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"disqusTitle": "UC Student Health Plan Slips Through Loophole in Affordable Care Act",
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"content": "\u003cfigure id=\"attachment_10256\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/01/30/uc-student-health-plan-slips-through-loophole-in-affordable-care-act/calcampus120626/\" rel=\"attachment wp-att-10256\">\u003cimg class=\"size-medium wp-image-10256\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/CalCampus120626-300x198.jpg\" alt=\"A UC Berkeley student discovered the limits of his UC student health coverage after a cancer diagnosis.(Studio H (Chris)/Flickr)\" width=\"300\" height=\"198\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A UC Berkeley student discovered the limits of his UC student health coverage after a cancer diagnosis.(Studio H (Chris)/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>If you are a student at any of the UC campuses -- or a family member of one -- you might want to pay close attention to the case of Kenya Wheeler at UC Berkeley. A year ago he was \"healthy as a horse,\" the San Francisco Chronicle reports and biked to school every day.\u003c/p>\n\u003cp>But everything changed when he was diagnosed with cancer. He had health insurance through the UC Student Health Plan. But as medical bills mounted, he closed in on the $400,000 lifetime cap of the policy -- caps that were made illegal under the Affordable Care Act.\u003c/p>\n\u003cp>Illegal, that is, except for self-funded college health insurance plans, such as the one UC has. In its self-funded plan, UC bears the financial risk of medical coverage. From\u003ca href=\"http://www.sfgate.com/health/article/Obamacare-loophole-threatens-UC-students-4234269.php#page-1\" target=\"_blank\"> the Chronicle\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Universities have long offered student health coverage to make sure their students have access to health care. Most college health plans purchase a group policy from a health insurance company and must adhere to the new federal requirements.\u003c!--more-->\u003c/p>\n\u003cp>But some large universities - an estimated 30 universities and systems covering some 300,000 students nationwide - prefer self-funded health plans because they provide more control over policy terms, offer lower taxes and let schools keep funds until it's time to pay a claim. Similar self-funded plans are offered by corporations and other large businesses, but they are subject to the new federal regulations.\u003c/p>\n\u003cp>It's not clear why self-funded student policies were left out of the law, but federal health officials indicated last year they did not believe they had the legal authority to regulate this type of plan.\u003c/p>\n\u003cp>Nonetheless, starting Jan. 1, the federal law will require Americans - including students - to have health insurance that meets certain minimum requirements or face penalties.\u003c/p>\n\u003cp>Meanwhile, UC and other universities, including Harvard, have asked federal health officials to add self-funded student health plans to the new law, in which case UC would be required to lift the caps, said \u003ca href=\"http://www.sfgate.com/?controllerName=search&action=search&channel=health&search=1&inlineLink=1&query=%22Grace+Crickette%22\">Grace Crickette\u003c/a>, UC's chief risk officer. Asked why, Crickette said it was to benefit students, who might otherwise suffer tax penalties\u003cstrong>.\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>\u003c/strong>\"We don't know if we'll get in,\" she said. \"We might be rejected.\"\u003c/p>\u003c/blockquote>\n\u003cp>UC students have started a petition drive, demanding that UC lift the lifetime cap immediately, the Chronicle says:\u003c/p>\n\u003cblockquote>\u003cp>UC officials say they're weighing their options but are hesitant to voluntarily lift the caps until they know what it would cost - and how much they'd have to raise the price of student health care to pay for it.\u003c/p>\n\u003cp>\"It's a front-burner issue,\" said \u003ca href=\"http://www.sfgate.com/?controllerName=search&action=search&channel=health&search=1&inlineLink=1&query=%22Peter+Taylor%22\">Peter Taylor\u003c/a>, UC's chief financial officer, who became aware of the problem last summer. \"We're not making a profit on (student health care) - but I can't afford to lose money, either.\"\u003c/p>\u003c/blockquote>\n\u003cp>Kenya Wheeler did hit his lifetime cap, was turned down for Medi-Cal but then married his girlfriend so he could continue receiving insurance through her plan. The Chronicle reports his cancer is now in remission.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_10256\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/01/30/uc-student-health-plan-slips-through-loophole-in-affordable-care-act/calcampus120626/\" rel=\"attachment wp-att-10256\">\u003cimg class=\"size-medium wp-image-10256\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/CalCampus120626-300x198.jpg\" alt=\"A UC Berkeley student discovered the limits of his UC student health coverage after a cancer diagnosis.(Studio H (Chris)/Flickr)\" width=\"300\" height=\"198\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A UC Berkeley student discovered the limits of his UC student health coverage after a cancer diagnosis.(Studio H (Chris)/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>If you are a student at any of the UC campuses -- or a family member of one -- you might want to pay close attention to the case of Kenya Wheeler at UC Berkeley. A year ago he was \"healthy as a horse,\" the San Francisco Chronicle reports and biked to school every day.\u003c/p>\n\u003cp>But everything changed when he was diagnosed with cancer. He had health insurance through the UC Student Health Plan. But as medical bills mounted, he closed in on the $400,000 lifetime cap of the policy -- caps that were made illegal under the Affordable Care Act.\u003c/p>\n\u003cp>Illegal, that is, except for self-funded college health insurance plans, such as the one UC has. In its self-funded plan, UC bears the financial risk of medical coverage. From\u003ca href=\"http://www.sfgate.com/health/article/Obamacare-loophole-threatens-UC-students-4234269.php#page-1\" target=\"_blank\"> the Chronicle\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Universities have long offered student health coverage to make sure their students have access to health care. Most college health plans purchase a group policy from a health insurance company and must adhere to the new federal requirements.\u003c!--more-->\u003c/p>\n\u003cp>But some large universities - an estimated 30 universities and systems covering some 300,000 students nationwide - prefer self-funded health plans because they provide more control over policy terms, offer lower taxes and let schools keep funds until it's time to pay a claim. Similar self-funded plans are offered by corporations and other large businesses, but they are subject to the new federal regulations.\u003c/p>\n\u003cp>It's not clear why self-funded student policies were left out of the law, but federal health officials indicated last year they did not believe they had the legal authority to regulate this type of plan.\u003c/p>\n\u003cp>Nonetheless, starting Jan. 1, the federal law will require Americans - including students - to have health insurance that meets certain minimum requirements or face penalties.\u003c/p>\n\u003cp>Meanwhile, UC and other universities, including Harvard, have asked federal health officials to add self-funded student health plans to the new law, in which case UC would be required to lift the caps, said \u003ca href=\"http://www.sfgate.com/?controllerName=search&action=search&channel=health&search=1&inlineLink=1&query=%22Grace+Crickette%22\">Grace Crickette\u003c/a>, UC's chief risk officer. Asked why, Crickette said it was to benefit students, who might otherwise suffer tax penalties\u003cstrong>.\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>\u003c/strong>\"We don't know if we'll get in,\" she said. \"We might be rejected.\"\u003c/p>\u003c/blockquote>\n\u003cp>UC students have started a petition drive, demanding that UC lift the lifetime cap immediately, the Chronicle says:\u003c/p>\n\u003cblockquote>\u003cp>UC officials say they're weighing their options but are hesitant to voluntarily lift the caps until they know what it would cost - and how much they'd have to raise the price of student health care to pay for it.\u003c/p>\n\u003cp>\"It's a front-burner issue,\" said \u003ca href=\"http://www.sfgate.com/?controllerName=search&action=search&channel=health&search=1&inlineLink=1&query=%22Peter+Taylor%22\">Peter Taylor\u003c/a>, UC's chief financial officer, who became aware of the problem last summer. \"We're not making a profit on (student health care) - but I can't afford to lose money, either.\"\u003c/p>\u003c/blockquote>\n\u003cp>Kenya Wheeler did hit his lifetime cap, was turned down for Medi-Cal but then married his girlfriend so he could continue receiving insurance through her plan. The Chronicle reports his cancer is now in remission.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Advocacy Group Says Anthem Blue Cross Pharmacy Program is Discriminatory",
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"content": "\u003cfigure id=\"attachment_9978\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/Pills.Credit_Grumpy-Puddin2.jpg\">\u003cimg class=\"size-medium wp-image-9978\" title=\"(Paul Wilson/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/Pills.Credit_Grumpy-Puddin2-300x199.jpg\" alt=\"(Paul Wilson/Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Paul Wilson/Flickr) \u003ccite>(Photo by Paul Wilson/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The advocacy group Consumer Watchdog has filed a statewide \u003ca href=\"http://www.consumerwatchdog.org/resources/anthem_complaint.final_.1.11.13.pdf\" target=\"_blank\">class action lawsuit \u003c/a>against Anthem Blue Cross saying the health insurer is discriminating against HIV/AIDS patients.\u003c/p>\n\u003cp>Anthem is changing its pharmacy program and will require anyone using drugs from a list of \"specialty\" medications to use a mail-order pharmacy, approved by Anthem. But patients seeking to fill other prescriptions may still use their local bricks-and-mortar pharmacy. \"That's exactly the kind of targeting and discrimination barred under the Civil Rights Act in California,\" Consumer Watchdog attorney Jerry Flanagan says.\u003c/p>\n\u003cp>In a statement, Anthem denies the change is discriminatory, because the list of specialty medications includes not only HIV/AIDS drugs, but also medicines for other conditions, such as cancer and multiple sclerosis. Anthem says that the practice is already established. From Anthem's statement:\u003c/p>\n\u003cblockquote>\u003cp>\"For many years, health plans in California and other states have sought, subject to certain exceptions, that specialty drugs be filled by Specialty Pharmacies and received via confidential home or other private delivery location that benefits the member. ... This is being done with the knowledge of our regulator and applies to several hundred different drugs for many medical ailments. Anthem's policies do not discriminate on the basis of disease states, and they are reasonable and compliant with applicable laws.\"\u003c/p>\u003c/blockquote>\n\u003cp>Marta Green at the Department of Managed Health Care confirmed that there are three similar programs already in place in California from Health Net, Sharp and United Health Care of California. Green declined to comment on Consumer Watchdog's lawsuit, saying the Department had just received it.\u003c/p>\n\u003cp>\u003c!--more-->In its statement, Anthem pointed to costs savings as one driving factor. \"This program allows our contracted specialty pharmacy to secure bulk discounts for high cost drugs that help keep the benefit more affordable,\" the statement reads. Anthem also says that the mail order pharmacy it contracted with has a special program for HIV/AIDS patients, and evidence shows that patients in the program have a 93 percent drug adherence rate, \"nearly 10% higher than patients using a retail pharmacy.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But Flanagan notes, \"Consumers can't be drug compliant if they can't afford the drug.\"\u003c/p>\n\u003cp>He points out that many low and middle income HIV/AIDS patients depend on payment assistance programs established between pharmaceutical companies and retail pharmacies. These programs help pay for deductibles and co-pays. One patient participating in the lawsuit -- who goes by John Doe for confidentiality purposes -- has already incurred hundreds of dollars in out of pocket expenses, Flanagan says.\u003c/p>\n\u003cp>David Lazarus at the\u003cem> LA Times\u003c/em> took \u003ca href=\"http://www.latimes.com/business/la-fi-lazarus-20130111,0,1228877.column\" target=\"_blank\">a close look\u003c/a> at the legality of the move:\u003c/p>\n\u003cblockquote>\u003cp>\"California law clearly states that no one can be discriminated against because of a medical condition,\" said Lynda Gledhill, a spokeswoman for Atty. Gen. \u003ca id=\"PEPLT00008198\" title=\"Kamala D. Harris\" href=\"http://www.latimes.com/topic/politics/government/kamala-d.-harris-PEPLT00008198.topic\">Kamala D. Harris\u003c/a>. \"If patients are being required to get their prescriptions from a certain pharmacy because of their condition, that is likely illegal.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Anthem says that any patient who faces a hardship because of the new requirement may request an exception to the proposal.\u003c/p>\n\n",
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"excerpt": "The advocacy group Consumer Watchdog has filed a statewide class action lawsuit against Anthem Blue Cross saying the health insurer is discriminating against HIV/AIDS patients.\r\n\r\nAnthem is changing its pharmacy program and will require anyone using drugs from a list of \"specialty\" medications to use a mail-order pharmacy, approved by Anthem. But patients seeking to fill other prescriptions may still use their local bricks-and-mortar pharmacy. \"That's exactly the kind of targeting and discrimination barred under the Civil Rights Act in California,\" Consumer Watchdog attorney Jerry Flanagan says.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_9978\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/Pills.Credit_Grumpy-Puddin2.jpg\">\u003cimg class=\"size-medium wp-image-9978\" title=\"(Paul Wilson/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/Pills.Credit_Grumpy-Puddin2-300x199.jpg\" alt=\"(Paul Wilson/Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Paul Wilson/Flickr) \u003ccite>(Photo by Paul Wilson/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The advocacy group Consumer Watchdog has filed a statewide \u003ca href=\"http://www.consumerwatchdog.org/resources/anthem_complaint.final_.1.11.13.pdf\" target=\"_blank\">class action lawsuit \u003c/a>against Anthem Blue Cross saying the health insurer is discriminating against HIV/AIDS patients.\u003c/p>\n\u003cp>Anthem is changing its pharmacy program and will require anyone using drugs from a list of \"specialty\" medications to use a mail-order pharmacy, approved by Anthem. But patients seeking to fill other prescriptions may still use their local bricks-and-mortar pharmacy. \"That's exactly the kind of targeting and discrimination barred under the Civil Rights Act in California,\" Consumer Watchdog attorney Jerry Flanagan says.\u003c/p>\n\u003cp>In a statement, Anthem denies the change is discriminatory, because the list of specialty medications includes not only HIV/AIDS drugs, but also medicines for other conditions, such as cancer and multiple sclerosis. Anthem says that the practice is already established. From Anthem's statement:\u003c/p>\n\u003cblockquote>\u003cp>\"For many years, health plans in California and other states have sought, subject to certain exceptions, that specialty drugs be filled by Specialty Pharmacies and received via confidential home or other private delivery location that benefits the member. ... This is being done with the knowledge of our regulator and applies to several hundred different drugs for many medical ailments. Anthem's policies do not discriminate on the basis of disease states, and they are reasonable and compliant with applicable laws.\"\u003c/p>\u003c/blockquote>\n\u003cp>Marta Green at the Department of Managed Health Care confirmed that there are three similar programs already in place in California from Health Net, Sharp and United Health Care of California. Green declined to comment on Consumer Watchdog's lawsuit, saying the Department had just received it.\u003c/p>\n\u003cp>\u003c!--more-->In its statement, Anthem pointed to costs savings as one driving factor. \"This program allows our contracted specialty pharmacy to secure bulk discounts for high cost drugs that help keep the benefit more affordable,\" the statement reads. Anthem also says that the mail order pharmacy it contracted with has a special program for HIV/AIDS patients, and evidence shows that patients in the program have a 93 percent drug adherence rate, \"nearly 10% higher than patients using a retail pharmacy.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But Flanagan notes, \"Consumers can't be drug compliant if they can't afford the drug.\"\u003c/p>\n\u003cp>He points out that many low and middle income HIV/AIDS patients depend on payment assistance programs established between pharmaceutical companies and retail pharmacies. These programs help pay for deductibles and co-pays. One patient participating in the lawsuit -- who goes by John Doe for confidentiality purposes -- has already incurred hundreds of dollars in out of pocket expenses, Flanagan says.\u003c/p>\n\u003cp>David Lazarus at the\u003cem> LA Times\u003c/em> took \u003ca href=\"http://www.latimes.com/business/la-fi-lazarus-20130111,0,1228877.column\" target=\"_blank\">a close look\u003c/a> at the legality of the move:\u003c/p>\n\u003cblockquote>\u003cp>\"California law clearly states that no one can be discriminated against because of a medical condition,\" said Lynda Gledhill, a spokeswoman for Atty. Gen. \u003ca id=\"PEPLT00008198\" title=\"Kamala D. Harris\" href=\"http://www.latimes.com/topic/politics/government/kamala-d.-harris-PEPLT00008198.topic\">Kamala D. Harris\u003c/a>. \"If patients are being required to get their prescriptions from a certain pharmacy because of their condition, that is likely illegal.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Anthem says that any patient who faces a hardship because of the new requirement may request an exception to the proposal.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_9899\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/brown20130110.jpg\">\u003cimg class=\"size-medium wp-image-9899\" title=\"(Justin Sullivan/Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/brown20130110-300x214.jpg\" alt=\"(Justin Sullivan/Getty Images)\" width=\"300\" height=\"214\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Gov. Brown is proposing California's counties relinquish some of their state health funding once the Affordable Care Act is in place. (Justin Sullivan/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>We're now 354 days from the rollout of the Affordable Care Act next Jan. 1. While the governor declared the state's participation in the Medicaid expansion at his budget unveiling yesterday, he also proposed \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/01/10/governors-proposals-for-medicaid-expansion/\" target=\"_blank\">two ways\u003c/a> to handle that expansion.\u003c/p>\n\u003cp>Under one scenario, the state will continue to administer the program. Under the other, each of California's 58 counties will oversee running Medi-Cal, California's version of Medicaid, for its own residents.\u003c/p>\n\u003cp>The Affordable Care Act dictates that the federal government will pay 100 percent of the cost for those people newly eligible for Medicaid, and in both proposals, the state's position is that California counties will get some fiscal relief once those federal dollars start flowing.\u003c/p>\n\u003cp>But don't get too excited, counties.\u003c/p>\n\u003cp>California Secretary of Health and Human Services Diana Dooley yesterday referred to a \"conversation\" around \"appropriate sharing\" that needs to happen between the state and its counties around financial responsibilities.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"There's an assumption we've been fully funded. That is simply not accurate.\"\u003c/aside>\n\u003cp>\"Conversation\" might prove to be a euphemism for what could become a vocal debate between the state and the counties. And maybe between counties themselves.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Alex Briscoe, Director of Alameda County's Health Care Services Agency, told me this morning that \"sharing\" presumes that current state funding is sufficient to meet the needs of the indigent poor, an idea he called \"simply preposterous.\"\u003c!--more-->\u003c/p>\n\u003cp>\"There's an assumption we've been fully funded,\" he said. \"That is simply not accurate.\"\u003c/p>\n\u003cp>Counties bear the responsibility for caring for poor uninsured adults, and Alameda is one of 55 California counties that has moved forward with implementing a Low Income Health Plan (LIHP), a bridge to the 2014 Medi-Cal expansion. About a half-million Californians are currently enrolled.\u003c/p>\n\u003cp>Bill Walker, Contra Costa County's Health Director, says he would support having county-level responsibility for overseeing the Medi-Cal expansion. \"The devil is alwyas in the details win terms of agreements between the state and the county,\" he told KQED's Mina Kim yesterday. \"And obviously at the end of the day, the question is what are the rates, what is the cost sharing, and how do the dollars flow?\"\u003c/p>\n\u003cp>But whether the state or counties handle the Medi-Cal expansion, there will still be at least two million people who lack insurance, as Sarah Varney explained at \u003ca href=\"http://capsules.kaiserhealthnews.org/index.php/2013/01/is-california-headed-for-state-vs-counties-health-budget-battle/\" target=\"_blank\">Kaiser Health News\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Those residents, many of whom are undocumented and barred from buying their own insurance coverage through “Covered California,” the state’s online marketplace, and are ineligible for any public insurance programs, will continue to rely on county-run facilities and safety-net clinics.\u003c/p>\n\u003cp>If the state drains the counties of health care funding, says Anthony Wright, executive director of Health Access, an advocacy group, “You run the risk of losing public hospitals and clinics at exactly the moment we need all the capacity we can get.”\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Later this month, the governor is expected to call for a special legislative session on health care issues.\u003c/p>\n\n",
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"excerpt": "We're now 354 days until the Affordable Care Act rolls out next January 1st. While the governor committed in his budget unveiling yesterday that the state will participate in the Medicaid expansion -- health insurance for the poor and disabled -- he also proposed two ways to handle that expansion.\r\n\r\nUnder one scenario, the state will continue to administer the program. Under the other idea, each of California's 58 counties will oversee running Medi-Cal for its own residents.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_9899\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/brown20130110.jpg\">\u003cimg class=\"size-medium wp-image-9899\" title=\"(Justin Sullivan/Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/brown20130110-300x214.jpg\" alt=\"(Justin Sullivan/Getty Images)\" width=\"300\" height=\"214\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Gov. Brown is proposing California's counties relinquish some of their state health funding once the Affordable Care Act is in place. (Justin Sullivan/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>We're now 354 days from the rollout of the Affordable Care Act next Jan. 1. While the governor declared the state's participation in the Medicaid expansion at his budget unveiling yesterday, he also proposed \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/01/10/governors-proposals-for-medicaid-expansion/\" target=\"_blank\">two ways\u003c/a> to handle that expansion.\u003c/p>\n\u003cp>Under one scenario, the state will continue to administer the program. Under the other, each of California's 58 counties will oversee running Medi-Cal, California's version of Medicaid, for its own residents.\u003c/p>\n\u003cp>The Affordable Care Act dictates that the federal government will pay 100 percent of the cost for those people newly eligible for Medicaid, and in both proposals, the state's position is that California counties will get some fiscal relief once those federal dollars start flowing.\u003c/p>\n\u003cp>But don't get too excited, counties.\u003c/p>\n\u003cp>California Secretary of Health and Human Services Diana Dooley yesterday referred to a \"conversation\" around \"appropriate sharing\" that needs to happen between the state and its counties around financial responsibilities.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"There's an assumption we've been fully funded. That is simply not accurate.\"\u003c/aside>\n\u003cp>\"Conversation\" might prove to be a euphemism for what could become a vocal debate between the state and the counties. And maybe between counties themselves.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Alex Briscoe, Director of Alameda County's Health Care Services Agency, told me this morning that \"sharing\" presumes that current state funding is sufficient to meet the needs of the indigent poor, an idea he called \"simply preposterous.\"\u003c!--more-->\u003c/p>\n\u003cp>\"There's an assumption we've been fully funded,\" he said. \"That is simply not accurate.\"\u003c/p>\n\u003cp>Counties bear the responsibility for caring for poor uninsured adults, and Alameda is one of 55 California counties that has moved forward with implementing a Low Income Health Plan (LIHP), a bridge to the 2014 Medi-Cal expansion. About a half-million Californians are currently enrolled.\u003c/p>\n\u003cp>Bill Walker, Contra Costa County's Health Director, says he would support having county-level responsibility for overseeing the Medi-Cal expansion. \"The devil is alwyas in the details win terms of agreements between the state and the county,\" he told KQED's Mina Kim yesterday. \"And obviously at the end of the day, the question is what are the rates, what is the cost sharing, and how do the dollars flow?\"\u003c/p>\n\u003cp>But whether the state or counties handle the Medi-Cal expansion, there will still be at least two million people who lack insurance, as Sarah Varney explained at \u003ca href=\"http://capsules.kaiserhealthnews.org/index.php/2013/01/is-california-headed-for-state-vs-counties-health-budget-battle/\" target=\"_blank\">Kaiser Health News\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Those residents, many of whom are undocumented and barred from buying their own insurance coverage through “Covered California,” the state’s online marketplace, and are ineligible for any public insurance programs, will continue to rely on county-run facilities and safety-net clinics.\u003c/p>\n\u003cp>If the state drains the counties of health care funding, says Anthony Wright, executive director of Health Access, an advocacy group, “You run the risk of losing public hospitals and clinics at exactly the moment we need all the capacity we can get.”\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Later this month, the governor is expected to call for a special legislative session on health care issues.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Governor's Proposals for Medicaid Expansion",
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"content": "\u003cfigure id=\"attachment_9886\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/PatientMoved_05252012_MilitaryHealth_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-9886\" title=\"(Military Health/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/PatientMoved_05252012_MilitaryHealth_Flickr-300x232.jpg\" alt=\"(Military Health/Flickr)\" width=\"300\" height=\"232\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Military Health/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Gov. Jerry Brown has released his \u003ca href=\"http://ww2.kqed.org/news/2013/01/10/governor-to-propose-budget-more-money-for-schools-expected/\" target=\"_blank\">new state budget\u003c/a>, including plans for implementing the Affordable Care Act in California. In a press conference this morning, the governor said he plans to handle that implementation \"cautiously.\"\u003c/p>\n\u003cp>\"We are committed to expanding Medi-Cal, we’re committed to bringing more people into the healthcare system, but we recognize there are big costs out there,\" the governor told reporters. \"There are big unknowns so we’re going to move carefully, but we’re going to move with commitment, because I believe people do need decent healthcare, and I believe what Pres. Obama did was historic. It was heroic, and I’m going to do everything I can to be a good partner to make sure his plan works.\"\u003c/p>\n\u003cp>The ACA calls for an expansion of the Medicaid program, known as Medi-Cal in California. The federal government will pay 100 percent of the costs of the new enrollees through 2016. After that, the federal contribution will decline to 90 percent by 2020.\u003c/p>\n\u003cp>The governor is proposing two ways to handle the expansion.\u003c!--more-->\u003c/p>\n\u003cp>The first option would be a pretty straightforward expansion of the existing program, which would cover people earning up to 138 percent of poverty as described in the federal law. But the governor is proposing that this expansion would cover only health care costs, not long term care costs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The governor's second option would be a county-based expansion. Counties would build on the Low Income Health Program, also called the \"Bridge to Reform,\" currently in place in 55 of 58 California counties. In a press call with reporters, California's Secretary of Health and Human Services Diana Dooley pointed out the counties stand to benefit financially from the influx of federal dollars when new enrollees enter the system. Both proposals acknowledge that counties benefit.\u003c/p>\n\u003cp>\"It is a recognition they will have costs reduced,\" Dooley said, referring to counties. \"The relief to the system is a relief to the counties whether we do it at the counties or whether we do it at the state. The counties have the obligation to provide care to this population and that obligation will be satisfied with new federal funds. So the conversation has to be what is an appropriate sharing of that new relationship with the availability of new federal funds.\"\u003c/p>\n\u003cp>Dooley did not put a timetable on reaching a decision of which path to take, but said \"the conversation starts today.\"\u003c/p>\n\u003cp>While those newly eligible for Medi-Cal under the Affordable Care Act will be funded 100 percent by the federal government, many tens of thousands of people currently eligible but not enrolled are also expected to sign up for Medi-Cal. That's because of several factors. The individual mandate requires everyone to have health insurance, and the Affordable Care Act requires more streamlined enrollment into state run Medicaid programs. The Health Insurance Exchange, Covered California, is expected to launch a major marketing effort to bring people in to purchase insurance. Many people eligible for Medi-Cal will likely respond.\u003c/p>\n\u003cp>The federal government is not picking up the whole tab of this currently-eligible-but-not-enrolled population. The state has put $350 million in the budget as a \"placeholder,\" Dooley said. It's hard to be sure if that's enough or too much money. Dooley discussed the difficulty of determining true numbers because estimates of how many people will enroll vary widely. \u003ca href=\"http://laborcenter.berkeley.edu/healthcare/medi-cal_expansion.shtml\" target=\"_blank\">One recent report\u003c/a> showed that between 240,000 and 510,000 currently eligible people are expected to be enrolled between 2014 and 2019. That's a big differential.\u003c/p>\n\u003cp>At a rally by health advocates in San Francisco today, Linda Lew of Health Access chided the state for being so careful. \"It's good to be cautious,\" she told KQED's Mina Kim, \"but in some ways it's needlessly cautious. The Medicaid expansion is one good example. The first two years are 100 percent federally funded and subsequent years are 90 percent funded, so it's not going to be a huge lift on the state.\"\u003c/p>\n\u003cp>In \u003ca href=\"http://www.csac.counties.org/post/csac-issues-statement-regarding-governors-budget-proposal\" target=\"_blank\">a statement on its website\u003c/a>, the California State Association of Counties said it was \"pleased\" that the governor is moving ahead with implementing the Affordable Care Act. But the group echoed the Administration in discussing the challenges.\u003c/p>\n\u003cp>\"Counties recognize that a number of short- and long-term questions about health reform remain unanswered and the uncertainty makes implementation challenging. These proposals carry risks for counties, too. Counties want to be sure that all options for Medicaid expansion are discussed and that the critical role of counties in delivering health services, including hospital and safety net services, is maintained.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor's note: This post has been updated with details from California's Secretary of Health and Human Services and other reactions to the governor's budget.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Gov. Jerry Brown has released his new state budget, including plans for implementing the Affordable Care Act in California. In a press conference this morning, the governor said he plans to handle that implementation \"cautiously.\"\r\n\r\n\"We are committed to expanding Medi-Cal, we’re committed to bringing more people into the healthcare system, but we recognize there are big costs out there,\" the governor told reporters.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_9886\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/PatientMoved_05252012_MilitaryHealth_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-9886\" title=\"(Military Health/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/PatientMoved_05252012_MilitaryHealth_Flickr-300x232.jpg\" alt=\"(Military Health/Flickr)\" width=\"300\" height=\"232\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Military Health/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Gov. Jerry Brown has released his \u003ca href=\"http://ww2.kqed.org/news/2013/01/10/governor-to-propose-budget-more-money-for-schools-expected/\" target=\"_blank\">new state budget\u003c/a>, including plans for implementing the Affordable Care Act in California. In a press conference this morning, the governor said he plans to handle that implementation \"cautiously.\"\u003c/p>\n\u003cp>\"We are committed to expanding Medi-Cal, we’re committed to bringing more people into the healthcare system, but we recognize there are big costs out there,\" the governor told reporters. \"There are big unknowns so we’re going to move carefully, but we’re going to move with commitment, because I believe people do need decent healthcare, and I believe what Pres. Obama did was historic. It was heroic, and I’m going to do everything I can to be a good partner to make sure his plan works.\"\u003c/p>\n\u003cp>The ACA calls for an expansion of the Medicaid program, known as Medi-Cal in California. The federal government will pay 100 percent of the costs of the new enrollees through 2016. After that, the federal contribution will decline to 90 percent by 2020.\u003c/p>\n\u003cp>The governor is proposing two ways to handle the expansion.\u003c!--more-->\u003c/p>\n\u003cp>The first option would be a pretty straightforward expansion of the existing program, which would cover people earning up to 138 percent of poverty as described in the federal law. But the governor is proposing that this expansion would cover only health care costs, not long term care costs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The governor's second option would be a county-based expansion. Counties would build on the Low Income Health Program, also called the \"Bridge to Reform,\" currently in place in 55 of 58 California counties. In a press call with reporters, California's Secretary of Health and Human Services Diana Dooley pointed out the counties stand to benefit financially from the influx of federal dollars when new enrollees enter the system. Both proposals acknowledge that counties benefit.\u003c/p>\n\u003cp>\"It is a recognition they will have costs reduced,\" Dooley said, referring to counties. \"The relief to the system is a relief to the counties whether we do it at the counties or whether we do it at the state. The counties have the obligation to provide care to this population and that obligation will be satisfied with new federal funds. So the conversation has to be what is an appropriate sharing of that new relationship with the availability of new federal funds.\"\u003c/p>\n\u003cp>Dooley did not put a timetable on reaching a decision of which path to take, but said \"the conversation starts today.\"\u003c/p>\n\u003cp>While those newly eligible for Medi-Cal under the Affordable Care Act will be funded 100 percent by the federal government, many tens of thousands of people currently eligible but not enrolled are also expected to sign up for Medi-Cal. That's because of several factors. The individual mandate requires everyone to have health insurance, and the Affordable Care Act requires more streamlined enrollment into state run Medicaid programs. The Health Insurance Exchange, Covered California, is expected to launch a major marketing effort to bring people in to purchase insurance. Many people eligible for Medi-Cal will likely respond.\u003c/p>\n\u003cp>The federal government is not picking up the whole tab of this currently-eligible-but-not-enrolled population. The state has put $350 million in the budget as a \"placeholder,\" Dooley said. It's hard to be sure if that's enough or too much money. Dooley discussed the difficulty of determining true numbers because estimates of how many people will enroll vary widely. \u003ca href=\"http://laborcenter.berkeley.edu/healthcare/medi-cal_expansion.shtml\" target=\"_blank\">One recent report\u003c/a> showed that between 240,000 and 510,000 currently eligible people are expected to be enrolled between 2014 and 2019. That's a big differential.\u003c/p>\n\u003cp>At a rally by health advocates in San Francisco today, Linda Lew of Health Access chided the state for being so careful. \"It's good to be cautious,\" she told KQED's Mina Kim, \"but in some ways it's needlessly cautious. The Medicaid expansion is one good example. The first two years are 100 percent federally funded and subsequent years are 90 percent funded, so it's not going to be a huge lift on the state.\"\u003c/p>\n\u003cp>In \u003ca href=\"http://www.csac.counties.org/post/csac-issues-statement-regarding-governors-budget-proposal\" target=\"_blank\">a statement on its website\u003c/a>, the California State Association of Counties said it was \"pleased\" that the governor is moving ahead with implementing the Affordable Care Act. But the group echoed the Administration in discussing the challenges.\u003c/p>\n\u003cp>\"Counties recognize that a number of short- and long-term questions about health reform remain unanswered and the uncertainty makes implementation challenging. These proposals carry risks for counties, too. Counties want to be sure that all options for Medicaid expansion are discussed and that the critical role of counties in delivering health services, including hospital and safety net services, is maintained.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor's note: This post has been updated with details from California's Secretary of Health and Human Services and other reactions to the governor's budget.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cem>By Mina Kim\u003c/em>\u003c/p>\n\u003cp>State Insurance Commissioner Dave Jones says Anthem Blue Cross's rate hike on small business plans is \"unreasonable\" ... but he's powerless to stop it. .\u003c/p>\n\u003cp>Jones says his department actuaries calculated Anthem's average 11 percent rate hike on small employers would grow to nearly twenty percent in two years. On a call with reporters Tuesday, Jones blasted the insurer for overstating health care costs and for charging policy holders fees that won't be collected until 2014 under the Affordable Care Act.\u003c/p>\n\u003cp>\"If you look at, on a return-on-equity basis,\" Jones said, \"the profits that Anthem Blue Cross of California has made, they have been extraordinary.\"\u003c/p>\n\u003cp>Anthem Blue Cross spokesman Darrel Ng disputes Jones's figures saying the average rate increase is about half what Jones projects and that Anthem's profits last year, were about one percent.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It is unfortunate that rates have to go up, but they reflect our underlying costs and the fact that people are using health care more,\" Ng said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>State regulators have no power to stop what they declare to be excessive rates. Jones is backing a November 2014 ballot measure that would change that and give his office the authority to reject rate hikes or demand rollbacks.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>By Mina Kim\u003c/em>\u003c/p>\n\u003cp>State Insurance Commissioner Dave Jones says Anthem Blue Cross's rate hike on small business plans is \"unreasonable\" ... but he's powerless to stop it. .\u003c/p>\n\u003cp>Jones says his department actuaries calculated Anthem's average 11 percent rate hike on small employers would grow to nearly twenty percent in two years. On a call with reporters Tuesday, Jones blasted the insurer for overstating health care costs and for charging policy holders fees that won't be collected until 2014 under the Affordable Care Act.\u003c/p>\n\u003cp>\"If you look at, on a return-on-equity basis,\" Jones said, \"the profits that Anthem Blue Cross of California has made, they have been extraordinary.\"\u003c/p>\n\u003cp>Anthem Blue Cross spokesman Darrel Ng disputes Jones's figures saying the average rate increase is about half what Jones projects and that Anthem's profits last year, were about one percent.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It is unfortunate that rates have to go up, but they reflect our underlying costs and the fact that people are using health care more,\" Ng said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>State regulators have no power to stop what they declare to be excessive rates. Jones is backing a November 2014 ballot measure that would change that and give his office the authority to reject rate hikes or demand rollbacks.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_9756\" class=\"wp-caption alignleft\" style=\"max-width: 165px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Screen-Shot-2012-12-27-at-4.03.30-PM.png\">\u003cimg class=\"size-full wp-image-9756\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Screen-Shot-2012-12-27-at-4.03.30-PM.png\" alt=\"\" width=\"165\" height=\"174\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Image: ClearHealthCost)\u003c/figcaption>\u003c/figure>\n\u003cp>If you're uninsured or have a high deductible health plan, you've likely experienced the frustration of trying to figure out how much a specific medical procedure might cost you.\u003c/p>\n\u003cp>Start up \u003ca title=\"http://clearhealthcosts.com\" href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts\u003c/a> is trying to help. Former \u003cem>New York Times\u003c/em> journalist Jeanne Pinder hatched the idea on the simple premise that \"somehow you could bring transparency to the health care marketplace,\" as she told me today in an interview.\u003c/p>\n\u003cp>The site launched with price comparisons across 30 common procedures in New York and then (lucky for those in the Bay Area) added San Francisco. Let's pick a \u003ca href=\"http://clearhealthcosts.com/search/?query=Lower+Back+MRI+without+Dye&state=&rzip-distance=25&rzip=94111\" target=\"_blank\">simple lower back MRI without dye\u003c/a>. I searched within 25 miles of San Francisco, and the range was $500 on the low end to $1945 on the high end. If you're paying out of pocket, that's a whopping $1,445 savings to you.\u003c/p>\n\u003cp>In this case, the main driver of the big cost difference appeared to be whether the MRI would be done in a hospital (more overhead) or a clinic.\u003c!--more-->\u003c/p>\n\u003cp>Pinder says that her team is \"committing acts of journalism\" with this site. They collect data in a variety of ways, but Pinder says one thing she has learned is that \"in some cases, the prices seem to be kind of made up.\" If you are using the site, be sure to click the \"notes\" button next to a price. It often includes helpful information about additional costs or price options at that facility.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>CalPERS -- the California Public Employees Retirement System -- has been shopping around, too. CalPERS asked Anthem Blue Cross, which manages its PPO plans, to look at prices for hip and knee replacements in California. Anthem found a range of $15,000 on the low end to $110,000 on the high end.\u003c/p>\n\u003cp>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. Members were still welcome to go to any of the more expensive facilities, but they would have to pay the difference out of pocket. CalPERS also made sure the facilities they were directing their members to met a quality standard.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Look for more attention to cost as the Affordable Care Act ramps up in anticipation of its January 1, 2014 launch. In the meantime, if you're paying most or all of your health costs out of pocket, ClearHealthCosts is a solid resource. If you don't live near San Francisco, \u003ca href=\"http://clearhealthcosts.com/blog/2012/12/the-5-most-important-things-you-can-do-to-cut-health-care-costs/\" target=\"_blank\">check out their blog\u003c/a> for strategies on cutting your health care costs.\u003c/p>\n\n",
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"excerpt": "If you're uninsured or have a high deductible health plan, you've likely experienced the frustration of trying to figure out how much a specific medical procedure might cost you. \r\n\r\nA new start up, ClearHealthCosts is trying to help. Former New York Times journalist Jeanne Pinder hatched the idea on the simple premise that \"somehow you could bring transparency to the health care marketplace,\" as she told me today in an interview.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_9756\" class=\"wp-caption alignleft\" style=\"max-width: 165px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Screen-Shot-2012-12-27-at-4.03.30-PM.png\">\u003cimg class=\"size-full wp-image-9756\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Screen-Shot-2012-12-27-at-4.03.30-PM.png\" alt=\"\" width=\"165\" height=\"174\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Image: ClearHealthCost)\u003c/figcaption>\u003c/figure>\n\u003cp>If you're uninsured or have a high deductible health plan, you've likely experienced the frustration of trying to figure out how much a specific medical procedure might cost you.\u003c/p>\n\u003cp>Start up \u003ca title=\"http://clearhealthcosts.com\" href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts\u003c/a> is trying to help. Former \u003cem>New York Times\u003c/em> journalist Jeanne Pinder hatched the idea on the simple premise that \"somehow you could bring transparency to the health care marketplace,\" as she told me today in an interview.\u003c/p>\n\u003cp>The site launched with price comparisons across 30 common procedures in New York and then (lucky for those in the Bay Area) added San Francisco. Let's pick a \u003ca href=\"http://clearhealthcosts.com/search/?query=Lower+Back+MRI+without+Dye&state=&rzip-distance=25&rzip=94111\" target=\"_blank\">simple lower back MRI without dye\u003c/a>. I searched within 25 miles of San Francisco, and the range was $500 on the low end to $1945 on the high end. If you're paying out of pocket, that's a whopping $1,445 savings to you.\u003c/p>\n\u003cp>In this case, the main driver of the big cost difference appeared to be whether the MRI would be done in a hospital (more overhead) or a clinic.\u003c!--more-->\u003c/p>\n\u003cp>Pinder says that her team is \"committing acts of journalism\" with this site. They collect data in a variety of ways, but Pinder says one thing she has learned is that \"in some cases, the prices seem to be kind of made up.\" If you are using the site, be sure to click the \"notes\" button next to a price. It often includes helpful information about additional costs or price options at that facility.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>CalPERS -- the California Public Employees Retirement System -- has been shopping around, too. CalPERS asked Anthem Blue Cross, which manages its PPO plans, to look at prices for hip and knee replacements in California. Anthem found a range of $15,000 on the low end to $110,000 on the high end.\u003c/p>\n\u003cp>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. Members were still welcome to go to any of the more expensive facilities, but they would have to pay the difference out of pocket. CalPERS also made sure the facilities they were directing their members to met a quality standard.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Look for more attention to cost as the Affordable Care Act ramps up in anticipation of its January 1, 2014 launch. In the meantime, if you're paying most or all of your health costs out of pocket, ClearHealthCosts is a solid resource. If you don't live near San Francisco, \u003ca href=\"http://clearhealthcosts.com/blog/2012/12/the-5-most-important-things-you-can-do-to-cut-health-care-costs/\" target=\"_blank\">check out their blog\u003c/a> for strategies on cutting your health care costs.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "No Evidence of Benefit from Routine Pelvic Exams",
"title": "No Evidence of Benefit from Routine Pelvic Exams",
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"content": "\u003cp>\u003cstrong>Women can add pelvic exams to list of medical tests they may not need as often -- or at all\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_9590\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PelvicExamStirrups_Maigh_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-9590\" title=\"(Maigh/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PelvicExamStirrups_Maigh_Flickr-300x225.jpg\" alt=\"(Maigh/Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Maigh/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>First, let's review. We've been getting a lot of updates to cancer screening tests lately.\u003c/p>\n\u003cp>Pap Smears, a screening test for cervical cancer, were recommended to be done annually, until a group of experts in prevention concluded that \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm\" target=\"_blank\">every three years\u003c/a> was equally effective. \u003ca href=\"http://www.acog.org/About_ACOG/Announcements/New_Cervical_Cancer_Screening_Recommendations\" target=\"_blank\">Most medical groups,\u003c/a> including the American Cancer Society, agree on this one.\u003c/p>\n\u003cp>Then there's mammography. I think everyone knows the debate around that. \u003ca href=\"http://www.acog.org/About_ACOG/News_Room/News_Releases/2011/Annual_Mammograms_Now_Recommended_for_Women_Beginning_at_Age_40\" target=\"_blank\">Every year\u003c/a> or \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" target=\"_blank\">every other year\u003c/a>? Starting at 40? or 50? The evidence points to every two years after age 50, although many doctors maintain younger and more often is better.\u003c/p>\n\u003caside class=\"pullquote alignright\">Women get them annually, even though we “lack data” that they do much for us.\u003c/aside>\n\u003cp>But this latest one -- about pelvic exams -- caught me by surprise. It turns out there's really not a whole lot of evidence that doing an annual pelvic exam makes any difference to a healthy woman's continuing good health. (Again, we're stressing healthy women. Women having symptoms are definitely candidates for a pelvic exam).\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Here's what the\u003ca href=\"http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Gynecologic_Practice/Well-Woman_Visit\" target=\"_blank\"> American College of Obstetricians and Gynecologists\u003c/a> (ACOG) says about the pelvic exam, \u003cem>after\u003c/em> recommending it be done annually:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>No evidence supports or refutes the annual pelvic examination or speculum and bimanual examination for the asymptomatic, low-risk patient. An annual pelvic examination seems logical, but also lacks data to support a specific time frame or frequency of such examinations.\u003c/p>\u003c/blockquote>\n\u003cp>Just take a minute with that. Women get them annually, even though we \"lack data\" that they do much for us.\u003c/p>\n\u003cp>Then there's the \"bi-manual exam\" part of the pelvic exam. That's where a doctor palpates a woman's ovaries, in part to screen for ovarian cancer. But ACOG writes that the test has \"low sensitivity\" for finding masses in the ovaries.\u003c/p>\n\u003cp>Still with me? Anyone wondering why women are getting a bi-manual exam every year?\u003c/p>\n\u003cp>None of this should be news to doctors. But a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23159688\" target=\"_blank\">new survey from UCSF\u003c/a> shows that it is. Researchers surveyed 521 OB/GYNS across the country to assess why doctors were doing the exam. Nearly all doctors surveyed said they would perform the bi-manual screen on healthy, asymptomatic women. And here's the kicker: nearly half said they were performing the bi-manual exam \u003cem>to screen for ovarian cancer\u003c/em>.\u003c/p>\n\u003cp>Professor Jillian Henderson performed the research while at UCSF. (She's now at the Kaiser Permanente Center for Health Research in Portland.) \"We think we're getting the exam to be told that everything's OK,\" she told me in an interview. \"But if it's not good at detecting one of the main cancers that we think that it's telling us we're OK about, we're falsely reassured.\"\u003c/p>\n\u003cp>There were other caveats too. In the survey researchers asked doctors about varying types of patients, including 18-year-olds. ACOG recommends the bi-manual exam start at age 21, but 87 percent of doctors surveyed said they would perform the exam on the 18-year-old.\u003c/p>\n\u003cp>Henderson was also troubled that some doctors said they would also require a woman who wanted the birth control pill to have a pelvic exam, again, despite guidelines that say it is not necessary. This creates a barrier to accessing birth control.\u003c/p>\n\u003cp>Henderson was clear that their survey was not all encompassing, pointing out that there may be reasons for the annual checkup that were not captured in the survey. \"Sometimes women want to talk to a specialist about the reproductive organs and body and sexual health,\" she said.\u003c/p>\n\u003cp>In fairness to doctors, about 80 percent of respondents said that patients expected the test. Women probably do, pointing out that we need more information. \"We need to understand a little more about what women gain from this exam and whether they really want to have this exam,\" Henderson says, \"even if it doesn't have a strong role in preventing cancer.\"\u003c/p>\n\u003cp>On a different note, about half of doctors said it was important to do the test to \"ensure adequate compensation.\" But this is not necessarily about greed, it's also a reality of the way health care is reimbursed in this country. \"We have a health care system that funds the examinations you conduct,\" Henderson said. \"I think we do need to shift toward looking at ways to fund women's contacts with health care providers that they value highly even if it's just discussions that are taking place.\"\u003c/p>\n\u003cp>While we're waiting for that to happen, you might want to talk with your doctor if you don't feel a need to have the bi-manual exam or any other part of the pelvic examination.\u003c/p>\n\u003cp>\u003cstrong>Learn More\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://well.blogs.nytimes.com/2013/04/29/an-exam-with-poor-results/?ref=health\" target=\"_blank\">Questioning the Pelvic Exam\u003c/a> (New York Times)\u003c/p>\n\n",
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"excerpt": "Women can add pelvic exams to the list of things they may not need as often -- or at all\r\n\r\nFirst, let's review. We've been getting a lot of updates to cancer screening tests lately.\r\n\r\nPap Smears, a screening test for cervical cancer, were recommended to be done annually, until a group of experts in prevention concluded that every three years was equally effective. Most medical groups, including the American Cancer Society, agree on this one.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Women can add pelvic exams to list of medical tests they may not need as often -- or at all\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_9590\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PelvicExamStirrups_Maigh_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-9590\" title=\"(Maigh/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PelvicExamStirrups_Maigh_Flickr-300x225.jpg\" alt=\"(Maigh/Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Maigh/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>First, let's review. We've been getting a lot of updates to cancer screening tests lately.\u003c/p>\n\u003cp>Pap Smears, a screening test for cervical cancer, were recommended to be done annually, until a group of experts in prevention concluded that \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm\" target=\"_blank\">every three years\u003c/a> was equally effective. \u003ca href=\"http://www.acog.org/About_ACOG/Announcements/New_Cervical_Cancer_Screening_Recommendations\" target=\"_blank\">Most medical groups,\u003c/a> including the American Cancer Society, agree on this one.\u003c/p>\n\u003cp>Then there's mammography. I think everyone knows the debate around that. \u003ca href=\"http://www.acog.org/About_ACOG/News_Room/News_Releases/2011/Annual_Mammograms_Now_Recommended_for_Women_Beginning_at_Age_40\" target=\"_blank\">Every year\u003c/a> or \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" target=\"_blank\">every other year\u003c/a>? Starting at 40? or 50? The evidence points to every two years after age 50, although many doctors maintain younger and more often is better.\u003c/p>\n\u003caside class=\"pullquote alignright\">Women get them annually, even though we “lack data” that they do much for us.\u003c/aside>\n\u003cp>But this latest one -- about pelvic exams -- caught me by surprise. It turns out there's really not a whole lot of evidence that doing an annual pelvic exam makes any difference to a healthy woman's continuing good health. (Again, we're stressing healthy women. Women having symptoms are definitely candidates for a pelvic exam).\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Here's what the\u003ca href=\"http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Gynecologic_Practice/Well-Woman_Visit\" target=\"_blank\"> American College of Obstetricians and Gynecologists\u003c/a> (ACOG) says about the pelvic exam, \u003cem>after\u003c/em> recommending it be done annually:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>No evidence supports or refutes the annual pelvic examination or speculum and bimanual examination for the asymptomatic, low-risk patient. An annual pelvic examination seems logical, but also lacks data to support a specific time frame or frequency of such examinations.\u003c/p>\u003c/blockquote>\n\u003cp>Just take a minute with that. Women get them annually, even though we \"lack data\" that they do much for us.\u003c/p>\n\u003cp>Then there's the \"bi-manual exam\" part of the pelvic exam. That's where a doctor palpates a woman's ovaries, in part to screen for ovarian cancer. But ACOG writes that the test has \"low sensitivity\" for finding masses in the ovaries.\u003c/p>\n\u003cp>Still with me? Anyone wondering why women are getting a bi-manual exam every year?\u003c/p>\n\u003cp>None of this should be news to doctors. But a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23159688\" target=\"_blank\">new survey from UCSF\u003c/a> shows that it is. Researchers surveyed 521 OB/GYNS across the country to assess why doctors were doing the exam. Nearly all doctors surveyed said they would perform the bi-manual screen on healthy, asymptomatic women. And here's the kicker: nearly half said they were performing the bi-manual exam \u003cem>to screen for ovarian cancer\u003c/em>.\u003c/p>\n\u003cp>Professor Jillian Henderson performed the research while at UCSF. (She's now at the Kaiser Permanente Center for Health Research in Portland.) \"We think we're getting the exam to be told that everything's OK,\" she told me in an interview. \"But if it's not good at detecting one of the main cancers that we think that it's telling us we're OK about, we're falsely reassured.\"\u003c/p>\n\u003cp>There were other caveats too. In the survey researchers asked doctors about varying types of patients, including 18-year-olds. ACOG recommends the bi-manual exam start at age 21, but 87 percent of doctors surveyed said they would perform the exam on the 18-year-old.\u003c/p>\n\u003cp>Henderson was also troubled that some doctors said they would also require a woman who wanted the birth control pill to have a pelvic exam, again, despite guidelines that say it is not necessary. This creates a barrier to accessing birth control.\u003c/p>\n\u003cp>Henderson was clear that their survey was not all encompassing, pointing out that there may be reasons for the annual checkup that were not captured in the survey. \"Sometimes women want to talk to a specialist about the reproductive organs and body and sexual health,\" she said.\u003c/p>\n\u003cp>In fairness to doctors, about 80 percent of respondents said that patients expected the test. Women probably do, pointing out that we need more information. \"We need to understand a little more about what women gain from this exam and whether they really want to have this exam,\" Henderson says, \"even if it doesn't have a strong role in preventing cancer.\"\u003c/p>\n\u003cp>On a different note, about half of doctors said it was important to do the test to \"ensure adequate compensation.\" But this is not necessarily about greed, it's also a reality of the way health care is reimbursed in this country. \"We have a health care system that funds the examinations you conduct,\" Henderson said. \"I think we do need to shift toward looking at ways to fund women's contacts with health care providers that they value highly even if it's just discussions that are taking place.\"\u003c/p>\n\u003cp>While we're waiting for that to happen, you might want to talk with your doctor if you don't feel a need to have the bi-manual exam or any other part of the pelvic examination.\u003c/p>\n\u003cp>\u003cstrong>Learn More\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://well.blogs.nytimes.com/2013/04/29/an-exam-with-poor-results/?ref=health\" target=\"_blank\">Questioning the Pelvic Exam\u003c/a> (New York Times)\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_9517\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Capitol_KarlEisenhower_KHN.jpg\">\u003cimg class=\"size-full wp-image-9517\" title=\"(Karl Eisenhower/Kaiser Health News)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Capitol_KarlEisenhower_KHN.jpg\" alt=\"(Karl Eisenhower/Kaiser Health News)\" width=\"300\" height=\"205\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Karl Eisenhower/Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>Then-presidential candidate Mitt Romney made headlines when he asserted that \u003ca href=\"http://www.kqed.org/a/forum/R201209190900\" target=\"_blank\">47 percent of Americans \u003c/a>were \"victims\" dependent upon government assistance. I'm guessing he wasn't thinking of people who receive employer-based health insurance as being the beneficiary of government largess. But, the government loses a lot of money in the benefit.\u003c/p>\n\u003cp>Here's how: First, people who receive employer-based health insurance do not pay taxes on its cost. Second, employers deduct the cost of the policies as a business expense.\u003c/p>\n\u003cp>As the fiscal cliff approaches, some policy wonks are saying the U.S. can't afford that tax break any more.\u003c/p>\n\u003cp>As Julie Appleby reports for \u003ca href=\"http://capsules.kaiserhealthnews.org/index.php/2012/12/tax-exclusion-for-health-benefits-could-become-part-of-fiscal-cliff-talks/\" target=\"_blank\">Kaiser Health News\u003c/a>, it's the largest cost to the U.S. Treasury, \"\u003ca href=\"http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/99xx/doc9924/12-18-keyissues.pdf\">an estimated $246 billion annually\u003c/a>, according to Congress’ Joint Committee on Taxation, dwarfing the second-largest break, the mortgage interest deduction, which costs an estimated $98 billion.\"\u003c/p>\n\u003cp>That is a lot of money.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Appleby quotes G. William Hoagland of the Bipartisan Policy Center. He spoke Thursday at a conference sponsored by the Employee Benefit Research Institute. “There’s no way on God’s green earth,\" he said \"that we will not see that exclusion on the table.\"\u003c/p>\n\u003cp>Of course, ditching the exclusion would be \"wildly unpopular\" among voters.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The calculus of ending the tax exclusion has changed since passage of the Affordable Care Act, as Appleby explains:\u003c/p>\n\u003cblockquote>\u003cp>Even if employers were still be able to deduct the cost of paying for health insurance as a business expense, some might drop health coverage if they thought workers valued the benefit less because now had to pay taxes on it.\u003c/p>\n\u003cp>“In the past, before the federal Affordable Care Act, it was assumed that (changing) the tax exclusion would increase the number of uninsured,” said Hoagland, a former staff director of the Senate Budget Committee and senior vice president at insurer CIGNA. “I would argue that (concern) now goes away,” because the health law provides subsidies to help lower income Americans buy coverage.\u003c/p>\n\u003cp>At least a few lawmakers might regard changing the tax exclusion as politically easier than reducing payments to hospitals and other medical providers, said Steve Wojcik, a vice president of public policy at the National Business Group on Health, who was also on the panel.\u003c/p>\n\u003cp>Some economists think that \u003ca href=\"http://www.thefiscaltimes.com/Articles/2012/10/01/End-the-Health-Care-Tax-Break-Reduce-Coverage.aspx#page1\">reducing or eliminating the tax exclusion would slow spending on health care\u003c/a> because it would prompt employers to choose less generous insurance plans that cost less. Others say the savings would be small. Several attempts to revise or cap the exclusion have failed in the past two decades.\u003c/p>\u003c/blockquote>\n\n",
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"excerpt": "Then-presidential candidate Mitt Romney made headlines when he asserted that 47 percent of Americans were \"victims\" dependent upon government assistance. I'm guessing a lot of people don't know that people who receive employer-based health insurance are getting a little government assistance in that expensive benefit.\r\n\r\nFirst, people who receive employer-based health insurance do not pay taxes on the benefit. Second, employers deduct the cost of the policies as a business expense.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_9517\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Capitol_KarlEisenhower_KHN.jpg\">\u003cimg class=\"size-full wp-image-9517\" title=\"(Karl Eisenhower/Kaiser Health News)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Capitol_KarlEisenhower_KHN.jpg\" alt=\"(Karl Eisenhower/Kaiser Health News)\" width=\"300\" height=\"205\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Karl Eisenhower/Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>Then-presidential candidate Mitt Romney made headlines when he asserted that \u003ca href=\"http://www.kqed.org/a/forum/R201209190900\" target=\"_blank\">47 percent of Americans \u003c/a>were \"victims\" dependent upon government assistance. I'm guessing he wasn't thinking of people who receive employer-based health insurance as being the beneficiary of government largess. But, the government loses a lot of money in the benefit.\u003c/p>\n\u003cp>Here's how: First, people who receive employer-based health insurance do not pay taxes on its cost. Second, employers deduct the cost of the policies as a business expense.\u003c/p>\n\u003cp>As the fiscal cliff approaches, some policy wonks are saying the U.S. can't afford that tax break any more.\u003c/p>\n\u003cp>As Julie Appleby reports for \u003ca href=\"http://capsules.kaiserhealthnews.org/index.php/2012/12/tax-exclusion-for-health-benefits-could-become-part-of-fiscal-cliff-talks/\" target=\"_blank\">Kaiser Health News\u003c/a>, it's the largest cost to the U.S. Treasury, \"\u003ca href=\"http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/99xx/doc9924/12-18-keyissues.pdf\">an estimated $246 billion annually\u003c/a>, according to Congress’ Joint Committee on Taxation, dwarfing the second-largest break, the mortgage interest deduction, which costs an estimated $98 billion.\"\u003c/p>\n\u003cp>That is a lot of money.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Appleby quotes G. William Hoagland of the Bipartisan Policy Center. He spoke Thursday at a conference sponsored by the Employee Benefit Research Institute. “There’s no way on God’s green earth,\" he said \"that we will not see that exclusion on the table.\"\u003c/p>\n\u003cp>Of course, ditching the exclusion would be \"wildly unpopular\" among voters.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The calculus of ending the tax exclusion has changed since passage of the Affordable Care Act, as Appleby explains:\u003c/p>\n\u003cblockquote>\u003cp>Even if employers were still be able to deduct the cost of paying for health insurance as a business expense, some might drop health coverage if they thought workers valued the benefit less because now had to pay taxes on it.\u003c/p>\n\u003cp>“In the past, before the federal Affordable Care Act, it was assumed that (changing) the tax exclusion would increase the number of uninsured,” said Hoagland, a former staff director of the Senate Budget Committee and senior vice president at insurer CIGNA. “I would argue that (concern) now goes away,” because the health law provides subsidies to help lower income Americans buy coverage.\u003c/p>\n\u003cp>At least a few lawmakers might regard changing the tax exclusion as politically easier than reducing payments to hospitals and other medical providers, said Steve Wojcik, a vice president of public policy at the National Business Group on Health, who was also on the panel.\u003c/p>\n\u003cp>Some economists think that \u003ca href=\"http://www.thefiscaltimes.com/Articles/2012/10/01/End-the-Health-Care-Tax-Break-Reduce-Coverage.aspx#page1\">reducing or eliminating the tax exclusion would slow spending on health care\u003c/a> because it would prompt employers to choose less generous insurance plans that cost less. Others say the savings would be small. Several attempts to revise or cap the exclusion have failed in the past two decades.\u003c/p>\u003c/blockquote>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Federal Appeals Court Approves Cuts to Medi-Cal Providers",
"title": "Federal Appeals Court Approves Cuts to Medi-Cal Providers",
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"content": "\u003cfigure id=\"attachment_9480\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Child_Doctor_DavidMason_Flickr_07092012.jpg\">\u003cimg class=\"size-medium wp-image-9480\" title=\"(David Mason/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Child_Doctor_DavidMason_Flickr_07092012-300x199.jpg\" alt=\"(David Mason/Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(David Mason/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A three-judge panel of the Ninth Circuit Court has upheld payment reductions to Medi-Cal doctors, pharmacists and other providers. The cuts have been tied up in courts for more than a year -- and they're not settled yet. Advocates say they expect to ask for a review of the decision by the full court.\u003c/p>\n\u003cp>Some history:\u003c/p>\n\u003cul>\n\u003cli>Medi-Cal cuts must be approved by the federal government.\u003c/li>\n\u003cli>The current reductions, proposed by the Brown Administration, \u003ca href=\"http://www.dhcs.ca.gov/formsandpubs/publications/opa/Documents/11-06%20SPA%20Approvals.pdf\" target=\"_blank\">were approved\u003c/a> by the Centers for Medicare & Medicaid Services in October, 2011.\u003c/li>\n\u003cli>That approval was promptly challenged by the California Medical Association (and others) in federal court.\u003c/li>\n\u003cli>In January, a federal judge \u003ca href=\"http://www.californiahealthline.org/articles/2012/1/31/judge-tentatively-blocks-10-cut-to-medi-cal-reimbursement-rates.aspx\" target=\"_blank\">blocked the cuts\u003c/a>.\u003c!--more-->\u003c/li>\n\u003cli>The state appealed to the Ninth Circuit Court of Appeals -- and that's where we are today.\u003c/li>\n\u003c/ul>\n\u003cp>The Sacramento Bee quotes Lynn S. Carman, counsel for the Medicaid Defense Fund, saying that his side would take the case to the Supreme Court, if the Ninth Circuit's full bench either does not take up the care or does not block the cuts.\u003c/p>\n\u003cp>Also from \u003ca href=\"http://blogs.sacbee.com/capitolalertlatest/2012/12/federal-appeals-court-allows-lower-payments-to-medi-cal-providers.html\" target=\"_blank\">The Bee\u003c/a>:\u003c/p>\n\u003cdiv>\n\u003cdiv id=\"more\">\n\u003cblockquote>\u003cp>Circumstances have changed significantly since Gov. \u003cstrong>Jerry Brown\u003c/strong> and Democratic lawmakers agreed last year to cut Medi-Cal rates. Voters in November approved two statewide tax initiatives, generating several billion dollars annually for the budget, and President \u003cstrong>Barack Obama\u003c/strong>'s health care overhaul has survived political and legal hurdles en route to wide implementation in 2014.\u003c/p>\n\u003cp>The Obama plan calls for increasing rates paid to Medi-Cal primary care physicians starting in January 2013 to the higher Medicare rate, presumably sparing them from state rate cuts.\u003c/p>\n\u003cp>But it also expands Medi-Cal to a new group of uninsured low-income residents, largely able-bodied adults without children, starting in 2014. Meanwhile, Brown officials are pushing hard to move 860,000 lower-middle-class children to Medi-Cal next year.\u003c/p>\n\u003cp>Providers and advocates for the poor, who have repeatedly filed suits blocking state Medi-Cal cuts, argue that lower payments will discourage health care professionals from serving Medi-Cal patients. They say that will hurt access to doctors, particularly from specialty fields, leaving Medi-Cal patients without care.\u003c/p>\n\u003cp>\"Our hope is the state will reconsider,\" said California Medical Association spokeswoman \u003cstrong>Molly Weedn\u003c/strong>. \"The state implemented these cuts when it was in much more dire straits than it is now. This is going to hugely impact care, especially now that the Healthy Families transition is going to happen.\"\u003c/p>\n\u003cp>Brown spokesman Gareth Lacy responded to the ruling in a statement: \"The Court of Appeals ruled that trial courts cannot block California from making Medi-Cal cuts that were approved by the federal government. Today's decision allows California to continue providing quality care for people on Medi-Cal while saving the state millions of dollars in unnecessary costs.\"\u003c/p>\u003c/blockquote>\n\u003c/div>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "A three-judge panel of the Ninth Circuit Court has upheld payment reductions to Medi-Cal providers. The cuts have been tied up in courts for more than a year -- and they're not settled yet. Advocates say they expect to ask for a review of the decision by the full court.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_9480\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Child_Doctor_DavidMason_Flickr_07092012.jpg\">\u003cimg class=\"size-medium wp-image-9480\" title=\"(David Mason/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Child_Doctor_DavidMason_Flickr_07092012-300x199.jpg\" alt=\"(David Mason/Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(David Mason/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A three-judge panel of the Ninth Circuit Court has upheld payment reductions to Medi-Cal doctors, pharmacists and other providers. The cuts have been tied up in courts for more than a year -- and they're not settled yet. Advocates say they expect to ask for a review of the decision by the full court.\u003c/p>\n\u003cp>Some history:\u003c/p>\n\u003cul>\n\u003cli>Medi-Cal cuts must be approved by the federal government.\u003c/li>\n\u003cli>The current reductions, proposed by the Brown Administration, \u003ca href=\"http://www.dhcs.ca.gov/formsandpubs/publications/opa/Documents/11-06%20SPA%20Approvals.pdf\" target=\"_blank\">were approved\u003c/a> by the Centers for Medicare & Medicaid Services in October, 2011.\u003c/li>\n\u003cli>That approval was promptly challenged by the California Medical Association (and others) in federal court.\u003c/li>\n\u003cli>In January, a federal judge \u003ca href=\"http://www.californiahealthline.org/articles/2012/1/31/judge-tentatively-blocks-10-cut-to-medi-cal-reimbursement-rates.aspx\" target=\"_blank\">blocked the cuts\u003c/a>.\u003c!--more-->\u003c/li>\n\u003cli>The state appealed to the Ninth Circuit Court of Appeals -- and that's where we are today.\u003c/li>\n\u003c/ul>\n\u003cp>The Sacramento Bee quotes Lynn S. Carman, counsel for the Medicaid Defense Fund, saying that his side would take the case to the Supreme Court, if the Ninth Circuit's full bench either does not take up the care or does not block the cuts.\u003c/p>\n\u003cp>Also from \u003ca href=\"http://blogs.sacbee.com/capitolalertlatest/2012/12/federal-appeals-court-allows-lower-payments-to-medi-cal-providers.html\" target=\"_blank\">The Bee\u003c/a>:\u003c/p>\n\u003cdiv>\n\u003cdiv id=\"more\">\n\u003cblockquote>\u003cp>Circumstances have changed significantly since Gov. \u003cstrong>Jerry Brown\u003c/strong> and Democratic lawmakers agreed last year to cut Medi-Cal rates. Voters in November approved two statewide tax initiatives, generating several billion dollars annually for the budget, and President \u003cstrong>Barack Obama\u003c/strong>'s health care overhaul has survived political and legal hurdles en route to wide implementation in 2014.\u003c/p>\n\u003cp>The Obama plan calls for increasing rates paid to Medi-Cal primary care physicians starting in January 2013 to the higher Medicare rate, presumably sparing them from state rate cuts.\u003c/p>\n\u003cp>But it also expands Medi-Cal to a new group of uninsured low-income residents, largely able-bodied adults without children, starting in 2014. Meanwhile, Brown officials are pushing hard to move 860,000 lower-middle-class children to Medi-Cal next year.\u003c/p>\n\u003cp>Providers and advocates for the poor, who have repeatedly filed suits blocking state Medi-Cal cuts, argue that lower payments will discourage health care professionals from serving Medi-Cal patients. They say that will hurt access to doctors, particularly from specialty fields, leaving Medi-Cal patients without care.\u003c/p>\n\u003cp>\"Our hope is the state will reconsider,\" said California Medical Association spokeswoman \u003cstrong>Molly Weedn\u003c/strong>. \"The state implemented these cuts when it was in much more dire straits than it is now. This is going to hugely impact care, especially now that the Healthy Families transition is going to happen.\"\u003c/p>\n\u003cp>Brown spokesman Gareth Lacy responded to the ruling in a statement: \"The Court of Appeals ruled that trial courts cannot block California from making Medi-Cal cuts that were approved by the federal government. Today's decision allows California to continue providing quality care for people on Medi-Cal while saving the state millions of dollars in unnecessary costs.\"\u003c/p>\u003c/blockquote>\n\u003c/div>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Fiscal Cliffnotes: What Are the Trade-offs in Raising Medicare's Eligibility Age?",
"title": "Fiscal Cliffnotes: What Are the Trade-offs in Raising Medicare's Eligibility Age?",
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"content": "\u003cfigure id=\"attachment_9340\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Aging_Healthy_Patrick_Flickr_02212012.jpg\">\u003cimg class=\"size-medium wp-image-9340\" title=\"(Patrick/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Aging_Healthy_Patrick_Flickr_02212012-300x240.jpg\" alt=\"(Patrick/Flickr)\" width=\"300\" height=\"240\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Patrick/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>It seems seductively easy: people are living longer, so why not raise the Medicare eligibility age from 65 to 67? This kind of entitlement reform is key to Republican strategies to pull the federal government back from the so-called Fiscal Cliff.\u003c/p>\n\u003cp>The problem is that while raising the Medicare eligibility age looks great in the short run, longterm it could actually cost money.\u003c/p>\n\u003cp>First, the short run: the non-partisan Kaiser Family Foundation says the federal government would save an \u003ca href=\"http://www.kff.org/medicare/8169.cfm\" target=\"_blank\">estimated $5.7 billion\u003c/a> in 2014 if the eligibility age were raised. Using a slightly different analysis, the nonpartisan Congressional Budget Office says savings could total \u003ca href=\"http://www.cbo.gov/sites/default/files/cbofiles/attachments/01-10-2012-Medicare_SS_EligibilityAgesBrief.pdf\" target=\"_blank\">$113 billion over the next decade\u003c/a>.\u003c/p>\n\u003cp>But, those 65 and 66-year-olds are the youngest and presumably healthiest people in the Medicare program --- meaning that if they leave Medicare, they would then be the oldest and presumably sickest people in any other insurance pool.\u003c/p>\n\u003cp>What would happen to those people?\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Some or many might stay in the workforce, and their presence would likely drive up costs to their employers or the new health insurance exchanges.\u003c/p>\n\u003cp>Some might find themselves eligible for Medicaid, the government sponsored health plan for the poor.\u003c/p>\n\u003cp>In its analysis, the Kaiser Family Foundation estimates that two-thirds of the five million affected 65 and 66-year-olds \"would pay an average of $2,200 more for their health care in 2014 than they would have paid if covered under Medicare.\"\u003c/p>\n\u003cp>And what about those still in Medicare? Without those younger, healthier 65 and 66-year-olds, Medicare premiums for the people left would rise by 3 percent, according to the Kaiser Family Foundation analysis.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A recent Associated Press-GfK poll found that many Americans -- 40 percent -- are willing to consider raising Medicare's eligibility age, but 48 percent are opposed. The poll showed a pretty big division by age, as \u003ca href=\"http://www.google.com/hostednews/ap/article/ALeqM5gtzIcX1ShjCgocK2J3-AjpqdbOGQ?docId=c39d6b640cbd414589744774ba7b98fd\" target=\"_blank\">the AP indicated in its report:\u003c/a>\u003c/p>\n\u003cblockquote>\u003cp>Those under age 30 were most supportive, while a clear majority of those between the ages of 30 and 64 were opposed. Seniors were split. Surprisingly, there were no significant differences by political party. Overall, foes of the idea were more adamant, with strong opponents outnumbering strong supporters by 2-1.\u003c/p>\n\u003cp>U.S. life expectancy has risen by about eight years since Medicare was created in 1965. During the 1980s, Republican President Ronald Reagan and Democratic congressional leaders agreed to gradually increase the age for receiving full Social Security benefits from 65 to 67. But they didn't touch Medicare eligibility.\u003c/p>\n\u003cp>Since then, some policy experts have advocated aligning the Medicare and Social Security eligibility ages through a gradual phase-in that would spare those close to retirement.\u003c/p>\u003c/blockquote>\n\n",
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"excerpt": "It seems seductively easy: people are living longer, so why not raise the Medicare eligibility age from 65 to 67? This kind of entitlement reform is key to Republican strategies to pull the federal government back from the so-called Fiscal Cliff.\r\n\r\nThe problem is that while raising the Medicare eligibility age looks great in the short run, longterm it could actually cost money.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_9340\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Aging_Healthy_Patrick_Flickr_02212012.jpg\">\u003cimg class=\"size-medium wp-image-9340\" title=\"(Patrick/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Aging_Healthy_Patrick_Flickr_02212012-300x240.jpg\" alt=\"(Patrick/Flickr)\" width=\"300\" height=\"240\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Patrick/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>It seems seductively easy: people are living longer, so why not raise the Medicare eligibility age from 65 to 67? This kind of entitlement reform is key to Republican strategies to pull the federal government back from the so-called Fiscal Cliff.\u003c/p>\n\u003cp>The problem is that while raising the Medicare eligibility age looks great in the short run, longterm it could actually cost money.\u003c/p>\n\u003cp>First, the short run: the non-partisan Kaiser Family Foundation says the federal government would save an \u003ca href=\"http://www.kff.org/medicare/8169.cfm\" target=\"_blank\">estimated $5.7 billion\u003c/a> in 2014 if the eligibility age were raised. Using a slightly different analysis, the nonpartisan Congressional Budget Office says savings could total \u003ca href=\"http://www.cbo.gov/sites/default/files/cbofiles/attachments/01-10-2012-Medicare_SS_EligibilityAgesBrief.pdf\" target=\"_blank\">$113 billion over the next decade\u003c/a>.\u003c/p>\n\u003cp>But, those 65 and 66-year-olds are the youngest and presumably healthiest people in the Medicare program --- meaning that if they leave Medicare, they would then be the oldest and presumably sickest people in any other insurance pool.\u003c/p>\n\u003cp>What would happen to those people?\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Some or many might stay in the workforce, and their presence would likely drive up costs to their employers or the new health insurance exchanges.\u003c/p>\n\u003cp>Some might find themselves eligible for Medicaid, the government sponsored health plan for the poor.\u003c/p>\n\u003cp>In its analysis, the Kaiser Family Foundation estimates that two-thirds of the five million affected 65 and 66-year-olds \"would pay an average of $2,200 more for their health care in 2014 than they would have paid if covered under Medicare.\"\u003c/p>\n\u003cp>And what about those still in Medicare? Without those younger, healthier 65 and 66-year-olds, Medicare premiums for the people left would rise by 3 percent, according to the Kaiser Family Foundation analysis.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A recent Associated Press-GfK poll found that many Americans -- 40 percent -- are willing to consider raising Medicare's eligibility age, but 48 percent are opposed. The poll showed a pretty big division by age, as \u003ca href=\"http://www.google.com/hostednews/ap/article/ALeqM5gtzIcX1ShjCgocK2J3-AjpqdbOGQ?docId=c39d6b640cbd414589744774ba7b98fd\" target=\"_blank\">the AP indicated in its report:\u003c/a>\u003c/p>\n\u003cblockquote>\u003cp>Those under age 30 were most supportive, while a clear majority of those between the ages of 30 and 64 were opposed. Seniors were split. Surprisingly, there were no significant differences by political party. Overall, foes of the idea were more adamant, with strong opponents outnumbering strong supporters by 2-1.\u003c/p>\n\u003cp>U.S. life expectancy has risen by about eight years since Medicare was created in 1965. During the 1980s, Republican President Ronald Reagan and Democratic congressional leaders agreed to gradually increase the age for receiving full Social Security benefits from 65 to 67. But they didn't touch Medicare eligibility.\u003c/p>\n\u003cp>Since then, some policy experts have advocated aligning the Medicare and Social Security eligibility ages through a gradual phase-in that would spare those close to retirement.\u003c/p>\u003c/blockquote>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How Many Dentists Accept Children on Medi-Cal? Depends on Who You Ask",
"title": "How Many Dentists Accept Children on Medi-Cal? Depends on Who You Ask",
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"content": "\u003cp>\u003cstrong>New report says one in four dentists accept state's Denti-Cal insurance; older reports say closer to two-thirds\u003c/strong>\u003c/p>\n\u003cp>By Emily Bazar, \u003ca href=\"http://centerforhealthreporting.org/blog/how-many-california-dentists-accept-poor-kids-medi-cal-new-report-says-one-four1026\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_9308\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/KidAtDentist_PaulGoyette_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-9308\" title=\"(Paul Goyette/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/KidAtDentist_PaulGoyette_Flickr-300x200.jpg\" alt=\"(Paul Goyette/Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Paul Goyette/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>I’ve spent many months reporting on dental care for poor California children, looking into what kind of access they have to treatment.\u003c/p>\n\u003cp>(About half of kids in the Medi-Cal dental program see a dentist annually, although figures vary wildly by county.)\u003c/p>\n\u003cp>But I haven’t focused as much on the dentists who participate in the program, called Denti-Cal.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"http://centerforhealthreporting.org/sites/default/files/denti-cal_final_report_nov_2_2012.pdf\" target=\"_blank\">A new report\u003c/a> by \u003ca href=\"http://www.barbaraavedassociates.com/\" target=\"_blank\">health care consultant Barbara Aved\u003c/a> does just that. Based on her research, Aved concludes that 25 percent of California’s general dentists participate in the program.\u003c/p>\n\u003cp>Why not more? Here are some of Aved’s primary conclusions, based in part on a survey of dentists in five counties that she says reflect California as a whole. Out of about 2,000 general and pediatric dentists invited to participate, 322 responded.\u003c/p>\n\u003cul>\n\u003cul>\n\u003cli>Of dentists who do not participate, 97 percent cited the state’s low reimbursement rates as the No. 1 reason. California’s rates, Aved said, are among the lowest in the nation.\u003c/li>\n\u003c/ul>\n\u003c/ul>\n\u003cp>“Unlike physician practices, dental practices are in large part solo or two-person practices,” she said. “It’s really like a small business. Economically, it just doesn’t make sense to do business where you’re not going to be fully reimbursed.”\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>Many dentists also blamed their non-participation on the bureaucratic requirements associated with enrolling and billing.\u003c/li>\n\u003c/ul>\n\u003cp>“Make the claim process simple and straightforward; quit denying claims for stupid, little reasons and obscure criteria,” wrote one dentist who responded to the survey.\u003c/p>\n\u003cp>“I would rather treat some people for nothing than jump through all the hoops Denti-Cal makes you go through,” wrote another.\u003c/p>\n\u003cul>\n\u003cli>Some dentists complained about patients breaking appointments and other compliance issues.\u003c/li>\n\u003c/ul>\n\u003cp>Aved’s study, which also analyzed 2011 Denti-Cal claims data, was commissioned by dental plans LIBERTY Dental and HealthNet.\u003c/p>\n\u003cp>The Department of Health Care Services (DHCS), which administers Denti-Cal, has a very different take on the percentage of California dentists who participate: Two thirds of dentists, or 66 percent.\u003c/p>\n\u003cp>“What we’ve done with our numbers is take a look at verifiable data, data that was collected and that represents the actual figures that are kept by the state of California,” said spokesman Norman Williams. “It wasn’t a survey. … It’s actual data and that’s what we base our numbers on.”\u003c/p>\n\u003cp>But Aved pointed to a \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/D/PDF%20DentiCalFactsAndFigures2010.pdf\" target=\"_blank\">California HealthCare Foundation report\u003c/a> on Denti-Cal from 2010 that also concluded that 25 percent of California dentists accept Medi-Cal patients.\u003c/p>\n\u003cp>Williams said current dentist participation in Denti-Cal already “ensures sufficient access,” but the department is taking several steps to boost participation. They include:\u003c/p>\n\u003cul>\n\u003cli>Developing a survey for Denti-Cal beneficiaries to determine their satisfaction with the program;\u003c/li>\n\u003cli>Offering a new customer service line to help children and their families locate participating dentists; and\u003c/li>\n\u003cli>Reaching out to dentists to urge them to join the program or take more Denti-Cal patients.\u003c/li>\n\u003c/ul>\n\u003cp>The department is addressing complaints about bureaucratic obstacles by developing a webinar series, video tutorials and other materials for dentists to help them with enrollment and billing, Williams said.\u003c/p>\n\u003cp>But raising rates isn’t on the table.\u003c/p>\n\u003cp>“Because of our current economic situation, the state is not in a financial position to increase Medi-Cal payments to dentists,” Williams said.\u003c/p>\n\u003cp>Gayle Mathe, director of policy development for the \u003ca href=\"http://www.cda.org/\" target=\"_blank\">California Dental Association\u003c/a>, applauded the department for its recent moves to boost dentist ranks in the program. In many cases, she said, her association is partnering on these initiatives.\u003c/p>\n\u003cp>“We’re starting to see movement and changes in a positive direction,” she said. “And the department is really engaged in doing that.”\u003c/p>\n\u003cp>But the association questions the department’s conclusion that two-thirds of dentists participate Denti-Cal, saying that Aved’s figure is closer.\u003c/p>\n\u003cp>“We don’t have access to data, but the 25 percent is consistent with what we’ve heard anecdotally over the years,” Mathe said.\u003c/p>\n\u003cp>Aved said she’s concerned that not enough dentists participate as it is and worries that Denti-Cal isn’t prepared for the hundreds of thousands of new children coming into the program in the next few years. This will be primarily as a result of the transition of children \u003ca href=\"http://www.dhcs.ca.gov/services/Pages/HealthyFamiliesTransition.aspx\" target=\"_blank\">from the publicly-funded Healthy Families program into Medi-Cal\u003c/a> and the expansion of Medi-Cal under the Affordable Care Act.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If it’s this way now, we should be worried about the future for sure,” she said.\u003c/p>\n\n",
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"excerpt": "I’ve spent many months reporting on dental care for poor California children, looking into what kind of access they have to treatment.\r\n\r\n(About half of kids in the Medi-Cal dental program see a dentist annually, although figures vary wildly by county.)\r\n\r\nBut I haven’t focused as much on the dentists who participate in the program, called Denti-Cal.\r\n\r\nA new report by health care consultant Barbara Aved does just that. Based on her research, Aved concludes that 25 percent of California’s general dentists participate in the program.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>New report says one in four dentists accept state's Denti-Cal insurance; older reports say closer to two-thirds\u003c/strong>\u003c/p>\n\u003cp>By Emily Bazar, \u003ca href=\"http://centerforhealthreporting.org/blog/how-many-california-dentists-accept-poor-kids-medi-cal-new-report-says-one-four1026\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_9308\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/KidAtDentist_PaulGoyette_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-9308\" title=\"(Paul Goyette/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/KidAtDentist_PaulGoyette_Flickr-300x200.jpg\" alt=\"(Paul Goyette/Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Paul Goyette/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>I’ve spent many months reporting on dental care for poor California children, looking into what kind of access they have to treatment.\u003c/p>\n\u003cp>(About half of kids in the Medi-Cal dental program see a dentist annually, although figures vary wildly by county.)\u003c/p>\n\u003cp>But I haven’t focused as much on the dentists who participate in the program, called Denti-Cal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://centerforhealthreporting.org/sites/default/files/denti-cal_final_report_nov_2_2012.pdf\" target=\"_blank\">A new report\u003c/a> by \u003ca href=\"http://www.barbaraavedassociates.com/\" target=\"_blank\">health care consultant Barbara Aved\u003c/a> does just that. Based on her research, Aved concludes that 25 percent of California’s general dentists participate in the program.\u003c/p>\n\u003cp>Why not more? Here are some of Aved’s primary conclusions, based in part on a survey of dentists in five counties that she says reflect California as a whole. Out of about 2,000 general and pediatric dentists invited to participate, 322 responded.\u003c/p>\n\u003cul>\n\u003cul>\n\u003cli>Of dentists who do not participate, 97 percent cited the state’s low reimbursement rates as the No. 1 reason. California’s rates, Aved said, are among the lowest in the nation.\u003c/li>\n\u003c/ul>\n\u003c/ul>\n\u003cp>“Unlike physician practices, dental practices are in large part solo or two-person practices,” she said. “It’s really like a small business. Economically, it just doesn’t make sense to do business where you’re not going to be fully reimbursed.”\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>Many dentists also blamed their non-participation on the bureaucratic requirements associated with enrolling and billing.\u003c/li>\n\u003c/ul>\n\u003cp>“Make the claim process simple and straightforward; quit denying claims for stupid, little reasons and obscure criteria,” wrote one dentist who responded to the survey.\u003c/p>\n\u003cp>“I would rather treat some people for nothing than jump through all the hoops Denti-Cal makes you go through,” wrote another.\u003c/p>\n\u003cul>\n\u003cli>Some dentists complained about patients breaking appointments and other compliance issues.\u003c/li>\n\u003c/ul>\n\u003cp>Aved’s study, which also analyzed 2011 Denti-Cal claims data, was commissioned by dental plans LIBERTY Dental and HealthNet.\u003c/p>\n\u003cp>The Department of Health Care Services (DHCS), which administers Denti-Cal, has a very different take on the percentage of California dentists who participate: Two thirds of dentists, or 66 percent.\u003c/p>\n\u003cp>“What we’ve done with our numbers is take a look at verifiable data, data that was collected and that represents the actual figures that are kept by the state of California,” said spokesman Norman Williams. “It wasn’t a survey. … It’s actual data and that’s what we base our numbers on.”\u003c/p>\n\u003cp>But Aved pointed to a \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/D/PDF%20DentiCalFactsAndFigures2010.pdf\" target=\"_blank\">California HealthCare Foundation report\u003c/a> on Denti-Cal from 2010 that also concluded that 25 percent of California dentists accept Medi-Cal patients.\u003c/p>\n\u003cp>Williams said current dentist participation in Denti-Cal already “ensures sufficient access,” but the department is taking several steps to boost participation. They include:\u003c/p>\n\u003cul>\n\u003cli>Developing a survey for Denti-Cal beneficiaries to determine their satisfaction with the program;\u003c/li>\n\u003cli>Offering a new customer service line to help children and their families locate participating dentists; and\u003c/li>\n\u003cli>Reaching out to dentists to urge them to join the program or take more Denti-Cal patients.\u003c/li>\n\u003c/ul>\n\u003cp>The department is addressing complaints about bureaucratic obstacles by developing a webinar series, video tutorials and other materials for dentists to help them with enrollment and billing, Williams said.\u003c/p>\n\u003cp>But raising rates isn’t on the table.\u003c/p>\n\u003cp>“Because of our current economic situation, the state is not in a financial position to increase Medi-Cal payments to dentists,” Williams said.\u003c/p>\n\u003cp>Gayle Mathe, director of policy development for the \u003ca href=\"http://www.cda.org/\" target=\"_blank\">California Dental Association\u003c/a>, applauded the department for its recent moves to boost dentist ranks in the program. In many cases, she said, her association is partnering on these initiatives.\u003c/p>\n\u003cp>“We’re starting to see movement and changes in a positive direction,” she said. “And the department is really engaged in doing that.”\u003c/p>\n\u003cp>But the association questions the department’s conclusion that two-thirds of dentists participate Denti-Cal, saying that Aved’s figure is closer.\u003c/p>\n\u003cp>“We don’t have access to data, but the 25 percent is consistent with what we’ve heard anecdotally over the years,” Mathe said.\u003c/p>\n\u003cp>Aved said she’s concerned that not enough dentists participate as it is and worries that Denti-Cal isn’t prepared for the hundreds of thousands of new children coming into the program in the next few years. This will be primarily as a result of the transition of children \u003ca href=\"http://www.dhcs.ca.gov/services/Pages/HealthyFamiliesTransition.aspx\" target=\"_blank\">from the publicly-funded Healthy Families program into Medi-Cal\u003c/a> and the expansion of Medi-Cal under the Affordable Care Act.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If it’s this way now, we should be worried about the future for sure,” she said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Spends Less Than 4 Cents of Every Tobacco Dollar to Reduce Tobacco Use",
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"content": "\u003cp>\u003cem>By Joshua Johnson and Lisa Aliferis\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_9296\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Cigarette_RaulLieberwirth_Flickr_04172012.jpg\">\u003cimg class=\"size-medium wp-image-9296\" title=\"(Raul Lieberwirth/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Cigarette_RaulLieberwirth_Flickr_04172012-300x237.jpg\" alt=\"\" width=\"300\" height=\"237\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Raul Lieberwirth/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Tobacco prevention advocates are calling on California to spend more on anti-smoking programs -- especially since the state already has the money for it.\u003c/p>\n\u003cp>A new report published Thursday titled \u003ca href=\"http://www.tobaccofreekids.org/what_we_do/state_local/tobacco_settlement/?utm_source=home&utm_medium=carousel&utm_campaign=home\" target=\"_blank\">Broken Promises to Our Children\u003c/a> looked nationwide at how states are spending the money from the 1998 master settlement agreement with cigarette companies and from states' tobacco taxes.\u003c/p>\n\u003cp>Campaign for Tobacco-Free Kids, which published the analysis, says states spend only a \"minuscule portion\" or tobacco revenue on cessation and prevention programs. The group estimates California will get $1.6 billion this year in tobacco revenue, but will spend just $62 million on smoking prevention and cessation efforts. Nationwide, states spend just two percent of their total tobacco revenue on prevention and cessation.\u003c/p>\n\u003cp>\"California and other states have shown that these tobacco prevention/cessation programs more than pay for themselves,\" said Danny McGoldrick, vice-president for research with the Campaign for Tobacco Free Kids. \"When we cut them and reverse our progress in reducing smoking, we're actually costing the state money, because we're going to have more costs related to treating tobacco-caused disease.\" His group estimates health care costs to treat tobacco-caused diseases total $9 billion in California.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In its\u003ca href=\"http://www.cdc.gov/tobacco/stateandcommunity/best_practices/pdfs/2007/BestPractices_Complete.pdf\" target=\"_blank\"> best practices recommendations\u003c/a>, the Centers for Disease Control says that California should spend about $440 million on cessation and prevention. By contrast, Campaign for Tobacco-Free Kids estimates tobacco companies spend more than $500 million in marketing in the state.\u003c/p>\n\u003cp>\"The decision makers are the people sitting in the legislature and the governor,\" McGoldrick said. \"They have to decide that 36,000 people dying every year in California from tobacco-caused disease and losing 12-14 years off their lives ... are worth doing more about than California has already done and is currently doing. But in order to do that, they need to hear from us -- the citizens and tobacco control advocates have to let them know this is important to us.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Sixteen percent of Californians smoked in 2011, according to the \u003ca href=\"http://www.gallup.com/poll/142694/Adult-Smoking-Ranges-Across-States.aspx\" target=\"_blank\">Gallup Healthways Well Being Index\u003c/a>, the second lowest rate in the U.S. behind Utah, at 13 percent.\u003c/p>\n\n",
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"description": "By Joshua Johnson and Lisa Aliferis Tobacco prevention advocates are calling on California to spend more on anti-smoking programs -- especially since the state already has the money for it. A new report published Thursday titled Broken Promises to Our Children looked nationwide at how states are spending the money from the 1998 master settlement agreement",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>By Joshua Johnson and Lisa Aliferis\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_9296\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Cigarette_RaulLieberwirth_Flickr_04172012.jpg\">\u003cimg class=\"size-medium wp-image-9296\" title=\"(Raul Lieberwirth/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Cigarette_RaulLieberwirth_Flickr_04172012-300x237.jpg\" alt=\"\" width=\"300\" height=\"237\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Raul Lieberwirth/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Tobacco prevention advocates are calling on California to spend more on anti-smoking programs -- especially since the state already has the money for it.\u003c/p>\n\u003cp>A new report published Thursday titled \u003ca href=\"http://www.tobaccofreekids.org/what_we_do/state_local/tobacco_settlement/?utm_source=home&utm_medium=carousel&utm_campaign=home\" target=\"_blank\">Broken Promises to Our Children\u003c/a> looked nationwide at how states are spending the money from the 1998 master settlement agreement with cigarette companies and from states' tobacco taxes.\u003c/p>\n\u003cp>Campaign for Tobacco-Free Kids, which published the analysis, says states spend only a \"minuscule portion\" or tobacco revenue on cessation and prevention programs. The group estimates California will get $1.6 billion this year in tobacco revenue, but will spend just $62 million on smoking prevention and cessation efforts. Nationwide, states spend just two percent of their total tobacco revenue on prevention and cessation.\u003c/p>\n\u003cp>\"California and other states have shown that these tobacco prevention/cessation programs more than pay for themselves,\" said Danny McGoldrick, vice-president for research with the Campaign for Tobacco Free Kids. \"When we cut them and reverse our progress in reducing smoking, we're actually costing the state money, because we're going to have more costs related to treating tobacco-caused disease.\" His group estimates health care costs to treat tobacco-caused diseases total $9 billion in California.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
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"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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},
"closealltabs": {
"id": "closealltabs",
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"order": 1
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"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"source": "Commonwealth Club of California"
},
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"order": 9
},
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"id": "freakonomics-radio",
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"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
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"id": "fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"hidden-brain": {
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"airtime": "SUN 7:30pm-8pm",
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"link": "/radio/program/how-i-built-this",
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"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"order": 18
},
"link": "/podcasts/jerrybrown",
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},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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},
"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)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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},
"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": {
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"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/",
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},
"link": "/radio/program/pbs-newshour",
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"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/",
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
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"npr": "https://www.npr.org/podcasts/432309616/perspectives",
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},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
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