window.__IS_SSR__=true
window.__INITIAL_STATE__={
"attachmentsReducer": {
"audio_0": {
"type": "attachments",
"id": "audio_0",
"imgSizes": {
"kqedFullSize": {
"file": "https://ww2.kqed.org/news/wp-content/themes/KQED-unified/img/audio_bgs/background0.jpg"
}
}
},
"audio_1": {
"type": "attachments",
"id": "audio_1",
"imgSizes": {
"kqedFullSize": {
"file": "https://ww2.kqed.org/news/wp-content/themes/KQED-unified/img/audio_bgs/background1.jpg"
}
}
},
"audio_2": {
"type": "attachments",
"id": "audio_2",
"imgSizes": {
"kqedFullSize": {
"file": "https://ww2.kqed.org/news/wp-content/themes/KQED-unified/img/audio_bgs/background2.jpg"
}
}
},
"audio_3": {
"type": "attachments",
"id": "audio_3",
"imgSizes": {
"kqedFullSize": {
"file": "https://ww2.kqed.org/news/wp-content/themes/KQED-unified/img/audio_bgs/background3.jpg"
}
}
},
"audio_4": {
"type": "attachments",
"id": "audio_4",
"imgSizes": {
"kqedFullSize": {
"file": "https://ww2.kqed.org/news/wp-content/themes/KQED-unified/img/audio_bgs/background4.jpg"
}
}
},
"placeholder": {
"type": "attachments",
"id": "placeholder",
"imgSizes": {
"thumbnail": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-160x107.jpg",
"width": 160,
"height": 107,
"mimeType": "image/jpeg"
},
"medium": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-800x533.jpg",
"width": 800,
"height": 533,
"mimeType": "image/jpeg"
},
"medium_large": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-768x512.jpg",
"width": 768,
"height": 512,
"mimeType": "image/jpeg"
},
"large": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-1020x680.jpg",
"width": 1020,
"height": 680,
"mimeType": "image/jpeg"
},
"1536x1536": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-1536x1024.jpg",
"width": 1536,
"height": 1024,
"mimeType": "image/jpeg"
},
"fd-lrg": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-1536x1024.jpg",
"width": 1536,
"height": 1024,
"mimeType": "image/jpeg"
},
"fd-med": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-1020x680.jpg",
"width": 1020,
"height": 680,
"mimeType": "image/jpeg"
},
"fd-sm": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-800x533.jpg",
"width": 800,
"height": 533,
"mimeType": "image/jpeg"
},
"post-thumbnail": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-672x372.jpg",
"width": 672,
"height": 372,
"mimeType": "image/jpeg"
},
"twentyfourteen-full-width": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-1038x576.jpg",
"width": 1038,
"height": 576,
"mimeType": "image/jpeg"
},
"xxsmall": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-160x107.jpg",
"width": 160,
"height": 107,
"mimeType": "image/jpeg"
},
"xsmall": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-672x372.jpg",
"width": 672,
"height": 372,
"mimeType": "image/jpeg"
},
"small": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-672x372.jpg",
"width": 672,
"height": 372,
"mimeType": "image/jpeg"
},
"xlarge": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-1020x680.jpg",
"width": 1020,
"height": 680,
"mimeType": "image/jpeg"
},
"full-width": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-1920x1280.jpg",
"width": 1920,
"height": 1280,
"mimeType": "image/jpeg"
},
"guest-author-32": {
"file": "https://cdn.kqed.org/wp-content/uploads/2025/01/KQED-Default-Image-816638274-1333x1333-1-160x160.jpg",
"width": 32,
"height": 32,
"mimeType": "image/jpeg"
},
"guest-author-50": {
"file": "https://cdn.kqed.org/wp-content/uploads/2025/01/KQED-Default-Image-816638274-1333x1333-1-160x160.jpg",
"width": 50,
"height": 50,
"mimeType": "image/jpeg"
},
"guest-author-64": {
"file": "https://cdn.kqed.org/wp-content/uploads/2025/01/KQED-Default-Image-816638274-1333x1333-1-160x160.jpg",
"width": 64,
"height": 64,
"mimeType": "image/jpeg"
},
"guest-author-96": {
"file": "https://cdn.kqed.org/wp-content/uploads/2025/01/KQED-Default-Image-816638274-1333x1333-1-160x160.jpg",
"width": 96,
"height": 96,
"mimeType": "image/jpeg"
},
"guest-author-128": {
"file": "https://cdn.kqed.org/wp-content/uploads/2025/01/KQED-Default-Image-816638274-1333x1333-1-160x160.jpg",
"width": 128,
"height": 128,
"mimeType": "image/jpeg"
},
"detail": {
"file": "https://cdn.kqed.org/wp-content/uploads/2025/01/KQED-Default-Image-816638274-1333x1333-1-160x160.jpg",
"width": 160,
"height": 160,
"mimeType": "image/jpeg"
},
"kqedFullSize": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1.jpg",
"width": 2000,
"height": 1333
}
}
},
"stateofhealth_5549": {
"type": "attachments",
"id": "stateofhealth_5549",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "5549",
"found": true
},
"parent": 5528,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-e1364611633110-1038x576.jpg",
"width": 1038,
"mimeType": "image/jpeg",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-e1364611633110-400x272.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 272
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-e1364611633110-320x217.jpg",
"width": 320,
"mimeType": "image/jpeg",
"height": 217
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-e1364611633110-672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-e1364611633110.jpg",
"width": 2100,
"height": 1427
},
"large": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-e1364611633110-1440x979.jpg",
"width": 1440,
"mimeType": "image/jpeg",
"height": 979
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-e1364611633110-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-e1364611633110-800x544.jpg",
"width": 800,
"mimeType": "image/jpeg",
"height": 544
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-e1364611633110-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-e1364611633110-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"fd-lrg": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-e1364611633110-1180x802.jpg",
"width": 1180,
"mimeType": "image/jpeg",
"height": 802
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-e1364611633110-768x522.jpg",
"width": 768,
"mimeType": "image/jpeg",
"height": 522
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-e1364611633110-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-e1364611633110-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1335911277,
"modified": 1335911277,
"caption": "(Photo: U.S. Navy)",
"description": "mammogram 080922-N-2688M-004 \r\nSAN DIEGO - Lead Mammography Technologist Carmen Waters, Naval Medical Center San Diego Breast Health Center, assists a patient preparing for a mammography. In conjunction with NMCSDÃs pharmacy, the Breast Health Center has started a new program called ìMammograms While You Wait,î which allows patients to take the exam while their prescriptions are being filled. (HIPAA Complete) Photo by Mass Communications Specialist 2nd Class Joseph Moon",
"title": "(Photo: U.S. Navy)",
"credit": null,
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_11753": {
"type": "attachments",
"id": "stateofhealth_11753",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "11753",
"found": true
},
"parent": 11752,
"imgSizes": {
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-10.18.38-AM-400x340.png",
"width": 400,
"mimeType": "image/png",
"height": 340
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-10.18.38-AM-320x272.png",
"width": 320,
"mimeType": "image/png",
"height": 272
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-10.18.38-AM-598x372.png",
"width": 598,
"mimeType": "image/png",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-10.18.38-AM.png",
"width": 598,
"height": 508
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-10.18.38-AM-96x96.png",
"width": 96,
"mimeType": "image/png",
"height": 96
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-10.18.38-AM-64x64.png",
"width": 64,
"mimeType": "image/png",
"height": 64
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-10.18.38-AM-75x75.png",
"width": 75,
"mimeType": "image/png",
"height": 75
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-10.18.38-AM-32x32.png",
"width": 32,
"mimeType": "image/png",
"height": 32
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-10.18.38-AM-128x128.png",
"width": 128,
"mimeType": "image/png",
"height": 128
}
},
"publishDate": 1364409558,
"modified": 1364409558,
"caption": null,
"description": "CDC chart",
"title": "Screen Shot 2013-03-27 at 10.18.38 AM",
"credit": null,
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_11745": {
"type": "attachments",
"id": "stateofhealth_11745",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "11745",
"found": true
},
"parent": 11736,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls-1024x576.jpg",
"width": 1024,
"mimeType": "image/jpeg",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls-400x300.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 300
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls-320x240.jpg",
"width": 320,
"mimeType": "image/jpeg",
"height": 240
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls-672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls.jpg",
"width": 1024,
"height": 768
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls-768x576.jpg",
"width": 768,
"mimeType": "image/jpeg",
"height": 576
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls-800x600.jpg",
"width": 800,
"mimeType": "image/jpeg",
"height": 600
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1364404089,
"modified": 1364404089,
"caption": "(401(k)2012/Flickr)",
"description": "stack of dollar bills; money",
"title": "RS2147_Stackof100DollarBIlls",
"credit": null,
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_10728": {
"type": "attachments",
"id": "stateofhealth_10728",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "10728",
"found": true
},
"parent": 10704,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ASR-Hip-799x576.jpg",
"width": 799,
"mimeType": "image/jpeg",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ASR-Hip-400x401.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 401
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ASR-Hip-320x320.jpg",
"width": 320,
"mimeType": "image/jpeg",
"height": 320
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ASR-Hip-672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ASR-Hip.jpg",
"width": 799,
"height": 800
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ASR-Hip-768x769.jpg",
"width": 768,
"mimeType": "image/jpeg",
"height": 769
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ASR-Hip-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ASR-Hip-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ASR-Hip-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ASR-Hip-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ASR-Hip-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1361544531,
"modified": 1361544531,
"caption": "Michael Kelly, attorney for plaintiff Loren Kransky, holds up an ASR XL hip implant made by Johnson & Johnson during his opening statement to the jury at the trial of Kransky v. DePuy, at California Superior Court in Los Angeles, on Friday, Jan. 25, 2013. (Credit: Patrick T. Fallon/Bloomberg)",
"description": "Michael Kelly, attorney for plaintiff Loren Kransky, holds up an ASR XL hip implant in his opening statement to the jury during the trial of Kransky v. DePuy, at the California Superior Court house in Los Angeles, California, U.S., on on Friday, January 25, 2013. The plaintiff's attorney, representing Loren Kransky, a retired prison guard who got an ASR XL hip implant in 2007, said Johnson & Johnson failed to warn of the risks of defective metal hip implants it pulled from the market. J&J faced 10,100 lawsuits through September, according to a regulatory filing. Photographer: Patrick Fallon/Bloomberg",
"title": "J&J Study Predicted 37% Failure Rate for Hip Implants",
"credit": null,
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_212": {
"type": "attachments",
"id": "stateofhealth_212",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "212",
"found": true
},
"parent": 207,
"imgSizes": {
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2011/11/Walmart-300.jpg",
"width": 300,
"height": 199
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2011/11/Walmart-300-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2011/11/Walmart-300-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2011/11/Walmart-300-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2011/11/Walmart-300-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2011/11/Walmart-300-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1320880447,
"modified": 1320880447,
"caption": "(Illustration by Kaiser Health News from photo by Walmart via Flickr)",
"description": "(Illustration by Kaiser Health News from photo by Walmart via Flickr)",
"title": "(Illustration by Kaiser Health News from photo by Walmart via Flickr)",
"credit": null,
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_10588": {
"type": "attachments",
"id": "stateofhealth_10588",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "10588",
"found": true
},
"parent": 10585,
"imgSizes": {
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/EmergencyRoomSign_anName-Taber-Andrew-Bain--400x264.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 264
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/EmergencyRoomSign_anName-Taber-Andrew-Bain--320x211.jpg",
"width": 320,
"mimeType": "image/jpeg",
"height": 211
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/EmergencyRoomSign_anName-Taber-Andrew-Bain--672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/EmergencyRoomSign_anName-Taber-Andrew-Bain-.jpg",
"width": 703,
"height": 464
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/EmergencyRoomSign_anName-Taber-Andrew-Bain--96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/EmergencyRoomSign_anName-Taber-Andrew-Bain--64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/EmergencyRoomSign_anName-Taber-Andrew-Bain--75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/EmergencyRoomSign_anName-Taber-Andrew-Bain--32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/EmergencyRoomSign_anName-Taber-Andrew-Bain--128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1360867907,
"modified": 1360867907,
"caption": "Among other changes, Scripps Health streamlined its ER admission process, slashing wait times and saving $29 million. (Taber Andrew Bain/Flickr)",
"description": "emergency sign, ER",
"title": "Among other changes, Scripps Health streamlined its ER admission process, slashing wait times and saving $29 million. (Taber Andrew Bain/Flickr)(Taber Andrew Bain/Flickr)",
"credit": null,
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_8836": {
"type": "attachments",
"id": "stateofhealth_8836",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "8836",
"found": true
},
"parent": 8832,
"imgSizes": {
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/11/CoveredCalifornia1.png",
"width": 290,
"height": 302
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/11/CoveredCalifornia1-96x96.png",
"width": 96,
"mimeType": "image/png",
"height": 96
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/11/CoveredCalifornia1-64x64.png",
"width": 64,
"mimeType": "image/png",
"height": 64
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/11/CoveredCalifornia1-75x75.png",
"width": 75,
"mimeType": "image/png",
"height": 75
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/11/CoveredCalifornia1-32x32.png",
"width": 32,
"mimeType": "image/png",
"height": 32
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2012/11/CoveredCalifornia1-128x128.png",
"width": 128,
"mimeType": "image/png",
"height": 128
}
},
"publishDate": 1352744059,
"modified": 1352744059,
"caption": "California's insurance marketplace, Covered California, will open in October, 2013. People will be able to buy insurance, which will take effect January 1, 2014.",
"description": "California's insurance marketplace, Covered California, will open in October, 2013. People will be able to buy insurance, which will take effect January 1, 2014.",
"title": "California's insurance marketplace, Covered California, will open in October, 2013. People will be able to buy insurance, which will take effect January 1, 2014.",
"credit": null,
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_10509": {
"type": "attachments",
"id": "stateofhealth_10509",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "10509",
"found": true
},
"parent": 10505,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ArtificialHip_okadots_Flickr-1034x576.jpg",
"width": 1034,
"mimeType": "image/jpeg",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ArtificialHip_okadots_Flickr-400x329.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 329
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ArtificialHip_okadots_Flickr-320x263.jpg",
"width": 320,
"mimeType": "image/jpeg",
"height": 263
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ArtificialHip_okadots_Flickr-672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ArtificialHip_okadots_Flickr.jpg",
"width": 1034,
"height": 850
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ArtificialHip_okadots_Flickr-768x631.jpg",
"width": 768,
"mimeType": "image/jpeg",
"height": 631
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ArtificialHip_okadots_Flickr-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ArtificialHip_okadots_Flickr-800x658.jpg",
"width": 800,
"mimeType": "image/jpeg",
"height": 658
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ArtificialHip_okadots_Flickr-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ArtificialHip_okadots_Flickr-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ArtificialHip_okadots_Flickr-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/ArtificialHip_okadots_Flickr-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1360631190,
"modified": 1360631190,
"caption": "X-ray showing a new artificial hip. No, I don't know how much the patient paid for it. (okadots/Flickr)",
"description": "x-ray, artificial hip replacement",
"title": "X-ray showing a new artificial hip. No, I don't know how much the patient paid for it. (okadots/Flickr)",
"credit": null,
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_10402": {
"type": "attachments",
"id": "stateofhealth_10402",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "10402",
"found": true
},
"parent": 10394,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/kaiserquake-1000x576.jpg",
"width": 1000,
"mimeType": "image/jpeg",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/kaiserquake-400x267.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 267
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/kaiserquake-320x213.jpg",
"width": 320,
"mimeType": "image/jpeg",
"height": 213
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/kaiserquake-672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/kaiserquake.jpg",
"width": 1000,
"height": 667
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/kaiserquake-768x512.jpg",
"width": 768,
"mimeType": "image/jpeg",
"height": 512
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/kaiserquake-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/kaiserquake-800x534.jpg",
"width": 800,
"mimeType": "image/jpeg",
"height": 534
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/kaiserquake-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/kaiserquake-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/kaiserquake-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2013/02/kaiserquake-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1360090137,
"modified": 1360090137,
"caption": "The Kaiser Permanente clinic in Granada Hills, CA was severely damaged in the 1994 Northridge earthquake. (Photo/NOAA)",
"description": "The Kaiser Permanente clinic in Granada Hills, CA was severely damaged in the 1994 Northridge earthquake. (Photo/NOAA)",
"title": "The Kaiser Permanente clinic in Granada Hills, CA was severely damaged in the 1994 Northridge earthquake. (Photo/NOAA)",
"credit": null,
"status": "inherit",
"isLoading": false,
"fetchFailed": false
}
},
"audioPlayerReducer": {
"postId": "stream_live",
"isPaused": true,
"isPlaying": false,
"pfsActive": false,
"pledgeModalIsOpen": true,
"playerDrawerIsOpen": false,
"liveAudioPlayStartedAt": 0,
"liveAudioPlayContext": ""
},
"authorsReducer": {
"lisaaliferis": {
"type": "authors",
"id": "240",
"meta": {
"index": "authors_1716337520",
"id": "240",
"found": true
},
"name": "Lisa Aliferis",
"firstName": "Lisa",
"lastName": "Aliferis",
"slug": "lisaaliferis",
"email": "laliferis@kqed.org",
"display_author_email": false,
"staff_mastheads": [],
"title": "KQED Contributor",
"bio": "Lisa Aliferis is the founding editor of KQED's \u003cem>State of Health\u003c/em> blog. Since 2011, she's been writing and editing stories for the site. Before taking up blogging, she toiled for many years (more than we can count) producing health stories for television, including\u003cem> Dateline NBC\u003c/em> and San Francisco's CBS affiliate, KPIX-TV. She also wrote up a \u003ca title=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\">handy guide to the Affordable Care Act\u003c/a>, especially for Californians. Her work has been honored for many awards. Most recently she was a finalist for \"Best Topical Reporting\" from the Online News Association. You can follow her on Twitter: \u003ca title=\"https://twitter.com/laliferis\" href=\"https://twitter.com/laliferis\">@laliferis\u003c/a>",
"avatar": "https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=mm&r=g",
"twitter": "laliferis",
"facebook": null,
"instagram": null,
"linkedin": null,
"sites": [
{
"site": "news",
"roles": [
"subscriber"
]
},
{
"site": "futureofyou",
"roles": [
"subscriber"
]
},
{
"site": "stateofhealth",
"roles": [
"subscriber"
]
},
{
"site": "science",
"roles": [
"subscriber"
]
},
{
"site": "food",
"roles": []
}
],
"headData": {
"title": "Lisa Aliferis | KQED",
"description": "KQED Contributor",
"ogImgSrc": "https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=mm&r=g",
"twImgSrc": "https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=mm&r=g"
},
"isLoading": false,
"link": "/author/lisaaliferis"
},
"rachael-myrow": {
"type": "authors",
"id": "251",
"meta": {
"index": "authors_1716337520",
"id": "251",
"found": true
},
"name": "Rachael Myrow",
"firstName": "Rachael",
"lastName": "Myrow",
"slug": "rachael-myrow",
"email": "rmyrow@kqed.org",
"display_author_email": true,
"staff_mastheads": [
"news"
],
"title": "Senior Editor of KQED's Silicon Valley News Desk",
"bio": "• I write and edit stories about how Silicon Valley power and policies shape everyday life in California. I’m also passionate about making Bay Area history and culture more accessible to a broad public. • I’ve been a journalist for most of my life, starting in high school with The Franklin Press in Los Angeles, where I grew up. While earning my first degree in English at UC Berkeley, I got my start in public radio at KALX-FM. After completing a second degree in journalism at Cal, I landed my first professional job at Marketplace, then moved on to KPCC (now LAist), and then KQED, where I hosted The California Report for more than seven years. • My reporting has appeared on NPR, The World, WBUR’s \u003ci>Here & Now\u003c/i>, and the BBC. I also guest host for KQED’s \u003ci>Forum\u003c/i>, as well as the Commonwealth Club in San Francisco. • I speak periodically on media, democracy and technology issues, and do voiceover work for documentaries and educational video projects. • Outside of the studio, you'll find me hiking Bay Area trails and whipping up Insta-ready meals in my kitchen. • I do not accept gifts, money, or favors from anyone connected to my reporting, I don't pay people for information, and I do not support or donate to political causes. • I strive to treat the people I report on with fairness, honesty, and respect. I also recognize there are often multiple sides to a story and work to verify information through multiple sources and documentation. If I get something wrong, I correct it.",
"avatar": "https://secure.gravatar.com/avatar/3ed8a3c5f26025e4a805ba634cda8cd764906b97438a6d9ce216b044e340da4e?s=600&d=blank&r=g",
"twitter": "rachaelmyrow",
"bluesky": null,
"facebook": null,
"instagram": null,
"linkedin": "https://www.linkedin.com/in/rachaelmyrow/",
"sites": [
{
"site": "arts",
"roles": [
"administrator"
]
},
{
"site": "news",
"roles": [
"edit_others_posts",
"editor"
]
},
{
"site": "futureofyou",
"roles": [
"editor"
]
},
{
"site": "bayareabites",
"roles": [
"editor"
]
},
{
"site": "stateofhealth",
"roles": [
"editor"
]
},
{
"site": "science",
"roles": [
"editor"
]
},
{
"site": "food",
"roles": [
"editor"
]
},
{
"site": "forum",
"roles": [
"editor"
]
},
{
"site": "liveblog",
"roles": [
"author"
]
}
],
"headData": {
"title": "Rachael Myrow | KQED",
"description": "Senior Editor of KQED's Silicon Valley News Desk",
"ogImgSrc": "https://secure.gravatar.com/avatar/3ed8a3c5f26025e4a805ba634cda8cd764906b97438a6d9ce216b044e340da4e?s=600&d=blank&r=g",
"twImgSrc": "https://secure.gravatar.com/avatar/3ed8a3c5f26025e4a805ba634cda8cd764906b97438a6d9ce216b044e340da4e?s=600&d=blank&r=g"
},
"isLoading": false,
"link": "/author/rachael-myrow"
},
"state-of-health": {
"type": "authors",
"id": "8344",
"meta": {
"index": "authors_1716337520",
"id": "8344",
"found": true
},
"name": "State of Health",
"firstName": "State of Health",
"lastName": null,
"slug": "state-of-health",
"email": "stateofhealth@kqed.org",
"display_author_email": false,
"staff_mastheads": [],
"title": null,
"bio": null,
"avatar": "https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g",
"twitter": null,
"facebook": null,
"instagram": null,
"linkedin": null,
"sites": [
{
"site": "arts",
"roles": [
"author"
]
},
{
"site": "stateofhealth",
"roles": [
"editor"
]
}
],
"headData": {
"title": "State of Health | KQED",
"description": null,
"ogImgSrc": "https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g",
"twImgSrc": "https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g"
},
"isLoading": false,
"link": "/author/state-of-health"
}
},
"pagesReducer": {
"stateofhealth_category_tests-treatments": {
"type": "terms",
"id": "stateofhealth_13",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "13",
"score": 14.407137
},
"featImg": null,
"name": "Tests & Treatments",
"description": "Information and new research about advances in discovering and treating diseases and conditions.",
"taxonomy": "category",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": "Information and new research about advances in discovering and treating diseases and conditions.",
"title": "Tests & Treatments Archives | KQED Arts",
"ogDescription": null
},
"ttid": 13,
"slug": "tests-treatments",
"isLoading": false,
"title": "Tests & Treatments",
"pageMeta": {
"site": "stateofhealth",
"WpPageTemplate": "page-topic-editorial",
"currentPage": 29
},
"blocks": [
{
"blockName": "kqed/company-paragraph",
"content": "Information and new research about advances in discovering and treating diseases and conditions."
},
{
"blockName": "kqed/post-list",
"attrs": {
"layout": "cardArticle2",
"query": "posts/stateofhealth?category=tests-treatments",
"seeMore": false,
"paginated": true,
"page": 29
}
},
{
"blockName": "kqed/ad"
}
]
}
},
"pfsSessionReducer": {},
"postsReducer": {
"stream_live": {
"type": "live",
"id": "stream_live",
"audioUrl": "https://hls.kqed.org/hls/kqed_app/playlist.m3u8",
"title": "Live Stream",
"excerpt": "Live Stream information currently unavailable.",
"link": "/radio",
"featImg": "",
"label": {
"name": "KQED Live",
"link": "/"
}
},
"stream_kqedNewscast": {
"type": "posts",
"id": "stream_kqedNewscast",
"audioUrl": "https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1",
"title": "KQED Newscast",
"featImg": "",
"label": {
"name": "88.5 FM",
"link": "/"
}
},
"stateofhealth_11804": {
"type": "posts",
"id": "stateofhealth_11804",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "11804",
"score": null,
"sort": [
1364601228000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1364601228,
"format": "aside",
"disqusTitle": "California's Breast Density Notification Law Goes Into Effect",
"title": "California's Breast Density Notification Law Goes Into Effect",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_5549\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/01/new-research-for-women-in-their-40s-on-mammograms/080922-n-2688m-004/\" rel=\"attachment wp-att-5549\">\u003cimg class=\"size-medium wp-image-5549\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-300x203.jpg\" alt=\"(Photo: U.S. Navy)\" width=\"300\" height=\"203\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: U.S. Navy)\u003c/figcaption>\u003c/figure>\n\u003cp>As women are well aware, the purpose of a mammogram is to screen for cancer. What many women don't know is that as part of the screening, radiologists also assess the level of density in a woman's breast tissue.\u003c/p>\n\u003cp>Starting Monday, \u003ca href=\"http://leginfo.ca.gov/pub/11-12/bill/sen/sb_1501-1550/sb_1538_bill_20120922_chaptered.html\" target=\"_blank\">a new California law\u003c/a> will require that doctors notify women if their breast tissue is dense. Dense breast tissue makes it harder to read mammograms and is associated with an increased risk of breast cancer.\u003c/p>\n\u003cp>Former state Sen. Joe Simitian (D-Palo Alto) introduced the law last year. It grew out of his concern that while doctors were aware of a patient's breast density, the patient herself was not, preventing women from talking with their doctors about how they might want to address their potential increased risk. He wanted to change that.\u003c/p>\n\u003cp>\"The fundamental premise of the legislation,\" he said in a recent call with reporters, \"is that absent this information, these conversations weren't going to take place.\"\u003c/p>\n\u003cp>Some background: breast tissue is graded from 1 (not dense) to 4 (extremely dense). The law requires that women graded either a 3 or a 4 be notified.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Here's the specific notification required by the law:\u003c/p>\n\u003cblockquote>\u003cp>Your mammogram shows that your breast tissue is dense. Dense breast tissue is common and is not abnormal. However, dense breast tissue can make it harder to evaluate the \u003c!--more-->results of your mammogram and may also be associated with an increased risk of breast cancer.\u003c/p>\n\u003cp>This information about the results of your mammogram is given to you to raise your awareness and to inform your conversations with your doctor. Together, you can decide which screening options are right for you. A report of your results was sent to your physician.\u003c/p>\u003c/blockquote>\n\u003cp>But here's where the law and medical data collide: while there's fairly solid scientific evidence about the increased breast cancer risk for women with a \"4\" rating, there's not for women with a \"3\" rating. Yet, women with a \"3\" rating will be notified.\u003c/p>\n\u003cp>To put the increased risk in perspective, a woman in her 40s with \"extremely dense breasts\" has roughly the same risk of breast cancer as an average-risk woman in her 50s, according to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/19/mammograms-which-women-how-often/\" target=\"_blank\">a study of nearly 1 million women\u003c/a> published earlier this month by researchers from UCSF. About 12 to 15 percent of women in their 40s have \"extremely dense breasts.\"\u003c/p>\n\u003cp>So, what's a woman who receives the notification to do? The law simply suggests women decide on a course of action with their doctors.\u003c/p>\n\u003cp>The UCSF study looked specifically at the issue of breast density and found that women in their 40s with \"extremely dense breasts\" should have a mammogram every year. Major guidelines conflict as to the frequency of mammograms for women in their 40s. \u003ca href=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" target=\"_blank\">One says annually\u003c/a>; \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" target=\"_blank\">another says \u003c/a>it's a woman's individual choice.\u003c/p>\n\u003cp>But this most recent study from UCSF suggests that women in their 40s with extremely dense breasts will reduce their risk of being diagnosed with advanced disease if they have a digital mammogram every year. For women in their 50s, the researchers found no increased risk of late- stage disease if a woman had a mammogram every two years -- no matter how dense the breast tissue is.\u003c/p>\n\u003cp>So, that's some of the most up-to-date research on mammography.\u003c/p>\n\u003cp>But the new law also mentions deciding \"which screening options are right for you.\" The press call with Simitian included a radiologist and a nurse. Both discussed ultrasound screening for breast cancer. But Karla Kerlikowske, biostatistician and lead researcher of the UCSF study, said that while she supports women having information, in this case, the law may be ahead of the science \"because we don't know that women need additional imaging tests beyond digital mammography if they fall into one of those (breast density) categories.\"\u003c/p>\n\u003cp>In a subsequent email, Kerlikowske said that there are no studies of what's known as \"whole breast ultrasound\" to determine cancer detection and whether detection makes a difference in cancer staging.\u003c/p>\n\u003cp>Women with higher breast density are also at higher risk of false positives and might need to go through additional imaging and unnecessary biopsies. As Otis Brawley, chief medical officer of the American Cancer Society, noted, \"The thing that increases risk also makes screening more difficult to do. God is not fair here.\"\u003c/p>\n\u003cp>Perhaps that is what's most worth remembering: that life is not fair. At a time when people in general -- not just women -- want certainty in the face of a possible disease, medical science cannot yet provide it.\u003c/p>\n\u003cp>Again, what should you do if you get a notification of high breast density? Talk to your doctor.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003cbr>\n\u003ca href=\"http://www.kqed.org/news/story/2013/04/01/118772/breast_density_notification_law_goes_into_effect?category=bay+area\" target=\"_blank\">Listen to the story.\u003c/a>\u003c/p>\n\n",
"disqusIdentifier": "11804 http://blogs.kqed.org/stateofhealth/?p=11804",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2013/03/29/californias-breast-density-notification-law-goes-into-effect/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 802,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 22
},
"modified": 1371246989,
"excerpt": "As women are well aware, the purpose of a mammogram is to screen for cancer. What many women don't know is that as part of the screening, radiologists also assess the level of density in a woman's breast tissue.\r\n\r\nStarting Monday, a new California law will require that doctors notify women if their breast tissue is dense. Dense breast tissue makes it harder to read mammograms and is associated with an increased risk of breast cancer.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "As women are well aware, the purpose of a mammogram is to screen for cancer. What many women don't know is that as part of the screening, radiologists also assess the level of density in a woman's breast tissue.\r\n\r\nStarting Monday, a new California law will require that doctors notify women if their breast tissue is dense. Dense breast tissue makes it harder to read mammograms and is associated with an increased risk of breast cancer.",
"title": "California's Breast Density Notification Law Goes Into Effect | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "California's Breast Density Notification Law Goes Into Effect",
"datePublished": "2013-03-29T16:53:48-07:00",
"dateModified": "2013-06-14T14:56:29-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "californias-breast-density-notification-law-goes-into-effect",
"status": "publish",
"path": "/stateofhealth/11804/californias-breast-density-notification-law-goes-into-effect",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5549\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/01/new-research-for-women-in-their-40s-on-mammograms/080922-n-2688m-004/\" rel=\"attachment wp-att-5549\">\u003cimg class=\"size-medium wp-image-5549\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-300x203.jpg\" alt=\"(Photo: U.S. Navy)\" width=\"300\" height=\"203\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: U.S. Navy)\u003c/figcaption>\u003c/figure>\n\u003cp>As women are well aware, the purpose of a mammogram is to screen for cancer. What many women don't know is that as part of the screening, radiologists also assess the level of density in a woman's breast tissue.\u003c/p>\n\u003cp>Starting Monday, \u003ca href=\"http://leginfo.ca.gov/pub/11-12/bill/sen/sb_1501-1550/sb_1538_bill_20120922_chaptered.html\" target=\"_blank\">a new California law\u003c/a> will require that doctors notify women if their breast tissue is dense. Dense breast tissue makes it harder to read mammograms and is associated with an increased risk of breast cancer.\u003c/p>\n\u003cp>Former state Sen. Joe Simitian (D-Palo Alto) introduced the law last year. It grew out of his concern that while doctors were aware of a patient's breast density, the patient herself was not, preventing women from talking with their doctors about how they might want to address their potential increased risk. He wanted to change that.\u003c/p>\n\u003cp>\"The fundamental premise of the legislation,\" he said in a recent call with reporters, \"is that absent this information, these conversations weren't going to take place.\"\u003c/p>\n\u003cp>Some background: breast tissue is graded from 1 (not dense) to 4 (extremely dense). The law requires that women graded either a 3 or a 4 be notified.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Here's the specific notification required by the law:\u003c/p>\n\u003cblockquote>\u003cp>Your mammogram shows that your breast tissue is dense. Dense breast tissue is common and is not abnormal. However, dense breast tissue can make it harder to evaluate the \u003c!--more-->results of your mammogram and may also be associated with an increased risk of breast cancer.\u003c/p>\n\u003cp>This information about the results of your mammogram is given to you to raise your awareness and to inform your conversations with your doctor. Together, you can decide which screening options are right for you. A report of your results was sent to your physician.\u003c/p>\u003c/blockquote>\n\u003cp>But here's where the law and medical data collide: while there's fairly solid scientific evidence about the increased breast cancer risk for women with a \"4\" rating, there's not for women with a \"3\" rating. Yet, women with a \"3\" rating will be notified.\u003c/p>\n\u003cp>To put the increased risk in perspective, a woman in her 40s with \"extremely dense breasts\" has roughly the same risk of breast cancer as an average-risk woman in her 50s, according to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/19/mammograms-which-women-how-often/\" target=\"_blank\">a study of nearly 1 million women\u003c/a> published earlier this month by researchers from UCSF. About 12 to 15 percent of women in their 40s have \"extremely dense breasts.\"\u003c/p>\n\u003cp>So, what's a woman who receives the notification to do? The law simply suggests women decide on a course of action with their doctors.\u003c/p>\n\u003cp>The UCSF study looked specifically at the issue of breast density and found that women in their 40s with \"extremely dense breasts\" should have a mammogram every year. Major guidelines conflict as to the frequency of mammograms for women in their 40s. \u003ca href=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" target=\"_blank\">One says annually\u003c/a>; \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" target=\"_blank\">another says \u003c/a>it's a woman's individual choice.\u003c/p>\n\u003cp>But this most recent study from UCSF suggests that women in their 40s with extremely dense breasts will reduce their risk of being diagnosed with advanced disease if they have a digital mammogram every year. For women in their 50s, the researchers found no increased risk of late- stage disease if a woman had a mammogram every two years -- no matter how dense the breast tissue is.\u003c/p>\n\u003cp>So, that's some of the most up-to-date research on mammography.\u003c/p>\n\u003cp>But the new law also mentions deciding \"which screening options are right for you.\" The press call with Simitian included a radiologist and a nurse. Both discussed ultrasound screening for breast cancer. But Karla Kerlikowske, biostatistician and lead researcher of the UCSF study, said that while she supports women having information, in this case, the law may be ahead of the science \"because we don't know that women need additional imaging tests beyond digital mammography if they fall into one of those (breast density) categories.\"\u003c/p>\n\u003cp>In a subsequent email, Kerlikowske said that there are no studies of what's known as \"whole breast ultrasound\" to determine cancer detection and whether detection makes a difference in cancer staging.\u003c/p>\n\u003cp>Women with higher breast density are also at higher risk of false positives and might need to go through additional imaging and unnecessary biopsies. As Otis Brawley, chief medical officer of the American Cancer Society, noted, \"The thing that increases risk also makes screening more difficult to do. God is not fair here.\"\u003c/p>\n\u003cp>Perhaps that is what's most worth remembering: that life is not fair. At a time when people in general -- not just women -- want certainty in the face of a possible disease, medical science cannot yet provide it.\u003c/p>\n\u003cp>Again, what should you do if you get a notification of high breast density? Talk to your doctor.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003cbr>\n\u003ca href=\"http://www.kqed.org/news/story/2013/04/01/118772/breast_density_notification_law_goes_into_effect?category=bay+area\" target=\"_blank\">Listen to the story.\u003c/a>\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/11804/californias-breast-density-notification-law-goes-into-effect",
"authors": [
"240"
],
"categories": [
"stateofhealth_14",
"stateofhealth_13"
],
"tags": [
"stateofhealth_46",
"stateofhealth_176",
"stateofhealth_461"
],
"featImg": "stateofhealth_5549",
"label": "stateofhealth"
},
"stateofhealth_11752": {
"type": "posts",
"id": "stateofhealth_11752",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "11752",
"score": null,
"sort": [
1364410188000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1364410188,
"format": "aside",
"disqusTitle": "Chart of the Day: Health Care's 'Financial Burden' on Families",
"title": "Chart of the Day: Health Care's 'Financial Burden' on Families",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>It seems that \"32 percent\" is the number of the day today. First, actuaries believe that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/27/health-care-overhaul-actuaries-say-costs-could-go-up-32-percent/\" target=\"_blank\">medical claims costs will go up 32 percent\u003c/a>, and now the Centers for Disease Control tells us that 32 percent of U.S. families are having trouble paying their medical bills:\u003c/p>\n\u003cfigure id=\"attachment_11755\" class=\"wp-caption aligncenter\" style=\"max-width: 607px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/27/chart-of-the-day-health-cares-financial-burden/screen-shot-2013-03-27-at-11-40-59-am/\" rel=\"attachment wp-att-11755\">\u003cimg class=\"size-full wp-image-11755\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-11.40.59-AM.png\" alt=\"(Centers for Disease Control)\" width=\"607\" height=\"457\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-11.40.59-AM.png 607w, https://ww2.kqed.org/app/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-11.40.59-AM-400x301.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-11.40.59-AM-320x241.png 320w\" sizes=\"(max-width: 607px) 100vw, 607px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Centers for Disease Control)\u003c/figcaption>\u003c/figure>\n\u003cp>Nearly one in four children ages birth to 17 live in families that are struggling to pay medical bills, according to CDC data from the National Health Interview Survey, from January - June, 2011.\u003c/p>\n\u003cp>Here are more findings. In the first six months of 2011:\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>one in three persons was in a family experiencing financial burden of medical care\u003c/li>\n\u003cli>one in 5 persons was in a family having problems paying medical bills\u003c/li>\n\u003cli>one in 4 persons was in a family paying medical bills over time\u003c/li>\n\u003cli>one in 10 persons was in a family that had medical bills they were unable to pay at all\u003c/li>\n\u003c/ul>\n\u003cp>The CDC has more sobering charts\u003ca href=\"http://www.cdc.gov/nchs/data/nhis/earlyrelease/financial_burden_of_medical_care_032012.pdf\" target=\"_blank\"> here\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
"disqusIdentifier": "11752 http://blogs.kqed.org/stateofhealth/?p=11752",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2013/03/27/chart-of-the-day-health-cares-financial-burden/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 163,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 6
},
"modified": 1364576487,
"excerpt": " The Centers for Disease Control reports that 32 percent of U.S. families are having trouble paying their medical bills:",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": " The Centers for Disease Control reports that 32 percent of U.S. families are having trouble paying their medical bills:",
"title": "Chart of the Day: Health Care's 'Financial Burden' on Families | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Chart of the Day: Health Care's 'Financial Burden' on Families",
"datePublished": "2013-03-27T11:49:48-07:00",
"dateModified": "2013-03-29T10:01:27-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "chart-of-the-day-health-cares-financial-burden",
"status": "publish",
"path": "/stateofhealth/11752/chart-of-the-day-health-cares-financial-burden",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It seems that \"32 percent\" is the number of the day today. First, actuaries believe that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/27/health-care-overhaul-actuaries-say-costs-could-go-up-32-percent/\" target=\"_blank\">medical claims costs will go up 32 percent\u003c/a>, and now the Centers for Disease Control tells us that 32 percent of U.S. families are having trouble paying their medical bills:\u003c/p>\n\u003cfigure id=\"attachment_11755\" class=\"wp-caption aligncenter\" style=\"max-width: 607px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/27/chart-of-the-day-health-cares-financial-burden/screen-shot-2013-03-27-at-11-40-59-am/\" rel=\"attachment wp-att-11755\">\u003cimg class=\"size-full wp-image-11755\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-11.40.59-AM.png\" alt=\"(Centers for Disease Control)\" width=\"607\" height=\"457\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-11.40.59-AM.png 607w, https://ww2.kqed.org/app/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-11.40.59-AM-400x301.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/03/Screen-Shot-2013-03-27-at-11.40.59-AM-320x241.png 320w\" sizes=\"(max-width: 607px) 100vw, 607px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Centers for Disease Control)\u003c/figcaption>\u003c/figure>\n\u003cp>Nearly one in four children ages birth to 17 live in families that are struggling to pay medical bills, according to CDC data from the National Health Interview Survey, from January - June, 2011.\u003c/p>\n\u003cp>Here are more findings. In the first six months of 2011:\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>one in three persons was in a family experiencing financial burden of medical care\u003c/li>\n\u003cli>one in 5 persons was in a family having problems paying medical bills\u003c/li>\n\u003cli>one in 4 persons was in a family paying medical bills over time\u003c/li>\n\u003cli>one in 10 persons was in a family that had medical bills they were unable to pay at all\u003c/li>\n\u003c/ul>\n\u003cp>The CDC has more sobering charts\u003ca href=\"http://www.cdc.gov/nchs/data/nhis/earlyrelease/financial_burden_of_medical_care_032012.pdf\" target=\"_blank\"> here\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/11752/chart-of-the-day-health-cares-financial-burden",
"authors": [
"240"
],
"categories": [
"stateofhealth_13"
],
"tags": [
"stateofhealth_482"
],
"featImg": "stateofhealth_11753",
"label": "stateofhealth"
},
"stateofhealth_11736": {
"type": "posts",
"id": "stateofhealth_11736",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "11736",
"score": null,
"sort": [
1364403996000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1364403996,
"format": "aside",
"disqusTitle": "Health Care Overhaul: Study Say Costs Could Go Up 32 Percent",
"title": "Health Care Overhaul: Study Say Costs Could Go Up 32 Percent",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_11745\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/27/health-care-overhaul-actuaries-say-costs-could-go-up-32-percent/rs2147_stackof100dollarbills/\" rel=\"attachment wp-att-11745\">\u003cimg class=\"size-medium wp-image-11745\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls-300x225.jpg\" alt=\"(401(k)2012/Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(401(k)2012/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Now the actuaries are weighing in.\u003c/p>\n\u003cp>In a \u003ca href=\"http://cdn-files.soa.org/web/research-cost-aca-report.pdf\" target=\"_blank\">new analysis,\u003c/a> the Society of Actuaries says insurance companies will pay an average 32 percent more for medical claims under the health care overhaul.\u003c/p>\n\u003cp>That means premiums could go up, especially in the individual market.\u003c/p>\n\u003cp>The Obama Administration isn't convinced, though, saying the report didn't consider all the ways in which the administration says the Affordable Care Act will reduce costs.\u003c/p>\n\u003cp>More from the AP:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>Actuaries are financial risk professionals who conduct long-range cost estimates for pension plans, insurance companies and government programs.\u003c/p>\n\u003cp>The study says claims costs will go up largely because sicker people will join the insurance pool. That's because the law forbids insurers from turning down those with pre-existing medical problems, effective Jan. 1. Everyone gets sick sooner or later, but sicker people also use more health care services.\u003c/p>\n\u003cp>\"Claims cost is the most important driver of health care premiums,\" said Kristi Bohn, an actuary who worked on the study. Spending on sicker people and other high-cost groups will overwhelm an influx of younger, healthier people into the program, said the report.\u003c/p>\n\u003cp>The Obama administration challenged the design of the study, saying it focused only on one piece of the puzzle and ignored cost relief strategies in the law, such as tax credits to help people afford premiums and special payments to insurers who attract an outsize share of the sick.\u003c/p>\n\u003cp>The study also doesn't take into account the potential price-cutting effect of competition in new state insurance markets that will go live Oct. 1, administration officials said.\u003c/p>\n\u003cp>At a White House briefing Tuesday, Health and Human Services Secretary Kathleen Sebelius said some of what passes for health insurance today is so skimpy it can't be compared to the comprehensive coverage available under the law. \"Some of these folks have very high catastrophic plans that don't pay for anything unless you get hit by a bus,\" she said. \"They're really mortgage protection, not health insurance.\"\u003c/p>\n\u003cp>Sebelius said the picture on premiums won't start coming into focus until insurers submit their bids. Those results may not be publicly known until late summer. ...\u003c/p>\n\u003cp>A prominent national expert, recently retired Medicare chief actuary Rick Foster, said the report does \"a credible job\" of estimating potential enrollment and costs under the law, \"without trying to tilt the answers in any particular direction.\"\u003c/p>\n\u003cp>\"Having said that,\" Foster added, \"actuaries tend to be financially conservative, so the various assumptions might be more inclined to consider what might go wrong than to anticipate that everything will work beautifully.\" Actuaries use statistics and economic theory to make long-range cost projections for insurance and pension programs sponsored by businesses and government. The society is headquartered near Chicago.\u003c/p>\u003c/blockquote>\n\u003cp> \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
"disqusIdentifier": "11736 http://blogs.kqed.org/stateofhealth/?p=11736",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2013/03/27/health-care-overhaul-actuaries-say-costs-could-go-up-32-percent/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 469,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 16
},
"modified": 1364408859,
"excerpt": "A new study finds that insurance companies will have to pay out an average of 32 percent more for medical claims under President Barack Obama's health care overhaul.\r\n\r\nWhat does that mean for you?\r\n\r\nIt could increase premiums for at least some Americans.\r\n\r\nIf you are uninsured, or you buy your policy directly from an insurance company, you should pay attention.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "A new study finds that insurance companies will have to pay out an average of 32 percent more for medical claims under President Barack Obama's health care overhaul.\r\n\r\nWhat does that mean for you?\r\n\r\nIt could increase premiums for at least some Americans.\r\n\r\nIf you are uninsured, or you buy your policy directly from an insurance company, you should pay attention.",
"title": "Health Care Overhaul: Study Say Costs Could Go Up 32 Percent | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Health Care Overhaul: Study Say Costs Could Go Up 32 Percent",
"datePublished": "2013-03-27T10:06:36-07:00",
"dateModified": "2013-03-27T11:27:39-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "health-care-overhaul-actuaries-say-costs-could-go-up-32-percent",
"status": "publish",
"path": "/stateofhealth/11736/health-care-overhaul-actuaries-say-costs-could-go-up-32-percent",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_11745\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/27/health-care-overhaul-actuaries-say-costs-could-go-up-32-percent/rs2147_stackof100dollarbills/\" rel=\"attachment wp-att-11745\">\u003cimg class=\"size-medium wp-image-11745\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls-300x225.jpg\" alt=\"(401(k)2012/Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(401(k)2012/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Now the actuaries are weighing in.\u003c/p>\n\u003cp>In a \u003ca href=\"http://cdn-files.soa.org/web/research-cost-aca-report.pdf\" target=\"_blank\">new analysis,\u003c/a> the Society of Actuaries says insurance companies will pay an average 32 percent more for medical claims under the health care overhaul.\u003c/p>\n\u003cp>That means premiums could go up, especially in the individual market.\u003c/p>\n\u003cp>The Obama Administration isn't convinced, though, saying the report didn't consider all the ways in which the administration says the Affordable Care Act will reduce costs.\u003c/p>\n\u003cp>More from the AP:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>Actuaries are financial risk professionals who conduct long-range cost estimates for pension plans, insurance companies and government programs.\u003c/p>\n\u003cp>The study says claims costs will go up largely because sicker people will join the insurance pool. That's because the law forbids insurers from turning down those with pre-existing medical problems, effective Jan. 1. Everyone gets sick sooner or later, but sicker people also use more health care services.\u003c/p>\n\u003cp>\"Claims cost is the most important driver of health care premiums,\" said Kristi Bohn, an actuary who worked on the study. Spending on sicker people and other high-cost groups will overwhelm an influx of younger, healthier people into the program, said the report.\u003c/p>\n\u003cp>The Obama administration challenged the design of the study, saying it focused only on one piece of the puzzle and ignored cost relief strategies in the law, such as tax credits to help people afford premiums and special payments to insurers who attract an outsize share of the sick.\u003c/p>\n\u003cp>The study also doesn't take into account the potential price-cutting effect of competition in new state insurance markets that will go live Oct. 1, administration officials said.\u003c/p>\n\u003cp>At a White House briefing Tuesday, Health and Human Services Secretary Kathleen Sebelius said some of what passes for health insurance today is so skimpy it can't be compared to the comprehensive coverage available under the law. \"Some of these folks have very high catastrophic plans that don't pay for anything unless you get hit by a bus,\" she said. \"They're really mortgage protection, not health insurance.\"\u003c/p>\n\u003cp>Sebelius said the picture on premiums won't start coming into focus until insurers submit their bids. Those results may not be publicly known until late summer. ...\u003c/p>\n\u003cp>A prominent national expert, recently retired Medicare chief actuary Rick Foster, said the report does \"a credible job\" of estimating potential enrollment and costs under the law, \"without trying to tilt the answers in any particular direction.\"\u003c/p>\n\u003cp>\"Having said that,\" Foster added, \"actuaries tend to be financially conservative, so the various assumptions might be more inclined to consider what might go wrong than to anticipate that everything will work beautifully.\" Actuaries use statistics and economic theory to make long-range cost projections for insurance and pension programs sponsored by businesses and government. The society is headquartered near Chicago.\u003c/p>\u003c/blockquote>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/11736/health-care-overhaul-actuaries-say-costs-could-go-up-32-percent",
"authors": [
"240"
],
"categories": [
"stateofhealth_15",
"stateofhealth_13"
],
"tags": [
"stateofhealth_38"
],
"featImg": "stateofhealth_11745",
"label": "stateofhealth"
},
"stateofhealth_11439": {
"type": "posts",
"id": "stateofhealth_11439",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "11439",
"score": null,
"sort": [
1363719369000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1363719369,
"format": "aside",
"disqusTitle": "Mammograms: Which Women? How Often?",
"title": "Mammograms: Which Women? How Often?",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_5549\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/01/new-research-for-women-in-their-40s-on-mammograms/080922-n-2688m-004/\" rel=\"attachment wp-att-5549\">\u003cimg class=\"size-medium wp-image-5549\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-300x203.jpg\" alt=\"(Photo: U.S. Navy)\" width=\"300\" height=\"203\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: U.S. Navy)\u003c/figcaption>\u003c/figure>\n\u003cp>As everybody knows by now, how frequently a woman should have a mammogram is a topic of hot debate in the U.S. In particular, women in their 40s have been troubled by recommendations almost four years ago from the U.S. Preventive Services Task Force that mammograms are \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" target=\"_blank\">not routinely recommended\u003c/a> for them. Instead, the decision is an \"individual one\" that a woman can make, presumably in conversation with her doctor.\u003c/p>\n\u003cp>Now, \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1669103\" target=\"_blank\">a new study\u003c/a> has a tailored recommendation. For women in their 40s with \"extremely dense breasts,\" annual screening will reduce their risk of being diagnosed with advanced stage breast cancer.\u003c/p>\n\u003cp>\"There is this sub-group that is higher risk and has more aggressive tumors,\" said lead researcher Karla Kerlikowske, an epidemiologist and biostatistician at UCSF. \"Annual mammography is probably better for that group.\"\u003c/p>\n\u003cp>To date, most recommendations have relied on one risk factor: age. A woman's risk of breast cancer increases as she gets older. But there are other risk factors, too, like breast density. About 12 to 15 percent of women in their 40s have \"extremely dense breasts.\" Radiologists categorize breast density on a scale of 1 to 4, and a score of 4 is \"extremely dense.\"\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But women with dense breasts are also at higher risk of false positives and may need to go through additional imaging and unnecessary biopsies. How much? The researchers report that women with extremely dense breasts have a 65.5 percent likelihood of a false positive over a ten year period. Still, \"annual screening has added benefit to detect breast cancer at an earlier stage\" than screening every other year, the researchers write.\u003c/p>\n\u003cp>(As an aside: if you're a woman in your 40s with doctor-diagnosed \"extremely dense breasts,\" then your risk of breast cancer matches that of an average-risk woman in her 50s, according to the analysis.)\u003c/p>\n\u003cp>In the study, published in this week's JAMA Internal Medicine, researchers looked at nearly one million women -- more than 11,000 women with breast cancer and more than 900,000 without breast cancer, all of whom had mammograms.\u003c/p>\n\u003cp>Researchers also looked at women who used hormone therapy after menopause. Hormone therapy has been shown to increase a woman's risk of breast cancer. For women ages 50-74, even for women with dense breasts or hormone therapy use, annual screening made no difference.\u003c/p>\n\u003cp>\"They could be screened every two years and have the same benefit as being screened every year and fewer harms from mammography,\" Kerlikowske said.\u003c/p>\n\u003cp>Those harms can be common. If you're a woman in the 50-74 group, with less dense breasts (a \"2\" scored by a radiologist), and do not take hormone therapy, your risk of a false positive after ten years of annual mammography is 49.8 percent. The likelihood of a false positive falls to 30.7 percent if a woman is having a mammogram every other year.\u003c/p>\n\u003cp>In a \u003ca href=\"http://annfammed.org/content/11/2/106.full\" target=\"_blank\">separate study\u003c/a> this week, researchers found that these false positives lead to \"long-term psychosocial harm\" for many women.\u003c/p>\n\u003cp>It's unlikely that recommendations will be changed based on this study. The American Cancer Society offers\u003ca href=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" target=\"_blank\"> different recommendations\u003c/a> than the U.S. Preventive Services Task Force. The ACS continues to recommend an annual mammogram for women beginning at age 40. The group's chief medical officer, Dr. Otis Brawley says he doesn't \"see us changing right now.\"\u003c/p>\n\u003cp>But he also said he could foresee a time of targeted recommendations for women-- not just for having mammograms more frequently, but less frequently, too.\u003c/p>\n\u003cp>\"I think we are moving toward a period of time,\" Brawley said, \"where we will identify through a bunch of questions that involve family history, age, density of breast tissue ... whether one is menopausal or not menopausal, and we're going to have a group of women who will be in their 50s, and we will tell them you ought to have a mammogram every three years.\"\u003c/p>\n\u003cp>He added there could be a group that needs mammograms annually and a very targeted group that might need to be screened even more frequently.\u003c/p>\n\u003cp>\u003cstrong>New law takes effect April 1st\u003c/strong>\u003c/p>\n\u003cp>The study comes just as\u003ca href=\"http://www.leginfo.ca.gov/pub/11-12/bill/sen/sb_1501-1550/sb_1538_bill_20120922_chaptered.pdf\" target=\"_blank\"> a new law\u003c/a> is scheduled to take effect in California. Starting April 1st, radiologists will be required to notify women if they have heterogeneously dense or extremely dense breast tissue (category 3 or 4). Radiologists already send women a report after their mammogram; they would add this information to that letter.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The law passed with overwhelming support in the California legislature, but Brawley says aside from extremely dense breasts, that breast density is a subjective measure. UCSF's Kerlikowske says she thinks the \"law is ahead of the science,\" because there's no data showing that other kinds of screening tests, such as ultrasound or MRI, have any benefit for these women.\u003c/p>\n\n",
"disqusIdentifier": "11439 http://blogs.kqed.org/stateofhealth/?p=11439",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2013/03/19/mammograms-which-women-how-often/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 815,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 21
},
"modified": 1371247025,
"excerpt": "As everybody knows by now, how frequently a woman should have a mammogram is a topic of hot debate in the U.S. In particular, women in their 40s have been troubled by recommendations four years ago from the US Preventive Services Task Force that mammograms are not routinely recommended for them. Instead, the decision is an \"individual one\" that a woman can make, presumably in conversation with her doctor.\r\n\r\nTo date, most recommendations have relied on one risk factor: age. A woman's risk of breast cancer increases as she gets older. But there are other risk factors, too. In particular, women with dense breasts are at higher risk for cancer. Now a new study, led by researchers at UCSF have looked specifically at breast density and how what doctors call the \"screening interval\" of mammograms might affect their risk of being diagnosed with advanced breast cancer.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "As everybody knows by now, how frequently a woman should have a mammogram is a topic of hot debate in the U.S. In particular, women in their 40s have been troubled by recommendations four years ago from the US Preventive Services Task Force that mammograms are not routinely recommended for them. Instead, the decision is an "individual one" that a woman can make, presumably in conversation with her doctor.\r\n\r\nTo date, most recommendations have relied on one risk factor: age. A woman's risk of breast cancer increases as she gets older. But there are other risk factors, too. In particular, women with dense breasts are at higher risk for cancer. Now a new study, led by researchers at UCSF have looked specifically at breast density and how what doctors call the "screening interval" of mammograms might affect their risk of being diagnosed with advanced breast cancer.",
"title": "Mammograms: Which Women? How Often? | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Mammograms: Which Women? How Often?",
"datePublished": "2013-03-19T11:56:09-07:00",
"dateModified": "2013-06-14T14:57:05-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "mammograms-which-women-how-often",
"status": "publish",
"path": "/stateofhealth/11439/mammograms-which-women-how-often",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5549\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/01/new-research-for-women-in-their-40s-on-mammograms/080922-n-2688m-004/\" rel=\"attachment wp-att-5549\">\u003cimg class=\"size-medium wp-image-5549\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-300x203.jpg\" alt=\"(Photo: U.S. Navy)\" width=\"300\" height=\"203\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: U.S. Navy)\u003c/figcaption>\u003c/figure>\n\u003cp>As everybody knows by now, how frequently a woman should have a mammogram is a topic of hot debate in the U.S. In particular, women in their 40s have been troubled by recommendations almost four years ago from the U.S. Preventive Services Task Force that mammograms are \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" target=\"_blank\">not routinely recommended\u003c/a> for them. Instead, the decision is an \"individual one\" that a woman can make, presumably in conversation with her doctor.\u003c/p>\n\u003cp>Now, \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1669103\" target=\"_blank\">a new study\u003c/a> has a tailored recommendation. For women in their 40s with \"extremely dense breasts,\" annual screening will reduce their risk of being diagnosed with advanced stage breast cancer.\u003c/p>\n\u003cp>\"There is this sub-group that is higher risk and has more aggressive tumors,\" said lead researcher Karla Kerlikowske, an epidemiologist and biostatistician at UCSF. \"Annual mammography is probably better for that group.\"\u003c/p>\n\u003cp>To date, most recommendations have relied on one risk factor: age. A woman's risk of breast cancer increases as she gets older. But there are other risk factors, too, like breast density. About 12 to 15 percent of women in their 40s have \"extremely dense breasts.\" Radiologists categorize breast density on a scale of 1 to 4, and a score of 4 is \"extremely dense.\"\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But women with dense breasts are also at higher risk of false positives and may need to go through additional imaging and unnecessary biopsies. How much? The researchers report that women with extremely dense breasts have a 65.5 percent likelihood of a false positive over a ten year period. Still, \"annual screening has added benefit to detect breast cancer at an earlier stage\" than screening every other year, the researchers write.\u003c/p>\n\u003cp>(As an aside: if you're a woman in your 40s with doctor-diagnosed \"extremely dense breasts,\" then your risk of breast cancer matches that of an average-risk woman in her 50s, according to the analysis.)\u003c/p>\n\u003cp>In the study, published in this week's JAMA Internal Medicine, researchers looked at nearly one million women -- more than 11,000 women with breast cancer and more than 900,000 without breast cancer, all of whom had mammograms.\u003c/p>\n\u003cp>Researchers also looked at women who used hormone therapy after menopause. Hormone therapy has been shown to increase a woman's risk of breast cancer. For women ages 50-74, even for women with dense breasts or hormone therapy use, annual screening made no difference.\u003c/p>\n\u003cp>\"They could be screened every two years and have the same benefit as being screened every year and fewer harms from mammography,\" Kerlikowske said.\u003c/p>\n\u003cp>Those harms can be common. If you're a woman in the 50-74 group, with less dense breasts (a \"2\" scored by a radiologist), and do not take hormone therapy, your risk of a false positive after ten years of annual mammography is 49.8 percent. The likelihood of a false positive falls to 30.7 percent if a woman is having a mammogram every other year.\u003c/p>\n\u003cp>In a \u003ca href=\"http://annfammed.org/content/11/2/106.full\" target=\"_blank\">separate study\u003c/a> this week, researchers found that these false positives lead to \"long-term psychosocial harm\" for many women.\u003c/p>\n\u003cp>It's unlikely that recommendations will be changed based on this study. The American Cancer Society offers\u003ca href=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" target=\"_blank\"> different recommendations\u003c/a> than the U.S. Preventive Services Task Force. The ACS continues to recommend an annual mammogram for women beginning at age 40. The group's chief medical officer, Dr. Otis Brawley says he doesn't \"see us changing right now.\"\u003c/p>\n\u003cp>But he also said he could foresee a time of targeted recommendations for women-- not just for having mammograms more frequently, but less frequently, too.\u003c/p>\n\u003cp>\"I think we are moving toward a period of time,\" Brawley said, \"where we will identify through a bunch of questions that involve family history, age, density of breast tissue ... whether one is menopausal or not menopausal, and we're going to have a group of women who will be in their 50s, and we will tell them you ought to have a mammogram every three years.\"\u003c/p>\n\u003cp>He added there could be a group that needs mammograms annually and a very targeted group that might need to be screened even more frequently.\u003c/p>\n\u003cp>\u003cstrong>New law takes effect April 1st\u003c/strong>\u003c/p>\n\u003cp>The study comes just as\u003ca href=\"http://www.leginfo.ca.gov/pub/11-12/bill/sen/sb_1501-1550/sb_1538_bill_20120922_chaptered.pdf\" target=\"_blank\"> a new law\u003c/a> is scheduled to take effect in California. Starting April 1st, radiologists will be required to notify women if they have heterogeneously dense or extremely dense breast tissue (category 3 or 4). Radiologists already send women a report after their mammogram; they would add this information to that letter.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The law passed with overwhelming support in the California legislature, but Brawley says aside from extremely dense breasts, that breast density is a subjective measure. UCSF's Kerlikowske says she thinks the \"law is ahead of the science,\" because there's no data showing that other kinds of screening tests, such as ultrasound or MRI, have any benefit for these women.\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/11439/mammograms-which-women-how-often",
"authors": [
"240"
],
"categories": [
"stateofhealth_12",
"stateofhealth_13"
],
"tags": [
"stateofhealth_46",
"stateofhealth_176",
"stateofhealth_461"
],
"featImg": "stateofhealth_5549",
"label": "stateofhealth"
},
"stateofhealth_10704": {
"type": "posts",
"id": "stateofhealth_10704",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "10704",
"score": null,
"sort": [
1361554680000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1361554680,
"format": "aside",
"disqusTitle": "When Artificial Hips Go Bad: Thousands Sue over ASR XL by Johnson & Johnson Subsidiary",
"title": "When Artificial Hips Go Bad: Thousands Sue over ASR XL by Johnson & Johnson Subsidiary",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_10728\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/22/when-artificial-hips-go-bad/jj-study-predicted-37-failure-rate-for-hip-implants/\" rel=\"attachment wp-att-10728\">\u003cimg class=\"size-medium wp-image-10728\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/ASR-Hip-300x300.jpg\" alt=\"Michael Kelly, attorney for plaintiff Loren Kransky, holds up an ASR XL hip implant made by Johnson & Johnson during his opening statement to the jury at the trial of Kransky v. DePuy, at California Superior Court in Los Angeles, on Friday, Jan. 25, 2013. (Credit: Patrick T. Fallon/Bloomberg)\" width=\"300\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Michael Kelly, attorney for plaintiff Loren Kransky, holds up an ASR XL hip implant made by Johnson & Johnson during his opening statement to the jury at the trial of Kransky v. DePuy, at California Superior Court in Los Angeles, on Friday, Jan. 25, 2013. (Credit: Patrick T. Fallon/Bloomberg)\u003c/figcaption>\u003c/figure>\n\u003cp>In recent weeks, a jury in Los Angeles Superior Court has been diving deep into the world of artificial hips. They’re hearing the case of a Montana man whose hip implant went bad –- but they’re also laying the legal groundwork for what’s expected to be a massive settlement between the maker of the hip and more than 10,000 Americans.\u003c/p>\n\u003cp>\u003ca href=\"http://www.depuy.com\" target=\"_blank\">De Puy\u003c/a>, a subsidiary of Johnson and Johnson, stands accused of producing a defective design, failing to warn doctors and patients when word first came trickling back the hip was failing at high rates, and then moving too slowly to recall the product.\u003c/p>\n\u003cp>The ASR hip went to market in Europe in 2003; in the US, in 2005. Within a year or two of when it was first sold in Europe, concerns about the ASR began filtering back to J&J through surgeons. \u003c!--more-->Patients complained of pain. The device would work its way loose in the hip.\u003c/p>\n\u003cp>In 2008, a committee was established to determine whether to redesign the ASR. “That was called Project Alpha,” says Bloomberg News reporter David Voreacos, who spoke with me this week on the \u003ca href=\"http://www.californiareport.org/archive/R201302210850/b\">California Report\u003c/a>. “The company scrapped it.” The committee, that is. Not the hip.\u003c/p>\n\u003cp>That wouldn’t happen until August of 2010, after UK data showed more than 12 percent failed within five years. But by 2010, some 93,000 people worldwide had been implanted with a version of this artificial hip, 37,000 of them in the US.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The world’s largest seller of health-care products has revealed the \u003ca href=\"http://www.bloomberg.com/news/2013-02-22/j-j-discloses-government-investigations-of-hips-mesh.html\">Justice Department is investigating\u003c/a> possible false claims related to the hip devices.\u003c/p>\n\u003cp>In the meantime, 10,000 lawsuits have been consolidated into pending class action suits in Toledo, San Francisco and Los Angeles.\u003c/p>\n\u003cp>Loren Kransky’s case is the first to go to trial. He’s a retired prison guard who got an ASR XL hip implant in 2007. In 2012, after his doctor noticed it was shedding metal ions into his blood stream, Kransky had the device removed and replaced.\u003c/p>\n\u003cp>“The ASR XL was dangerous and it was defective in design and we will prove it,” Kransky’s lawyer, Michael Kelly, said in his \u003ca href=\"//www.bloomberg.com/news/2013-01-25/j-j-failed-to-warn-of-hip-implant-s-risks-jurors-told-1-.html\">opening statement\u003c/a> last month.\u003c/p>\n\u003cp>“It was seen as a revolutionary device,” says Voreacos. “Patients were told it would last 20 years.” Since most models last about 15 years, the device was particularly attractive to young patients hoping to regain mobility lost from conditions like arthritis or lupus.\u003c/p>\n\u003cp>Then there's the issue of toxicity. It turns out the ASR also has a tendency to leach cobalt and chromium ions into the bloodstream.\u003c/p>\n\u003cp>“It’s sort of a long term question, the health effect of those ions.” Voreacos says.\u003c/p>\n\u003cp>Reporter Barry Meier of the \u003cem>New York Times\u003c/em> is more blunt. In a \u003ca href=\"http://www.nytimes.com/2013/01/17/business/fda-to-tighten-regulation-of-all-metal-hip-implants.html\">recent article,\u003c/a> he wrote, “Tiny particles of metallic debris released as the artificial joints move have caused severe tissue and bone damage in hundreds of patients, leaving some of them disabled.”\u003c/p>\n\u003cp>Even if a person isn’t left disabled, a hip implant surgery requires removing bone. So if the device fails to take, or the ion issue prompts a person to want to get rid of the ASR, replacing the hip can be a painful business. The more surgeries, the more bone material is removed from the joint. Most artificial hip recipients speak glowingly of the mobility they've regained, but it's fair to say the fewer the number of surgeries in a lifetime, the better.\u003c/p>\n\u003cp>Prosecutors in Los Angeles Superior Court point to another data set coming from Australia that suggested the ASR would fail in 44 percent of patients within seven years - eight times the failure rate of most orthopedic implants.\u003c/p>\n\u003cp>You might be thinking this is just the kind of situation pre-market clinical studies are designed to forestall. You’d be right, but federal rules do not require it for all medical devices. Only now is the \u003ca href=\"http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/MetalonMetalHipImplants/ucm241604.htm\">Food and Drug Administration\u003c/a> proposing that makers of artificial hips with all-metal components \u003cem>prove\u003c/em> the devices are safe and effective \u003cem>before\u003c/em> they continue selling existing ones or get approval for new all-metal designs.\u003c/p>\n\u003cp>Currently, companies have to show only that their devices resemble ones already on the market. Over the years, the FDA repeatedly started the process required to classify all-metal hips as high-risk products rather than moderate-risk ones, but federal officials never crossed the goal line -- in part due to heavy lobbying from industry.\u003c/p>\n\u003cp>The FDA is reportedly moving now to close that \u003ca href=\"http://www.nytimes.com/2013/01/17/business/fda-to-tighten-regulation-of-all-metal-hip-implants.html\">loophole\u003c/a> in the \u003ca href=\"//www.fda.gov/medicaldevices/productsandmedicalprocedures/deviceapprovalsandclearances/pmaapprovals/default.htm\">Medical Device Amendments of 1976\u003c/a>.\u003c/p>\n\u003cp>In the meantime, the use of all-metal implants has plummeted, with the devices now accounting for about five percent of hip implants. But as Voreacos notes, evidence presented in the Kransky trial suggests all all-metal hips are not alike. The ASR failure rate is the highest of any hip implant, in any class.\u003c/p>\n\u003cp>So that’s one compelling back story to the story of the ASR hip. The other one is the apparent complicity of consulting hip specialists. Surgeons developed the design, including one at \u003ca href=\"http://orthosurg.ucsf.edu/home/faculty/biography/thomas-parker-vail-md/\">UCSF\u003c/a> and another in \u003ca href=\"http://www.jri-docs.com/about/MeetMDs/Pages/ThomasPSchmalzriedMD.aspx\">Los Angeles\u003c/a> who\u003cspan style=\"color: #000000\"> is the Joint Replacement Section Editor for \u003cem>Orthopedics Today\u003c/em>\u003c/span>. One presumes medical devices are best developed by the top names in any given field, and naturally, they should receive royalties on those devices. But that creates a structural incentive to downplay reports of problematic outcomes from other surgeons in the field.\u003c/p>\n\u003cp>DePuy denies all the claims pending in Los Angeles -- and it also argues Kransky's claims are particularly suspect. Hip or no hip, he's struggled with a laundry list of health problems, including diabetes, coronary artery disease, high blood pressure, kidney disease, strokes and cancer. That may affect the strength of this case as a precedent setter.\u003c/p>\n\u003cp>A couple more cases are headed to trial, including one in Chicago and one in Toledo. Lawyers are both sides are expected to use what happens in these first three trials to set parameters for settlements.\u003c/p>\n\u003cp>In any case, a new development just out today does not bode well for Johnson & Johnson.\u003c/p>\n\u003cp>The FDA has notified healthcare professionals of a Class I recall, the most serious type, of another orthopedic device made by Johnson & Johnson: the \u003ca href=\"http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm340740.htm\">LPS Diaphyseal Sleeve\u003c/a>, used in reconstructive knee surgery. It was recalled because of the potential for fractures, the FDA said.\u003c/p>\n\u003cp>\"The FDA has received a total of 10 reports (6 fractures and 4 reports of loosening that may or may not be attributed to the same device design issue) of incidents in which the device has malfunctioned.\"\u003c/p>\n\u003cp>And further, this:\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"A fracture in the sleeve at the joint of it could lead to loss of function or loss of limb, infection, compromised soft tissue or death.\"\u003c/p>\n\n",
"disqusIdentifier": "10704 http://blogs.kqed.org/stateofhealth/?p=10704",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2013/02/22/when-artificial-hips-go-bad/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 1220,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 29
},
"modified": 1361799049,
"excerpt": "In recent weeks, a jury in Los Angeles Superior Court has been diving deep into the world of artificial hips. They’re hearing the case of a Montana man whose hip implant went bad –- but they’re also laying the legal groundwork for what’s expected to be a massive settlement between the maker of the hip and more than 10,000 Americans.\r\n\r\nDe Puy, a subsidiary of Johnson and Johnson, stands accused of producing a defective design, failing to warn doctors and patients when word first came trickling back the hip was failing at high rates, and then moving too slowly to recall the product.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "In recent weeks, a jury in Los Angeles Superior Court has been diving deep into the world of artificial hips. They’re hearing the case of a Montana man whose hip implant went bad –- but they’re also laying the legal groundwork for what’s expected to be a massive settlement between the maker of the hip and more than 10,000 Americans.\r\n\r\nDe Puy, a subsidiary of Johnson and Johnson, stands accused of producing a defective design, failing to warn doctors and patients when word first came trickling back the hip was failing at high rates, and then moving too slowly to recall the product.",
"title": "When Artificial Hips Go Bad: Thousands Sue over ASR XL by Johnson & Johnson Subsidiary | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "When Artificial Hips Go Bad: Thousands Sue over ASR XL by Johnson & Johnson Subsidiary",
"datePublished": "2013-02-22T09:38:00-08:00",
"dateModified": "2013-02-25T05:30:49-08:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "when-artificial-hips-go-bad",
"status": "publish",
"path": "/stateofhealth/10704/when-artificial-hips-go-bad",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_10728\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/22/when-artificial-hips-go-bad/jj-study-predicted-37-failure-rate-for-hip-implants/\" rel=\"attachment wp-att-10728\">\u003cimg class=\"size-medium wp-image-10728\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/ASR-Hip-300x300.jpg\" alt=\"Michael Kelly, attorney for plaintiff Loren Kransky, holds up an ASR XL hip implant made by Johnson & Johnson during his opening statement to the jury at the trial of Kransky v. DePuy, at California Superior Court in Los Angeles, on Friday, Jan. 25, 2013. (Credit: Patrick T. Fallon/Bloomberg)\" width=\"300\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Michael Kelly, attorney for plaintiff Loren Kransky, holds up an ASR XL hip implant made by Johnson & Johnson during his opening statement to the jury at the trial of Kransky v. DePuy, at California Superior Court in Los Angeles, on Friday, Jan. 25, 2013. (Credit: Patrick T. Fallon/Bloomberg)\u003c/figcaption>\u003c/figure>\n\u003cp>In recent weeks, a jury in Los Angeles Superior Court has been diving deep into the world of artificial hips. They’re hearing the case of a Montana man whose hip implant went bad –- but they’re also laying the legal groundwork for what’s expected to be a massive settlement between the maker of the hip and more than 10,000 Americans.\u003c/p>\n\u003cp>\u003ca href=\"http://www.depuy.com\" target=\"_blank\">De Puy\u003c/a>, a subsidiary of Johnson and Johnson, stands accused of producing a defective design, failing to warn doctors and patients when word first came trickling back the hip was failing at high rates, and then moving too slowly to recall the product.\u003c/p>\n\u003cp>The ASR hip went to market in Europe in 2003; in the US, in 2005. Within a year or two of when it was first sold in Europe, concerns about the ASR began filtering back to J&J through surgeons. \u003c!--more-->Patients complained of pain. The device would work its way loose in the hip.\u003c/p>\n\u003cp>In 2008, a committee was established to determine whether to redesign the ASR. “That was called Project Alpha,” says Bloomberg News reporter David Voreacos, who spoke with me this week on the \u003ca href=\"http://www.californiareport.org/archive/R201302210850/b\">California Report\u003c/a>. “The company scrapped it.” The committee, that is. Not the hip.\u003c/p>\n\u003cp>That wouldn’t happen until August of 2010, after UK data showed more than 12 percent failed within five years. But by 2010, some 93,000 people worldwide had been implanted with a version of this artificial hip, 37,000 of them in the US.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The world’s largest seller of health-care products has revealed the \u003ca href=\"http://www.bloomberg.com/news/2013-02-22/j-j-discloses-government-investigations-of-hips-mesh.html\">Justice Department is investigating\u003c/a> possible false claims related to the hip devices.\u003c/p>\n\u003cp>In the meantime, 10,000 lawsuits have been consolidated into pending class action suits in Toledo, San Francisco and Los Angeles.\u003c/p>\n\u003cp>Loren Kransky’s case is the first to go to trial. He’s a retired prison guard who got an ASR XL hip implant in 2007. In 2012, after his doctor noticed it was shedding metal ions into his blood stream, Kransky had the device removed and replaced.\u003c/p>\n\u003cp>“The ASR XL was dangerous and it was defective in design and we will prove it,” Kransky’s lawyer, Michael Kelly, said in his \u003ca href=\"//www.bloomberg.com/news/2013-01-25/j-j-failed-to-warn-of-hip-implant-s-risks-jurors-told-1-.html\">opening statement\u003c/a> last month.\u003c/p>\n\u003cp>“It was seen as a revolutionary device,” says Voreacos. “Patients were told it would last 20 years.” Since most models last about 15 years, the device was particularly attractive to young patients hoping to regain mobility lost from conditions like arthritis or lupus.\u003c/p>\n\u003cp>Then there's the issue of toxicity. It turns out the ASR also has a tendency to leach cobalt and chromium ions into the bloodstream.\u003c/p>\n\u003cp>“It’s sort of a long term question, the health effect of those ions.” Voreacos says.\u003c/p>\n\u003cp>Reporter Barry Meier of the \u003cem>New York Times\u003c/em> is more blunt. In a \u003ca href=\"http://www.nytimes.com/2013/01/17/business/fda-to-tighten-regulation-of-all-metal-hip-implants.html\">recent article,\u003c/a> he wrote, “Tiny particles of metallic debris released as the artificial joints move have caused severe tissue and bone damage in hundreds of patients, leaving some of them disabled.”\u003c/p>\n\u003cp>Even if a person isn’t left disabled, a hip implant surgery requires removing bone. So if the device fails to take, or the ion issue prompts a person to want to get rid of the ASR, replacing the hip can be a painful business. The more surgeries, the more bone material is removed from the joint. Most artificial hip recipients speak glowingly of the mobility they've regained, but it's fair to say the fewer the number of surgeries in a lifetime, the better.\u003c/p>\n\u003cp>Prosecutors in Los Angeles Superior Court point to another data set coming from Australia that suggested the ASR would fail in 44 percent of patients within seven years - eight times the failure rate of most orthopedic implants.\u003c/p>\n\u003cp>You might be thinking this is just the kind of situation pre-market clinical studies are designed to forestall. You’d be right, but federal rules do not require it for all medical devices. Only now is the \u003ca href=\"http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/MetalonMetalHipImplants/ucm241604.htm\">Food and Drug Administration\u003c/a> proposing that makers of artificial hips with all-metal components \u003cem>prove\u003c/em> the devices are safe and effective \u003cem>before\u003c/em> they continue selling existing ones or get approval for new all-metal designs.\u003c/p>\n\u003cp>Currently, companies have to show only that their devices resemble ones already on the market. Over the years, the FDA repeatedly started the process required to classify all-metal hips as high-risk products rather than moderate-risk ones, but federal officials never crossed the goal line -- in part due to heavy lobbying from industry.\u003c/p>\n\u003cp>The FDA is reportedly moving now to close that \u003ca href=\"http://www.nytimes.com/2013/01/17/business/fda-to-tighten-regulation-of-all-metal-hip-implants.html\">loophole\u003c/a> in the \u003ca href=\"//www.fda.gov/medicaldevices/productsandmedicalprocedures/deviceapprovalsandclearances/pmaapprovals/default.htm\">Medical Device Amendments of 1976\u003c/a>.\u003c/p>\n\u003cp>In the meantime, the use of all-metal implants has plummeted, with the devices now accounting for about five percent of hip implants. But as Voreacos notes, evidence presented in the Kransky trial suggests all all-metal hips are not alike. The ASR failure rate is the highest of any hip implant, in any class.\u003c/p>\n\u003cp>So that’s one compelling back story to the story of the ASR hip. The other one is the apparent complicity of consulting hip specialists. Surgeons developed the design, including one at \u003ca href=\"http://orthosurg.ucsf.edu/home/faculty/biography/thomas-parker-vail-md/\">UCSF\u003c/a> and another in \u003ca href=\"http://www.jri-docs.com/about/MeetMDs/Pages/ThomasPSchmalzriedMD.aspx\">Los Angeles\u003c/a> who\u003cspan style=\"color: #000000\"> is the Joint Replacement Section Editor for \u003cem>Orthopedics Today\u003c/em>\u003c/span>. One presumes medical devices are best developed by the top names in any given field, and naturally, they should receive royalties on those devices. But that creates a structural incentive to downplay reports of problematic outcomes from other surgeons in the field.\u003c/p>\n\u003cp>DePuy denies all the claims pending in Los Angeles -- and it also argues Kransky's claims are particularly suspect. Hip or no hip, he's struggled with a laundry list of health problems, including diabetes, coronary artery disease, high blood pressure, kidney disease, strokes and cancer. That may affect the strength of this case as a precedent setter.\u003c/p>\n\u003cp>A couple more cases are headed to trial, including one in Chicago and one in Toledo. Lawyers are both sides are expected to use what happens in these first three trials to set parameters for settlements.\u003c/p>\n\u003cp>In any case, a new development just out today does not bode well for Johnson & Johnson.\u003c/p>\n\u003cp>The FDA has notified healthcare professionals of a Class I recall, the most serious type, of another orthopedic device made by Johnson & Johnson: the \u003ca href=\"http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm340740.htm\">LPS Diaphyseal Sleeve\u003c/a>, used in reconstructive knee surgery. It was recalled because of the potential for fractures, the FDA said.\u003c/p>\n\u003cp>\"The FDA has received a total of 10 reports (6 fractures and 4 reports of loosening that may or may not be attributed to the same device design issue) of incidents in which the device has malfunctioned.\"\u003c/p>\n\u003cp>And further, this:\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "floatright"
},
"numeric": [
"floatright"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"A fracture in the sleeve at the joint of it could lead to loss of function or loss of limb, infection, compromised soft tissue or death.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/10704/when-artificial-hips-go-bad",
"authors": [
"251"
],
"categories": [
"stateofhealth_13"
],
"featImg": "stateofhealth_10728",
"label": "stateofhealth"
},
"stateofhealth_10661": {
"type": "posts",
"id": "stateofhealth_10661",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "10661",
"score": null,
"sort": [
1361293490000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1361293490,
"format": "aside",
"disqusTitle": "Self-Screening Stations Coming to Walmart -- 2,500 of Them ",
"title": "Self-Screening Stations Coming to Walmart -- 2,500 of Them ",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_212\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2011/11/09/walmart-where-you-can-get-clothes-food-and-a-health-check-up/olympus-digital-camera/\" rel=\"attachment wp-att-212\">\u003cimg class=\"size-full wp-image-212\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/Walmart-300.jpg\" alt=\"(Illustration by Kaiser Health News from photo by Walmart via Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Illustration by Kaiser Health News from photo by Walmart via Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>By Julie Appleby,\u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/February/19/self-health-care-kiosks-walmart.aspx\" target=\"_blank\"> Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Perched by a computer monitor wedged between shelves of cough drops and the pharmacy in a bustling Walmart in Sterling, Va., Mohamed Khader taps out answers to questions such as how often he eats vegetables, whether anyone in his family has diabetes and his age. He tests his eyesight, weighs himself and checks his blood pressure as a middle-aged couple watches at the blue-and-white SoloHealth station advertising \"free health screenings.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">Such programs raise a red flag for some consumer advocates who worry the \"advice\" might be an advertisement.\u003c/aside>\n\u003cp>\"You may not go to the doctor every year, but you come to Walmart often,\" says the fit-looking 43-year-old Khader who lives in nearby Ashburn, Va. \"I get bored while my wife is shopping. This is a time killer. I’ll come back in two months or so, and track my results.\"\u003c/p>\n\u003cp>A burgeoning consumer health industry is betting that millions of consumers will do just that.\u003c!--more-->\u003c/p>\n\u003cp>As Americans gain coverage under the federal health law, putting increased demand on primary care doctors and spurring interest in cheaper, more convenient care, unmanned kiosks like these may be part of what their manufacturer bills as a \"self-service healthcare revolution.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The SoloHealth Station gives consumers free and convenient access to health care by allowing them to screen their vision, blood pressure, weight, and body mass index (BMI) -- or any combination of the four -- in seven minutes or less for free according to the manufacturer.\u003c/p>\n\u003cp>Walmart's interest is especially significant, given the giant retailer's reach, the growth of its pharmacies and retail medical clinics and a top official’s recent statements -- before being walked back by the company -- outlining plans for a push into primary care. SoloHealth' stations are slated to be in 2,500 Walmarts and Sam's Clubs starting next month.\u003c/p>\n\u003cp>Some doctors' groups and consumer advocates urge caution, raising concerns about how companies might use personal health data, the quality of their medical information and whether advertisers and other sponsors might shape their advice and referrals for commercial reasons.\u003c/p>\n\u003cp>\"There is a trend in general by retailers and health insurers to provide 'fluff' to consumers in the guise of real medical information as an advertising delivery device,\" says Carmen Balber of the left leaning advocacy group Consumer Watchdog.\u003c/p>\n\u003cp>\u003cstrong>Bringing Exam Rooms To Patients\u003c/strong>\u003c/p>\n\u003cdiv>\n\u003cdiv>\n\u003cp>SoloHealth's backers have big plans. The Georgia-based company aims to expand its kiosk offerings to teach people how to quit smoking, test whether they are at risk for diabetes and even enroll them in health coverage.\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003cp>Self-serve computer stations are also eyed as a way to help consumers figure out whether they need medications for conditions such as high cholesterol, under a proposal now before the FDA to make some prescription medications over the counter. \"It is clear there are now many interactive mechanisms that can step the consumer through the process of self-diagnosis and medication selection,\" said Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research at a public hearing last March. The proposal is still under review.\u003c/p>\n\u003cp>Rival firms are marketing similar technologies. HealthSpot, based in Ohio, has enclosed cubicles that allow patients to pay $59 to $79 for a video \"visit\" with a doctor. NowClinic online, a subsidiary of UnitedHealth Group, provides 10-minute video chats with physicians for $45.\u003c/p>\n\u003cp>Technology \"has become a new arm of the health care delivery system,\" says Jay Sanders, CEO of The Global Telemedicine Group, a consulting firm. \"You need to bring the exam room to where the patient is, not where the doctor is.\"\u003c/p>\n\u003cp>\u003cstrong>'Treading A Fine Line'\u003c/strong>\u003c/p>\n\u003cp>SoloHealth's founder and CEO Bart Foster saw larger possibilities for automated screening after he began providing Walmart with self-service vision tests as a way to get shoppers from the product aisles to Walmart's optical shops.\u003c/p>\n\u003cp>In 2010, the firm got a $1.2 million grant from the National Institutes of Health to develop new approaches to screening for people in underserved communities. It has also received more than $43 million in investments from computer maker Dell Corp., health insurer WellPoint and Coinstar, maker of the Red Box DVD rental boxes, he says.\u003c/p>\n\u003cp>Today, SoloHealth's kiosks, which are not connected to a live physician, allow consumers not just to test their eyesight and learn if they are obese, but to get information on diet, vitamins and pain management. A \"find a doctor\" function can direct users to nearby doctors, although the one in Sterling, Va., listed only \"optical doctors\" -- and those appeared mainly to be Walmart-affiliated.\u003c/p>\n\u003cp>Foster says SoloHealth has received lists of doctors from sponsors, including Walmart, and also allows doctors to buy a listing. SoloHealth does not do any independent review of doctors' credentials. About 20 to 30 doctors are typically offered.\u003c/p>\n\u003cp>Among its programs is one that advises those suffering symptoms of heartburn whether it may indeed be heartburn and which over-the-counter product might be useful, says Stephen Kendig, the firm’s chief commercial officer.\u003c/p>\n\u003cp>\"We’re treading a fine line,\" Foster says. \"We don’t want to practice medicine, just educate people.\"\u003c/p>\n\u003cp>But such programs raise a red flag for some consumer advocates who worry the \"advice\" might be an advertisement.\u003c/p>\n\u003cp>The SoloHealth station in Sterling, Va., for example, runs a video for Healthy Choice yogurt while the blood pressure device inflates. Ads for Nature Made fish oil supplements or Healthy Choice frozen meals appear when consumers respond yes to a written question asking if they want more information about a healthy lifestyle. Others appear for allergy drug Zyrtec and heartburn medication Prilosec.\u003c/p>\n\u003cp>The ads, which can be targeted to particular consumers based on their answers, are SoloHealth’s revenue model. \"Reach customers when they are aisles, not miles, away,\" the firm's message to advertisers on its website says.\u003c/p>\n\u003cp>Users who enter their email addresses -- and about 18 percent do -- will receive test results, along with information that might include \"ask your doctor about this drug\" or \"pick up some Advil on aisle four,\" says Foster. Despite those efforts, every one of the five people who used the kiosk in the space of about an hour, including Khader, said they did not notice the advertising.\u003c/p>\n\u003cp>\u003cstrong>Privacy Risk?\u003c/strong>\u003c/p>\n\u003cp>Consumers Union Senior Attorney Mark Savage says it’s a good thing to get people more engaged in their health, but he says the new technology carries potential risks.\u003c/p>\n\u003cp>\"You have a situation where a patient is voluntarily disclosing information, which means there is no privacy protection, generally,\" Savage says. \"They may not know if the information is being kept and might be used weeks or years after.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Solohealth’s Kendig says the firm is not considered a covered entity under HIPAA, the Health Insurance Portability and Accountability Act of 1996, meaning it is not required to meet the law’s privacy standards.\u003c/p>\n\n",
"disqusIdentifier": "10661 http://blogs.kqed.org/stateofhealth/?p=10661",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2013/02/19/self-screening-stations-coming-to-walmart-2500-of-them/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 1186,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 31
},
"modified": 1361393913,
"excerpt": "Perched by a computer monitor wedged between shelves of cough drops and the pharmacy in a bustling Walmart in Sterling, Va., Mohamed Khader taps out answers to questions such as how often he eats vegetables, whether anyone in his family has diabetes and his age. He tests his eyesight, weighs himself and checks his blood pressure as a middle-aged couple watches at the blue-and-white SoloHealth station advertising \"free health screenings.\"",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "Perched by a computer monitor wedged between shelves of cough drops and the pharmacy in a bustling Walmart in Sterling, Va., Mohamed Khader taps out answers to questions such as how often he eats vegetables, whether anyone in his family has diabetes and his age. He tests his eyesight, weighs himself and checks his blood pressure as a middle-aged couple watches at the blue-and-white SoloHealth station advertising "free health screenings."",
"title": "Self-Screening Stations Coming to Walmart -- 2,500 of Them | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Self-Screening Stations Coming to Walmart -- 2,500 of Them ",
"datePublished": "2013-02-19T09:04:50-08:00",
"dateModified": "2013-02-20T12:58:33-08:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "self-screening-stations-coming-to-walmart-2500-of-them",
"status": "publish",
"path": "/stateofhealth/10661/self-screening-stations-coming-to-walmart-2500-of-them",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_212\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2011/11/09/walmart-where-you-can-get-clothes-food-and-a-health-check-up/olympus-digital-camera/\" rel=\"attachment wp-att-212\">\u003cimg class=\"size-full wp-image-212\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/Walmart-300.jpg\" alt=\"(Illustration by Kaiser Health News from photo by Walmart via Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Illustration by Kaiser Health News from photo by Walmart via Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>By Julie Appleby,\u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/February/19/self-health-care-kiosks-walmart.aspx\" target=\"_blank\"> Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Perched by a computer monitor wedged between shelves of cough drops and the pharmacy in a bustling Walmart in Sterling, Va., Mohamed Khader taps out answers to questions such as how often he eats vegetables, whether anyone in his family has diabetes and his age. He tests his eyesight, weighs himself and checks his blood pressure as a middle-aged couple watches at the blue-and-white SoloHealth station advertising \"free health screenings.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">Such programs raise a red flag for some consumer advocates who worry the \"advice\" might be an advertisement.\u003c/aside>\n\u003cp>\"You may not go to the doctor every year, but you come to Walmart often,\" says the fit-looking 43-year-old Khader who lives in nearby Ashburn, Va. \"I get bored while my wife is shopping. This is a time killer. I’ll come back in two months or so, and track my results.\"\u003c/p>\n\u003cp>A burgeoning consumer health industry is betting that millions of consumers will do just that.\u003c!--more-->\u003c/p>\n\u003cp>As Americans gain coverage under the federal health law, putting increased demand on primary care doctors and spurring interest in cheaper, more convenient care, unmanned kiosks like these may be part of what their manufacturer bills as a \"self-service healthcare revolution.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The SoloHealth Station gives consumers free and convenient access to health care by allowing them to screen their vision, blood pressure, weight, and body mass index (BMI) -- or any combination of the four -- in seven minutes or less for free according to the manufacturer.\u003c/p>\n\u003cp>Walmart's interest is especially significant, given the giant retailer's reach, the growth of its pharmacies and retail medical clinics and a top official’s recent statements -- before being walked back by the company -- outlining plans for a push into primary care. SoloHealth' stations are slated to be in 2,500 Walmarts and Sam's Clubs starting next month.\u003c/p>\n\u003cp>Some doctors' groups and consumer advocates urge caution, raising concerns about how companies might use personal health data, the quality of their medical information and whether advertisers and other sponsors might shape their advice and referrals for commercial reasons.\u003c/p>\n\u003cp>\"There is a trend in general by retailers and health insurers to provide 'fluff' to consumers in the guise of real medical information as an advertising delivery device,\" says Carmen Balber of the left leaning advocacy group Consumer Watchdog.\u003c/p>\n\u003cp>\u003cstrong>Bringing Exam Rooms To Patients\u003c/strong>\u003c/p>\n\u003cdiv>\n\u003cdiv>\n\u003cp>SoloHealth's backers have big plans. The Georgia-based company aims to expand its kiosk offerings to teach people how to quit smoking, test whether they are at risk for diabetes and even enroll them in health coverage.\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003cp>Self-serve computer stations are also eyed as a way to help consumers figure out whether they need medications for conditions such as high cholesterol, under a proposal now before the FDA to make some prescription medications over the counter. \"It is clear there are now many interactive mechanisms that can step the consumer through the process of self-diagnosis and medication selection,\" said Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research at a public hearing last March. The proposal is still under review.\u003c/p>\n\u003cp>Rival firms are marketing similar technologies. HealthSpot, based in Ohio, has enclosed cubicles that allow patients to pay $59 to $79 for a video \"visit\" with a doctor. NowClinic online, a subsidiary of UnitedHealth Group, provides 10-minute video chats with physicians for $45.\u003c/p>\n\u003cp>Technology \"has become a new arm of the health care delivery system,\" says Jay Sanders, CEO of The Global Telemedicine Group, a consulting firm. \"You need to bring the exam room to where the patient is, not where the doctor is.\"\u003c/p>\n\u003cp>\u003cstrong>'Treading A Fine Line'\u003c/strong>\u003c/p>\n\u003cp>SoloHealth's founder and CEO Bart Foster saw larger possibilities for automated screening after he began providing Walmart with self-service vision tests as a way to get shoppers from the product aisles to Walmart's optical shops.\u003c/p>\n\u003cp>In 2010, the firm got a $1.2 million grant from the National Institutes of Health to develop new approaches to screening for people in underserved communities. It has also received more than $43 million in investments from computer maker Dell Corp., health insurer WellPoint and Coinstar, maker of the Red Box DVD rental boxes, he says.\u003c/p>\n\u003cp>Today, SoloHealth's kiosks, which are not connected to a live physician, allow consumers not just to test their eyesight and learn if they are obese, but to get information on diet, vitamins and pain management. A \"find a doctor\" function can direct users to nearby doctors, although the one in Sterling, Va., listed only \"optical doctors\" -- and those appeared mainly to be Walmart-affiliated.\u003c/p>\n\u003cp>Foster says SoloHealth has received lists of doctors from sponsors, including Walmart, and also allows doctors to buy a listing. SoloHealth does not do any independent review of doctors' credentials. About 20 to 30 doctors are typically offered.\u003c/p>\n\u003cp>Among its programs is one that advises those suffering symptoms of heartburn whether it may indeed be heartburn and which over-the-counter product might be useful, says Stephen Kendig, the firm’s chief commercial officer.\u003c/p>\n\u003cp>\"We’re treading a fine line,\" Foster says. \"We don’t want to practice medicine, just educate people.\"\u003c/p>\n\u003cp>But such programs raise a red flag for some consumer advocates who worry the \"advice\" might be an advertisement.\u003c/p>\n\u003cp>The SoloHealth station in Sterling, Va., for example, runs a video for Healthy Choice yogurt while the blood pressure device inflates. Ads for Nature Made fish oil supplements or Healthy Choice frozen meals appear when consumers respond yes to a written question asking if they want more information about a healthy lifestyle. Others appear for allergy drug Zyrtec and heartburn medication Prilosec.\u003c/p>\n\u003cp>The ads, which can be targeted to particular consumers based on their answers, are SoloHealth’s revenue model. \"Reach customers when they are aisles, not miles, away,\" the firm's message to advertisers on its website says.\u003c/p>\n\u003cp>Users who enter their email addresses -- and about 18 percent do -- will receive test results, along with information that might include \"ask your doctor about this drug\" or \"pick up some Advil on aisle four,\" says Foster. Despite those efforts, every one of the five people who used the kiosk in the space of about an hour, including Khader, said they did not notice the advertising.\u003c/p>\n\u003cp>\u003cstrong>Privacy Risk?\u003c/strong>\u003c/p>\n\u003cp>Consumers Union Senior Attorney Mark Savage says it’s a good thing to get people more engaged in their health, but he says the new technology carries potential risks.\u003c/p>\n\u003cp>\"You have a situation where a patient is voluntarily disclosing information, which means there is no privacy protection, generally,\" Savage says. \"They may not know if the information is being kept and might be used weeks or years after.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "floatright"
},
"numeric": [
"floatright"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Solohealth’s Kendig says the firm is not considered a covered entity under HIPAA, the Health Insurance Portability and Accountability Act of 1996, meaning it is not required to meet the law’s privacy standards.\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/10661/self-screening-stations-coming-to-walmart-2500-of-them",
"authors": [
"240"
],
"categories": [
"stateofhealth_13"
],
"featImg": "stateofhealth_212",
"label": "stateofhealth"
},
"stateofhealth_10585": {
"type": "posts",
"id": "stateofhealth_10585",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "10585",
"score": null,
"sort": [
1360868727000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1360868727,
"format": "aside",
"disqusTitle": "Systems Can Work: Rooting Out Variation and Saving Millions in San Diego ",
"title": "Systems Can Work: Rooting Out Variation and Saving Millions in San Diego ",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>By Russ Mitchell, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/February/14/chris-van-gorder-scripps-health-costs-solutions.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_10588\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/14/systems-can-work-rooting-out-variation-and-saving-millions-in-san-diego/emergencyroomsign_anname-taber-andrew-bain/\" rel=\"attachment wp-att-10588\">\u003cimg class=\"size-medium wp-image-10588\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/EmergencyRoomSign_anName-Taber-Andrew-Bain--300x198.jpg\" alt=\"Among other changes, Scripps Health streamlined its ER admission process, slashing wait times and saving $29 million. (Taber Andrew Bain/Flickr)\" width=\"300\" height=\"198\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Among other changes, Scripps Health streamlined its ER admission process, slashing wait times and saving $29 million. (Taber Andrew Bain/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A hundred managers at Scripps Health jam shoulder-to-shoulder into a break room in San Diego. CEO Chris Van Gorder goes at them like a football coach down by 3 at halftime.\u003c/p>\n\u003cp>\"What are we trying to do in our health care system?\"\u003c/p>\n\u003cp>\"Reduce costs!\"\u003c/p>\n\u003cp>\"Why?\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Health care is too expensive.\"\u003c/p>\n\u003cp>\"The solution is going to come from Washington D.C., right?\"\u003c/p>\n\u003caside class=\"pullquote alignright\">There was a cost difference of $6,000 between two Scripps hospitals performing the same cardiac procedures.\u003c/aside>\n\u003cp>\"Ha ha ha ha.\"\u003c/p>\n\u003cp>\"Sacramento then, right?\"\u003c/p>\n\u003cp>\"Ha.\"\u003c/p>\n\u003cp>\"The solution,\" says Van Gorder, pumping an index figure toward his team, \"is going to come from right here.\"\u003c/p>\n\u003cp>Van Gorder, an ex-cop turned hospital executive, rescued troubled Scripps from near insolvency a dozen years ago as its new CEO. Now, he's put Scripps in the middle of a cultural transformation aimed at saving hundreds of millions of dollars a year by -- get this -- coaxing physicians and managers at Scripps to work together, and standardizing care across every hospital in the system.\u003c/p>\n\u003cp>Just this week, we've seen how lack of standardization leads to a nearly-inexplicable price range of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/11/how-much-for-a-hip-replacement-good-luck-trying-to-find-out/\" target=\"_blank\">$11,000 to $125,000 for a standard hip replacement\u003c/a> across the country.\u003c!--more-->\u003c/p>\n\u003cp>Price variation among hospitals within the same system is even harder to explain. At Scripps, there was a cost difference of $6,000 between two Scripps hospitals performing the same cardiac procedures, using the same protocol, even with the same surgeon.\u003c/p>\n\u003cp>And that's standard: Most health care systems still manage each hospital or clinic as its own silo -- each with different management, operations and clinical procedures.\u003c/p>\n\u003cp>Van Gorder, 60, tells his staff that major change is inevitable. Political leaders, employers and patients themselves are fed up with health care costs. Given federal budget deficits and the calls for entitlement reform, Medicare margins will continue to be under pressure. Politicians fearing a backlash from cutting benefits to consumers will take aim at hospitals and other providers. The Advisory Board Company predicts the typical hospital will see its margins collapse by as much as 20 percent over the next 10 years as reimbursements drop.\u003c/p>\n\u003cp>\"Hospitals that can't find a way to deliver their product less expensively and with better quality are going to go out of business,\" Van Gorder says. \"It's as simple as that.\"\u003c/p>\n\u003cp>\u003cstrong>The $6,000 Cost Difference\u003c/strong>\u003c/p>\n\u003cp>Consider the $6,000 cost difference for the cardiac valve and coronary artery bypass graft procedures. No one paid attention to it, because there was no incentive to do so. When a cross-system team dissected hospital-to-hospital variations in 2010, they found that the Scripps Memorial Hospital in La Jolla required that nitric oxide be administered to the patient, ostensibly to boost oxygen intake in the blood.\u003c/p>\n\u003cp>Fourteen miles away, at Mercy Hospital in downtown San Diego, such patients received no nitric oxide. A look at the data showed the outcomes were the same. Today, a doctor at any hospital in the Scripps system can still order up nitric oxide, but it’s no longer required. Savings: $400,000 per year.\u003c/p>\n\u003cp>Some of the other savings that netted $150 million in the first year:\u003c/p>\n\u003cul>\n\u003cli>The ER: Once, the wait could be as long as eight hours. Now, it averages 30 minutes. Scripps requires doctors and nurses to see patients at the same time, early in the process, instead of forcing them through a gauntlet of information-takers, where they’d repeat the same complaints over and over. Fewer handoffs mean better communications, fewer errors and more patients seen for a $29 million revenue boost.\u003c/li>\n\u003cli>Radiology: For imaging tests, each hospital stocked its radiologist's own favorite contrast agents -- the iodine, barium, gadolinium and other chemicals used to highlight structures and fluids in a patient's body. After doctors agreed to use a few brands, volume discounts saved $1.5 million a year.\u003c/li>\n\u003cli>Surgery: OneScripps focused on three cardiac surgeons at one hospital and studied their work habits for needless variation. Voluntary best-practice protocols were established which have decreased length of hospital stay by almost a day and saved the system $3.6 million a year.\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>A Story With Twists And Turns\u003c/strong>\u003c/p>\n\u003cp>Van Gorder's campaign has not been without challenges. Historically, doctors have felt threatened by changes imposed from outside the profession, which they fear will undermine their autonomy and income. \"You can’t force feed doctors,\" says Brent Eastman, recently retired chief of medicine at Scripps, now president-elect of the American College of Surgeons.\u003c/p>\n\u003cp>Sensitive to this culture, Van Gorder created what he called a Physician Leadership Cabinet \"to share the responsibility of running this company together.\" The board includes the medical staff and physician members elected by their peers because \"We don't want 'yes people' sitting on the group.\" The key to cooperation, says Van Gorder, is transparency -- sharing all information.\u003c/p>\n\u003cp>Early on he was tested. The doctors demanded $4 million to pay for on-call doctors for the emergency rooms. Van Gorder said he couldn’t afford it, and laid out the numbers. The doctors cut the demand in half.\u003c/p>\n\u003cp>Van Gorder trusts that sharing financial information, especially on costs, along with data on treatment and outcomes, will usually lead doctors to the best-outcome-at-lowest-cost decisions.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So far, that strategy has inspired buy-in. \"Probably only once every hundred years will there be a generation that can truly change the way health care is delivered,\" says Eastman, the physician. \"We are that generation.\"\u003c/p>\n\n",
"disqusIdentifier": "10585 http://blogs.kqed.org/stateofhealth/?p=10585",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2013/02/14/systems-can-work-rooting-out-variation-and-saving-millions-in-san-diego/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 959,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 29
},
"modified": 1360868731,
"excerpt": "Van Gorder, an ex-cop turned hospital executive, rescued troubled Scripps from near insolvency a dozen years ago as its new CEO. Now, he's put Scripps in the middle of a cultural transformation aimed at saving hundreds of millions of dollars a year by -- get this -- coaxing physicians and managers at Scripps to work together, and standardizing care across every hospital in the system.\r\n\r\nJust this week, we've seen how lack of standardization leads to a nearly-inexplicable price range of $11,000 to $125,000 for a standard hip replacement across the country.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "Van Gorder, an ex-cop turned hospital executive, rescued troubled Scripps from near insolvency a dozen years ago as its new CEO. Now, he's put Scripps in the middle of a cultural transformation aimed at saving hundreds of millions of dollars a year by -- get this -- coaxing physicians and managers at Scripps to work together, and standardizing care across every hospital in the system.\r\n\r\nJust this week, we've seen how lack of standardization leads to a nearly-inexplicable price range of $11,000 to $125,000 for a standard hip replacement across the country.",
"title": "Systems Can Work: Rooting Out Variation and Saving Millions in San Diego | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Systems Can Work: Rooting Out Variation and Saving Millions in San Diego ",
"datePublished": "2013-02-14T11:05:27-08:00",
"dateModified": "2013-02-14T11:05:31-08:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "systems-can-work-rooting-out-variation-and-saving-millions-in-san-diego",
"status": "publish",
"path": "/stateofhealth/10585/systems-can-work-rooting-out-variation-and-saving-millions-in-san-diego",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Russ Mitchell, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/February/14/chris-van-gorder-scripps-health-costs-solutions.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_10588\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/14/systems-can-work-rooting-out-variation-and-saving-millions-in-san-diego/emergencyroomsign_anname-taber-andrew-bain/\" rel=\"attachment wp-att-10588\">\u003cimg class=\"size-medium wp-image-10588\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/EmergencyRoomSign_anName-Taber-Andrew-Bain--300x198.jpg\" alt=\"Among other changes, Scripps Health streamlined its ER admission process, slashing wait times and saving $29 million. (Taber Andrew Bain/Flickr)\" width=\"300\" height=\"198\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Among other changes, Scripps Health streamlined its ER admission process, slashing wait times and saving $29 million. (Taber Andrew Bain/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A hundred managers at Scripps Health jam shoulder-to-shoulder into a break room in San Diego. CEO Chris Van Gorder goes at them like a football coach down by 3 at halftime.\u003c/p>\n\u003cp>\"What are we trying to do in our health care system?\"\u003c/p>\n\u003cp>\"Reduce costs!\"\u003c/p>\n\u003cp>\"Why?\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Health care is too expensive.\"\u003c/p>\n\u003cp>\"The solution is going to come from Washington D.C., right?\"\u003c/p>\n\u003caside class=\"pullquote alignright\">There was a cost difference of $6,000 between two Scripps hospitals performing the same cardiac procedures.\u003c/aside>\n\u003cp>\"Ha ha ha ha.\"\u003c/p>\n\u003cp>\"Sacramento then, right?\"\u003c/p>\n\u003cp>\"Ha.\"\u003c/p>\n\u003cp>\"The solution,\" says Van Gorder, pumping an index figure toward his team, \"is going to come from right here.\"\u003c/p>\n\u003cp>Van Gorder, an ex-cop turned hospital executive, rescued troubled Scripps from near insolvency a dozen years ago as its new CEO. Now, he's put Scripps in the middle of a cultural transformation aimed at saving hundreds of millions of dollars a year by -- get this -- coaxing physicians and managers at Scripps to work together, and standardizing care across every hospital in the system.\u003c/p>\n\u003cp>Just this week, we've seen how lack of standardization leads to a nearly-inexplicable price range of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/11/how-much-for-a-hip-replacement-good-luck-trying-to-find-out/\" target=\"_blank\">$11,000 to $125,000 for a standard hip replacement\u003c/a> across the country.\u003c!--more-->\u003c/p>\n\u003cp>Price variation among hospitals within the same system is even harder to explain. At Scripps, there was a cost difference of $6,000 between two Scripps hospitals performing the same cardiac procedures, using the same protocol, even with the same surgeon.\u003c/p>\n\u003cp>And that's standard: Most health care systems still manage each hospital or clinic as its own silo -- each with different management, operations and clinical procedures.\u003c/p>\n\u003cp>Van Gorder, 60, tells his staff that major change is inevitable. Political leaders, employers and patients themselves are fed up with health care costs. Given federal budget deficits and the calls for entitlement reform, Medicare margins will continue to be under pressure. Politicians fearing a backlash from cutting benefits to consumers will take aim at hospitals and other providers. The Advisory Board Company predicts the typical hospital will see its margins collapse by as much as 20 percent over the next 10 years as reimbursements drop.\u003c/p>\n\u003cp>\"Hospitals that can't find a way to deliver their product less expensively and with better quality are going to go out of business,\" Van Gorder says. \"It's as simple as that.\"\u003c/p>\n\u003cp>\u003cstrong>The $6,000 Cost Difference\u003c/strong>\u003c/p>\n\u003cp>Consider the $6,000 cost difference for the cardiac valve and coronary artery bypass graft procedures. No one paid attention to it, because there was no incentive to do so. When a cross-system team dissected hospital-to-hospital variations in 2010, they found that the Scripps Memorial Hospital in La Jolla required that nitric oxide be administered to the patient, ostensibly to boost oxygen intake in the blood.\u003c/p>\n\u003cp>Fourteen miles away, at Mercy Hospital in downtown San Diego, such patients received no nitric oxide. A look at the data showed the outcomes were the same. Today, a doctor at any hospital in the Scripps system can still order up nitric oxide, but it’s no longer required. Savings: $400,000 per year.\u003c/p>\n\u003cp>Some of the other savings that netted $150 million in the first year:\u003c/p>\n\u003cul>\n\u003cli>The ER: Once, the wait could be as long as eight hours. Now, it averages 30 minutes. Scripps requires doctors and nurses to see patients at the same time, early in the process, instead of forcing them through a gauntlet of information-takers, where they’d repeat the same complaints over and over. Fewer handoffs mean better communications, fewer errors and more patients seen for a $29 million revenue boost.\u003c/li>\n\u003cli>Radiology: For imaging tests, each hospital stocked its radiologist's own favorite contrast agents -- the iodine, barium, gadolinium and other chemicals used to highlight structures and fluids in a patient's body. After doctors agreed to use a few brands, volume discounts saved $1.5 million a year.\u003c/li>\n\u003cli>Surgery: OneScripps focused on three cardiac surgeons at one hospital and studied their work habits for needless variation. Voluntary best-practice protocols were established which have decreased length of hospital stay by almost a day and saved the system $3.6 million a year.\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>A Story With Twists And Turns\u003c/strong>\u003c/p>\n\u003cp>Van Gorder's campaign has not been without challenges. Historically, doctors have felt threatened by changes imposed from outside the profession, which they fear will undermine their autonomy and income. \"You can’t force feed doctors,\" says Brent Eastman, recently retired chief of medicine at Scripps, now president-elect of the American College of Surgeons.\u003c/p>\n\u003cp>Sensitive to this culture, Van Gorder created what he called a Physician Leadership Cabinet \"to share the responsibility of running this company together.\" The board includes the medical staff and physician members elected by their peers because \"We don't want 'yes people' sitting on the group.\" The key to cooperation, says Van Gorder, is transparency -- sharing all information.\u003c/p>\n\u003cp>Early on he was tested. The doctors demanded $4 million to pay for on-call doctors for the emergency rooms. Van Gorder said he couldn’t afford it, and laid out the numbers. The doctors cut the demand in half.\u003c/p>\n\u003cp>Van Gorder trusts that sharing financial information, especially on costs, along with data on treatment and outcomes, will usually lead doctors to the best-outcome-at-lowest-cost decisions.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So far, that strategy has inspired buy-in. \"Probably only once every hundred years will there be a generation that can truly change the way health care is delivered,\" says Eastman, the physician. \"We are that generation.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/10585/systems-can-work-rooting-out-variation-and-saving-millions-in-san-diego",
"authors": [
"240"
],
"categories": [
"stateofhealth_15",
"stateofhealth_13"
],
"tags": [
"stateofhealth_344"
],
"featImg": "stateofhealth_10588",
"label": "stateofhealth"
},
"stateofhealth_10542": {
"type": "posts",
"id": "stateofhealth_10542",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "10542",
"score": null,
"sort": [
1360793019000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1360793019,
"format": "aside",
"disqusTitle": "ACA Updates: Covered California Benefit Plans and Calculate Your Premium Online ",
"title": "ACA Updates: Covered California Benefit Plans and Calculate Your Premium Online ",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>\u003cstrong>California is first state to announce benefit plans including co-pays, deductibles\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_8836\" class=\"wp-caption alignleft\" style=\"max-width: 290px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/11/12/%e2%80%98last-distraction%e2%80%99-removed-as-california-moves-ahead-on-health-reform/coveredcalifornia1/\" rel=\"attachment wp-att-8836\">\u003cimg class=\"size-full wp-image-8836\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/11/CoveredCalifornia1.png\" alt=\"California's insurance marketplace, Covered California, will open in October, 2013. People will be able to buy insurance, which will take effect January 1, 2014.\" width=\"290\" height=\"302\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/11/CoveredCalifornia1.png 290w, https://ww2.kqed.org/app/uploads/sites/27/2012/11/CoveredCalifornia1-32x32.png 32w\" sizes=\"(max-width: 290px) 100vw, 290px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">California's insurance marketplace, Covered California, will open in October, 2013. People will be able to buy insurance, which will take effect January 1, 2014.\u003c/figcaption>\u003c/figure>\n\u003cp>Calling today a \"game changer for California and a game changer for the nation,\" Peter Lee, executive director of Covered California, the state's marketplace for health insurance, announced benefit plans that will be featured in the exchange.\u003c/p>\n\u003cp>He also unveiled \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">its updated website\u003c/a> (in English and \u003ca href=\"http://www.coveredca.com/es/\" target=\"_blank\">Spanish\u003c/a>) where consumers can access what is sure to be a very popular \u003ca href=\"http://www.coveredca.com/resources/calculating-the-cost/\" target=\"_blank\">premium calculator\u003c/a>. People with incomes up to 400 percent of poverty are eligible for subsidies from the federal government to help purchase insurance. The calculator gives an estimate of what you will pay after the subsidy.\u003c/p>\n\u003cp>\u003cstrong>[Update September, 2013: Covered California has new\u003c/strong> \u003ca href=\"http://www.coveredca.com/shopandcompare/\" target=\"_blank\">Shop and Compare Tool\u003c/a>]\u003c/p>\n\u003cp>An estimated 2.6 million Californians are expected to qualify for the subsidy. People who receive Medi-Cal or employer-based health insurance are not eligible and will continue to receive health insurance through their current plans.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\u003ca href=\"http://kff.org/interactive/subsidy-calculator/\" target=\"_blank\">Calculate your monthly premium here\u003c/a>. \u003c/aside>\n\u003cp>California is the first state in the nation to release benefit packages for the public to review. \"The most important aspect of these plans is that they’re standardized. ... Consumers will be able to make apples-to-apples comparisons that they haven’t been able to make in the past,\" Lee said in a press conference.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As called for in the Affordable Care Act, there will be four tiers of coverage: platinum, gold, silver and bronze. The platinum plan will cover 90 percent of health care costs and have the highest premium. The gold plan will cover 80 percent; the silver 70 percent.\u003c/p>\n\u003cp>The bronze plan will have the lowest premium and cover 60 percent of costs, \"meaning a consumer would pay 40 percent out of pocket,\" said Ken Wood, senior advisor for Covered California. \"That’s really a catastrophic plan that’s designed to protect someone from financial collapse if they had a severe illness. … So we are defining benefits across a wide range of richness and design and thus affordability.”\u003c/p>\n\u003cp style=\"text-align: center\">\u003cstrong>[Related Content: \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Obamacare Explained -- A Guide for Californians\u003c/a>]\u003c/strong>\u003c/p>\n\u003cp>In other words, pay a higher premium and more of your health care costs will be covered.\u003c/p>\n\u003cp>California goes beyond federal requirements by detailing what deductibles and co-pays consumers may be charged. Platinum and gold plans will have no deductible, and a doctor's office visit will be $25 (platinum) or $45 (gold). From there, silver plans will have $2,000 deductibles, a $45 doctor's office visit co-pay and an additional $500 deductible for medications. (See chart at end of post for more detail on deductibles and co-pays.)\u003c/p>\n\u003cp>While Wednesday's announcement detailed many aspects of costs, the premium prices are still estimated and will not be finalized until June.\u003c/p>\n\u003cp>These standardized deductibles and co-pays are rules which apply to plans sold in the exchange. While health insurers may still offer plans of other designs outside the exchange, consumers who qualify for the subsidy must purchase their plan on the exchange.\u003c/p>\n\u003cp>\u003cstrong>\"The HR department for the rest of us\"\u003c/strong>\u003cbr>\nCalling these announcements a \"bold, big step forward,\" Anthony Wright, executive director of the advocacy group Health Access said, \"Consumers will get good and simple information about what the plan covers, and what it doesn't. It will remove the guesswork so many consumers go through trying to figure out the differences between plans. ... For individuals and families who don't work for large employers with significant purchasing power, Covered California will serve as the HR department for the rest of us.\"\u003c/p>\n\u003cp>Consumers can calculate their subsidies, but they should be sure to read the disclaimers -- especially noting that the subsidy is based on the \"silver\" tier of coverage.\u003c/p>\n\u003cp>Patrick Johnston, president of the California Association of Health Plans sounded a cautionary note, saying that the standardization of plans may reduce confusion, but might also increase premiums, then pointed to some of the requirements of the Affordable Care Act not addressed in Wednesday's news.\u003c/p>\n\u003cp>\"New taxes, limits on geography-based pricing and age rating restrictions are all part of the Affordable Care Act that will drive up the cost of coverage for millions of consumers and employers,\" Johnston said. \"We will see in the coming months whether the standardized benefit designs adversely impact premiums or not.\"\u003c/p>\n\u003cp>The benefit plans also feature out-of-pocket maximums: $6,400 for individuals and $12,800 for a family. In other words, if you get very sick or injured, that is the maximum amount you will have to pay outside of your premium.\u003c/p>\n\u003cp>“That’s a lot of money, let’s face it,\" said Ken Wood. \"But when people can have hospital bills at $500,000 or $1,000,000, can find they’re in a bankruptcy situation because of that type of tragedy, having their exposure limited to $12,000 is a bit is a breakthrough.”\u003c/p>\n\u003cp style=\"text-align: center\">\u003cstrong>[Related: \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/25/some-say-obamacares-affordable-coverage-isnt-so-affordable/\" target=\"_blank\">Some Say Obamacare's \"Affordable\" Coverage Isn't So Affordable]\u003c/a>\u003c/strong>\u003c/p>\n\u003cp> \u003c/p>\n\u003cfigure id=\"attachment_10575\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/13/aca-updates-covered-california-benefit-plans-and-calculate-your-subsidy-online/print/\" rel=\"attachment wp-att-10575\">\u003cimg class=\"size-large wp-image-10575\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/CC-Standard-Individual-Benefit-Plans-620x348.jpg\" alt=\"(Chart: Covered California)\" width=\"620\" height=\"348\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Chart: Covered California)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor's Note: This post has been updated to reflect that the CaliforniaCovered website includes a calculator for insurance costs, not the subsidy from the federal government. \u003c/em>\u003c/p>\n\n",
"disqusIdentifier": "10542 http://blogs.kqed.org/stateofhealth/?p=10542",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2013/02/13/aca-updates-covered-california-benefit-plans-and-calculate-your-subsidy-online/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 896,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 21
},
"modified": 1381856921,
"excerpt": "Calling today a \"game changer for California and a game changer for the nation,\" Peter Lee, executive director of Covered California, announced health insurance benefit designs that will be featured in the insurance exchange. He also revealed launch of its new website (in English and Spanish) where consumers can access what is sure to be a very popular premium subsidy calculator. California is the first state in the nation to release benefit packages for the public to review.\r\n",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "Calling today a "game changer for California and a game changer for the nation," Peter Lee, executive director of Covered California, announced health insurance benefit designs that will be featured in the insurance exchange. He also revealed launch of its new website (in English and Spanish) where consumers can access what is sure to be a very popular premium subsidy calculator. California is the first state in the nation to release benefit packages for the public to review.\r\n",
"title": "ACA Updates: Covered California Benefit Plans and Calculate Your Premium Online | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "ACA Updates: Covered California Benefit Plans and Calculate Your Premium Online ",
"datePublished": "2013-02-13T14:03:39-08:00",
"dateModified": "2013-10-15T10:08:41-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "aca-updates-covered-california-benefit-plans-and-calculate-your-subsidy-online",
"status": "publish",
"path": "/stateofhealth/10542/aca-updates-covered-california-benefit-plans-and-calculate-your-subsidy-online",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>California is first state to announce benefit plans including co-pays, deductibles\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_8836\" class=\"wp-caption alignleft\" style=\"max-width: 290px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/11/12/%e2%80%98last-distraction%e2%80%99-removed-as-california-moves-ahead-on-health-reform/coveredcalifornia1/\" rel=\"attachment wp-att-8836\">\u003cimg class=\"size-full wp-image-8836\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/11/CoveredCalifornia1.png\" alt=\"California's insurance marketplace, Covered California, will open in October, 2013. People will be able to buy insurance, which will take effect January 1, 2014.\" width=\"290\" height=\"302\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/11/CoveredCalifornia1.png 290w, https://ww2.kqed.org/app/uploads/sites/27/2012/11/CoveredCalifornia1-32x32.png 32w\" sizes=\"(max-width: 290px) 100vw, 290px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">California's insurance marketplace, Covered California, will open in October, 2013. People will be able to buy insurance, which will take effect January 1, 2014.\u003c/figcaption>\u003c/figure>\n\u003cp>Calling today a \"game changer for California and a game changer for the nation,\" Peter Lee, executive director of Covered California, the state's marketplace for health insurance, announced benefit plans that will be featured in the exchange.\u003c/p>\n\u003cp>He also unveiled \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">its updated website\u003c/a> (in English and \u003ca href=\"http://www.coveredca.com/es/\" target=\"_blank\">Spanish\u003c/a>) where consumers can access what is sure to be a very popular \u003ca href=\"http://www.coveredca.com/resources/calculating-the-cost/\" target=\"_blank\">premium calculator\u003c/a>. People with incomes up to 400 percent of poverty are eligible for subsidies from the federal government to help purchase insurance. The calculator gives an estimate of what you will pay after the subsidy.\u003c/p>\n\u003cp>\u003cstrong>[Update September, 2013: Covered California has new\u003c/strong> \u003ca href=\"http://www.coveredca.com/shopandcompare/\" target=\"_blank\">Shop and Compare Tool\u003c/a>]\u003c/p>\n\u003cp>An estimated 2.6 million Californians are expected to qualify for the subsidy. People who receive Medi-Cal or employer-based health insurance are not eligible and will continue to receive health insurance through their current plans.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\u003ca href=\"http://kff.org/interactive/subsidy-calculator/\" target=\"_blank\">Calculate your monthly premium here\u003c/a>. \u003c/aside>\n\u003cp>California is the first state in the nation to release benefit packages for the public to review. \"The most important aspect of these plans is that they’re standardized. ... Consumers will be able to make apples-to-apples comparisons that they haven’t been able to make in the past,\" Lee said in a press conference.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As called for in the Affordable Care Act, there will be four tiers of coverage: platinum, gold, silver and bronze. The platinum plan will cover 90 percent of health care costs and have the highest premium. The gold plan will cover 80 percent; the silver 70 percent.\u003c/p>\n\u003cp>The bronze plan will have the lowest premium and cover 60 percent of costs, \"meaning a consumer would pay 40 percent out of pocket,\" said Ken Wood, senior advisor for Covered California. \"That’s really a catastrophic plan that’s designed to protect someone from financial collapse if they had a severe illness. … So we are defining benefits across a wide range of richness and design and thus affordability.”\u003c/p>\n\u003cp style=\"text-align: center\">\u003cstrong>[Related Content: \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Obamacare Explained -- A Guide for Californians\u003c/a>]\u003c/strong>\u003c/p>\n\u003cp>In other words, pay a higher premium and more of your health care costs will be covered.\u003c/p>\n\u003cp>California goes beyond federal requirements by detailing what deductibles and co-pays consumers may be charged. Platinum and gold plans will have no deductible, and a doctor's office visit will be $25 (platinum) or $45 (gold). From there, silver plans will have $2,000 deductibles, a $45 doctor's office visit co-pay and an additional $500 deductible for medications. (See chart at end of post for more detail on deductibles and co-pays.)\u003c/p>\n\u003cp>While Wednesday's announcement detailed many aspects of costs, the premium prices are still estimated and will not be finalized until June.\u003c/p>\n\u003cp>These standardized deductibles and co-pays are rules which apply to plans sold in the exchange. While health insurers may still offer plans of other designs outside the exchange, consumers who qualify for the subsidy must purchase their plan on the exchange.\u003c/p>\n\u003cp>\u003cstrong>\"The HR department for the rest of us\"\u003c/strong>\u003cbr>\nCalling these announcements a \"bold, big step forward,\" Anthony Wright, executive director of the advocacy group Health Access said, \"Consumers will get good and simple information about what the plan covers, and what it doesn't. It will remove the guesswork so many consumers go through trying to figure out the differences between plans. ... For individuals and families who don't work for large employers with significant purchasing power, Covered California will serve as the HR department for the rest of us.\"\u003c/p>\n\u003cp>Consumers can calculate their subsidies, but they should be sure to read the disclaimers -- especially noting that the subsidy is based on the \"silver\" tier of coverage.\u003c/p>\n\u003cp>Patrick Johnston, president of the California Association of Health Plans sounded a cautionary note, saying that the standardization of plans may reduce confusion, but might also increase premiums, then pointed to some of the requirements of the Affordable Care Act not addressed in Wednesday's news.\u003c/p>\n\u003cp>\"New taxes, limits on geography-based pricing and age rating restrictions are all part of the Affordable Care Act that will drive up the cost of coverage for millions of consumers and employers,\" Johnston said. \"We will see in the coming months whether the standardized benefit designs adversely impact premiums or not.\"\u003c/p>\n\u003cp>The benefit plans also feature out-of-pocket maximums: $6,400 for individuals and $12,800 for a family. In other words, if you get very sick or injured, that is the maximum amount you will have to pay outside of your premium.\u003c/p>\n\u003cp>“That’s a lot of money, let’s face it,\" said Ken Wood. \"But when people can have hospital bills at $500,000 or $1,000,000, can find they’re in a bankruptcy situation because of that type of tragedy, having their exposure limited to $12,000 is a bit is a breakthrough.”\u003c/p>\n\u003cp style=\"text-align: center\">\u003cstrong>[Related: \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/25/some-say-obamacares-affordable-coverage-isnt-so-affordable/\" target=\"_blank\">Some Say Obamacare's \"Affordable\" Coverage Isn't So Affordable]\u003c/a>\u003c/strong>\u003c/p>\n\u003cp> \u003c/p>\n\u003cfigure id=\"attachment_10575\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/13/aca-updates-covered-california-benefit-plans-and-calculate-your-subsidy-online/print/\" rel=\"attachment wp-att-10575\">\u003cimg class=\"size-large wp-image-10575\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/CC-Standard-Individual-Benefit-Plans-620x348.jpg\" alt=\"(Chart: Covered California)\" width=\"620\" height=\"348\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Chart: Covered California)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor's Note: This post has been updated to reflect that the CaliforniaCovered website includes a calculator for insurance costs, not the subsidy from the federal government. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/10542/aca-updates-covered-california-benefit-plans-and-calculate-your-subsidy-online",
"authors": [
"240"
],
"categories": [
"stateofhealth_15",
"stateofhealth_13"
],
"tags": [
"stateofhealth_294",
"stateofhealth_38"
],
"featImg": "stateofhealth_8836",
"label": "stateofhealth"
},
"stateofhealth_10505": {
"type": "posts",
"id": "stateofhealth_10505",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "10505",
"score": null,
"sort": [
1360631510000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1360631510,
"format": "aside",
"disqusTitle": "How Much for A Hip Replacement? Good Luck Trying to Find Out",
"title": "How Much for A Hip Replacement? Good Luck Trying to Find Out",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_10509\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/11/how-much-for-a-hip-replacement-good-luck-trying-to-find-out/artificialhip_okadots_flickr/\" rel=\"attachment wp-att-10509\">\u003cimg class=\"size-medium wp-image-10509\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/ArtificialHip_okadots_Flickr-300x246.jpg\" alt=\"X-ray showing a new artificial hip. No, I don't know how much the patient paid for it. (okadots/Flickr)\" width=\"300\" height=\"246\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">X-ray showing a new artificial hip. No, I don't know how much the patient paid for it. (okadots/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>If you want to buy a new car, you can probably figure out a price range within a matter of minutes with a google search. The same is true for many other products. But in health care, forget it.\u003c/p>\n\u003cp>In a \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1569848#COMMENT\" target=\"_blank\">new study\u003c/a> published today in JAMA Internal Medicine, researchers called more than 100 hospitals across the country. They included a range of both top-ranked centers and community hospitals and inquired about a common elective surgical procedure -- a hip replacement -- for a fictitious 62-year-old grandmother.\u003c/p>\n\u003cp>First off, only 10 percent of the non-top-ranked hospitals and 45 percent of the top-ranked hospitals were even able to provide a price. Researchers were a bit more successful when they called the hospital and physician separately.\u003c/p>\n\u003caside class=\"pullquote alignright\">“It is time we stop forcing people to buy health care services blindfolded.\"\u003c/aside>\n\u003cp>And just what was the price range? $11,100 on the low end to $125,000 on the high end.\u003c/p>\n\u003cp>\"Patients seeking elective (hip replacement) may find considerable price savings through comparison shopping,\" the authors write. No kidding -- except that half of the institutions couldn't even provide a price.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Americans hear over and over that they must be better consumers of health care, but it's pretty tough when information can be so hard to get or difficult to interpret. Maybe you can get crash data on that new car you want to buy, but it can be tougher to get information about quality for a health care procedure than it is to get a price.\u003c/p>\n\u003cp>\"Without quality data to accompany price data, physicians, consumers, and other health care decision makers have no idea if a lower price represents shoddy quality or if it constitutes good value,\" say medical ethicist Ezekiel Emanuel and Andrew Steinmetz in an \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1569849\" target=\"_blank\">accompanying commentary\u003c/a> they co-wrote. \"And, since patients are reluctant to cut corners when it comes to their health and the health of their family members, they are liable to falsely assume — as they do in other markets — that higher prices correlate with higher quality.\"\u003c/p>\n\u003cp>Emanuel opens his commentary with a brief history of trying to buy a car in the 1950s, how buyers were completely at the mercy of dealers, that little quality data was available. It took an act of Congress in 1958 to force car dealers to display the now-ubiquitous MSRP to the window of every new car for sale.\u003c/p>\n\u003cp>\"The history of the automobile industry shows that information asymmetry is treatable,\" Ezekial and Steinmetz conclude. \"Health care will need to travel down a similar path. It is time we stop forcing people to buy health care services blindfolded — and then blame them for not seeing.\"\u003c/p>\n\u003cp>We're still in the infancy of transparency of cost and quality information. Sites like \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/12/27/clearhealthcosts-sorts-out-bewildering-health-prices/\" target=\"_blank\">ClearHealthCosts\u003c/a> have pricing information on a number of common procedures. CalPERS -- the California Public Employees Retirement System -- looked at its own claims for knee and hip replacement. It, too, found a range of $15,000 to $110,000. In 2011 \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/04/27/steps-toward-lower-cost-higher-quality-health-care/\" target=\"_blank\">CalPERS set a threshhold price of $30,000\u003c/a> for a hip or knee replacement. A CalPERS spokesperson says they made sure its approved facilities met a quality standard.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We have a long way to go. In the meantime, caveat emptor.\u003c/p>\n\n",
"disqusIdentifier": "10505 http://blogs.kqed.org/stateofhealth/?p=10505",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2013/02/11/how-much-for-a-hip-replacement-good-luck-trying-to-find-out/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 576,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 13
},
"modified": 1368054964,
"excerpt": "If you want to buy a new car, you can probably figure out a price range within a matter of minutes with a google search. The same is true for many other products. But in health care, forget it.\r\n\r\nIn a new study published today, researchers called more than 100 hospitals across the country. They included a range of both top-ranked centers and community hospitals and inquired about a common elective surgical procedure -- a hip replacement -- for a fictitious 62-year-old grandmother. ",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "If you want to buy a new car, you can probably figure out a price range within a matter of minutes with a google search. The same is true for many other products. But in health care, forget it.\r\n\r\nIn a new study published today, researchers called more than 100 hospitals across the country. They included a range of both top-ranked centers and community hospitals and inquired about a common elective surgical procedure -- a hip replacement -- for a fictitious 62-year-old grandmother. ",
"title": "How Much for A Hip Replacement? Good Luck Trying to Find Out | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "How Much for A Hip Replacement? Good Luck Trying to Find Out",
"datePublished": "2013-02-11T17:11:50-08:00",
"dateModified": "2013-05-08T16:16:04-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "how-much-for-a-hip-replacement-good-luck-trying-to-find-out",
"status": "publish",
"path": "/stateofhealth/10505/how-much-for-a-hip-replacement-good-luck-trying-to-find-out",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_10509\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/11/how-much-for-a-hip-replacement-good-luck-trying-to-find-out/artificialhip_okadots_flickr/\" rel=\"attachment wp-att-10509\">\u003cimg class=\"size-medium wp-image-10509\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/ArtificialHip_okadots_Flickr-300x246.jpg\" alt=\"X-ray showing a new artificial hip. No, I don't know how much the patient paid for it. (okadots/Flickr)\" width=\"300\" height=\"246\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">X-ray showing a new artificial hip. No, I don't know how much the patient paid for it. (okadots/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>If you want to buy a new car, you can probably figure out a price range within a matter of minutes with a google search. The same is true for many other products. But in health care, forget it.\u003c/p>\n\u003cp>In a \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1569848#COMMENT\" target=\"_blank\">new study\u003c/a> published today in JAMA Internal Medicine, researchers called more than 100 hospitals across the country. They included a range of both top-ranked centers and community hospitals and inquired about a common elective surgical procedure -- a hip replacement -- for a fictitious 62-year-old grandmother.\u003c/p>\n\u003cp>First off, only 10 percent of the non-top-ranked hospitals and 45 percent of the top-ranked hospitals were even able to provide a price. Researchers were a bit more successful when they called the hospital and physician separately.\u003c/p>\n\u003caside class=\"pullquote alignright\">“It is time we stop forcing people to buy health care services blindfolded.\"\u003c/aside>\n\u003cp>And just what was the price range? $11,100 on the low end to $125,000 on the high end.\u003c/p>\n\u003cp>\"Patients seeking elective (hip replacement) may find considerable price savings through comparison shopping,\" the authors write. No kidding -- except that half of the institutions couldn't even provide a price.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Americans hear over and over that they must be better consumers of health care, but it's pretty tough when information can be so hard to get or difficult to interpret. Maybe you can get crash data on that new car you want to buy, but it can be tougher to get information about quality for a health care procedure than it is to get a price.\u003c/p>\n\u003cp>\"Without quality data to accompany price data, physicians, consumers, and other health care decision makers have no idea if a lower price represents shoddy quality or if it constitutes good value,\" say medical ethicist Ezekiel Emanuel and Andrew Steinmetz in an \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1569849\" target=\"_blank\">accompanying commentary\u003c/a> they co-wrote. \"And, since patients are reluctant to cut corners when it comes to their health and the health of their family members, they are liable to falsely assume — as they do in other markets — that higher prices correlate with higher quality.\"\u003c/p>\n\u003cp>Emanuel opens his commentary with a brief history of trying to buy a car in the 1950s, how buyers were completely at the mercy of dealers, that little quality data was available. It took an act of Congress in 1958 to force car dealers to display the now-ubiquitous MSRP to the window of every new car for sale.\u003c/p>\n\u003cp>\"The history of the automobile industry shows that information asymmetry is treatable,\" Ezekial and Steinmetz conclude. \"Health care will need to travel down a similar path. It is time we stop forcing people to buy health care services blindfolded — and then blame them for not seeing.\"\u003c/p>\n\u003cp>We're still in the infancy of transparency of cost and quality information. Sites like \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/12/27/clearhealthcosts-sorts-out-bewildering-health-prices/\" target=\"_blank\">ClearHealthCosts\u003c/a> have pricing information on a number of common procedures. CalPERS -- the California Public Employees Retirement System -- looked at its own claims for knee and hip replacement. It, too, found a range of $15,000 to $110,000. In 2011 \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/04/27/steps-toward-lower-cost-higher-quality-health-care/\" target=\"_blank\">CalPERS set a threshhold price of $30,000\u003c/a> for a hip or knee replacement. A CalPERS spokesperson says they made sure its approved facilities met a quality standard.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We have a long way to go. In the meantime, caveat emptor.\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/10505/how-much-for-a-hip-replacement-good-luck-trying-to-find-out",
"authors": [
"240"
],
"categories": [
"stateofhealth_12",
"stateofhealth_13"
],
"tags": [
"stateofhealth_482"
],
"featImg": "stateofhealth_10509",
"label": "stateofhealth"
},
"stateofhealth_10394": {
"type": "posts",
"id": "stateofhealth_10394",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "10394",
"score": null,
"sort": [
1360090385000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1360090385,
"format": "aside",
"disqusTitle": "Quake Breakdown: Hospitals Balk Over Sharing Disaster Preparedness Data",
"title": "Quake Breakdown: Hospitals Balk Over Sharing Disaster Preparedness Data",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>By Deborah Schoch, \u003ca href=\"http://centerforhealthreporting.org/article/many-socal-hospitals-rebuff-government-over-disaster-plans1056\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_10402\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/05/quake-breakdown-hospitals-balk-over-sharing-disaster-preparedness-data/kaiserquake/\" rel=\"attachment wp-att-10402\">\u003cimg class=\"size-medium wp-image-10402\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/kaiserquake-300x200.jpg\" alt=\"The Kaiser Permanente clinic in Granada Hills, CA was severely damaged in the 1994 Northridge earthquake. (Photo/NOAA)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Kaiser Permanente clinic in Granada Hills, CA was severely damaged in the 1994 Northridge earthquake. (Photo/NOAA)\u003c/figcaption>\u003c/figure>\n\u003cp>In early 2011, federal and state officials asked 200 Southern California hospitals to provide information about their ability to survive a catastrophic earthquake along the southern San Andreas Fault.\u003c/p>\n\u003cp>Among other things, the hospitals were asked how many back-up generators they had on hand, what fuel they use and whether their water tanks could survive a major quake long predicted for one of the nation’s most dangerous faults.\u003c/p>\n\u003cp>The survey was aimed at speeding post-earthquake recovery efforts, such as rushing backup power generators, fuel and water to damaged hospitals struggling to care for patients. The concept was approved by the Federal Emergency Management Agency (FEMA), which would coordinate the federal response to such a disaster.\u003c/p>\n\u003caside class=\"pullquote alignright\">“These hospitals are getting hundreds of millions –- maybe billions –- of dollars from Medicare and Medicaid every year, and they can’t fill out a questionnaire?\"\u003c/aside>\n\u003cp>Sounds like a great idea, right?\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But nearly two years later, almost half of the hospitals still have not responded, leaving some disaster officials frustrated over their inability to help the hospitals plan for the worst.\u003c/p>\n\u003cp>The unsuccessful effort casts a harsh light on the potential pitfalls of forging public-private partnerships among health care facilities to plan for earthquakes, floods and other natural disasters.\u003c!--more-->\u003c/p>\n\u003cp>One national emergency expert, \u003ca href=\"http://www.rand.org/about/people/k/kellermann_arthur.html\" target=\"_blank\">Dr. Arthur L. Kellermann\u003c/a>, said he finds the poor response inexplicable.\u003c/p>\n\u003cp>“This is FEMA, for God’s sake, and federal agencies that are charged with helping hospitals in emergency events,” said Kellermann, a policy analyst at the RAND Corp.\u003c/p>\n\u003cp>“These hospitals are getting hundreds of millions –- maybe billions –- of dollars from Medicare and Medicaid every year, and they can’t fill out a questionnaire of interest to the country and Southern California? I find that deeply disturbing,” he said.\u003c/p>\n\u003cp>Disaster preparedness is taking on new urgency after the ravages of this fall’s Hurricane Sandy. Backup power generators failed at several New York City area hospital and endangered patients’ lives, especially those on ventilators and other machines.\u003c/p>\n\u003cp>The vulnerability of those hospitals has revived concern about experts’ predictions that more than 60 percent of Los Angeles area hospitals would be damaged beyond repair in a major quake.\u003c/p>\n\u003cp>That specter led to the 2011 survey, called the Southern California Catastrophic Earthquake Plan Survey, which local emergency agencies sent to hospitals early in early 2011, some with an April 30, 2011, deadline.\u003c/p>\n\u003cp>The largest group of hospitals declining to participate was \u003ca href=\"http://info.kaiserpermanente.org/communitybenefit/html/our_communities/southern-california/our_communities_2.html\" target=\"_blank\">Kaiser Permanente of Southern California\u003c/a>. A spokeswoman would say only that Kaiser had concerns about “the format and the amount of details being asked for in this optional questionnaire.”\u003c/p>\n\u003cp>Among hospital groups that did cooperate were \u003ca href=\"http://www.dignityhealth.org/index.htm\" target=\"_blank\">Dignity Health\u003c/a> (formerly Catholic Healthcare West), three \u003ca href=\"https://california.providence.org/Pages/Home.aspx?utm_source=google&utm_medium=cpc&utm_campaign=Providence%20Branded&utm_term=providence%20hospital\" target=\"_blank\">Providence hospitals\u003c/a> in the San Fernando Valley and \u003ca href=\"http://www.uclahealth.org/homepage_med.cfm\" target=\"_blank\">UCLA Medical Center\u003c/a>.\u003c/p>\n\u003cp>Leaders of the \u003ca href=\"http://www.calhospital.org/\" target=\"_blank\">California Hospital Association\u003c/a>, the state’s hospital industry group, were troubled that they was not involved at the start, and that the survey was issued outside “normal communications channels,” said spokeswoman Jan Emerson-Shea. Her group later worked with surveyors to review and refine the questions, she said.\u003c/p>\n\u003cp>Some local emergency officials, however, said the association’s uneasiness with the survey had an effect. “They were watching over their members, but it ended up throwing a big wrench into the process,” said Jerry Nevarez, hospital preparedness coordinator at the \u003ca href=\"http://www.sbcounty.gov/ICEMA/Default.aspx\" target=\"_blank\">Inland Counties Emergency Medical Services Agency\u003c/a> in San Bernardino.\u003c/p>\n\u003cp>Now, new talks have begun with the hospital association and state and local officials over fashioning an earthquake survey that would go to hospitals statewide in 2013.\u003c/p>\n\u003cp>Spurring the survey was a landmark 2008 report called “\u003ca href=\"http://pubs.usgs.gov/of/2008/1150/\" target=\"_blank\">The Shakeout Scenario\u003c/a>,” produced by 300 top-level government, academic and industry experts which scrutinized what damage would be inflicted by a 7.8-magnitude quake near the Salton Sea on the southern San Andreas Fault.\u003c/p>\n\u003cp>The impact would spread to nine counties, killing 1,800 people, forcing 50,000 injured to emergency rooms and ripping apart freeways and power lines, the report predicted.\u003c/p>\n\u003cp>“When you have all counties impacted at the same time to the same level, it takes the government to make sure they get what they need to keep going,” said Gerold Fenner, regional emergency coordinator in San Francisco for the \u003ca href=\"http://www.hhs.gov/open/contacts/aspr.html\" target=\"_blank\">U.S. Department of Health and Human Services' preparedness and response branch\u003c/a>. Fenner recently returned from working on the federal response to Sandy.\u003c/p>\n\u003cp>For instance, FEMA has a cache of emergency back-up generators that could be air-lifted to a beleaguered hospital stranded without power, Fenner said. If his agency has that hospital’s information filed away, FEMA could help federal authorities deliver the generator more quickly, he said.\u003c/p>\n\u003cp>Federal officials have collected that sort of information in other states, including hurricane-prone states in the South, he said.\u003c/p>\n\u003cp>At RAND, Kellermann said that state and national policy makers may need to review whether such surveys should be made mandatory.\u003c/p>\n\u003cp>“The whole point of these surveys is not to make hospitals look bad. It’s to help them systematically figure out how to get better,” he said.\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://centerforhealthreporting.org/article/major-quake-could-sideline-60-percent-socal-hospitals1057\" target=\"_blank\">Major Quake Could Sideline 60 percent of SoCal Hospitals\u003c/a> (CHCF Center for Health Reporting)\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
"disqusIdentifier": "10394 http://blogs.kqed.org/stateofhealth/?p=10394",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2013/02/05/quake-breakdown-hospitals-balk-over-sharing-disaster-preparedness-data/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 925,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 29
},
"modified": 1360119814,
"excerpt": "In early 2011, federal and state officials asked 200 Southern California hospitals to provide information about their ability to survive a catastrophic earthquake along the southern San Andreas Fault. The survey was aimed at speeding post-earthquake recovery efforts, such as rushing backup power generators, fuel and water to damaged hospitals struggling to care for patients. \r\n\r\nBut nearly two years later, almost half of the hospitals still have not responded, leaving some disaster officials frustrated over their inability to help the hospitals plan for the worst.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "In early 2011, federal and state officials asked 200 Southern California hospitals to provide information about their ability to survive a catastrophic earthquake along the southern San Andreas Fault. The survey was aimed at speeding post-earthquake recovery efforts, such as rushing backup power generators, fuel and water to damaged hospitals struggling to care for patients. \r\n\r\nBut nearly two years later, almost half of the hospitals still have not responded, leaving some disaster officials frustrated over their inability to help the hospitals plan for the worst.",
"title": "Quake Breakdown: Hospitals Balk Over Sharing Disaster Preparedness Data | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Quake Breakdown: Hospitals Balk Over Sharing Disaster Preparedness Data",
"datePublished": "2013-02-05T10:53:05-08:00",
"dateModified": "2013-02-05T19:03:34-08:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "quake-breakdown-hospitals-balk-over-sharing-disaster-preparedness-data",
"status": "publish",
"path": "/stateofhealth/10394/quake-breakdown-hospitals-balk-over-sharing-disaster-preparedness-data",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Deborah Schoch, \u003ca href=\"http://centerforhealthreporting.org/article/many-socal-hospitals-rebuff-government-over-disaster-plans1056\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_10402\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/05/quake-breakdown-hospitals-balk-over-sharing-disaster-preparedness-data/kaiserquake/\" rel=\"attachment wp-att-10402\">\u003cimg class=\"size-medium wp-image-10402\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/kaiserquake-300x200.jpg\" alt=\"The Kaiser Permanente clinic in Granada Hills, CA was severely damaged in the 1994 Northridge earthquake. (Photo/NOAA)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Kaiser Permanente clinic in Granada Hills, CA was severely damaged in the 1994 Northridge earthquake. (Photo/NOAA)\u003c/figcaption>\u003c/figure>\n\u003cp>In early 2011, federal and state officials asked 200 Southern California hospitals to provide information about their ability to survive a catastrophic earthquake along the southern San Andreas Fault.\u003c/p>\n\u003cp>Among other things, the hospitals were asked how many back-up generators they had on hand, what fuel they use and whether their water tanks could survive a major quake long predicted for one of the nation’s most dangerous faults.\u003c/p>\n\u003cp>The survey was aimed at speeding post-earthquake recovery efforts, such as rushing backup power generators, fuel and water to damaged hospitals struggling to care for patients. The concept was approved by the Federal Emergency Management Agency (FEMA), which would coordinate the federal response to such a disaster.\u003c/p>\n\u003caside class=\"pullquote alignright\">“These hospitals are getting hundreds of millions –- maybe billions –- of dollars from Medicare and Medicaid every year, and they can’t fill out a questionnaire?\"\u003c/aside>\n\u003cp>Sounds like a great idea, right?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But nearly two years later, almost half of the hospitals still have not responded, leaving some disaster officials frustrated over their inability to help the hospitals plan for the worst.\u003c/p>\n\u003cp>The unsuccessful effort casts a harsh light on the potential pitfalls of forging public-private partnerships among health care facilities to plan for earthquakes, floods and other natural disasters.\u003c!--more-->\u003c/p>\n\u003cp>One national emergency expert, \u003ca href=\"http://www.rand.org/about/people/k/kellermann_arthur.html\" target=\"_blank\">Dr. Arthur L. Kellermann\u003c/a>, said he finds the poor response inexplicable.\u003c/p>\n\u003cp>“This is FEMA, for God’s sake, and federal agencies that are charged with helping hospitals in emergency events,” said Kellermann, a policy analyst at the RAND Corp.\u003c/p>\n\u003cp>“These hospitals are getting hundreds of millions –- maybe billions –- of dollars from Medicare and Medicaid every year, and they can’t fill out a questionnaire of interest to the country and Southern California? I find that deeply disturbing,” he said.\u003c/p>\n\u003cp>Disaster preparedness is taking on new urgency after the ravages of this fall’s Hurricane Sandy. Backup power generators failed at several New York City area hospital and endangered patients’ lives, especially those on ventilators and other machines.\u003c/p>\n\u003cp>The vulnerability of those hospitals has revived concern about experts’ predictions that more than 60 percent of Los Angeles area hospitals would be damaged beyond repair in a major quake.\u003c/p>\n\u003cp>That specter led to the 2011 survey, called the Southern California Catastrophic Earthquake Plan Survey, which local emergency agencies sent to hospitals early in early 2011, some with an April 30, 2011, deadline.\u003c/p>\n\u003cp>The largest group of hospitals declining to participate was \u003ca href=\"http://info.kaiserpermanente.org/communitybenefit/html/our_communities/southern-california/our_communities_2.html\" target=\"_blank\">Kaiser Permanente of Southern California\u003c/a>. A spokeswoman would say only that Kaiser had concerns about “the format and the amount of details being asked for in this optional questionnaire.”\u003c/p>\n\u003cp>Among hospital groups that did cooperate were \u003ca href=\"http://www.dignityhealth.org/index.htm\" target=\"_blank\">Dignity Health\u003c/a> (formerly Catholic Healthcare West), three \u003ca href=\"https://california.providence.org/Pages/Home.aspx?utm_source=google&utm_medium=cpc&utm_campaign=Providence%20Branded&utm_term=providence%20hospital\" target=\"_blank\">Providence hospitals\u003c/a> in the San Fernando Valley and \u003ca href=\"http://www.uclahealth.org/homepage_med.cfm\" target=\"_blank\">UCLA Medical Center\u003c/a>.\u003c/p>\n\u003cp>Leaders of the \u003ca href=\"http://www.calhospital.org/\" target=\"_blank\">California Hospital Association\u003c/a>, the state’s hospital industry group, were troubled that they was not involved at the start, and that the survey was issued outside “normal communications channels,” said spokeswoman Jan Emerson-Shea. Her group later worked with surveyors to review and refine the questions, she said.\u003c/p>\n\u003cp>Some local emergency officials, however, said the association’s uneasiness with the survey had an effect. “They were watching over their members, but it ended up throwing a big wrench into the process,” said Jerry Nevarez, hospital preparedness coordinator at the \u003ca href=\"http://www.sbcounty.gov/ICEMA/Default.aspx\" target=\"_blank\">Inland Counties Emergency Medical Services Agency\u003c/a> in San Bernardino.\u003c/p>\n\u003cp>Now, new talks have begun with the hospital association and state and local officials over fashioning an earthquake survey that would go to hospitals statewide in 2013.\u003c/p>\n\u003cp>Spurring the survey was a landmark 2008 report called “\u003ca href=\"http://pubs.usgs.gov/of/2008/1150/\" target=\"_blank\">The Shakeout Scenario\u003c/a>,” produced by 300 top-level government, academic and industry experts which scrutinized what damage would be inflicted by a 7.8-magnitude quake near the Salton Sea on the southern San Andreas Fault.\u003c/p>\n\u003cp>The impact would spread to nine counties, killing 1,800 people, forcing 50,000 injured to emergency rooms and ripping apart freeways and power lines, the report predicted.\u003c/p>\n\u003cp>“When you have all counties impacted at the same time to the same level, it takes the government to make sure they get what they need to keep going,” said Gerold Fenner, regional emergency coordinator in San Francisco for the \u003ca href=\"http://www.hhs.gov/open/contacts/aspr.html\" target=\"_blank\">U.S. Department of Health and Human Services' preparedness and response branch\u003c/a>. Fenner recently returned from working on the federal response to Sandy.\u003c/p>\n\u003cp>For instance, FEMA has a cache of emergency back-up generators that could be air-lifted to a beleaguered hospital stranded without power, Fenner said. If his agency has that hospital’s information filed away, FEMA could help federal authorities deliver the generator more quickly, he said.\u003c/p>\n\u003cp>Federal officials have collected that sort of information in other states, including hurricane-prone states in the South, he said.\u003c/p>\n\u003cp>At RAND, Kellermann said that state and national policy makers may need to review whether such surveys should be made mandatory.\u003c/p>\n\u003cp>“The whole point of these surveys is not to make hospitals look bad. It’s to help them systematically figure out how to get better,” he said.\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://centerforhealthreporting.org/article/major-quake-could-sideline-60-percent-socal-hospitals1057\" target=\"_blank\">Major Quake Could Sideline 60 percent of SoCal Hospitals\u003c/a> (CHCF Center for Health Reporting)\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/10394/quake-breakdown-hospitals-balk-over-sharing-disaster-preparedness-data",
"authors": [
"8344"
],
"categories": [
"stateofhealth_13"
],
"featImg": "stateofhealth_10402",
"label": "stateofhealth"
},
"stateofhealth_10370": {
"type": "posts",
"id": "stateofhealth_10370",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "10370",
"score": null,
"sort": [
1360076456000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1360076456,
"format": "aside",
"disqusTitle": "Mammograms: Strong Evidence That Every Two Years Is Best Option For Older Women",
"title": "Mammograms: Strong Evidence That Every Two Years Is Best Option For Older Women",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_5549\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/01/new-research-for-women-in-their-40s-on-mammograms/080922-n-2688m-004/\" rel=\"attachment wp-att-5549\">\u003cimg class=\"size-medium wp-image-5549\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-300x203.jpg\" alt=\"(Photo: U.S. Navy)\" width=\"300\" height=\"203\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: U.S. Navy)\u003c/figcaption>\u003c/figure>\n\u003cp>A major new study has found that -- in older women -- mammograms done every two years were as effective as mammograms done annually and led to far fewer false positive results.\u003c/p>\n\u003cp>\u003ca href=\"http://jnci.oxfordjournals.org/content/early/2013/02/01/jnci.djs645.abstract\" target=\"_blank\">The study\u003c/a>, published online Tuesday in the Journal of the National Cancer Institute, included more than 140,000 women ages 66 to 89 from across the country.\u003c/p>\n\u003cp>Frequency of mammograms among women in their 40s and 50s has been the subject of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/01/new-research-for-women-in-their-40s-on-mammograms/\" target=\"_blank\">intense debate\u003c/a> for more than two decades, but this older group of women has been much less studied.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The women screened annually had a dramatically higher rate of false positives.\u003c/aside>\n\u003cp>A team led by researchers at UC San Francisco sought to answer the question: among older women, if a woman is screened for breast cancer every two years, instead of every year, will a deadly cancer be missed?\u003c/p>\n\u003cp>\"We found that there really was no difference,\" Dejana Braithwaite, assistant professor of cancer epidemiology at UCSF and part of the research team, told me. \"The women who were screened every two years were not at a greater risk. They did not have a higher probability of being diagnosed with late stage breast cancer compared to those women who were screened every year.\"\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In addition, the women screened annually had a dramatically higher rate of false positives; they were called back for unnecessary mammograms or biopsies. In the study, nearly half of women screened annually -- 48 percent -- had a false positive over a 10-year period, versus about 29 percent of women screened every two years.\u003c/p>\n\u003cp>\"The overall message is that the probability of false positive results is much greater with annual screening and yet there is no added benefit,\" Braithwaite said.\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force created a firestorm of controversy in 2009 when it said women ages 50 to 74 should be screened every two years instead of annually. At that time,\u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" target=\"_blank\"> the task force said that\u003c/a> \"the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older.\" Braithwaite says today's study is one step toward advancing the evidence.\u003c/p>\n\u003cp>\"It doesn't mean to say that women in (their) 70s and even in their 80s should not be screened. Indeed, if they are in good health -- women in their 70s -- there is not reason for them not to be screened.\" But if they have other health issues, breast cancer screening could end up causing unnecessary harms.\u003c/p>\n\u003cp>\"So there's a lot of uncertainty about the value of screening in these older age groups, and that's why we're trying to address is this gap of information in evidence,\" Braithwaite said.\u003c/p>\n\u003cp>And as the population ages, it's becoming an \"increasingly important question,\" she concluded.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to the story\u003c/strong>:\u003cbr>\n[audio:http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/Mammograms-in-Older-Women.mp3]\u003c/p>\n\n",
"disqusIdentifier": "10370 http://blogs.kqed.org/stateofhealth/?p=10370",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2013/02/05/mammograms-strong-evidence-that-every-two-years-is-best-option-for-older-women/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": true,
"hasPolis": false,
"wordCount": 492,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 14
},
"modified": 1371247057,
"excerpt": "A major new study has found that -- in older women -- mammograms done every two years are as effective as mammograms done annually and led to far fewer false positive results.\r\n\r\nThe study, published today in the Journal of the National Cancer Institute, included more than 140-thousand women ages 66 to 89 from across the country. Frequency of mammograms among women in their 40s and 50s has been the subject of intense debate for more than two decades, but this older group of women has been much less studied.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "A major new study has found that -- in older women -- mammograms done every two years are as effective as mammograms done annually and led to far fewer false positive results.\r\n\r\nThe study, published today in the Journal of the National Cancer Institute, included more than 140-thousand women ages 66 to 89 from across the country. Frequency of mammograms among women in their 40s and 50s has been the subject of intense debate for more than two decades, but this older group of women has been much less studied.",
"title": "Mammograms: Strong Evidence That Every Two Years Is Best Option For Older Women | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Mammograms: Strong Evidence That Every Two Years Is Best Option For Older Women",
"datePublished": "2013-02-05T07:00:56-08:00",
"dateModified": "2013-06-14T14:57:37-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "mammograms-strong-evidence-that-every-two-years-is-best-option-for-older-women",
"status": "publish",
"path": "/stateofhealth/10370/mammograms-strong-evidence-that-every-two-years-is-best-option-for-older-women",
"audioUrl": "http://blogs.kqed.org/stateofhealth/files/2013/02/Mammograms-in-Older-Women.mp3",
"audioDuration": null,
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5549\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/01/new-research-for-women-in-their-40s-on-mammograms/080922-n-2688m-004/\" rel=\"attachment wp-att-5549\">\u003cimg class=\"size-medium wp-image-5549\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-300x203.jpg\" alt=\"(Photo: U.S. Navy)\" width=\"300\" height=\"203\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: U.S. Navy)\u003c/figcaption>\u003c/figure>\n\u003cp>A major new study has found that -- in older women -- mammograms done every two years were as effective as mammograms done annually and led to far fewer false positive results.\u003c/p>\n\u003cp>\u003ca href=\"http://jnci.oxfordjournals.org/content/early/2013/02/01/jnci.djs645.abstract\" target=\"_blank\">The study\u003c/a>, published online Tuesday in the Journal of the National Cancer Institute, included more than 140,000 women ages 66 to 89 from across the country.\u003c/p>\n\u003cp>Frequency of mammograms among women in their 40s and 50s has been the subject of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/01/new-research-for-women-in-their-40s-on-mammograms/\" target=\"_blank\">intense debate\u003c/a> for more than two decades, but this older group of women has been much less studied.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The women screened annually had a dramatically higher rate of false positives.\u003c/aside>\n\u003cp>A team led by researchers at UC San Francisco sought to answer the question: among older women, if a woman is screened for breast cancer every two years, instead of every year, will a deadly cancer be missed?\u003c/p>\n\u003cp>\"We found that there really was no difference,\" Dejana Braithwaite, assistant professor of cancer epidemiology at UCSF and part of the research team, told me. \"The women who were screened every two years were not at a greater risk. They did not have a higher probability of being diagnosed with late stage breast cancer compared to those women who were screened every year.\"\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In addition, the women screened annually had a dramatically higher rate of false positives; they were called back for unnecessary mammograms or biopsies. In the study, nearly half of women screened annually -- 48 percent -- had a false positive over a 10-year period, versus about 29 percent of women screened every two years.\u003c/p>\n\u003cp>\"The overall message is that the probability of false positive results is much greater with annual screening and yet there is no added benefit,\" Braithwaite said.\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force created a firestorm of controversy in 2009 when it said women ages 50 to 74 should be screened every two years instead of annually. At that time,\u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" target=\"_blank\"> the task force said that\u003c/a> \"the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older.\" Braithwaite says today's study is one step toward advancing the evidence.\u003c/p>\n\u003cp>\"It doesn't mean to say that women in (their) 70s and even in their 80s should not be screened. Indeed, if they are in good health -- women in their 70s -- there is not reason for them not to be screened.\" But if they have other health issues, breast cancer screening could end up causing unnecessary harms.\u003c/p>\n\u003cp>\"So there's a lot of uncertainty about the value of screening in these older age groups, and that's why we're trying to address is this gap of information in evidence,\" Braithwaite said.\u003c/p>\n\u003cp>And as the population ages, it's becoming an \"increasingly important question,\" she concluded.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to the story\u003c/strong>:\u003cbr>\n\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "audio",
"attributes": {
"named": {
"label": ":http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/Mammograms-in-Older-Women.mp3"
},
"numeric": [
":http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/Mammograms-in-Older-Women.mp3"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/10370/mammograms-strong-evidence-that-every-two-years-is-best-option-for-older-women",
"authors": [
"240"
],
"categories": [
"stateofhealth_12",
"stateofhealth_13"
],
"tags": [
"stateofhealth_176",
"stateofhealth_235",
"stateofhealth_86"
],
"featImg": "stateofhealth_5549",
"label": "stateofhealth"
},
"stateofhealth_10319": {
"type": "posts",
"id": "stateofhealth_10319",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "10319",
"score": null,
"sort": [
1359671307000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1359671307,
"format": "aside",
"disqusTitle": "Economist Rekindles Debate over Geographic Differences in Health Spending ",
"title": "Economist Rekindles Debate over Geographic Differences in Health Spending ",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>By Jordan Rau, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/January/31/disputing-dartmouth-medicare-federal-reserve.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>An economist at the Federal Reserve has restoked the debate over the causes of regional differences in Medicare spending, and her analysis disputes some of the thinking behind a number of policy changes in the 2010 health overhaul.\u003c/p>\n\u003cp>The Obama administration and many prominent economists believe that as much as a third of the $2.7 trillion spent on health care may be due to wasteful practices of physicians and hospitals that could be eliminated without hurting patients. This is based on decades of research, principally by the \u003ca href=\"http://www.tdi.dartmouth.edu/\">Dartmouth Institute for Health Policy & Clinical Practice\u003c/a> in New Hampshire, showing that Medicare spending in some regions of the country is significantly higher than others.\u003c/p>\n\u003cp>This geographic variation in spending, which the government has also \u003ca href=\"http://www.medpac.gov/documents/Dec09_RegionalVariation_report.pdf\">examined\u003c/a>, was a motivating force behind a number of government initiatives including changes in Medicare payment to \u003ca href=\"http://www.kaiserhealthnews.org/stories/2012/december/21/medicare-hospitals-value-based-purchasing.aspx\">reward hospitals\u003c/a> and \u003ca href=\"http://www.kaiserhealthnews.org/stories/2012/april/15/medicare-doctor-pay.aspx\">doctors\u003c/a> who provide good care efficiently.\u003c!--more-->\u003c/p>\n\u003cp>The Institute of Medicine has been \u003ca href=\"http://www8.nationalacademies.org/cp/projectview.aspx?key=IOM-HCS-09-08\">studying\u003c/a> the causes of regional variation, and its conclusions could influence more policies as the government seeks to clamp down on health spending. The policy implications are significant, because if these variations do help identify ways to economize, the government and private insurers might be able to cut large amounts from Medicare in some areas of the country without harming patients.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But the thesis has sparked passionate opposition by medical professionals and facilities and their lobbies in Washington.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.federalreserve.gov/pubs/feds/2013/201304/201304pap.pdf\">new paper\u003c/a> by \u003ca href=\"http://www.federalreserve.gov/econresdata/louise-m-sheiner.htm\">Louise Sheiner\u003c/a>, an economist at the Federal Reserve, provides them with additional fodder. Sheiner examines health spending differences among states and the health of people in those states. She concludes health and socioeconomic factors — things like the prevalence of smoking, obesity and diabetes — best explain why health spending in some regions of the country is higher. That view has been argued for years by researchers such as Dr. \u003ca href=\"http://www.kaiserhealthnews.org/stories/2009/november/16/cooper-debate.aspx\">Richard “Buz” Cooper\u003c/a> of the University of Pennsylvania.\u003c/p>\n\u003cp>Sheiner writes:\u003c/p>\n\u003cblockquote>\u003cp>[T]he variation in Medicare spending across states is attributable to factors that affect health and health behaviors, rather than practice styles. … It is not surprising that states in the South spend more on Medicare and have worse outcomes. These states perform significantly worse in numerous areas, including high school graduation rates, test scores, insurance, unemployment, violent crime, and teenage pregnancy. There are many ways that such differences can affect health utilization and outcomes, including differences in underlying health, social supports and social stressors, patient self-care and advocacy, ease of access to services, capabilities and quality of hospital and physician nurses and technicians, and cultural differences in attitudes toward care. A comparison of health spending in Mississippi with health spending in Minnesota is not likely to provide a usual metric of the ‘inefficiencies’ of the health system, nor is likely to provide a useful guide to improve the quality of care in places where it is lacking.\u003c/p>\u003c/blockquote>\n\u003cp>Sheiner’s analysis was issued as a working paper, which the Fed calls “preliminary materials circulated to stimulate discussion and critical comment,” not representations of the views of the central bank.\u003c/p>\n\u003cp>Nonetheless, the paper has circulated widely enough in health policy circles that the Dartmouth Institute this week rebutted it in a statement from \u003ca href=\"http://www.dartmouth.edu/~jskinner/\">Jonathan Skinner\u003c/a> and Dr.\u003ca href=\"http://geiselmed.dartmouth.edu/faculty/facultydb/view.php?uid=61\">Elliott Fisher\u003c/a>, two senior Dartmouth researchers. \u003ca href=\"http://tdi.dartmouth.edu/press/press-releases/response-of-the-dartmouth-institute-for-health-policy--clinical-practice-to-sheiner-on-variation\" target=\"_blank\">They wrote\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>The focus on states … ignores much of the variation within states, or … the greater than 1.5 fold differences in overall utilization rates across providers in the care of patients with health conditions (such as hip fracture or heart attack) that could not be accounted for by individual patient characteristics, nor, of course, by state level differences in population health. Most of the variations in spending are due to greater use of discretionary services, such as avoidable hospital readmissions or differences in the use of post-acute care, largely ignored in Sheiner’s analysis. … To argue that the geographic variations found in hundreds of studies are pure statistical artifacts seems farfetched.\u003c/p>\u003c/blockquote>\n\u003cp>The dustup is quickly spreading around health policy circles. On the \u003ca href=\"http://blog.academyhealth.org/geographic-variation-in-health-care-spending-and-the-ecological-fallacy/\" target=\"_blank\">Academy Health blog\u003c/a> Thursday, economist \u003ca href=\"http://theincidentaleconomist.com/wordpress/about/about-austin/\" target=\"_blank\">Austin Frakt \u003c/a>of the Incidental Economist rebutted Sheiner. He agrees with Dartmouth that Sheiner erred in focusing on differences between states rather than the individual level as Dartmouth does. Frakt writes:\u003c/p>\n\u003cblockquote>\u003cp>I wish Sheiner's conclusions could be believed. It would really simplify things if the vast majority of health spending variation was due to obesity, sedentary lifestyles, lack of insurance, and a few other things. Were that true, we'd know better how to shape policy. However, based on the body of evidence, it's far more likely the story is more complex and also includes the efficiency with which care is delivered.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor's note: The 1973 paper \u003ca href=\"http://www.dartmouthatlas.org/downloads/papers/Science_1973.pdf\" target=\"_blank\">Small Area Variations in Health Care Delivery\u003c/a> essentially launched the field of study of geographic variation in health care. That study looked at regional variation within the state of Vermont. In the study, researchers found the rate of tonsillectomy, to take one example, ranged from 13 percent in one area of Vermont to 66 percent in another.\u003c/em>\u003c/p>\n\n",
"disqusIdentifier": "10319 http://blogs.kqed.org/stateofhealth/?p=10319",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2013/01/31/economist-rekindles-debate-over-geographic-differences-in-health-spending/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 878,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 17
},
"modified": 1359673003,
"excerpt": "An economist at the Federal Reserve has restoked the debate over the causes of regional differences in Medicare spending, and her analysis disputes some of the thinking behind a number of policy changes in the 2010 health law.\r\n\r\nThe Obama administration and many prominent economists believe that as much as a third of the $2.7 trillion spent on health care may be due to wasteful practices of physicians and hospitals that could be eliminated without hurting patients. This is based on decades of research, principally by the Dartmouth Institute for Health Policy & Clinical Practice in New Hampshire, showing that Medicare spending in some regions of the country is significantly higher than others.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "An economist at the Federal Reserve has restoked the debate over the causes of regional differences in Medicare spending, and her analysis disputes some of the thinking behind a number of policy changes in the 2010 health law.\r\n\r\nThe Obama administration and many prominent economists believe that as much as a third of the $2.7 trillion spent on health care may be due to wasteful practices of physicians and hospitals that could be eliminated without hurting patients. This is based on decades of research, principally by the Dartmouth Institute for Health Policy & Clinical Practice in New Hampshire, showing that Medicare spending in some regions of the country is significantly higher than others.",
"title": "Economist Rekindles Debate over Geographic Differences in Health Spending | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Economist Rekindles Debate over Geographic Differences in Health Spending ",
"datePublished": "2013-01-31T14:28:27-08:00",
"dateModified": "2013-01-31T14:56:43-08:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "economist-rekindles-debate-over-geographic-differences-in-health-spending",
"status": "publish",
"path": "/stateofhealth/10319/economist-rekindles-debate-over-geographic-differences-in-health-spending",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Jordan Rau, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/January/31/disputing-dartmouth-medicare-federal-reserve.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>An economist at the Federal Reserve has restoked the debate over the causes of regional differences in Medicare spending, and her analysis disputes some of the thinking behind a number of policy changes in the 2010 health overhaul.\u003c/p>\n\u003cp>The Obama administration and many prominent economists believe that as much as a third of the $2.7 trillion spent on health care may be due to wasteful practices of physicians and hospitals that could be eliminated without hurting patients. This is based on decades of research, principally by the \u003ca href=\"http://www.tdi.dartmouth.edu/\">Dartmouth Institute for Health Policy & Clinical Practice\u003c/a> in New Hampshire, showing that Medicare spending in some regions of the country is significantly higher than others.\u003c/p>\n\u003cp>This geographic variation in spending, which the government has also \u003ca href=\"http://www.medpac.gov/documents/Dec09_RegionalVariation_report.pdf\">examined\u003c/a>, was a motivating force behind a number of government initiatives including changes in Medicare payment to \u003ca href=\"http://www.kaiserhealthnews.org/stories/2012/december/21/medicare-hospitals-value-based-purchasing.aspx\">reward hospitals\u003c/a> and \u003ca href=\"http://www.kaiserhealthnews.org/stories/2012/april/15/medicare-doctor-pay.aspx\">doctors\u003c/a> who provide good care efficiently.\u003c!--more-->\u003c/p>\n\u003cp>The Institute of Medicine has been \u003ca href=\"http://www8.nationalacademies.org/cp/projectview.aspx?key=IOM-HCS-09-08\">studying\u003c/a> the causes of regional variation, and its conclusions could influence more policies as the government seeks to clamp down on health spending. The policy implications are significant, because if these variations do help identify ways to economize, the government and private insurers might be able to cut large amounts from Medicare in some areas of the country without harming patients.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But the thesis has sparked passionate opposition by medical professionals and facilities and their lobbies in Washington.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.federalreserve.gov/pubs/feds/2013/201304/201304pap.pdf\">new paper\u003c/a> by \u003ca href=\"http://www.federalreserve.gov/econresdata/louise-m-sheiner.htm\">Louise Sheiner\u003c/a>, an economist at the Federal Reserve, provides them with additional fodder. Sheiner examines health spending differences among states and the health of people in those states. She concludes health and socioeconomic factors — things like the prevalence of smoking, obesity and diabetes — best explain why health spending in some regions of the country is higher. That view has been argued for years by researchers such as Dr. \u003ca href=\"http://www.kaiserhealthnews.org/stories/2009/november/16/cooper-debate.aspx\">Richard “Buz” Cooper\u003c/a> of the University of Pennsylvania.\u003c/p>\n\u003cp>Sheiner writes:\u003c/p>\n\u003cblockquote>\u003cp>[T]he variation in Medicare spending across states is attributable to factors that affect health and health behaviors, rather than practice styles. … It is not surprising that states in the South spend more on Medicare and have worse outcomes. These states perform significantly worse in numerous areas, including high school graduation rates, test scores, insurance, unemployment, violent crime, and teenage pregnancy. There are many ways that such differences can affect health utilization and outcomes, including differences in underlying health, social supports and social stressors, patient self-care and advocacy, ease of access to services, capabilities and quality of hospital and physician nurses and technicians, and cultural differences in attitudes toward care. A comparison of health spending in Mississippi with health spending in Minnesota is not likely to provide a usual metric of the ‘inefficiencies’ of the health system, nor is likely to provide a useful guide to improve the quality of care in places where it is lacking.\u003c/p>\u003c/blockquote>\n\u003cp>Sheiner’s analysis was issued as a working paper, which the Fed calls “preliminary materials circulated to stimulate discussion and critical comment,” not representations of the views of the central bank.\u003c/p>\n\u003cp>Nonetheless, the paper has circulated widely enough in health policy circles that the Dartmouth Institute this week rebutted it in a statement from \u003ca href=\"http://www.dartmouth.edu/~jskinner/\">Jonathan Skinner\u003c/a> and Dr.\u003ca href=\"http://geiselmed.dartmouth.edu/faculty/facultydb/view.php?uid=61\">Elliott Fisher\u003c/a>, two senior Dartmouth researchers. \u003ca href=\"http://tdi.dartmouth.edu/press/press-releases/response-of-the-dartmouth-institute-for-health-policy--clinical-practice-to-sheiner-on-variation\" target=\"_blank\">They wrote\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>The focus on states … ignores much of the variation within states, or … the greater than 1.5 fold differences in overall utilization rates across providers in the care of patients with health conditions (such as hip fracture or heart attack) that could not be accounted for by individual patient characteristics, nor, of course, by state level differences in population health. Most of the variations in spending are due to greater use of discretionary services, such as avoidable hospital readmissions or differences in the use of post-acute care, largely ignored in Sheiner’s analysis. … To argue that the geographic variations found in hundreds of studies are pure statistical artifacts seems farfetched.\u003c/p>\u003c/blockquote>\n\u003cp>The dustup is quickly spreading around health policy circles. On the \u003ca href=\"http://blog.academyhealth.org/geographic-variation-in-health-care-spending-and-the-ecological-fallacy/\" target=\"_blank\">Academy Health blog\u003c/a> Thursday, economist \u003ca href=\"http://theincidentaleconomist.com/wordpress/about/about-austin/\" target=\"_blank\">Austin Frakt \u003c/a>of the Incidental Economist rebutted Sheiner. He agrees with Dartmouth that Sheiner erred in focusing on differences between states rather than the individual level as Dartmouth does. Frakt writes:\u003c/p>\n\u003cblockquote>\u003cp>I wish Sheiner's conclusions could be believed. It would really simplify things if the vast majority of health spending variation was due to obesity, sedentary lifestyles, lack of insurance, and a few other things. Were that true, we'd know better how to shape policy. However, based on the body of evidence, it's far more likely the story is more complex and also includes the efficiency with which care is delivered.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor's note: The 1973 paper \u003ca href=\"http://www.dartmouthatlas.org/downloads/papers/Science_1973.pdf\" target=\"_blank\">Small Area Variations in Health Care Delivery\u003c/a> essentially launched the field of study of geographic variation in health care. That study looked at regional variation within the state of Vermont. In the study, researchers found the rate of tonsillectomy, to take one example, ranged from 13 percent in one area of Vermont to 66 percent in another.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/10319/economist-rekindles-debate-over-geographic-differences-in-health-spending",
"authors": [
"8344"
],
"categories": [
"stateofhealth_166",
"stateofhealth_14",
"stateofhealth_13"
],
"tags": [
"stateofhealth_421"
],
"label": "stateofhealth"
}
},
"podcastsReducer": {
"isFetching": false,
"fetchFailed": false,
"hasFetched": false,
"podcasts": {}
},
"radioProgramsReducer": {
"isFetching": false,
"fetchFailed": false,
"hasFetched": false,
"radioPrograms": {}
},
"radioSearchSegmentsReducer": {},
"programsReducer": {
"all-things-considered": {
"id": "all-things-considered",
"title": "All Things Considered",
"info": "Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.",
"airtime": "MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/all-things-considered/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/all-things-considered"
},
"american-suburb-podcast": {
"id": "american-suburb-podcast",
"title": "American Suburb: The Podcast",
"tagline": "The flip side of gentrification, told through one town",
"info": "Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg",
"officialWebsiteLink": "/news/series/american-suburb-podcast",
"meta": {
"site": "news",
"source": "kqed",
"order": 19
},
"link": "/news/series/american-suburb-podcast/",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/RBrW",
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328",
"tuneIn": "https://tunein.com/radio/American-Suburb-p1086805/",
"rss": "https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"
}
},
"baycurious": {
"id": "baycurious",
"title": "Bay Curious",
"tagline": "Exploring the Bay Area, one question at a time",
"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Bay Curious",
"officialWebsiteLink": "/news/series/baycurious",
"meta": {
"site": "news",
"source": "kqed",
"order": 3
},
"link": "/podcasts/baycurious",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/bay-curious/id1172473406",
"npr": "https://www.npr.org/podcasts/500557090/bay-curious",
"rss": "https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast",
"amazon": "https://music.amazon.com/podcasts/9a90d476-aa04-455d-9a4c-0871ed6216d4/bay-curious",
"stitcher": "https://www.stitcher.com/podcast/kqed/bay-curious",
"spotify": "https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"
}
},
"bbc-world-service": {
"id": "bbc-world-service",
"title": "BBC World Service",
"info": "The day's top stories from BBC News compiled twice daily in the week, once at weekends.",
"airtime": "MON-FRI 9pm-10pm, TUE-FRI 1am-2am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.bbc.co.uk/sounds/play/live:bbc_world_service",
"meta": {
"site": "news",
"source": "BBC World Service"
},
"link": "/radio/program/bbc-world-service",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2",
"tuneIn": "https://tunein.com/radio/BBC-World-Service-p455581/",
"rss": "https://podcasts.files.bbci.co.uk/p02nq0gn.rss"
}
},
"californiareport": {
"id": "californiareport",
"title": "The California Report",
"tagline": "California, day by day",
"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The California Report",
"officialWebsiteLink": "/californiareport",
"meta": {
"site": "news",
"source": "kqed",
"order": 8
},
"link": "/californiareport",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/kqeds-the-california-report/id79681292",
"amazon": "https://music.amazon.com/podcasts/26099305-72af-4542-9dde-ac1807fe36d5/kqed-s-the-california-report",
"npr": "https://www.npr.org/podcasts/432285393/the-california-report",
"stitcher": "https://www.stitcher.com/podcast/kqedfm-kqeds-the-california-report-podcast-8838",
"rss": "https://ww2.kqed.org/news/tag/tcram/feed/podcast"
}
},
"californiareportmagazine": {
"id": "californiareportmagazine",
"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Magazine-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The California Report Magazine",
"officialWebsiteLink": "/californiareportmagazine",
"meta": {
"site": "news",
"source": "kqed",
"order": 10
},
"link": "/californiareportmagazine",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/the-california-report-magazine/id1314750545",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
"npr": "https://www.npr.org/podcasts/564733126/the-california-report-magazine",
"stitcher": "https://www.stitcher.com/podcast/kqed/the-california-report-magazine",
"rss": "https://ww2.kqed.org/news/tag/tcrmag/feed/podcast"
}
},
"city-arts": {
"id": "city-arts",
"title": "City Arts & Lectures",
"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
"subscribe": {
"tuneIn": "https://tunein.com/radio/City-Arts-and-Lectures-p692/",
"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
"id": "closealltabs",
"title": "Close All Tabs",
"tagline": "Your irreverent guide to the trends redefining our world",
"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/02/CAT_2_Tile-scaled.jpg",
"imageAlt": "KQED Close All Tabs",
"officialWebsiteLink": "/podcasts/closealltabs",
"meta": {
"site": "news",
"source": "kqed",
"order": 1
},
"link": "/podcasts/closealltabs",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/close-all-tabs/id214663465",
"rss": "https://feeds.megaphone.fm/KQINC6993880386",
"amazon": "https://music.amazon.com/podcasts/92d9d4ac-67a3-4eed-b10a-fb45d45b1ef2/close-all-tabs",
"spotify": "https://open.spotify.com/show/6LAJFHnGK1pYXYzv6SIol6?si=deb0cae19813417c"
}
},
"code-switch-life-kit": {
"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
"airtime": "SUN 9pm-10pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg",
"meta": {
"site": "radio",
"source": "npr"
},
"link": "/radio/program/code-switch-life-kit",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy",
"spotify": "https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV",
"rss": "https://feeds.npr.org/510312/podcast.xml"
}
},
"commonwealth-club": {
"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.commonwealthclub.org/podcasts",
"meta": {
"site": "news",
"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2",
"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
"tuneIn": "https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"
}
},
"forum": {
"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
"officialWebsiteLink": "/forum",
"meta": {
"site": "news",
"source": "kqed",
"order": 9
},
"link": "/forum",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/kqeds-forum/id73329719",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
"npr": "https://www.npr.org/podcasts/432307980/forum",
"stitcher": "https://www.stitcher.com/podcast/kqedfm-kqeds-forum-podcast",
"rss": "https://feeds.megaphone.fm/KQINC9557381633"
}
},
"freakonomics-radio": {
"id": "freakonomics-radio",
"title": "Freakonomics Radio",
"info": "Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/4s8b",
"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
}
},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
"airtime": "MON-FRI 7pm-8pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Fresh-Air-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/fresh-air/",
"meta": {
"site": "radio",
"source": "npr"
},
"link": "/radio/program/fresh-air",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/4s8b",
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
"tuneIn": "https://tunein.com/radio/Fresh-Air-p17/",
"rss": "https://feeds.npr.org/381444908/podcast.xml"
}
},
"here-and-now": {
"id": "here-and-now",
"title": "Here & Now",
"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
"airtime": "MON-THU 11am-12pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Here-And-Now-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "http://www.wbur.org/hereandnow",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/here-and-now",
"subsdcribe": {
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=426698661",
"tuneIn": "https://tunein.com/radio/Here--Now-p211/",
"rss": "https://feeds.npr.org/510051/podcast.xml"
}
},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/hiddenbrain.jpg",
"officialWebsiteLink": "https://www.npr.org/series/423302056/hidden-brain",
"airtime": "SUN 7pm-8pm",
"meta": {
"site": "news",
"source": "NPR"
},
"link": "/radio/program/hidden-brain",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/hidden-brain/id1028908750?mt=2",
"tuneIn": "https://tunein.com/podcasts/Science-Podcasts/Hidden-Brain-p787503/",
"rss": "https://feeds.npr.org/510308/podcast.xml"
}
},
"how-i-built-this": {
"id": "how-i-built-this",
"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/how-i-built-this",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
"tuneIn": "https://tunein.com/podcasts/Arts--Culture-Podcasts/How-I-Built-This-p910896/",
"rss": "https://feeds.npr.org/510313/podcast.xml"
}
},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
"imageAlt": "KQED Hyphenación",
"officialWebsiteLink": "/podcasts/hyphenacion",
"meta": {
"site": "news",
"source": "kqed",
"order": 15
},
"link": "/podcasts/hyphenacion",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/hyphenaci%C3%B3n/id1191591838",
"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
"youtube": "https://www.youtube.com/c/kqedarts",
"amazon": "https://music.amazon.com/podcasts/6c3dd23c-93fb-4aab-97ba-1725fa6315f1/hyphenaci%C3%B3n",
"rss": "https://feeds.megaphone.fm/KQINC2275451163"
}
},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The Political Mind of Jerry Brown",
"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
"site": "news",
"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
"subscribe": {
"npr": "https://www.npr.org/podcasts/790253322/the-political-mind-of-jerry-brown",
"apple": "https://itunes.apple.com/us/podcast/id1492194549",
"rss": "https://ww2.kqed.org/news/series/jerrybrown/feed/podcast/",
"tuneIn": "http://tun.in/pjGcK",
"stitcher": "https://www.stitcher.com/podcast/kqed/the-political-mind-of-jerry-brown",
"spotify": "https://open.spotify.com/show/54C1dmuyFyKMFttY6X2j6r?si=K8SgRCoISNK6ZbjpXrX5-w",
"amazon": "https://music.amazon.com/podcasts/44420f75-3b0e-4301-ab3b-16da6b09e543/the-political-mind-of-jerry-brown"
}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/latino-usa",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/xtTd",
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
"tuneIn": "https://tunein.com/radio/Latino-USA-p621/",
"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
"subscribe": {
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=201853034&at=11l79Y&ct=nprdirectory",
"tuneIn": "https://tunein.com/radio/APM-Marketplace-p88/",
"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
"site": "news",
"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
"npr": "https://www.npr.org/podcasts/464615685/mind-shift-podcast",
"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
"spotify": "https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"
}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
"npr": "https://rpb3r.app.goo.gl/onourwatch",
"spotify": "https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x",
"tuneIn": "https://tunein.com/radio/On-Our-Watch-p1436229/",
"stitcher": "https://www.stitcher.com/show/on-our-watch",
"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
"site": "news",
"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
"meta": {
"site": "news",
"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
"imageAlt": "KQED Perspectives",
"officialWebsiteLink": "/perspectives/",
"meta": {
"site": "radio",
"source": "kqed",
"order": 14
},
"link": "/perspectives",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/id73801135",
"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"
}
},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/M4f5",
"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
"tuneIn": "https://tunein.com/podcasts/Business--Economics-Podcasts/Planet-Money-p164680/",
"rss": "https://feeds.npr.org/510289/podcast.xml"
}
},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"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.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Political Breakdown",
"officialWebsiteLink": "/podcasts/politicalbreakdown",
"meta": {
"site": "radio",
"source": "kqed",
"order": 5
},
"link": "/podcasts/politicalbreakdown",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/political-breakdown/id1327641087",
"amazon": "https://music.amazon.com/podcasts/e0c2d153-ad36-4c8d-901d-f1da6a724824/political-breakdown",
"npr": "https://www.npr.org/podcasts/572155894/political-breakdown",
"stitcher": "https://www.stitcher.com/podcast/kqed/political-breakdown",
"spotify": "https://open.spotify.com/show/07RVyIjIdk2WDuVehvBMoN",
"rss": "https://ww2.kqed.org/news/tag/political-breakdown/feed/podcast"
}
},
"possible": {
"id": "possible",
"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.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
"meta": {
"site": "news",
"source": "Possible"
},
"link": "/radio/program/possible",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/possible/id1677184070",
"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
}
},
"pri-the-world": {
"id": "pri-the-world",
"title": "PRI's The World: Latest Edition",
"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.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pri.org/programs/the-world",
"meta": {
"site": "news",
"source": "PRI"
},
"link": "/radio/program/pri-the-world",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pris-the-world-latest-edition/id278196007?mt=2",
"tuneIn": "https://tunein.com/podcasts/News--Politics-Podcasts/PRIs-The-World-p24/",
"rss": "http://feeds.feedburner.com/pri/theworld"
}
},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"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.",
"airtime": "SUN 12am-1am, SAT 2pm-3pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/radiolab1400.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/radiolab/",
"meta": {
"site": "science",
"source": "WNYC"
},
"link": "/radio/program/radiolab",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/radiolab/id152249110?mt=2",
"tuneIn": "https://tunein.com/radio/RadioLab-p68032/",
"rss": "https://feeds.wnyc.org/radiolab"
}
},
"reveal": {
"id": "reveal",
"title": "Reveal",
"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.",
"airtime": "SAT 4pm-5pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/reveal300px.png",
"officialWebsiteLink": "https://www.revealnews.org/episodes/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/reveal",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/reveal/id886009669",
"tuneIn": "https://tunein.com/radio/Reveal-p679597/",
"rss": "http://feeds.revealradio.org/revealpodcast"
}
},
"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.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Rightnowish-Podcast-Tile-500x500-1.jpg",
"imageAlt": "KQED Rightnowish with Pendarvis Harshaw",
"officialWebsiteLink": "/podcasts/rightnowish",
"meta": {
"site": "arts",
"source": "kqed",
"order": 16
},
"link": "/podcasts/rightnowish",
"subscribe": {
"npr": "https://www.npr.org/podcasts/721590300/rightnowish",
"rss": "https://ww2.kqed.org/arts/programs/rightnowish/feed/podcast",
"apple": "https://podcasts.apple.com/us/podcast/rightnowish/id1482187648",
"stitcher": "https://www.stitcher.com/podcast/kqed/rightnowish",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMxMjU5MTY3NDc4",
"spotify": "https://open.spotify.com/show/7kEJuafTzTVan7B78ttz1I"
}
},
"science-friday": {
"id": "science-friday",
"title": "Science Friday",
"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
"airtime": "FRI 11am-1pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Science-Friday-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/science-friday",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/science-friday",
"subscribe": {
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=73329284&at=11l79Y&ct=nprdirectory",
"tuneIn": "https://tunein.com/radio/Science-Friday-p394/",
"rss": "http://feeds.wnyc.org/science-friday"
}
},
"snap-judgment": {
"id": "snap-judgment",
"title": "Snap Judgment",
"tagline": "Real stories with killer beats",
"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
"airtime": "SAT 1pm-2pm, 9pm-10pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/05/Snap-Judgment-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Snap Judgment",
"officialWebsiteLink": "https://snapjudgment.org",
"meta": {
"site": "arts",
"source": "kqed",
"order": 4
},
"link": "https://snapjudgment.org",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/snap-judgment/id283657561",
"npr": "https://www.npr.org/podcasts/449018144/snap-judgment",
"stitcher": "https://www.pandora.com/podcast/snap-judgment/PC:241?source=stitcher-sunset",
"spotify": "https://open.spotify.com/show/3Cct7ZWmxHNAtLgBTqjC5v",
"rss": "https://snap.feed.snapjudgment.org/"
}
},
"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Sold-Out-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Sold Out: Rethinking Housing in America",
"officialWebsiteLink": "/podcasts/soldout",
"meta": {
"site": "news",
"source": "kqed",
"order": 13
},
"link": "/podcasts/soldout",
"subscribe": {
"npr": "https://www.npr.org/podcasts/911586047/s-o-l-d-o-u-t-a-new-future-for-housing",
"apple": "https://podcasts.apple.com/us/podcast/introducing-sold-out-rethinking-housing-in-america/id1531354937",
"rss": "https://feeds.megaphone.fm/soldout",
"spotify": "https://open.spotify.com/show/38dTBSk2ISFoPiyYNoKn1X",
"stitcher": "https://www.stitcher.com/podcast/kqed/sold-out-rethinking-housing-in-america",
"tunein": "https://tunein.com/radio/SOLD-OUT-Rethinking-Housing-in-America-p1365871/"
}
},
"spooked": {
"id": "spooked",
"title": "Spooked",
"tagline": "True-life supernatural stories",
"info": "",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/10/Spooked-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Spooked",
"officialWebsiteLink": "https://spookedpodcast.org/",
"meta": {
"site": "news",
"source": "kqed",
"order": 7
},
"link": "https://spookedpodcast.org/",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/spooked/id1279361017",
"npr": "https://www.npr.org/podcasts/549547848/snap-judgment-presents-spooked",
"spotify": "https://open.spotify.com/show/76571Rfl3m7PLJQZKQIGCT",
"rss": "https://feeds.simplecast.com/TBotaapn"
}
},
"tech-nation": {
"id": "tech-nation",
"title": "Tech Nation Radio Podcast",
"info": "Tech Nation is a weekly public radio program, hosted by Dr. Moira Gunn. Founded in 1993, it has grown from a simple interview show to a multi-faceted production, featuring conversations with noted technology and science leaders, and a weekly science and technology-related commentary.",
"airtime": "FRI 10pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Tech-Nation-Radio-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "http://technation.podomatic.com/",
"meta": {
"site": "science",
"source": "Tech Nation Media"
},
"link": "/radio/program/tech-nation",
"subscribe": {
"rss": "https://technation.podomatic.com/rss2.xml"
}
},
"ted-radio-hour": {
"id": "ted-radio-hour",
"title": "TED Radio Hour",
"info": "The TED Radio Hour is a journey through fascinating ideas, astonishing inventions, fresh approaches to old problems, and new ways to think and create.",
"airtime": "SUN 3pm-4pm, SAT 10pm-11pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/tedRadioHour.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/ted-radio-hour/?showDate=2018-06-22",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/ted-radio-hour",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/8vsS",
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=523121474&at=11l79Y&ct=nprdirectory",
"tuneIn": "https://tunein.com/radio/TED-Radio-Hour-p418021/",
"rss": "https://feeds.npr.org/510298/podcast.xml"
}
},
"thebay": {
"id": "thebay",
"title": "The Bay",
"tagline": "Local news to keep you rooted",
"info": "Host Devin Katayama walks you through the biggest story of the day with reporters and newsmakers.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Bay-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The Bay",
"officialWebsiteLink": "/podcasts/thebay",
"meta": {
"site": "radio",
"source": "kqed",
"order": 2
},
"link": "/podcasts/thebay",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/the-bay/id1350043452",
"amazon": "https://music.amazon.com/podcasts/d800ea4c-7a2c-42f2-b861-edaf78a5db0b/the-bay",
"npr": "https://www.npr.org/podcasts/586725995/the-bay",
"stitcher": "https://www.stitcher.com/podcast/kqed/the-bay",
"spotify": "https://open.spotify.com/show/4BIKBKIujizLHlIlBNaAqQ",
"rss": "https://feeds.megaphone.fm/KQINC8259786327"
}
},
"thelatest": {
"id": "thelatest",
"title": "The Latest",
"tagline": "Trusted local news in real time",
"info": "",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/05/The-Latest-2025-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The Latest",
"officialWebsiteLink": "/thelatest",
"meta": {
"site": "news",
"source": "kqed",
"order": 6
},
"link": "/thelatest",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/the-latest-from-kqed/id1197721799",
"npr": "https://www.npr.org/podcasts/1257949365/the-latest-from-k-q-e-d",
"spotify": "https://open.spotify.com/show/5KIIXMgM9GTi5AepwOYvIZ?si=bd3053fec7244dba",
"rss": "https://feeds.megaphone.fm/KQINC9137121918"
}
},
"theleap": {
"id": "theleap",
"title": "The Leap",
"tagline": "What if you closed your eyes, and jumped?",
"info": "Stories about people making dramatic, risky changes, told by award-winning public radio reporter Judy Campbell.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Leap-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The Leap",
"officialWebsiteLink": "/podcasts/theleap",
"meta": {
"site": "news",
"source": "kqed",
"order": 17
},
"link": "/podcasts/theleap",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/the-leap/id1046668171",
"npr": "https://www.npr.org/podcasts/447248267/the-leap",
"stitcher": "https://www.stitcher.com/podcast/kqed/the-leap",
"spotify": "https://open.spotify.com/show/3sSlVHHzU0ytLwuGs1SD1U",
"rss": "https://ww2.kqed.org/news/programs/the-leap/feed/podcast"
}
},
"the-moth-radio-hour": {
"id": "the-moth-radio-hour",
"title": "The Moth Radio Hour",
"info": "Since its launch in 1997, The Moth has presented thousands of true stories, told live and without notes, to standing-room-only crowds worldwide. Moth storytellers stand alone, under a spotlight, with only a microphone and a roomful of strangers. The storyteller and the audience embark on a high-wire act of shared experience which is both terrifying and exhilarating. Since 2008, The Moth podcast has featured many of our favorite stories told live on Moth stages around the country. For information on all of our programs and live events, visit themoth.org.",
"airtime": "SAT 8pm-9pm and SUN 11am-12pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/theMoth.jpg",
"officialWebsiteLink": "https://themoth.org/",
"meta": {
"site": "arts",
"source": "prx"
},
"link": "/radio/program/the-moth-radio-hour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/the-moth-podcast/id275699983?mt=2",
"tuneIn": "https://tunein.com/radio/The-Moth-p273888/",
"rss": "http://feeds.themoth.org/themothpodcast"
}
},
"the-new-yorker-radio-hour": {
"id": "the-new-yorker-radio-hour",
"title": "The New Yorker Radio Hour",
"info": "The New Yorker Radio Hour is a weekly program presented by the magazine's editor, David Remnick, and produced by WNYC Studios and The New Yorker. Each episode features a diverse mix of interviews, profiles, storytelling, and an occasional burst of humor inspired by the magazine, and shaped by its writers, artists, and editors. This isn't a radio version of a magazine, but something all its own, reflecting the rich possibilities of audio storytelling and conversation. Theme music for the show was composed and performed by Merrill Garbus of tUnE-YArDs.",
"airtime": "SAT 10am-11am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-New-Yorker-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/tnyradiohour",
"meta": {
"site": "arts",
"source": "WNYC"
},
"link": "/radio/program/the-new-yorker-radio-hour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/id1050430296",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/New-Yorker-Radio-Hour-p803804/",
"rss": "https://feeds.feedburner.com/newyorkerradiohour"
}
},
"the-sam-sanders-show": {
"id": "the-sam-sanders-show",
"title": "The Sam Sanders Show",
"info": "One of public radio's most dynamic voices, Sam Sanders helped launch The NPR Politics Podcast and hosted NPR's hit show It's Been A Minute. Now, the award-winning host returns with something brand new, The Sam Sanders Show. Every week, Sam Sanders and friends dig into the culture that shapes our lives: what's driving the biggest trends, how artists really think, and even the memes you can't stop scrolling past. Sam is beloved for his way of unpacking the world and bringing you up close to fresh currents and engaging conversations. The Sam Sanders Show is smart, funny and always a good time.",
"airtime": "FRI 12-1pm AND SAT 11am-12pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/11/The-Sam-Sanders-Show-Podcast-Tile-400x400-1.jpg",
"officialWebsiteLink": "https://www.kcrw.com/shows/the-sam-sanders-show/latest",
"meta": {
"site": "arts",
"source": "KCRW"
},
"link": "https://www.kcrw.com/shows/the-sam-sanders-show/latest",
"subscribe": {
"rss": "https://feed.cdnstream1.com/zjb/feed/download/ac/28/59/ac28594c-e1d0-4231-8728-61865cdc80e8.xml"
}
},
"the-splendid-table": {
"id": "the-splendid-table",
"title": "The Splendid Table",
"info": "\u003cem>The Splendid Table\u003c/em> hosts our nation's conversations about cooking, sustainability and food culture.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Splendid-Table-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.splendidtable.org/",
"airtime": "SUN 10-11 pm",
"meta": {
"site": "radio",
"source": "npr"
},
"link": "/radio/program/the-splendid-table"
},
"this-american-life": {
"id": "this-american-life",
"title": "This American Life",
"info": "This American Life is a weekly public radio show, heard by 2.2 million people on more than 500 stations. Another 2.5 million people download the weekly podcast. It is hosted by Ira Glass, produced in collaboration with Chicago Public Media, delivered to stations by PRX The Public Radio Exchange, and has won all of the major broadcasting awards.",
"airtime": "SAT 12pm-1pm, 7pm-8pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/thisAmericanLife.png",
"officialWebsiteLink": "https://www.thisamericanlife.org/",
"meta": {
"site": "news",
"source": "wbez"
},
"link": "/radio/program/this-american-life",
"subscribe": {
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=201671138&at=11l79Y&ct=nprdirectory",
"rss": "https://www.thisamericanlife.org/podcast/rss.xml"
}
},
"tinydeskradio": {
"id": "tinydeskradio",
"title": "Tiny Desk Radio",
"info": "We're bringing the best of Tiny Desk to the airwaves, only on public radio.",
"airtime": "SUN 8pm and SAT 9pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/04/300x300-For-Member-Station-Logo-Tiny-Desk-Radio-@2x.png",
"officialWebsiteLink": "https://www.npr.org/series/g-s1-52030/tiny-desk-radio",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/tinydeskradio",
"subscribe": {
"rss": "https://feeds.npr.org/g-s1-52030/rss.xml"
}
},
"wait-wait-dont-tell-me": {
"id": "wait-wait-dont-tell-me",
"title": "Wait Wait... Don't Tell Me!",
"info": "Peter Sagal and Bill Kurtis host the weekly NPR News quiz show alongside some of the best and brightest news and entertainment personalities.",
"airtime": "SUN 10am-11am, SAT 11am-12pm, SAT 6pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Wait-Wait-Podcast-Tile-300x300-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/wait-wait-dont-tell-me/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/wait-wait-dont-tell-me",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/Xogv",
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=121493804&at=11l79Y&ct=nprdirectory",
"tuneIn": "https://tunein.com/radio/Wait-Wait-Dont-Tell-Me-p46/",
"rss": "https://feeds.npr.org/344098539/podcast.xml"
}
},
"weekend-edition-saturday": {
"id": "weekend-edition-saturday",
"title": "Weekend Edition Saturday",
"info": "Weekend Edition Saturday wraps up the week's news and offers a mix of analysis and features on a wide range of topics, including arts, sports, entertainment, and human interest stories. The two-hour program is hosted by NPR's Peabody Award-winning Scott Simon.",
"airtime": "SAT 5am-10am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Weekend-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/weekend-edition-saturday/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/weekend-edition-saturday"
},
"weekend-edition-sunday": {
"id": "weekend-edition-sunday",
"title": "Weekend Edition Sunday",
"info": "Weekend Edition Sunday features interviews with newsmakers, artists, scientists, politicians, musicians, writers, theologians and historians. The program has covered news events from Nelson Mandela's 1990 release from a South African prison to the capture of Saddam Hussein.",
"airtime": "SUN 5am-10am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Weekend-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/weekend-edition-sunday/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/weekend-edition-sunday"
}
},
"racesReducer": {},
"racesGenElectionReducer": {},
"racesGenElection2026Reducer": {},
"racesGenElection2026PresidentialReducer": {},
"radioSchedulesReducer": {},
"listsReducer": {
"posts/stateofhealth?category=tests-treatments": {
"isFetching": false,
"latestQuery": {
"from": 336,
"size": 12
},
"vitalsOnly": false,
"totalRequested": 12,
"isLoading": false,
"isLoadingMore": true,
"total": {
"value": 411,
"relation": "eq"
},
"items": [
"stateofhealth_11804",
"stateofhealth_11752",
"stateofhealth_11736",
"stateofhealth_11439",
"stateofhealth_10704",
"stateofhealth_10661",
"stateofhealth_10585",
"stateofhealth_10542",
"stateofhealth_10505",
"stateofhealth_10394",
"stateofhealth_10370",
"stateofhealth_10319"
],
"complete": true
}
},
"recallGuideReducer": {
"intros": {},
"policy": {},
"candidates": {}
},
"savedArticleReducer": {
"articles": [],
"status": {}
},
"newslettersReducer": {
"isFetching": false,
"fetchFailed": false,
"hasFetched": false,
"newsletters": {},
"isSubscribing": false,
"isUnsubscribing": false,
"subscribedNewsletters": {}
},
"termsReducer": {
"about": {
"name": "About",
"type": "terms",
"id": "about",
"slug": "about",
"link": "/about",
"taxonomy": "site"
},
"arts": {
"name": "Arts & Culture",
"grouping": [
"arts",
"pop",
"trulyca"
],
"description": "KQED Arts provides daily in-depth coverage of the Bay Area's music, art, film, performing arts, literature and arts news, as well as cultural commentary and criticism.",
"type": "terms",
"id": "arts",
"slug": "arts",
"link": "/arts",
"taxonomy": "site"
},
"artschool": {
"name": "Art School",
"parent": "arts",
"type": "terms",
"id": "artschool",
"slug": "artschool",
"link": "/artschool",
"taxonomy": "site"
},
"bayareabites": {
"name": "KQED food",
"grouping": [
"food",
"bayareabites",
"checkplease"
],
"parent": "food",
"type": "terms",
"id": "bayareabites",
"slug": "bayareabites",
"link": "/food",
"taxonomy": "site"
},
"bayareahiphop": {
"name": "Bay Area Hiphop",
"type": "terms",
"id": "bayareahiphop",
"slug": "bayareahiphop",
"link": "/bayareahiphop",
"taxonomy": "site"
},
"campaign21": {
"name": "Campaign 21",
"type": "terms",
"id": "campaign21",
"slug": "campaign21",
"link": "/campaign21",
"taxonomy": "site"
},
"careers": {
"name": "Careers",
"type": "terms",
"id": "careers",
"slug": "careers",
"link": "/careers",
"taxonomy": "site"
},
"checkplease": {
"name": "KQED food",
"grouping": [
"food",
"bayareabites",
"checkplease"
],
"parent": "food",
"type": "terms",
"id": "checkplease",
"slug": "checkplease",
"link": "/food",
"taxonomy": "site"
},
"education": {
"name": "Education",
"grouping": [
"education"
],
"type": "terms",
"id": "education",
"slug": "education",
"link": "/education",
"taxonomy": "site"
},
"elections": {
"name": "Elections",
"type": "terms",
"id": "elections",
"slug": "elections",
"link": "/elections",
"taxonomy": "site"
},
"events": {
"name": "Events",
"type": "terms",
"id": "events",
"slug": "events",
"link": "/events",
"taxonomy": "site"
},
"event": {
"name": "Event",
"alias": "events",
"type": "terms",
"id": "event",
"slug": "event",
"link": "/event",
"taxonomy": "site"
},
"filmschoolshorts": {
"name": "Film School Shorts",
"type": "terms",
"id": "filmschoolshorts",
"slug": "filmschoolshorts",
"link": "/filmschoolshorts",
"taxonomy": "site"
},
"food": {
"name": "KQED food",
"grouping": [
"food",
"bayareabites",
"checkplease"
],
"type": "terms",
"id": "food",
"slug": "food",
"link": "/food",
"taxonomy": "site"
},
"forum": {
"name": "Forum",
"relatedContentQuery": "posts/forum?",
"parent": "news",
"type": "terms",
"id": "forum",
"slug": "forum",
"link": "/forum",
"taxonomy": "site"
},
"futureofyou": {
"name": "Future of You",
"grouping": [
"science",
"futureofyou"
],
"parent": "science",
"type": "terms",
"id": "futureofyou",
"slug": "futureofyou",
"link": "/futureofyou",
"taxonomy": "site"
},
"jpepinheart": {
"name": "KQED food",
"relatedContentQuery": "posts/food,bayareabites,checkplease",
"parent": "food",
"type": "terms",
"id": "jpepinheart",
"slug": "jpepinheart",
"link": "/food",
"taxonomy": "site"
},
"liveblog": {
"name": "Live Blog",
"type": "terms",
"id": "liveblog",
"slug": "liveblog",
"link": "/liveblog",
"taxonomy": "site"
},
"livetv": {
"name": "Live TV",
"parent": "tv",
"type": "terms",
"id": "livetv",
"slug": "livetv",
"link": "/livetv",
"taxonomy": "site"
},
"lowdown": {
"name": "The Lowdown",
"relatedContentQuery": "posts/lowdown?",
"parent": "news",
"type": "terms",
"id": "lowdown",
"slug": "lowdown",
"link": "/lowdown",
"taxonomy": "site"
},
"mindshift": {
"name": "Mindshift",
"parent": "news",
"description": "MindShift explores the future of education by highlighting the innovative – and sometimes counterintuitive – ways educators and parents are helping all children succeed.",
"type": "terms",
"id": "mindshift",
"slug": "mindshift",
"link": "/mindshift",
"taxonomy": "site"
},
"news": {
"name": "News",
"grouping": [
"news",
"forum"
],
"type": "terms",
"id": "news",
"slug": "news",
"link": "/news",
"taxonomy": "site"
},
"newsletters": {
"name": "newsletters",
"type": "terms",
"id": "newsletters",
"slug": "newsletters",
"link": "/newsletters",
"taxonomy": "site"
},
"perspectives": {
"name": "Perspectives",
"parent": "radio",
"type": "terms",
"id": "perspectives",
"slug": "perspectives",
"link": "/perspectives",
"taxonomy": "site"
},
"podcasts": {
"name": "Podcasts",
"type": "terms",
"id": "podcasts",
"slug": "podcasts",
"link": "/podcasts",
"taxonomy": "site"
},
"pop": {
"name": "Pop",
"parent": "arts",
"type": "terms",
"id": "pop",
"slug": "pop",
"link": "/pop",
"taxonomy": "site"
},
"pressroom": {
"name": "Pressroom",
"type": "terms",
"id": "pressroom",
"slug": "pressroom",
"link": "/pressroom",
"taxonomy": "site"
},
"quest": {
"name": "Quest",
"parent": "science",
"type": "terms",
"id": "quest",
"slug": "quest",
"link": "/quest",
"taxonomy": "site"
},
"radio": {
"name": "Radio",
"grouping": [
"forum",
"perspectives"
],
"description": "Listen to KQED Public Radio – home of Forum and The California Report – on 88.5 FM in San Francisco, 89.3 FM in Sacramento, 88.3 FM in Santa Rosa and 88.1 FM in Martinez.",
"type": "terms",
"id": "radio",
"slug": "radio",
"link": "/radio",
"taxonomy": "site"
},
"root": {
"name": "KQED",
"image": "https://ww2.kqed.org/app/uploads/2020/02/KQED-OG-Image@1x.png",
"imageWidth": 1200,
"imageHeight": 630,
"headData": {
"title": "KQED | News, Radio, Podcasts, TV | Public Media for Northern California",
"description": "KQED provides public radio, television, and independent reporting on issues that matter to the Bay Area. We’re the NPR and PBS member station for Northern California."
},
"type": "terms",
"id": "root",
"slug": "root",
"link": "/root",
"taxonomy": "site"
},
"science": {
"name": "Science",
"grouping": [
"science",
"futureofyou"
],
"description": "KQED Science brings you award-winning science and environment coverage from the Bay Area and beyond.",
"type": "terms",
"id": "science",
"slug": "science",
"link": "/science",
"taxonomy": "site"
},
"stateofhealth": {
"name": "State of Health",
"parent": "science",
"type": "terms",
"id": "stateofhealth",
"slug": "stateofhealth",
"link": "/stateofhealth",
"taxonomy": "site"
},
"support": {
"name": "Support",
"type": "terms",
"id": "support",
"slug": "support",
"link": "/support",
"taxonomy": "site"
},
"thedolist": {
"name": "The Do List",
"parent": "arts",
"type": "terms",
"id": "thedolist",
"slug": "thedolist",
"link": "/thedolist",
"taxonomy": "site"
},
"trulyca": {
"name": "Truly CA",
"grouping": [
"arts",
"pop",
"trulyca"
],
"parent": "arts",
"type": "terms",
"id": "trulyca",
"slug": "trulyca",
"link": "/trulyca",
"taxonomy": "site"
},
"tv": {
"name": "TV",
"type": "terms",
"id": "tv",
"slug": "tv",
"link": "/tv",
"taxonomy": "site"
},
"voterguide": {
"name": "Voter Guide",
"parent": "elections",
"alias": "elections",
"type": "terms",
"id": "voterguide",
"slug": "voterguide",
"link": "/voterguide",
"taxonomy": "site"
},
"guiaelectoral": {
"name": "Guia Electoral",
"parent": "elections",
"alias": "elections",
"type": "terms",
"id": "guiaelectoral",
"slug": "guiaelectoral",
"link": "/guiaelectoral",
"taxonomy": "site"
},
"stateofhealth_category_tests-treatments": {
"isLoading": true
},
"stateofhealth_13": {
"type": "terms",
"id": "stateofhealth_13",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "13",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Tests & Treatments",
"description": "Information and new research about advances in discovering and treating diseases and conditions.",
"taxonomy": "category",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": "Information and new research about advances in discovering and treating diseases and conditions.",
"title": "Tests & Treatments Archives | KQED Arts",
"ogDescription": null
},
"ttid": 13,
"slug": "tests-treatments",
"isLoading": false,
"link": "/stateofhealth/category/tests-treatments"
},
"stateofhealth_14": {
"type": "terms",
"id": "stateofhealth_14",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "14",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Policy",
"description": "Actions by people in power – lawmakers, regulators and the like – can make a difference to your health, for better or for worse. We keep you informed",
"taxonomy": "category",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": "Actions by people in power – lawmakers, regulators and the like – can make a difference to your health, for better or for worse. We keep you informed",
"title": "Policy Archives | KQED Arts",
"ogDescription": null
},
"ttid": 14,
"slug": "policy",
"isLoading": false,
"link": "/stateofhealth/category/policy"
},
"stateofhealth_46": {
"type": "terms",
"id": "stateofhealth_46",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "46",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Breast Cancer",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Breast Cancer Archives | KQED Arts",
"ogDescription": null
},
"ttid": 46,
"slug": "breast-cancer",
"isLoading": false,
"link": "/stateofhealth/tag/breast-cancer"
},
"stateofhealth_176": {
"type": "terms",
"id": "stateofhealth_176",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "176",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Mammograms",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Mammograms Archives | KQED Arts",
"ogDescription": null
},
"ttid": 176,
"slug": "mammograms",
"isLoading": false,
"link": "/stateofhealth/tag/mammograms"
},
"stateofhealth_461": {
"type": "terms",
"id": "stateofhealth_461",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "461",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Science",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Science Archives | KQED Arts",
"ogDescription": null
},
"ttid": 462,
"slug": "science",
"isLoading": false,
"link": "/stateofhealth/tag/science"
},
"stateofhealth_482": {
"type": "terms",
"id": "stateofhealth_482",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "482",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Health Care Costs",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Health Care Costs Archives | KQED Arts",
"ogDescription": null
},
"ttid": 483,
"slug": "health-care-costs",
"isLoading": false,
"link": "/stateofhealth/tag/health-care-costs"
},
"stateofhealth_15": {
"type": "terms",
"id": "stateofhealth_15",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "15",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Obamacare",
"description": "The Affordable Care Act celebrates its seventh birthday this year. California has embraced the law, but will it survive a new Congress and President? \r\n",
"taxonomy": "category",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": "The Affordable Care Act celebrates its seventh birthday this year. California has embraced the law, but will it survive a new Congress and President?",
"title": "Obamacare Archives | KQED Arts",
"ogDescription": null
},
"ttid": 15,
"slug": "reform",
"isLoading": false,
"link": "/stateofhealth/category/reform"
},
"stateofhealth_38": {
"type": "terms",
"id": "stateofhealth_38",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "38",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Affordable Care Act",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Affordable Care Act Archives | KQED Arts",
"ogDescription": null
},
"ttid": 38,
"slug": "affordable-care-act",
"isLoading": false,
"link": "/stateofhealth/tag/affordable-care-act"
},
"stateofhealth_12": {
"type": "terms",
"id": "stateofhealth_12",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "12",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Living Healthy",
"description": "Health is about much more than medicine. We show you what's new to help you attain and maintain a healthy life",
"taxonomy": "category",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": "Health is about much more than medicine. We show you what's new to help you attain and maintain a healthy life",
"title": "Living Healthy Archives | KQED Arts",
"ogDescription": null
},
"ttid": 12,
"slug": "living-healthy",
"isLoading": false,
"link": "/stateofhealth/category/living-healthy"
},
"stateofhealth_344": {
"type": "terms",
"id": "stateofhealth_344",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "344",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Evidence Based Medicine",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Evidence Based Medicine Archives | KQED Arts",
"ogDescription": null
},
"ttid": 345,
"slug": "evidence-based-medicine",
"isLoading": false,
"link": "/stateofhealth/tag/evidence-based-medicine"
},
"stateofhealth_294": {
"type": "terms",
"id": "stateofhealth_294",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "294",
"found": true
},
"relationships": {},
"featImg": null,
"name": "ACA",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "ACA Archives | KQED Arts",
"ogDescription": null
},
"ttid": 295,
"slug": "aca",
"isLoading": false,
"link": "/stateofhealth/tag/aca"
},
"stateofhealth_235": {
"type": "terms",
"id": "stateofhealth_235",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "235",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Overtreatment",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Overtreatment Archives | KQED Arts",
"ogDescription": null
},
"ttid": 235,
"slug": "overtreatment",
"isLoading": false,
"link": "/stateofhealth/tag/overtreatment"
},
"stateofhealth_86": {
"type": "terms",
"id": "stateofhealth_86",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "86",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Unnecessary Care",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Unnecessary Care Archives | KQED Arts",
"ogDescription": null
},
"ttid": 86,
"slug": "unnecessary-care",
"isLoading": false,
"link": "/stateofhealth/tag/unnecessary-care"
},
"stateofhealth_166": {
"type": "terms",
"id": "stateofhealth_166",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "166",
"found": true
},
"relationships": {},
"featImg": null,
"name": "KQED blogs",
"description": null,
"taxonomy": "category",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "KQED blogs Archives | KQED Arts",
"ogDescription": null
},
"ttid": 166,
"slug": "kqed-blogs",
"isLoading": false,
"link": "/stateofhealth/category/kqed-blogs"
},
"stateofhealth_421": {
"type": "terms",
"id": "stateofhealth_421",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "421",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Geographic Variation",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Geographic Variation Archives | KQED Arts",
"ogDescription": null
},
"ttid": 422,
"slug": "geographic-variation",
"isLoading": false,
"link": "/stateofhealth/tag/geographic-variation"
}
},
"userPermissionsReducer": {
"wpLoggedIn": false
},
"eventsReducer": {},
"fssReducer": {},
"tvDailyScheduleReducer": {},
"tvWeeklyScheduleReducer": {},
"tvPrimetimeScheduleReducer": {},
"tvMonthlyScheduleReducer": {},
"userAccountReducer": {
"user": {
"email": null,
"emailStatus": "EMAIL_UNVALIDATED",
"loggedStatus": "LOGGED_OUT",
"loggingChecked": false,
"articles": [],
"firstName": null,
"lastName": null,
"phoneNumber": null,
"fetchingMembership": false,
"membershipError": false,
"memberships": [
{
"id": null,
"startDate": null,
"firstName": null,
"lastName": null,
"familyNumber": null,
"memberNumber": null,
"memberSince": null,
"expirationDate": null,
"pfsEligible": false,
"isSustaining": false,
"membershipLevel": "Prospect",
"membershipStatus": "Non Member",
"lastGiftDate": null,
"renewalDate": null,
"lastDonationAmount": null
}
]
},
"authModal": {
"isOpen": false,
"view": "LANDING_VIEW"
},
"error": null
},
"youthMediaReducer": {},
"checkPleaseReducer": {
"filterData": {
"region": {
"key": "Restaurant Region",
"filters": [
"Any Region"
]
},
"cuisine": {
"key": "Restaurant Cuisine",
"filters": [
"Any Cuisine"
]
}
},
"restaurantDataById": {},
"restaurantIdsSorted": [],
"error": null
},
"userAgentReducer": {
"userAgent": "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)",
"isBot": true
},
"requestOutcomesReducer": {
"notFound": []
},
"navPromosReducer": {
"isFetching": false,
"fetchFailed": false,
"hasFetched": true,
"promos": {
"news": {
"name": "2026 Voter Guide",
"link": "/voterguide",
"imageURL": "https://cdn.kqed.org/wp-content/uploads/2026/10/Nav-News-Nov2026ElectionCoverage@2x-7bd4aad4.png",
"description": "Get informed in minutes with our Voter Guide for California’s November 3 election."
},
"podcasts-radio": {},
"video-tv": {},
"events": {},
"support": {}
}
}
}