back US Department of Agriculture efforts to make the \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/11/17/mamma-mia-is-pizza-a-vegetable-or-not/\" href=\"http://ww2.kqed.org/stateofhealth/2011/11/17/mamma-mia-is-pizza-a-vegetable-or-not/\" target=\"_blank\">school lunch program more healthful\u003c/a>, today Congress delayed attempts at finalizing voluntary guidelines for food marketing to children.\u003c/p>\n\u003cp>Some background -- a year and a half ago, the Obama administration set in motion an effort to establish guidelines around the kinds of foods and drinks that can be marketed to children. The effort was to be voluntary, not regulatory, and the goal was to help combat \u003ca title=\"http://www.cdc.gov/healthyyouth/obesity/facts.htm\" href=\"http://www.cdc.gov/healthyyouth/obesity/facts.htm\" target=\"_blank\">childhood obesity\u003c/a>, now hovering around 20 percent for six to 19-year-olds. But, not surprisingly, the food and beverage industry has been fighting hard against the proposal. Today, public health advocates were set back when Congress asked for a cost/benefit analysis of the proposed guidelines.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"What's frustrating here is that Congress listened to industry instead of parents and the American public.\"\u003c/aside>\n\u003cp>As \u003ca title=\"http://www.washingtonpost.com/business/economy/lawmakers-want-cost-benefit-analysis-on-child-food-marketing-restrictions/2011/12/15/gIQAdqxywO_story.html\" href=\"http://www.washingtonpost.com/business/economy/lawmakers-want-cost-benefit-analysis-on-child-food-marketing-restrictions/2011/12/15/gIQAdqxywO_story.html\" target=\"_blank\">The Washington Post\u003c/a> reports, the cost-benefit requirement is buried in the huge spending bill Congress was debating today, the omnibus bill needed to keep the federal government running.\u003c/p>\n\u003cblockquote>\u003cp>The administration’s proposal aims to tackle childhood obesity by having the industry market to children only those foods and drinks that make a “meaningful contribution” to a healthful diet and limit sodium, fats and added sugars. Foods that do not meet the guidelines could not be advertised to children.\u003cbr>\n\u003c!--more-->The administration has stressed repeatedly that the plan is voluntary and meant to serve only as a guideline. But the industry says the initiative amounts to a backdoor regulation that will in effect wipe out advertising to children, eliminate millions of jobs and infringe on commercial free speech.\u003c/p>\n\u003cp>The spending bill rider bars the Federal Trade Commission, the lead agency on the food marketing initiative, from spending money on finalizing the proposal until the agency and its partners comply with an executive order signed in January by President Obama.\u003c/p>\u003c/blockquote>\n\u003cp>But the President's executive order is about regulations, not voluntary efforts. Margo Wootan of the Center for Science in the Public Interest pointed out in a statement today, \"There is no cost associated with something that is totally voluntary.\"\u003c/p>\n\u003cp>Lori Dorfman, co-chair of the \u003ca title=\"http://www.bmsg.org/about/projects/the-food-marketing-workgroup\" href=\"http://www.bmsg.org/about/projects/the-food-marketing-workgroup\" target=\"_blank\">Food Marketing Workgroup\u003c/a>, a national coalition of organizations and experts in support of the guideline, said from her office in Berkeley today that she was \"bitterly disappointed\" by the Congressional roadblock. \"What's frustrating here,\" she continued, \"is that Congress listened to industry instead of parents and the American public.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And the public had weighed in; 29,000 people responded to the request for public comment with the \u003ca title=\"http://Republicans.EnergyCommerce.house.gov/Media/file/Hearings/Joint/101211_CMT_Health/Wootan.pdf\" href=\"http://Republicans.EnergyCommerce.house.gov/Media/file/Hearings/Joint/101211_CMT_Health/Wootan.pdf\" target=\"_blank\">overwhelming majority reportedly\u003c/a> [PDF] favoring the guidelines. \"I read a lot of those comments,\" Dorfman said, \"some were hand written pleas from parents, saying 'please help us.' Those pleas have been ignored.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In her statement, Margo Wootan also registered her dismay and pointed to the money the food and beverage industry has spent\u003ca title=\"http://reporting.sunlightfoundation.com/2011/Food_and_media_companies_lobby/\" href=\"http://reporting.sunlightfoundation.com/2011/Food_and_media_companies_lobby/\" target=\"_blank\"> lobbying Congress\u003c/a> this year. \"First Congress declared \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/11/17/mamma-mia-is-pizza-a-vegetable-or-not/\" href=\"http://ww2.kqed.org/stateofhealth/2011/11/17/mamma-mia-is-pizza-a-vegetable-or-not/\" target=\"_blank\">pizza a vegetable\u003c/a>; now it defends companies' ability to market Froot Loops as healthy for children. This Congress has quite the nutrition track record. Too bad kids don't have their own PAC [political action committee], or $37 million in lobbying clout.\"\u003c/p>\n\n",
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"excerpt": "Score another round for junk food marketing. Just weeks after Congress turned back US Department of Agriculture efforts to make the school lunch program more healthful, today Congress delayed attempts at finalizing voluntary guidelines for food marketing to children.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_1491\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Screen-Shot-2011-12-16-at-4.11.08-PM.png\">\u003cimg class=\"size-medium wp-image-1491 \" title=\"One of the 29,000 public comments in response to food marketing guideline proposal submitted to the federal government. \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Screen-Shot-2011-12-16-at-4.11.08-PM-300x261.png\" alt=\"One of the 29,000 public comments in response to food marketing guideline proposal submitted to the federal government. \" width=\"300\" height=\"261\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Scan of one of the 29,000 public comments in response to food marketing guideline proposal submitted to the federal government.\u003c/figcaption>\u003c/figure>\n\u003cp>Score another round for junk food marketing. Just weeks after Congress turned back US Department of Agriculture efforts to make the \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/11/17/mamma-mia-is-pizza-a-vegetable-or-not/\" href=\"http://ww2.kqed.org/stateofhealth/2011/11/17/mamma-mia-is-pizza-a-vegetable-or-not/\" target=\"_blank\">school lunch program more healthful\u003c/a>, today Congress delayed attempts at finalizing voluntary guidelines for food marketing to children.\u003c/p>\n\u003cp>Some background -- a year and a half ago, the Obama administration set in motion an effort to establish guidelines around the kinds of foods and drinks that can be marketed to children. The effort was to be voluntary, not regulatory, and the goal was to help combat \u003ca title=\"http://www.cdc.gov/healthyyouth/obesity/facts.htm\" href=\"http://www.cdc.gov/healthyyouth/obesity/facts.htm\" target=\"_blank\">childhood obesity\u003c/a>, now hovering around 20 percent for six to 19-year-olds. But, not surprisingly, the food and beverage industry has been fighting hard against the proposal. Today, public health advocates were set back when Congress asked for a cost/benefit analysis of the proposed guidelines.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"What's frustrating here is that Congress listened to industry instead of parents and the American public.\"\u003c/aside>\n\u003cp>As \u003ca title=\"http://www.washingtonpost.com/business/economy/lawmakers-want-cost-benefit-analysis-on-child-food-marketing-restrictions/2011/12/15/gIQAdqxywO_story.html\" href=\"http://www.washingtonpost.com/business/economy/lawmakers-want-cost-benefit-analysis-on-child-food-marketing-restrictions/2011/12/15/gIQAdqxywO_story.html\" target=\"_blank\">The Washington Post\u003c/a> reports, the cost-benefit requirement is buried in the huge spending bill Congress was debating today, the omnibus bill needed to keep the federal government running.\u003c/p>\n\u003cblockquote>\u003cp>The administration’s proposal aims to tackle childhood obesity by having the industry market to children only those foods and drinks that make a “meaningful contribution” to a healthful diet and limit sodium, fats and added sugars. Foods that do not meet the guidelines could not be advertised to children.\u003cbr>\n\u003c!--more-->The administration has stressed repeatedly that the plan is voluntary and meant to serve only as a guideline. But the industry says the initiative amounts to a backdoor regulation that will in effect wipe out advertising to children, eliminate millions of jobs and infringe on commercial free speech.\u003c/p>\n\u003cp>The spending bill rider bars the Federal Trade Commission, the lead agency on the food marketing initiative, from spending money on finalizing the proposal until the agency and its partners comply with an executive order signed in January by President Obama.\u003c/p>\u003c/blockquote>\n\u003cp>But the President's executive order is about regulations, not voluntary efforts. Margo Wootan of the Center for Science in the Public Interest pointed out in a statement today, \"There is no cost associated with something that is totally voluntary.\"\u003c/p>\n\u003cp>Lori Dorfman, co-chair of the \u003ca title=\"http://www.bmsg.org/about/projects/the-food-marketing-workgroup\" href=\"http://www.bmsg.org/about/projects/the-food-marketing-workgroup\" target=\"_blank\">Food Marketing Workgroup\u003c/a>, a national coalition of organizations and experts in support of the guideline, said from her office in Berkeley today that she was \"bitterly disappointed\" by the Congressional roadblock. \"What's frustrating here,\" she continued, \"is that Congress listened to industry instead of parents and the American public.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And the public had weighed in; 29,000 people responded to the request for public comment with the \u003ca title=\"http://Republicans.EnergyCommerce.house.gov/Media/file/Hearings/Joint/101211_CMT_Health/Wootan.pdf\" href=\"http://Republicans.EnergyCommerce.house.gov/Media/file/Hearings/Joint/101211_CMT_Health/Wootan.pdf\" target=\"_blank\">overwhelming majority reportedly\u003c/a> [PDF] favoring the guidelines. \"I read a lot of those comments,\" Dorfman said, \"some were hand written pleas from parents, saying 'please help us.' Those pleas have been ignored.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In her statement, Margo Wootan also registered her dismay and pointed to the money the food and beverage industry has spent\u003ca title=\"http://reporting.sunlightfoundation.com/2011/Food_and_media_companies_lobby/\" href=\"http://reporting.sunlightfoundation.com/2011/Food_and_media_companies_lobby/\" target=\"_blank\"> lobbying Congress\u003c/a> this year. \"First Congress declared \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/11/17/mamma-mia-is-pizza-a-vegetable-or-not/\" href=\"http://ww2.kqed.org/stateofhealth/2011/11/17/mamma-mia-is-pizza-a-vegetable-or-not/\" target=\"_blank\">pizza a vegetable\u003c/a>; now it defends companies' ability to market Froot Loops as healthy for children. This Congress has quite the nutrition track record. Too bad kids don't have their own PAC [political action committee], or $37 million in lobbying clout.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How Lawsuits Can Stymie Some Trigger Cuts",
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"content": "\u003cp>By Sarah Varney\u003c/p>\n\u003cfigure id=\"attachment_1365\" class=\"wp-caption alignleft\" style=\"max-width: 180px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/JerryBrown_LeagueofWomenVoters.jpg\">\u003cimg class=\"size-full wp-image-1365\" title=\"(League of Women Voters: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/JerryBrown_LeagueofWomenVoters.jpg\" alt=\"(League of Women Voters: Flickr)\" width=\"180\" height=\"195\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(League of Women Voters: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Trigger cuts have been the weapon of choice in many recent budgetary negotiations, most famously as the Congressional 'Super Committee' failed to come to agreement last month.\u003c/p>\n\u003cp>But in California, where Governor Jerry Brown yesterday announced nearly a billion dollars in additional reductions to state spending, that budget gun is jammed, as advocates for the elderly and mentally and physically disabled have managed to thwart the automatic reductions by asserting that the state's severe cuts -- some $15 billion to health and human services since 2008 -- are beginning to violate federal law.\u003c/p>\n\u003cp>That defense has largely been the result of an aggressive legal strategy by disability rights groups, something witnessed recently when the state aborted a plan to eliminate funding for adult day health care centers in the face of a lawsuit by\u003ca title=\"http://www.disabilityrightsca.org/\" href=\"http://www.disabilityrightsca.org/\" target=\"_blank\"> Disability Rights California\u003c/a>. The centers offer health care services, shared meals and exercise among other activities and, most experts agree, help keep seniors and disabled people out of nursing homes.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The state cuts are running headlong into the Americans with Disabilities Act. \u003c/aside>\n\u003cp>But that's not the only place where state lawyers are busy. Officials in Sacramento are also preparing to defend the recent decision by state lawmakers to reduce what it pays doctors who care for Medicaid recipients before the U.S. Supreme Court. Legal advocates also successfully sued in federal court to stop $100 million in automatic cuts to the state's home care program for the disabled and frail seniors known as In-Home Supportive Services. A hearing has yet to be set.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->Melinda Bird, an attorney with Disability Rights California, based in Los Angeles, says the state cuts are running headlong into the Americans with Disabilities Act, the two decades old civil rights law that bars discrimination based on disability. \"The ADA mandates that people be provided services in the most integrated setting appropriate to their needs,\" says Bird. \"And that means providing the services to people at a home rather than in a nursing home.\" Without home aides to help them bathe, dress, eat and take medications, many of these disabled Californians, says Bird, would end up in costly nursing homes or psychiatric hospitals.\u003c/p>\n\u003cp>Not all of which is bad news for some politicians, says \u003ca title=\"http://www.cbp.org/about/about_staff.html\" href=\"http://www.cbp.org/about/about_staff.html\" target=\"_blank\">Jean Ross\u003c/a>, Executive Director of the \u003ca title=\"http://www.cbp.org/\" href=\"http://www.cbp.org/\" target=\"_blank\">California Budget Project\u003c/a>, a nonpartisan watchdog group. Lawsuits can provide political cover for legislators and agency directors reluctant to cut programs they support, says Ross, but which are vulnerable in tight economic times.\u003c/p>\n\u003cp>\"When the proposed policies the courts in some cases have ruled against were debated before the legislature, advocates [and] others would raise the concern that they might not pass judicial muster,\" says Ross. In several cases, those familiar with the budget process say, lawmakers approve budget reductions knowing that the courts will likely stop them from going into effect.\u003c/p>\n\u003cp>In some cases, advocates for such programs are also just stalling for time. Attorneys can slow budget cuts down by arguing that recipients of public programs haven't received adequate notice, says Mike Herald, a legislative advocate for the \u003ca title=\"http://www.wclp.org/\" href=\"http://www.wclp.org/\" target=\"_blank\">Western Center on Law and Poverty\u003c/a> in Sacramento. He cited a suit that his group filed against former Governor Arnold Schwarzenegger after that adminstration sought to cut child care programs for the working poor.\u003c/p>\n\u003cp>\"We were able to go and get a judge to say, 'No, you've got to send out a notice that gives people 30 days advance warning,'\" says Herald. \"That pushed back the whole schedule and by then we had a new governor, and then voila he changed his position and the cuts never really went into effect.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That said, Mr. Herald and others legal advocate insist they do not just sit on the sidelines waiting to file lawsuits, saying that they would much rather negotiate up front with lawmakers to find ways to save money and preserve vital programs. But trying to make deals with anyone in a state with as many money problems as California can be difficult.\u003c/p>\n\n",
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"excerpt": "Trigger cuts have been the weapon of choice in many recent budgetary negotiations, most famously as the Congressional 'Super Committee' failed to come to agreement last month.\r\n\r\nBut in California, where Governor Jerry Brown yesterday announced nearly a billion dollars in additional reductions to state spending, that budget gun is jammed, as advocates for the elderly and mentally and physically disabled have managed to thwart the automatic reductions by asserting that the state's severe cuts -- some $15 billion to health and human services since 2008 -- are beginning to violate federal law.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Sarah Varney\u003c/p>\n\u003cfigure id=\"attachment_1365\" class=\"wp-caption alignleft\" style=\"max-width: 180px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/JerryBrown_LeagueofWomenVoters.jpg\">\u003cimg class=\"size-full wp-image-1365\" title=\"(League of Women Voters: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/JerryBrown_LeagueofWomenVoters.jpg\" alt=\"(League of Women Voters: Flickr)\" width=\"180\" height=\"195\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(League of Women Voters: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Trigger cuts have been the weapon of choice in many recent budgetary negotiations, most famously as the Congressional 'Super Committee' failed to come to agreement last month.\u003c/p>\n\u003cp>But in California, where Governor Jerry Brown yesterday announced nearly a billion dollars in additional reductions to state spending, that budget gun is jammed, as advocates for the elderly and mentally and physically disabled have managed to thwart the automatic reductions by asserting that the state's severe cuts -- some $15 billion to health and human services since 2008 -- are beginning to violate federal law.\u003c/p>\n\u003cp>That defense has largely been the result of an aggressive legal strategy by disability rights groups, something witnessed recently when the state aborted a plan to eliminate funding for adult day health care centers in the face of a lawsuit by\u003ca title=\"http://www.disabilityrightsca.org/\" href=\"http://www.disabilityrightsca.org/\" target=\"_blank\"> Disability Rights California\u003c/a>. The centers offer health care services, shared meals and exercise among other activities and, most experts agree, help keep seniors and disabled people out of nursing homes.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The state cuts are running headlong into the Americans with Disabilities Act. \u003c/aside>\n\u003cp>But that's not the only place where state lawyers are busy. Officials in Sacramento are also preparing to defend the recent decision by state lawmakers to reduce what it pays doctors who care for Medicaid recipients before the U.S. Supreme Court. Legal advocates also successfully sued in federal court to stop $100 million in automatic cuts to the state's home care program for the disabled and frail seniors known as In-Home Supportive Services. A hearing has yet to be set.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->Melinda Bird, an attorney with Disability Rights California, based in Los Angeles, says the state cuts are running headlong into the Americans with Disabilities Act, the two decades old civil rights law that bars discrimination based on disability. \"The ADA mandates that people be provided services in the most integrated setting appropriate to their needs,\" says Bird. \"And that means providing the services to people at a home rather than in a nursing home.\" Without home aides to help them bathe, dress, eat and take medications, many of these disabled Californians, says Bird, would end up in costly nursing homes or psychiatric hospitals.\u003c/p>\n\u003cp>Not all of which is bad news for some politicians, says \u003ca title=\"http://www.cbp.org/about/about_staff.html\" href=\"http://www.cbp.org/about/about_staff.html\" target=\"_blank\">Jean Ross\u003c/a>, Executive Director of the \u003ca title=\"http://www.cbp.org/\" href=\"http://www.cbp.org/\" target=\"_blank\">California Budget Project\u003c/a>, a nonpartisan watchdog group. Lawsuits can provide political cover for legislators and agency directors reluctant to cut programs they support, says Ross, but which are vulnerable in tight economic times.\u003c/p>\n\u003cp>\"When the proposed policies the courts in some cases have ruled against were debated before the legislature, advocates [and] others would raise the concern that they might not pass judicial muster,\" says Ross. In several cases, those familiar with the budget process say, lawmakers approve budget reductions knowing that the courts will likely stop them from going into effect.\u003c/p>\n\u003cp>In some cases, advocates for such programs are also just stalling for time. Attorneys can slow budget cuts down by arguing that recipients of public programs haven't received adequate notice, says Mike Herald, a legislative advocate for the \u003ca title=\"http://www.wclp.org/\" href=\"http://www.wclp.org/\" target=\"_blank\">Western Center on Law and Poverty\u003c/a> in Sacramento. He cited a suit that his group filed against former Governor Arnold Schwarzenegger after that adminstration sought to cut child care programs for the working poor.\u003c/p>\n\u003cp>\"We were able to go and get a judge to say, 'No, you've got to send out a notice that gives people 30 days advance warning,'\" says Herald. \"That pushed back the whole schedule and by then we had a new governor, and then voila he changed his position and the cuts never really went into effect.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That said, Mr. Herald and others legal advocate insist they do not just sit on the sidelines waiting to file lawsuits, saying that they would much rather negotiate up front with lawmakers to find ways to save money and preserve vital programs. But trying to make deals with anyone in a state with as many money problems as California can be difficult.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_1175\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/230136_President-Obama-signs-Health-Reform-Law3.jpg\">\u003cimg class=\"size-medium wp-image-1175\" title=\"President Obama signs health care reform law. (Photo: White House)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/230136_President-Obama-signs-Health-Reform-Law3-300x200.jpg\" alt=\"President Obama signs health care reform law. (Photo: White House)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">President Obama signs health care reform law. (Photo: White House)\u003c/figcaption>\u003c/figure>\n\u003cp>Earlier this week, the \u003cem>Los Angeles Times\u003c/em> published an opinion piece from Spike Dolomite Ward, a San Fernando Valley woman who ended up uninsured.\u003c/p>\n\u003cp>Her story sparked heated debate on the Times' discussion board -- 1,190 comments so far. It's worth reading her \u003ca title=\"http://www.latimes.com/news/opinion/commentary/la-oe-ward-in-praise-of-obamacare-20111206,0,6794828.story\" href=\"http://www.latimes.com/news/opinion/commentary/la-oe-ward-in-praise-of-obamacare-20111206,0,6794828.story\" target=\"_blank\">entire essay\u003c/a>, but I excerpt it here and include some of the more pointed reader comments at the end.\u003c/p>\n\u003cblockquote>\u003cp>I want to apologize to President Obama. But first, some background.\u003c/p>\n\u003cp>I found out three weeks ago I have cancer. I'm 49 years old, have been married for almost 20 years and have two kids. My husband has his own small computer business, and I run a small nonprofit in the San Fernando Valley. I am also an artist. Money is tight, and we don't spend it frivolously. ...\u003c/p>\n\u003cp>\u003c!--more-->We're good people, and we work hard. But we haven't been able to afford health insurance for more than two years. And now I have third-stage breast cancer and am facing months of expensive treatment.\u003c/p>\n\u003cp>To understand how such a thing could happen to a family like ours, I need to take you back nine years to when my husband got laid off from the entertainment company where he'd worked for 10 years. Until then, we had been insured through his work, with a first-rate plan. After he got laid off, we got to keep that health insurance for 18 months through COBRA, by paying $1,300 a month, which was a huge burden on an unemployed father and his family.\u003c/p>\n\u003cp>By the time the COBRA ran out, my husband had decided to go into business for himself, so we had to purchase our own insurance. That was fine for a while. Every year his business grew. But insurance premiums were steadily rising too. ...\u003c/p>\n\u003cp>With the recession, both of our businesses took a huge hit. ... We had to start using a home equity line of credit to pay for our health insurance premiums (which by that point cost as much as our monthly mortgage). When the bank capped our home equity line, we were forced to cash in my husband's IRA. The time finally came when we had to make a choice between paying our mortgage or paying for health insurance. We chose to keep our house. We made a nerve-racking gamble, and we lost.\u003c/p>\n\u003cp>Not having insurance amplifies cancer stress. After the diagnosis, instead of focusing all of my energy on getting well, I was panicked about how we were going to pay for everything. I felt guilty and embarrassed about not being insured.\u003c/p>\u003c/blockquote>\n\u003cp>Despite the embarrassment, she decided to \"out\" herself in the \u003cem>Times\u003c/em>. \"What I want people to understand,\" she writes, \"is that, if this could happen to us, it could happen to anybody.\"\u003c/p>\n\u003cblockquote>\u003cp>Fortunately for me, I've been saved by the federal government's Pre-existing Condition Insurance Plan, something I had never heard of before needing it. It's part of President Obama's healthcare plan, one of the things that has already kicked in, and it guarantees access to insurance for U.S. citizens with preexisting conditions who have been uninsured for at least six months. The application was short, the premiums are affordable, and I have found the people who work in the administration office to be quite compassionate ...\u003c/p>\n\u003cp>Which brings me to my apology. I was pretty mad at Obama before I learned about this new insurance plan. I had changed my registration from Democrat to Independent, and I had blacked out the top of the \"h\" on my Obama bumper sticker, so that it read, \"Got nope\" instead of \"got hope.\" I felt like he had let down the struggling middle class. My son and I had campaigned for him, but since he took office, we felt he had let us down.\u003c/p>\n\u003cp>So this is my public apology. I'm sorry I didn't do enough of my own research to find out what promises the president has made good on. I'm sorry I didn't realize that he really has stood up for me and my family, and for so many others like us. I'm getting a new bumper sticker to cover the one that says \"Got nope.\" It will say \"ObamaCares.\"\u003c/p>\u003c/blockquote>\n\u003cp>Her essay ends there, but the story does not. As noted above, this piece sparked an intense debate. Here are just a few of the comments:\u003c/p>\n\u003cblockquote>\u003cp>\u003cstrong>llyKerwin\u003c/strong> at 10:31 PM December 8, 2011\u003c/p>\n\u003cp>You're a good person because you have a house? No, you are not. You chose owning real estate over insuring yourself. I have no idea if that makes you a bad person, but it is absolutely not a virtue.\u003c/p>\n\u003cp>If you make money on that house, are you willing to share it with the taxpayers who are forced to subsidize your health care because you chose to keep a potentially appreciating asset?\u003c/p>\n\u003cp>\u003cstrong>WordsMatter\u003c/strong> at 6:12 PM December 8, 2011\u003c/p>\n\u003cp>Dear Spike Dolomite Ward, Let me get this straight. Because you were irresponsible and didn't plan for your health needs, I am paying for your irresponsibility. Right? Right! Your on the healthcare welfare roll because you made bad decisions that we're all having to pay for now.\u003c/p>\n\u003cp>\u003cstrong>Computer Forensics Expert\u003c/strong> at 2:53 PM December 8, 2011\u003c/p>\n\u003cp>... Compassion? As a working slob, why should I have to go out, work my butt off and then have my tax money spent on someone who chooses to be a \"free spirit\" artist and working for a non-profit, instead of assuming some personal responsibilty and getting a REAL job?\u003c/p>\n\u003cp>Now, Spike Dolomite Ward gets a government handout at our expense. Well, Spike, guess what? You are no different than the bum on the street or the person living in Bel-Air. People make choices, and you are a victim of your own devices.\u003c/p>\n\u003cp>Nobama in 2012. NO MORE TAKERS!!!!\u003c/p>\u003c/blockquote>\n\u003cp>Yesterday, the \u003cem>Times\u003c/em> ran a response from Ward:\u003c/p>\n\u003cblockquote>\u003cp>My husband and I both knew that by doing this, we would invite hatred into our lives, and that indeed has happened. To those of you who don’t want to see the commonalities between me and my family, let me pose it to you this way: If your sister or mother lost her job and health insurance, and then turned up with breast cancer, what would you do? Would you let her die? Would you pick up the cancer tab yourself?, or would you tell her about PCIP?\u003c/p>\u003c/blockquote>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Earlier this week, the Los Angeles Times published an opinion piece from Spike Dolomite Ward, a San Fernando Valley resident who ended up uninsured.\r\n\r\nHer story sparked heated debate on the Times' discussion board -- 1,190 comments so far. It's worth reading her entire essay, but I excerpt it here and include some of the more pointed reader comments at the end.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_1175\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/230136_President-Obama-signs-Health-Reform-Law3.jpg\">\u003cimg class=\"size-medium wp-image-1175\" title=\"President Obama signs health care reform law. (Photo: White House)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/230136_President-Obama-signs-Health-Reform-Law3-300x200.jpg\" alt=\"President Obama signs health care reform law. (Photo: White House)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">President Obama signs health care reform law. (Photo: White House)\u003c/figcaption>\u003c/figure>\n\u003cp>Earlier this week, the \u003cem>Los Angeles Times\u003c/em> published an opinion piece from Spike Dolomite Ward, a San Fernando Valley woman who ended up uninsured.\u003c/p>\n\u003cp>Her story sparked heated debate on the Times' discussion board -- 1,190 comments so far. It's worth reading her \u003ca title=\"http://www.latimes.com/news/opinion/commentary/la-oe-ward-in-praise-of-obamacare-20111206,0,6794828.story\" href=\"http://www.latimes.com/news/opinion/commentary/la-oe-ward-in-praise-of-obamacare-20111206,0,6794828.story\" target=\"_blank\">entire essay\u003c/a>, but I excerpt it here and include some of the more pointed reader comments at the end.\u003c/p>\n\u003cblockquote>\u003cp>I want to apologize to President Obama. But first, some background.\u003c/p>\n\u003cp>I found out three weeks ago I have cancer. I'm 49 years old, have been married for almost 20 years and have two kids. My husband has his own small computer business, and I run a small nonprofit in the San Fernando Valley. I am also an artist. Money is tight, and we don't spend it frivolously. ...\u003c/p>\n\u003cp>\u003c!--more-->We're good people, and we work hard. But we haven't been able to afford health insurance for more than two years. And now I have third-stage breast cancer and am facing months of expensive treatment.\u003c/p>\n\u003cp>To understand how such a thing could happen to a family like ours, I need to take you back nine years to when my husband got laid off from the entertainment company where he'd worked for 10 years. Until then, we had been insured through his work, with a first-rate plan. After he got laid off, we got to keep that health insurance for 18 months through COBRA, by paying $1,300 a month, which was a huge burden on an unemployed father and his family.\u003c/p>\n\u003cp>By the time the COBRA ran out, my husband had decided to go into business for himself, so we had to purchase our own insurance. That was fine for a while. Every year his business grew. But insurance premiums were steadily rising too. ...\u003c/p>\n\u003cp>With the recession, both of our businesses took a huge hit. ... We had to start using a home equity line of credit to pay for our health insurance premiums (which by that point cost as much as our monthly mortgage). When the bank capped our home equity line, we were forced to cash in my husband's IRA. The time finally came when we had to make a choice between paying our mortgage or paying for health insurance. We chose to keep our house. We made a nerve-racking gamble, and we lost.\u003c/p>\n\u003cp>Not having insurance amplifies cancer stress. After the diagnosis, instead of focusing all of my energy on getting well, I was panicked about how we were going to pay for everything. I felt guilty and embarrassed about not being insured.\u003c/p>\u003c/blockquote>\n\u003cp>Despite the embarrassment, she decided to \"out\" herself in the \u003cem>Times\u003c/em>. \"What I want people to understand,\" she writes, \"is that, if this could happen to us, it could happen to anybody.\"\u003c/p>\n\u003cblockquote>\u003cp>Fortunately for me, I've been saved by the federal government's Pre-existing Condition Insurance Plan, something I had never heard of before needing it. It's part of President Obama's healthcare plan, one of the things that has already kicked in, and it guarantees access to insurance for U.S. citizens with preexisting conditions who have been uninsured for at least six months. The application was short, the premiums are affordable, and I have found the people who work in the administration office to be quite compassionate ...\u003c/p>\n\u003cp>Which brings me to my apology. I was pretty mad at Obama before I learned about this new insurance plan. I had changed my registration from Democrat to Independent, and I had blacked out the top of the \"h\" on my Obama bumper sticker, so that it read, \"Got nope\" instead of \"got hope.\" I felt like he had let down the struggling middle class. My son and I had campaigned for him, but since he took office, we felt he had let us down.\u003c/p>\n\u003cp>So this is my public apology. I'm sorry I didn't do enough of my own research to find out what promises the president has made good on. I'm sorry I didn't realize that he really has stood up for me and my family, and for so many others like us. I'm getting a new bumper sticker to cover the one that says \"Got nope.\" It will say \"ObamaCares.\"\u003c/p>\u003c/blockquote>\n\u003cp>Her essay ends there, but the story does not. As noted above, this piece sparked an intense debate. Here are just a few of the comments:\u003c/p>\n\u003cblockquote>\u003cp>\u003cstrong>llyKerwin\u003c/strong> at 10:31 PM December 8, 2011\u003c/p>\n\u003cp>You're a good person because you have a house? No, you are not. You chose owning real estate over insuring yourself. I have no idea if that makes you a bad person, but it is absolutely not a virtue.\u003c/p>\n\u003cp>If you make money on that house, are you willing to share it with the taxpayers who are forced to subsidize your health care because you chose to keep a potentially appreciating asset?\u003c/p>\n\u003cp>\u003cstrong>WordsMatter\u003c/strong> at 6:12 PM December 8, 2011\u003c/p>\n\u003cp>Dear Spike Dolomite Ward, Let me get this straight. Because you were irresponsible and didn't plan for your health needs, I am paying for your irresponsibility. Right? Right! Your on the healthcare welfare roll because you made bad decisions that we're all having to pay for now.\u003c/p>\n\u003cp>\u003cstrong>Computer Forensics Expert\u003c/strong> at 2:53 PM December 8, 2011\u003c/p>\n\u003cp>... Compassion? As a working slob, why should I have to go out, work my butt off and then have my tax money spent on someone who chooses to be a \"free spirit\" artist and working for a non-profit, instead of assuming some personal responsibilty and getting a REAL job?\u003c/p>\n\u003cp>Now, Spike Dolomite Ward gets a government handout at our expense. Well, Spike, guess what? You are no different than the bum on the street or the person living in Bel-Air. People make choices, and you are a victim of your own devices.\u003c/p>\n\u003cp>Nobama in 2012. NO MORE TAKERS!!!!\u003c/p>\u003c/blockquote>\n\u003cp>Yesterday, the \u003cem>Times\u003c/em> ran a response from Ward:\u003c/p>\n\u003cblockquote>\u003cp>My husband and I both knew that by doing this, we would invite hatred into our lives, and that indeed has happened. To those of you who don’t want to see the commonalities between me and my family, let me pose it to you this way: If your sister or mother lost her job and health insurance, and then turned up with breast cancer, what would you do? Would you let her die? Would you pick up the cancer tab yourself?, or would you tell her about PCIP?\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "How Candid Should Doctors Be with Patients at End of Life?",
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"content": "\u003cfigure id=\"attachment_1099\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Hands_RyanWilcox_Flickr_12082011.jpg\">\u003cimg class=\"size-medium wp-image-1099\" title=\"(Ryan Wilcox: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Hands_RyanWilcox_Flickr_12082011-300x200.jpg\" alt=\"(Ryan Wilcox: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ryan Wilcox: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Not so long ago, it was common for doctors to keep sick patients, even terminally ill patients, in the dark about their prognosis. Today, many patients are actively involved in managing their illnesses, in partnership with their doctors. Indeed, one of the tabs on this blog is \"You're the Boss.\"\u003c/p>\n\u003cp>But a \"Perspective\" in today's\u003cem> \u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMp1109990?query=TOC\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1109990?query=TOC\" target=\"_blank\">New England Journal of Medicine\u003c/a>\u003c/em> says doctors have shied away from explicit conversations about prognosis with a group of patients they should engage--the very elderly. The writers recommend doctors discuss \"overall prognosis\" with elderly patients who have a life expectancy of less than 10 years or who are 85.\u003c/p>\n\u003cp>\u003c!--more-->If you're thinking that conversation sounds a bit, well, \u003cem>unpleasant\u003c/em>, research shows that a majority of elderly patients want to have the information. In one study, 55 percent of frail elderly patients whose doctor had never discussed their prognosis wanted to. In a second study, albeit a small one with 60 people including disabled African-American, Chinese-American, Latino and white patients, 65 percent said they would want to be told if they had less than five years to live.\u003c/p>\n\u003cp>The recommendations come from a team of doctors in the \u003ca title=\"http://geriatrics.medicine.ucsf.edu/\" href=\"http://geriatrics.medicine.ucsf.edu/\" target=\"_blank\">Division of Geriatrics at UC San Francisco\u003c/a> and the \u003ca title=\"http://www.sanfrancisco.va.gov/\" href=\"http://www.sanfrancisco.va.gov/\" target=\"_blank\">San Francisco VA Medical Center.\u003c/a> \"People want to know not just for medical reasons,\" said Dr. Alexander Smith of the San Francisco VA, one of the authors, \"but because they want to make life choices, put financial affairs in order, arrange for a durable power of attorney for health care and think about longterm care.\"\u003c/p>\n\u003cp>Smith is a palliative care physician, someone who is trained in talking with patients about challenging medical news. He acknowledged that it is a skill to have these conversations. But for many elderly patients, information about lifespan is not a surprise. \"In our experience, many older adults are aware that they are in life's final chapter, so such a conversation would not come as a shock to them. As physicians we have an obligation to give them honest information.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Of particular concern is the risk of many medical interventions, including screening tests. The writers cite a specific example of colonoscopy, an invasive procedure where the benefits may not be seen for years, benefits the patient may not live to see.\u003c/p>\n\u003cp>\"This is really about empowering patients,\" Smith said, \"giving patients information so they can make informed choices.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Still, doctors must tread carefully. While a majority of surveyed patients did want prognostic information, a sizable minority did not. Doctors should not force the discussion, the writers say.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_1099\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Hands_RyanWilcox_Flickr_12082011.jpg\">\u003cimg class=\"size-medium wp-image-1099\" title=\"(Ryan Wilcox: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Hands_RyanWilcox_Flickr_12082011-300x200.jpg\" alt=\"(Ryan Wilcox: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ryan Wilcox: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Not so long ago, it was common for doctors to keep sick patients, even terminally ill patients, in the dark about their prognosis. Today, many patients are actively involved in managing their illnesses, in partnership with their doctors. Indeed, one of the tabs on this blog is \"You're the Boss.\"\u003c/p>\n\u003cp>But a \"Perspective\" in today's\u003cem> \u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMp1109990?query=TOC\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1109990?query=TOC\" target=\"_blank\">New England Journal of Medicine\u003c/a>\u003c/em> says doctors have shied away from explicit conversations about prognosis with a group of patients they should engage--the very elderly. The writers recommend doctors discuss \"overall prognosis\" with elderly patients who have a life expectancy of less than 10 years or who are 85.\u003c/p>\n\u003cp>\u003c!--more-->If you're thinking that conversation sounds a bit, well, \u003cem>unpleasant\u003c/em>, research shows that a majority of elderly patients want to have the information. In one study, 55 percent of frail elderly patients whose doctor had never discussed their prognosis wanted to. In a second study, albeit a small one with 60 people including disabled African-American, Chinese-American, Latino and white patients, 65 percent said they would want to be told if they had less than five years to live.\u003c/p>\n\u003cp>The recommendations come from a team of doctors in the \u003ca title=\"http://geriatrics.medicine.ucsf.edu/\" href=\"http://geriatrics.medicine.ucsf.edu/\" target=\"_blank\">Division of Geriatrics at UC San Francisco\u003c/a> and the \u003ca title=\"http://www.sanfrancisco.va.gov/\" href=\"http://www.sanfrancisco.va.gov/\" target=\"_blank\">San Francisco VA Medical Center.\u003c/a> \"People want to know not just for medical reasons,\" said Dr. Alexander Smith of the San Francisco VA, one of the authors, \"but because they want to make life choices, put financial affairs in order, arrange for a durable power of attorney for health care and think about longterm care.\"\u003c/p>\n\u003cp>Smith is a palliative care physician, someone who is trained in talking with patients about challenging medical news. He acknowledged that it is a skill to have these conversations. But for many elderly patients, information about lifespan is not a surprise. \"In our experience, many older adults are aware that they are in life's final chapter, so such a conversation would not come as a shock to them. As physicians we have an obligation to give them honest information.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Of particular concern is the risk of many medical interventions, including screening tests. The writers cite a specific example of colonoscopy, an invasive procedure where the benefits may not be seen for years, benefits the patient may not live to see.\u003c/p>\n\u003cp>\"This is really about empowering patients,\" Smith said, \"giving patients information so they can make informed choices.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Still, doctors must tread carefully. While a majority of surveyed patients did want prognostic information, a sizable minority did not. Doctors should not force the discussion, the writers say.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "And The Environmental Causes of Breast Cancer Are...?",
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"content": "\u003cfigure id=\"attachment_1063\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Mammogram_KristieWells_Flickr_12072011.jpg\">\u003cimg class=\"size-medium wp-image-1063 \" title=\"Suspicious mass on mammogram. (KristieWells: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Mammogram_KristieWells_Flickr_12072011-300x225.jpg\" alt=\"Suspicious mass on mammogram. (KristieWells: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Suspicious mass on mammogram. (KristieWells: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Seventy percent of women who develop breast cancer have \u003ca title=\"http://www.dslrf.org/breastcancer/content.asp?L2=7&L3=2&SID=232\" href=\"http://www.dslrf.org/breastcancer/content.asp?L2=7&L3=2&SID=232\" target=\"_blank\">no known risk factors\u003c/a>. For years, advocates and activists have trumpeted the need for more research into possible environmental causes of the disease. Today, the prestigious \u003ca title=\"http://www.iom.edu/\" href=\"http://www.iom.edu/\" target=\"_blank\">Institute of Medicine\u003c/a> (IOM) released a much anticipated 360 page study, \u003ca title=\"http://www.iom.edu/Reports/2011/Breast-Cancer-and-the-Environment-A-Life-Course-Approach.aspx\" href=\"http://www.iom.edu/Reports/2011/Breast-Cancer-and-the-Environment-A-Life-Course-Approach.aspx\" target=\"_blank\">Breast Cancer and the Environment\u003c/a>. But it unfortunately was unable to give women or their doctors any new environmental clues.\u003c/p>\n\u003cp>As the \u003ca title=\"http://www.nytimes.com/2011/12/08/health/scientific-panel-finds-few-clear-environmental-links-to-breast-cancer.html?ref=health\" href=\"http://www.nytimes.com/2011/12/08/health/scientific-panel-finds-few-clear-environmental-links-to-breast-cancer.html?ref=health\" target=\"_blank\">New York Times reports\u003c/a>, most of what the IOM did recommend is already known and might not have much effect anyway.\u003c/p>\n\u003cblockquote>\u003cp>The most consistent data suggest that women can reduce their risk by avoiding unnecessary medical radiation, forgoing hormone treatments for menopause that combine estrogen and progestin, limiting alcohol intake and minimizing weight gain, the report found. (Controlling weight appears helpful only in preventing postmenopausal breast cancers, not those in younger women.) Overuse of CT scans, which deliver a relatively high dose of radiation, was a particular concern, but the report stated that women should not be deterred from having routine mammograms, which use a much smaller dose. ...\u003c/p>\n\u003cp>\u003c!--more-->For women who were hoping for definitive safety information about the huge number of chemicals to which people are exposed — from air pollution and cosmetics to cleaning products, food and drinking water — the report may come as a disappointment. It is based largely on a review of existing research, and its limited advice reflects the lack of solid scientific information in many areas of concern to the public.\u003c/p>\u003c/blockquote>\n\u003cp>One of those who was disappointed was Karuna Jaggar, Executive Director of \u003ca href=\"http://bcaction.org/\" target=\"_blank\">Breast Cancer Action\u003c/a>. \"I'm frankly shocked. I expected something different,\" she says. \"In a way the report highlights the need for a report about breast cancer and the environment.\"\u003c/p>\n\u003cp>Jaggar said she appreciated how difficult it is to prove a link between a specific chemical and breast cancer. Studies of a possible carcinogen cannot be done on humans for ethical reasons, for example.\u003c/p>\n\u003cp>\"The question is what do we do in the meantime?\" she said. \"Do we wait decades for measurement tools to measure lifetime exposures to many of these chemicals?\" She argued for more caution in allowing suspected chemicals or products to be on the market.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The study was requested and sponsored entirely by the breast cancer advocacy group \u003ca title=\"http://ww5.komen.org/\" href=\"http://ww5.komen.org/\" target=\"_blank\">Susan G. Komen for the Cure\u003c/a>.\u003c/p>\n\n",
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"excerpt": "Seventy percent of women who develop breast cancer have no known risk factors. For years, advocates and activists have trumpeted the need for more research into possible environmental causes of the disease. Today, the prestigious Institute of Medicine released a much anticipated 360 page study, Breast Cancer and the Environment. But it unfortunately was unable to give women or their doctors any new environmental clues.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_1063\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Mammogram_KristieWells_Flickr_12072011.jpg\">\u003cimg class=\"size-medium wp-image-1063 \" title=\"Suspicious mass on mammogram. (KristieWells: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Mammogram_KristieWells_Flickr_12072011-300x225.jpg\" alt=\"Suspicious mass on mammogram. (KristieWells: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Suspicious mass on mammogram. (KristieWells: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Seventy percent of women who develop breast cancer have \u003ca title=\"http://www.dslrf.org/breastcancer/content.asp?L2=7&L3=2&SID=232\" href=\"http://www.dslrf.org/breastcancer/content.asp?L2=7&L3=2&SID=232\" target=\"_blank\">no known risk factors\u003c/a>. For years, advocates and activists have trumpeted the need for more research into possible environmental causes of the disease. Today, the prestigious \u003ca title=\"http://www.iom.edu/\" href=\"http://www.iom.edu/\" target=\"_blank\">Institute of Medicine\u003c/a> (IOM) released a much anticipated 360 page study, \u003ca title=\"http://www.iom.edu/Reports/2011/Breast-Cancer-and-the-Environment-A-Life-Course-Approach.aspx\" href=\"http://www.iom.edu/Reports/2011/Breast-Cancer-and-the-Environment-A-Life-Course-Approach.aspx\" target=\"_blank\">Breast Cancer and the Environment\u003c/a>. But it unfortunately was unable to give women or their doctors any new environmental clues.\u003c/p>\n\u003cp>As the \u003ca title=\"http://www.nytimes.com/2011/12/08/health/scientific-panel-finds-few-clear-environmental-links-to-breast-cancer.html?ref=health\" href=\"http://www.nytimes.com/2011/12/08/health/scientific-panel-finds-few-clear-environmental-links-to-breast-cancer.html?ref=health\" target=\"_blank\">New York Times reports\u003c/a>, most of what the IOM did recommend is already known and might not have much effect anyway.\u003c/p>\n\u003cblockquote>\u003cp>The most consistent data suggest that women can reduce their risk by avoiding unnecessary medical radiation, forgoing hormone treatments for menopause that combine estrogen and progestin, limiting alcohol intake and minimizing weight gain, the report found. (Controlling weight appears helpful only in preventing postmenopausal breast cancers, not those in younger women.) Overuse of CT scans, which deliver a relatively high dose of radiation, was a particular concern, but the report stated that women should not be deterred from having routine mammograms, which use a much smaller dose. ...\u003c/p>\n\u003cp>\u003c!--more-->For women who were hoping for definitive safety information about the huge number of chemicals to which people are exposed — from air pollution and cosmetics to cleaning products, food and drinking water — the report may come as a disappointment. It is based largely on a review of existing research, and its limited advice reflects the lack of solid scientific information in many areas of concern to the public.\u003c/p>\u003c/blockquote>\n\u003cp>One of those who was disappointed was Karuna Jaggar, Executive Director of \u003ca href=\"http://bcaction.org/\" target=\"_blank\">Breast Cancer Action\u003c/a>. \"I'm frankly shocked. I expected something different,\" she says. \"In a way the report highlights the need for a report about breast cancer and the environment.\"\u003c/p>\n\u003cp>Jaggar said she appreciated how difficult it is to prove a link between a specific chemical and breast cancer. Studies of a possible carcinogen cannot be done on humans for ethical reasons, for example.\u003c/p>\n\u003cp>\"The question is what do we do in the meantime?\" she said. \"Do we wait decades for measurement tools to measure lifetime exposures to many of these chemicals?\" She argued for more caution in allowing suspected chemicals or products to be on the market.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The study was requested and sponsored entirely by the breast cancer advocacy group \u003ca title=\"http://ww5.komen.org/\" href=\"http://ww5.komen.org/\" target=\"_blank\">Susan G. Komen for the Cure\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Could Richmond Be First California City to Tax Soda?",
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"content": "\u003cfigure id=\"attachment_1002\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/SodaOnShelves_Flickr_KarenBlumberg_12072011.jpg\">\u003cimg class=\"size-medium wp-image-1002 \" title=\"Price going up? (Karen Blumberg: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/SodaOnShelves_Flickr_KarenBlumberg_12072011-300x219.jpg\" alt=\"Price going up? (Karen Blumberg: Flickr)\" width=\"300\" height=\"219\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Price going up? (Karen Blumberg: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Last night the Richmond City Council voted to let the people decide. The Council instructed staff to prepare a ballot measure for next November to tax sugar-sweetened beverages, what most people call a \"soda tax.\"\u003c/p>\n\u003cp>Richmond voters may have the chance to make their city the first in California, and one of the first in the country, to slap a special tax not just on sodas, but also sports drinks, energy drinks, fruit-flavored drinks and the like. 100 percent fruit juice and diet drinks would not be affected.\u003c/p>\n\u003cp>The goals are twofold. If the drinks cost more, people will drink fewer of them. Plus, taxes generate revenue, which the City Council says it would devote to new sports fields and other health programs. The motivation for the tax is childhood obesity. Wendel Brunner, Public Health Director of the Contra Costa Health Department walked people through the makings of what has become an epidemic.\u003c/p>\n\u003cul>\n\u003cli>32 percent of school children in Richmond are obese\u003c/li>\n\u003cli>24 percent of adults in Richmond are obese\u003c/li>\n\u003cli>11 percent of all deaths in Richmond are linked to obesity--obesity is shortening people's lives by years\u003c/li>\n\u003c/ul>\n\u003cdiv>And, if childhood obesity goes unchecked in Richmond, \u003ca title=\"http://cchealth.org/topics/nutrition/pdf/ssb_report_richmond.pdf\" href=\"http://cchealth.org/topics/nutrition/pdf/ssb_report_richmond.pdf\" target=\"_blank\">Contra Costa Health researchers found\u003c/a>, the percentage of obese adults will almost double from the current 24 percent to 42 percent. \n\u003caside class=\"pullquote alignright\">\"The thing about sugar-sweetened beverages is that the calories are insidious.\" \u003c/aside>\n\u003cp> So, what's the connection to sugar-sweetened beverages? It comes from Brunner's most jaw-dropping number: the average Richmond teenager who drinks sugary beverages every day consumes a whopping 150,000 calories a year--just from these sweetened drinks. That adds up to 20-30 pounds of additional weight over the year. As Brunner reported, it's those sweet drinks that are driving the obesity epidemic. \"The thing about sugar-sweetened beverages is that the calories are insidious,\" he says, \"so you consume a Big Gulp, you don't realize that you've drunk about 350 calories.\" \u003c!--more-->\u003c/p>\n\u003cp>Harold Goldstein of the \u003ca title=\"http://www.publichealthadvocacy.org/\" href=\"http://www.publichealthadvocacy.org/\" target=\"_blank\">California Center for Public Health Advocacy\u003c/a> agrees. \"As mammals for the last 250 million years,\" Goldstein said, \"we've consumed mother's milk and water. It turns out if you just drink sugar and water, our body doesn't notice it. ... Every time you drink soda, it's like having a little piece of chocolate cake, except if you ate the cake you'd be full, but if you drink the soda you won't be.\" And so you continue to eat. And then gain more weight. \u003c/p>\n\u003cp>Goldstein \u003ca title=\"http://cwh.berkeley.edu/sites/default/files/primary_pdfs/Sweetened_Bevs_Obesity_Epidemic_PHN_2010_0.pdf\" href=\"http://cwh.berkeley.edu/sites/default/files/primary_pdfs/Sweetened_Bevs_Obesity_Epidemic_PHN_2010_0.pdf\" target=\"_blank\">cites a study\u003c/a> from UC Berkeley Center for Weight and Health which looked at average daily caloric consumption from 1977-2001 and found the average American was eating 278 more calories each day and almost half of those calories were from sweetened drinks. \"The results were mind-blowing,\" he said, but added, \"I realize in my adult lifetime, the beverage industry has changed dramatically. It used to be one little glass with ice. If you wanted more, you had to pay more. Every restaurant now provides free refills. What comes out of the vending machine has gone from 12 ounces to 20 ounces.\"\u003c/p>\n\u003cp>Which brings us back to Richmond and the soda tax coming on next year's ballot. People who spoke up at the meeting were divided. Richmond is a multi-ethnic city that suffers from a high crime rate. Many of the people live at or below the federal poverty level. Some people thought the tax would provide much needed funds for children's health programs; others argued the tax was regressive.\u003c/p>\n\u003cp>City Council member Jeff Ritterman was one of the sponsors of the tax proposal. He said this kind of bold move was needed. \"It's sensible to send this to the voters and if voters vote it down, at least we will be able to talk about childhood obesity for many, many months until the election. We'll do something bold right now. Cautious isn't going to get us anywhere. Cautious is going to get us a 42 percent obesity rate.\"\u003c/p>\n\u003cp>The amount of the tax is under consideration but a penny per ounce is being discussed. Final ballot language will be considered in early 2012.\u003c/p>\n\u003cdiv>\u003cstrong>UPDATE: \u003c/strong>\u003cem>This story was corrected to reflect that the Richmond City Council voted to instruct staff to draft ballot language for a soda tax-- as opposed to voting to put the tax on the ballot. The staff will have the language ready for Council consideration and action in the coming months. State of Health will keep you updated.\u003c/em>\u003c/div>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "Last night the Richmond City Council voted to let the people decide. The Council instructed staff to prepare a ballot measure for next November to tax sugar-sweetened beverages, what most people call a \"soda tax.\"\r\n\r\nRichmond voters may have the chance to make their city the first in California, and one of the first in the country, to slap a special tax not just on sodas, but also sports drinks, energy drinks, fruit-flavored drinks and the like",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_1002\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/SodaOnShelves_Flickr_KarenBlumberg_12072011.jpg\">\u003cimg class=\"size-medium wp-image-1002 \" title=\"Price going up? (Karen Blumberg: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/SodaOnShelves_Flickr_KarenBlumberg_12072011-300x219.jpg\" alt=\"Price going up? (Karen Blumberg: Flickr)\" width=\"300\" height=\"219\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Price going up? (Karen Blumberg: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Last night the Richmond City Council voted to let the people decide. The Council instructed staff to prepare a ballot measure for next November to tax sugar-sweetened beverages, what most people call a \"soda tax.\"\u003c/p>\n\u003cp>Richmond voters may have the chance to make their city the first in California, and one of the first in the country, to slap a special tax not just on sodas, but also sports drinks, energy drinks, fruit-flavored drinks and the like. 100 percent fruit juice and diet drinks would not be affected.\u003c/p>\n\u003cp>The goals are twofold. If the drinks cost more, people will drink fewer of them. Plus, taxes generate revenue, which the City Council says it would devote to new sports fields and other health programs. The motivation for the tax is childhood obesity. Wendel Brunner, Public Health Director of the Contra Costa Health Department walked people through the makings of what has become an epidemic.\u003c/p>\n\u003cul>\n\u003cli>32 percent of school children in Richmond are obese\u003c/li>\n\u003cli>24 percent of adults in Richmond are obese\u003c/li>\n\u003cli>11 percent of all deaths in Richmond are linked to obesity--obesity is shortening people's lives by years\u003c/li>\n\u003c/ul>\n\u003cdiv>And, if childhood obesity goes unchecked in Richmond, \u003ca title=\"http://cchealth.org/topics/nutrition/pdf/ssb_report_richmond.pdf\" href=\"http://cchealth.org/topics/nutrition/pdf/ssb_report_richmond.pdf\" target=\"_blank\">Contra Costa Health researchers found\u003c/a>, the percentage of obese adults will almost double from the current 24 percent to 42 percent. \n\u003caside class=\"pullquote alignright\">\"The thing about sugar-sweetened beverages is that the calories are insidious.\" \u003c/aside>\n\u003cp> So, what's the connection to sugar-sweetened beverages? It comes from Brunner's most jaw-dropping number: the average Richmond teenager who drinks sugary beverages every day consumes a whopping 150,000 calories a year--just from these sweetened drinks. That adds up to 20-30 pounds of additional weight over the year. As Brunner reported, it's those sweet drinks that are driving the obesity epidemic. \"The thing about sugar-sweetened beverages is that the calories are insidious,\" he says, \"so you consume a Big Gulp, you don't realize that you've drunk about 350 calories.\" \u003c!--more-->\u003c/p>\n\u003cp>Harold Goldstein of the \u003ca title=\"http://www.publichealthadvocacy.org/\" href=\"http://www.publichealthadvocacy.org/\" target=\"_blank\">California Center for Public Health Advocacy\u003c/a> agrees. \"As mammals for the last 250 million years,\" Goldstein said, \"we've consumed mother's milk and water. It turns out if you just drink sugar and water, our body doesn't notice it. ... Every time you drink soda, it's like having a little piece of chocolate cake, except if you ate the cake you'd be full, but if you drink the soda you won't be.\" And so you continue to eat. And then gain more weight. \u003c/p>\n\u003cp>Goldstein \u003ca title=\"http://cwh.berkeley.edu/sites/default/files/primary_pdfs/Sweetened_Bevs_Obesity_Epidemic_PHN_2010_0.pdf\" href=\"http://cwh.berkeley.edu/sites/default/files/primary_pdfs/Sweetened_Bevs_Obesity_Epidemic_PHN_2010_0.pdf\" target=\"_blank\">cites a study\u003c/a> from UC Berkeley Center for Weight and Health which looked at average daily caloric consumption from 1977-2001 and found the average American was eating 278 more calories each day and almost half of those calories were from sweetened drinks. \"The results were mind-blowing,\" he said, but added, \"I realize in my adult lifetime, the beverage industry has changed dramatically. It used to be one little glass with ice. If you wanted more, you had to pay more. Every restaurant now provides free refills. What comes out of the vending machine has gone from 12 ounces to 20 ounces.\"\u003c/p>\n\u003cp>Which brings us back to Richmond and the soda tax coming on next year's ballot. People who spoke up at the meeting were divided. Richmond is a multi-ethnic city that suffers from a high crime rate. Many of the people live at or below the federal poverty level. Some people thought the tax would provide much needed funds for children's health programs; others argued the tax was regressive.\u003c/p>\n\u003cp>City Council member Jeff Ritterman was one of the sponsors of the tax proposal. He said this kind of bold move was needed. \"It's sensible to send this to the voters and if voters vote it down, at least we will be able to talk about childhood obesity for many, many months until the election. We'll do something bold right now. Cautious isn't going to get us anywhere. Cautious is going to get us a 42 percent obesity rate.\"\u003c/p>\n\u003cp>The amount of the tax is under consideration but a penny per ounce is being discussed. Final ballot language will be considered in early 2012.\u003c/p>\n\u003cdiv>\u003cstrong>UPDATE: \u003c/strong>\u003cem>This story was corrected to reflect that the Richmond City Council voted to instruct staff to draft ballot language for a soda tax-- as opposed to voting to put the tax on the ballot. The staff will have the language ready for Council consideration and action in the coming months. State of Health will keep you updated.\u003c/em>\u003c/div>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Doing Things Right: Why Three Hospitals Didn't Hurt My Wife",
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"content": "\u003cdiv>\n\u003cfigure id=\"attachment_972\" class=\"wp-caption alignleft\" style=\"max-width: 176px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Millenson_and_Susan.jpg\">\u003cimg class=\"size-full wp-image-972 \" title=\"Michael Millenson and his wife, Susan. (Photo: Michael Millenson)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Millenson_and_Susan.jpg\" alt=\"Michael Millenson and his wife, Susan. (Photo: Michael Millenson)\" width=\"176\" height=\"250\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Michael Millenson and his wife, Susan. (Photo: Michael Millenson)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By: Michael Millenson\u003c/strong>\u003c/p>\n\u003cp>My wife was lying in the back of an ambulance, dazed and bloody, while I sat in the front, distraught and distracted. We had been bicycling in a quiet neighborhood in southern Maine when she hit the handbrakes too hard and catapulted over the handlebars, turning our first day of vacation into a race to the nearest hospital.\u003c/p>\n\u003cp>The anxiety when a loved one is injured is compounded when you know just how risky making things better can get. As a long-time advocate for patient safety, my interest in the topic has always been passionate, but never personal. Now, as Susan was being rushed into the emergency room, I wanted to keep it that way. \"Wife of patient safety expert is victim\" was a headline I deeply hoped to avoid.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Wife of patient safety expert is victim\" was a headline I deeply hoped to avoid. \u003c/aside>\n\u003cp>In the weeks after the accident, we spent time at a 50-bed hospital in Maine; a Boston teaching hospital where Susan was transferred with a small vertebra fracture at the base of her neck and broken bones in her left elbow and hand; and a large community hospital near our suburban Chicago home. There were plenty of opportunities for bad things to happen -- but nothing did. As far as I could tell, we didn't even experience any near misses.\u003c/p>\n\u003cp>\u003c!--more-->What went right? After all, though our health care system knows how to prevent errors that kill 44,000 to 98,000 people in hospitals each year, that death toll \u003ca href=\"http://www.nytimes.com/2010/11/25/health/research/25patient.html\">has remained stubbornly constant\u003c/a>. Based on personal and professional observations, I'd simplify the formula that kept Susan safe into three variables: consciousness, culture and cash.\u003c/p>\n\u003cp>Consciousness of patient safety sounds easy, but it isn't. The harm caused patients is inadvertent and often occurs as part of complex interventions. As a result, \u003ca href=\"http://jama.ama-assn.org/content/301/12/1273.short\" target=\"_blank\">a 2009 JAMA commentary\u003c/a> pointedly noted, \"clinicians have labeled virtually all harm as inevitable for decades.\"\u003c/p>\n\u003cp>But today, the cloak of invisibility is being lifted. Twenty-six states require hospitals to report certain medical errors; Medicare and some private insurers won't pay for problems caused by a growing list of quality and safety lapses, and the government has launched the $1 billion Partnership for Patients to dramatically reduce avoidable harm.\u003c/p>\n\u003cp>Just as importantly, patients are worried. In a poll by Consumers Union, 77 percent of respondents expressed high or moderate concern that they might be harmed by a hospital infection and 71 percent had the same concern about medication errors. Inevitably, more patients and their families are speaking up -- as I most certainly did, albeit as politely as possible.\u003c/p>\n\u003cp>When the ER nurse at Maine's York Hospital gave Susan morphine, I asked about the dosage and timing. When she was transferred to Massachusetts General Hospital in Boston, I asked each medical professional to identify themselves and what they were doing. Although it's impossible to know if my questions had any positive impact, at a minimum they reinforced an existing safety consciousness.\u003c/p>\n\u003cp>Although consciousness of a problem can spur change, sustaining it requires a supportive culture. Can there be any more graphic expression of a safety culture commitment than Baylor Health Care System's mission to eliminate preventable deaths, preventable injuries and preventable risk? Or Ascension Health's \"healing without harm\" initiative and its goal of reducing preventable deaths by 900 each year? (They've reached a minimum of 1,500 so far.) Both organizations have published results in the peer-reviewed literature.\u003c/p>\n\u003cp>Glenbrook Hospital in suburban Chicago -- it's part of the NorthShore University HealthSystem -- isn't quite as ambitious in its objectives. Still, its culture was obvious even before I peeked at the monthly infection report left sitting on a reception desk. When the orthopedic surgeon was explaining the procedure he would be doing, he talked about safety. The consulting neurosurgeon (due to Susan's neck injury) talked about safety. The anesthesiologist talked about safety. Right before surgery, nurses fitted Susan with surgical stockings to prevent deep vein thrombosis -- an evidence-based guideline followed by fewer than half of hospitals. When I challenged the surgical team on appropriate prophylactic antibiotic use, a nurse indignantly cited a study showing I was mistaken.\u003c/p>\n\u003cp>I backed off, happy they'd thought about the issue seriously. But I did feel emboldened to ask whether the team in the operating room took time-outs before surgery (the evidence shows it helps make sure everyone's on the same page before you start cutting) and whether the team introduced themselves before proceeding (believe it or not, even the doctors may not be entirely certain who is behind those masks). Yes and yes, the answers came back.\u003c/p>\n\u003cp>Culture change at hospitals is easier these days with \u003ca href=\"http://www.implementationscience.com/content/4/1/25/\">role models\u003c/a> like Ascension and Baylor, and with safety checklists like the one developed by Johns Hopkins' critical care specialist \u003ca href=\"http://www.hopkinsmedicine.org/quality/safety/pronovost/index.html\" target=\"_blank\">Peter Pronovost\u003c/a>. But if consciousness is one barrier to culture change, another one of at least equal importance is cash.\u003c/p>\n\u003cp>There's a link between financial stress and patient distress. A recent study in \u003ca href=\"http://content.healthaffairs.org/content/30/10/1904.abstract\" target=\"_blank\">Health Affairs\u003c/a> found the 178 \"worst\" hospitals in the United States care for more than twice the proportion of elderly minority and poor patients as the nation's 122 \"best\" hospitals, where costs are lowest and quality highest. As one headline put it, \"Bad Hospitals, Poor Patients.\"\u003c/p>\n\u003cp>Money talks in other ways. I've written about how some hospitals implicitly see adverse events \u003ca href=\"http://healthaffairs.org/blog/2010/12/06/why-we-still-kill-patients-invisibility-inertia-and-income/\">as a way to keep beds filled\u003c/a> (although, of course, actual patient deaths thwart that goal). The hospitals where my wife was treated were all prosperous. Even without worrying about a reluctance to confront complications, would a cash-strapped York have transferred Susan to a tertiary care facility, or would they have assured a well-insured patient they could take care of her broken neck? Would a bottom line-driven Mass General or Glenbrook have angled for a longer hospital stay?\u003c/p>\n\u003cp>It's tough enough to change culture. It's even tougher if it you think you’ll lose money doing so. That's why Medicare is increasingly linking payment to explicit quality and safety indicators.\u003c/p>\n\u003cp>We ask a great deal of physicians, nurses and other professionals. Those whom we encountered juggled multiple roles -- healers attending to the ill and scared, prudent managers of health-care resources and team players in system improvement. For the skill and grace with which they performed all those roles we were deeply grateful. Thanks to them, Susan has now recovered to the point that to the casual observer there's no obvious evidence of her multiple injuries.\u003c/p>\n\u003cp>Our experience showed that \"doing the right thing\" -- appropriate care -- and \"doing the right thing right\" -- safe and effective care -- can become the norm at rural, suburban and big urban teaching hospitals alike. On a personal level for the two of us, and on a system level for all of us, that's very good news.\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>. This article first appeared in \u003ca title=\"http://www.kaiserhealthnews.org/Stories/2011/December/05/millenson-first-person-patient-safety.aspx\" href=\"http://www.kaiserhealthnews.org/Stories/2011/December/05/millenson-first-person-patient-safety.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cdiv>\n\u003cfigure id=\"attachment_972\" class=\"wp-caption alignleft\" style=\"max-width: 176px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Millenson_and_Susan.jpg\">\u003cimg class=\"size-full wp-image-972 \" title=\"Michael Millenson and his wife, Susan. (Photo: Michael Millenson)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Millenson_and_Susan.jpg\" alt=\"Michael Millenson and his wife, Susan. (Photo: Michael Millenson)\" width=\"176\" height=\"250\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Michael Millenson and his wife, Susan. (Photo: Michael Millenson)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By: Michael Millenson\u003c/strong>\u003c/p>\n\u003cp>My wife was lying in the back of an ambulance, dazed and bloody, while I sat in the front, distraught and distracted. We had been bicycling in a quiet neighborhood in southern Maine when she hit the handbrakes too hard and catapulted over the handlebars, turning our first day of vacation into a race to the nearest hospital.\u003c/p>\n\u003cp>The anxiety when a loved one is injured is compounded when you know just how risky making things better can get. As a long-time advocate for patient safety, my interest in the topic has always been passionate, but never personal. Now, as Susan was being rushed into the emergency room, I wanted to keep it that way. \"Wife of patient safety expert is victim\" was a headline I deeply hoped to avoid.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Wife of patient safety expert is victim\" was a headline I deeply hoped to avoid. \u003c/aside>\n\u003cp>In the weeks after the accident, we spent time at a 50-bed hospital in Maine; a Boston teaching hospital where Susan was transferred with a small vertebra fracture at the base of her neck and broken bones in her left elbow and hand; and a large community hospital near our suburban Chicago home. There were plenty of opportunities for bad things to happen -- but nothing did. As far as I could tell, we didn't even experience any near misses.\u003c/p>\n\u003cp>\u003c!--more-->What went right? After all, though our health care system knows how to prevent errors that kill 44,000 to 98,000 people in hospitals each year, that death toll \u003ca href=\"http://www.nytimes.com/2010/11/25/health/research/25patient.html\">has remained stubbornly constant\u003c/a>. Based on personal and professional observations, I'd simplify the formula that kept Susan safe into three variables: consciousness, culture and cash.\u003c/p>\n\u003cp>Consciousness of patient safety sounds easy, but it isn't. The harm caused patients is inadvertent and often occurs as part of complex interventions. As a result, \u003ca href=\"http://jama.ama-assn.org/content/301/12/1273.short\" target=\"_blank\">a 2009 JAMA commentary\u003c/a> pointedly noted, \"clinicians have labeled virtually all harm as inevitable for decades.\"\u003c/p>\n\u003cp>But today, the cloak of invisibility is being lifted. Twenty-six states require hospitals to report certain medical errors; Medicare and some private insurers won't pay for problems caused by a growing list of quality and safety lapses, and the government has launched the $1 billion Partnership for Patients to dramatically reduce avoidable harm.\u003c/p>\n\u003cp>Just as importantly, patients are worried. In a poll by Consumers Union, 77 percent of respondents expressed high or moderate concern that they might be harmed by a hospital infection and 71 percent had the same concern about medication errors. Inevitably, more patients and their families are speaking up -- as I most certainly did, albeit as politely as possible.\u003c/p>\n\u003cp>When the ER nurse at Maine's York Hospital gave Susan morphine, I asked about the dosage and timing. When she was transferred to Massachusetts General Hospital in Boston, I asked each medical professional to identify themselves and what they were doing. Although it's impossible to know if my questions had any positive impact, at a minimum they reinforced an existing safety consciousness.\u003c/p>\n\u003cp>Although consciousness of a problem can spur change, sustaining it requires a supportive culture. Can there be any more graphic expression of a safety culture commitment than Baylor Health Care System's mission to eliminate preventable deaths, preventable injuries and preventable risk? Or Ascension Health's \"healing without harm\" initiative and its goal of reducing preventable deaths by 900 each year? (They've reached a minimum of 1,500 so far.) Both organizations have published results in the peer-reviewed literature.\u003c/p>\n\u003cp>Glenbrook Hospital in suburban Chicago -- it's part of the NorthShore University HealthSystem -- isn't quite as ambitious in its objectives. Still, its culture was obvious even before I peeked at the monthly infection report left sitting on a reception desk. When the orthopedic surgeon was explaining the procedure he would be doing, he talked about safety. The consulting neurosurgeon (due to Susan's neck injury) talked about safety. The anesthesiologist talked about safety. Right before surgery, nurses fitted Susan with surgical stockings to prevent deep vein thrombosis -- an evidence-based guideline followed by fewer than half of hospitals. When I challenged the surgical team on appropriate prophylactic antibiotic use, a nurse indignantly cited a study showing I was mistaken.\u003c/p>\n\u003cp>I backed off, happy they'd thought about the issue seriously. But I did feel emboldened to ask whether the team in the operating room took time-outs before surgery (the evidence shows it helps make sure everyone's on the same page before you start cutting) and whether the team introduced themselves before proceeding (believe it or not, even the doctors may not be entirely certain who is behind those masks). Yes and yes, the answers came back.\u003c/p>\n\u003cp>Culture change at hospitals is easier these days with \u003ca href=\"http://www.implementationscience.com/content/4/1/25/\">role models\u003c/a> like Ascension and Baylor, and with safety checklists like the one developed by Johns Hopkins' critical care specialist \u003ca href=\"http://www.hopkinsmedicine.org/quality/safety/pronovost/index.html\" target=\"_blank\">Peter Pronovost\u003c/a>. But if consciousness is one barrier to culture change, another one of at least equal importance is cash.\u003c/p>\n\u003cp>There's a link between financial stress and patient distress. A recent study in \u003ca href=\"http://content.healthaffairs.org/content/30/10/1904.abstract\" target=\"_blank\">Health Affairs\u003c/a> found the 178 \"worst\" hospitals in the United States care for more than twice the proportion of elderly minority and poor patients as the nation's 122 \"best\" hospitals, where costs are lowest and quality highest. As one headline put it, \"Bad Hospitals, Poor Patients.\"\u003c/p>\n\u003cp>Money talks in other ways. I've written about how some hospitals implicitly see adverse events \u003ca href=\"http://healthaffairs.org/blog/2010/12/06/why-we-still-kill-patients-invisibility-inertia-and-income/\">as a way to keep beds filled\u003c/a> (although, of course, actual patient deaths thwart that goal). The hospitals where my wife was treated were all prosperous. Even without worrying about a reluctance to confront complications, would a cash-strapped York have transferred Susan to a tertiary care facility, or would they have assured a well-insured patient they could take care of her broken neck? Would a bottom line-driven Mass General or Glenbrook have angled for a longer hospital stay?\u003c/p>\n\u003cp>It's tough enough to change culture. It's even tougher if it you think you’ll lose money doing so. That's why Medicare is increasingly linking payment to explicit quality and safety indicators.\u003c/p>\n\u003cp>We ask a great deal of physicians, nurses and other professionals. Those whom we encountered juggled multiple roles -- healers attending to the ill and scared, prudent managers of health-care resources and team players in system improvement. For the skill and grace with which they performed all those roles we were deeply grateful. Thanks to them, Susan has now recovered to the point that to the casual observer there's no obvious evidence of her multiple injuries.\u003c/p>\n\u003cp>Our experience showed that \"doing the right thing\" -- appropriate care -- and \"doing the right thing right\" -- safe and effective care -- can become the norm at rural, suburban and big urban teaching hospitals alike. On a personal level for the two of us, and on a system level for all of us, that's very good news.\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>. This article first appeared in \u003ca title=\"http://www.kaiserhealthnews.org/Stories/2011/December/05/millenson-first-person-patient-safety.aspx\" href=\"http://www.kaiserhealthnews.org/Stories/2011/December/05/millenson-first-person-patient-safety.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cfigure id=\"attachment_932\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/CareNowHealthClinicUninsuredLosAngeles102111.jpg\">\u003cimg class=\"size-medium wp-image-932\" title=\"The number of young registered nurses entering the workforce more than doubled in the past decade. (photo: Krissy Clark/KQED)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/CareNowHealthClinicUninsuredLosAngeles102111-300x225.jpg\" alt=\"The number of young registered nurses entering the workforce more than doubled in the past decade. (photo: Krissy Clark/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The number of young registered nurses entering the workforce more than doubled in the past decade. (photo: Krissy Clark/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>From the 1980s to the 2000s, the number of young people going into nursing schools plummeted -- both nationally and in California. To reverse the trend, the government launched recruitment efforts to to spur more people to go into nursing.\u003c/p>\n\u003cp>It looks like they did a pretty good job. The number of registered nurses nationwide skyrocketed in the past decade, according to a study released in today's Health Affairs. Recent grads aged 23-26 increased by 62 percent. There hasn't been a spike in nursing grads like this in the U.S. since the 1970s.\u003c/p>\n\u003caside class=\"pullquote alignright\">There hasn't been a spike in nursing graduates like this in the U.S. since the 1970s.\u003c/aside>\n\u003cp>And it's no different in California. Nursing school enrollments have doubled in the past decade, says Joanne Spetz, a nursing professor at UCSF and co-author of \u003ca title=\"California Nursing Forecast\" href=\"http://www.rn.ca.gov/pdfs/forms/forecasts2011.pdf\" target=\"_blank\">a UCSF report\u003c/a> looking at California's nursing forecast. The report shows that in the past five years, the number of California nursing graduates has doubled. Spetz says that's because California also made huge efforts to recruit nursing students, like implementing accelerated degree programs.\u003c/p>\n\u003cp>\u003c!--more-->As the \u003ca title=\"Sac Bee Nursing Graduates\" href=\"http://www.sacbee.com/2011/12/04/4097980/new-california-nursing-graduates.html\" target=\"_blank\">Sacramento Bee\u003c/a> reported yesterday:\u003c/p>\n\u003cblockquote>\u003cp>California has spent at least $95 million in federal, state and private funds in the past decade to double the number of nursing graduates by expanding college programs and grants. As recently as three years ago, hospitals were offering moving expenses, housing allowances and signing bonuses to recent graduates of nursing schools.\u003c/p>\u003c/blockquote>\n\u003cp>Spetz says with the recession lingering, older nurses aren't retiring and hospitals aren't hiring. And that means it's harder for nurses across the country, including California, to find jobs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Now, there may actually be a surplus of nurses in California. But it depends on where you live.\u003c/p>\n\u003cp>\"In the Inland Empire and in some of the more rural areas, there is definitely a sense that there is shortage of nurses still,\" Spetz said. \"But in other parts of the state like the Bay Area and Sacramento I think that people are looking for work and can't find because there's so many nurses in those regions already.\"\u003c/p>\n\u003cp>So should prospective nursing students find a new career path? Absolutely not, said Spetz. In the coming years, more recent graduates will be more likely to find jobs in California.\u003c/p>\n\u003cp>\"The Baby Boomer will retire [from nursing] at the same time that they will need more health care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Spetz says it's important to keep recent nursing grads engaged -- through internships and other programs -- so that when Baby Boomers do retire and there are more jobs available those nurses can step right into them. But in the meantime, recent grads may have a hard time finding a job.\u003c/p>\n\n",
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"excerpt": "From the 1980s to the 2000s, the number of young people going into nursing schools plummeted -- both nationally and in California. To reverse the trend, the government launched recruitment efforts to get more people into nursing schools.\r\n\r\nIt looks like they did a pretty good job. The number of registered nurses nationwide skyrocketed in the past decade, according to a study released in today's Health Affairs. Recent grads aged 23-26 increased by 62 percent. There hasn't been a spike in nursing grads like this in the U.S. since the 1970s.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_932\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/CareNowHealthClinicUninsuredLosAngeles102111.jpg\">\u003cimg class=\"size-medium wp-image-932\" title=\"The number of young registered nurses entering the workforce more than doubled in the past decade. (photo: Krissy Clark/KQED)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/CareNowHealthClinicUninsuredLosAngeles102111-300x225.jpg\" alt=\"The number of young registered nurses entering the workforce more than doubled in the past decade. (photo: Krissy Clark/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The number of young registered nurses entering the workforce more than doubled in the past decade. (photo: Krissy Clark/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>From the 1980s to the 2000s, the number of young people going into nursing schools plummeted -- both nationally and in California. To reverse the trend, the government launched recruitment efforts to to spur more people to go into nursing.\u003c/p>\n\u003cp>It looks like they did a pretty good job. The number of registered nurses nationwide skyrocketed in the past decade, according to a study released in today's Health Affairs. Recent grads aged 23-26 increased by 62 percent. There hasn't been a spike in nursing grads like this in the U.S. since the 1970s.\u003c/p>\n\u003caside class=\"pullquote alignright\">There hasn't been a spike in nursing graduates like this in the U.S. since the 1970s.\u003c/aside>\n\u003cp>And it's no different in California. Nursing school enrollments have doubled in the past decade, says Joanne Spetz, a nursing professor at UCSF and co-author of \u003ca title=\"California Nursing Forecast\" href=\"http://www.rn.ca.gov/pdfs/forms/forecasts2011.pdf\" target=\"_blank\">a UCSF report\u003c/a> looking at California's nursing forecast. The report shows that in the past five years, the number of California nursing graduates has doubled. Spetz says that's because California also made huge efforts to recruit nursing students, like implementing accelerated degree programs.\u003c/p>\n\u003cp>\u003c!--more-->As the \u003ca title=\"Sac Bee Nursing Graduates\" href=\"http://www.sacbee.com/2011/12/04/4097980/new-california-nursing-graduates.html\" target=\"_blank\">Sacramento Bee\u003c/a> reported yesterday:\u003c/p>\n\u003cblockquote>\u003cp>California has spent at least $95 million in federal, state and private funds in the past decade to double the number of nursing graduates by expanding college programs and grants. As recently as three years ago, hospitals were offering moving expenses, housing allowances and signing bonuses to recent graduates of nursing schools.\u003c/p>\u003c/blockquote>\n\u003cp>Spetz says with the recession lingering, older nurses aren't retiring and hospitals aren't hiring. And that means it's harder for nurses across the country, including California, to find jobs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now, there may actually be a surplus of nurses in California. But it depends on where you live.\u003c/p>\n\u003cp>\"In the Inland Empire and in some of the more rural areas, there is definitely a sense that there is shortage of nurses still,\" Spetz said. \"But in other parts of the state like the Bay Area and Sacramento I think that people are looking for work and can't find because there's so many nurses in those regions already.\"\u003c/p>\n\u003cp>So should prospective nursing students find a new career path? Absolutely not, said Spetz. In the coming years, more recent graduates will be more likely to find jobs in California.\u003c/p>\n\u003cp>\"The Baby Boomer will retire [from nursing] at the same time that they will need more health care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Spetz says it's important to keep recent nursing grads engaged -- through internships and other programs -- so that when Baby Boomers do retire and there are more jobs available those nurses can step right into them. But in the meantime, recent grads may have a hard time finding a job.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Are CA Hospital Report Cards Going Away?",
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"content": "\u003cp>\u003cem>By: Sarah Varney\u003c/em>\u003c/p>\n\u003cp>\u003cem>Editor's Note: This story is part of a reporting partnership that includes KQED, \u003ca href=\"http://www.npr.org/blogs/health/2011/11/21/142601116/california-republicans-quietly-embrace-medicaid-expansion?ps=sh_stcathdl\" target=\"_blank\">\u003cimg src=\"http://www.kaiserhealthnews.org/~/media/Images/KHN%20Partners/logo_npr.jpg\" alt=\"NPR\" width=\"45\" height=\"15\">\u003c/a> and \u003ca title=\"http://www.kaiserhealthnews.org/\" href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_912\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Hospital_Sign_Flickr_RyanOzawa.jpg\">\u003cimg class=\"size-medium wp-image-912\" title=\"(Ryan Ozawa: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Hospital_Sign_Flickr_RyanOzawa-300x225.jpg\" alt=\"(Ryan Ozawa: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ryan Ozawa: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>On the \u003ca href=\"http://www.calhospitalcompare.org/\">Cal Hospital Compare\u003c/a> website, conscientious consumers in California can look up scorecards for their local hospitals. How well does the hospital control infections? How often do patients die from complications that can be treated? How satisfied are most patients with their experience?\u003c/p>\n\u003cp>Most major hospitals in California give the data voluntarily to independent researchers who analyze and publish consumer-friendly reports.\u003c/p>\n\u003cp>The project was considered a pioneering effort when it started in 2004, but Jan Emerson-Shea, a spokesperson for the California Hospital Association, says the report cards have outlived their usefulness. \"Today there are numerous places consumers can get information on the quality of care delivered by hospitals,\" Emerson-Shea says. \"Public reporting has very much come of age at this point in time.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>As a result, the California Hospital Association recently sent a letter to the California Hospital Assessment and Reporting Taskforce, which oversees the scorecards, announcing its intention to withdraw from the project.\u003c/p>\n\u003cp>Emerson-Shea says hospitals have become overwhelmed by the administrative burden of reporting data to multiple agencies.\u003c/p>\n\u003cp>Indeed, Medicare now requires all hospitals to \u003ca href=\"http://www.kaiserhealthnews.org/stories/2011/october/17/medicare-releases-patient-safety-ratings-for-hospitals.aspx?\">publicly report \u003c/a>a limited number of quality measures, but patient safety advocates say the federal data suffers from the Lake Wobegon-effect: just about everyone is above average, and consumers have a hard time making truly informed choices.\u003c/p>\n\u003cp>\"Chances are you won’t find a hospital that stands out,\" says David Hopkins, a senior advisor at the Pacific Business Group on Health, an employer group concerned about health care costs and quality.\u003c/p>\n\u003cp>Hopkins also sits on the California Hospital Assessment and Reporting Taskforce, and he argues that Cal Hospital Compare uses a more rigorous, and ruthless, analysis than the Medicare report cards. That means hospitals that don’t do a good job stand out. \"This is one of the problems in the industry,\" Hopkins says. \"The provider says, 'Wait a minute, this is affecting my business.'\"\u003c/p>\n\u003cp>Patient safety advocates insist the only way hospitals will become safer is through unflinching transparency. Indeed, Cal Hospital Compare publishes a hospital’s ICU mortality rate, measure of how frequently people die in a hospital’s intensive care unit. The measure is adjusted for the mix of patients.\u003c/p>\n\u003cp>Hopkins says publicly reporting ICU mortality has gotten hospitals to pay attention. \"We’ve been reporting the ICU mortality rates for the last three years, and they’ve been getting steadily better, by about 1 percentage point per year, and that has saved a lot of lives. Thousands of lives, as a matter of fact.\"\u003c/p>\n\u003cp>The board of directors of the task force which includes consumer advocates, health insurance companies, hospitals and employers, will meet in the coming weeks to make a final decision on the future of the reporting effort. But with the California Hospital Association withdrawing its support, it seems unlikely that Cal Hospital Compare can continue.\u003c/p>\n\u003cp>Jan Emerson-Shea from the hospital association says nearly all of the measures, except ICU mortality, will continue to be reported either to Medicare or to California state regulators.\u003c/p>\n\u003cp>A new state law requires health officials to collect and publish their own hospital quality data, but there’s widespread agreement that the reports are so unreliable, they can’t be used to compare hospitals.\u003c/p>\n\u003cp>There is plenty of data, to be sure, says Betsy Imholz, a longtime safety expert with Consumers Union, but it’s not necessarily useful. \"We’re at a really critical crossroads in health care quality and safety,\" Imholz says. \"The public needs the data. And we need it uniform and we need it really accessible and understandable.\" If consumers are being asked to take responsibility for their health care, she says, they should at least know what they’re getting.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>More Info\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca title=\"http://www.kqed.org/a/forum/R201112060900\" href=\"http://www.kqed.org/a/forum/R201112060900\" target=\"_blank\">Rating Hospitals, on KQED's \u003cem>Forum\u003c/em> with Michael Krasny\u003c/a>\u003c/li>\n\u003c/ul>\n\n",
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"excerpt": "On the Cal Hospital Compare website, conscientious consumers in California can look up scorecards for their local hospitals. How well does the hospital control infections? How often do patients die from complications that can be treated? How satisfied are most patients with their experience?\r\n\r\nMost major hospitals in California give the data voluntarily to independent researchers who analyze and publish consumer-friendly reports.\r\n\r\nThe project was considered a pioneering effort when it started in 2004, but Jan Emerson-Shea, a spokesperson for the California Hospital Association, says the report cards have outlived their usefulness.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>By: Sarah Varney\u003c/em>\u003c/p>\n\u003cp>\u003cem>Editor's Note: This story is part of a reporting partnership that includes KQED, \u003ca href=\"http://www.npr.org/blogs/health/2011/11/21/142601116/california-republicans-quietly-embrace-medicaid-expansion?ps=sh_stcathdl\" target=\"_blank\">\u003cimg src=\"http://www.kaiserhealthnews.org/~/media/Images/KHN%20Partners/logo_npr.jpg\" alt=\"NPR\" width=\"45\" height=\"15\">\u003c/a> and \u003ca title=\"http://www.kaiserhealthnews.org/\" href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_912\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Hospital_Sign_Flickr_RyanOzawa.jpg\">\u003cimg class=\"size-medium wp-image-912\" title=\"(Ryan Ozawa: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Hospital_Sign_Flickr_RyanOzawa-300x225.jpg\" alt=\"(Ryan Ozawa: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ryan Ozawa: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>On the \u003ca href=\"http://www.calhospitalcompare.org/\">Cal Hospital Compare\u003c/a> website, conscientious consumers in California can look up scorecards for their local hospitals. How well does the hospital control infections? How often do patients die from complications that can be treated? How satisfied are most patients with their experience?\u003c/p>\n\u003cp>Most major hospitals in California give the data voluntarily to independent researchers who analyze and publish consumer-friendly reports.\u003c/p>\n\u003cp>The project was considered a pioneering effort when it started in 2004, but Jan Emerson-Shea, a spokesperson for the California Hospital Association, says the report cards have outlived their usefulness. \"Today there are numerous places consumers can get information on the quality of care delivered by hospitals,\" Emerson-Shea says. \"Public reporting has very much come of age at this point in time.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>As a result, the California Hospital Association recently sent a letter to the California Hospital Assessment and Reporting Taskforce, which oversees the scorecards, announcing its intention to withdraw from the project.\u003c/p>\n\u003cp>Emerson-Shea says hospitals have become overwhelmed by the administrative burden of reporting data to multiple agencies.\u003c/p>\n\u003cp>Indeed, Medicare now requires all hospitals to \u003ca href=\"http://www.kaiserhealthnews.org/stories/2011/october/17/medicare-releases-patient-safety-ratings-for-hospitals.aspx?\">publicly report \u003c/a>a limited number of quality measures, but patient safety advocates say the federal data suffers from the Lake Wobegon-effect: just about everyone is above average, and consumers have a hard time making truly informed choices.\u003c/p>\n\u003cp>\"Chances are you won’t find a hospital that stands out,\" says David Hopkins, a senior advisor at the Pacific Business Group on Health, an employer group concerned about health care costs and quality.\u003c/p>\n\u003cp>Hopkins also sits on the California Hospital Assessment and Reporting Taskforce, and he argues that Cal Hospital Compare uses a more rigorous, and ruthless, analysis than the Medicare report cards. That means hospitals that don’t do a good job stand out. \"This is one of the problems in the industry,\" Hopkins says. \"The provider says, 'Wait a minute, this is affecting my business.'\"\u003c/p>\n\u003cp>Patient safety advocates insist the only way hospitals will become safer is through unflinching transparency. Indeed, Cal Hospital Compare publishes a hospital’s ICU mortality rate, measure of how frequently people die in a hospital’s intensive care unit. The measure is adjusted for the mix of patients.\u003c/p>\n\u003cp>Hopkins says publicly reporting ICU mortality has gotten hospitals to pay attention. \"We’ve been reporting the ICU mortality rates for the last three years, and they’ve been getting steadily better, by about 1 percentage point per year, and that has saved a lot of lives. Thousands of lives, as a matter of fact.\"\u003c/p>\n\u003cp>The board of directors of the task force which includes consumer advocates, health insurance companies, hospitals and employers, will meet in the coming weeks to make a final decision on the future of the reporting effort. But with the California Hospital Association withdrawing its support, it seems unlikely that Cal Hospital Compare can continue.\u003c/p>\n\u003cp>Jan Emerson-Shea from the hospital association says nearly all of the measures, except ICU mortality, will continue to be reported either to Medicare or to California state regulators.\u003c/p>\n\u003cp>A new state law requires health officials to collect and publish their own hospital quality data, but there’s widespread agreement that the reports are so unreliable, they can’t be used to compare hospitals.\u003c/p>\n\u003cp>There is plenty of data, to be sure, says Betsy Imholz, a longtime safety expert with Consumers Union, but it’s not necessarily useful. \"We’re at a really critical crossroads in health care quality and safety,\" Imholz says. \"The public needs the data. And we need it uniform and we need it really accessible and understandable.\" If consumers are being asked to take responsibility for their health care, she says, they should at least know what they’re getting.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>More Info\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca title=\"http://www.kqed.org/a/forum/R201112060900\" href=\"http://www.kqed.org/a/forum/R201112060900\" target=\"_blank\">Rating Hospitals, on KQED's \u003cem>Forum\u003c/em> with Michael Krasny\u003c/a>\u003c/li>\n\u003c/ul>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Court OKs Compensation to Bone Marrow Donors",
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"content": "\u003cfigure id=\"attachment_861\" class=\"wp-caption alignleft\" style=\"max-width: 159px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Apheresis_12022011Credit_ec-jpr_Flickr1.jpg\">\u003cimg class=\"size-medium wp-image-861 \" title=\"Bone marrow donation can be done by apheresis. (ec-jpr/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Apheresis_12022011Credit_ec-jpr_Flickr1-300x451.jpg\" alt=\"Bone marrow donation can be done by apheresis. (ec-jpr/Flickr)\" width=\"159\" height=\"240\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Bone marrow donation can be done by apheresis. (ec-jpr/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>More than 3,000 Americans die every year waiting for a bone marrow donor match. Federal law has banned compensation to bone marrow donors since 1984, under the National Organ Transplant Act which likened bone marrow donation to organ donation. Yesterday, a federal appeals court ruled that the law no longer extends to bone marrow, declaring that marrow cells are \"blood parts\" and not \"organ parts.\"\u003c/p>\n\u003cp>Back in the 80s extracting bone marrow was risky for the donor. But in the last 20 years, the process for obtaining marrow has become much safer and can be achieved through \u003ca title=\"http://bloodcenter.stanford.edu/donate/apheresis.html\" href=\"http://bloodcenter.stanford.edu/donate/apheresis.html\" target=\"_blank\">apheresis\u003c/a>, a process similar to blood donation.\u003c/p>\n\u003cp>From\u003ca title=\"http://www.latimes.com/news/local/la-me-bone-marrow-20111202,0,6753589.story\" href=\"http://www.latimes.com/news/local/la-me-bone-marrow-20111202,0,6753589.story\" target=\"_blank\"> The Los Angeles Times\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"This is a fundamental change to how deadly blood diseases will be treated in the country,\" said Jeff Rowes, the Institute for Justice attorney who argued the case before the 9th Circuit panel in February. \"Compensation will expand the donor pool by at least hundreds and potentially thousands each year.\"\u003c/p>\n\u003cp>The lead plaintiff in the case is Doreen Flynn of Lewiston, Maine, a single mother of five trying to ensure that a broader field of potential donors is available when her three daughters suffering from Fanconi anemia need marrow transplants after treatment for the potentially fatal genetic disorder.\u003c/p>\n\u003cp>\"That is, like, the best Christmas news ever!\" said a jubilant Flynn upon hearing that the 9th Circuit had ruled to exclude marrow from the compensation ban. Her 13-year-old daughter is already on medication to stave off the need for a marrow transplant while waiting for a well matched donor, and Flynn must decide soon whether to put one of her 7-year-old twins on the same medication, she said.\u003c/p>\n\u003cp>MoreMarrowDonors.org wanted the organ transplant law struck down or amended to allow the nonprofit to offer $3,000 scholarships or housing payments to attract new registrants to the National Marrow Donor Program. The registry has more than 7 million members, but many joined years ago during donor drives for friends or family members and are often reluctant to donate to a stranger.\u003c/p>\u003c/blockquote>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "More than 3,000 Americans die every year waiting for a bone marrow donor match. Federal law has banned compensation to bone marrow donors since 1984, under the National Organ Transplant Act which likened bone marrow donation to organ donation. Yesterday, a federal appeals court ruled that the law no longer extends to bone marrow, declaring that marrow cells are \"blood parts\" and not \"organ parts.\"\r\n\r\nBack in the 80s extracting bone marrow was risky for the donor. But in the last 20 years, the process for obtaining marrow has become much safer and can be achieved through apheresis, a process similar to blood donation.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_861\" class=\"wp-caption alignleft\" style=\"max-width: 159px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Apheresis_12022011Credit_ec-jpr_Flickr1.jpg\">\u003cimg class=\"size-medium wp-image-861 \" title=\"Bone marrow donation can be done by apheresis. (ec-jpr/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Apheresis_12022011Credit_ec-jpr_Flickr1-300x451.jpg\" alt=\"Bone marrow donation can be done by apheresis. (ec-jpr/Flickr)\" width=\"159\" height=\"240\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Bone marrow donation can be done by apheresis. (ec-jpr/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>More than 3,000 Americans die every year waiting for a bone marrow donor match. Federal law has banned compensation to bone marrow donors since 1984, under the National Organ Transplant Act which likened bone marrow donation to organ donation. Yesterday, a federal appeals court ruled that the law no longer extends to bone marrow, declaring that marrow cells are \"blood parts\" and not \"organ parts.\"\u003c/p>\n\u003cp>Back in the 80s extracting bone marrow was risky for the donor. But in the last 20 years, the process for obtaining marrow has become much safer and can be achieved through \u003ca title=\"http://bloodcenter.stanford.edu/donate/apheresis.html\" href=\"http://bloodcenter.stanford.edu/donate/apheresis.html\" target=\"_blank\">apheresis\u003c/a>, a process similar to blood donation.\u003c/p>\n\u003cp>From\u003ca title=\"http://www.latimes.com/news/local/la-me-bone-marrow-20111202,0,6753589.story\" href=\"http://www.latimes.com/news/local/la-me-bone-marrow-20111202,0,6753589.story\" target=\"_blank\"> The Los Angeles Times\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"This is a fundamental change to how deadly blood diseases will be treated in the country,\" said Jeff Rowes, the Institute for Justice attorney who argued the case before the 9th Circuit panel in February. \"Compensation will expand the donor pool by at least hundreds and potentially thousands each year.\"\u003c/p>\n\u003cp>The lead plaintiff in the case is Doreen Flynn of Lewiston, Maine, a single mother of five trying to ensure that a broader field of potential donors is available when her three daughters suffering from Fanconi anemia need marrow transplants after treatment for the potentially fatal genetic disorder.\u003c/p>\n\u003cp>\"That is, like, the best Christmas news ever!\" said a jubilant Flynn upon hearing that the 9th Circuit had ruled to exclude marrow from the compensation ban. Her 13-year-old daughter is already on medication to stave off the need for a marrow transplant while waiting for a well matched donor, and Flynn must decide soon whether to put one of her 7-year-old twins on the same medication, she said.\u003c/p>\n\u003cp>MoreMarrowDonors.org wanted the organ transplant law struck down or amended to allow the nonprofit to offer $3,000 scholarships or housing payments to attract new registrants to the National Marrow Donor Program. The registry has more than 7 million members, but many joined years ago during donor drives for friends or family members and are often reluctant to donate to a stranger.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Mental Health Care May be Mandated in California, But Most Aren't Getting Treated",
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"content": "\u003cfigure id=\"attachment_831\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/stressed-woman.jpg\">\u003cimg class=\"size-medium wp-image-831\" title=\"Stressed woman\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/stressed-woman-300x226.jpg\" alt=\"17 percent of unmarried women with children report having mental health problems, according to a recent UCLA study. ((Photo: Getty Images)\" width=\"300\" height=\"226\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">17 percent of unmarried women with children report having mental health problems, according to a recent UCLA study. ((Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>More than two million adults in California say they need mental health care, but about half of them aren't getting it, according to a report released Wednesday by the \u003ca href=\"http://healthpolicy.ucla.edu/NewsReleaseDetails.aspx?id=95\" target=\"_blank\">UCLA Center for Health Policy Research\u003c/a>.\u003c/p>\n\u003cp>California \u003ca href=\"http://www.dmhc.ca.gov/dmhc_consumer/br/br_mentalhlth.aspx\" target=\"_blank\">mandates health insurance\u003c/a> companies provide equal care for mental and physical health problems. But mental health services are often inadequate--or they don't exist at all, says lead author David Grant.\u003c/p>\n\u003cp>One reason is when hospitals want to cut costs, mental health care is often the first to go. Grant notes that, just this morning, LA's Cedars-Sinai Medical Center announced it is cutting most of its psychiatric services.\u003c/p>\n\u003cp>\"It's a disaster,\" Grant said about Cedars-Sinai's closing. \"Health care is undergoing so much change and it's under so much financial stress right now. Providers are really looking for ways to reduce health care costs.\"\u003cbr>\n\u003c!--more-->\u003c/p>\n\u003cp>As \u003ca href=\"http://www.latimes.com/health/la-me-cedars-mental-20111201,0,7075456.story\" target=\"_blank\">The Los Angeles Times\u003c/a> reports, these cuts are a part of a larger, statewide trend:\u003c/p>\n\u003cblockquote>\u003cp>California has roughly 6,500 acute in-patient psychiatric beds, down from 8,500 in 1996, according to the California Hospital Assn. There have also been significant cutbacks in Medi-Cal funding for mental health services statewide.\u003c/p>\u003c/blockquote>\n\u003cp>But closing mental health facilities might not save money in the long run. Grant says that's because people with mental health needs are more likely to have chronic diseases like high blood pressure, heart disease and diabetes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"These are folks that are going to have higher smoking rates, drinking rates, higher rates of disability,\" Grant said. \"And these are factors that will cost the state more and more financial resources.\"\u003c/p>\n\u003cp>The study also shows there are huge disparities in who actually \u003cem>needs \u003c/em>mental health services. Statewide, eight percent of Californians report a mental health issue. But within the LGBT community 20 percent, more than double the state average, report a problem; 17 percent of unmarried women with children, and 12 percent of US-born Latinos also have mental health needs.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Grant says he hopes the report will increase awareness that these groups need to be screened more frequently ... assuming their hospital still has a psychiatric program.\u003c/p>\n\n",
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"excerpt": "More than two million adults in California say they need mental health care, but about half of them aren't getting it, according to a report released Wednesday by the UCLA Center for Health Policy Research.\r\n\r\nCalifornia mandates health insurance companies provide equal care for mental and physical health problems. But mental health services are often inadequate--or they don't exist at all, says lead author David Grant.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_831\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/stressed-woman.jpg\">\u003cimg class=\"size-medium wp-image-831\" title=\"Stressed woman\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/stressed-woman-300x226.jpg\" alt=\"17 percent of unmarried women with children report having mental health problems, according to a recent UCLA study. ((Photo: Getty Images)\" width=\"300\" height=\"226\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">17 percent of unmarried women with children report having mental health problems, according to a recent UCLA study. ((Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>More than two million adults in California say they need mental health care, but about half of them aren't getting it, according to a report released Wednesday by the \u003ca href=\"http://healthpolicy.ucla.edu/NewsReleaseDetails.aspx?id=95\" target=\"_blank\">UCLA Center for Health Policy Research\u003c/a>.\u003c/p>\n\u003cp>California \u003ca href=\"http://www.dmhc.ca.gov/dmhc_consumer/br/br_mentalhlth.aspx\" target=\"_blank\">mandates health insurance\u003c/a> companies provide equal care for mental and physical health problems. But mental health services are often inadequate--or they don't exist at all, says lead author David Grant.\u003c/p>\n\u003cp>One reason is when hospitals want to cut costs, mental health care is often the first to go. Grant notes that, just this morning, LA's Cedars-Sinai Medical Center announced it is cutting most of its psychiatric services.\u003c/p>\n\u003cp>\"It's a disaster,\" Grant said about Cedars-Sinai's closing. \"Health care is undergoing so much change and it's under so much financial stress right now. Providers are really looking for ways to reduce health care costs.\"\u003cbr>\n\u003c!--more-->\u003c/p>\n\u003cp>As \u003ca href=\"http://www.latimes.com/health/la-me-cedars-mental-20111201,0,7075456.story\" target=\"_blank\">The Los Angeles Times\u003c/a> reports, these cuts are a part of a larger, statewide trend:\u003c/p>\n\u003cblockquote>\u003cp>California has roughly 6,500 acute in-patient psychiatric beds, down from 8,500 in 1996, according to the California Hospital Assn. There have also been significant cutbacks in Medi-Cal funding for mental health services statewide.\u003c/p>\u003c/blockquote>\n\u003cp>But closing mental health facilities might not save money in the long run. Grant says that's because people with mental health needs are more likely to have chronic diseases like high blood pressure, heart disease and diabetes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"These are folks that are going to have higher smoking rates, drinking rates, higher rates of disability,\" Grant said. \"And these are factors that will cost the state more and more financial resources.\"\u003c/p>\n\u003cp>The study also shows there are huge disparities in who actually \u003cem>needs \u003c/em>mental health services. Statewide, eight percent of Californians report a mental health issue. But within the LGBT community 20 percent, more than double the state average, report a problem; 17 percent of unmarried women with children, and 12 percent of US-born Latinos also have mental health needs.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Grant says he hopes the report will increase awareness that these groups need to be screened more frequently ... assuming their hospital still has a psychiatric program.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_811\" class=\"wp-caption alignleft\" style=\"max-width: 225px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/AIDSredribbon_Flickr_gernhaex.jpg\">\u003cimg class=\"size-medium wp-image-811\" title=\"(gernhaex: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/AIDSredribbon_Flickr_gernhaex-300x400.jpg\" alt=\"(gernhaex: Flickr)\" width=\"225\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(gernhaex: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Timed to today's observance of \u003ca title=\"http://www.worldaidsday.org/\" href=\"http://www.worldaidsday.org/\" target=\"_blank\">World AIDS Day\u003c/a>, California's Office of Statewide Health Planning and Development \u003ca title=\"http://oshpd.ca.gov/HID/Products/Health_Facts/HealthFacts_HIV_AIDS_WEB.pdf\" href=\"http://oshpd.ca.gov/HID/Products/Health_Facts/HealthFacts_HIV_AIDS_WEB.pdf\" target=\"_blank\">released a brief\u003c/a> [PDF] looking at over 20 years of hospitalization trends for people with HIV and AIDS.\u003c/p>\n\u003cp>The state's analysis showed that the number of people living with HIV and AIDS is up most significantly among blacks and Hispanics. Between 1988 and 2008, the number of white people with HIV/AIDS had nearly doubled, but the number of cases for blacks had more than tripled and were up more than five times for Hispanics.\u003c/p>\n\u003cp>Native Americans and Asian/Pacific Islanders with HIV/AIDS were also up dramatically, although these groups represent a small percentage of the total number of Californians living with HIV/AIDS.\u003c/p>\n\u003cp>The State's analysis looked in detail at hospitalization rates for people with HIV/AIDS and found they have dropped dramatically, largely due to the introduction of \u003ca href=\"http://www.cancer.gov/dictionary?cdrid=306492\" target=\"_blank\">antiretroviral therapy\u003c/a> in 1997.\u003cbr>\n\u003c!--more-->Other findings include:\u003c/p>\n\u003cul>\n\u003cli>Cases in women are up significantly, more than sixfold since 1988. While HIV/AIDS overwhelmingly affects men, today women make up about 10 percent of total cases.\u003c/li>\n\u003cli>The patient population is older. 70 percent of people with HIV/AIDS are between ages 40-64, a big change since 1988, when the majority of cases were in people ages 20-39. Patients today are developing the illnesses associated with aging that are seen in the general population.\u003c/li>\n\u003cli>Hospitalization for mental and alcohol/drug-related issues more than doubled.\u003c/li>\n\u003c/ul>\n\u003cdiv>Public health officials encourage people to get tested for HIV. \"One important way we can prevent the spread of HIV is to ensure that everyone knows their HIV status,\" said Dr. Ron Chapman, Director of the California Department of Public Health in a statement.\u003c/div>\n\u003cdiv>Nationally, the Centers for Disease Control and Prevention says 20 percent of people with HIV don't know they are infected. Without effective HIV treatment, patients are at greater risk of developing AIDS. \"HIV medications not only help HIV infected persons live longer, healthier lives, but also decrease the chance that they will transmit HIV,\" Dr. Chapman added.\u003c/div>\n\u003cp> \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "Timed to today's observance of World AIDS Day, California's Office of Statewide Health Planning and Development released a brief [PDF] looking at over 20 years of hospitalization trends for people with HIV and AIDS.\r\n\r\nThe state's analysis showed that the number of people living with HIV and AIDS is up most significantly among blacks and Hispanics. Between 1988 and 2008, the number of white people with HIV/AIDS had nearly doubled, but the number of cases for blacks had more than tripled and were up more than five times for Hispanics.",
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"description": "Timed to today's observance of World AIDS Day, California's Office of Statewide Health Planning and Development released a brief looking at over 20 years of hospitalization trends for people with HIV and AIDS.\r\n\r\nThe state's analysis showed that the number of people living with HIV and AIDS is up most significantly among blacks and Hispanics. Between 1988 and 2008, the number of white people with HIV/AIDS had nearly doubled, but the number of cases for blacks had more than tripled and were up more than five times for Hispanics.",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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"reveal": {
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"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"order": 16
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},
"science-friday": {
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