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"disqusTitle": "Many Walgreens Customers Need to Find New Pharmacy",
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"content": "\u003cp>\u003cstrong>\u003cspan style=\"color: black;font-family: 'Times New Roman';font-size: medium\">By Sarah Varney\u003c/span>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_1809\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Walgreens_RyanOzawa_Flickr_01082012.jpg\">\u003cimg class=\"size-medium wp-image-1809 \" title=\"(Ryan Ozawa: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Walgreens_RyanOzawa_Flickr_01082012-300x225.jpg\" alt=\"(Ryan Ozawa: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ryan Ozawa: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>As of January 1, Californians who go to \u003ca href=\"http://www.walgreens.com/\">\u003cstrong>Walgreens\u003c/strong>\u003c/a> to get their prescriptions filled may have been in for a surprise. Because of a contract dispute between Walgreens, the nation’s largest drugstore chain, and the company that manages prescriptions for \u003ca href=\"http://www.anthem.com/health-insurance/home/overview\">\u003cstrong>Anthem Blue Cross\u003c/strong>\u003c/a> health insurance, many customers will have to find a new pharmacy.\u003c/p>\n\u003cp>To find out if you’re affected by the dispute, you should check the back of your insurance card. If it says “Express Scripts,” you can no longer fill your prescription at Walgreens under your insurance plan. \u003ca href=\"http://www.express-scripts.com/\">\u003cstrong>Express Scripts\u003c/strong>\u003c/a> is a pharmacy benefit manager or PBM. PBMs negotiate prices for drugs and oversee prescription drug programs for health insurance companies, governments, unions and others.\u003c/p>\n\u003cp>\u003c!--more-->Express Scripts is one of the nation’s largest PBMs. Its clients include Anthem Blue Cross. The two companies had been negotiating a new contract to keep Walgreens in its network, but Express Scripts spokesman Brian Henry says Walgreens was asking for too much money. \"Their rates and terms as they currently stand would be as much as 20 percent more,\" Henry said, \"and our clients aren't willing to pay that premium for basically the same service you can get at many other thousands of other pharmacies.\"\u003c/p>\n\u003cp>But Walgreens' spokesman Michael Polzin adamantly denies the charge. \"We did not propose any increase in our rate,\" he said. \"So there would not be any significant savings to Express Scripts clients for excluding Walgreens from their network. So it's really a situation of all pain and no gain for their clients.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Health care experts are somewhat befuddled by the stand off. Sean Brandle is a pharmacy benefit expert at the \u003ca href=\"http://www.segalco.com/\">\u003cstrong>Segal Company\u003c/strong>\u003c/a>, a New York-based employer benefits firm. He says tussles between pharmacy chains and PBMs are pretty typical. But he also said he’s surprised Walgreens would walk away from so many pharmacy customers and all that in-store foot traffic. Express Scripts says of the 750 million prescriptions it processed last year, about 90 million were filled at Walgreens.\u003c/p>\n\u003cp>Caught in the middle of the dispute is one of California’s biggest health insurance companies, Anthem Blue Cross, and its millions of customers like San Francisco resident David Forer. There’s a Walgreens just down the street from his downtown San Francisco office, and he used to stop in weekly to pick up insulin for his daughter who has Type 1 diabetes. \"They knew me on a first name basis,\" Forer said. “They wouldn’t even ask me my name when I came up. I would just go and get the prescriptions. They would ask how she was doing, and now I can’t go there anymore.”\u003c/p>\n\u003cp>Forer has switched his family’s prescriptions to a \u003ca href=\"http://www.cvs.com/CVSApp/user/home/home.jsp\">\u003cstrong>CVS\u003c/strong>\u003c/a> pharmacy. But while CVS is a national chain, it’s not as omnipresent on the city’s streets as Walgreens. \"I imagine there will be huge line ups because there are very few CVSs and so many people are going to have to switch to CVS so this is a major inconvenience,\" Forer added.\u003c/p>\n\u003cp>Anthem Blue Cross says throughout the state there is another in-network pharmacy typically within a half a mile of a Walgreens, and the company is trying to help customers make the transition.\u003c/p>\n\u003cp>Pharmacy benefit expert Brandel says there could be an upside for all the headache. Brandel says Express Scripts should be able to negotiate steeper discounts with CVS and other pharmacies since excluding Walgreens will mean more business for them.\u003c/p>\n\u003cp>\u003cem>Read More: \u003ca title=\"http://www.businessweek.com/news/2012-01-09/walgreen-open-to-express-scripts-deal-pharmacy-chief-says.html\" href=\"http://www.businessweek.com/news/2012-01-09/walgreen-open-to-express-scripts-deal-pharmacy-chief-says.html\" target=\"_blank\">Walgreens and Express Scripts both say they are still open to a deal.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Listen to Sarah Varney's report:\u003c/em>\u003cbr>\n\u003cobject width=\"335\" height=\"85\">\u003cparam name=\"movie\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201201090850b.xml\">\u003cembed src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" type=\"application/x-shockwave-flash\" width=\"335\" height=\"85\" flashvars=\"file=http://www.kqed.org/radio/archives/R201201090850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "As of January 1, Californians who went to Walgreens to get their prescriptions filled may have been in for a surprise. Because of a contract dispute between Walgreens, the nation’s largest drugstore chain, and the company that manages prescriptions for Anthem Blue Cross health insurance, many customers will have to find a new pharmacy. ",
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"description": "As of January 1, Californians who went to Walgreens to get their prescriptions filled may have been in for a surprise. Because of a contract dispute between Walgreens, the nation’s largest drugstore chain, and the company that manages prescriptions for Anthem Blue Cross health insurance, many customers will have to find a new pharmacy. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>\u003cspan style=\"color: black;font-family: 'Times New Roman';font-size: medium\">By Sarah Varney\u003c/span>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_1809\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Walgreens_RyanOzawa_Flickr_01082012.jpg\">\u003cimg class=\"size-medium wp-image-1809 \" title=\"(Ryan Ozawa: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Walgreens_RyanOzawa_Flickr_01082012-300x225.jpg\" alt=\"(Ryan Ozawa: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ryan Ozawa: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>As of January 1, Californians who go to \u003ca href=\"http://www.walgreens.com/\">\u003cstrong>Walgreens\u003c/strong>\u003c/a> to get their prescriptions filled may have been in for a surprise. Because of a contract dispute between Walgreens, the nation’s largest drugstore chain, and the company that manages prescriptions for \u003ca href=\"http://www.anthem.com/health-insurance/home/overview\">\u003cstrong>Anthem Blue Cross\u003c/strong>\u003c/a> health insurance, many customers will have to find a new pharmacy.\u003c/p>\n\u003cp>To find out if you’re affected by the dispute, you should check the back of your insurance card. If it says “Express Scripts,” you can no longer fill your prescription at Walgreens under your insurance plan. \u003ca href=\"http://www.express-scripts.com/\">\u003cstrong>Express Scripts\u003c/strong>\u003c/a> is a pharmacy benefit manager or PBM. PBMs negotiate prices for drugs and oversee prescription drug programs for health insurance companies, governments, unions and others.\u003c/p>\n\u003cp>\u003c!--more-->Express Scripts is one of the nation’s largest PBMs. Its clients include Anthem Blue Cross. The two companies had been negotiating a new contract to keep Walgreens in its network, but Express Scripts spokesman Brian Henry says Walgreens was asking for too much money. \"Their rates and terms as they currently stand would be as much as 20 percent more,\" Henry said, \"and our clients aren't willing to pay that premium for basically the same service you can get at many other thousands of other pharmacies.\"\u003c/p>\n\u003cp>But Walgreens' spokesman Michael Polzin adamantly denies the charge. \"We did not propose any increase in our rate,\" he said. \"So there would not be any significant savings to Express Scripts clients for excluding Walgreens from their network. So it's really a situation of all pain and no gain for their clients.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Health care experts are somewhat befuddled by the stand off. Sean Brandle is a pharmacy benefit expert at the \u003ca href=\"http://www.segalco.com/\">\u003cstrong>Segal Company\u003c/strong>\u003c/a>, a New York-based employer benefits firm. He says tussles between pharmacy chains and PBMs are pretty typical. But he also said he’s surprised Walgreens would walk away from so many pharmacy customers and all that in-store foot traffic. Express Scripts says of the 750 million prescriptions it processed last year, about 90 million were filled at Walgreens.\u003c/p>\n\u003cp>Caught in the middle of the dispute is one of California’s biggest health insurance companies, Anthem Blue Cross, and its millions of customers like San Francisco resident David Forer. There’s a Walgreens just down the street from his downtown San Francisco office, and he used to stop in weekly to pick up insulin for his daughter who has Type 1 diabetes. \"They knew me on a first name basis,\" Forer said. “They wouldn’t even ask me my name when I came up. I would just go and get the prescriptions. They would ask how she was doing, and now I can’t go there anymore.”\u003c/p>\n\u003cp>Forer has switched his family’s prescriptions to a \u003ca href=\"http://www.cvs.com/CVSApp/user/home/home.jsp\">\u003cstrong>CVS\u003c/strong>\u003c/a> pharmacy. But while CVS is a national chain, it’s not as omnipresent on the city’s streets as Walgreens. \"I imagine there will be huge line ups because there are very few CVSs and so many people are going to have to switch to CVS so this is a major inconvenience,\" Forer added.\u003c/p>\n\u003cp>Anthem Blue Cross says throughout the state there is another in-network pharmacy typically within a half a mile of a Walgreens, and the company is trying to help customers make the transition.\u003c/p>\n\u003cp>Pharmacy benefit expert Brandel says there could be an upside for all the headache. Brandel says Express Scripts should be able to negotiate steeper discounts with CVS and other pharmacies since excluding Walgreens will mean more business for them.\u003c/p>\n\u003cp>\u003cem>Read More: \u003ca title=\"http://www.businessweek.com/news/2012-01-09/walgreen-open-to-express-scripts-deal-pharmacy-chief-says.html\" href=\"http://www.businessweek.com/news/2012-01-09/walgreen-open-to-express-scripts-deal-pharmacy-chief-says.html\" target=\"_blank\">Walgreens and Express Scripts both say they are still open to a deal.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Listen to Sarah Varney's report:\u003c/em>\u003cbr>\n\u003cobject width=\"335\" height=\"85\">\u003cparam name=\"movie\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201201090850b.xml\">\u003cembed src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" type=\"application/x-shockwave-flash\" width=\"335\" height=\"85\" flashvars=\"file=http://www.kqed.org/radio/archives/R201201090850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Quick Read: Most Hospital Errors Go Unreported",
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"content": "\u003cfigure id=\"attachment_1759\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/HospitalGeneric_TimSamoff_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-1759\" title=\"(Tim Samoff: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/HospitalGeneric_TimSamoff_Flickr-300x225.jpg\" alt=\"(Tim Samoff: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Tim Samoff: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The \u003ca title=\"http://www.nytimes.com/2012/01/06/health/study-of-medicare-patients-finds-most-hospital-errors-unreported.html?ref=health\" href=\"http://www.nytimes.com/2012/01/06/health/study-of-medicare-patients-finds-most-hospital-errors-unreported.html?ref=health\" target=\"_blank\">New York Times\u003c/a> reports that \"hospital employees recognize and report only one out of seven errors, accidents and other events that harm \u003ca title=\"Recent and archival health news about Medicare.\" href=\"http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medicare/index.html?inline=nyt-classifier\">Medicare\u003c/a> patients while they are hospitalized.\" The \u003cem>Times\u003c/em> cites a\u003ca title=\"http://oig.hhs.gov/oei/reports/oei-06-09-00091.pdf\" href=\"http://oig.hhs.gov/oei/reports/oei-06-09-00091.pdf\" target=\"_blank\"> federal study\u003c/a> [PDF] released today.\u003c/p>\n\u003cp>In order to be paid by Medicare, hospitals must track and report errors. A \u003ca title=\"http://www.iom.edu/~/media/Files/Report%20Files/1999/To-Err-is-Human/To%20Err%20is%20Human%201999%20%20report%20brief.pdf\" href=\"http://www.iom.edu/~/media/Files/Report%20Files/1999/To-Err-is-Human/To%20Err%20is%20Human%201999%20%20report%20brief.pdf\" target=\"_blank\">major study\u003c/a> by the Institute of Medicine in 1999 found that between 44,000 and 98,000 hospital patients die each year because of errors that could have been prevented.\u003c/p>\n\u003cp>Perhaps the most troubling point in the \u003cem>Times\u003c/em> piece was this, from \u003ca href=\"http://www.hhs.gov/open/contacts/oig.html\">Daniel R. Levinson\u003c/a>, inspector general of the \u003ca title=\"More articles about Health and Human Services Department, U.S.\" href=\"http://topics.nytimes.com/top/reference/timestopics/organizations/h/health_and_human_services_department/index.html?inline=nyt-org\">Department of Health and Human Services\u003c/a>, which published the report:\u003c/p>\n\u003cblockquote>\u003cp>...the problem is that hospital employees do not recognize “what constitutes patient harm” or do not realize that particular events harmed patients and should be reported.\u003c/p>\n\u003cp>In some cases, he said, employees assumed someone else would report the episode, or they thought it was so common that it did not need to be reported, or “suspected that the events were isolated incidents unlikely to recur.”\u003c/p>\u003c/blockquote>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "The New York Times reports today that \"hospital employees recognize and report only one out of seven errors, accidents and other events that harm Medicare patients while they are hospitalized.\" The Times cites a federal study [PDF] released today.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_1759\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/HospitalGeneric_TimSamoff_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-1759\" title=\"(Tim Samoff: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/HospitalGeneric_TimSamoff_Flickr-300x225.jpg\" alt=\"(Tim Samoff: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Tim Samoff: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The \u003ca title=\"http://www.nytimes.com/2012/01/06/health/study-of-medicare-patients-finds-most-hospital-errors-unreported.html?ref=health\" href=\"http://www.nytimes.com/2012/01/06/health/study-of-medicare-patients-finds-most-hospital-errors-unreported.html?ref=health\" target=\"_blank\">New York Times\u003c/a> reports that \"hospital employees recognize and report only one out of seven errors, accidents and other events that harm \u003ca title=\"Recent and archival health news about Medicare.\" href=\"http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medicare/index.html?inline=nyt-classifier\">Medicare\u003c/a> patients while they are hospitalized.\" The \u003cem>Times\u003c/em> cites a\u003ca title=\"http://oig.hhs.gov/oei/reports/oei-06-09-00091.pdf\" href=\"http://oig.hhs.gov/oei/reports/oei-06-09-00091.pdf\" target=\"_blank\"> federal study\u003c/a> [PDF] released today.\u003c/p>\n\u003cp>In order to be paid by Medicare, hospitals must track and report errors. A \u003ca title=\"http://www.iom.edu/~/media/Files/Report%20Files/1999/To-Err-is-Human/To%20Err%20is%20Human%201999%20%20report%20brief.pdf\" href=\"http://www.iom.edu/~/media/Files/Report%20Files/1999/To-Err-is-Human/To%20Err%20is%20Human%201999%20%20report%20brief.pdf\" target=\"_blank\">major study\u003c/a> by the Institute of Medicine in 1999 found that between 44,000 and 98,000 hospital patients die each year because of errors that could have been prevented.\u003c/p>\n\u003cp>Perhaps the most troubling point in the \u003cem>Times\u003c/em> piece was this, from \u003ca href=\"http://www.hhs.gov/open/contacts/oig.html\">Daniel R. Levinson\u003c/a>, inspector general of the \u003ca title=\"More articles about Health and Human Services Department, U.S.\" href=\"http://topics.nytimes.com/top/reference/timestopics/organizations/h/health_and_human_services_department/index.html?inline=nyt-org\">Department of Health and Human Services\u003c/a>, which published the report:\u003c/p>\n\u003cblockquote>\u003cp>...the problem is that hospital employees do not recognize “what constitutes patient harm” or do not realize that particular events harmed patients and should be reported.\u003c/p>\n\u003cp>In some cases, he said, employees assumed someone else would report the episode, or they thought it was so common that it did not need to be reported, or “suspected that the events were isolated incidents unlikely to recur.”\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Governor's Budget: Health and Social Services Cuts",
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"content": "\u003cfigure id=\"attachment_1744\" class=\"wp-caption alignleft\" style=\"max-width: 200px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/DrugsMoneyGeneric_Getty.jpg\">\u003cimg class=\"size-medium wp-image-1744 \" title=\"(Jupiterimages: Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/DrugsMoneyGeneric_Getty-300x449.jpg\" alt=\"(Jupiterimages: Getty Images)\" width=\"200\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Jupiterimages: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>California's Governor Jerry Brown\u003ca title=\"http://ww2.kqed.org/news/2012/01/05/calif-budget-released-early/\" href=\"http://ww2.kqed.org/news/2012/01/05/calif-budget-released-early/\" target=\"_blank\"> released his budget for the 2012-13 fiscal year\u003c/a> today and it includes \"painful\" cuts in healthcare and social services.\u003c/p>\n\u003cp>Reaction has been swift from groups that work on behalf of the poor and disabled.\u003c/p>\n\u003cp>From the \u003ca title=\"http://www.hhsnetworkca.org/about-2/\" href=\"http://www.hhsnetworkca.org/about-2/\" target=\"_blank\">HHS Network of CA\u003c/a>, a coalition of organizations including the Western Poverty Law Center and Health Access:\u003c/p>\n\u003cblockquote>\u003cp>We are appalled that Governor Brown’s solution to California’s budget crisis is $2.5 billion cuts to essential health and human services. Since 2008, California’s health and human services have suffered an astounding $15 billion in cuts, and this budget only continues the gutting of the social safety net that so many Californian families depend on. From our quick analysis, the Governor is making a $946 million cut to CalWORKS, an $842 million cut to MediCal, a $163 million cut to In-Home Supportive Services, a $447 million cut to child care, and $87 million in cuts to various other HHS services.\u003c/p>\u003c/blockquote>\n\u003cp>From Darcel Lee, Executive Director of the \u003ca title=\"http://cablackhealthnetwork.org/\" href=\"http://cablackhealthnetwork.org/\" target=\"_blank\">California Black Health Network\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Once again, the proposed budget balances the deficit on the backs of our most vulnerable communities,” said B. Darcel Lee, (CBHN). “The number of uninsured in California grew to 7 million last year. At a time when so many families are struggling to make ends meet, we can’t afford to take away basic support programs for working families.\u003c/p>\u003c/blockquote>\n\u003cp>From the \u003ca title=\"http://www.cmanet.org/news/press-detail/?article=california-medical-association-responds-to\" href=\"http://www.cmanet.org/news/press-detail/?article=california-medical-association-responds-to\" target=\"_blank\">California Medical Association\u003c/a>, reacting to the planned transition of children and teenagers in the \u003ca title=\"http://www.healthyfamilies.ca.gov/Home/default.aspx\" href=\"http://www.healthyfamilies.ca.gov/Home/default.aspx\" target=\"_blank\">Healthy Families Program\u003c/a> to Medi-Cal:\u003c/p>\n\u003cblockquote>\u003cp>“On one hand, Governor Brown is advocating for a 10 percent cut in Medi-Cal. On the other hand, he wants to add just under a million more young people to the program, which data shows is already struggling to meet the needs of the existing patients,” said Dustin Corcoran, CMA CEO. “The Medi-Cal provider network will simply not be able to accommodate this large influx of kids and teens. It’s unclear how anybody wins in that scenario.”\u003c/p>\u003c/blockquote>\n\u003cp>The governor is also calling for new taxes to close the budget deficit. From Jean Ross, Executive Director of the \u003ca title=\"http://www.cbp.org/\" href=\"http://www.cbp.org/\" target=\"_blank\">California Budget Project\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>The Proposed Budget includes major reductions in a number of critical areas, especially support for low- and middle-income Californians who need health coverage, child care, help in moving from welfare to work, or help financing a college education. Still, the governor should be commended for a balanced approach that calls for new revenue, instead of taking a cuts-only approach to addressing the state's fiscal challenges.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"border-collapse: collapse\">\u003cbr>\n\u003c/span>\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_1744\" class=\"wp-caption alignleft\" style=\"max-width: 200px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/DrugsMoneyGeneric_Getty.jpg\">\u003cimg class=\"size-medium wp-image-1744 \" title=\"(Jupiterimages: Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/DrugsMoneyGeneric_Getty-300x449.jpg\" alt=\"(Jupiterimages: Getty Images)\" width=\"200\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Jupiterimages: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>California's Governor Jerry Brown\u003ca title=\"http://ww2.kqed.org/news/2012/01/05/calif-budget-released-early/\" href=\"http://ww2.kqed.org/news/2012/01/05/calif-budget-released-early/\" target=\"_blank\"> released his budget for the 2012-13 fiscal year\u003c/a> today and it includes \"painful\" cuts in healthcare and social services.\u003c/p>\n\u003cp>Reaction has been swift from groups that work on behalf of the poor and disabled.\u003c/p>\n\u003cp>From the \u003ca title=\"http://www.hhsnetworkca.org/about-2/\" href=\"http://www.hhsnetworkca.org/about-2/\" target=\"_blank\">HHS Network of CA\u003c/a>, a coalition of organizations including the Western Poverty Law Center and Health Access:\u003c/p>\n\u003cblockquote>\u003cp>We are appalled that Governor Brown’s solution to California’s budget crisis is $2.5 billion cuts to essential health and human services. Since 2008, California’s health and human services have suffered an astounding $15 billion in cuts, and this budget only continues the gutting of the social safety net that so many Californian families depend on. From our quick analysis, the Governor is making a $946 million cut to CalWORKS, an $842 million cut to MediCal, a $163 million cut to In-Home Supportive Services, a $447 million cut to child care, and $87 million in cuts to various other HHS services.\u003c/p>\u003c/blockquote>\n\u003cp>From Darcel Lee, Executive Director of the \u003ca title=\"http://cablackhealthnetwork.org/\" href=\"http://cablackhealthnetwork.org/\" target=\"_blank\">California Black Health Network\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Once again, the proposed budget balances the deficit on the backs of our most vulnerable communities,” said B. Darcel Lee, (CBHN). “The number of uninsured in California grew to 7 million last year. At a time when so many families are struggling to make ends meet, we can’t afford to take away basic support programs for working families.\u003c/p>\u003c/blockquote>\n\u003cp>From the \u003ca title=\"http://www.cmanet.org/news/press-detail/?article=california-medical-association-responds-to\" href=\"http://www.cmanet.org/news/press-detail/?article=california-medical-association-responds-to\" target=\"_blank\">California Medical Association\u003c/a>, reacting to the planned transition of children and teenagers in the \u003ca title=\"http://www.healthyfamilies.ca.gov/Home/default.aspx\" href=\"http://www.healthyfamilies.ca.gov/Home/default.aspx\" target=\"_blank\">Healthy Families Program\u003c/a> to Medi-Cal:\u003c/p>\n\u003cblockquote>\u003cp>“On one hand, Governor Brown is advocating for a 10 percent cut in Medi-Cal. On the other hand, he wants to add just under a million more young people to the program, which data shows is already struggling to meet the needs of the existing patients,” said Dustin Corcoran, CMA CEO. “The Medi-Cal provider network will simply not be able to accommodate this large influx of kids and teens. It’s unclear how anybody wins in that scenario.”\u003c/p>\u003c/blockquote>\n\u003cp>The governor is also calling for new taxes to close the budget deficit. From Jean Ross, Executive Director of the \u003ca title=\"http://www.cbp.org/\" href=\"http://www.cbp.org/\" target=\"_blank\">California Budget Project\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>The Proposed Budget includes major reductions in a number of critical areas, especially support for low- and middle-income Californians who need health coverage, child care, help in moving from welfare to work, or help financing a college education. Still, the governor should be commended for a balanced approach that calls for new revenue, instead of taking a cuts-only approach to addressing the state's fiscal challenges.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"border-collapse: collapse\">\u003cbr>\n\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Here's how the non-profit Blue Shield of California \u003ca title=\"https://www.blueshieldca.com/sites/make-care-affordable/home.jsp\" href=\"https://www.blueshieldca.com/sites/make-care-affordable/home.jsp\" target=\"_blank\">says it spends each health care premium dollar\u003c/a> it receives:\u003c/p>\n\u003cfigure id=\"attachment_1726\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Screen-Shot-2012-01-05-at-9.51.41-AM.png\">\u003cimg class=\"size-large wp-image-1726\" title=\"(Image: Blue Shield)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Screen-Shot-2012-01-05-at-9.51.41-AM-620x434.png\" alt=\"(Image: Blue Shield)\" width=\"620\" height=\"434\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Image: Blue Shield)\u003c/figcaption>\u003c/figure>\n\u003cp>What's significant here is that Blue Shield says it's spending 85 percent of your dollar on medical care. This is right in line with a requirement of health care reform which has already gone into effect, the \"medical loss ratio.\" The MLR requires large employer plans to spend 85 percent of revenue on patient care. If they spend less, they must issue a refund to members. Blue Shield also has capped its income (i.e. profit) at two percent. It has pledged to return any income above two percent to its members.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Here's how the non-profit Blue Shield of California \u003ca title=\"https://www.blueshieldca.com/sites/make-care-affordable/home.jsp\" href=\"https://www.blueshieldca.com/sites/make-care-affordable/home.jsp\" target=\"_blank\">says it spends each health care premium dollar\u003c/a> it receives:\u003c/p>\n\u003cfigure id=\"attachment_1726\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Screen-Shot-2012-01-05-at-9.51.41-AM.png\">\u003cimg class=\"size-large wp-image-1726\" title=\"(Image: Blue Shield)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Screen-Shot-2012-01-05-at-9.51.41-AM-620x434.png\" alt=\"(Image: Blue Shield)\" width=\"620\" height=\"434\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Image: Blue Shield)\u003c/figcaption>\u003c/figure>\n\u003cp>What's significant here is that Blue Shield says it's spending 85 percent of your dollar on medical care. This is right in line with a requirement of health care reform which has already gone into effect, the \"medical loss ratio.\" The MLR requires large employer plans to spend 85 percent of revenue on patient care. If they spend less, they must issue a refund to members. Blue Shield also has capped its income (i.e. profit) at two percent. It has pledged to return any income above two percent to its members.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Health Care Privacy? Apparently Not.",
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"content": "\u003cfigure id=\"attachment_1712\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/PrimeHealth_HQ_MonicaLam_CaliforniaWatch.jpg\">\u003cimg class=\"size-medium wp-image-1712\" title=\"(Monica Lam: California Watch)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/PrimeHealth_HQ_MonicaLam_CaliforniaWatch-300x168.jpg\" alt=\"(Monica Lam: California Watch)\" width=\"300\" height=\"168\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Monica Lam: California Watch)\u003c/figcaption>\u003c/figure>\n\u003cp>For more than a year \u003ca title=\"http://www.primehealthcare.com/\" href=\"http://www.primehealthcare.com/\" target=\"_blank\">Prime Healthcare Services\u003c/a>, which owns 14 hospitals in California, has been the subject of state and federal investigation into potentially fraudulent billing with Medicare and Medi-Cal. Journalists at California Watch have \u003ca title=\"http://californiawatch.org/prime\" href=\"http://californiawatch.org/prime\" target=\"_blank\">filed numerous stories\u003c/a> and even done their own analysis of 50 million Medicare records about Prime's billing practices.\u003c/p>\n\u003cp>But this post is not about Medicare fraud.\u003c/p>\n\u003cp>Instead, it's about unapproved release of one patient's medical records, as Mike Hiltzik of the Los Angeles Times\u003ca title=\"http://www.latimes.com/health/healthcare/la-fi-hiltzik-20120104,0,3519433.column\" href=\"http://www.latimes.com/health/healthcare/la-fi-hiltzik-20120104,0,3519433.column\" target=\"_blank\"> explained in his column\u003c/a> today:\u003c/p>\n\u003cblockquote>\u003cp>Of all the personal information that you might want to keep private, your medical records are the most important. That's why federal and state laws carry stiff penalties, up to and including jail time, for healthcare providers who let such data loose into the wild.\u003c/p>\n\u003cp>So you should be aghast at how free and easy Prime Healthcare Services and two executives at Prime-owned Shasta Regional Medical Center have been with the medical chart of a patient named Darlene Courtois. They showed the entire chart to an editor of her hometown newspaper, and Prime's corporate office divulged some of her medical examination results to me (though I didn't ask for them). They didn't have her permission for those disclosures, her daughter says.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c!--more-->A little background--California Watch had told \u003ca title=\"http://californiawatch.org/health-and-welfare/prime-hospital-bills-malnutrition-patient-says-she-wasn-t-treated-14055\" href=\"http://californiawatch.org/health-and-welfare/prime-hospital-bills-malnutrition-patient-says-she-wasn-t-treated-14055\" target=\"_blank\">Courtois' story\u003c/a> as evidence that Prime had fraudulently billed Medicare. Courtois had been treated at Shasta Medical Center after a fall in early 2010. The hospital had billed Medicare for a rare nutritional disorder, kwashiorkor. But Courtois later requested her medical records. In the 63 pages she received, there was no mention of kwashiorkor, California Watch reported.\u003c/p>\n\u003cp>But the 63 pages apparently were not the complete record. Prime argues that because Courtois had already shared her medical records publicly that she essentially waived her right to privacy. Privacy of medical records is guaranteed under the 1996 Health Insurance Portability and Accountability Act, known as HIPAA. Prime insists it had the right to share other internal documents about her treatment.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But Hiltzik didn't buy that argument, nor did many of the legal experts he talked to:\u003c/p>\n\u003cblockquote>\u003cp>Under the law, there's no such thing as an implied authorization by a patient for disclosure of personal records, said Linda Ackerman, a San Francisco expert in privacy law.\u003c/p>\n\u003cp>The office of civil rights of the \u003ca id=\"ORGOV0000126162\" title=\"U.S. Department of Health and Human Services\" href=\"http://www.latimes.com/topic/health/u.s.-department-of-health-human-services-ORGOV0000126162.topic\">U.S. Department of Health and Human Services\u003c/a>, which enforces HIPAA, put it this way: \"There is no 'waiver' that would apply to the release of a chart or medical record to the media without an individual's written authorization.\"\u003c/p>\n\u003cp>Several experts told me it doesn't matter if the hospital was trying to contradict misinformation provided by a patient (even if that's what Courtois did, which is debatable). Under the law, patients themselves can divulge anything they wish about their medical conditions and their treatment by a hospital. But a hospital's obligation is to keep its mouth shut. A desire to deflect bad PR is not an excuse. Even if they think they're in the right, the law says healthcare providers have to suffer in silence, the experts say.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>The whole of Hiltzik's column is a great read, and he ends with a call for prosecutors to step in:\u003c/p>\n\u003cblockquote>\u003cp>The behavior of Prime and Shasta Regional should provide rich fodder for investigations by state and federal agencies and by U.S. prosecutors in Sacramento, who cover Shasta County. Dr. McCampbell holds a California medical license issued in 2005, and it would be worthwhile for the state medical board to look into her participation in this matter and determine whether it meets the standards of professional conduct required of a California licensee.\u003c/p>\n\u003cp>As for the rest of the bigwigs at Prime and Shasta, plainly they all need to be shipped to a reeducation camp in the rules of patient confidentiality. If, that is, they can stay out of jail.\u003c/p>\u003c/blockquote>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_1712\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/PrimeHealth_HQ_MonicaLam_CaliforniaWatch.jpg\">\u003cimg class=\"size-medium wp-image-1712\" title=\"(Monica Lam: California Watch)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/PrimeHealth_HQ_MonicaLam_CaliforniaWatch-300x168.jpg\" alt=\"(Monica Lam: California Watch)\" width=\"300\" height=\"168\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Monica Lam: California Watch)\u003c/figcaption>\u003c/figure>\n\u003cp>For more than a year \u003ca title=\"http://www.primehealthcare.com/\" href=\"http://www.primehealthcare.com/\" target=\"_blank\">Prime Healthcare Services\u003c/a>, which owns 14 hospitals in California, has been the subject of state and federal investigation into potentially fraudulent billing with Medicare and Medi-Cal. Journalists at California Watch have \u003ca title=\"http://californiawatch.org/prime\" href=\"http://californiawatch.org/prime\" target=\"_blank\">filed numerous stories\u003c/a> and even done their own analysis of 50 million Medicare records about Prime's billing practices.\u003c/p>\n\u003cp>But this post is not about Medicare fraud.\u003c/p>\n\u003cp>Instead, it's about unapproved release of one patient's medical records, as Mike Hiltzik of the Los Angeles Times\u003ca title=\"http://www.latimes.com/health/healthcare/la-fi-hiltzik-20120104,0,3519433.column\" href=\"http://www.latimes.com/health/healthcare/la-fi-hiltzik-20120104,0,3519433.column\" target=\"_blank\"> explained in his column\u003c/a> today:\u003c/p>\n\u003cblockquote>\u003cp>Of all the personal information that you might want to keep private, your medical records are the most important. That's why federal and state laws carry stiff penalties, up to and including jail time, for healthcare providers who let such data loose into the wild.\u003c/p>\n\u003cp>So you should be aghast at how free and easy Prime Healthcare Services and two executives at Prime-owned Shasta Regional Medical Center have been with the medical chart of a patient named Darlene Courtois. They showed the entire chart to an editor of her hometown newspaper, and Prime's corporate office divulged some of her medical examination results to me (though I didn't ask for them). They didn't have her permission for those disclosures, her daughter says.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c!--more-->A little background--California Watch had told \u003ca title=\"http://californiawatch.org/health-and-welfare/prime-hospital-bills-malnutrition-patient-says-she-wasn-t-treated-14055\" href=\"http://californiawatch.org/health-and-welfare/prime-hospital-bills-malnutrition-patient-says-she-wasn-t-treated-14055\" target=\"_blank\">Courtois' story\u003c/a> as evidence that Prime had fraudulently billed Medicare. Courtois had been treated at Shasta Medical Center after a fall in early 2010. The hospital had billed Medicare for a rare nutritional disorder, kwashiorkor. But Courtois later requested her medical records. In the 63 pages she received, there was no mention of kwashiorkor, California Watch reported.\u003c/p>\n\u003cp>But the 63 pages apparently were not the complete record. Prime argues that because Courtois had already shared her medical records publicly that she essentially waived her right to privacy. Privacy of medical records is guaranteed under the 1996 Health Insurance Portability and Accountability Act, known as HIPAA. Prime insists it had the right to share other internal documents about her treatment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But Hiltzik didn't buy that argument, nor did many of the legal experts he talked to:\u003c/p>\n\u003cblockquote>\u003cp>Under the law, there's no such thing as an implied authorization by a patient for disclosure of personal records, said Linda Ackerman, a San Francisco expert in privacy law.\u003c/p>\n\u003cp>The office of civil rights of the \u003ca id=\"ORGOV0000126162\" title=\"U.S. Department of Health and Human Services\" href=\"http://www.latimes.com/topic/health/u.s.-department-of-health-human-services-ORGOV0000126162.topic\">U.S. Department of Health and Human Services\u003c/a>, which enforces HIPAA, put it this way: \"There is no 'waiver' that would apply to the release of a chart or medical record to the media without an individual's written authorization.\"\u003c/p>\n\u003cp>Several experts told me it doesn't matter if the hospital was trying to contradict misinformation provided by a patient (even if that's what Courtois did, which is debatable). Under the law, patients themselves can divulge anything they wish about their medical conditions and their treatment by a hospital. But a hospital's obligation is to keep its mouth shut. A desire to deflect bad PR is not an excuse. Even if they think they're in the right, the law says healthcare providers have to suffer in silence, the experts say.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>The whole of Hiltzik's column is a great read, and he ends with a call for prosecutors to step in:\u003c/p>\n\u003cblockquote>\u003cp>The behavior of Prime and Shasta Regional should provide rich fodder for investigations by state and federal agencies and by U.S. prosecutors in Sacramento, who cover Shasta County. Dr. McCampbell holds a California medical license issued in 2005, and it would be worthwhile for the state medical board to look into her participation in this matter and determine whether it meets the standards of professional conduct required of a California licensee.\u003c/p>\n\u003cp>As for the rest of the bigwigs at Prime and Shasta, plainly they all need to be shipped to a reeducation camp in the rules of patient confidentiality. If, that is, they can stay out of jail.\u003c/p>\u003c/blockquote>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_1427\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/ChildCare_ijiwaru-jimbo_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-1427\" title=\"(Ijiwaru Jimbo: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/ChildCare_ijiwaru-jimbo_Flickr-300x225.jpg\" alt=\"(Ijiwaru Jimbo: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ijiwaru Jimbo: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In the nearly \u003ca title=\"http://blogs.kqed.org/capitalnotes/2011/12/13/brown-announces-some-not-all-budget-trigger-cuts/\" href=\"http://blogs.kqed.org/capitalnotes/2011/12/13/brown-announces-some-not-all-budget-trigger-cuts/\" target=\"_blank\">one billion dollars in budget cuts\u003c/a> Governor Jerry Brown put into place on Tuesday were $23 million to child care financing. That's on top of a $110 million reduction in child care from 2010 to 2011. What all these cuts mean is more low income children losing access to child care, making it more difficult for their parents to continue working.\u003c/p>\n\u003cp>If you're wondering what a child care story is doing on a health blog, consider this perspective, provided by the \u003ca title=\"http://www.ccrcla.org/\" href=\"http://www.ccrcla.org/\" target=\"_blank\">Child Care Resource Center\u003c/a> in Los Angeles. After earlier budget cuts, CCRC surveyed its clients. Carissa, a northern Los Angeles County woman who lost her child care subsidy told CCRC she had no choice but to leave her two younger children with her teenage daughter, who quickly become overwhelmed.\u003c/p>\n\u003cblockquote>\u003cp>\"It's very sad when you have a 15-year-old saying 'I can't take it anymore.' Mentally and emotionally, it was too much for her. She had to take care of the children and then be on top of them to do their homework. The two youngest went from being in the honor roll to almost failing.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003c!--more-->The $23 million in cuts means 7,500 California children will lose their child care slots. The irony is that subsidizing child care came out of the \u003ca title=\"http://aspe.hhs.gov/hsp/abbrev/prwora96.htm\" href=\"http://aspe.hhs.gov/hsp/abbrev/prwora96.htm\" target=\"_blank\">1996 federal welfare reform act.\u003c/a> A major reform goal was to get people off welfare and back to work. But in order for mothers to work, they need child care.\u003c/p>\n\u003cp>One northern California woman I spoke to yesterday preferred to remain anonymous, but said she began receiving government assistance in 2006 when her husband died. She was pregnant and had a toddler. She qualified for a child care subsidy, but earlier this year, it was pulled. After a scramble, she qualified for a different program, but in this round of budget cuts, her subsidy is in jeopardy.\u003c/p>\n\u003cblockquote>\u003cp>\"Without the child care, I could not have gone back to school. I was sending them to a child care center. Their hours were 6am-6pm. ... We've been struggling. My children get Social Security benefits, but it's not a lot. ... I've got two years to get the BA to have a good life. I'm so close to being self-sufficient, but I'm consistently stopped. It's just messed up, the whole thing.\"\u003c/p>\u003c/blockquote>\n\u003cp>In addition to school, this woman also works. But what she wants, she told me, is to get her BA so that she will be able to secure higher paid work and get off all aid. Right now, she doesn't know how she will be able to get through these last two years of college if her child care subsidy ends. Child care is expensive everywhere, but according to a study\u003ca title=\"http://www.rrnetwork.org/rr-research-in-action/2011-california-child-care.html\" href=\"http://www.rrnetwork.org/rr-research-in-action/2011-california-child-care.html\" target=\"_blank\"> released yesterday\u003c/a>, the statewide annual average ranges from $6,500 for pre-schoolers to $11,000 for infants. In the Bay Area, those numbers are often much higher.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The stories are similar all over California. Arlyce Currie is the Executive Director of \u003ca title=\"http://www.bananasinc.org/\" href=\"http://www.bananasinc.org/\" target=\"_blank\">Bananas\u003c/a>, a child care resource and referral agency in Oakland. \"We were serving over 1,000 children in 2009 and then everything started crumbling. And it's just so ironic because the problem is we need to put people to work and if they have children, they have to have child care. It's appalling to me that people don't put those two things together.\"\u003c/p>\n\u003cp>In Los Angeles \u003ca title=\"http://www.ccrcla.org/about/leadership/executive-team/executive-team-biographies\" href=\"http://www.ccrcla.org/about/leadership/executive-team/executive-team-biographies\" target=\"_blank\">Michael Olenick\u003c/a>, who heads the Child Care Resource Center, pointed out that in addition to subsidies being lost, child care providers are also going out of business. This further reduces the limited supply of child care slots available, a double whammy of providers losing jobs and the parents of children they care for being unable to continue working.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The number of stories out there, it's just horrendous,\" Olenick said. \"These are people who were contributing to the economy and now they're not.\"\u003c/p>\n\n",
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"excerpt": "In the nearly one billion dollars in budget cuts Governor Jerry Brown put into place on Tuesday were $23 million to child care financing. That's on top of a $110 million reduction in child care from 2010 to 2011. What all these cuts mean is more low income children losing access to child care, making it more difficult for their parents to continue working.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_1427\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/ChildCare_ijiwaru-jimbo_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-1427\" title=\"(Ijiwaru Jimbo: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/ChildCare_ijiwaru-jimbo_Flickr-300x225.jpg\" alt=\"(Ijiwaru Jimbo: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ijiwaru Jimbo: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In the nearly \u003ca title=\"http://blogs.kqed.org/capitalnotes/2011/12/13/brown-announces-some-not-all-budget-trigger-cuts/\" href=\"http://blogs.kqed.org/capitalnotes/2011/12/13/brown-announces-some-not-all-budget-trigger-cuts/\" target=\"_blank\">one billion dollars in budget cuts\u003c/a> Governor Jerry Brown put into place on Tuesday were $23 million to child care financing. That's on top of a $110 million reduction in child care from 2010 to 2011. What all these cuts mean is more low income children losing access to child care, making it more difficult for their parents to continue working.\u003c/p>\n\u003cp>If you're wondering what a child care story is doing on a health blog, consider this perspective, provided by the \u003ca title=\"http://www.ccrcla.org/\" href=\"http://www.ccrcla.org/\" target=\"_blank\">Child Care Resource Center\u003c/a> in Los Angeles. After earlier budget cuts, CCRC surveyed its clients. Carissa, a northern Los Angeles County woman who lost her child care subsidy told CCRC she had no choice but to leave her two younger children with her teenage daughter, who quickly become overwhelmed.\u003c/p>\n\u003cblockquote>\u003cp>\"It's very sad when you have a 15-year-old saying 'I can't take it anymore.' Mentally and emotionally, it was too much for her. She had to take care of the children and then be on top of them to do their homework. The two youngest went from being in the honor roll to almost failing.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003c!--more-->The $23 million in cuts means 7,500 California children will lose their child care slots. The irony is that subsidizing child care came out of the \u003ca title=\"http://aspe.hhs.gov/hsp/abbrev/prwora96.htm\" href=\"http://aspe.hhs.gov/hsp/abbrev/prwora96.htm\" target=\"_blank\">1996 federal welfare reform act.\u003c/a> A major reform goal was to get people off welfare and back to work. But in order for mothers to work, they need child care.\u003c/p>\n\u003cp>One northern California woman I spoke to yesterday preferred to remain anonymous, but said she began receiving government assistance in 2006 when her husband died. She was pregnant and had a toddler. She qualified for a child care subsidy, but earlier this year, it was pulled. After a scramble, she qualified for a different program, but in this round of budget cuts, her subsidy is in jeopardy.\u003c/p>\n\u003cblockquote>\u003cp>\"Without the child care, I could not have gone back to school. I was sending them to a child care center. Their hours were 6am-6pm. ... We've been struggling. My children get Social Security benefits, but it's not a lot. ... I've got two years to get the BA to have a good life. I'm so close to being self-sufficient, but I'm consistently stopped. It's just messed up, the whole thing.\"\u003c/p>\u003c/blockquote>\n\u003cp>In addition to school, this woman also works. But what she wants, she told me, is to get her BA so that she will be able to secure higher paid work and get off all aid. Right now, she doesn't know how she will be able to get through these last two years of college if her child care subsidy ends. Child care is expensive everywhere, but according to a study\u003ca title=\"http://www.rrnetwork.org/rr-research-in-action/2011-california-child-care.html\" href=\"http://www.rrnetwork.org/rr-research-in-action/2011-california-child-care.html\" target=\"_blank\"> released yesterday\u003c/a>, the statewide annual average ranges from $6,500 for pre-schoolers to $11,000 for infants. In the Bay Area, those numbers are often much higher.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The stories are similar all over California. Arlyce Currie is the Executive Director of \u003ca title=\"http://www.bananasinc.org/\" href=\"http://www.bananasinc.org/\" target=\"_blank\">Bananas\u003c/a>, a child care resource and referral agency in Oakland. \"We were serving over 1,000 children in 2009 and then everything started crumbling. And it's just so ironic because the problem is we need to put people to work and if they have children, they have to have child care. It's appalling to me that people don't put those two things together.\"\u003c/p>\n\u003cp>In Los Angeles \u003ca title=\"http://www.ccrcla.org/about/leadership/executive-team/executive-team-biographies\" href=\"http://www.ccrcla.org/about/leadership/executive-team/executive-team-biographies\" target=\"_blank\">Michael Olenick\u003c/a>, who heads the Child Care Resource Center, pointed out that in addition to subsidies being lost, child care providers are also going out of business. This further reduces the limited supply of child care slots available, a double whammy of providers losing jobs and the parents of children they care for being unable to continue working.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The number of stories out there, it's just horrendous,\" Olenick said. \"These are people who were contributing to the economy and now they're not.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How Lawsuits Can Stymie Some Trigger Cuts",
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"content": "\u003cp>By Sarah Varney\u003c/p>\n\u003cfigure id=\"attachment_1365\" class=\"wp-caption alignleft\" style=\"max-width: 180px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/JerryBrown_LeagueofWomenVoters.jpg\">\u003cimg class=\"size-full wp-image-1365\" title=\"(League of Women Voters: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/JerryBrown_LeagueofWomenVoters.jpg\" alt=\"(League of Women Voters: Flickr)\" width=\"180\" height=\"195\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(League of Women Voters: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Trigger cuts have been the weapon of choice in many recent budgetary negotiations, most famously as the Congressional 'Super Committee' failed to come to agreement last month.\u003c/p>\n\u003cp>But in California, where Governor Jerry Brown yesterday announced nearly a billion dollars in additional reductions to state spending, that budget gun is jammed, as advocates for the elderly and mentally and physically disabled have managed to thwart the automatic reductions by asserting that the state's severe cuts -- some $15 billion to health and human services since 2008 -- are beginning to violate federal law.\u003c/p>\n\u003cp>That defense has largely been the result of an aggressive legal strategy by disability rights groups, something witnessed recently when the state aborted a plan to eliminate funding for adult day health care centers in the face of a lawsuit by\u003ca title=\"http://www.disabilityrightsca.org/\" href=\"http://www.disabilityrightsca.org/\" target=\"_blank\"> Disability Rights California\u003c/a>. The centers offer health care services, shared meals and exercise among other activities and, most experts agree, help keep seniors and disabled people out of nursing homes.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The state cuts are running headlong into the Americans with Disabilities Act. \u003c/aside>\n\u003cp>But that's not the only place where state lawyers are busy. Officials in Sacramento are also preparing to defend the recent decision by state lawmakers to reduce what it pays doctors who care for Medicaid recipients before the U.S. Supreme Court. Legal advocates also successfully sued in federal court to stop $100 million in automatic cuts to the state's home care program for the disabled and frail seniors known as In-Home Supportive Services. A hearing has yet to be set.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->Melinda Bird, an attorney with Disability Rights California, based in Los Angeles, says the state cuts are running headlong into the Americans with Disabilities Act, the two decades old civil rights law that bars discrimination based on disability. \"The ADA mandates that people be provided services in the most integrated setting appropriate to their needs,\" says Bird. \"And that means providing the services to people at a home rather than in a nursing home.\" Without home aides to help them bathe, dress, eat and take medications, many of these disabled Californians, says Bird, would end up in costly nursing homes or psychiatric hospitals.\u003c/p>\n\u003cp>Not all of which is bad news for some politicians, says \u003ca title=\"http://www.cbp.org/about/about_staff.html\" href=\"http://www.cbp.org/about/about_staff.html\" target=\"_blank\">Jean Ross\u003c/a>, Executive Director of the \u003ca title=\"http://www.cbp.org/\" href=\"http://www.cbp.org/\" target=\"_blank\">California Budget Project\u003c/a>, a nonpartisan watchdog group. Lawsuits can provide political cover for legislators and agency directors reluctant to cut programs they support, says Ross, but which are vulnerable in tight economic times.\u003c/p>\n\u003cp>\"When the proposed policies the courts in some cases have ruled against were debated before the legislature, advocates [and] others would raise the concern that they might not pass judicial muster,\" says Ross. In several cases, those familiar with the budget process say, lawmakers approve budget reductions knowing that the courts will likely stop them from going into effect.\u003c/p>\n\u003cp>In some cases, advocates for such programs are also just stalling for time. Attorneys can slow budget cuts down by arguing that recipients of public programs haven't received adequate notice, says Mike Herald, a legislative advocate for the \u003ca title=\"http://www.wclp.org/\" href=\"http://www.wclp.org/\" target=\"_blank\">Western Center on Law and Poverty\u003c/a> in Sacramento. He cited a suit that his group filed against former Governor Arnold Schwarzenegger after that adminstration sought to cut child care programs for the working poor.\u003c/p>\n\u003cp>\"We were able to go and get a judge to say, 'No, you've got to send out a notice that gives people 30 days advance warning,'\" says Herald. \"That pushed back the whole schedule and by then we had a new governor, and then voila he changed his position and the cuts never really went into effect.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That said, Mr. Herald and others legal advocate insist they do not just sit on the sidelines waiting to file lawsuits, saying that they would much rather negotiate up front with lawmakers to find ways to save money and preserve vital programs. But trying to make deals with anyone in a state with as many money problems as California can be difficult.\u003c/p>\n\n",
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"excerpt": "Trigger cuts have been the weapon of choice in many recent budgetary negotiations, most famously as the Congressional 'Super Committee' failed to come to agreement last month.\r\n\r\nBut in California, where Governor Jerry Brown yesterday announced nearly a billion dollars in additional reductions to state spending, that budget gun is jammed, as advocates for the elderly and mentally and physically disabled have managed to thwart the automatic reductions by asserting that the state's severe cuts -- some $15 billion to health and human services since 2008 -- are beginning to violate federal law.",
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"description": "Trigger cuts have been the weapon of choice in many recent budgetary negotiations, most famously as the Congressional 'Super Committee' failed to come to agreement last month.\r\n\r\nBut in California, where Governor Jerry Brown yesterday announced nearly a billion dollars in additional reductions to state spending, that budget gun is jammed, as advocates for the elderly and mentally and physically disabled have managed to thwart the automatic reductions by asserting that the state's severe cuts -- some $15 billion to health and human services since 2008 -- are beginning to violate federal law.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Sarah Varney\u003c/p>\n\u003cfigure id=\"attachment_1365\" class=\"wp-caption alignleft\" style=\"max-width: 180px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/JerryBrown_LeagueofWomenVoters.jpg\">\u003cimg class=\"size-full wp-image-1365\" title=\"(League of Women Voters: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/JerryBrown_LeagueofWomenVoters.jpg\" alt=\"(League of Women Voters: Flickr)\" width=\"180\" height=\"195\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(League of Women Voters: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Trigger cuts have been the weapon of choice in many recent budgetary negotiations, most famously as the Congressional 'Super Committee' failed to come to agreement last month.\u003c/p>\n\u003cp>But in California, where Governor Jerry Brown yesterday announced nearly a billion dollars in additional reductions to state spending, that budget gun is jammed, as advocates for the elderly and mentally and physically disabled have managed to thwart the automatic reductions by asserting that the state's severe cuts -- some $15 billion to health and human services since 2008 -- are beginning to violate federal law.\u003c/p>\n\u003cp>That defense has largely been the result of an aggressive legal strategy by disability rights groups, something witnessed recently when the state aborted a plan to eliminate funding for adult day health care centers in the face of a lawsuit by\u003ca title=\"http://www.disabilityrightsca.org/\" href=\"http://www.disabilityrightsca.org/\" target=\"_blank\"> Disability Rights California\u003c/a>. The centers offer health care services, shared meals and exercise among other activities and, most experts agree, help keep seniors and disabled people out of nursing homes.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The state cuts are running headlong into the Americans with Disabilities Act. \u003c/aside>\n\u003cp>But that's not the only place where state lawyers are busy. Officials in Sacramento are also preparing to defend the recent decision by state lawmakers to reduce what it pays doctors who care for Medicaid recipients before the U.S. Supreme Court. Legal advocates also successfully sued in federal court to stop $100 million in automatic cuts to the state's home care program for the disabled and frail seniors known as In-Home Supportive Services. A hearing has yet to be set.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->Melinda Bird, an attorney with Disability Rights California, based in Los Angeles, says the state cuts are running headlong into the Americans with Disabilities Act, the two decades old civil rights law that bars discrimination based on disability. \"The ADA mandates that people be provided services in the most integrated setting appropriate to their needs,\" says Bird. \"And that means providing the services to people at a home rather than in a nursing home.\" Without home aides to help them bathe, dress, eat and take medications, many of these disabled Californians, says Bird, would end up in costly nursing homes or psychiatric hospitals.\u003c/p>\n\u003cp>Not all of which is bad news for some politicians, says \u003ca title=\"http://www.cbp.org/about/about_staff.html\" href=\"http://www.cbp.org/about/about_staff.html\" target=\"_blank\">Jean Ross\u003c/a>, Executive Director of the \u003ca title=\"http://www.cbp.org/\" href=\"http://www.cbp.org/\" target=\"_blank\">California Budget Project\u003c/a>, a nonpartisan watchdog group. Lawsuits can provide political cover for legislators and agency directors reluctant to cut programs they support, says Ross, but which are vulnerable in tight economic times.\u003c/p>\n\u003cp>\"When the proposed policies the courts in some cases have ruled against were debated before the legislature, advocates [and] others would raise the concern that they might not pass judicial muster,\" says Ross. In several cases, those familiar with the budget process say, lawmakers approve budget reductions knowing that the courts will likely stop them from going into effect.\u003c/p>\n\u003cp>In some cases, advocates for such programs are also just stalling for time. Attorneys can slow budget cuts down by arguing that recipients of public programs haven't received adequate notice, says Mike Herald, a legislative advocate for the \u003ca title=\"http://www.wclp.org/\" href=\"http://www.wclp.org/\" target=\"_blank\">Western Center on Law and Poverty\u003c/a> in Sacramento. He cited a suit that his group filed against former Governor Arnold Schwarzenegger after that adminstration sought to cut child care programs for the working poor.\u003c/p>\n\u003cp>\"We were able to go and get a judge to say, 'No, you've got to send out a notice that gives people 30 days advance warning,'\" says Herald. \"That pushed back the whole schedule and by then we had a new governor, and then voila he changed his position and the cuts never really went into effect.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That said, Mr. Herald and others legal advocate insist they do not just sit on the sidelines waiting to file lawsuits, saying that they would much rather negotiate up front with lawmakers to find ways to save money and preserve vital programs. But trying to make deals with anyone in a state with as many money problems as California can be difficult.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Should Older Adults be Screened for Cancer?",
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"content": "\u003cfigure id=\"attachment_1314\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Grandparents_JasonDeRusha_Flickr_12132011.jpg\">\u003cimg class=\"size-medium wp-image-1314\" title=\"(Jason DeRusha: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Grandparents_JasonDeRusha_Flickr_12132011-300x200.jpg\" alt=\"(Jason DeRusha: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Jason DeRusha: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Right about now, you might be thinking you've heard enough of cancer screening. From mammography to prostate cancer, cancer screening tests have been much debated this fall. \u003ca title=\"http://www.npr.org/templates/story/story.php?storyId=120493002\" href=\"http://www.npr.org/templates/story/story.php?storyId=120493002\" target=\"_blank\">Should a 40 year old woman get a mammogram or not\u003c/a>? \u003ca title=\"http://www.npr.org/blogs/health/2011/10/07/141148384/influential-panel-giving-thumbs-down-to-prostate-blood-test\" href=\"http://www.npr.org/blogs/health/2011/10/07/141148384/influential-panel-giving-thumbs-down-to-prostate-blood-test\" target=\"_blank\">Should men abandon the PSA test\u003c/a>? Yet another study released this week looks at a surprisingly unexplored group--older Americans.\u003c/p>\n\u003cp>Researchers wanted to look at this group because of an \"ambiguity of recommendations\" for them. While it seems like there's some ambiguity for the rest of us, the ambiguity here is particularly surprising since age is perhaps the most significant risk factor for many cancers.\u003c/p>\n\u003cp>\u003c!--more-->The study, \"\u003ca href=\"http://archinte.ama-assn.org/cgi/content/short/171/22/2031\" target=\"_blank\">Prevalence of Cancer Screening in Older, Racially Diverse Adults\u003c/a>\u003cem>,\u003c/em>\" appears in the Archives of Internal Medicine and found that, among adults aged 75 to 79, the screening rates for colorectal, breast, cervical and prostate cancer were between 56 and 62 percent. Screening rates are lower for older adults who are not white.\u003c/p>\n\u003cp>But are these rates good or bad? Too high or too low? The major organizations that issue guidelines on screening are divided on age cutoffs, as are many doctors. \u003ca title=\"http://geriatrics.medicine.ucsf.edu/facstaff/walter.html\" href=\"http://geriatrics.medicine.ucsf.edu/facstaff/walter.html\" target=\"_blank\">Dr. Louise Walter of UC San Francisco's Division of Geriatrics\u003c/a>, captures that divide in a commentary that accompanies the published study:\u003c/p>\n\u003cblockquote>\u003cp>\"Some had advocated for high breast and colorectal cancer screening rates in healthy older adults because the incidence and mortality of these cancers increase with age. ... Others have advocated for low cancer screening rates in persons older than 75 years because the benefit of continuing screening is uncertain and screening can cause substantial harm, especially in frail, older adults.\"\u003c/p>\u003c/blockquote>\n\u003cp>In an interview, Walter spoke of experiences from her own practice. \"I have 80-year-olds hiking in mountains ... and likely to live a long time, and I have people who have serious medical issues, dementia and life limiting disease.\" The types of preventive care she would recommend for these two patients, she says, is very different and not based on age, but on their overall health status.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The study also found that nearly one in ten patients with terminal cancer still received screening tests for breast, cervical or prostate cancer. Walter described cases of older women who have had a hysterectomy, including removal of the cervix, yet still receive Pap smears to test for cervical cancer.\u003c/p>\n\u003cp>\"The thing I try to emphasis is let's do thoughtful cancer screening. Let's avoid cancer screening in someone without a cervix, someone who is in a nursing home, very frail.\" While people often think of screening tests as fairly benign, a positive result can lead to more and more invasive procedures to confirm a diagnosis, invasive procedures that can be very difficult for frail patients to withstand.\u003c/p>\n\u003cp>This study underscores the need for \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" href=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" target=\"_blank\">doctors to talk with older patients about their overall prognosis.\u003c/a> Walter pointed out that screening tests can become a \"distraction\" from someone's overall health concerns. \"If you had a recent heart attack, that's your major problem. Any major problem should make you rethink, 'Why am I looking for an asymptomatic problem that I probably don't have?'\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "From mammography to prostate cancer, cancer screening tests have been much debated this fall. Yet another study released this week looks at a surprisingly unexplored group--older Americans. Researchers wanted to look at this group because of an \"ambiguity of recommendations\" for them. This ambiguity is surprising since age is perhaps the most significant risk factor for many cancers.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_1314\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Grandparents_JasonDeRusha_Flickr_12132011.jpg\">\u003cimg class=\"size-medium wp-image-1314\" title=\"(Jason DeRusha: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Grandparents_JasonDeRusha_Flickr_12132011-300x200.jpg\" alt=\"(Jason DeRusha: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Jason DeRusha: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Right about now, you might be thinking you've heard enough of cancer screening. From mammography to prostate cancer, cancer screening tests have been much debated this fall. \u003ca title=\"http://www.npr.org/templates/story/story.php?storyId=120493002\" href=\"http://www.npr.org/templates/story/story.php?storyId=120493002\" target=\"_blank\">Should a 40 year old woman get a mammogram or not\u003c/a>? \u003ca title=\"http://www.npr.org/blogs/health/2011/10/07/141148384/influential-panel-giving-thumbs-down-to-prostate-blood-test\" href=\"http://www.npr.org/blogs/health/2011/10/07/141148384/influential-panel-giving-thumbs-down-to-prostate-blood-test\" target=\"_blank\">Should men abandon the PSA test\u003c/a>? Yet another study released this week looks at a surprisingly unexplored group--older Americans.\u003c/p>\n\u003cp>Researchers wanted to look at this group because of an \"ambiguity of recommendations\" for them. While it seems like there's some ambiguity for the rest of us, the ambiguity here is particularly surprising since age is perhaps the most significant risk factor for many cancers.\u003c/p>\n\u003cp>\u003c!--more-->The study, \"\u003ca href=\"http://archinte.ama-assn.org/cgi/content/short/171/22/2031\" target=\"_blank\">Prevalence of Cancer Screening in Older, Racially Diverse Adults\u003c/a>\u003cem>,\u003c/em>\" appears in the Archives of Internal Medicine and found that, among adults aged 75 to 79, the screening rates for colorectal, breast, cervical and prostate cancer were between 56 and 62 percent. Screening rates are lower for older adults who are not white.\u003c/p>\n\u003cp>But are these rates good or bad? Too high or too low? The major organizations that issue guidelines on screening are divided on age cutoffs, as are many doctors. \u003ca title=\"http://geriatrics.medicine.ucsf.edu/facstaff/walter.html\" href=\"http://geriatrics.medicine.ucsf.edu/facstaff/walter.html\" target=\"_blank\">Dr. Louise Walter of UC San Francisco's Division of Geriatrics\u003c/a>, captures that divide in a commentary that accompanies the published study:\u003c/p>\n\u003cblockquote>\u003cp>\"Some had advocated for high breast and colorectal cancer screening rates in healthy older adults because the incidence and mortality of these cancers increase with age. ... Others have advocated for low cancer screening rates in persons older than 75 years because the benefit of continuing screening is uncertain and screening can cause substantial harm, especially in frail, older adults.\"\u003c/p>\u003c/blockquote>\n\u003cp>In an interview, Walter spoke of experiences from her own practice. \"I have 80-year-olds hiking in mountains ... and likely to live a long time, and I have people who have serious medical issues, dementia and life limiting disease.\" The types of preventive care she would recommend for these two patients, she says, is very different and not based on age, but on their overall health status.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The study also found that nearly one in ten patients with terminal cancer still received screening tests for breast, cervical or prostate cancer. Walter described cases of older women who have had a hysterectomy, including removal of the cervix, yet still receive Pap smears to test for cervical cancer.\u003c/p>\n\u003cp>\"The thing I try to emphasis is let's do thoughtful cancer screening. Let's avoid cancer screening in someone without a cervix, someone who is in a nursing home, very frail.\" While people often think of screening tests as fairly benign, a positive result can lead to more and more invasive procedures to confirm a diagnosis, invasive procedures that can be very difficult for frail patients to withstand.\u003c/p>\n\u003cp>This study underscores the need for \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" href=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" target=\"_blank\">doctors to talk with older patients about their overall prognosis.\u003c/a> Walter pointed out that screening tests can become a \"distraction\" from someone's overall health concerns. \"If you had a recent heart attack, that's your major problem. Any major problem should make you rethink, 'Why am I looking for an asymptomatic problem that I probably don't have?'\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "One Woman's Apology to President Obama",
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"content": "\u003cfigure id=\"attachment_1175\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/230136_President-Obama-signs-Health-Reform-Law3.jpg\">\u003cimg class=\"size-medium wp-image-1175\" title=\"President Obama signs health care reform law. (Photo: White House)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/230136_President-Obama-signs-Health-Reform-Law3-300x200.jpg\" alt=\"President Obama signs health care reform law. (Photo: White House)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">President Obama signs health care reform law. (Photo: White House)\u003c/figcaption>\u003c/figure>\n\u003cp>Earlier this week, the \u003cem>Los Angeles Times\u003c/em> published an opinion piece from Spike Dolomite Ward, a San Fernando Valley woman who ended up uninsured.\u003c/p>\n\u003cp>Her story sparked heated debate on the Times' discussion board -- 1,190 comments so far. It's worth reading her \u003ca title=\"http://www.latimes.com/news/opinion/commentary/la-oe-ward-in-praise-of-obamacare-20111206,0,6794828.story\" href=\"http://www.latimes.com/news/opinion/commentary/la-oe-ward-in-praise-of-obamacare-20111206,0,6794828.story\" target=\"_blank\">entire essay\u003c/a>, but I excerpt it here and include some of the more pointed reader comments at the end.\u003c/p>\n\u003cblockquote>\u003cp>I want to apologize to President Obama. But first, some background.\u003c/p>\n\u003cp>I found out three weeks ago I have cancer. I'm 49 years old, have been married for almost 20 years and have two kids. My husband has his own small computer business, and I run a small nonprofit in the San Fernando Valley. I am also an artist. Money is tight, and we don't spend it frivolously. ...\u003c/p>\n\u003cp>\u003c!--more-->We're good people, and we work hard. But we haven't been able to afford health insurance for more than two years. And now I have third-stage breast cancer and am facing months of expensive treatment.\u003c/p>\n\u003cp>To understand how such a thing could happen to a family like ours, I need to take you back nine years to when my husband got laid off from the entertainment company where he'd worked for 10 years. Until then, we had been insured through his work, with a first-rate plan. After he got laid off, we got to keep that health insurance for 18 months through COBRA, by paying $1,300 a month, which was a huge burden on an unemployed father and his family.\u003c/p>\n\u003cp>By the time the COBRA ran out, my husband had decided to go into business for himself, so we had to purchase our own insurance. That was fine for a while. Every year his business grew. But insurance premiums were steadily rising too. ...\u003c/p>\n\u003cp>With the recession, both of our businesses took a huge hit. ... We had to start using a home equity line of credit to pay for our health insurance premiums (which by that point cost as much as our monthly mortgage). When the bank capped our home equity line, we were forced to cash in my husband's IRA. The time finally came when we had to make a choice between paying our mortgage or paying for health insurance. We chose to keep our house. We made a nerve-racking gamble, and we lost.\u003c/p>\n\u003cp>Not having insurance amplifies cancer stress. After the diagnosis, instead of focusing all of my energy on getting well, I was panicked about how we were going to pay for everything. I felt guilty and embarrassed about not being insured.\u003c/p>\u003c/blockquote>\n\u003cp>Despite the embarrassment, she decided to \"out\" herself in the \u003cem>Times\u003c/em>. \"What I want people to understand,\" she writes, \"is that, if this could happen to us, it could happen to anybody.\"\u003c/p>\n\u003cblockquote>\u003cp>Fortunately for me, I've been saved by the federal government's Pre-existing Condition Insurance Plan, something I had never heard of before needing it. It's part of President Obama's healthcare plan, one of the things that has already kicked in, and it guarantees access to insurance for U.S. citizens with preexisting conditions who have been uninsured for at least six months. The application was short, the premiums are affordable, and I have found the people who work in the administration office to be quite compassionate ...\u003c/p>\n\u003cp>Which brings me to my apology. I was pretty mad at Obama before I learned about this new insurance plan. I had changed my registration from Democrat to Independent, and I had blacked out the top of the \"h\" on my Obama bumper sticker, so that it read, \"Got nope\" instead of \"got hope.\" I felt like he had let down the struggling middle class. My son and I had campaigned for him, but since he took office, we felt he had let us down.\u003c/p>\n\u003cp>So this is my public apology. I'm sorry I didn't do enough of my own research to find out what promises the president has made good on. I'm sorry I didn't realize that he really has stood up for me and my family, and for so many others like us. I'm getting a new bumper sticker to cover the one that says \"Got nope.\" It will say \"ObamaCares.\"\u003c/p>\u003c/blockquote>\n\u003cp>Her essay ends there, but the story does not. As noted above, this piece sparked an intense debate. Here are just a few of the comments:\u003c/p>\n\u003cblockquote>\u003cp>\u003cstrong>llyKerwin\u003c/strong> at 10:31 PM December 8, 2011\u003c/p>\n\u003cp>You're a good person because you have a house? No, you are not. You chose owning real estate over insuring yourself. I have no idea if that makes you a bad person, but it is absolutely not a virtue.\u003c/p>\n\u003cp>If you make money on that house, are you willing to share it with the taxpayers who are forced to subsidize your health care because you chose to keep a potentially appreciating asset?\u003c/p>\n\u003cp>\u003cstrong>WordsMatter\u003c/strong> at 6:12 PM December 8, 2011\u003c/p>\n\u003cp>Dear Spike Dolomite Ward, Let me get this straight. Because you were irresponsible and didn't plan for your health needs, I am paying for your irresponsibility. Right? Right! Your on the healthcare welfare roll because you made bad decisions that we're all having to pay for now.\u003c/p>\n\u003cp>\u003cstrong>Computer Forensics Expert\u003c/strong> at 2:53 PM December 8, 2011\u003c/p>\n\u003cp>... Compassion? As a working slob, why should I have to go out, work my butt off and then have my tax money spent on someone who chooses to be a \"free spirit\" artist and working for a non-profit, instead of assuming some personal responsibilty and getting a REAL job?\u003c/p>\n\u003cp>Now, Spike Dolomite Ward gets a government handout at our expense. Well, Spike, guess what? You are no different than the bum on the street or the person living in Bel-Air. People make choices, and you are a victim of your own devices.\u003c/p>\n\u003cp>Nobama in 2012. NO MORE TAKERS!!!!\u003c/p>\u003c/blockquote>\n\u003cp>Yesterday, the \u003cem>Times\u003c/em> ran a response from Ward:\u003c/p>\n\u003cblockquote>\u003cp>My husband and I both knew that by doing this, we would invite hatred into our lives, and that indeed has happened. To those of you who don’t want to see the commonalities between me and my family, let me pose it to you this way: If your sister or mother lost her job and health insurance, and then turned up with breast cancer, what would you do? Would you let her die? Would you pick up the cancer tab yourself?, or would you tell her about PCIP?\u003c/p>\u003c/blockquote>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Earlier this week, the Los Angeles Times published an opinion piece from Spike Dolomite Ward, a San Fernando Valley resident who ended up uninsured.\r\n\r\nHer story sparked heated debate on the Times' discussion board -- 1,190 comments so far. It's worth reading her entire essay, but I excerpt it here and include some of the more pointed reader comments at the end.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_1175\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/230136_President-Obama-signs-Health-Reform-Law3.jpg\">\u003cimg class=\"size-medium wp-image-1175\" title=\"President Obama signs health care reform law. (Photo: White House)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/230136_President-Obama-signs-Health-Reform-Law3-300x200.jpg\" alt=\"President Obama signs health care reform law. (Photo: White House)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">President Obama signs health care reform law. (Photo: White House)\u003c/figcaption>\u003c/figure>\n\u003cp>Earlier this week, the \u003cem>Los Angeles Times\u003c/em> published an opinion piece from Spike Dolomite Ward, a San Fernando Valley woman who ended up uninsured.\u003c/p>\n\u003cp>Her story sparked heated debate on the Times' discussion board -- 1,190 comments so far. It's worth reading her \u003ca title=\"http://www.latimes.com/news/opinion/commentary/la-oe-ward-in-praise-of-obamacare-20111206,0,6794828.story\" href=\"http://www.latimes.com/news/opinion/commentary/la-oe-ward-in-praise-of-obamacare-20111206,0,6794828.story\" target=\"_blank\">entire essay\u003c/a>, but I excerpt it here and include some of the more pointed reader comments at the end.\u003c/p>\n\u003cblockquote>\u003cp>I want to apologize to President Obama. But first, some background.\u003c/p>\n\u003cp>I found out three weeks ago I have cancer. I'm 49 years old, have been married for almost 20 years and have two kids. My husband has his own small computer business, and I run a small nonprofit in the San Fernando Valley. I am also an artist. Money is tight, and we don't spend it frivolously. ...\u003c/p>\n\u003cp>\u003c!--more-->We're good people, and we work hard. But we haven't been able to afford health insurance for more than two years. And now I have third-stage breast cancer and am facing months of expensive treatment.\u003c/p>\n\u003cp>To understand how such a thing could happen to a family like ours, I need to take you back nine years to when my husband got laid off from the entertainment company where he'd worked for 10 years. Until then, we had been insured through his work, with a first-rate plan. After he got laid off, we got to keep that health insurance for 18 months through COBRA, by paying $1,300 a month, which was a huge burden on an unemployed father and his family.\u003c/p>\n\u003cp>By the time the COBRA ran out, my husband had decided to go into business for himself, so we had to purchase our own insurance. That was fine for a while. Every year his business grew. But insurance premiums were steadily rising too. ...\u003c/p>\n\u003cp>With the recession, both of our businesses took a huge hit. ... We had to start using a home equity line of credit to pay for our health insurance premiums (which by that point cost as much as our monthly mortgage). When the bank capped our home equity line, we were forced to cash in my husband's IRA. The time finally came when we had to make a choice between paying our mortgage or paying for health insurance. We chose to keep our house. We made a nerve-racking gamble, and we lost.\u003c/p>\n\u003cp>Not having insurance amplifies cancer stress. After the diagnosis, instead of focusing all of my energy on getting well, I was panicked about how we were going to pay for everything. I felt guilty and embarrassed about not being insured.\u003c/p>\u003c/blockquote>\n\u003cp>Despite the embarrassment, she decided to \"out\" herself in the \u003cem>Times\u003c/em>. \"What I want people to understand,\" she writes, \"is that, if this could happen to us, it could happen to anybody.\"\u003c/p>\n\u003cblockquote>\u003cp>Fortunately for me, I've been saved by the federal government's Pre-existing Condition Insurance Plan, something I had never heard of before needing it. It's part of President Obama's healthcare plan, one of the things that has already kicked in, and it guarantees access to insurance for U.S. citizens with preexisting conditions who have been uninsured for at least six months. The application was short, the premiums are affordable, and I have found the people who work in the administration office to be quite compassionate ...\u003c/p>\n\u003cp>Which brings me to my apology. I was pretty mad at Obama before I learned about this new insurance plan. I had changed my registration from Democrat to Independent, and I had blacked out the top of the \"h\" on my Obama bumper sticker, so that it read, \"Got nope\" instead of \"got hope.\" I felt like he had let down the struggling middle class. My son and I had campaigned for him, but since he took office, we felt he had let us down.\u003c/p>\n\u003cp>So this is my public apology. I'm sorry I didn't do enough of my own research to find out what promises the president has made good on. I'm sorry I didn't realize that he really has stood up for me and my family, and for so many others like us. I'm getting a new bumper sticker to cover the one that says \"Got nope.\" It will say \"ObamaCares.\"\u003c/p>\u003c/blockquote>\n\u003cp>Her essay ends there, but the story does not. As noted above, this piece sparked an intense debate. Here are just a few of the comments:\u003c/p>\n\u003cblockquote>\u003cp>\u003cstrong>llyKerwin\u003c/strong> at 10:31 PM December 8, 2011\u003c/p>\n\u003cp>You're a good person because you have a house? No, you are not. You chose owning real estate over insuring yourself. I have no idea if that makes you a bad person, but it is absolutely not a virtue.\u003c/p>\n\u003cp>If you make money on that house, are you willing to share it with the taxpayers who are forced to subsidize your health care because you chose to keep a potentially appreciating asset?\u003c/p>\n\u003cp>\u003cstrong>WordsMatter\u003c/strong> at 6:12 PM December 8, 2011\u003c/p>\n\u003cp>Dear Spike Dolomite Ward, Let me get this straight. Because you were irresponsible and didn't plan for your health needs, I am paying for your irresponsibility. Right? Right! Your on the healthcare welfare roll because you made bad decisions that we're all having to pay for now.\u003c/p>\n\u003cp>\u003cstrong>Computer Forensics Expert\u003c/strong> at 2:53 PM December 8, 2011\u003c/p>\n\u003cp>... Compassion? As a working slob, why should I have to go out, work my butt off and then have my tax money spent on someone who chooses to be a \"free spirit\" artist and working for a non-profit, instead of assuming some personal responsibilty and getting a REAL job?\u003c/p>\n\u003cp>Now, Spike Dolomite Ward gets a government handout at our expense. Well, Spike, guess what? You are no different than the bum on the street or the person living in Bel-Air. People make choices, and you are a victim of your own devices.\u003c/p>\n\u003cp>Nobama in 2012. NO MORE TAKERS!!!!\u003c/p>\u003c/blockquote>\n\u003cp>Yesterday, the \u003cem>Times\u003c/em> ran a response from Ward:\u003c/p>\n\u003cblockquote>\u003cp>My husband and I both knew that by doing this, we would invite hatred into our lives, and that indeed has happened. To those of you who don’t want to see the commonalities between me and my family, let me pose it to you this way: If your sister or mother lost her job and health insurance, and then turned up with breast cancer, what would you do? Would you let her die? Would you pick up the cancer tab yourself?, or would you tell her about PCIP?\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cfigure id=\"attachment_932\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/CareNowHealthClinicUninsuredLosAngeles102111.jpg\">\u003cimg class=\"size-medium wp-image-932\" title=\"The number of young registered nurses entering the workforce more than doubled in the past decade. (photo: Krissy Clark/KQED)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/CareNowHealthClinicUninsuredLosAngeles102111-300x225.jpg\" alt=\"The number of young registered nurses entering the workforce more than doubled in the past decade. (photo: Krissy Clark/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The number of young registered nurses entering the workforce more than doubled in the past decade. (photo: Krissy Clark/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>From the 1980s to the 2000s, the number of young people going into nursing schools plummeted -- both nationally and in California. To reverse the trend, the government launched recruitment efforts to to spur more people to go into nursing.\u003c/p>\n\u003cp>It looks like they did a pretty good job. The number of registered nurses nationwide skyrocketed in the past decade, according to a study released in today's Health Affairs. Recent grads aged 23-26 increased by 62 percent. There hasn't been a spike in nursing grads like this in the U.S. since the 1970s.\u003c/p>\n\u003caside class=\"pullquote alignright\">There hasn't been a spike in nursing graduates like this in the U.S. since the 1970s.\u003c/aside>\n\u003cp>And it's no different in California. Nursing school enrollments have doubled in the past decade, says Joanne Spetz, a nursing professor at UCSF and co-author of \u003ca title=\"California Nursing Forecast\" href=\"http://www.rn.ca.gov/pdfs/forms/forecasts2011.pdf\" target=\"_blank\">a UCSF report\u003c/a> looking at California's nursing forecast. The report shows that in the past five years, the number of California nursing graduates has doubled. Spetz says that's because California also made huge efforts to recruit nursing students, like implementing accelerated degree programs.\u003c/p>\n\u003cp>\u003c!--more-->As the \u003ca title=\"Sac Bee Nursing Graduates\" href=\"http://www.sacbee.com/2011/12/04/4097980/new-california-nursing-graduates.html\" target=\"_blank\">Sacramento Bee\u003c/a> reported yesterday:\u003c/p>\n\u003cblockquote>\u003cp>California has spent at least $95 million in federal, state and private funds in the past decade to double the number of nursing graduates by expanding college programs and grants. As recently as three years ago, hospitals were offering moving expenses, housing allowances and signing bonuses to recent graduates of nursing schools.\u003c/p>\u003c/blockquote>\n\u003cp>Spetz says with the recession lingering, older nurses aren't retiring and hospitals aren't hiring. And that means it's harder for nurses across the country, including California, to find jobs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Now, there may actually be a surplus of nurses in California. But it depends on where you live.\u003c/p>\n\u003cp>\"In the Inland Empire and in some of the more rural areas, there is definitely a sense that there is shortage of nurses still,\" Spetz said. \"But in other parts of the state like the Bay Area and Sacramento I think that people are looking for work and can't find because there's so many nurses in those regions already.\"\u003c/p>\n\u003cp>So should prospective nursing students find a new career path? Absolutely not, said Spetz. In the coming years, more recent graduates will be more likely to find jobs in California.\u003c/p>\n\u003cp>\"The Baby Boomer will retire [from nursing] at the same time that they will need more health care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Spetz says it's important to keep recent nursing grads engaged -- through internships and other programs -- so that when Baby Boomers do retire and there are more jobs available those nurses can step right into them. But in the meantime, recent grads may have a hard time finding a job.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_932\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/CareNowHealthClinicUninsuredLosAngeles102111.jpg\">\u003cimg class=\"size-medium wp-image-932\" title=\"The number of young registered nurses entering the workforce more than doubled in the past decade. (photo: Krissy Clark/KQED)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/CareNowHealthClinicUninsuredLosAngeles102111-300x225.jpg\" alt=\"The number of young registered nurses entering the workforce more than doubled in the past decade. (photo: Krissy Clark/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The number of young registered nurses entering the workforce more than doubled in the past decade. (photo: Krissy Clark/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>From the 1980s to the 2000s, the number of young people going into nursing schools plummeted -- both nationally and in California. To reverse the trend, the government launched recruitment efforts to to spur more people to go into nursing.\u003c/p>\n\u003cp>It looks like they did a pretty good job. The number of registered nurses nationwide skyrocketed in the past decade, according to a study released in today's Health Affairs. Recent grads aged 23-26 increased by 62 percent. There hasn't been a spike in nursing grads like this in the U.S. since the 1970s.\u003c/p>\n\u003caside class=\"pullquote alignright\">There hasn't been a spike in nursing graduates like this in the U.S. since the 1970s.\u003c/aside>\n\u003cp>And it's no different in California. Nursing school enrollments have doubled in the past decade, says Joanne Spetz, a nursing professor at UCSF and co-author of \u003ca title=\"California Nursing Forecast\" href=\"http://www.rn.ca.gov/pdfs/forms/forecasts2011.pdf\" target=\"_blank\">a UCSF report\u003c/a> looking at California's nursing forecast. The report shows that in the past five years, the number of California nursing graduates has doubled. Spetz says that's because California also made huge efforts to recruit nursing students, like implementing accelerated degree programs.\u003c/p>\n\u003cp>\u003c!--more-->As the \u003ca title=\"Sac Bee Nursing Graduates\" href=\"http://www.sacbee.com/2011/12/04/4097980/new-california-nursing-graduates.html\" target=\"_blank\">Sacramento Bee\u003c/a> reported yesterday:\u003c/p>\n\u003cblockquote>\u003cp>California has spent at least $95 million in federal, state and private funds in the past decade to double the number of nursing graduates by expanding college programs and grants. As recently as three years ago, hospitals were offering moving expenses, housing allowances and signing bonuses to recent graduates of nursing schools.\u003c/p>\u003c/blockquote>\n\u003cp>Spetz says with the recession lingering, older nurses aren't retiring and hospitals aren't hiring. And that means it's harder for nurses across the country, including California, to find jobs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now, there may actually be a surplus of nurses in California. But it depends on where you live.\u003c/p>\n\u003cp>\"In the Inland Empire and in some of the more rural areas, there is definitely a sense that there is shortage of nurses still,\" Spetz said. \"But in other parts of the state like the Bay Area and Sacramento I think that people are looking for work and can't find because there's so many nurses in those regions already.\"\u003c/p>\n\u003cp>So should prospective nursing students find a new career path? Absolutely not, said Spetz. In the coming years, more recent graduates will be more likely to find jobs in California.\u003c/p>\n\u003cp>\"The Baby Boomer will retire [from nursing] at the same time that they will need more health care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Spetz says it's important to keep recent nursing grads engaged -- through internships and other programs -- so that when Baby Boomers do retire and there are more jobs available those nurses can step right into them. But in the meantime, recent grads may have a hard time finding a job.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How one health system persuaded its doctors to change. Hint: It wasn't easy.",
"title": "How one health system persuaded its doctors to change. Hint: It wasn't easy.",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_730\" class=\"wp-caption alignleft\" style=\"max-width: 225px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/WomanReceivesC_Section_BrettNeilson_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-730 \" title='Women who received an \"adhesion barrier\" after a cesarian section had no better outcomes. (Brett Neilson: Flickr)' src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/WomanReceivesC_Section_BrettNeilson_Flickr-300x400.jpg\" alt='Women who received an \"adhesion barrier\" after a cesarian section had no better outcomes. (Brett Neilson: Flickr)' width=\"225\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Women who received an \"adhesion barrier\" after a cesarian section had no better outcomes. (Brett Neilson: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By: \u003ca title=\"http://centerforhealthreporting.org/blogs/emily-bazar\" href=\"http://centerforhealthreporting.org/blogs/emily-bazar\" target=\"_blank\">Emily Bazar\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>The \u003ca href=\"http://www.bannerhealth.com/\" target=\"_blank\">Banner Health\u003c/a> system, which stretches from Alaska to Arizona, delivers about 30,000 babies a year, about a third by \u003ca href=\"http://www.nlm.nih.gov/medlineplus/ency/article/002911.htm\" target=\"_blank\">cesarean section\u003c/a>.\u003c/p>\n\u003cp>When Banner officials scoured their data, they found wildly different patterns in how those C-sections were performed.\u003c/p>\n\u003cp>That was the easy part. Getting doctors to change their behavior proved more challenging.\u003c/p>\n\u003cp>“We realized just asking them was not going to cut it,” said Ken Welch, chief medical officer of Banner Estrella Medical Center in Phoenix.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"http://www.centerforhealthreporting.org/article/health-systems-find-nexus-between-improved-patient-care-and-lower-costs693\" target=\"_blank\">We described Banner’s efforts\u003c/a> to rein in variation in a recent \u003cem>\u003ca href=\"http://www.usatoday.com/\" target=\"_blank\">USA TODAY\u003c/a>. \u003c/em>But we didn’t get into the nitty gritty of how the system convinced doctors to change. It’s an object lesson in the difficulty of getting doctors to change, but also the lengths to which health systems and insurers will go these days to make it happen.\u003c/p>\n\u003cp>Let’s start from the beginning. In its data analysis, Banner found striking differences in the use of pieces of film or fabric — called \u003ca href=\"http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm072879.htm\" target=\"_blank\">adhesion barriers\u003c/a> — during C-sections. Some hospitals used the barriers during 79 percent of C-sections, while others used them less than 1 percent of the time.\u003c/p>\n\u003cp>\u003c!--more--> The barriers are used to prevent abnormal scarring after abdominal and pelvic surgery, and marketers had urged doctors to use them for C-sections, Welch said.\u003c/p>\n\u003cp>But when \u003ca href=\"http://journals.lww.com/greenjournal/Abstract/2011/07000/Adhesion_Barriers_at_Cesarean_Delivery_.21.aspx\" target=\"_blank\">Banner analyzed the data and academic literature\u003c/a>, it concluded the barriers made no difference in how patients fared. It shared this information with its doctors and asked them to stop using them.\u003c/p>\n\u003cp>“We educated them and showed them data,” he said. “There were no differences between the various hospitals as far as the outcomes and no studies that supported what they were doing.”\u003c/p>\n\u003cp>The soft sell didn’t work.\u003c/p>\n\u003cp>After trying for six months to persuade doctors to stop using the barriers, the system got tougher. It told the doctors it no longer would provide the product for C-sections starting this year.\u003c/p>\n\u003cp>“We said no more, we’re not paying for it,” he said. “That was the turning point. … We took it off the supply shelf in the OB department.”\u003c/p>\n\u003cp>That helped, but there were still some holdouts. “We said if you really insist, do it, but we’ll track it,” Welch said.\u003c/p>\n\u003cp>Officials built an electronic dashboard available on the company intranet which showed how many adhesion barriers are used daily, and by whom.\u003c/p>\n\u003cp>“You can find out who is using it. It’s like the wall on the post office: Here are the guilty people,” he said\u003c/p>\n\u003cp>The tactic worked.\u003c/p>\n\u003cp>“They grumbled at first. What they have seen is that we mean it. We’re not going to waste money,” Welch said.\u003c/p>\n\u003cp>It costs $250 each time one of the barriers is used in a C-section, Welch said. So far in 2011, the barriers have been used in fewer than 1 percent of C-sections, which has meant a cost savings of more than $1 million systemwide.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post first appeared in the California HealthCare Foundation \u003ca title=\"http://www.centerforhealthreporting.org/blog/how-one-health-system-persuaded-its-doctors-change-hint-it-wasnt-easy\" href=\"http://www.centerforhealthreporting.org/blog/how-one-health-system-persuaded-its-doctors-change-hint-it-wasnt-easy\" target=\"_blank\">Center for Health Reporting blog\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.centerforhealthreporting.org/article/health-systems-find-nexus-between-improved-patient-care-and-lower-costs693\" target=\"_blank\">We described Banner’s efforts\u003c/a> to rein in variation in a recent \u003cem>\u003ca href=\"http://www.usatoday.com/\" target=\"_blank\">USA TODAY\u003c/a>. \u003c/em>But we didn’t get into the nitty gritty of how the system convinced doctors to change. It’s an object lesson in the difficulty of getting doctors to change, but also the lengths to which health systems and insurers will go these days to make it happen.\u003c/p>\n\u003cp>Let’s start from the beginning. In its data analysis, Banner found striking differences in the use of pieces of film or fabric — called \u003ca href=\"http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm072879.htm\" target=\"_blank\">adhesion barriers\u003c/a> — during C-sections. Some hospitals used the barriers during 79 percent of C-sections, while others used them less than 1 percent of the time.\u003c/p>\n\u003cp>\u003c!--more--> The barriers are used to prevent abnormal scarring after abdominal and pelvic surgery, and marketers had urged doctors to use them for C-sections, Welch said.\u003c/p>\n\u003cp>But when \u003ca href=\"http://journals.lww.com/greenjournal/Abstract/2011/07000/Adhesion_Barriers_at_Cesarean_Delivery_.21.aspx\" target=\"_blank\">Banner analyzed the data and academic literature\u003c/a>, it concluded the barriers made no difference in how patients fared. It shared this information with its doctors and asked them to stop using them.\u003c/p>\n\u003cp>“We educated them and showed them data,” he said. “There were no differences between the various hospitals as far as the outcomes and no studies that supported what they were doing.”\u003c/p>\n\u003cp>The soft sell didn’t work.\u003c/p>\n\u003cp>After trying for six months to persuade doctors to stop using the barriers, the system got tougher. It told the doctors it no longer would provide the product for C-sections starting this year.\u003c/p>\n\u003cp>“We said no more, we’re not paying for it,” he said. “That was the turning point. … We took it off the supply shelf in the OB department.”\u003c/p>\n\u003cp>That helped, but there were still some holdouts. “We said if you really insist, do it, but we’ll track it,” Welch said.\u003c/p>\n\u003cp>Officials built an electronic dashboard available on the company intranet which showed how many adhesion barriers are used daily, and by whom.\u003c/p>\n\u003cp>“You can find out who is using it. It’s like the wall on the post office: Here are the guilty people,” he said\u003c/p>\n\u003cp>The tactic worked.\u003c/p>\n\u003cp>“They grumbled at first. What they have seen is that we mean it. We’re not going to waste money,” Welch said.\u003c/p>\n\u003cp>It costs $250 each time one of the barriers is used in a C-section, Welch said. So far in 2011, the barriers have been used in fewer than 1 percent of C-sections, which has meant a cost savings of more than $1 million systemwide.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post first appeared in the California HealthCare Foundation \u003ca title=\"http://www.centerforhealthreporting.org/blog/how-one-health-system-persuaded-its-doctors-change-hint-it-wasnt-easy\" href=\"http://www.centerforhealthreporting.org/blog/how-one-health-system-persuaded-its-doctors-change-hint-it-wasnt-easy\" target=\"_blank\">Center for Health Reporting blog\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>By: Julie Appleby, \u003ca title=\"http://www.kaiserhealthnews.org/\" href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003cbr>\n\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/OECD-chart-500.png\">\u003cimg class=\"aligncenter wp-image-657\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/OECD-chart-5005.png\" alt=\"\" width=\"500\" height=\"375\">\u003c/a>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>We’re No. 1. In health spending. Again.\u003c/p>\n\u003cp>The United States far outpaces other countries in how much it spends on health care, although Americans have a lower rate of doctor visits and hospitalizations than most of the other 34 member countries of the Organization for Economic Co-operation and Development.\u003c/p>\n\u003cp>In its \u003ca href=\"http://www.oecd.org/document/11/0,3746,en_2649_33929_16502667_1_1_1_1,00.html\" target=\"_blank\">Health at a Glance 2011\u003c/a> report, out today, the OECD shows that the United States spent about $7,960 per person on health care in 2009 – about 2.5 times the average of the countries studied. It also found that health spending in the U.S. has increased faster than in all other high-income OECD countries since 1970, even accounting for population growth.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Why? Generally, prices for medical care are \u003ca href=\"http://capsules.kaiserhealthnews.org/wp-content/uploads/2011/11/PPTWebinarUSHealthSystem.pdf\" target=\"_blank\">higher in the U.S.\u003c/a> – and some services are performed more often. Hospital prices are 60 percent higher than the average of 12 selected OECD countries, and the U.S. also generally pays more for each appendectomy, birth, joint replacement or cardiac procedure. Americans have more imaging tests, such as CT scans and MRIs, than residents of other countries and are far more likely to have knee replacements, coronary angioplasty or surgery to remove their tonsils.\u003c/p>\n\u003cp>Even with all that, compared with most of the other developed countries, the U.S. has fewer practicing physicians per person, fewer hospital beds, and patients don’t stay as long in the hospital.\u003c/p>\n\u003cp>Administrative costs in the U.S. are also high, the report notes, accounting for about 7 percent of total spending. That is roughly comparable to what is spent in France and Germany, which have universal health coverage. In Canada — another country with national health care – administrative costs are about 4 percent of health spending.\u003c/p>\n\u003cp>So what are Americans getting for their money? The U.S. has the best five-year survival rate for breast cancer and comes in second, behind Japan, in terms of colorectal cancer survival. But the U.S. ranks 27th in life expectancy at birth, 31st in premature mortality, and 25th in the rate of cardiovascular mortality. The U.S. has the second worst rate of adult diabetes, behind Mexico, and has the highest rate of adult obesity, at 34 percent.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By: Julie Appleby, \u003ca title=\"http://www.kaiserhealthnews.org/\" href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003cbr>\n\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/OECD-chart-500.png\">\u003cimg class=\"aligncenter wp-image-657\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/OECD-chart-5005.png\" alt=\"\" width=\"500\" height=\"375\">\u003c/a>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>We’re No. 1. In health spending. Again.\u003c/p>\n\u003cp>The United States far outpaces other countries in how much it spends on health care, although Americans have a lower rate of doctor visits and hospitalizations than most of the other 34 member countries of the Organization for Economic Co-operation and Development.\u003c/p>\n\u003cp>In its \u003ca href=\"http://www.oecd.org/document/11/0,3746,en_2649_33929_16502667_1_1_1_1,00.html\" target=\"_blank\">Health at a Glance 2011\u003c/a> report, out today, the OECD shows that the United States spent about $7,960 per person on health care in 2009 – about 2.5 times the average of the countries studied. It also found that health spending in the U.S. has increased faster than in all other high-income OECD countries since 1970, even accounting for population growth.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Why? Generally, prices for medical care are \u003ca href=\"http://capsules.kaiserhealthnews.org/wp-content/uploads/2011/11/PPTWebinarUSHealthSystem.pdf\" target=\"_blank\">higher in the U.S.\u003c/a> – and some services are performed more often. Hospital prices are 60 percent higher than the average of 12 selected OECD countries, and the U.S. also generally pays more for each appendectomy, birth, joint replacement or cardiac procedure. Americans have more imaging tests, such as CT scans and MRIs, than residents of other countries and are far more likely to have knee replacements, coronary angioplasty or surgery to remove their tonsils.\u003c/p>\n\u003cp>Even with all that, compared with most of the other developed countries, the U.S. has fewer practicing physicians per person, fewer hospital beds, and patients don’t stay as long in the hospital.\u003c/p>\n\u003cp>Administrative costs in the U.S. are also high, the report notes, accounting for about 7 percent of total spending. That is roughly comparable to what is spent in France and Germany, which have universal health coverage. In Canada — another country with national health care – administrative costs are about 4 percent of health spending.\u003c/p>\n\u003cp>So what are Americans getting for their money? The U.S. has the best five-year survival rate for breast cancer and comes in second, behind Japan, in terms of colorectal cancer survival. But the U.S. ranks 27th in life expectancy at birth, 31st in premature mortality, and 25th in the rate of cardiovascular mortality. The U.S. has the second worst rate of adult diabetes, behind Mexico, and has the highest rate of adult obesity, at 34 percent.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
"airtime": "SUN 9pm-10pm",
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"meta": {
"site": "radio",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.commonwealthclub.org/podcasts",
"meta": {
"site": "news",
"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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}
},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
"title": "Freakonomics Radio",
"info": "Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
}
},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"link": "/radio/program/fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/381444908/podcast.xml"
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"id": "here-and-now",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/hiddenbrain.jpg",
"officialWebsiteLink": "https://www.npr.org/series/423302056/hidden-brain",
"airtime": "SUN 7pm-8pm",
"meta": {
"site": "news",
"source": "NPR"
},
"link": "/radio/program/hidden-brain",
"subscribe": {
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"tuneIn": "https://tunein.com/podcasts/Science-Podcasts/Hidden-Brain-p787503/",
"rss": "https://feeds.npr.org/510308/podcast.xml"
}
},
"how-i-built-this": {
"id": "how-i-built-this",
"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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"rss": "https://feeds.npr.org/510313/podcast.xml"
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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",
"imageAlt": "KQED Hyphenación",
"officialWebsiteLink": "/podcasts/hyphenacion",
"meta": {
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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"amazon": "https://music.amazon.com/podcasts/6c3dd23c-93fb-4aab-97ba-1725fa6315f1/hyphenaci%C3%B3n",
"rss": "https://feeds.megaphone.fm/KQINC2275451163"
}
},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The Political Mind of Jerry Brown",
"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"order": 18
},
"link": "/podcasts/jerrybrown",
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"apple": "https://itunes.apple.com/us/podcast/id1492194549",
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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/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/latino-usa",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/xtTd",
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
"npr": "https://www.npr.org/podcasts/464615685/mind-shift-podcast",
"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"stitcher": "https://www.stitcher.com/show/on-our-watch",
"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
"site": "news",
"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
"meta": {
"site": "news",
"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
"imageAlt": "KQED Perspectives",
"officialWebsiteLink": "/perspectives/",
"meta": {
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/id73801135",
"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"
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},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/M4f5",
"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
"tuneIn": "https://tunein.com/podcasts/Business--Economics-Podcasts/Planet-Money-p164680/",
"rss": "https://feeds.npr.org/510289/podcast.xml"
}
},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Political Breakdown",
"officialWebsiteLink": "/podcasts/politicalbreakdown",
"meta": {
"site": "radio",
"source": "kqed",
"order": 5
},
"link": "/podcasts/politicalbreakdown",
"subscribe": {
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"amazon": "https://music.amazon.com/podcasts/e0c2d153-ad36-4c8d-901d-f1da6a724824/political-breakdown",
"npr": "https://www.npr.org/podcasts/572155894/political-breakdown",
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