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"content": "\u003cp>Health insurers are gearing up to comply with a new Covered California rule that will require them next year to ensure that all enrollees have a primary care provider.\u003c/p>\n\u003caside class=\"pullquote alignright\">'You need a captain of the ship.'\u003ccite> Lance Lang, chief medical officer of Covered California \u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>The policy change for 2017 is part of a broader push by the exchange to improve the quality of care, even as it faces double-digit premium increases.\u003c/p>\n\u003cp>Health insurers selling through Covered California will designate a family doctor — or in some cases a nurse practitioner or physician’s assistant — for every plan holder who doesn’t already have one within 60 days of the coverage start date. The role of the assigned provider will be to help enrollees “navigate the system,” the exchange said last week.\u003c/p>\n\u003cp>The new policy applies to all enrollees, including those in Preferred Provider Organizations (PPOs), in which patients choose the physicians they want, and in HMOs, where the doctor networks are narrower and patients need a referral from their primary care doctor to see other providers.\u003c/p>\n\u003cp>“You need a captain of the ship,” Lance Lang, chief medical officer of Covered California, said of the role primary care providers play in coordinating patient health. These clinicians “[know] the patient, not just their statistics and lab values.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Lang said the new policy is meant to improve both the quality and cost efficiency of care.\u003c/p>\n\u003cp>As the agency \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/07/18/why-obamacare-covered-california-premiums-going-up/\" target=\"_blank\">unveiled its 2017 health plans and premium rates\u003c/a> last week, Executive Director Peter Lee said officials wanted to make sure that “having coverage means [policyholders] also have access to care.”\u003c/p>\n\u003cp>PPO enrollees will still have the freedom to choose their own providers and will not require referrals from their primary care doctors to see other providers.\u003c/p>\n\u003cp>For them, “this isn’t a ‘mother may I’ doctor,” said Lee.\u003c/p>\n\u003cp>Consumers Union, a nonprofit advocacy group with a seat on a Covered California advisory committee, supported the change but wants the exchange to make sure it’s easy for consumers to change doctors if they need to and to find providers in their network who are accepting new patients.\u003c/p>\n\u003cp>The move to more coordinated care did not surprise health policy experts.\u003c/p>\n\u003cp>“California has definitely, relative to the nation as a whole, been far more aggressive in moving into managed care,” said Dr. Geoffrey Joyce, director of health policy at the University of Southern California’s Schaeffer Center.\u003c/p>\n\u003cp>However, Joyce said the Covered California policy change is not a full shift to managed care because the primary care assignments would not be as binding or restrictive as in traditional HMOs, in which patients have to pay more if they see doctors to whom they are not referred.\u003c/p>\n\u003cp>But the new policy could have clinical and financial benefits, he said.\u003c/p>\n\u003cp>“Everyone’s moving towards better integrated care, better coordinated care. And so having one primary care provider be your sort of gatekeeper and your focal point makes sense,” Joyce said.\u003c/p>\n\u003cp>Lang said that Covered California is moving away from a “fragmented, disorganized, wild west” kind of care but is not trying to steer consumers away from PPOs and into HMOs.\u003c/p>\n\u003cp>Primary care relationships can simply help avoid unnecessary medical costs, Lang said, because a family doctor can prevent duplication of tests and other services and make it less likely a patient will be readmitted to a hospital.\u003c/p>\n\u003cp>The new primary care requirement is part of a series of new measures meant to improve the quality of care in Covered California health plans. The exchange’s board of directors recently approved rules that include penalizing hospitals financially for underperforming and even removing them — or doctors — from health insurance networks if they perform too poorly or charge too much.\u003c/p>\n\u003cp>Health plans will also be required to share data about chronic diseases among their patients and work to reduce health disparities.\u003c/p>\n\u003cp>Covered California’s health plan premiums will increase by an \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/07/18/why-obamacare-covered-california-premiums-going-up/\" target=\"_blank\">average of 13.2 percent statewide\u003c/a> next year, but Lang said rising costs are not the impetus for the policy change on primary care. A body of research shows the benefits of coordinated care, he said.\u003c/p>\n\u003cp>How many of the 1.4 million Covered California enrollees who currently have primary care doctors is unknown, but about half of the patients in the marketplace are in HMOs, where primary care physicians are the first point of contact.\u003c/p>\n\u003cp>The California Academy of Family Physicians applauded the Covered California decision, saying primary care can help reduce costs in the current health care system, where “patients sometimes think the emergency room is their only option for urgent care.”\u003c/p>\n\u003cp>The success of Covered California’s effort depends on how it’s carried out, and the implementation should be monitored to make sure there is an adequate number of providers for patients, the family doctors group said.\u003c/p>\n\u003cp>California laws and insurance exchange rules require health plans to ensure that patients can see providers within a certain timeframe. But in some areas where there is a shortage of primary care providers, patients already have to wait to see a clinician, Joyce said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>It’s possible patients will still have to wait to see a provider under the new Covered California policy, but being assigned to a primary care provider might help expedite a patient’s search for an in-network doctor, Joyce said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Health insurers are gearing up to comply with a new Covered California rule that will require them next year to ensure that all enrollees have a primary care provider.\u003c/p>\n\u003caside class=\"pullquote alignright\">'You need a captain of the ship.'\u003ccite> Lance Lang, chief medical officer of Covered California \u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>The policy change for 2017 is part of a broader push by the exchange to improve the quality of care, even as it faces double-digit premium increases.\u003c/p>\n\u003cp>Health insurers selling through Covered California will designate a family doctor — or in some cases a nurse practitioner or physician’s assistant — for every plan holder who doesn’t already have one within 60 days of the coverage start date. The role of the assigned provider will be to help enrollees “navigate the system,” the exchange said last week.\u003c/p>\n\u003cp>The new policy applies to all enrollees, including those in Preferred Provider Organizations (PPOs), in which patients choose the physicians they want, and in HMOs, where the doctor networks are narrower and patients need a referral from their primary care doctor to see other providers.\u003c/p>\n\u003cp>“You need a captain of the ship,” Lance Lang, chief medical officer of Covered California, said of the role primary care providers play in coordinating patient health. These clinicians “[know] the patient, not just their statistics and lab values.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Lang said the new policy is meant to improve both the quality and cost efficiency of care.\u003c/p>\n\u003cp>As the agency \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/07/18/why-obamacare-covered-california-premiums-going-up/\" target=\"_blank\">unveiled its 2017 health plans and premium rates\u003c/a> last week, Executive Director Peter Lee said officials wanted to make sure that “having coverage means [policyholders] also have access to care.”\u003c/p>\n\u003cp>PPO enrollees will still have the freedom to choose their own providers and will not require referrals from their primary care doctors to see other providers.\u003c/p>\n\u003cp>For them, “this isn’t a ‘mother may I’ doctor,” said Lee.\u003c/p>\n\u003cp>Consumers Union, a nonprofit advocacy group with a seat on a Covered California advisory committee, supported the change but wants the exchange to make sure it’s easy for consumers to change doctors if they need to and to find providers in their network who are accepting new patients.\u003c/p>\n\u003cp>The move to more coordinated care did not surprise health policy experts.\u003c/p>\n\u003cp>“California has definitely, relative to the nation as a whole, been far more aggressive in moving into managed care,” said Dr. Geoffrey Joyce, director of health policy at the University of Southern California’s Schaeffer Center.\u003c/p>\n\u003cp>However, Joyce said the Covered California policy change is not a full shift to managed care because the primary care assignments would not be as binding or restrictive as in traditional HMOs, in which patients have to pay more if they see doctors to whom they are not referred.\u003c/p>\n\u003cp>But the new policy could have clinical and financial benefits, he said.\u003c/p>\n\u003cp>“Everyone’s moving towards better integrated care, better coordinated care. And so having one primary care provider be your sort of gatekeeper and your focal point makes sense,” Joyce said.\u003c/p>\n\u003cp>Lang said that Covered California is moving away from a “fragmented, disorganized, wild west” kind of care but is not trying to steer consumers away from PPOs and into HMOs.\u003c/p>\n\u003cp>Primary care relationships can simply help avoid unnecessary medical costs, Lang said, because a family doctor can prevent duplication of tests and other services and make it less likely a patient will be readmitted to a hospital.\u003c/p>\n\u003cp>The new primary care requirement is part of a series of new measures meant to improve the quality of care in Covered California health plans. The exchange’s board of directors recently approved rules that include penalizing hospitals financially for underperforming and even removing them — or doctors — from health insurance networks if they perform too poorly or charge too much.\u003c/p>\n\u003cp>Health plans will also be required to share data about chronic diseases among their patients and work to reduce health disparities.\u003c/p>\n\u003cp>Covered California’s health plan premiums will increase by an \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/07/18/why-obamacare-covered-california-premiums-going-up/\" target=\"_blank\">average of 13.2 percent statewide\u003c/a> next year, but Lang said rising costs are not the impetus for the policy change on primary care. A body of research shows the benefits of coordinated care, he said.\u003c/p>\n\u003cp>How many of the 1.4 million Covered California enrollees who currently have primary care doctors is unknown, but about half of the patients in the marketplace are in HMOs, where primary care physicians are the first point of contact.\u003c/p>\n\u003cp>The California Academy of Family Physicians applauded the Covered California decision, saying primary care can help reduce costs in the current health care system, where “patients sometimes think the emergency room is their only option for urgent care.”\u003c/p>\n\u003cp>The success of Covered California’s effort depends on how it’s carried out, and the implementation should be monitored to make sure there is an adequate number of providers for patients, the family doctors group said.\u003c/p>\n\u003cp>California laws and insurance exchange rules require health plans to ensure that patients can see providers within a certain timeframe. But in some areas where there is a shortage of primary care providers, patients already have to wait to see a clinician, Joyce said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>It’s possible patients will still have to wait to see a provider under the new Covered California policy, but being assigned to a primary care provider might help expedite a patient’s search for an in-network doctor, Joyce said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Oakland, S.F. Revise Medical Marijuana Regulations in Face of New State Law",
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"content": "\u003cp>A new state law has Oakland and San Francisco remaking their medical cannabis laws in the face of new state requirements.\u003c/p>\n\u003cp>The actions are distinct from a November statewide ballot measure that would legalize recreational marijuana for adults over 21 years old.\u003c/p>\n\u003cp>The present law, passed last fall, imposes new regulatory measures on medical pot businesses in California. Previously, businesses needed only a city license. Now they must also be licensed by the state and, depending on what type of business is run, there are now 17 different license types covering dispensaries, manufacturing, cultivation, transportation, distribution and testing.\u003c/p>\n\u003cp>It’s all part of the Medical Marijuana Regulation and Safety Act and there’s more coming. State agencies are expected to issue further regulations and guidelines for cities by January 2017. The new laws take full effect in January 2018.\u003c/p>\n\u003cp>Overall, the act leaves cities scrambling to meet the standards taking effect now.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>San Francisco started working toward updating its regulations with a hearing before the Land Use and Transportation Committee earlier this month.\u003c/p>\n\u003cp>“We need to make sure that our regulations are keeping up with the reality of where medical cannabis is today,” said Supervisor Scott Wiener, who called for the hearing.\u003c/p>\n\u003cp>Currently, San Francisco has only one type of medical cannabis permit, for dispensaries. With the state soon to offer those 17 different types of licenses, the city will have to decide whether to allow or prohibit different marijuana enterprises such as cultivation, manufacturing and delivery.\u003c/p>\n\u003cp>Much of the discussion at the hearing focused on land use and where dispensaries may be located. One consideration is changing buffer zones around schools. Aaron Starr from the San Francisco Planning Department recommended reducing the current buffer zone from 1,000 feet around schools to 600 feet.\u003c/p>\n\u003cp>“San Francisco is a dense environment,” Starr said. He said that 1,000 feet from a school could be a completely different neighborhood. That generous buffer makes it difficult for new dispensaries to open in the city. Under current zoning regulations, many of the city’s 28 dispensaries are being clustered in the South of Market neighborhood.\u003c/p>\n\u003cp>Starr also recommended that the city should amend the planning code to align with the new license types surrounding cultivation and make clear how much cannabis can be grown -- and in which parts of the city.\u003c/p>\n\u003cp>The other major issue under discussion was taxation. Currently, dispensaries in San Francisco may only be nonprofit, but the new law will allow them to operate as for-profit businesses.\u003c/p>\n\u003cp>“The new law gives the city the opportunity to impose taxation on cultivation, production and dispensing,” said Cyndy Comerford, a manager in the planning and policy office of San Francisco’s Department of Public Health. Comerford did not have an estimate on how much revenue taxation could bring the city.\u003c/p>\n\u003cp>Comerford said the city’s next steps are twofold: participating with state agencies developing new regulations and crafting local legislation.\u003c/p>\n\u003cp>Meanwhile, Oakland is significantly ahead of its Bay Area neighbor in responding to the Medical Marijuana Regulation and Safety Act.\u003c/p>\n\u003cp>In May, the Oakland City Council updated the city’s medical cannabis ordinances to mirror the state law and make it possible for Oakland residents to apply for the necessary local permits. It also expanded the number of dispensaries that can operate in the city, allowing up to eight new dispensaries to open a year.\u003c/p>\n\u003cp>Oakland’s updated ordinance includes employment regulations geared toward Oakland residents. Under Oakland’s new laws, half of dispensary staff members must be Oakland residents -- and half of that group must live in high-unemployment areas. The ordinance also provides potential tax breaks and other incentives to dispensaries that hire Oakland residents who have been previously incarcerated.\u003c/p>\n\u003cp>Another twist in the new ordinance is an “equity” requirement. Fifty percent of new Oakland dispensaries will be eligible for a license in the Dispensary Equity Permit Program. Under the program, applicants must have at least one member who:\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">has lived in Oakland for at least two years in one of six police beats that have been most affected by cannabis-related crime\u003c/li>\n\u003cli style=\"font-weight: 400\">has been incarcerated for a cannabis-related offense in the past 10 years\u003c/li>\n\u003cli style=\"font-weight: 400\">has at least a 50 percent ownership share in the dispensary\u003c/li>\n\u003c/ul>\n\u003cp>These stipulations are aimed at rewarding low income and previously incarcerated communities. While the new rules were unanimously approved by the Oakland City Council in May, they have not been universally endorsed and continue to be the subject of debate.\u003c/p>\n\u003cp>“There’s been a lot of back and forth,” said Joe DeVries, assistant to the city administrator and a staff member on the city’s Cannabis Regulation Commission. DeVries said the bigger focus right now is getting applications out under the current ordinance.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The commission is slated to further discuss the equity provisions at its meeting Thursday evening.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A new state law has Oakland and San Francisco remaking their medical cannabis laws in the face of new state requirements.\u003c/p>\n\u003cp>The actions are distinct from a November statewide ballot measure that would legalize recreational marijuana for adults over 21 years old.\u003c/p>\n\u003cp>The present law, passed last fall, imposes new regulatory measures on medical pot businesses in California. Previously, businesses needed only a city license. Now they must also be licensed by the state and, depending on what type of business is run, there are now 17 different license types covering dispensaries, manufacturing, cultivation, transportation, distribution and testing.\u003c/p>\n\u003cp>It’s all part of the Medical Marijuana Regulation and Safety Act and there’s more coming. State agencies are expected to issue further regulations and guidelines for cities by January 2017. The new laws take full effect in January 2018.\u003c/p>\n\u003cp>Overall, the act leaves cities scrambling to meet the standards taking effect now.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>San Francisco started working toward updating its regulations with a hearing before the Land Use and Transportation Committee earlier this month.\u003c/p>\n\u003cp>“We need to make sure that our regulations are keeping up with the reality of where medical cannabis is today,” said Supervisor Scott Wiener, who called for the hearing.\u003c/p>\n\u003cp>Currently, San Francisco has only one type of medical cannabis permit, for dispensaries. With the state soon to offer those 17 different types of licenses, the city will have to decide whether to allow or prohibit different marijuana enterprises such as cultivation, manufacturing and delivery.\u003c/p>\n\u003cp>Much of the discussion at the hearing focused on land use and where dispensaries may be located. One consideration is changing buffer zones around schools. Aaron Starr from the San Francisco Planning Department recommended reducing the current buffer zone from 1,000 feet around schools to 600 feet.\u003c/p>\n\u003cp>“San Francisco is a dense environment,” Starr said. He said that 1,000 feet from a school could be a completely different neighborhood. That generous buffer makes it difficult for new dispensaries to open in the city. Under current zoning regulations, many of the city’s 28 dispensaries are being clustered in the South of Market neighborhood.\u003c/p>\n\u003cp>Starr also recommended that the city should amend the planning code to align with the new license types surrounding cultivation and make clear how much cannabis can be grown -- and in which parts of the city.\u003c/p>\n\u003cp>The other major issue under discussion was taxation. Currently, dispensaries in San Francisco may only be nonprofit, but the new law will allow them to operate as for-profit businesses.\u003c/p>\n\u003cp>“The new law gives the city the opportunity to impose taxation on cultivation, production and dispensing,” said Cyndy Comerford, a manager in the planning and policy office of San Francisco’s Department of Public Health. Comerford did not have an estimate on how much revenue taxation could bring the city.\u003c/p>\n\u003cp>Comerford said the city’s next steps are twofold: participating with state agencies developing new regulations and crafting local legislation.\u003c/p>\n\u003cp>Meanwhile, Oakland is significantly ahead of its Bay Area neighbor in responding to the Medical Marijuana Regulation and Safety Act.\u003c/p>\n\u003cp>In May, the Oakland City Council updated the city’s medical cannabis ordinances to mirror the state law and make it possible for Oakland residents to apply for the necessary local permits. It also expanded the number of dispensaries that can operate in the city, allowing up to eight new dispensaries to open a year.\u003c/p>\n\u003cp>Oakland’s updated ordinance includes employment regulations geared toward Oakland residents. Under Oakland’s new laws, half of dispensary staff members must be Oakland residents -- and half of that group must live in high-unemployment areas. The ordinance also provides potential tax breaks and other incentives to dispensaries that hire Oakland residents who have been previously incarcerated.\u003c/p>\n\u003cp>Another twist in the new ordinance is an “equity” requirement. Fifty percent of new Oakland dispensaries will be eligible for a license in the Dispensary Equity Permit Program. Under the program, applicants must have at least one member who:\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">has lived in Oakland for at least two years in one of six police beats that have been most affected by cannabis-related crime\u003c/li>\n\u003cli style=\"font-weight: 400\">has been incarcerated for a cannabis-related offense in the past 10 years\u003c/li>\n\u003cli style=\"font-weight: 400\">has at least a 50 percent ownership share in the dispensary\u003c/li>\n\u003c/ul>\n\u003cp>These stipulations are aimed at rewarding low income and previously incarcerated communities. While the new rules were unanimously approved by the Oakland City Council in May, they have not been universally endorsed and continue to be the subject of debate.\u003c/p>\n\u003cp>“There’s been a lot of back and forth,” said Joe DeVries, assistant to the city administrator and a staff member on the city’s Cannabis Regulation Commission. DeVries said the bigger focus right now is getting applications out under the current ordinance.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The commission is slated to further discuss the equity provisions at its meeting Thursday evening.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Attorney General Joins Federal Suit to Block Anthem-Cigna Merger",
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"content": "\u003cp>California Attorney General Kamala Harris is joining a federal Justice Department antitrust lawsuit to block the proposed health insurance mega-merger between Anthem and Cigna, a consolidation that would create the country's largest health insurer.\u003c/p>\n\u003caside class=\"pullquote align right\">'The proposed merger would drive up costs for consumers and reduce access to quality healthcare for millions of Californians.'\u003ccite>Kamala Harris,\u003cbr>Attorney General of California\u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>While Harris acknowledged that mergers can create benefits for consumers, this deal \"does not strike that balance and would drive up costs for consumers and reduce access to quality healthcare for millions of Californians,\" she said in a statement.\u003c/p>\n\u003cp>The lawsuit was filed by the Justice Department and attorneys general in nine other states, in addition to California.\u003c/p>\n\u003cp>In California, Anthem Blue Cross is a \u003ca href=\"http://www.chcf.org/publications/2016/01/california-health-plans-insurers\" target=\"_blank\">huge player with about 20 percent \u003c/a>of private insurance market. Cigna has a smaller presence here, but the two companies \"compete head-to-head for customers, especially large employers,\" the attorney general's office said.\u003c/p>\n\u003cp>The Justice Department also filed a second suit, seeking to block a proposed merger between Aetna and Humana. California is not joining that suit because Humana does not have significant market share in the state, a spokeswoman for the attorney general's office said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Consumer advocates had long raised concerns about both deals and hailed today's news, saying these mergers would likely lead to \"reduced competition, increased prices, and more market power\" for the companies, said Anthony Wright, executive director of Health Access California, an advocacy group.\u003c/p>\n\u003cp>\"Bigger is not better,\" he said in a statement. \"Health care premiums are high enough without major insurers merging and reducing choice and competition further.\"\u003c/p>\n\u003cp>Aetna Inc. proposed last summer to buy Humana Inc. for $34 billion, while Anthem Inc. moved to acquire Cigna Corp. for $48 billion. The companies said Thursday they plan to fight the federal suit. Anthem called it \"an unfortunate and misguided\" step backward for access to affordable care.\u003c/p>\n\u003cp>Consumers have been dealing with rising health care costs for years, a result of several factors. Prices for prescription drugs and care have risen, and as they have, insurers — who ultimately pay most of the bill — have raised premiums and out-of-pocket expenses like deductibles to shift more costs to consumers and help protect their own bottom lines.\u003c/p>\n\u003cp>The big insurers argue that by getting larger they will be able to negotiate better prices with pharmaceutical companies, hospitals and doctor groups that also are growing. They also expect to cut expenses and add more customers, which helps them better spread the cost of investing in technology to manage and improve care.\u003c/p>\n\u003cp>In recent years insurers have invested in more elaborate technology to help customers find the most appropriate doctors and care providers and to help them take their medicines and manage their care, which can improve health and cut costs.\u003c/p>\n\u003cp>But it's unclear how much the savings from these improvements would filter down to the customer, especially if there are fewer insurers competing for business.\u003c/p>\n\u003cp>\"There's no reason to give those savings to their customers unless someone else is pushing you,\" said Gary Claxton, a vice president with the nonprofit Kaiser Family Foundation, which studies health care issues.\u003c/p>\n\u003cp>Regulators were worried about how the deals will affect competition in three areas in particular: coverage offered by large employers, insurance sold on the Affordable Care Act's public exchanges and Medicare Advantage plans, which are privately run versions of the government's Medicare program for the elderly.\u003c/p>\n\u003cp>Bill Baer, acting associate attorney general, said Thursday that major health insurers like Anthem and Aetna are thriving as independent companies.\u003c/p>\n\u003cp>\"They do not need these deals to survive, and consumers are entitled to benefit from their continued competition,\" he said.\u003c/p>\n\u003cp>Analysts who follow the industry say that when insurers grow big nationally it doesn't necessarily mean they dominate the local markets where their products are sold because there are so many regional insurers. They've also said that the insurers could sell off some of their business to ease concerns regulators might have.\u003c/p>\n\u003cp>But Baer said what the insurers offered to sell wasn't enough.\u003c/p>\n\u003cp>Industry experts say any impact from the deals on consumers would take years to materialize and could lead to savings in some areas, along with the risk of higher costs elsewhere.\u003c/p>\n\u003cp>Morningstar analyst Vishnu Lekraj said he's not sure how much stomach the insurers will have for a protracted legal battle. He thinks they eventually will walk away from these deals and hunt for smaller acquisitions that give them a presence in new markets.\u003c/p>\n\u003cp>\"In order for these firms to succeed longer term, they need to build scale,\" he said.\u003c/p>\n\u003cp>Shares of all four health insurers jumped Thursday after the Justice Department announced the lawsuit. The stocks had slumped in recent weeks as investors waited to learn what regulators would decide.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The Associated Press contributed to this report. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California Attorney General Kamala Harris is joining a federal Justice Department antitrust lawsuit to block the proposed health insurance mega-merger between Anthem and Cigna, a consolidation that would create the country's largest health insurer.\u003c/p>\n\u003caside class=\"pullquote align right\">'The proposed merger would drive up costs for consumers and reduce access to quality healthcare for millions of Californians.'\u003ccite>Kamala Harris,\u003cbr>Attorney General of California\u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>While Harris acknowledged that mergers can create benefits for consumers, this deal \"does not strike that balance and would drive up costs for consumers and reduce access to quality healthcare for millions of Californians,\" she said in a statement.\u003c/p>\n\u003cp>The lawsuit was filed by the Justice Department and attorneys general in nine other states, in addition to California.\u003c/p>\n\u003cp>In California, Anthem Blue Cross is a \u003ca href=\"http://www.chcf.org/publications/2016/01/california-health-plans-insurers\" target=\"_blank\">huge player with about 20 percent \u003c/a>of private insurance market. Cigna has a smaller presence here, but the two companies \"compete head-to-head for customers, especially large employers,\" the attorney general's office said.\u003c/p>\n\u003cp>The Justice Department also filed a second suit, seeking to block a proposed merger between Aetna and Humana. California is not joining that suit because Humana does not have significant market share in the state, a spokeswoman for the attorney general's office said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Consumer advocates had long raised concerns about both deals and hailed today's news, saying these mergers would likely lead to \"reduced competition, increased prices, and more market power\" for the companies, said Anthony Wright, executive director of Health Access California, an advocacy group.\u003c/p>\n\u003cp>\"Bigger is not better,\" he said in a statement. \"Health care premiums are high enough without major insurers merging and reducing choice and competition further.\"\u003c/p>\n\u003cp>Aetna Inc. proposed last summer to buy Humana Inc. for $34 billion, while Anthem Inc. moved to acquire Cigna Corp. for $48 billion. The companies said Thursday they plan to fight the federal suit. Anthem called it \"an unfortunate and misguided\" step backward for access to affordable care.\u003c/p>\n\u003cp>Consumers have been dealing with rising health care costs for years, a result of several factors. Prices for prescription drugs and care have risen, and as they have, insurers — who ultimately pay most of the bill — have raised premiums and out-of-pocket expenses like deductibles to shift more costs to consumers and help protect their own bottom lines.\u003c/p>\n\u003cp>The big insurers argue that by getting larger they will be able to negotiate better prices with pharmaceutical companies, hospitals and doctor groups that also are growing. They also expect to cut expenses and add more customers, which helps them better spread the cost of investing in technology to manage and improve care.\u003c/p>\n\u003cp>In recent years insurers have invested in more elaborate technology to help customers find the most appropriate doctors and care providers and to help them take their medicines and manage their care, which can improve health and cut costs.\u003c/p>\n\u003cp>But it's unclear how much the savings from these improvements would filter down to the customer, especially if there are fewer insurers competing for business.\u003c/p>\n\u003cp>\"There's no reason to give those savings to their customers unless someone else is pushing you,\" said Gary Claxton, a vice president with the nonprofit Kaiser Family Foundation, which studies health care issues.\u003c/p>\n\u003cp>Regulators were worried about how the deals will affect competition in three areas in particular: coverage offered by large employers, insurance sold on the Affordable Care Act's public exchanges and Medicare Advantage plans, which are privately run versions of the government's Medicare program for the elderly.\u003c/p>\n\u003cp>Bill Baer, acting associate attorney general, said Thursday that major health insurers like Anthem and Aetna are thriving as independent companies.\u003c/p>\n\u003cp>\"They do not need these deals to survive, and consumers are entitled to benefit from their continued competition,\" he said.\u003c/p>\n\u003cp>Analysts who follow the industry say that when insurers grow big nationally it doesn't necessarily mean they dominate the local markets where their products are sold because there are so many regional insurers. They've also said that the insurers could sell off some of their business to ease concerns regulators might have.\u003c/p>\n\u003cp>But Baer said what the insurers offered to sell wasn't enough.\u003c/p>\n\u003cp>Industry experts say any impact from the deals on consumers would take years to materialize and could lead to savings in some areas, along with the risk of higher costs elsewhere.\u003c/p>\n\u003cp>Morningstar analyst Vishnu Lekraj said he's not sure how much stomach the insurers will have for a protracted legal battle. He thinks they eventually will walk away from these deals and hunt for smaller acquisitions that give them a presence in new markets.\u003c/p>\n\u003cp>\"In order for these firms to succeed longer term, they need to build scale,\" he said.\u003c/p>\n\u003cp>Shares of all four health insurers jumped Thursday after the Justice Department announced the lawsuit. The stocks had slumped in recent weeks as investors waited to learn what regulators would decide.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The Associated Press contributed to this report. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Florida Officials Probe Possible Zika Case from Mosquito",
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"content": "\u003cp>Health officials are investigating a Zika virus infection in Florida that could be the first case in which someone caught the virus by being bitten by a mosquito in the United States.\u003c/p>\n\u003cp>In a \u003ca href=\"http://www.floridahealth.gov/newsroom/2016/07/071916-investigating-possible-non-travel-related-case-zika.html\" target=\"_blank\">statement\u003c/a> posted on its website Tuesday, the Florida Department of Health says the \"possible non-travel related case of Zika\" occurred in Miami-Dade County.\u003c/p>\n\u003cp>That means it's possible that the infected person did not catch the virus while traveling in another country where the virus is spreading. Rather, the infection might have been acquired from an infected mosquito.\u003c/p>\n\u003cp>But there's also the possibility that the Florida case may have occurred another way, such as sexual contact.\u003c/p>\n\u003cp>The statement does not mention sexual transmission, and officials did not provide any additional information in response to a request from NPR.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We do not have additional information to share at this time,\" Brad Dalton, deputy press secretary in the department's office of communications, said in an email. He added that the investigation is ongoing.\u003c/p>\n\u003cp>The federal Centers for Disease Control and Prevention said in an email that the agency \"has been informed\" of the case and is \"closely coordinating\" with Florida officials in the investigation.\u003c/p>\n\u003cp>Mosquito control inspectors have been going door-to-door in the area under investigation since health authorities alerted them late last week, spraying to kill mosquitoes and emptying containers of the water they need to breed. If the virus is there, they want to keep it from spreading through more mosquito bites.\u003c/p>\n\u003cp>\"We're constantly in the area. We're doing hand-held spraying, and we'll do more truck spraying Thursday,\" said Gayle Love, a spokeswoman for Miami-Dade County Solid Waste Management.\u003c/p>\n\u003cp>Zika prevention kits and mosquito repellent — strongly recommended for women who are pregnant or planning to be pregnant — are being distributed in the area and can be picked up at the health department as well.\u003c/p>\n\u003cp>Health authorities have been expecting that Zika could eventually spread by mosquitoes in parts of the United States. But they have repeatedly said they are confident they could prevent any large outbreaks from occurring.\u003c/p>\n\u003cp>More than 1,300 cases of Zika have been reported in the the continental United States and Hawaii. So far none have occurred by being bitten by a mosquito in this country. Most have been in travelers returning from countries where the virus is spreading. At least 14 are believed to have occurred through sexual contact with someone who was infected elsewhere.\u003c/p>\n\u003cp>Zika can cause \u003ca href=\"https://www.cdc.gov/zika/\" target=\"_blank\">serious birth defects\u003c/a> when pregnant women get infected, and can cause neurological complications in adults in rare cases.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The Associated Press contributed to this report. \u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Florida+Officials+Probe+Zika+Case+That+May+Not+Be+Related+To+Travel&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Health officials are investigating a Zika virus infection in Florida that could be the first case in which someone caught the virus by being bitten by a mosquito in the United States.\u003c/p>\n\u003cp>In a \u003ca href=\"http://www.floridahealth.gov/newsroom/2016/07/071916-investigating-possible-non-travel-related-case-zika.html\" target=\"_blank\">statement\u003c/a> posted on its website Tuesday, the Florida Department of Health says the \"possible non-travel related case of Zika\" occurred in Miami-Dade County.\u003c/p>\n\u003cp>That means it's possible that the infected person did not catch the virus while traveling in another country where the virus is spreading. Rather, the infection might have been acquired from an infected mosquito.\u003c/p>\n\u003cp>But there's also the possibility that the Florida case may have occurred another way, such as sexual contact.\u003c/p>\n\u003cp>The statement does not mention sexual transmission, and officials did not provide any additional information in response to a request from NPR.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We do not have additional information to share at this time,\" Brad Dalton, deputy press secretary in the department's office of communications, said in an email. He added that the investigation is ongoing.\u003c/p>\n\u003cp>The federal Centers for Disease Control and Prevention said in an email that the agency \"has been informed\" of the case and is \"closely coordinating\" with Florida officials in the investigation.\u003c/p>\n\u003cp>Mosquito control inspectors have been going door-to-door in the area under investigation since health authorities alerted them late last week, spraying to kill mosquitoes and emptying containers of the water they need to breed. If the virus is there, they want to keep it from spreading through more mosquito bites.\u003c/p>\n\u003cp>\"We're constantly in the area. We're doing hand-held spraying, and we'll do more truck spraying Thursday,\" said Gayle Love, a spokeswoman for Miami-Dade County Solid Waste Management.\u003c/p>\n\u003cp>Zika prevention kits and mosquito repellent — strongly recommended for women who are pregnant or planning to be pregnant — are being distributed in the area and can be picked up at the health department as well.\u003c/p>\n\u003cp>Health authorities have been expecting that Zika could eventually spread by mosquitoes in parts of the United States. But they have repeatedly said they are confident they could prevent any large outbreaks from occurring.\u003c/p>\n\u003cp>More than 1,300 cases of Zika have been reported in the the continental United States and Hawaii. So far none have occurred by being bitten by a mosquito in this country. Most have been in travelers returning from countries where the virus is spreading. At least 14 are believed to have occurred through sexual contact with someone who was infected elsewhere.\u003c/p>\n\u003cp>Zika can cause \u003ca href=\"https://www.cdc.gov/zika/\" target=\"_blank\">serious birth defects\u003c/a> when pregnant women get infected, and can cause neurological complications in adults in rare cases.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The Associated Press contributed to this report. \u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Florida+Officials+Probe+Zika+Case+That+May+Not+Be+Related+To+Travel&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Anti-Abortion Forces Regroup In Wake Of Supreme Court Decision",
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"headTitle": "State of Health | KQED News",
"content": "\u003cp>Delegates at the Republican convention in Cleveland have approved the strongest anti-abortion platform in the party’s history. But groups that oppose abortion — and that lobbied for the strong language — are far from unified.\u003c/p>\n\u003cp>In fact, in the wake of last month’s Supreme Court decision reaffirming a woman’s right to abortion, leaders of a movement known for speaking largely with one voice are showing some surprising disagreement.\u003c/p>\n\u003cp>For the past several years, anti-abortion groups have pushed an agenda aimed at imposing much stricter regulation on abortion facilities. The groups said it was to promote the health and safety of women; abortion-rights supporters said it was an effort to \u003ca href=\"http://www.reproductiverights.org/project/targeted-regulation-of-abortion-providers-trap\" target=\"_blank\">regulate the clinics out of existence\u003c/a>.\u003c/p>\n\u003cp>At least for now, the Supreme Court is siding with abortion-rights backers. Neither of the portions of Texas’ omnibus abortion law that were up for review “offers medical benefits sufficient to justify the burdens upon access that each imposes,” wrote Justice Stephen Breyer in the \u003ca href=\"https://www.supremecourt.gov/opinions/15pdf/15-274_p8k0.pdf\" target=\"_blank\">majority opinion\u003c/a>.\u003c/p>\n\u003cp>The provisions that were struck down required abortion clinics in the state to meet the much higher safety standards for facilities that do much more advanced surgical procedures and required doctors who perform abortions to have admitting privileges at a hospital within 30 miles of the clinic.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In hindsight, “maybe it was a mistake for us to champion safeguards for women,” said Marjorie Dannenfelser, president of the \u003ca href=\"https://www.sba-list.org/about-susan-b-anthony-list\" target=\"_blank\">Susan B. Anthony List\u003c/a>, whose goal is to elect more anti-abortion candidates to public office. “Maybe we shouldn’t have done that.”\u003c/p>\n\u003cp>At a media briefing, Dannenfelser said her group will instead rally around legislation that has passed in more than a dozen states to \u003ca href=\"https://www.guttmacher.org/sites/default/files/pdfs/spibs/spib_PLTA.pdf\" target=\"_blank\">ban abortion at roughly 20 weeks\u003c/a> of pregnancy. Similar legislation \u003ca href=\"https://www.congress.gov/bill/114th-congress/house-bill/36\" target=\"_blank\">passed the U.S. House\u003c/a> but not the Senate.\u003c/p>\n\u003cp>The 20-week ban is “our top priority,” she said.\u003c/p>\n\u003cp>But Clarke Forsythe, acting president and senior counsel for Americans United for Life, said his group plans no fundamental change in strategy.\u003c/p>\n\u003cp>“It is more important than ever to focus on the risks to women and negative consequences,” he said in an interview. “The justices can’t sweep away the public health vacuum that they created with a few pen strokes.”\u003c/p>\n\u003cp>Forsythe said that while the court’s ruling has “put some roadblocks in the way, and we will have to take those into consideration,” there are still plenty of opportunities to regulate abortion providers that could pass constitutional muster, particularly if they are more narrowly targeted than the Texas law was.\u003c/p>\n\u003cp>The nation’s oldest anti-abortion group, the National Right to Life Committee, has never embraced the push for health and safety regulations aimed at women.\u003c/p>\n\u003cp>“Our focus has always been on the humanity of the unborn,” said its president, Carol Tobias, rather than potential risks to women seeking abortions.\u003c/p>\n\u003cp>Her group has instead been pushing state and federal bills to ban abortions after 20 weeks and ban “\u003ca href=\"http://www.webmd.com/women/dilation-and-evacuation-de-for-abortion\" target=\"_blank\">dilation and evacuation\u003c/a>” abortions, which are the most common procedure performed after the first trimester of pregnancy.\u003c/p>\n\u003cp>“I don’t think the Texas decision is necessarily going to impact those types of legislation, and I know it’s not going to affect us,” she said.\u003c/p>\n\u003cp>But there is one thing they all seem to agree on: The future makeup of the Supreme Court, and with it the future of abortion rights, hangs in the balance with the upcoming election.\u003c/p>\n\u003cp>Because of the vacancy left by the death of Justice Antonin Scalia last winter, “it is so obvious, so simple to make the case” about the importance of who controls the White House and Senate when it comes to Supreme Court appointments, said Dannenfelser.\u003c/p>\n\u003cp>“We say the court’s always important,” said Tobias. “But this time we have solid proof.”\u003c/p>\n\u003cp>The groups also agree on something else — that despite the victory at the Supreme Court, abortion-rights forces are not winning the fight.\u003c/p>\n\u003cp>“The pro-life cause has never been stronger,” said Dannenfelser. “And our opponents’ position has never been weaker.”\u003c/p>\n\u003cp>Immediately after the court’s ruling, said Tobias, “Planned Parenthood came out and said they were going to pass pro-abortion legislation and repeal pro-life legislation.”\u003c/p>\n\u003cp>That is true. “Today’s victory means we can fight state by state, legislature by legislature, law by law, and restore women’s access to reproductive health care,” said Planned Parenthood Action Fund Executive Vice President Dawn Laguens in a statement.\u003c/p>\n\u003cp>But in fact, said Tobias, “they haven’t been able to do that in 40 years. The only way they make advances is through the courts. They don’t have the people” on their side.\u003c/p>\n\u003cp>In an interview, Laguens agreed that her side has more work to do. “We’ve got to change hearts and minds,” she said. But Laguens insists it is abortion opponents who are “out of sync with America and out of sync with the new generation.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>With a more “social justice minded” generation of millennials now coming of age, she said, it is abortion foes on the defensive. “They’re in a last gasp moment,” she said. “They feel it slipping away.”\u003c/p>\n\n",
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"excerpt": "Anti-abortion groups are rethinking their approach following a U.S. Supreme Court decision last month. But they don't all agree on strategy.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Delegates at the Republican convention in Cleveland have approved the strongest anti-abortion platform in the party’s history. But groups that oppose abortion — and that lobbied for the strong language — are far from unified.\u003c/p>\n\u003cp>In fact, in the wake of last month’s Supreme Court decision reaffirming a woman’s right to abortion, leaders of a movement known for speaking largely with one voice are showing some surprising disagreement.\u003c/p>\n\u003cp>For the past several years, anti-abortion groups have pushed an agenda aimed at imposing much stricter regulation on abortion facilities. The groups said it was to promote the health and safety of women; abortion-rights supporters said it was an effort to \u003ca href=\"http://www.reproductiverights.org/project/targeted-regulation-of-abortion-providers-trap\" target=\"_blank\">regulate the clinics out of existence\u003c/a>.\u003c/p>\n\u003cp>At least for now, the Supreme Court is siding with abortion-rights backers. Neither of the portions of Texas’ omnibus abortion law that were up for review “offers medical benefits sufficient to justify the burdens upon access that each imposes,” wrote Justice Stephen Breyer in the \u003ca href=\"https://www.supremecourt.gov/opinions/15pdf/15-274_p8k0.pdf\" target=\"_blank\">majority opinion\u003c/a>.\u003c/p>\n\u003cp>The provisions that were struck down required abortion clinics in the state to meet the much higher safety standards for facilities that do much more advanced surgical procedures and required doctors who perform abortions to have admitting privileges at a hospital within 30 miles of the clinic.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In hindsight, “maybe it was a mistake for us to champion safeguards for women,” said Marjorie Dannenfelser, president of the \u003ca href=\"https://www.sba-list.org/about-susan-b-anthony-list\" target=\"_blank\">Susan B. Anthony List\u003c/a>, whose goal is to elect more anti-abortion candidates to public office. “Maybe we shouldn’t have done that.”\u003c/p>\n\u003cp>At a media briefing, Dannenfelser said her group will instead rally around legislation that has passed in more than a dozen states to \u003ca href=\"https://www.guttmacher.org/sites/default/files/pdfs/spibs/spib_PLTA.pdf\" target=\"_blank\">ban abortion at roughly 20 weeks\u003c/a> of pregnancy. Similar legislation \u003ca href=\"https://www.congress.gov/bill/114th-congress/house-bill/36\" target=\"_blank\">passed the U.S. House\u003c/a> but not the Senate.\u003c/p>\n\u003cp>The 20-week ban is “our top priority,” she said.\u003c/p>\n\u003cp>But Clarke Forsythe, acting president and senior counsel for Americans United for Life, said his group plans no fundamental change in strategy.\u003c/p>\n\u003cp>“It is more important than ever to focus on the risks to women and negative consequences,” he said in an interview. “The justices can’t sweep away the public health vacuum that they created with a few pen strokes.”\u003c/p>\n\u003cp>Forsythe said that while the court’s ruling has “put some roadblocks in the way, and we will have to take those into consideration,” there are still plenty of opportunities to regulate abortion providers that could pass constitutional muster, particularly if they are more narrowly targeted than the Texas law was.\u003c/p>\n\u003cp>The nation’s oldest anti-abortion group, the National Right to Life Committee, has never embraced the push for health and safety regulations aimed at women.\u003c/p>\n\u003cp>“Our focus has always been on the humanity of the unborn,” said its president, Carol Tobias, rather than potential risks to women seeking abortions.\u003c/p>\n\u003cp>Her group has instead been pushing state and federal bills to ban abortions after 20 weeks and ban “\u003ca href=\"http://www.webmd.com/women/dilation-and-evacuation-de-for-abortion\" target=\"_blank\">dilation and evacuation\u003c/a>” abortions, which are the most common procedure performed after the first trimester of pregnancy.\u003c/p>\n\u003cp>“I don’t think the Texas decision is necessarily going to impact those types of legislation, and I know it’s not going to affect us,” she said.\u003c/p>\n\u003cp>But there is one thing they all seem to agree on: The future makeup of the Supreme Court, and with it the future of abortion rights, hangs in the balance with the upcoming election.\u003c/p>\n\u003cp>Because of the vacancy left by the death of Justice Antonin Scalia last winter, “it is so obvious, so simple to make the case” about the importance of who controls the White House and Senate when it comes to Supreme Court appointments, said Dannenfelser.\u003c/p>\n\u003cp>“We say the court’s always important,” said Tobias. “But this time we have solid proof.”\u003c/p>\n\u003cp>The groups also agree on something else — that despite the victory at the Supreme Court, abortion-rights forces are not winning the fight.\u003c/p>\n\u003cp>“The pro-life cause has never been stronger,” said Dannenfelser. “And our opponents’ position has never been weaker.”\u003c/p>\n\u003cp>Immediately after the court’s ruling, said Tobias, “Planned Parenthood came out and said they were going to pass pro-abortion legislation and repeal pro-life legislation.”\u003c/p>\n\u003cp>That is true. “Today’s victory means we can fight state by state, legislature by legislature, law by law, and restore women’s access to reproductive health care,” said Planned Parenthood Action Fund Executive Vice President Dawn Laguens in a statement.\u003c/p>\n\u003cp>But in fact, said Tobias, “they haven’t been able to do that in 40 years. The only way they make advances is through the courts. They don’t have the people” on their side.\u003c/p>\n\u003cp>In an interview, Laguens agreed that her side has more work to do. “We’ve got to change hearts and minds,” she said. But Laguens insists it is abortion opponents who are “out of sync with America and out of sync with the new generation.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>With a more “social justice minded” generation of millennials now coming of age, she said, it is abortion foes on the defensive. “They’re in a last gasp moment,” she said. “They feel it slipping away.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Covered California Premiums Going up 13.2% Next Year. Here's Why.",
"title": "Covered California Premiums Going up 13.2% Next Year. Here's Why.",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>\u003cstrong>Update: 2:30 p.m.\u003c/strong>\u003c/p>\n\u003cp>Covered California, the state's Obamacare marketplace, released proposed 2017 premiums Tuesday morning, and the average statewide increase will be 13.2 percent, more than triple the increase seen each of the last two years.\u003c/p>\n\u003cp>Peter Lee, the agency's executive director, cited several factors as drivers in this year's spike.\u003c/p>\n\u003cp>Most notable is an expiring federal \"reinsurance\" program, created as part of the Affordable Care Act, to spread the risk of so many newly insured people entering the risk pool. Actuarial experts estimate that alone adds 4 to 7 percent to premiums, but it's viewed as a one-time effect.\u003c/p>\n\u003cp>Rising health care costs, including specialty prescription drugs, are also a factor.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Lee stressed that most people could reduce their own individual increase by shopping around.\u003c/p>\n\u003cp>\"Almost 80 percent of our customers could either pay less than they are paying today or pay no more than [a] 5 percent increase,\" Lee said, if they comparison shop.\u003c/p>\n\u003cp>Larry Levitt, senior vice president at the nonpartisan Kaiser Family Foundation, agreed there may be \"deals to be had.\"\u003c/p>\n\u003cp>“The market is still working much better in California than in most other states,\" he said. \"It’s quite competitive in giving consumers a large number of choices.\"\u003c/p>\n\u003cp>About 1.4 million Californians purchase their health insurance through the Covered California exchange.\u003c/p>\n\u003cp>Blue Shield and Anthem Blue Cross customers will face the steepest increases. They have about \"a quarter of the market each,\" Lee said. Anthem customers will see a statewide average increase of 16 percent, and Blue Shield is \"above 19 percent,\" Lee said.\u003c/p>\n\u003cp>In the Bay Area, those increases will be even steeper for Anthem and Blue Shield customers. Meanwhile, the average monthly premium hike for Kaiser members will be in the 5-6 percent range across much of the region.\u003c/p>\n\u003cp>\"We are committed to offering stable rates over the long term,\" said Bill Wehrle, a vice president at Kaiser Permanente, \"and are uniquely positioned to deliver more affordable health care coverage.\" He cited investments in technology and Kaiser's \"emphasis on wellness\" as factors keeping premium increases lower.\u003c/p>\n\u003cp>Here are some of the proposed rate increases for major plans in several Bay Area counties:\u003c/p>\n\u003cp>\u003cstrong>San Francisco\u003c/strong>\u003cbr>\nAverage increase: 14.8 percent\u003c/p>\n\u003cp>Kaiser: 5.3 percent\u003cbr>\nAnthem Blue Cross: 16.7 percent\u003cbr>\nBlue Shield: 24.2 percent\u003c/p>\n\u003cp>\u003cstrong>Contra Costa County\u003c/strong>\u003cbr>\nAverage increase: 13.6 percent\u003c/p>\n\u003cp>Kaiser: 5.6 percent\u003cbr>\nAnthem Blue Cross: 22.6 percent\u003cbr>\nBlue Shield: 24.4 percent\u003c/p>\n\u003cp>\u003cstrong>Alameda County\u003c/strong>\u003cbr>\nAverage increase: 12.3 percent\u003c/p>\n\u003cp>Kaiser: 5.6 percent\u003cbr>\nAnthem Blue Cross: 23.7 percent\u003cbr>\nBlue Shield: 18.9 percent\u003c/p>\n\u003cp>\u003cstrong>Santa Clara\u003c/strong>\u003cbr>\nAverage increase: 9.2 percent\u003c/p>\n\u003cp>Kaiser: 5.6 percent\u003cbr>\nAnthem Blue Cross (EPO): 8.4 percent\u003cbr>\nBlue Shield: 22.3 percent\u003c/p>\n\u003cp>You can look up the proposed rate for your plan in your specific area by checking Covered California's \u003ca href=\"http://www.coveredca.com/news/pdfs/CoveredCA-2017-rate-booklet.pdf\" target=\"_blank\">rate booklet.\u003c/a>\u003c/p>\n\u003cp>The rates are not yet final. State regulators will review them in the coming weeks.\u003c/p>\n\u003cp>\u003cstrong>Original post:\u003c/strong>\u003c/p>\n\u003cp>California's Obamacare customers can expect a hefty increase in their monthly health insurance premiums next year. Covered California will announce new 2017 rates Tuesday morning for people who buy their plan through the state marketplace, and experts are predicting that increases will be double or even triple what they were last year.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/274403157\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>“2017 is going to be a transition year,” said Peter Lee, executive director of Covered California, testifying before Congress last week. “We expect our rates to be higher than we saw in our first two years.”\u003c/p>\n\u003cp>In \u003ca href=\"https://ww2.kqed.org/stateofhealth/2014/07/31/californias-2015-obamacare-premiums-will-increase-modestly/\" target=\"_blank\">2015\u003c/a> and \u003ca href=\"https://ww2.kqed.org/stateofhealth/2015/07/27/covered-california-2016-premiums-to-increase-modestly/\" target=\"_blank\">2016\u003c/a>, marketplace premiums increased an average of 4 percent -- a rate celebrated by consumer advocates as “modest,” even “\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/07/27/covered-california-2016-premiums-to-increase-modestly/\">terrific\u003c/a>.”\u003c/p>\n\u003cp>Covered California’s proposed budget for 2017, released in May, \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/05/11/californias-obamacare-premiums-may-rise-8-percent-next-year/\" target=\"_blank\">projected average rate increases of 8 percent\u003c/a>. Industry insiders are suggesting the average jump could be even higher.\u003c/p>\n\u003cp>There are three key reasons why.\u003c/p>\n\u003cp>\u003cstrong>One: Medical Costs are Up\u003c/strong>\u003c/p>\n\u003cp>Insurance companies say premium prices are going up because medical costs are going up. Doctors, hospitals, labs and pharmaceutical companies are all raising their prices.\u003c/p>\n\u003cp>“Unquestionably, runaway drug prices remain a serious problem,” said Charles Bacchi, president and CEO of the California Association of Health Plans, a trade group for insurers. “We’re seeing new drugs coming out with blockbuster prices, and we’ve seen drugs that have been around for 30 years double and triple in price for no reason.”\u003c/p>\n\u003cp>Northern Californians have felt the burden of higher medical costs more so than people in Southern California because the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/12/03/why-health-insurance-in-the-bay-area-costs-more-than-in-southern-california-hospital-prices/\" target=\"_blank\">hospital market is more consolidated\u003c/a>, giving hospitals more bargaining power with insurers.\u003c/p>\n\u003cp>Early rate filings from other states indicate rising medical costs could contribute to premium increases anywhere from 3 to 9 percent.\u003c/p>\n\u003cp>California regulators will have a chance to review the proposed rate increases, and consumer advocacy groups say they look forward to participating in the process by challenging some of the assumptions health plans have made about costs.\u003c/p>\n\u003cp>\"To the extent insurers are booking a certain amount of medical inflation to prescription drugs, are they overestimating those costs?\" said Anthony Wright, executive director of Health Access. \"Is that a scapegoat or a true driver?*\u003c/p>\n\u003cp>\u003cstrong>Two: Federal Protections are Expiring\u003c/strong>\u003c/p>\n\u003cp>The Affordable Care Act established a “reinsurance” program that was designed to help insurance companies cover losses if they had a high proportion of really sick, expensive patients. Insurers didn’t know who was going to sign up for their plans, and basically had to guess how sick they would be and how much care they would need, then factor that into their premium rates.\u003c/p>\n\u003cp>Through the reinsurance program, all health plans paid into a shared pool, then those funds were distributed to companies that ended up with more high-cost patients. This meant plans didn’t have to make up losses by increasing premiums the following year. But that protection expires this year, adding a 4 to 7 percent increase to consumers’ monthly premiums in 2017, according to\u003ca href=\"http://www.actuary.org/content/drivers-2017-health-insurance-premium-changes-0\" target=\"_blank\"> an analysis\u003c/a> of the American Academy of Actuaries.\u003c/p>\n\u003cp>Another program, \"risk corridors,\" which is designed to protect consumers against excessive premium increases, also expires this year.\u003c/p>\n\u003cp>\u003cstrong>Three: People May Be Gaming the System\u003c/strong>\u003c/p>\n\u003cp>Most people buy their insurance during the set enrollment period starting in the fall. But people who lose their coverage during the year because they lose a job, get divorced or move (among other eligibility criteria) are able to buy a plan through Covered California outside normal enrollment periods.\u003c/p>\n\u003cp>But insurers are noticing that these customers have medical costs that are 25 to 40 percent higher than the rest of the health care population, said Bacchi.\u003c/p>\n\u003cp>Are people taking advantage of the system, signing up for coverage not because they had a qualifying change in life circumstances, but because they got sick? Or is it that sicker people are more motivated to look for ways to stay insured after they lose coverage through work or a divorce?\u003c/p>\n\u003cp>\u003cstrong>Californians May Be Better Off\u003c/strong>\u003c/p>\n\u003cp>Despite all these factors, state officials and the insurance industry say Californians are still better off than consumers in most other states. Peter Lee emphasized that Covered California is an “active purchaser,” meaning it negotiates with plans when they set their prices.\u003c/p>\n\u003cp>“Covered California does not negotiate by table-pounding, but rather by providing good data on the risk mix of who is enrolled and working the health plans to garner maximum enrollment,” Lee said in his remarks before Congress. “In 2015, we provided data that proved Covered California enrollees were healthier and presented less risk to insurance companies than anticipated, which helped drive down the cost of health premiums.”\u003c/p>\n\u003cp>Bacchi said consumers here also have more choice.\u003c/p>\n\u003cp>“We have a highly competitive health care market, with 11 health plans in Covered California duking it out over price and quality and in most of the regions of the state,” said Bacchi.\u003c/p>\n\u003cp>Health advocates say consumers should take advantage of that by shopping around for a better deal. So even if the average premium increases 8 to 12 percent, that doesn't mean every single plan jumped that much.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“If you’re in a Blue Shield plan in your region, it may be that there’s another health plan that’s the best deal for you for 2017,” said Wright of Health Access. \"The good thing about the Affordable Care Act is customers are not locked out because of a pre-existing condition. But they’re not locked in either. They can shop around for price.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Update: 2:30 p.m.\u003c/strong>\u003c/p>\n\u003cp>Covered California, the state's Obamacare marketplace, released proposed 2017 premiums Tuesday morning, and the average statewide increase will be 13.2 percent, more than triple the increase seen each of the last two years.\u003c/p>\n\u003cp>Peter Lee, the agency's executive director, cited several factors as drivers in this year's spike.\u003c/p>\n\u003cp>Most notable is an expiring federal \"reinsurance\" program, created as part of the Affordable Care Act, to spread the risk of so many newly insured people entering the risk pool. Actuarial experts estimate that alone adds 4 to 7 percent to premiums, but it's viewed as a one-time effect.\u003c/p>\n\u003cp>Rising health care costs, including specialty prescription drugs, are also a factor.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Lee stressed that most people could reduce their own individual increase by shopping around.\u003c/p>\n\u003cp>\"Almost 80 percent of our customers could either pay less than they are paying today or pay no more than [a] 5 percent increase,\" Lee said, if they comparison shop.\u003c/p>\n\u003cp>Larry Levitt, senior vice president at the nonpartisan Kaiser Family Foundation, agreed there may be \"deals to be had.\"\u003c/p>\n\u003cp>“The market is still working much better in California than in most other states,\" he said. \"It’s quite competitive in giving consumers a large number of choices.\"\u003c/p>\n\u003cp>About 1.4 million Californians purchase their health insurance through the Covered California exchange.\u003c/p>\n\u003cp>Blue Shield and Anthem Blue Cross customers will face the steepest increases. They have about \"a quarter of the market each,\" Lee said. Anthem customers will see a statewide average increase of 16 percent, and Blue Shield is \"above 19 percent,\" Lee said.\u003c/p>\n\u003cp>In the Bay Area, those increases will be even steeper for Anthem and Blue Shield customers. Meanwhile, the average monthly premium hike for Kaiser members will be in the 5-6 percent range across much of the region.\u003c/p>\n\u003cp>\"We are committed to offering stable rates over the long term,\" said Bill Wehrle, a vice president at Kaiser Permanente, \"and are uniquely positioned to deliver more affordable health care coverage.\" He cited investments in technology and Kaiser's \"emphasis on wellness\" as factors keeping premium increases lower.\u003c/p>\n\u003cp>Here are some of the proposed rate increases for major plans in several Bay Area counties:\u003c/p>\n\u003cp>\u003cstrong>San Francisco\u003c/strong>\u003cbr>\nAverage increase: 14.8 percent\u003c/p>\n\u003cp>Kaiser: 5.3 percent\u003cbr>\nAnthem Blue Cross: 16.7 percent\u003cbr>\nBlue Shield: 24.2 percent\u003c/p>\n\u003cp>\u003cstrong>Contra Costa County\u003c/strong>\u003cbr>\nAverage increase: 13.6 percent\u003c/p>\n\u003cp>Kaiser: 5.6 percent\u003cbr>\nAnthem Blue Cross: 22.6 percent\u003cbr>\nBlue Shield: 24.4 percent\u003c/p>\n\u003cp>\u003cstrong>Alameda County\u003c/strong>\u003cbr>\nAverage increase: 12.3 percent\u003c/p>\n\u003cp>Kaiser: 5.6 percent\u003cbr>\nAnthem Blue Cross: 23.7 percent\u003cbr>\nBlue Shield: 18.9 percent\u003c/p>\n\u003cp>\u003cstrong>Santa Clara\u003c/strong>\u003cbr>\nAverage increase: 9.2 percent\u003c/p>\n\u003cp>Kaiser: 5.6 percent\u003cbr>\nAnthem Blue Cross (EPO): 8.4 percent\u003cbr>\nBlue Shield: 22.3 percent\u003c/p>\n\u003cp>You can look up the proposed rate for your plan in your specific area by checking Covered California's \u003ca href=\"http://www.coveredca.com/news/pdfs/CoveredCA-2017-rate-booklet.pdf\" target=\"_blank\">rate booklet.\u003c/a>\u003c/p>\n\u003cp>The rates are not yet final. State regulators will review them in the coming weeks.\u003c/p>\n\u003cp>\u003cstrong>Original post:\u003c/strong>\u003c/p>\n\u003cp>California's Obamacare customers can expect a hefty increase in their monthly health insurance premiums next year. Covered California will announce new 2017 rates Tuesday morning for people who buy their plan through the state marketplace, and experts are predicting that increases will be double or even triple what they were last year.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/274403157&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/274403157'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“2017 is going to be a transition year,” said Peter Lee, executive director of Covered California, testifying before Congress last week. “We expect our rates to be higher than we saw in our first two years.”\u003c/p>\n\u003cp>In \u003ca href=\"https://ww2.kqed.org/stateofhealth/2014/07/31/californias-2015-obamacare-premiums-will-increase-modestly/\" target=\"_blank\">2015\u003c/a> and \u003ca href=\"https://ww2.kqed.org/stateofhealth/2015/07/27/covered-california-2016-premiums-to-increase-modestly/\" target=\"_blank\">2016\u003c/a>, marketplace premiums increased an average of 4 percent -- a rate celebrated by consumer advocates as “modest,” even “\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/07/27/covered-california-2016-premiums-to-increase-modestly/\">terrific\u003c/a>.”\u003c/p>\n\u003cp>Covered California’s proposed budget for 2017, released in May, \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/05/11/californias-obamacare-premiums-may-rise-8-percent-next-year/\" target=\"_blank\">projected average rate increases of 8 percent\u003c/a>. Industry insiders are suggesting the average jump could be even higher.\u003c/p>\n\u003cp>There are three key reasons why.\u003c/p>\n\u003cp>\u003cstrong>One: Medical Costs are Up\u003c/strong>\u003c/p>\n\u003cp>Insurance companies say premium prices are going up because medical costs are going up. Doctors, hospitals, labs and pharmaceutical companies are all raising their prices.\u003c/p>\n\u003cp>“Unquestionably, runaway drug prices remain a serious problem,” said Charles Bacchi, president and CEO of the California Association of Health Plans, a trade group for insurers. “We’re seeing new drugs coming out with blockbuster prices, and we’ve seen drugs that have been around for 30 years double and triple in price for no reason.”\u003c/p>\n\u003cp>Northern Californians have felt the burden of higher medical costs more so than people in Southern California because the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/12/03/why-health-insurance-in-the-bay-area-costs-more-than-in-southern-california-hospital-prices/\" target=\"_blank\">hospital market is more consolidated\u003c/a>, giving hospitals more bargaining power with insurers.\u003c/p>\n\u003cp>Early rate filings from other states indicate rising medical costs could contribute to premium increases anywhere from 3 to 9 percent.\u003c/p>\n\u003cp>California regulators will have a chance to review the proposed rate increases, and consumer advocacy groups say they look forward to participating in the process by challenging some of the assumptions health plans have made about costs.\u003c/p>\n\u003cp>\"To the extent insurers are booking a certain amount of medical inflation to prescription drugs, are they overestimating those costs?\" said Anthony Wright, executive director of Health Access. \"Is that a scapegoat or a true driver?*\u003c/p>\n\u003cp>\u003cstrong>Two: Federal Protections are Expiring\u003c/strong>\u003c/p>\n\u003cp>The Affordable Care Act established a “reinsurance” program that was designed to help insurance companies cover losses if they had a high proportion of really sick, expensive patients. Insurers didn’t know who was going to sign up for their plans, and basically had to guess how sick they would be and how much care they would need, then factor that into their premium rates.\u003c/p>\n\u003cp>Through the reinsurance program, all health plans paid into a shared pool, then those funds were distributed to companies that ended up with more high-cost patients. This meant plans didn’t have to make up losses by increasing premiums the following year. But that protection expires this year, adding a 4 to 7 percent increase to consumers’ monthly premiums in 2017, according to\u003ca href=\"http://www.actuary.org/content/drivers-2017-health-insurance-premium-changes-0\" target=\"_blank\"> an analysis\u003c/a> of the American Academy of Actuaries.\u003c/p>\n\u003cp>Another program, \"risk corridors,\" which is designed to protect consumers against excessive premium increases, also expires this year.\u003c/p>\n\u003cp>\u003cstrong>Three: People May Be Gaming the System\u003c/strong>\u003c/p>\n\u003cp>Most people buy their insurance during the set enrollment period starting in the fall. But people who lose their coverage during the year because they lose a job, get divorced or move (among other eligibility criteria) are able to buy a plan through Covered California outside normal enrollment periods.\u003c/p>\n\u003cp>But insurers are noticing that these customers have medical costs that are 25 to 40 percent higher than the rest of the health care population, said Bacchi.\u003c/p>\n\u003cp>Are people taking advantage of the system, signing up for coverage not because they had a qualifying change in life circumstances, but because they got sick? Or is it that sicker people are more motivated to look for ways to stay insured after they lose coverage through work or a divorce?\u003c/p>\n\u003cp>\u003cstrong>Californians May Be Better Off\u003c/strong>\u003c/p>\n\u003cp>Despite all these factors, state officials and the insurance industry say Californians are still better off than consumers in most other states. Peter Lee emphasized that Covered California is an “active purchaser,” meaning it negotiates with plans when they set their prices.\u003c/p>\n\u003cp>“Covered California does not negotiate by table-pounding, but rather by providing good data on the risk mix of who is enrolled and working the health plans to garner maximum enrollment,” Lee said in his remarks before Congress. “In 2015, we provided data that proved Covered California enrollees were healthier and presented less risk to insurance companies than anticipated, which helped drive down the cost of health premiums.”\u003c/p>\n\u003cp>Bacchi said consumers here also have more choice.\u003c/p>\n\u003cp>“We have a highly competitive health care market, with 11 health plans in Covered California duking it out over price and quality and in most of the regions of the state,” said Bacchi.\u003c/p>\n\u003cp>Health advocates say consumers should take advantage of that by shopping around for a better deal. So even if the average premium increases 8 to 12 percent, that doesn't mean every single plan jumped that much.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "In Medical Mystery, Caregiver of Utah Zika Patient Gets Virus",
"title": "In Medical Mystery, Caregiver of Utah Zika Patient Gets Virus",
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"content": "\u003cp>A person who cared for a Zika-infected relative in Utah also got the virus, but exactly how it was transmitted is a medical mystery, health officials announced Monday.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The new case in Utah is a surprise, showing that we still have more to learn about Zika.' \u003ccite>Erin Staples, CDC epidemiologist \u003c/cite>\u003c/aside>\n\u003cp>The tropical mosquito that mainly spreads Zika isn't found in the high-altitude area with cold winters where the two lived, Salt Lake County Health Department officials said. They didn't have sexual contact, which is how the virus is typically spread between adults when there's no mosquito bite or mother-to-child transmission.\u003c/p>\n\u003cp>\"The new case in Utah is a surprise, showing that we still have more to learn about Zika,\" Centers for Disease Control and Prevention medical epidemiologist Erin Staples said.\u003c/p>\n\u003cp>The caregiver has fully recovered, but authorities did not give further details. The person cared for an elderly man who contracted the disease overseas, where mosquitoes are known to spread Zika and who became the first Zika-infected person to die in the continental U.S.\u003c/p>\n\u003cp>The caregiver did not travel to an affected area, but it's possible that a mosquito came back with the relative, perhaps in a suitcase, CDC Director Tom Frieden said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The man who died in late June had an unusually high level of the virus in his blood, more than 100,000 times higher than other samples of infected people. Health workers are testing others who had contact with him, and officials are trapping mosquitoes in Utah to test them.\u003c/p>\n\u003cp>The new case was discovered after a doctor noticed the caregiver's Zika-like symptoms, which include rash, fever and pink eye, officials said. The relative had cared for the elderly man both at home and in the hospital.\u003c/p>\n\u003cp>It was unclear exactly how the older man died because of his age and another health condition he suffered, according to the CDC. The agency did not immediately revise its advice to health care workers or caregivers after the new case emerged.\u003c/p>\n\u003cp>\"Based on what we know so far about this case, there is no evidence that there is any risk of Zika virus transmission among the general public in Utah,\" said Dr. Angela Dunn, deputy state epidemiologist at the Utah Department of Health.\u003c/p>\n\u003cp>There's no evidence yet that the Zika infection in this case is an unusual mutation, but researchers are exploring that possibility through genomic analysis.\u003c/p>\n\u003cp>The virus causes only a mild illness in most people. But during recent outbreaks in Latin America, scientists discovered that infection during pregnancy has led to severe brain-related birth defects.\u003c/p>\n\u003cp>No cases of mosquito-spread Zika have been reported in the continental United States, according to the CDC. Health experts think mosquito transmission probably will occur in the U.S., but the expectation is that it will be in low-elevation, sweltering places where the insect has been a steady problem — such as southern Florida or southern Texas.\u003c/p>\n\u003cp>More than 1,300 Zika illnesses have been reported in the 50 states and the District of Columbia, including eight in Utah, according to health officials. Almost all were people who had traveled to Zika-outbreak countries and caught the virus there.\u003c/p>\n\u003cp>But 14 were people who had not traveled to Zika zones but had sex with someone who had.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The CDC has also been tracking pregnant women infected with Zika, and says they have five reports of pregnancy losses because of miscarriage, stillbirth or abortion.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A person who cared for a Zika-infected relative in Utah also got the virus, but exactly how it was transmitted is a medical mystery, health officials announced Monday.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The new case in Utah is a surprise, showing that we still have more to learn about Zika.' \u003ccite>Erin Staples, CDC epidemiologist \u003c/cite>\u003c/aside>\n\u003cp>The tropical mosquito that mainly spreads Zika isn't found in the high-altitude area with cold winters where the two lived, Salt Lake County Health Department officials said. They didn't have sexual contact, which is how the virus is typically spread between adults when there's no mosquito bite or mother-to-child transmission.\u003c/p>\n\u003cp>\"The new case in Utah is a surprise, showing that we still have more to learn about Zika,\" Centers for Disease Control and Prevention medical epidemiologist Erin Staples said.\u003c/p>\n\u003cp>The caregiver has fully recovered, but authorities did not give further details. The person cared for an elderly man who contracted the disease overseas, where mosquitoes are known to spread Zika and who became the first Zika-infected person to die in the continental U.S.\u003c/p>\n\u003cp>The caregiver did not travel to an affected area, but it's possible that a mosquito came back with the relative, perhaps in a suitcase, CDC Director Tom Frieden said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The man who died in late June had an unusually high level of the virus in his blood, more than 100,000 times higher than other samples of infected people. Health workers are testing others who had contact with him, and officials are trapping mosquitoes in Utah to test them.\u003c/p>\n\u003cp>The new case was discovered after a doctor noticed the caregiver's Zika-like symptoms, which include rash, fever and pink eye, officials said. The relative had cared for the elderly man both at home and in the hospital.\u003c/p>\n\u003cp>It was unclear exactly how the older man died because of his age and another health condition he suffered, according to the CDC. The agency did not immediately revise its advice to health care workers or caregivers after the new case emerged.\u003c/p>\n\u003cp>\"Based on what we know so far about this case, there is no evidence that there is any risk of Zika virus transmission among the general public in Utah,\" said Dr. Angela Dunn, deputy state epidemiologist at the Utah Department of Health.\u003c/p>\n\u003cp>There's no evidence yet that the Zika infection in this case is an unusual mutation, but researchers are exploring that possibility through genomic analysis.\u003c/p>\n\u003cp>The virus causes only a mild illness in most people. But during recent outbreaks in Latin America, scientists discovered that infection during pregnancy has led to severe brain-related birth defects.\u003c/p>\n\u003cp>No cases of mosquito-spread Zika have been reported in the continental United States, according to the CDC. Health experts think mosquito transmission probably will occur in the U.S., but the expectation is that it will be in low-elevation, sweltering places where the insect has been a steady problem — such as southern Florida or southern Texas.\u003c/p>\n\u003cp>More than 1,300 Zika illnesses have been reported in the 50 states and the District of Columbia, including eight in Utah, according to health officials. Almost all were people who had traveled to Zika-outbreak countries and caught the virus there.\u003c/p>\n\u003cp>But 14 were people who had not traveled to Zika zones but had sex with someone who had.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The CDC has also been tracking pregnant women infected with Zika, and says they have five reports of pregnancy losses because of miscarriage, stillbirth or abortion.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">A\u003c/span> 12-year-old boy named Strazh hangs from the monkey bars, staring at the ground. The other kids in the park aren’t interested in him. And he’s not interested in them.\u003c/p>\n\u003cp>“I just like to play by myself,” he says.\u003c/p>\n\u003cp>Strazh has autism. Today is a good day. But on most others, Strazh has meltdowns. Something frustrates him and he can’t control his emotions.\u003c/p>\n\u003cp>“I sometimes end up screaming,” he says. “And I end up yelling and screaming.”\u003c/p>\n\u003cp>And hitting and banging things, throwing things, adds Strazh’s mom, Natalie Dunnege. As a single parent, she says she bears the brunt of it.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“He told me that I disgusted him,” she says softly. “He tells me he hates me.”\u003c/p>\n\u003cp>Dunnege puts all her spare money into therapy for Strazh. She says it helps a lot. But Dunnege herself is struggling, feeling depressed and overwhelmed. She decided to look for her own therapist.\u003c/p>\n\u003cp>“One of the things that I’ve really had to wrap my head around is that I can’t change him. I can only change how I handle the situation,” she explains. “And not that I would want to change who he is. He’s a really good kid, but it’s a lot to handle, especially as a single parent.”\u003c/p>\n\u003cp>But when she logged onto her insurance website to find a therapist, she realized her copay for a mental health visit was going to be upwards of $75 – more than double her copay for other doctors’ appointments. Under a 2008 federal mental health law, those copays are supposed to be the same.\u003c/p>\n\u003cp>“There’s no way,” Dunnege says. “It’s out of my budget right now.”\u003c/p>\n\u003cfigure id=\"attachment_186111\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-186111\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/1010622-e1463762466497.jpg\" alt=\"Natalie Dunnege and her son, Strazh.\" width=\"1920\" height=\"1280\">\u003cfigcaption class=\"wp-caption-text\">Natalie Dunnege and her son, Strazh. \u003ccite>(Sheraz Sadiq/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dunnege lives in a one-bedroom apartment with her son and her father in San Francisco's Haight district. Grandfather and grandson sleep in twin beds side by side. It’s an awkward walk past those beds to the only bathroom. Dunnege says $75 a week for therapy is impossible.\u003c/p>\n\u003cp>“My income, I just made lower middle income. Just by the skin of my teeth,” she says. “So I just have to hold off until I’m actually middle class.”\u003c/p>\n\u003cp>More than 43 million Americans suffer from depression, anxiety and other mental health conditions, according to the most recent \u003ca href=\"http://www.samhsa.gov/data/sites/default/files/NSDUH-DR-FRR3-2014/NSDUH-DR-FRR3-2014/NSDUH-DR-FRR3-2014.htm\" target=\"_blank\" rel=\"noopener noreferrer\">federal data\u003c/a>. But more than half the people who felt like they needed help last year, never got it. Even people who had insurance complained of barriers to care. Some said they still couldn't afford it; some were embarrassed to ask for help. Others just couldn't get through \u003ca href=\"http://www.nap.edu/catalog/23442/ending-discrimination-against-people-with-mental-and-substance-use-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">the red tape\u003c/a>.\u003c/p>\n\u003cp>Recent health laws, the 2008 Mental Health Parity Act and the Affordable Care Act, were supposed to fix this. They require health plans to provide benefits for mental health conditions on par with physical health conditions. Under the law, insurance companies can’t charge higher copays or set up separate deductibles for mental health care compared to other medical or surgical care. They can’t limit hospital stays or require preauthorization for mental health treatment if the same limits are not applied to treatment for physical health conditions.\u003c/p>\n\u003cp>But advocates say insurance companies are still finding ways to keep people who need care from getting it. Some are still not complying with the law. And some have found subtle, technically legally, ways to limit treatment.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/265497893\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>\u003cstrong>Problems with Mental Health Provider Directories\u003c/strong>\u003c/p>\n\u003cp>Natalie Dunnege encountered some of these barriers when she tried again to find a therapist. In the last year, she got a promotion at work and moved into a larger apartment. Her employer switched to a better health plan, too. Now she has Blue Shield coverage, and her copay for mental health appointments is only $20.\u003c/p>\n\u003cp>\"Which I was really excited about,\" Dunnege says.\u003c/p>\n\u003cp>But when she looked for a therapist who took her insurance, she struck out.\u003c/p>\n\u003cp>“I contacted six or seven,” she says.\u003c/p>\n\u003cp>Only three called her back.\u003c/p>\n\u003cp>“One of them, they were completely booked,” she says. “And then the other two just didn’t accept the insurance anymore.”\u003c/p>\n\u003cp>Zero hits out of seven. Had to be a bad draw, right?\u003c/p>\n\u003cp>To find out, we decided to conduct our own survey and called all the psychologists -- 100 in total -- that were listed on the Blue Shield website for Natalie’s plan in San Francisco.\u003c/p>\n\u003cp>Here's what happened:\u003c/p>\n\u003cfigure id=\"attachment_186898\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/mentalHealthTreatmentPost.jpg\">\u003cimg class=\"wp-image-186898 size-full\" title=\"Blue Shield In-Network Psychologists\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/mentalHealthTreatmentPost.jpg\" alt=\"mentalHealthTreatmentPost\" width=\"1920\" height=\"2055\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-400x428.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-800x856.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-768x822.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-1440x1541.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-1180x1263.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-960x1028.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lisa Pickoff-White/KQED \u003ccite>(Lisa Pickoff-White/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The end result: 28 psychologists actually had appointments. And only eight of them had slots available outside regular work hours. Eight out of 100.\u003c/p>\n\u003cp>“Sorry, I wish you the best of luck,” was a common refrain in therapists’ voicemail messages.\u003c/p>\n\u003cp>For Natalie Dunnege, after seven rejections, she gave up looking.\u003c/p>\n\u003cp>\"It's hard when you're feeling sad and you feel like you can barely keep things together,” she says. “It just seemed like way too much at the time.”\u003c/p>\n\u003cp>Mental health advocates say this is exactly what insurance companies are hoping.\u003c/p>\n\u003cp>“It’s a way to control cost,” says Keith Humphreys, a Stanford psychiatry professor who served as an advisor to Congress when it was developing the 2008 Mental Health Parity Act. He says while insurers are now required to keep an adequate number of clinicians listed in their directories, they still find ways to sidestep the rules.\u003c/p>\n\u003cp>[contextly_sidebar id=\"KbISjuBjk7yP8P3jc2UosQlAqr1b85dD\"]“You know the law doesn't say you can't put people on there who are dead, or you can't put people on there who are not taking new patients,” he says. “What that translates into, then, is people have to wait longer for care, which then cuts expenditures for the insurer and reduces access.”\u003c/p>\n\u003cp>California passed a law last year, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB137\" target=\"_blank\" rel=\"noopener noreferrer\">SB 137\u003c/a>, raising the standards for physician directories. Insurers will have to police their lists for providers who are booked or retired. But a lot of questions remain about how the law will be enforced, especially when it comes to mental health providers, who are largely self-employed, solo practitioners.\u003c/p>\n\u003cp>The insurance industry says it will be a challenge.\u003c/p>\n\u003cp>“When you have networks as large as ours and you have as many enrollees as we have here in California, you're not going to be able to just have everything accurate every single second of every single day,” says Charles Bacchi, CEO of the California Association of Health Plans.\u003c/p>\n\u003cp>He said the industry is working to make it better.\u003c/p>\n\u003cp>“But we also need to be realistic,” he says. “We don't run a mental health provider's office. They do. And how they handle people calling their offices is their job.”\u003c/p>\n\u003cp>In a statement, Blue Shield said it tries to make it easy for providers to update changes in their contact information and schedule.\u003c/p>\n\u003cp>“We understand that there are a number of issues that impact a provider's availability to take new patients, such as administrative limitations and fluctuating numbers of patients based on their individual needs. When those instances arise, the provider is required to notify us so that patients have access to the most up-to-date information about who is available in their area.\"\u003c/p>\n\u003cp>The industry also says it’s facing another challenge: a nationwide shortage of mental health providers, further exacerbated by the millions of people who signed up for insurance under the Affordable Care Act.\u003c/p>\n\u003cp>In California, there are \"around 4 to 5 million more people with coverage, just in the last two years,” Bacchi says. “And that’s creating a strain for everybody, plans and mental health providers.”\u003c/p>\n\u003cp>But is it really just a supply and demand problem? Is it that there aren’t enough therapists, or is it that there aren’t enough therapists who are willing to work under the terms and rates set by the insurance companies?\u003c/p>\n\u003cp>\u003cem>This story was originally published on May 23, 2016. The video will be broadcast on KQED Newsroom July 15, 2016. \u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">A\u003c/span> 12-year-old boy named Strazh hangs from the monkey bars, staring at the ground. The other kids in the park aren’t interested in him. And he’s not interested in them.\u003c/p>\n\u003cp>“I just like to play by myself,” he says.\u003c/p>\n\u003cp>Strazh has autism. Today is a good day. But on most others, Strazh has meltdowns. Something frustrates him and he can’t control his emotions.\u003c/p>\n\u003cp>“I sometimes end up screaming,” he says. “And I end up yelling and screaming.”\u003c/p>\n\u003cp>And hitting and banging things, throwing things, adds Strazh’s mom, Natalie Dunnege. As a single parent, she says she bears the brunt of it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“He told me that I disgusted him,” she says softly. “He tells me he hates me.”\u003c/p>\n\u003cp>Dunnege puts all her spare money into therapy for Strazh. She says it helps a lot. But Dunnege herself is struggling, feeling depressed and overwhelmed. She decided to look for her own therapist.\u003c/p>\n\u003cp>“One of the things that I’ve really had to wrap my head around is that I can’t change him. I can only change how I handle the situation,” she explains. “And not that I would want to change who he is. He’s a really good kid, but it’s a lot to handle, especially as a single parent.”\u003c/p>\n\u003cp>But when she logged onto her insurance website to find a therapist, she realized her copay for a mental health visit was going to be upwards of $75 – more than double her copay for other doctors’ appointments. Under a 2008 federal mental health law, those copays are supposed to be the same.\u003c/p>\n\u003cp>“There’s no way,” Dunnege says. “It’s out of my budget right now.”\u003c/p>\n\u003cfigure id=\"attachment_186111\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-186111\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/1010622-e1463762466497.jpg\" alt=\"Natalie Dunnege and her son, Strazh.\" width=\"1920\" height=\"1280\">\u003cfigcaption class=\"wp-caption-text\">Natalie Dunnege and her son, Strazh. \u003ccite>(Sheraz Sadiq/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dunnege lives in a one-bedroom apartment with her son and her father in San Francisco's Haight district. Grandfather and grandson sleep in twin beds side by side. It’s an awkward walk past those beds to the only bathroom. Dunnege says $75 a week for therapy is impossible.\u003c/p>\n\u003cp>“My income, I just made lower middle income. Just by the skin of my teeth,” she says. “So I just have to hold off until I’m actually middle class.”\u003c/p>\n\u003cp>More than 43 million Americans suffer from depression, anxiety and other mental health conditions, according to the most recent \u003ca href=\"http://www.samhsa.gov/data/sites/default/files/NSDUH-DR-FRR3-2014/NSDUH-DR-FRR3-2014/NSDUH-DR-FRR3-2014.htm\" target=\"_blank\" rel=\"noopener noreferrer\">federal data\u003c/a>. But more than half the people who felt like they needed help last year, never got it. Even people who had insurance complained of barriers to care. Some said they still couldn't afford it; some were embarrassed to ask for help. Others just couldn't get through \u003ca href=\"http://www.nap.edu/catalog/23442/ending-discrimination-against-people-with-mental-and-substance-use-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">the red tape\u003c/a>.\u003c/p>\n\u003cp>Recent health laws, the 2008 Mental Health Parity Act and the Affordable Care Act, were supposed to fix this. They require health plans to provide benefits for mental health conditions on par with physical health conditions. Under the law, insurance companies can’t charge higher copays or set up separate deductibles for mental health care compared to other medical or surgical care. They can’t limit hospital stays or require preauthorization for mental health treatment if the same limits are not applied to treatment for physical health conditions.\u003c/p>\n\u003cp>But advocates say insurance companies are still finding ways to keep people who need care from getting it. Some are still not complying with the law. And some have found subtle, technically legally, ways to limit treatment.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/265497893&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/265497893'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Problems with Mental Health Provider Directories\u003c/strong>\u003c/p>\n\u003cp>Natalie Dunnege encountered some of these barriers when she tried again to find a therapist. In the last year, she got a promotion at work and moved into a larger apartment. Her employer switched to a better health plan, too. Now she has Blue Shield coverage, and her copay for mental health appointments is only $20.\u003c/p>\n\u003cp>\"Which I was really excited about,\" Dunnege says.\u003c/p>\n\u003cp>But when she looked for a therapist who took her insurance, she struck out.\u003c/p>\n\u003cp>“I contacted six or seven,” she says.\u003c/p>\n\u003cp>Only three called her back.\u003c/p>\n\u003cp>“One of them, they were completely booked,” she says. “And then the other two just didn’t accept the insurance anymore.”\u003c/p>\n\u003cp>Zero hits out of seven. Had to be a bad draw, right?\u003c/p>\n\u003cp>To find out, we decided to conduct our own survey and called all the psychologists -- 100 in total -- that were listed on the Blue Shield website for Natalie’s plan in San Francisco.\u003c/p>\n\u003cp>Here's what happened:\u003c/p>\n\u003cfigure id=\"attachment_186898\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/mentalHealthTreatmentPost.jpg\">\u003cimg class=\"wp-image-186898 size-full\" title=\"Blue Shield In-Network Psychologists\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/mentalHealthTreatmentPost.jpg\" alt=\"mentalHealthTreatmentPost\" width=\"1920\" height=\"2055\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-400x428.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-800x856.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-768x822.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-1440x1541.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-1180x1263.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-960x1028.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lisa Pickoff-White/KQED \u003ccite>(Lisa Pickoff-White/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The end result: 28 psychologists actually had appointments. And only eight of them had slots available outside regular work hours. Eight out of 100.\u003c/p>\n\u003cp>“Sorry, I wish you the best of luck,” was a common refrain in therapists’ voicemail messages.\u003c/p>\n\u003cp>For Natalie Dunnege, after seven rejections, she gave up looking.\u003c/p>\n\u003cp>\"It's hard when you're feeling sad and you feel like you can barely keep things together,” she says. “It just seemed like way too much at the time.”\u003c/p>\n\u003cp>Mental health advocates say this is exactly what insurance companies are hoping.\u003c/p>\n\u003cp>“It’s a way to control cost,” says Keith Humphreys, a Stanford psychiatry professor who served as an advisor to Congress when it was developing the 2008 Mental Health Parity Act. He says while insurers are now required to keep an adequate number of clinicians listed in their directories, they still find ways to sidestep the rules.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>“You know the law doesn't say you can't put people on there who are dead, or you can't put people on there who are not taking new patients,” he says. “What that translates into, then, is people have to wait longer for care, which then cuts expenditures for the insurer and reduces access.”\u003c/p>\n\u003cp>California passed a law last year, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB137\" target=\"_blank\" rel=\"noopener noreferrer\">SB 137\u003c/a>, raising the standards for physician directories. Insurers will have to police their lists for providers who are booked or retired. But a lot of questions remain about how the law will be enforced, especially when it comes to mental health providers, who are largely self-employed, solo practitioners.\u003c/p>\n\u003cp>The insurance industry says it will be a challenge.\u003c/p>\n\u003cp>“When you have networks as large as ours and you have as many enrollees as we have here in California, you're not going to be able to just have everything accurate every single second of every single day,” says Charles Bacchi, CEO of the California Association of Health Plans.\u003c/p>\n\u003cp>He said the industry is working to make it better.\u003c/p>\n\u003cp>“But we also need to be realistic,” he says. “We don't run a mental health provider's office. They do. And how they handle people calling their offices is their job.”\u003c/p>\n\u003cp>In a statement, Blue Shield said it tries to make it easy for providers to update changes in their contact information and schedule.\u003c/p>\n\u003cp>“We understand that there are a number of issues that impact a provider's availability to take new patients, such as administrative limitations and fluctuating numbers of patients based on their individual needs. When those instances arise, the provider is required to notify us so that patients have access to the most up-to-date information about who is available in their area.\"\u003c/p>\n\u003cp>The industry also says it’s facing another challenge: a nationwide shortage of mental health providers, further exacerbated by the millions of people who signed up for insurance under the Affordable Care Act.\u003c/p>\n\u003cp>In California, there are \"around 4 to 5 million more people with coverage, just in the last two years,” Bacchi says. “And that’s creating a strain for everybody, plans and mental health providers.”\u003c/p>\n\u003cp>But is it really just a supply and demand problem? Is it that there aren’t enough therapists, or is it that there aren’t enough therapists who are willing to work under the terms and rates set by the insurance companies?\u003c/p>\n\u003cp>\u003cem>This story was originally published on May 23, 2016. The video will be broadcast on KQED Newsroom July 15, 2016. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Three Oakland City Council members are calling on local and federal agencies to investigate opponents of the city's proposed soda tax on the fall ballot. They say the beverage industry's advertising is deceptive.\u003c/p>\n\u003cp>At issue are opposition \u003ca href=\"https://www.youtube.com/watch?v=VR39xsY7lHA\" target=\"_blank\">TV ads \u003c/a>and a flier that label the effort a \"Grocery Tax [that] can be applied to any item in the store, not just sodas.\"\u003c/p>\n\u003cp>“This is not a tax on bread or vegetables or milk or cheese,\" said Council member Annie Campbell Washington, one of the proponents of the ordinance. \"It has been disgraceful to see that the American Beverage Association has put out these fliers with blatant lies.\"\u003c/p>\n\u003cp>Washington and fellow Council members Rebecca Kaplan and Desley Brooks plan to file complaints both with the city's Ethics Commission and the Federal Communications Commission.\u003c/p>\n\u003cp>In \u003ca href=\"https://drive.google.com/file/d/0B_hwSHbql0a0UEt6Zzg4eWNlZ1U/view?pref=2&pli=1\" target=\"_blank\">a statement\u003c/a> Joe Arellano, spokesman for the No Oakland Grocery Tax Campaign, defended the choice of words:\u003c/p>\n\u003cblockquote>\u003cp>The backers of the grocery tax need to read their own measure. It is not a tax on beverages. It is a tax on distributors of sugar-sweetened beverages, which means any retailer who sells soda can decide to spread that new tax over any item in their stores.\u003c/p>\u003c/blockquote>\n\u003cp>Arellano's group is backed with \"\u003ca href=\"http://nooaklandgrocerytax.com/content.aspx?page=About\" target=\"_blank\">major funding\u003c/a>\" by the American Beverage Association.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Oakland City Council \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/04/oakland-city-council-puts-soda-tax-on-november-ballot/\" target=\"_blank\">voted unanimously in May\u003c/a> to put a penny-per-ounce 'health impact fee' on the distributors of sugar-sweetened beverages on the November ballot.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Similar fees on sugar-sweetened beverages will also be on the ballot in San Francisco and Albany. All three cities' proposals are modeled after the measure passed in \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\">Berkeley in 2014\u003c/a>, the first community in the country to pass a soda tax.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Three Oakland City Council members are calling on local and federal agencies to investigate opponents of the city's proposed soda tax on the fall ballot. They say the beverage industry's advertising is deceptive.\u003c/p>\n\u003cp>At issue are opposition \u003ca href=\"https://www.youtube.com/watch?v=VR39xsY7lHA\" target=\"_blank\">TV ads \u003c/a>and a flier that label the effort a \"Grocery Tax [that] can be applied to any item in the store, not just sodas.\"\u003c/p>\n\u003cp>“This is not a tax on bread or vegetables or milk or cheese,\" said Council member Annie Campbell Washington, one of the proponents of the ordinance. \"It has been disgraceful to see that the American Beverage Association has put out these fliers with blatant lies.\"\u003c/p>\n\u003cp>Washington and fellow Council members Rebecca Kaplan and Desley Brooks plan to file complaints both with the city's Ethics Commission and the Federal Communications Commission.\u003c/p>\n\u003cp>In \u003ca href=\"https://drive.google.com/file/d/0B_hwSHbql0a0UEt6Zzg4eWNlZ1U/view?pref=2&pli=1\" target=\"_blank\">a statement\u003c/a> Joe Arellano, spokesman for the No Oakland Grocery Tax Campaign, defended the choice of words:\u003c/p>\n\u003cblockquote>\u003cp>The backers of the grocery tax need to read their own measure. It is not a tax on beverages. It is a tax on distributors of sugar-sweetened beverages, which means any retailer who sells soda can decide to spread that new tax over any item in their stores.\u003c/p>\u003c/blockquote>\n\u003cp>Arellano's group is backed with \"\u003ca href=\"http://nooaklandgrocerytax.com/content.aspx?page=About\" target=\"_blank\">major funding\u003c/a>\" by the American Beverage Association.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Oakland City Council \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/04/oakland-city-council-puts-soda-tax-on-november-ballot/\" target=\"_blank\">voted unanimously in May\u003c/a> to put a penny-per-ounce 'health impact fee' on the distributors of sugar-sweetened beverages on the November ballot.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Similar fees on sugar-sweetened beverages will also be on the ballot in San Francisco and Albany. All three cities' proposals are modeled after the measure passed in \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\">Berkeley in 2014\u003c/a>, the first community in the country to pass a soda tax.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "In Conversation with the Head of California's Physician Lobby",
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"content": "\u003cp>The \u003ca href=\"http://www.cmanet.org/\" target=\"_blank\">\u003cu>California Medical Association\u003c/u>\u003c/a>, which represents about 41,000 doctors, has been at the heart of health care deliberations in Sacramento for decades. This year, it has staked out strong and sometimes surprising positions on the legalization of marijuana, Medi-Cal provider rates and the role it believes nurse practitioners should play in patient care.\u003c/p>\n\u003caside class=\"pullquote alignright\">One in three Californians is now on Medi-Cal. That is the public option. It needs to be funded. Right now, they’re funding it through discounts to physicians.\u003ccite>Steven Larson, California Medical Association president \u003c/cite>\u003c/aside>\n\u003cp>\u003ca href=\"http://californiahealthline.org/\" target=\"_blank\">\u003cu>California Healthline\u003c/u>\u003c/a> discussed these positions with current CMA president, \u003ca href=\"http://www.cmanet.org/about/cma-governance/cma-executive-committee/steven-larson-md/\" target=\"_blank\">\u003cu>Steven Larson\u003c/u>\u003c/a>, a primary care and infectious disease physician who practices in Riverside. Larson is also CEO of Riverside Medical Clinic, a multispecialty medical group.\u003c/p>\n\u003cp>Among Larson’s points is that his organization — which has long battled the state over low Medi-Cal reimbursement rates for doctors — is now taking its fight to the people. Medi-Cal is the state’s Medicaid program for low-income residents. It provides coverage to more than 13 million people, and the rates California pays to participating physicians are among the lowest in the country.\u003c/p>\n\u003cp>Larson said the CMA is looking to the state’s initiative process for relief. Proposition 56, a proposed cigarette tax, and Proposition 55, an extension of the Proposition 30 income tax increases that voters approved in 2012, \u003ca href=\"http://www.sos.ca.gov/administration/news-releases-and-advisories/2016-news-releases-and-advisories/proposition-numbers-november-ballot-measures/\" target=\"_blank\">\u003cu>are both on the November ballot\u003c/u>\u003c/a>. If they pass, they’re expected to provide some money for Medi-Cal services.\u003c/p>\n\u003cp>“We have to do it on our own because the state government is not very sympathetic,” Larson said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Q: With roughly 80 percent of Medi-Cal enrollees now in managed care and that number rising, shouldn’t your argument that payments to doctors are too low be addressed to private insurance companies instead of the stat\u003c/strong>e?\u003c/p>\n\u003cp>The managed care reimbursement to Medi-Cal providers is much lower than commercial rates. Just being in managed care doesn’t mean the rates are competitive with commercial rates. Not only are they not competitive, they are not sustainable for most practices.\u003c/p>\n\u003cp>Right now these patients are disadvantaged. If you have cancer in Medi-Cal, you do no better than if you have no insurance at all. That was \u003ca href=\"http://www.latimes.com/local/california/la-me-cancer-disparities-20151119-story.html\" target=\"_blank\">\u003cu>in the Los Angeles Times recently\u003c/u>\u003c/a>. I think that’s true. They have no access.\u003c/p>\n\u003cp>\u003ca href=\"http://www.bayareaeconomy.org/files/pdf/MainstreamingMedi-Cal.pdf\" target=\"_blank\">\u003cu>California is 47th out of 50 states\u003c/u>\u003c/a> in Medicaid payments to physicians. That includes managed care.\u003c/p>\n\u003cp>What we’re doing now is hoping to create revenue through taxation that’s directed to Medi-Cal rates. The cigarette tax initiative and perhaps some of the Proposition 30 extension monies might go toward propping up Medi-Cal rates.\u003c/p>\n\u003cp>\u003cstrong>Q: You’re saying that the CMA is using the ballot process to try to increase payments to doctors because its efforts through the Legislature have failed?\u003c/strong>\u003c/p>\n\u003cp>Absolutely. We have decided we have to do it on our own because the state government is not very sympathetic. We’ve gone to them many times and it doesn’t seem to matter.\u003c/p>\n\u003cp>The idea is that the citizens of California with Medi-Cal have no access because of low reimbursement rates to doctors.\u003c/p>\n\u003cp>One in three Californians is now on Medi-Cal. That is the public option. It needs to be funded. Right now, they’re funding it through discounts to physicians. And now they have added undocumented children to full Medi-Cal coverage.\u003c/p>\n\u003cp>\u003cstrong>Q: If these ballot initiatives pass and there’s more funding for Medi-Cal, how should it be distributed?\u003c/strong>\u003c/p>\n\u003cp>We hope the money flows through the system, both in managed care and fee-for-service.\u003c/p>\n\u003cp>You have to understand the managed care plans pay primary care physicians a capitated, per member, per month rate. They pay specialists the Medi-Cal fee-for-service rates.\u003c/p>\n\u003cp>An office visit for Medi-Cal is about $16. That’s for a primary care visit and a follow-up visit for a specialist. That’s what I pay for a haircut. There’s something wrong about that.\u003c/p>\n\u003cp>\u003cstrong>Q: You mentioned that immigrant children without papers can now get full Medi-Cal. Should adult immigrants who are here without proper documentation also get it?\u003c/strong>\u003c/p>\n\u003cp>We don’t have an official CMA policy on that. We do have a policy that states that all people who reside in the state should have insurance coverage. I certainly think we should expand Medi-Cal to all individuals that can’t afford health insurance through other means. That’s my personal belief, not the CMA position.\u003c/p>\n\u003cp>\u003cstrong>Q: The CMA says it \u003ca href=\"http://www.cmanet.org/news/press-detail/?article=ca-medical-association-announces-support-for\" target=\"_blank\">\u003cu>does not “encourage the use of marijuana and discourages smoking\u003c/u>\u003c/a>.” Yet it supports an initiative on the November ballot to \u003ca href=\"https://ballotpedia.org/California_Marijuana_Legalization_Initiative,_Proposition_64_(2016)\" target=\"_blank\">\u003cu>legalize marijuana\u003c/u>\u003c/a>. Why?\u003c/strong>\u003c/p>\n\u003cp>It sounds like a high-wire act. In reality, we suspect that marijuana may have some beneficial medical effects and it’s difficult to research those in the current climate.\u003c/p>\n\u003cp>We also know that marijuana is harmful to developing brains. We want to avoid it getting into the hands of adolescents. Our understanding is that it’s easier for high school kids to get marijuana than tobacco or alcohol. It shouldn’t be… If we could regulate marijuana, then we would hope it would be less available to adolescents. The black market will dry up.\u003c/p>\n\u003cp>\u003cstrong>Q: Isn’t there a risk that making it legal will create an industry with marketing clout similar to tobacco or unhealthy foods, thus increasing consumption?\u003c/strong>\u003c/p>\n\u003cp>We’re very concerned about that. We oppose smoking marijuana or ingesting marijuana for nonmedicinal reasons. But we’re not so naïve to think it’s not going to happen.\u003c/p>\n\u003cp>Right now, medicinal marijuana is terribly abused and misused and puts physicians in the middle. I’m a practicing physician and some patients inappropriately want a diagnosis to obtain marijuana.\u003c/p>\n\u003cp>The harm reduction in adolescents outweighs the risk. Some adults who smoke it already will continue to smoke it. I don’t think a lot of adults will go out and start smoking.\u003c/p>\n\u003cp>\u003cstrong>Q: A proposed law to allow nurse practitioners more independence in treating patients \u003ca href=\"http://californiahealthline.org/news/california-nurse-practitioners-lose-battle-for-independent-practice-again/\" target=\"_blank\">\u003cu>failed in the Legislature again this year\u003c/u>\u003c/a>. You opposed it. Why not allow it, particularly in the Medi-Cal population, thus making care more available?\u003c/strong>\u003c/p>\n\u003cp>Many of our practices, including my own, have nurse practitioners. We do not feel they should practice independently. If we allow them to practice medicine, they should have the same standards that physicians have. They should be licensed by the Medical Board. They should have the same liability and educational requirements.\u003c/p>\n\u003cp>Yes, nurse practitioners could help us treat diabetes, hypertension, obesity and many common diseases. It’s the uncommon diseases they haven’t been trained to treat, or even identify. When a person is going to a practice for a diagnosis, they need to go to a diagnostician, which would be a physician, not a nurse practitioner.\u003c/p>\n\u003cp>There’s no reason why we can’t expand access just because they require supervision. They can help with telehealth. Let’s say they’re in a remote location and through telehealth they communicate with a physician who oversees the patient’s history and lab studies. We think the supervision safeguards the public.\u003c/p>\n\u003cp>\u003cstrong>Q: Some other states already have given nurse practitioners more authority. Have there been problems there?\u003c/strong>\u003c/p>\n\u003cp>In other states that have allowed it, there are very few nurse practitioners that are practicing independently. For the most part, they recognize their liabilities and deficiencies. They want to practice in the same desirable locations that physicians do. So they frequently don’t go to areas of shortages and treat Medicaid patients, which is the rationale they’re giving for their scope-of-practice expansion [in California].\u003c/p>\n\u003cp>\u003cstrong>Q: How would you respond to people who say doctors oppose expanding scope of practice for nurse practitioners because they don’t want to see prices for their services suppressed by an influx of new providers?\u003c/strong>\u003c/p>\n\u003cp>That’s simply not true. Show me a state where they have had an influx of unsupervised nurse practitioners where the prices have dropped.\u003c/p>\n\u003cp>Having additional providers does not decrease the cost of care. It increases the cost of care. Tests cost money. The less trained an individual is, the more ancillary tests they’ll order.\u003c/p>\n\u003cp>\u003cstrong>Q: On the cost of prescription drugs, why support Sen. Ed Hernandez’s \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB1010\" target=\"_blank\">\u003cu>drug transparency bill\u003c/u>\u003c/a> yet fight \u003ca href=\"https://ballotpedia.org/California_Proposition_61,_Drug_Price_Standards_Initiative_(2016)\" target=\"_blank\">\u003cu>the initiative that will be on the November ballot\u003c/u>\u003c/a> to regulate the price that state agencies pay for drugs?\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The reason we oppose the [ballot] initiative is we believe it is poorly written. We think it’s cumbersome to tie drug costs to [Department of Veterans Affairs] drug pricing. It will probably result in drug shortages for California and it will inhibit innovation.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The \u003ca href=\"http://www.cmanet.org/\" target=\"_blank\">\u003cu>California Medical Association\u003c/u>\u003c/a>, which represents about 41,000 doctors, has been at the heart of health care deliberations in Sacramento for decades. This year, it has staked out strong and sometimes surprising positions on the legalization of marijuana, Medi-Cal provider rates and the role it believes nurse practitioners should play in patient care.\u003c/p>\n\u003caside class=\"pullquote alignright\">One in three Californians is now on Medi-Cal. That is the public option. It needs to be funded. Right now, they’re funding it through discounts to physicians.\u003ccite>Steven Larson, California Medical Association president \u003c/cite>\u003c/aside>\n\u003cp>\u003ca href=\"http://californiahealthline.org/\" target=\"_blank\">\u003cu>California Healthline\u003c/u>\u003c/a> discussed these positions with current CMA president, \u003ca href=\"http://www.cmanet.org/about/cma-governance/cma-executive-committee/steven-larson-md/\" target=\"_blank\">\u003cu>Steven Larson\u003c/u>\u003c/a>, a primary care and infectious disease physician who practices in Riverside. Larson is also CEO of Riverside Medical Clinic, a multispecialty medical group.\u003c/p>\n\u003cp>Among Larson’s points is that his organization — which has long battled the state over low Medi-Cal reimbursement rates for doctors — is now taking its fight to the people. Medi-Cal is the state’s Medicaid program for low-income residents. It provides coverage to more than 13 million people, and the rates California pays to participating physicians are among the lowest in the country.\u003c/p>\n\u003cp>Larson said the CMA is looking to the state’s initiative process for relief. Proposition 56, a proposed cigarette tax, and Proposition 55, an extension of the Proposition 30 income tax increases that voters approved in 2012, \u003ca href=\"http://www.sos.ca.gov/administration/news-releases-and-advisories/2016-news-releases-and-advisories/proposition-numbers-november-ballot-measures/\" target=\"_blank\">\u003cu>are both on the November ballot\u003c/u>\u003c/a>. If they pass, they’re expected to provide some money for Medi-Cal services.\u003c/p>\n\u003cp>“We have to do it on our own because the state government is not very sympathetic,” Larson said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Q: With roughly 80 percent of Medi-Cal enrollees now in managed care and that number rising, shouldn’t your argument that payments to doctors are too low be addressed to private insurance companies instead of the stat\u003c/strong>e?\u003c/p>\n\u003cp>The managed care reimbursement to Medi-Cal providers is much lower than commercial rates. Just being in managed care doesn’t mean the rates are competitive with commercial rates. Not only are they not competitive, they are not sustainable for most practices.\u003c/p>\n\u003cp>Right now these patients are disadvantaged. If you have cancer in Medi-Cal, you do no better than if you have no insurance at all. That was \u003ca href=\"http://www.latimes.com/local/california/la-me-cancer-disparities-20151119-story.html\" target=\"_blank\">\u003cu>in the Los Angeles Times recently\u003c/u>\u003c/a>. I think that’s true. They have no access.\u003c/p>\n\u003cp>\u003ca href=\"http://www.bayareaeconomy.org/files/pdf/MainstreamingMedi-Cal.pdf\" target=\"_blank\">\u003cu>California is 47th out of 50 states\u003c/u>\u003c/a> in Medicaid payments to physicians. That includes managed care.\u003c/p>\n\u003cp>What we’re doing now is hoping to create revenue through taxation that’s directed to Medi-Cal rates. The cigarette tax initiative and perhaps some of the Proposition 30 extension monies might go toward propping up Medi-Cal rates.\u003c/p>\n\u003cp>\u003cstrong>Q: You’re saying that the CMA is using the ballot process to try to increase payments to doctors because its efforts through the Legislature have failed?\u003c/strong>\u003c/p>\n\u003cp>Absolutely. We have decided we have to do it on our own because the state government is not very sympathetic. We’ve gone to them many times and it doesn’t seem to matter.\u003c/p>\n\u003cp>The idea is that the citizens of California with Medi-Cal have no access because of low reimbursement rates to doctors.\u003c/p>\n\u003cp>One in three Californians is now on Medi-Cal. That is the public option. It needs to be funded. Right now, they’re funding it through discounts to physicians. And now they have added undocumented children to full Medi-Cal coverage.\u003c/p>\n\u003cp>\u003cstrong>Q: If these ballot initiatives pass and there’s more funding for Medi-Cal, how should it be distributed?\u003c/strong>\u003c/p>\n\u003cp>We hope the money flows through the system, both in managed care and fee-for-service.\u003c/p>\n\u003cp>You have to understand the managed care plans pay primary care physicians a capitated, per member, per month rate. They pay specialists the Medi-Cal fee-for-service rates.\u003c/p>\n\u003cp>An office visit for Medi-Cal is about $16. That’s for a primary care visit and a follow-up visit for a specialist. That’s what I pay for a haircut. There’s something wrong about that.\u003c/p>\n\u003cp>\u003cstrong>Q: You mentioned that immigrant children without papers can now get full Medi-Cal. Should adult immigrants who are here without proper documentation also get it?\u003c/strong>\u003c/p>\n\u003cp>We don’t have an official CMA policy on that. We do have a policy that states that all people who reside in the state should have insurance coverage. I certainly think we should expand Medi-Cal to all individuals that can’t afford health insurance through other means. That’s my personal belief, not the CMA position.\u003c/p>\n\u003cp>\u003cstrong>Q: The CMA says it \u003ca href=\"http://www.cmanet.org/news/press-detail/?article=ca-medical-association-announces-support-for\" target=\"_blank\">\u003cu>does not “encourage the use of marijuana and discourages smoking\u003c/u>\u003c/a>.” Yet it supports an initiative on the November ballot to \u003ca href=\"https://ballotpedia.org/California_Marijuana_Legalization_Initiative,_Proposition_64_(2016)\" target=\"_blank\">\u003cu>legalize marijuana\u003c/u>\u003c/a>. Why?\u003c/strong>\u003c/p>\n\u003cp>It sounds like a high-wire act. In reality, we suspect that marijuana may have some beneficial medical effects and it’s difficult to research those in the current climate.\u003c/p>\n\u003cp>We also know that marijuana is harmful to developing brains. We want to avoid it getting into the hands of adolescents. Our understanding is that it’s easier for high school kids to get marijuana than tobacco or alcohol. It shouldn’t be… If we could regulate marijuana, then we would hope it would be less available to adolescents. The black market will dry up.\u003c/p>\n\u003cp>\u003cstrong>Q: Isn’t there a risk that making it legal will create an industry with marketing clout similar to tobacco or unhealthy foods, thus increasing consumption?\u003c/strong>\u003c/p>\n\u003cp>We’re very concerned about that. We oppose smoking marijuana or ingesting marijuana for nonmedicinal reasons. But we’re not so naïve to think it’s not going to happen.\u003c/p>\n\u003cp>Right now, medicinal marijuana is terribly abused and misused and puts physicians in the middle. I’m a practicing physician and some patients inappropriately want a diagnosis to obtain marijuana.\u003c/p>\n\u003cp>The harm reduction in adolescents outweighs the risk. Some adults who smoke it already will continue to smoke it. I don’t think a lot of adults will go out and start smoking.\u003c/p>\n\u003cp>\u003cstrong>Q: A proposed law to allow nurse practitioners more independence in treating patients \u003ca href=\"http://californiahealthline.org/news/california-nurse-practitioners-lose-battle-for-independent-practice-again/\" target=\"_blank\">\u003cu>failed in the Legislature again this year\u003c/u>\u003c/a>. You opposed it. Why not allow it, particularly in the Medi-Cal population, thus making care more available?\u003c/strong>\u003c/p>\n\u003cp>Many of our practices, including my own, have nurse practitioners. We do not feel they should practice independently. If we allow them to practice medicine, they should have the same standards that physicians have. They should be licensed by the Medical Board. They should have the same liability and educational requirements.\u003c/p>\n\u003cp>Yes, nurse practitioners could help us treat diabetes, hypertension, obesity and many common diseases. It’s the uncommon diseases they haven’t been trained to treat, or even identify. When a person is going to a practice for a diagnosis, they need to go to a diagnostician, which would be a physician, not a nurse practitioner.\u003c/p>\n\u003cp>There’s no reason why we can’t expand access just because they require supervision. They can help with telehealth. Let’s say they’re in a remote location and through telehealth they communicate with a physician who oversees the patient’s history and lab studies. We think the supervision safeguards the public.\u003c/p>\n\u003cp>\u003cstrong>Q: Some other states already have given nurse practitioners more authority. Have there been problems there?\u003c/strong>\u003c/p>\n\u003cp>In other states that have allowed it, there are very few nurse practitioners that are practicing independently. For the most part, they recognize their liabilities and deficiencies. They want to practice in the same desirable locations that physicians do. So they frequently don’t go to areas of shortages and treat Medicaid patients, which is the rationale they’re giving for their scope-of-practice expansion [in California].\u003c/p>\n\u003cp>\u003cstrong>Q: How would you respond to people who say doctors oppose expanding scope of practice for nurse practitioners because they don’t want to see prices for their services suppressed by an influx of new providers?\u003c/strong>\u003c/p>\n\u003cp>That’s simply not true. Show me a state where they have had an influx of unsupervised nurse practitioners where the prices have dropped.\u003c/p>\n\u003cp>Having additional providers does not decrease the cost of care. It increases the cost of care. Tests cost money. The less trained an individual is, the more ancillary tests they’ll order.\u003c/p>\n\u003cp>\u003cstrong>Q: On the cost of prescription drugs, why support Sen. Ed Hernandez’s \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB1010\" target=\"_blank\">\u003cu>drug transparency bill\u003c/u>\u003c/a> yet fight \u003ca href=\"https://ballotpedia.org/California_Proposition_61,_Drug_Price_Standards_Initiative_(2016)\" target=\"_blank\">\u003cu>the initiative that will be on the November ballot\u003c/u>\u003c/a> to regulate the price that state agencies pay for drugs?\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The reason we oppose the [ballot] initiative is we believe it is poorly written. We think it’s cumbersome to tie drug costs to [Department of Veterans Affairs] drug pricing. It will probably result in drug shortages for California and it will inhibit innovation.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>As an AIDS activist 30 years ago, Michael Weinstein helped defeat an inflammatory ballot measure that could have quarantined Californians with the disease. Today, Weinstein has turned to the ballot to advance his own controversial vision for public health.\u003c/p>\n\u003caside class=\"pullquote alignright\">'He is an outlier, and in many corners he is a pariah.' \u003ccite>San Francisco Supervisor Scott Wiener \u003c/cite>\u003c/aside>\n\u003cp>President of the Los Angeles-based AIDS Healthcare Foundation, which has clinics around the world, Weinstein is the architect of two initiatives Californians will vote on in November: Proposition 60, which would require actors in adult films to use condoms, and Proposition 61, which would cap the price state health programs pay for prescription drugs.\u003c/p>\n\u003cp>The drug measure – which would limit the state to the discounted price paid by the U.S. Department of Veterans Affairs – taps into widespread frustration about \u003ca href=\"https://calmatters.org/articles/california-takes-measures-to-control-drug-spending-but-costs-soar/\" target=\"_blank\">expensive medication\u003c/a>, an issue that plagues the state budget and has surfaced in the presidential campaign. A condom requirement was popular with Los Angeles County voters, who approved a measure backed by Weinstein on their local ballot four years ago.\u003c/p>\n\u003cp>Yet both statewide propositions have sparked concern in segments of the communities they purport to help. Some patient advocates \u003ca href=\"https://calmatters.org/articles/would-a-california-ballot-measure-reduce-drug-spending-nobody-knows/\" target=\"_blank\">question\u003c/a> whether the drug-pricing measure could really contain costs for people whose health depends on expensive medicine, while many porn actors say the condom proposal would kill their business or drive it underground.\u003c/p>\n\u003cp>Similar fights have already occurred in the state Capitol, where bills have stalled that would have required \u003ca href=\"http://www.leginfo.ca.gov/pub/13-14/bill/asm/ab_1551-1600/ab_1576_cfa_20140428_124049_asm_comm.html\" target=\"_blank\">condom use on adult movie sets \u003c/a>and mandated more \u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/asm/ab_0451-0500/ab_463_cfa_20160108_154309_asm_comm.html\" target=\"_blank\">disclosure from drug companies \u003c/a>in an effort to curb rising prices. Weinstein said he’s taking the issues directly to voters because lawmakers have kowtowed to the porn and pharmaceutical industries.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I have a hard time remembering any issue where the public was so strongly in one direction and the political system was so strongly stuck in inaction,” Weinstein said of his effort to cap drug prices.\u003c/p>\n\u003cp>The condom issue is related, he said, because of “inaction by government.”\u003c/p>\n\u003cp>The initiatives mark the latest iteration of Weinstein’s long advocacy career, one that has made him a maverick to some, anathema to others.\u003c/p>\n\u003cp>Weinstein, 63, said he experienced his political awakening in 1986, when, as a budding gay-rights activist, he campaigned against an initiative that would have barred AIDS patients from schools and some types of jobs.\u003c/p>\n\u003cp>He went on to open an AIDS hospice that eventually grew into the AIDS Healthcare Foundation. Today the organization spans 36 countries, operating health clinics, thrift shops and pharmacies that sell some of the high-priced drugs Weinstein is campaigning against.\u003c/p>\n\u003cp>“The more prices go up, the more we earn,” he said. “That’s the irony of this situation…. People say, ‘What’s in it for you?’ Nothing, from a financial point of view.”\u003c/p>\n\u003cp>Although Weinstein runs a global AIDS organization, he has publicly clashed with AIDS activists over his criticism of \u003ca href=\"http://www.nytimes.com/2014/11/17/upshot/aids-group-wages-lonely-fight-against-pill-to-prevent-hiv.html?_r=1\" target=\"_blank\">an HIV-prevention drug\u003c/a>. He says broad use could result in infection from unprotected sex, although most of the medical community recommends it to people at risk for the disease.\u003c/p>\n\u003cp>On the adult film issue, performers who say they contracted sexually transmitted diseases on the job rally behind him. Those who believe existing protections are adequate see him as a meddlesome nanny.\u003c/p>\n\u003cp>He is embroiled in planning disputes in Los Angeles, where he lives, and in San Francisco, where his effort to open a pharmacy in the famous Castro district put Weinstein – a gay man – at odds with the heavily gay community.\u003c/p>\n\u003cp>“He is an outlier, and in many corners he is a pariah,” said San Francisco Supervisor Scott Wiener, who represents the Castro neighborhood and \u003ca href=\"http://blog.sfgate.com/cityinsider/2014/08/06/aids-healthcare-foundation-sues-sf-over-chain-store-rules/\" target=\"_blank\">was sued\u003c/a> by Weinstein’s foundation over the pharmacy dispute. The lawsuit challenges regulations the supervisor authored.\u003c/p>\n\u003cp>Weinstein’s nonprofit AIDS Healthcare Foundation has spent $11 million so far to support the two measures it put on the November ballot. Opponents in the pharmaceutical industry have poured more than $69 million into fighting Proposition 61. Pornography producers have contributed roughly $60,000 against Proposition 60.\u003c/p>\n\u003cp>Since Weinstein’s take-it-to-the-people approach proved successful in Los Angeles in 2012, permits for X-rated film production have \u003ca href=\"http://www.latimes.com/entertainment/envelope/cotown/la-et-ct-onlocation-la-porn-industry-20140806-story.html\" target=\"_blank\">dropped dramatically \u003c/a>– fueling opponents’ arguments about pushing the $9-billion industry out of California.\u003c/p>\n\u003cfigure id=\"attachment_212278\" class=\"wp-caption aligncenter\" style=\"max-width: 1200px\">\u003cimg class=\"size-full wp-image-212278\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/07/adult_performers.jpg\" alt=\"Speakers line up to testify at a Capitol hearing about Proposition 60, which would require condom use in porn films. \" width=\"1200\" height=\"900\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/07/adult_performers.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/27/2016/07/adult_performers-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/07/adult_performers-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/07/adult_performers-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/07/adult_performers-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/07/adult_performers-960x720.jpg 960w\" sizes=\"(max-width: 1200px) 100vw, 1200px\">\u003cfigcaption class=\"wp-caption-text\">Speakers line up to testify at a Capitol hearing about Proposition 60, which would require condom use in porn films. \u003ccite>(Laurel Rosenhall/CALmatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Some in the adult film industry say they already minimize the spread of disease with frequent testing. Many of them filled a hearing room at the Capitol last month when lawmakers reviewed Proposition 60.\u003c/p>\n\u003cp>“We are not opposed to regulation itself, but instead [to] this new-age witch hunt perpetuated by the AIDS Healthcare Foundation,” said a performer who introduced herself as Mimosa.\u003c/p>\n\u003cp>On the other side was Cameron Adams, a former porn actor who said Proposition 60 could save others from her fate.\u003c/p>\n\u003cp>“Testing doesn’t stop infection,” Adams said through tears, addressing the panel of legislators. “I followed the adult film industry’s self-regulation, and I’m sitting here before you as an HIV-positive woman.”\u003c/p>\n\u003cp>State Sen. Isadore Hall (D-Compton) has carried bills in the Legislature that would have required condom use in porn movies. He described Weinstein as a “great guy” whose trailblazing work has protected lives and, naturally, made him controversial.\u003c/p>\n\u003cp>“That’s just the name of the game,” Hall said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>CALmatters is a non-profit journalism venture dedicated to exploring state policies and politics. For more stories by Laurel Rosenhall, go to calmatters.org/newsanalysis\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As an AIDS activist 30 years ago, Michael Weinstein helped defeat an inflammatory ballot measure that could have quarantined Californians with the disease. Today, Weinstein has turned to the ballot to advance his own controversial vision for public health.\u003c/p>\n\u003caside class=\"pullquote alignright\">'He is an outlier, and in many corners he is a pariah.' \u003ccite>San Francisco Supervisor Scott Wiener \u003c/cite>\u003c/aside>\n\u003cp>President of the Los Angeles-based AIDS Healthcare Foundation, which has clinics around the world, Weinstein is the architect of two initiatives Californians will vote on in November: Proposition 60, which would require actors in adult films to use condoms, and Proposition 61, which would cap the price state health programs pay for prescription drugs.\u003c/p>\n\u003cp>The drug measure – which would limit the state to the discounted price paid by the U.S. Department of Veterans Affairs – taps into widespread frustration about \u003ca href=\"https://calmatters.org/articles/california-takes-measures-to-control-drug-spending-but-costs-soar/\" target=\"_blank\">expensive medication\u003c/a>, an issue that plagues the state budget and has surfaced in the presidential campaign. A condom requirement was popular with Los Angeles County voters, who approved a measure backed by Weinstein on their local ballot four years ago.\u003c/p>\n\u003cp>Yet both statewide propositions have sparked concern in segments of the communities they purport to help. Some patient advocates \u003ca href=\"https://calmatters.org/articles/would-a-california-ballot-measure-reduce-drug-spending-nobody-knows/\" target=\"_blank\">question\u003c/a> whether the drug-pricing measure could really contain costs for people whose health depends on expensive medicine, while many porn actors say the condom proposal would kill their business or drive it underground.\u003c/p>\n\u003cp>Similar fights have already occurred in the state Capitol, where bills have stalled that would have required \u003ca href=\"http://www.leginfo.ca.gov/pub/13-14/bill/asm/ab_1551-1600/ab_1576_cfa_20140428_124049_asm_comm.html\" target=\"_blank\">condom use on adult movie sets \u003c/a>and mandated more \u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/asm/ab_0451-0500/ab_463_cfa_20160108_154309_asm_comm.html\" target=\"_blank\">disclosure from drug companies \u003c/a>in an effort to curb rising prices. Weinstein said he’s taking the issues directly to voters because lawmakers have kowtowed to the porn and pharmaceutical industries.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I have a hard time remembering any issue where the public was so strongly in one direction and the political system was so strongly stuck in inaction,” Weinstein said of his effort to cap drug prices.\u003c/p>\n\u003cp>The condom issue is related, he said, because of “inaction by government.”\u003c/p>\n\u003cp>The initiatives mark the latest iteration of Weinstein’s long advocacy career, one that has made him a maverick to some, anathema to others.\u003c/p>\n\u003cp>Weinstein, 63, said he experienced his political awakening in 1986, when, as a budding gay-rights activist, he campaigned against an initiative that would have barred AIDS patients from schools and some types of jobs.\u003c/p>\n\u003cp>He went on to open an AIDS hospice that eventually grew into the AIDS Healthcare Foundation. Today the organization spans 36 countries, operating health clinics, thrift shops and pharmacies that sell some of the high-priced drugs Weinstein is campaigning against.\u003c/p>\n\u003cp>“The more prices go up, the more we earn,” he said. “That’s the irony of this situation…. People say, ‘What’s in it for you?’ Nothing, from a financial point of view.”\u003c/p>\n\u003cp>Although Weinstein runs a global AIDS organization, he has publicly clashed with AIDS activists over his criticism of \u003ca href=\"http://www.nytimes.com/2014/11/17/upshot/aids-group-wages-lonely-fight-against-pill-to-prevent-hiv.html?_r=1\" target=\"_blank\">an HIV-prevention drug\u003c/a>. He says broad use could result in infection from unprotected sex, although most of the medical community recommends it to people at risk for the disease.\u003c/p>\n\u003cp>On the adult film issue, performers who say they contracted sexually transmitted diseases on the job rally behind him. Those who believe existing protections are adequate see him as a meddlesome nanny.\u003c/p>\n\u003cp>He is embroiled in planning disputes in Los Angeles, where he lives, and in San Francisco, where his effort to open a pharmacy in the famous Castro district put Weinstein – a gay man – at odds with the heavily gay community.\u003c/p>\n\u003cp>“He is an outlier, and in many corners he is a pariah,” said San Francisco Supervisor Scott Wiener, who represents the Castro neighborhood and \u003ca href=\"http://blog.sfgate.com/cityinsider/2014/08/06/aids-healthcare-foundation-sues-sf-over-chain-store-rules/\" target=\"_blank\">was sued\u003c/a> by Weinstein’s foundation over the pharmacy dispute. The lawsuit challenges regulations the supervisor authored.\u003c/p>\n\u003cp>Weinstein’s nonprofit AIDS Healthcare Foundation has spent $11 million so far to support the two measures it put on the November ballot. Opponents in the pharmaceutical industry have poured more than $69 million into fighting Proposition 61. Pornography producers have contributed roughly $60,000 against Proposition 60.\u003c/p>\n\u003cp>Since Weinstein’s take-it-to-the-people approach proved successful in Los Angeles in 2012, permits for X-rated film production have \u003ca href=\"http://www.latimes.com/entertainment/envelope/cotown/la-et-ct-onlocation-la-porn-industry-20140806-story.html\" target=\"_blank\">dropped dramatically \u003c/a>– fueling opponents’ arguments about pushing the $9-billion industry out of California.\u003c/p>\n\u003cfigure id=\"attachment_212278\" class=\"wp-caption aligncenter\" style=\"max-width: 1200px\">\u003cimg class=\"size-full wp-image-212278\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/07/adult_performers.jpg\" alt=\"Speakers line up to testify at a Capitol hearing about Proposition 60, which would require condom use in porn films. \" width=\"1200\" height=\"900\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/07/adult_performers.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/27/2016/07/adult_performers-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/07/adult_performers-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/07/adult_performers-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/07/adult_performers-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/07/adult_performers-960x720.jpg 960w\" sizes=\"(max-width: 1200px) 100vw, 1200px\">\u003cfigcaption class=\"wp-caption-text\">Speakers line up to testify at a Capitol hearing about Proposition 60, which would require condom use in porn films. \u003ccite>(Laurel Rosenhall/CALmatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Some in the adult film industry say they already minimize the spread of disease with frequent testing. Many of them filled a hearing room at the Capitol last month when lawmakers reviewed Proposition 60.\u003c/p>\n\u003cp>“We are not opposed to regulation itself, but instead [to] this new-age witch hunt perpetuated by the AIDS Healthcare Foundation,” said a performer who introduced herself as Mimosa.\u003c/p>\n\u003cp>On the other side was Cameron Adams, a former porn actor who said Proposition 60 could save others from her fate.\u003c/p>\n\u003cp>“Testing doesn’t stop infection,” Adams said through tears, addressing the panel of legislators. “I followed the adult film industry’s self-regulation, and I’m sitting here before you as an HIV-positive woman.”\u003c/p>\n\u003cp>State Sen. Isadore Hall (D-Compton) has carried bills in the Legislature that would have required condom use in porn movies. He described Weinstein as a “great guy” whose trailblazing work has protected lives and, naturally, made him controversial.\u003c/p>\n\u003cp>“That’s just the name of the game,” Hall said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>CALmatters is a non-profit journalism venture dedicated to exploring state policies and politics. For more stories by Laurel Rosenhall, go to calmatters.org/newsanalysis\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>Update July 13, 2016\u003c/strong>: The Berkeley City Council unanimously approved the resolution opposing the closure of the Alta Bates hospital and emergency room at Tuesday night's meeting.\u003c/p>\n\u003cp>\u003cstrong>Original Post:\u003c/strong>\u003c/p>\n\u003cp>Three members of the Berkeley City Council are backing a resolution to oppose the planned closure of the Alta Bates Medical Center emergency room and inpatient hospital. The full council will vote on the issue at its meeting Tuesday night.\u003c/p>\n\u003cp>Sutter Health, which owns Alta Bates, said last fall that it would \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/28/sutter-plans-closure-of-berkeleys-alta-bates-hospital-er/\" target=\"_blank\">close the acute care hospital and emergency department\u003c/a> sometime before 2030. That's when tough \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/29/finally-long-overdue-progress-in-hospital-seismic-safety/\" target=\"_blank\">California seismic standards\u003c/a> kick in. Sutter said it would consolidate emergency and inpatient services at its Oakland Summit Medical Center and make Alta Bates an outpatient hub.\u003c/p>\n\u003cp>\"Sutter made this decision unilaterally without consulting the city of Berkeley,\" said council member Jessie Arreguin, one of the authors of the resolution. \"We need to speak out, and we need to fight back.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In a statement, Sutter says the closure of the hospital and ER \"is not new information. We began discussion about this important transition with civic leaders several years ago.\"\u003c/p>\n\u003cp>Alta Bates maintains the only emergency department in Berkeley, but ramification of its closure would be felt well beyond the city's borders. Last year Doctors Medical Center in San Pablo \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/20/san-pablos-doctors-medical-center-to-close-tuesday/\" target=\"_blank\">closed\u003c/a>, including its inpatient hospital and emergency department. People north of Berkeley to Vallejo had relied on this safety-net hospital.\u003c/p>\n\u003cp>If Alta Bates were to close, that would leave Kaiser Richmond with the only emergency room between Richmond and Oakland.\u003c/p>\n\u003cp>Arreguin said he wants to work with Sutter to try to find a solution to keep Alta Bates open. He said he supports efforts to try to retrofit the existing hospital to meet the new standards.\u003c/p>\n\u003cp>\"But it's going to take building a broad coalition,\" he said, \"and we need to start that process.\"\u003c/p>\n\u003cp>Berkeley council members Kriss Worthington and Max Anderson are co-authors with Arreguin of the draft resolution to be introduced tonight, which says in part:\u003c/p>\n\u003cblockquote>\u003cp>(T)he Mayor and City Council of the City of Berkeley oppose Sutter Health Corporation’s plan to close its acute care services at Alta Bates Hospital and calls upon Sutter Health to cease and desist all actions in furtherance of any and all plans to close Alta Bates.\u003c/p>\u003c/blockquote>\n\u003cp>The resolution further hints at possible legal action, saying that the mayor and council \"request the City Attorney to investigate the actions taken by Sutter Health and initiate proceedings, whenever warranted, under relevant statues.\"\u003c/p>\n\u003cp>In its statement, Sutter said it is \"committed to a strong medical presence in the City of Berkeley,\" but that \"increasing demand for outpatient services and procedures decreases the need for inpatient care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Sutter's Summit Medical Center and Alta Bates are three miles apart. Sutter said that \"if we are to remain viable as an organization and affordable to our patients, we cannot operate two full-service hospitals\" in such close proximity.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Update July 13, 2016\u003c/strong>: The Berkeley City Council unanimously approved the resolution opposing the closure of the Alta Bates hospital and emergency room at Tuesday night's meeting.\u003c/p>\n\u003cp>\u003cstrong>Original Post:\u003c/strong>\u003c/p>\n\u003cp>Three members of the Berkeley City Council are backing a resolution to oppose the planned closure of the Alta Bates Medical Center emergency room and inpatient hospital. The full council will vote on the issue at its meeting Tuesday night.\u003c/p>\n\u003cp>Sutter Health, which owns Alta Bates, said last fall that it would \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/28/sutter-plans-closure-of-berkeleys-alta-bates-hospital-er/\" target=\"_blank\">close the acute care hospital and emergency department\u003c/a> sometime before 2030. That's when tough \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/29/finally-long-overdue-progress-in-hospital-seismic-safety/\" target=\"_blank\">California seismic standards\u003c/a> kick in. Sutter said it would consolidate emergency and inpatient services at its Oakland Summit Medical Center and make Alta Bates an outpatient hub.\u003c/p>\n\u003cp>\"Sutter made this decision unilaterally without consulting the city of Berkeley,\" said council member Jessie Arreguin, one of the authors of the resolution. \"We need to speak out, and we need to fight back.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In a statement, Sutter says the closure of the hospital and ER \"is not new information. We began discussion about this important transition with civic leaders several years ago.\"\u003c/p>\n\u003cp>Alta Bates maintains the only emergency department in Berkeley, but ramification of its closure would be felt well beyond the city's borders. Last year Doctors Medical Center in San Pablo \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/20/san-pablos-doctors-medical-center-to-close-tuesday/\" target=\"_blank\">closed\u003c/a>, including its inpatient hospital and emergency department. People north of Berkeley to Vallejo had relied on this safety-net hospital.\u003c/p>\n\u003cp>If Alta Bates were to close, that would leave Kaiser Richmond with the only emergency room between Richmond and Oakland.\u003c/p>\n\u003cp>Arreguin said he wants to work with Sutter to try to find a solution to keep Alta Bates open. He said he supports efforts to try to retrofit the existing hospital to meet the new standards.\u003c/p>\n\u003cp>\"But it's going to take building a broad coalition,\" he said, \"and we need to start that process.\"\u003c/p>\n\u003cp>Berkeley council members Kriss Worthington and Max Anderson are co-authors with Arreguin of the draft resolution to be introduced tonight, which says in part:\u003c/p>\n\u003cblockquote>\u003cp>(T)he Mayor and City Council of the City of Berkeley oppose Sutter Health Corporation’s plan to close its acute care services at Alta Bates Hospital and calls upon Sutter Health to cease and desist all actions in furtherance of any and all plans to close Alta Bates.\u003c/p>\u003c/blockquote>\n\u003cp>The resolution further hints at possible legal action, saying that the mayor and council \"request the City Attorney to investigate the actions taken by Sutter Health and initiate proceedings, whenever warranted, under relevant statues.\"\u003c/p>\n\u003cp>In its statement, Sutter said it is \"committed to a strong medical presence in the City of Berkeley,\" but that \"increasing demand for outpatient services and procedures decreases the need for inpatient care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Sutter's Summit Medical Center and Alta Bates are three miles apart. Sutter said that \"if we are to remain viable as an organization and affordable to our patients, we cannot operate two full-service hospitals\" in such close proximity.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"order": 9
},
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"id": "freakonomics-radio",
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"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/",
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},
"fresh-air": {
"id": "fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"hidden-brain": {
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
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"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"airtime": "SUN 7:30pm-8pm",
"meta": {
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"link": "/radio/program/how-i-built-this",
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"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"order": 18
},
"link": "/podcasts/jerrybrown",
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},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"rss": "https://feeds.npr.org/510360/podcast.xml"
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},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
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"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
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"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/",
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
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"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
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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": {
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"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
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"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",
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"officialWebsiteLink": "/podcasts/politicalbreakdown",
"meta": {
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"source": "kqed",
"order": 5
},
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