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"content": "\u003cfigure id=\"attachment_16162\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Alice_LanareStory-e1383958739240.jpg\">\u003cimg class=\"size-large wp-image-16162 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Alice_LanareStory-640x480.jpg\" alt=\"(Alice Daniel/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Isabel Solorio (left) and Carrie Bonner talk about water issues outside the Lanare Community Center. (Alice Daniel/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alice Daniel, KQED\u003c/strong>\u003c/p>\n\u003cp>There are no streetlights here in Lanare, no sidewalks, no sewer system in this tiny, rural enclave of 600 smack dab in the middle of farming country in the Central Valley.\u003c/p>\n\u003cp>There is a community center and on this night, many locals are here dancing and eating.\u003c/p>\n\u003cp>“Tonight I make salad and my friend makes beans, and I make beans so just, you know, everybody help,” said Isabel Solorio.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Many people stopped drinking the tap water years ago because it has high levels of arsenic.\u003c/aside>\n\u003cp>Solorio is the president of a local group that holds fundraisers twice a year to support the community center. The group also advocates for clean drinking water –- something Lanare doesn’t have. Lanare did not come out of an organized planning process. Like many unincorporated communities in the San Joaquin Valley, the town arose out of the fields surrounding it.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It was a lot of labor camps, they call them,” said Carrie Bonner, a Lanare resident still tall and strong at 89. “Cotton chopping, picking and cutting grapes. … Whatever season it was, that’s what they would do.”\u003c!--more-->\u003c/p>\n\u003cp>Lanare was once a series of shacks for African-American farmworkers, Bonner says. Her father-in-law ran a juke joint not far from here and was a labor contractor.\u003c/p>\n\u003cp>She said when she first moved to Lanare in the 1950s, there were very few farmworkers who came from Mexico. But as time went on, the population changed. “Now it’s just a few blacks and more Spanish, you know,” she said.\u003c/p>\n\u003cp>\u003cstrong>Water lines arrived in the 70s -- but drinkable water didn't last\u003c/strong>\u003c/p>\n\u003cp>In the 1970s, a Quaker organization helped the people of Lanare build houses and put in water lines. Bonner was one of the first to move into a new home, the one she still lives in today. But she and others stopped drinking the tap water years ago because it has high levels of arsenic.\u003c/p>\n\u003cp>In 2002, the town got some federal grant money to clean the water. “The county allocated it, 1.3 million dollars,” said Veronica Garibay of the Leadership Council for Justice and Accountability.\u003c/p>\n\u003cp>The town used the money to build a water treatment facility in 2006. But there was trouble from the start. Fresno county rubber-stamped the federally funded plant without an adequate cost analysis, said Garibay. It’s expensive to treat arsenic, and costs spiraled beyond what the community could manage. The town had no water meters to track residents’ usage. And some of the pricey filtered water was unintentionally going to irrigate fields. On top of that, the local water district lacked financial and technical expertise.\u003c/p>\n\u003cp>“A board of five volunteers from the community without any background in water operation or maintenance are running a treatment plant,” said Garibay.\u003c/p>\n\u003cp>Lanare couldn’t afford to run it, and the state shut down the plant after just six months. Now the town’s water system is operated by a private company or receiver. Residents pay a monthly bill for running water –- but they still can’t drink it. Instead, many spend $20 to $30 more each month for bottled water. That’s not uncommon in the valley where hundreds more small water districts have problems with pollutants, including nitrates and selenium.\u003c/p>\n\u003cp>\u003cstrong>\"Who gets control of the good water?\"\u003c/strong>\u003c/p>\n\u003cp>“It’s a really complicated story,” said John Capitman, a public policy expert at Fresno State University. “It may be the farming practices of somebody 20 miles away 20 years ago that spoiled the water that your well draws on. So this is something about a long term process of connected aquifers underneath the ground, pumping, history, exploitation. Who gets the control of the good water? It plays out all over the region.”\u003c/p>\n\u003cp>These small, volunteer water districts not only lack the political clout, but also technical and financial wherewithal, he says. “The patience to make it through crazy bureaucratic systems,” he added.\u003c/p>\n\u003cp>And there’s a catch when it comes to technical and financial expertise.\u003c/p>\n\u003cp>\u003cspan>“Those capabilities are also federal requirements in order to get funding,” said Mark Starr, deputy director of the Center for Environmental Health at the California Department of Public Health. His agency is charged with helping these communities comply with the Safe Drinking Water Act.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Millions for water improvements left unspent\u003c/strong>\u003c/p>\n\u003cp>But last spring, the EPA scolded the Department of Public Health for failing to spend hundreds of millions of dollars for water improvements. The state said it is working harder to move the funds more quickly and provide more technical assistance.\u003c/p>\n\u003cp>Lanare recently got grants to take steps toward a permanent solution, said Starr. The grants “were used to install water meters, a project that’s underway -- and also educate Lanare residents about conservation.”\u003c/p>\n\u003cp>A study to explore solutions for Lanare will be completed by June, said Starr. These options include digging a new well, restarting the old treatment plant and hooking into a nearby town’s water treatment facility.\u003c/p>\n\u003cp>Back\u003cem> \u003c/em>at the community center, Isabel Solorio said she knows the town is poor and treating tainted water is expensive. But she and other residents won’t quit pushing for clean water.\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s a lot of work, but you know what? I am so happy when I see part of my community here and tell everybody ‘come on let’s go working together,’” she said. “Because this is your community.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16162\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Alice_LanareStory-e1383958739240.jpg\">\u003cimg class=\"size-large wp-image-16162 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Alice_LanareStory-640x480.jpg\" alt=\"(Alice Daniel/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Isabel Solorio (left) and Carrie Bonner talk about water issues outside the Lanare Community Center. (Alice Daniel/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alice Daniel, KQED\u003c/strong>\u003c/p>\n\u003cp>There are no streetlights here in Lanare, no sidewalks, no sewer system in this tiny, rural enclave of 600 smack dab in the middle of farming country in the Central Valley.\u003c/p>\n\u003cp>There is a community center and on this night, many locals are here dancing and eating.\u003c/p>\n\u003cp>“Tonight I make salad and my friend makes beans, and I make beans so just, you know, everybody help,” said Isabel Solorio.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Many people stopped drinking the tap water years ago because it has high levels of arsenic.\u003c/aside>\n\u003cp>Solorio is the president of a local group that holds fundraisers twice a year to support the community center. The group also advocates for clean drinking water –- something Lanare doesn’t have. Lanare did not come out of an organized planning process. Like many unincorporated communities in the San Joaquin Valley, the town arose out of the fields surrounding it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It was a lot of labor camps, they call them,” said Carrie Bonner, a Lanare resident still tall and strong at 89. “Cotton chopping, picking and cutting grapes. … Whatever season it was, that’s what they would do.”\u003c!--more-->\u003c/p>\n\u003cp>Lanare was once a series of shacks for African-American farmworkers, Bonner says. Her father-in-law ran a juke joint not far from here and was a labor contractor.\u003c/p>\n\u003cp>She said when she first moved to Lanare in the 1950s, there were very few farmworkers who came from Mexico. But as time went on, the population changed. “Now it’s just a few blacks and more Spanish, you know,” she said.\u003c/p>\n\u003cp>\u003cstrong>Water lines arrived in the 70s -- but drinkable water didn't last\u003c/strong>\u003c/p>\n\u003cp>In the 1970s, a Quaker organization helped the people of Lanare build houses and put in water lines. Bonner was one of the first to move into a new home, the one she still lives in today. But she and others stopped drinking the tap water years ago because it has high levels of arsenic.\u003c/p>\n\u003cp>In 2002, the town got some federal grant money to clean the water. “The county allocated it, 1.3 million dollars,” said Veronica Garibay of the Leadership Council for Justice and Accountability.\u003c/p>\n\u003cp>The town used the money to build a water treatment facility in 2006. But there was trouble from the start. Fresno county rubber-stamped the federally funded plant without an adequate cost analysis, said Garibay. It’s expensive to treat arsenic, and costs spiraled beyond what the community could manage. The town had no water meters to track residents’ usage. And some of the pricey filtered water was unintentionally going to irrigate fields. On top of that, the local water district lacked financial and technical expertise.\u003c/p>\n\u003cp>“A board of five volunteers from the community without any background in water operation or maintenance are running a treatment plant,” said Garibay.\u003c/p>\n\u003cp>Lanare couldn’t afford to run it, and the state shut down the plant after just six months. Now the town’s water system is operated by a private company or receiver. Residents pay a monthly bill for running water –- but they still can’t drink it. Instead, many spend $20 to $30 more each month for bottled water. That’s not uncommon in the valley where hundreds more small water districts have problems with pollutants, including nitrates and selenium.\u003c/p>\n\u003cp>\u003cstrong>\"Who gets control of the good water?\"\u003c/strong>\u003c/p>\n\u003cp>“It’s a really complicated story,” said John Capitman, a public policy expert at Fresno State University. “It may be the farming practices of somebody 20 miles away 20 years ago that spoiled the water that your well draws on. So this is something about a long term process of connected aquifers underneath the ground, pumping, history, exploitation. Who gets the control of the good water? It plays out all over the region.”\u003c/p>\n\u003cp>These small, volunteer water districts not only lack the political clout, but also technical and financial wherewithal, he says. “The patience to make it through crazy bureaucratic systems,” he added.\u003c/p>\n\u003cp>And there’s a catch when it comes to technical and financial expertise.\u003c/p>\n\u003cp>\u003cspan>“Those capabilities are also federal requirements in order to get funding,” said Mark Starr, deputy director of the Center for Environmental Health at the California Department of Public Health. His agency is charged with helping these communities comply with the Safe Drinking Water Act.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Millions for water improvements left unspent\u003c/strong>\u003c/p>\n\u003cp>But last spring, the EPA scolded the Department of Public Health for failing to spend hundreds of millions of dollars for water improvements. The state said it is working harder to move the funds more quickly and provide more technical assistance.\u003c/p>\n\u003cp>Lanare recently got grants to take steps toward a permanent solution, said Starr. The grants “were used to install water meters, a project that’s underway -- and also educate Lanare residents about conservation.”\u003c/p>\n\u003cp>A study to explore solutions for Lanare will be completed by June, said Starr. These options include digging a new well, restarting the old treatment plant and hooking into a nearby town’s water treatment facility.\u003c/p>\n\u003cp>Back\u003cem> \u003c/em>at the community center, Isabel Solorio said she knows the town is poor and treating tainted water is expensive. But she and other residents won’t quit pushing for clean water.\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s a lot of work, but you know what? I am so happy when I see part of my community here and tell everybody ‘come on let’s go working together,’” she said. “Because this is your community.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Why Insurance Commissioner Can Delay Only Blue Shield's Cancellations",
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"content": "\u003cfigure id=\"attachment_16103\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/174426822-e1383684544419.jpg\">\u003cimg class=\"size-large wp-image-16103\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/174426822-640x423.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"423\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>California's insurance commissioner Dave Jones announced an agreement with Blue Shield on Tuesday morning that will mean some 113,000 people who had their policies cancelled will now be able to keep them through March 31, 2014.\u003c/p>\n\u003cp>If you're one of those 113,000 people, you now have the option either to hold onto your policy into next year or to shop on the Covered California marketplace where you might qualify for a subsidy.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Blue Shield warned that extension is not without risks.\u003c/aside>\n\u003cp>Jones says Blue Shield of California Life & Health agreed to send letters on Wednesday to its policyholders, informing them of the extension. If you've received a cancellation notice from another health insurance company, it is highly unlikely you will get an extension, as we detail below.\u003c/p>\n\u003cp>Blue Shield warned that extension is not without risks. Spokesman Steve Shivinsky says that policyholders who decide to stay with their current plan must still enroll in a new plan that complies with the Affordable Care Act by March 15, 2014. Otherwise, they risk a coverage gap. In addition, if people extend their current policy, they may have to pay a deductible twice in 2014 after they enroll in a new plan.\u003c!--more-->\u003c/p>\n\u003cp>\"It's confusing,\" Shivinsky said. \"It's bad for consumers that we have to mail these letters out and provide even more confusing information when they're trying to sort through their options.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Jones said that consumers must carefully consider their options. \"If these consumers anticipate a major health expense in the first three months of next year,\" Jones said, they should move to a new policy now. He also stressed that people should \"look at all your options,\" especially if they might qualify for a subsidy.\u003c/p>\n\u003cp>\u003cstrong>Blue Shield only, not other carriers\u003c/strong>\u003c/p>\n\u003cp>Jones could take this move with Blue Shield only because of what he called a \"rather complicated series of facts.\" California, he says, is the only state in the nation that has two separate regulators of health insurance products. Jones regulates policies that fall under the Department of Insurance. The Department of Managed Health Care (DMHC) regulates HMO products and other kinds of health plans.\u003c/p>\n\u003cp>Because of a special loophole in California law, Jones says, Blue Shield has the option to move its insurance products from the Department of Insurance to DMHC. Jones says that move between regulators requires Blue Shield to provide 180 days' notice of cancellation, but Blue Shield only provided 90 days. Blue Shield disagrees and argues that 90 days' notice was sufficient. Nonetheless it is complying with the Department of Insurance and allowing those 80,000 policyholders — covering 113,000 people — the option to extend.\u003c/p>\n\u003cp>In any case, an additional 90 days is the maximum extension. \"Three months is exactly what we could get\" under state law, Jones says.\u003c/p>\n\u003cp>Shivinsky said that Blue Shield elected to make the move to DMHC to \"consolidate its business\" under one regulator. He said the company already had about 80 percent of its business in DMHC. It will reduce the \"administrative burden,\" he said.\u003c/p>\n\u003cp>Jones says he had lobbied Covered California to allow all consumers to renew their individual policies through 2014. But Covered California, he says, determined that all individual policyholders must move to ACA-compliant plans on Jan. 1, 2014.\u003c/p>\n\u003cp>For all these reasons, if you've received a cancellation notice from any other carrier besides Blue Shield, you should not expect to get an extension.\u003c/p>\n\u003cp>\u003cstrong>ORIGINAL POST:\u003c/strong>\u003c/p>\n\u003cp>California's insurance commissioner, Dave Jones, is holding a press conference Tuesday morning to announce a deal the Department of Insurance has reached with what it terms a \"major health insurance company\" to delay the cancellation of more than 115,000 insurance policies statewide.\u003c/p>\n\u003cp>The San Francisco Business Times\u003ca href=\"http://www.bizjournals.com/sanfrancisco/blog/2013/11/blue-shield-has-deal-with-state-to.html?ana=RSS&s=article_search&page=all\" target=\"_blank\"> confirmed\u003c/a> that the insurer is Blue Shield of California from the company's spokesman, Steve Shivinsky. The Business Times described Blue Shield as not \"necessarily happy\" with this change. From the Business Times report:\u003c/p>\n\u003cblockquote>\u003cp>Blue Shield officials said Monday evening that the Department of Insurance had required them to take this step, on threat of a lawsuit compelling the insurer to delay the cancellations. The department declined official comment ahead of the insurance commissioner's press conference.\u003c/p>\n\u003cp>The extensions can't last more than three months, and must end March 31, Blue Shield said. Consumers need to be aware that taking advantage of the delay could come with downsides, including the possibility of being liable for two sets of deductibles and possibly missing out on tax credits and cost-sharing subsidies available only through the \u003ca href=\"http://www.bizjournals.com/profiles/company/us/ca/sacramento_/covered_california/3327461\">Covered California\u003c/a> exchange.\u003c!--more-->\u003c/p>\n\u003cp>\"We had a disagreement with the state over the 90 day notice we gave to ... policyholders and we were faced with a lawsuit if we did not agree to their requirement for the 90 day extension,\" Shivinsky clarified. He said 80,000 policyholders are being notified of the new course of action that regulators are requiring.\u003c/p>\n\u003cp>The deal has the look and feel of \u003ca href=\"http://www.usatoday.com/story/opinion/2013/11/03/obamacare-coverage-cancellations-president-obama-promise-editorials-debates/3426681/\">a political retreat \u003c/a>by Democratic officeholders worried about the recent outcry about cancelled individual policies.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>State of Health will have update this post after Jones' press conference.\u003c/p>\n\n",
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"excerpt": "California's insurance commissioner Dave Jones is holding a press conference Tuesday morning to announce a deal it has reached with what the press release terms a \"major health insurance company\" to delay the cancellation of more than 115,000 insurance policies statewide.\r\n\r\nThe San Francisco Business Times confirmed that the insurer is Blue Shield of California.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16103\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/174426822-e1383684544419.jpg\">\u003cimg class=\"size-large wp-image-16103\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/174426822-640x423.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"423\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>California's insurance commissioner Dave Jones announced an agreement with Blue Shield on Tuesday morning that will mean some 113,000 people who had their policies cancelled will now be able to keep them through March 31, 2014.\u003c/p>\n\u003cp>If you're one of those 113,000 people, you now have the option either to hold onto your policy into next year or to shop on the Covered California marketplace where you might qualify for a subsidy.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Blue Shield warned that extension is not without risks.\u003c/aside>\n\u003cp>Jones says Blue Shield of California Life & Health agreed to send letters on Wednesday to its policyholders, informing them of the extension. If you've received a cancellation notice from another health insurance company, it is highly unlikely you will get an extension, as we detail below.\u003c/p>\n\u003cp>Blue Shield warned that extension is not without risks. Spokesman Steve Shivinsky says that policyholders who decide to stay with their current plan must still enroll in a new plan that complies with the Affordable Care Act by March 15, 2014. Otherwise, they risk a coverage gap. In addition, if people extend their current policy, they may have to pay a deductible twice in 2014 after they enroll in a new plan.\u003c!--more-->\u003c/p>\n\u003cp>\"It's confusing,\" Shivinsky said. \"It's bad for consumers that we have to mail these letters out and provide even more confusing information when they're trying to sort through their options.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Jones said that consumers must carefully consider their options. \"If these consumers anticipate a major health expense in the first three months of next year,\" Jones said, they should move to a new policy now. He also stressed that people should \"look at all your options,\" especially if they might qualify for a subsidy.\u003c/p>\n\u003cp>\u003cstrong>Blue Shield only, not other carriers\u003c/strong>\u003c/p>\n\u003cp>Jones could take this move with Blue Shield only because of what he called a \"rather complicated series of facts.\" California, he says, is the only state in the nation that has two separate regulators of health insurance products. Jones regulates policies that fall under the Department of Insurance. The Department of Managed Health Care (DMHC) regulates HMO products and other kinds of health plans.\u003c/p>\n\u003cp>Because of a special loophole in California law, Jones says, Blue Shield has the option to move its insurance products from the Department of Insurance to DMHC. Jones says that move between regulators requires Blue Shield to provide 180 days' notice of cancellation, but Blue Shield only provided 90 days. Blue Shield disagrees and argues that 90 days' notice was sufficient. Nonetheless it is complying with the Department of Insurance and allowing those 80,000 policyholders — covering 113,000 people — the option to extend.\u003c/p>\n\u003cp>In any case, an additional 90 days is the maximum extension. \"Three months is exactly what we could get\" under state law, Jones says.\u003c/p>\n\u003cp>Shivinsky said that Blue Shield elected to make the move to DMHC to \"consolidate its business\" under one regulator. He said the company already had about 80 percent of its business in DMHC. It will reduce the \"administrative burden,\" he said.\u003c/p>\n\u003cp>Jones says he had lobbied Covered California to allow all consumers to renew their individual policies through 2014. But Covered California, he says, determined that all individual policyholders must move to ACA-compliant plans on Jan. 1, 2014.\u003c/p>\n\u003cp>For all these reasons, if you've received a cancellation notice from any other carrier besides Blue Shield, you should not expect to get an extension.\u003c/p>\n\u003cp>\u003cstrong>ORIGINAL POST:\u003c/strong>\u003c/p>\n\u003cp>California's insurance commissioner, Dave Jones, is holding a press conference Tuesday morning to announce a deal the Department of Insurance has reached with what it terms a \"major health insurance company\" to delay the cancellation of more than 115,000 insurance policies statewide.\u003c/p>\n\u003cp>The San Francisco Business Times\u003ca href=\"http://www.bizjournals.com/sanfrancisco/blog/2013/11/blue-shield-has-deal-with-state-to.html?ana=RSS&s=article_search&page=all\" target=\"_blank\"> confirmed\u003c/a> that the insurer is Blue Shield of California from the company's spokesman, Steve Shivinsky. The Business Times described Blue Shield as not \"necessarily happy\" with this change. From the Business Times report:\u003c/p>\n\u003cblockquote>\u003cp>Blue Shield officials said Monday evening that the Department of Insurance had required them to take this step, on threat of a lawsuit compelling the insurer to delay the cancellations. The department declined official comment ahead of the insurance commissioner's press conference.\u003c/p>\n\u003cp>The extensions can't last more than three months, and must end March 31, Blue Shield said. Consumers need to be aware that taking advantage of the delay could come with downsides, including the possibility of being liable for two sets of deductibles and possibly missing out on tax credits and cost-sharing subsidies available only through the \u003ca href=\"http://www.bizjournals.com/profiles/company/us/ca/sacramento_/covered_california/3327461\">Covered California\u003c/a> exchange.\u003c!--more-->\u003c/p>\n\u003cp>\"We had a disagreement with the state over the 90 day notice we gave to ... policyholders and we were faced with a lawsuit if we did not agree to their requirement for the 90 day extension,\" Shivinsky clarified. He said 80,000 policyholders are being notified of the new course of action that regulators are requiring.\u003c/p>\n\u003cp>The deal has the look and feel of \u003ca href=\"http://www.usatoday.com/story/opinion/2013/11/03/obamacare-coverage-cancellations-president-obama-promise-editorials-debates/3426681/\">a political retreat \u003c/a>by Democratic officeholders worried about the recent outcry about cancelled individual policies.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>State of Health will have update this post after Jones' press conference.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Study Finds Girls Entering Puberty Younger; Obesity Implicated",
"title": "Study Finds Girls Entering Puberty Younger; Obesity Implicated",
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"content": "\u003cfigure id=\"attachment_16054\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/50781677-2-e1383511143227.jpg\">\u003cimg class=\"size-large wp-image-16054\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/50781677-2-640x427.jpg\" alt=\"Retailer J.C. Penney features a Girls Plus clothing department tailored to overweight girls in this April, 2004 photo. (Scott Olson/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Retailer J.C. Penney features a Girls Plus clothing department tailored to overweight girls. (Scott Olson/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Building on earlier research a major new study has found that girls are starting puberty at even younger ages. The most significant changes were seen in Caucasian girls and in girls who are overweight or obese. Still, girls who were not overweight were also entering puberty younger, the study found.\u003c/p>\n\u003cp>Researchers at three sites around the country -- including the San Francisco Bay Area -- followed 1,239 ethnically diverse girls from 2004 to 2011. They looked at breast development, a key marker for the start of puberty.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Girls who mature earlier are at risk for lower self-esteem and higher rates of depression.\u003c/aside>\n\u003cp>Earlier studies had shown that African-American girls had reached this milestone at younger ages. \"Now it looks like it's happening earlier for Caucasian girls,\" said Dr. Louise Greenspan, a pediatric endocrinologist with Kaiser San Francisco and one of the authors of the study. \"Particularly, the overweight Caucasian girls are developing earlier than they have in the past.\"\u003c/p>\n\u003cp>Researchers looked at a number of factors, but the \"obesity epidemic appears to be a prime driver in the decrease in age at onset of breast development,\" the authors wrote. \u003c!--more-->\u003c/p>\n\u003cp>Researchers cannot say that being overweight or obese actually causes the earlier development, but there are biological reasons to suggest how body fat could contribute to the change. \"Fat makes hormones,\" Greenspan noted, \"and the hormones that are being made by the fat might also be generating high enough levels to make true breast development.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Greenspan specified \"true\" breast development, because their research was based on examining girls at least annually during the 7-year study period as opposed to other studies which had relied on observation. \"That's been a major criticism of prior studies,\" Greenspan said. \"Because when you look at a girl's chest, you can't tell whether there's fat tissue or true breast development, and our study was different because we examined the girls physically and were able to feel the difference between fat and real breast tissue.\"\u003c/p>\n\u003cp>The study, \u003ca href=\"http://pediatrics.aappublications.org/content/future/132/6#MONTHLYFEATURE\" target=\"_blank\">Onset of Breast Development in a Longitudinal Cohort\u003c/a>, was published online Monday in the journal Pediatrics. It was funded by the National Cancer Institute and the National Institute of Environmental Health Sciences.\u003c/p>\n\u003cp>\u003cstrong>Differences noted by ethnicity and race\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://children.webmd.com/tc/growth-and-development-ages-11-to-14-years-what-to-expect\" target=\"_blank\">Common sources\u003c/a> for health information often list puberty as starting around age 11 for girls. But in 1997, a \u003ca href=\"http://pediatrics.aappublications.org/content/99/4/505.abstract\" target=\"_blank\">landmark study \u003c/a>concluded that puberty was starting earlier, and African-American girls in particular were entering puberty younger than their peers. This study found average ages for the even-earlier breast development as follows:\u003c/p>\n\u003cul>\n\u003cli>8.76 years for African-American girls\u003c/li>\n\u003cli>9.23 years for Hispanic girls\u003c/li>\n\u003cli>9.62 years for Caucasian\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>9.92 years for Asian-American girls\u003c/li>\n\u003c/ul>\n\u003cp>This study is essentially the first to determine onset of puberty for Asian-American girls, although their study sample was still small. \"Previous studies have largely focused on the white/black difference,\" said Lawrence Kushi, Directory of Scientific Policy at Kaiser's Division of Research and the principal investigator for the \u003ca href=\"https://www.cygnetstudy.com/component/content/category/8-about-cygnet\" target=\"_blank\">San Francisco site\u003c/a> in this report. Hispanic girls have been somewhat more represented in prior studies than Asian-American girls, and Hispanic girls have \"shifted to somewhat younger ages,\" Kushi said.\u003c/p>\n\u003cp>The big difference is in Caucasian girls. The average age of breast development for them was four months earlier than seen in the 1997 study, and that's \"a pretty significant reduction\" on a percentage basis, says Greenspan, since puberty only lasts two to three years. But that's the average. The more obese girls had a \"greater shift,\" Kushi said. Some of these heavier girls were entering puberty close to a year earlier than previously reported.\u003c/p>\n\u003cp>African-American girls appeared to be \"holding steady\" compared to earlier studies, said Greenspan.\u003c/p>\n\u003cp>What's not clear from this study is if girls are also having their first period at a younger age. The research team has been following this group of girls since they were ages 6 to 8. Now they are 14 to 16. The researchers plan to analyze ages of the girls' first period once all the girls in the study have reached that milestone. \"One question we have,\" Greenspan said, \"is puberty starting earlier and ending earlier so there's an entire shift to an earlier age; or is puberty starting earlier and ending at the same time?\"\u003c/p>\n\u003cp>\u003cstrong>Psychological and physical health risks\u003c/strong>\u003c/p>\n\u003cp>This earlier onset of puberty puts girls at risk for certain mental and physical health issues. From the study:\u003c/p>\n\u003cblockquote>\u003cp>Girls with earlier maturation are at risk for lower self-esteem and higher rates of depression. They are more likely to be influenced by older peers and more deviant peers, and initiate intercourse, substance use and other norm-breaking behaviors at younger ages.\u003c/p>\u003c/blockquote>\n\u003cp>Many schools include classes about puberty and sexuality in 5th or 6th grade, Greenspan noted. But according to this new data, many girls are entering puberty in 3rd or 4th grade. This creates a \"real disconnect between the timing of girls' puberty and the timing of the education they receive about the puberty and their bodies in general.\" She argued for splitting the subject matter and teaching girls about puberty in the earlier grades and leaving sexuality for the later grades.\u003c/p>\n\u003cp>Girls who enter puberty younger are at higher risk for developing certain cancers as adults, including breast cancer -- possibly because earlier puberty increases exposure to estrogen, a known breast cancer risk. Greenspan hopes that the researchers will continue to receive funding to follow the girls into adulthood, which could yield better understanding of breast cancer risk.\u003c/p>\n\u003cp>The researchers also collected blood and urine samples from the girls at the beginning of the study and are analyzing certain chemicals to see what associations there may be between chemicals and breast development. They are looking at \u003ca href=\"http://www.npr.org/templates/archives/archive.php?thingId=141118712\" target=\"_blank\">Bisphenol A \u003c/a>(BPA), flame retardants, \u003ca href=\"http://www.cdc.gov/biomonitoring/Phthalates_FactSheet.html\" target=\"_blank\">phthalates\u003c/a>, heavy metals and chemicals used in nonstick cookware.\u003c/p>\n\u003cp>Karuna Jagger, executive director of Breast Cancer Action, a San Francisco-based advocacy group, called the study \"very important\" especially since causes of breast cancer are not fully understood, she said. She wants to know if chemical exposure means \"creating breasts that are susceptible to future insult and higher risk of breast cancer.\"\u003c/p>\n\u003cp>\u003cstrong>Living with uncertainty\u003c/strong>\u003c/p>\n\u003cp>In an \u003ca href=\"http://pediatrics.aappublications.org/content/future/132/6#COMMENTARIES\" target=\"_blank\">accompanying commentary\u003c/a> in Pediatrics, Marcia Herman-Giddens, lead researcher in the 1997 study, said that we may have to \"live with uncertainty\" for a long time, since the \"exact trigger for pubertal initiation is still unknown.\"\u003c/p>\n\u003cp>Herman-Giddens agreed that \"considerable research\" implicates obesity as a factor in the declining age of onset of puberty, but also points to other complex changes:\u003c/p>\n\u003cblockquote>\u003cp>Extensive interacting variables are known to be associated with earlier development in addition to weight and genetics: certain intrauterine conditions and exposures, preschool high-meat diets, dairy products, low fiber intake, isoflavones, high-stress families, absent fathers, certain endocrine disruptors, the microbiome as it influences weight, epigenetics, light exposure, hormone-laced hair products, insulin resistance, activity level, geographical location, and others.\u003c/p>\u003c/blockquote>\n\u003cp>This study did not look at boys. Greenspan noted there's \"mixed data\" for them, some suggesting boys are going through puberty earlier, some not. Further investigation needs to be done on boys, she said. \"The issue is that the chemicals or even fat may have a different effect on boys' puberty because [boys] have a different set of hormones.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This post has been updated with additional information about the range in onset of puberty for Caucasian girls.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Building on earlier research a major new study has found that girls are starting puberty at even younger ages. The most significant changes were seen in Caucasian girls and in girls who are overweight or obese. Still, girls who were not overweight were also entering puberty younger, the study found.\r\n\r\nResearchers at three sites around the country -- including the San Francisco Bay Area -- followed 1,239 ethnically diverse girls from 2004 to 2011. They looked at breast development, a key marker for the start of puberty.",
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"description": "Building on earlier research a major new study has found that girls are starting puberty at even younger ages. The most significant changes were seen in Caucasian girls and in girls who are overweight or obese. Still, girls who were not overweight were also entering puberty younger, the study found.\r\n\r\nResearchers at three sites around the country -- including the San Francisco Bay Area -- followed 1,239 ethnically diverse girls from 2004 to 2011. They looked at breast development, a key marker for the start of puberty.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16054\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/50781677-2-e1383511143227.jpg\">\u003cimg class=\"size-large wp-image-16054\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/50781677-2-640x427.jpg\" alt=\"Retailer J.C. Penney features a Girls Plus clothing department tailored to overweight girls in this April, 2004 photo. (Scott Olson/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Retailer J.C. Penney features a Girls Plus clothing department tailored to overweight girls. (Scott Olson/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Building on earlier research a major new study has found that girls are starting puberty at even younger ages. The most significant changes were seen in Caucasian girls and in girls who are overweight or obese. Still, girls who were not overweight were also entering puberty younger, the study found.\u003c/p>\n\u003cp>Researchers at three sites around the country -- including the San Francisco Bay Area -- followed 1,239 ethnically diverse girls from 2004 to 2011. They looked at breast development, a key marker for the start of puberty.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Girls who mature earlier are at risk for lower self-esteem and higher rates of depression.\u003c/aside>\n\u003cp>Earlier studies had shown that African-American girls had reached this milestone at younger ages. \"Now it looks like it's happening earlier for Caucasian girls,\" said Dr. Louise Greenspan, a pediatric endocrinologist with Kaiser San Francisco and one of the authors of the study. \"Particularly, the overweight Caucasian girls are developing earlier than they have in the past.\"\u003c/p>\n\u003cp>Researchers looked at a number of factors, but the \"obesity epidemic appears to be a prime driver in the decrease in age at onset of breast development,\" the authors wrote. \u003c!--more-->\u003c/p>\n\u003cp>Researchers cannot say that being overweight or obese actually causes the earlier development, but there are biological reasons to suggest how body fat could contribute to the change. \"Fat makes hormones,\" Greenspan noted, \"and the hormones that are being made by the fat might also be generating high enough levels to make true breast development.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Greenspan specified \"true\" breast development, because their research was based on examining girls at least annually during the 7-year study period as opposed to other studies which had relied on observation. \"That's been a major criticism of prior studies,\" Greenspan said. \"Because when you look at a girl's chest, you can't tell whether there's fat tissue or true breast development, and our study was different because we examined the girls physically and were able to feel the difference between fat and real breast tissue.\"\u003c/p>\n\u003cp>The study, \u003ca href=\"http://pediatrics.aappublications.org/content/future/132/6#MONTHLYFEATURE\" target=\"_blank\">Onset of Breast Development in a Longitudinal Cohort\u003c/a>, was published online Monday in the journal Pediatrics. It was funded by the National Cancer Institute and the National Institute of Environmental Health Sciences.\u003c/p>\n\u003cp>\u003cstrong>Differences noted by ethnicity and race\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://children.webmd.com/tc/growth-and-development-ages-11-to-14-years-what-to-expect\" target=\"_blank\">Common sources\u003c/a> for health information often list puberty as starting around age 11 for girls. But in 1997, a \u003ca href=\"http://pediatrics.aappublications.org/content/99/4/505.abstract\" target=\"_blank\">landmark study \u003c/a>concluded that puberty was starting earlier, and African-American girls in particular were entering puberty younger than their peers. This study found average ages for the even-earlier breast development as follows:\u003c/p>\n\u003cul>\n\u003cli>8.76 years for African-American girls\u003c/li>\n\u003cli>9.23 years for Hispanic girls\u003c/li>\n\u003cli>9.62 years for Caucasian\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>9.92 years for Asian-American girls\u003c/li>\n\u003c/ul>\n\u003cp>This study is essentially the first to determine onset of puberty for Asian-American girls, although their study sample was still small. \"Previous studies have largely focused on the white/black difference,\" said Lawrence Kushi, Directory of Scientific Policy at Kaiser's Division of Research and the principal investigator for the \u003ca href=\"https://www.cygnetstudy.com/component/content/category/8-about-cygnet\" target=\"_blank\">San Francisco site\u003c/a> in this report. Hispanic girls have been somewhat more represented in prior studies than Asian-American girls, and Hispanic girls have \"shifted to somewhat younger ages,\" Kushi said.\u003c/p>\n\u003cp>The big difference is in Caucasian girls. The average age of breast development for them was four months earlier than seen in the 1997 study, and that's \"a pretty significant reduction\" on a percentage basis, says Greenspan, since puberty only lasts two to three years. But that's the average. The more obese girls had a \"greater shift,\" Kushi said. Some of these heavier girls were entering puberty close to a year earlier than previously reported.\u003c/p>\n\u003cp>African-American girls appeared to be \"holding steady\" compared to earlier studies, said Greenspan.\u003c/p>\n\u003cp>What's not clear from this study is if girls are also having their first period at a younger age. The research team has been following this group of girls since they were ages 6 to 8. Now they are 14 to 16. The researchers plan to analyze ages of the girls' first period once all the girls in the study have reached that milestone. \"One question we have,\" Greenspan said, \"is puberty starting earlier and ending earlier so there's an entire shift to an earlier age; or is puberty starting earlier and ending at the same time?\"\u003c/p>\n\u003cp>\u003cstrong>Psychological and physical health risks\u003c/strong>\u003c/p>\n\u003cp>This earlier onset of puberty puts girls at risk for certain mental and physical health issues. From the study:\u003c/p>\n\u003cblockquote>\u003cp>Girls with earlier maturation are at risk for lower self-esteem and higher rates of depression. They are more likely to be influenced by older peers and more deviant peers, and initiate intercourse, substance use and other norm-breaking behaviors at younger ages.\u003c/p>\u003c/blockquote>\n\u003cp>Many schools include classes about puberty and sexuality in 5th or 6th grade, Greenspan noted. But according to this new data, many girls are entering puberty in 3rd or 4th grade. This creates a \"real disconnect between the timing of girls' puberty and the timing of the education they receive about the puberty and their bodies in general.\" She argued for splitting the subject matter and teaching girls about puberty in the earlier grades and leaving sexuality for the later grades.\u003c/p>\n\u003cp>Girls who enter puberty younger are at higher risk for developing certain cancers as adults, including breast cancer -- possibly because earlier puberty increases exposure to estrogen, a known breast cancer risk. Greenspan hopes that the researchers will continue to receive funding to follow the girls into adulthood, which could yield better understanding of breast cancer risk.\u003c/p>\n\u003cp>The researchers also collected blood and urine samples from the girls at the beginning of the study and are analyzing certain chemicals to see what associations there may be between chemicals and breast development. They are looking at \u003ca href=\"http://www.npr.org/templates/archives/archive.php?thingId=141118712\" target=\"_blank\">Bisphenol A \u003c/a>(BPA), flame retardants, \u003ca href=\"http://www.cdc.gov/biomonitoring/Phthalates_FactSheet.html\" target=\"_blank\">phthalates\u003c/a>, heavy metals and chemicals used in nonstick cookware.\u003c/p>\n\u003cp>Karuna Jagger, executive director of Breast Cancer Action, a San Francisco-based advocacy group, called the study \"very important\" especially since causes of breast cancer are not fully understood, she said. She wants to know if chemical exposure means \"creating breasts that are susceptible to future insult and higher risk of breast cancer.\"\u003c/p>\n\u003cp>\u003cstrong>Living with uncertainty\u003c/strong>\u003c/p>\n\u003cp>In an \u003ca href=\"http://pediatrics.aappublications.org/content/future/132/6#COMMENTARIES\" target=\"_blank\">accompanying commentary\u003c/a> in Pediatrics, Marcia Herman-Giddens, lead researcher in the 1997 study, said that we may have to \"live with uncertainty\" for a long time, since the \"exact trigger for pubertal initiation is still unknown.\"\u003c/p>\n\u003cp>Herman-Giddens agreed that \"considerable research\" implicates obesity as a factor in the declining age of onset of puberty, but also points to other complex changes:\u003c/p>\n\u003cblockquote>\u003cp>Extensive interacting variables are known to be associated with earlier development in addition to weight and genetics: certain intrauterine conditions and exposures, preschool high-meat diets, dairy products, low fiber intake, isoflavones, high-stress families, absent fathers, certain endocrine disruptors, the microbiome as it influences weight, epigenetics, light exposure, hormone-laced hair products, insulin resistance, activity level, geographical location, and others.\u003c/p>\u003c/blockquote>\n\u003cp>This study did not look at boys. Greenspan noted there's \"mixed data\" for them, some suggesting boys are going through puberty earlier, some not. Further investigation needs to be done on boys, she said. \"The issue is that the chemicals or even fat may have a different effect on boys' puberty because [boys] have a different set of hormones.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated with additional information about the range in onset of puberty for Caucasian girls.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Stanford Kissing Event: Fun for the Evening, But Now Students Have Stomach Flu",
"title": "Stanford Kissing Event: Fun for the Evening, But Now Students Have Stomach Flu",
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"content": "\u003cfigure id=\"attachment_16022\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/11863277@N00/2576355770/in/photolist-4VEuP5-uAzAm-fwxynu-dZoSVP-hHqoq-9T3Q2R-4Hf7AU-4PBjqd-5TQJMf-4CkYnv-asLYeP-dLFQxc-sogFv-5C4fLo-sogrW-apMDU4-apQn7m-dZusmd-6rVL69-9hpkA8-4Pvxvo-8Tc6mx-4PriGF-7vMuE-7vMtd-7vMA2-7vMy8-7vMvC-7vMwq-7vMzn-7vMxg-7vMxA-7vMyX-7vMtG-7vMu9-4PrjFH-agqrmm-agnL5F-agqphq-2NGfo-exgZjv-4t4pV2-tpiq9-942jpj-7dbSwP-bMTugX-6stDX-5LsjfK-6G8FJB-bkYEMP-6MeLsD\">\u003cimg class=\"size-large wp-image-16022\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/2576355770_4c78a887b8_b-640x480.jpg\" alt=\"Where the kissing event happens, just not during the day. (rolfkleef/Flickr)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Where the kissing event happens, just not during the day. (rolfkleef/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>I've lived in the Bay Area for more than 20 years, but somehow missed this tradition at Stanford: \u003ca href=\"http://www.stanforddaily.com/2013/10/18/roxy-sass-full-moon-on-the-quad-cheat-sheet/\" target=\"_blank\">Full Moon on the Quad\u003c/a>.\u003c/p>\n\u003cp>As the New York Times \u003ca href=\"http://www.nytimes.com/2013/11/01/education/welcomed-with-kisses-stanford-freshmen-risk-the-kissing-disease.html?partner=rss&emc=rss&_r=1&\" target=\"_blank\">reported\u003c/a> Friday it's \"an event unique in American education: an orgy of interclass kissing reluctantly but officially sanctioned by the university.\"\u003c/p>\n\u003cp>How you respond to this might depend on your age.\u003c/p>\n\u003cp>My initial reaction was \"ewwww!\" But a (younger) colleague asked, \"Is it horrible to confess to you: I'd probably join in?!?!\"\u003c/p>\n\u003cp>The event was held last week, on Oct. 22. With thousands of students milling around waiting, the Times described what happened next:\u003c/p>\n\u003cblockquote>\u003cp>Finally, a male senior saunters over to a group of the youngest-looking women and asks: “Hey! You freshmen? Can I kiss you?”\u003c!--more-->\u003c/p>\n\u003cp>As the Stanford Band plays and a giant screen shows famous movie clutches, the bravest women step forward and receive the traditional welcome to one of the nation’s most prestigious universities: a big wet upperclassman smack.\u003c/p>\u003c/blockquote>\n\u003cp>I think you can guess why this is a health story.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Days later, another tradition arrives: flu and mononucleosis, the 'kissing disease,' sweep the dorms,\" says the Times.\u003c/p>\n\u003cp>It's now been 10 days since Full Moon on the Quad or FMOTQ.\u003c/p>\n\u003cp>Just a few minutes after I read the Times' piece, a release from Stanford popped up in my inbox -- 52 students had come down with norovirus. That's the virus commonly called \"stomach flu\" and generally causes vomiting and diarrhea.\u003c/p>\n\u003cp>Norovirus spreads like wildfire and risk factors for contracting the virus include having \"close personal contact\" with an infected person, says \u003ca href=\"http://www.cdc.gov/norovirus/downloads/keyfacts.pdf\" target=\"_blank\">the CDC\u003c/a>.\u003c/p>\n\u003cp>While any reasonable person might think that \"an orgy of interclass kissing\" would qualify as \"close personal contact,\" it's also true that association does not equal causation, as a reader notes in the comments below.\u003c/p>\n\u003cp>The Stanford Daily is following the health story, from a different angle. On Friday the paper \u003ca href=\"http://www.stanforddaily.com/2013/11/01/five-campus-study-spots-ranked-by-coughing-awkwardness/\" target=\"_blank\">reported\u003c/a> \"there's no shortage of illness going around campus\" now that FMOTQ is over. And what's the \"worst, and probably most ubiquitous, symptom\" of post-FMOTQ sickness? Coughing, the Daily believes. So the paper \u003ca href=\"http://www.stanforddaily.com/2013/11/01/five-campus-study-spots-ranked-by-coughing-awkwardness/\" target=\"_blank\">helpfully ranks\u003c/a> five campus study spots by \"coughing awkwardness.\"\u003c/p>\n\u003cp>Yet there's a more serious health story, too. Not surprisingly, an event that involves kissing a bunch of strangers can make people nervous. That kind of social anxiety can lead to excess alcohol consumption. The Daily \u003ca href=\"http://www.stanforddaily.com/2013/10/24/fmotq-medical-transports-drop-to-two/\" target=\"_blank\">reported last week\u003c/a> that medical transports related to FMOTQ were down this year possibly due to attempts to emphasize \"safe drinking vs. unsafe drinking.\"\u003c/p>\n\u003cp>And yes, Stanford officials have tried to ban the event, The Times notes, but since they've been unsuccessful, the university is focusing on trying to make the event safer.\u003c/p>\n\u003cblockquote>\u003cp>The evening is overseen by student sobriety monitors and decorated with hand-drawn signs — of the ilk that usually say \"Beat Cal” — but bearing slogans like “Consent is Sexy.”\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>This post has been updated with more information about norovirus.\u003c/strong>\u003c/p>\n\n",
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"excerpt": "I've lived in the Bay Area for more than 20 years, but somehow missed this tradition at Stanford: Full Moon on the Quad.\r\n\r\nAs the New York Times reported Friday it's \"an event unique in American education: an orgy of interclass kissing reluctantly but officially sanctioned by the university.\"\r\n\r\nHow you respond to this might depend on your age.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16022\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/11863277@N00/2576355770/in/photolist-4VEuP5-uAzAm-fwxynu-dZoSVP-hHqoq-9T3Q2R-4Hf7AU-4PBjqd-5TQJMf-4CkYnv-asLYeP-dLFQxc-sogFv-5C4fLo-sogrW-apMDU4-apQn7m-dZusmd-6rVL69-9hpkA8-4Pvxvo-8Tc6mx-4PriGF-7vMuE-7vMtd-7vMA2-7vMy8-7vMvC-7vMwq-7vMzn-7vMxg-7vMxA-7vMyX-7vMtG-7vMu9-4PrjFH-agqrmm-agnL5F-agqphq-2NGfo-exgZjv-4t4pV2-tpiq9-942jpj-7dbSwP-bMTugX-6stDX-5LsjfK-6G8FJB-bkYEMP-6MeLsD\">\u003cimg class=\"size-large wp-image-16022\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/2576355770_4c78a887b8_b-640x480.jpg\" alt=\"Where the kissing event happens, just not during the day. (rolfkleef/Flickr)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Where the kissing event happens, just not during the day. (rolfkleef/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>I've lived in the Bay Area for more than 20 years, but somehow missed this tradition at Stanford: \u003ca href=\"http://www.stanforddaily.com/2013/10/18/roxy-sass-full-moon-on-the-quad-cheat-sheet/\" target=\"_blank\">Full Moon on the Quad\u003c/a>.\u003c/p>\n\u003cp>As the New York Times \u003ca href=\"http://www.nytimes.com/2013/11/01/education/welcomed-with-kisses-stanford-freshmen-risk-the-kissing-disease.html?partner=rss&emc=rss&_r=1&\" target=\"_blank\">reported\u003c/a> Friday it's \"an event unique in American education: an orgy of interclass kissing reluctantly but officially sanctioned by the university.\"\u003c/p>\n\u003cp>How you respond to this might depend on your age.\u003c/p>\n\u003cp>My initial reaction was \"ewwww!\" But a (younger) colleague asked, \"Is it horrible to confess to you: I'd probably join in?!?!\"\u003c/p>\n\u003cp>The event was held last week, on Oct. 22. With thousands of students milling around waiting, the Times described what happened next:\u003c/p>\n\u003cblockquote>\u003cp>Finally, a male senior saunters over to a group of the youngest-looking women and asks: “Hey! You freshmen? Can I kiss you?”\u003c!--more-->\u003c/p>\n\u003cp>As the Stanford Band plays and a giant screen shows famous movie clutches, the bravest women step forward and receive the traditional welcome to one of the nation’s most prestigious universities: a big wet upperclassman smack.\u003c/p>\u003c/blockquote>\n\u003cp>I think you can guess why this is a health story.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Days later, another tradition arrives: flu and mononucleosis, the 'kissing disease,' sweep the dorms,\" says the Times.\u003c/p>\n\u003cp>It's now been 10 days since Full Moon on the Quad or FMOTQ.\u003c/p>\n\u003cp>Just a few minutes after I read the Times' piece, a release from Stanford popped up in my inbox -- 52 students had come down with norovirus. That's the virus commonly called \"stomach flu\" and generally causes vomiting and diarrhea.\u003c/p>\n\u003cp>Norovirus spreads like wildfire and risk factors for contracting the virus include having \"close personal contact\" with an infected person, says \u003ca href=\"http://www.cdc.gov/norovirus/downloads/keyfacts.pdf\" target=\"_blank\">the CDC\u003c/a>.\u003c/p>\n\u003cp>While any reasonable person might think that \"an orgy of interclass kissing\" would qualify as \"close personal contact,\" it's also true that association does not equal causation, as a reader notes in the comments below.\u003c/p>\n\u003cp>The Stanford Daily is following the health story, from a different angle. On Friday the paper \u003ca href=\"http://www.stanforddaily.com/2013/11/01/five-campus-study-spots-ranked-by-coughing-awkwardness/\" target=\"_blank\">reported\u003c/a> \"there's no shortage of illness going around campus\" now that FMOTQ is over. And what's the \"worst, and probably most ubiquitous, symptom\" of post-FMOTQ sickness? Coughing, the Daily believes. So the paper \u003ca href=\"http://www.stanforddaily.com/2013/11/01/five-campus-study-spots-ranked-by-coughing-awkwardness/\" target=\"_blank\">helpfully ranks\u003c/a> five campus study spots by \"coughing awkwardness.\"\u003c/p>\n\u003cp>Yet there's a more serious health story, too. Not surprisingly, an event that involves kissing a bunch of strangers can make people nervous. That kind of social anxiety can lead to excess alcohol consumption. The Daily \u003ca href=\"http://www.stanforddaily.com/2013/10/24/fmotq-medical-transports-drop-to-two/\" target=\"_blank\">reported last week\u003c/a> that medical transports related to FMOTQ were down this year possibly due to attempts to emphasize \"safe drinking vs. unsafe drinking.\"\u003c/p>\n\u003cp>And yes, Stanford officials have tried to ban the event, The Times notes, but since they've been unsuccessful, the university is focusing on trying to make the event safer.\u003c/p>\n\u003cblockquote>\u003cp>The evening is overseen by student sobriety monitors and decorated with hand-drawn signs — of the ilk that usually say \"Beat Cal” — but bearing slogans like “Consent is Sexy.”\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>This post has been updated with more information about norovirus.\u003c/strong>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Recipe For Strong Teen Bones: Exercise, Calcium and Vitamin D",
"title": "Recipe For Strong Teen Bones: Exercise, Calcium and Vitamin D",
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"content": "\u003cfigure id=\"attachment_15872\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/39255507@N03/4566653777/in/photolist-7Xxi4X-7XxipH-7XAxqo-7XxihR-7Xxion-7Xxicp-7XxijP-7XxhYi-awfLC9-fEG3yB-fEYAfj-fEYC2G-fEYAgY-fEG4vp-fEG2MB-fEG4uc-fEG3zH-fEYAgE-fEYB55-fEYC2W-fEYAgb-fEG3A4-fEG3y2-fEG3xP-7Qw4Yw-7Qw4LN-7QsJKt-7QsJDV-7QsJFP-7Qw4QQ-7QsJCD-7Qw4P1-7Qw4SC-KSPPn-KSPXp-KSEEj-KSEU5-KSQ5T-KSQ4K-KSPNc-KSEM3-KSPRM-KSENE-KSQdX-KSEKE-KSPLX-KSEA1-KSQbe-KSPTg-KSESY-KSPYk\">\u003cimg class=\"size-large wp-image-15872\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/4566653777_3def509bde_o-640x426.jpg\" alt=\"Exercise helps build strong bones for a lifetime, says one expert. (KG Sand Soccer/Flickr)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Exercise helps build strong bones for a lifetime, says one expert. (KG Sand Soccer/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Patti Neighmond\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2013/10/28/240553878/the-recipe-for-strong-teenage-bones-exercise-calcium-and-d\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>It's really only a sliver of time when humans build the bulk of their skeleton. At age 9, the bones start a big growth spurt. And by the time puberty ends, around 14 or 15 years old, the adult-sized skeleton is all but done, about 90 percent complete.\u003c/p>\n\u003cp>But doctors say a lot of children aren't getting what they need to do that. Calcium and vitamin D are essential, sure, but so is lots of time jumping and running.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It's the magic window of time when bone is built.\"\u003c/aside>\n\u003cp>\"It's the magic window of time when bone is built,\" says \u003ca href=\"http://www.childrensnational.org/departmentsandprograms/default.aspx?Id=6112&Type=Program&Name=Bone%20Health%20Program\">Dr. Laura Tosi\u003c/a>, an orthopedic surgeon who directs the pediatric bone health program at Children's National Health system in Washington, D.C. And when it comes to bones, \"bigger is definitely better,\" she says. \"The wider and thicker the bone, the harder it is to break or tear.\"\u003c/p>\n\u003cp>Just about everybody knows that calcium and vitamin D are essential to build strong bones. But children and teenagers are all too often shunning the foods that would help them get enough calcium and vitamin D to build those bones.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Federal health officials recommend that children between the ages of 9 and 18 get 1,300 milligrams of calcium every day. That translates into four to five glasses of milk or the equivalent. According to \u003ca href=\"http://med.stanford.edu/profiles/Neville_Golden/\">Dr. Neville Golden\u003c/a>, an adolescent medicine specialist at the Stanford University School of Medicine, most teens are not drinking anywhere near that amount.\u003c!--more-->\u003c/p>\n\u003cp>Only about 15 percent of high school students are drinking milk, according to a 2011 federal\u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6104a1.htm\">survey\u003c/a>. And only about 9 percent of girls do. In part that's because milk drinking is viewed as \"uncool,\" says Golden, and teens, particularly girls, often think of milk as fattening.\u003c/p>\n\u003cp>But that's not true, he says. One glass of skim milk contains no fat and approximately 80 calories, about the same caloric content as an apple.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cp>Now of course there are other sources of calcium — yogurt and cheese, for example. But lots of kids think those are fattening, too, Golden says. And while vegetables can be a source of calcium, you'd have to eat an awful lot of them to reach the recommended levels — one cup of broccoli has just 42 mg of calcium. Fortunately, there are other food sources, including fortified orange juice, breakfast cereals and tofu.\u003c/p>\n\u003cp>Calcium supplements are often recommended for adults to meet their recommended daily requirement. But for kids, Golden says, it's far better to eat calcium-rich foods. That's because the body absorbs calcium better from food than it does from supplements.\u003c/p>\n\u003cp>Even if boys and girls get the recommended amount of calcium, if they're not also getting vitamin D it won't make a difference. \"You can drink as much calcium as you like, but if you don't have enough vitamin D, you're not going to absorb it,\" Golden says. The vitamin, which is actually a hormone, interacts with the lining of the stomach and intestines to help calcium get absorbed.\u003c/p>\n\u003cp>In 2010, the Institute of Medicine \u003ca href=\"http://www.iom.edu/Reports/2010/Dietary-Reference-Intakes-for-calcium-and-vitamin-D.aspx\">said\u003c/a> that children and most adults need 600 international units of vitamin D a day. They found no evidence of widespread vitamin D deficiency, though people these days spend much less time out in the sun, which stimulates the body's production of vitamin D.\u003c/p>\n\u003cp>Vitamin D is found in foods like fatty fish such as salmon and sardines, but teenage girls were least likely of all age groups to get enough vitamin D in food, according to a 2010 \u003ca href=\"http://jn.nutrition.org/content/140/4/817.full?sid=462ff172-96d3-455d-8958-cf4941c10251\">study\u003c/a>. One interesting point, says Golden: Farmed salmon is not as vitamin D rich as wild-caught salmon. And like calcium, vitamin D is added to foods like milk and orange juice.\u003c/p>\n\u003cp>If a teenager still isn't getting enough vitamin D from fish, milk and other healthy foods, Golden says, a reasonable workaround is taking supplements of about 400 international units per day.\u003c/p>\n\u003cp>Perhaps the secret ingredient to building strong bones for a lifetime is exercise, says orthopedic surgeon Tosi. One \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1359/jbmr.061205/full\">study\u003c/a> found that when children jumped up and down between classes, totaling about 15 minutes a day, they added mass to their leg bones.\u003c/p>\n\u003cp>The bounce is what's important, Tosi says. \"We think the bounce probably sends an electrical or other signal right up the skeleton, saying, 'OK, time to give more, time to build more bone.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So, jumping, jogging, tennis and basketball are all good options. Federal health officials suggest kids get at least one hour of exercise every day.\u003c/p>\n\n",
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"excerpt": "It's really only a sliver of time when humans build the bulk of their skeleton. At age 9, the bones start a big growth spurt. And by the time puberty ends, around 14 or 15 years old, the adult-sized skeleton is all but done, about 90 percent complete.\r\n\r\nBut doctors say a lot of children aren't getting what they need to do that. Calcium and vitamin D are essential, sure, but so is lots of time jumping and running.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15872\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/39255507@N03/4566653777/in/photolist-7Xxi4X-7XxipH-7XAxqo-7XxihR-7Xxion-7Xxicp-7XxijP-7XxhYi-awfLC9-fEG3yB-fEYAfj-fEYC2G-fEYAgY-fEG4vp-fEG2MB-fEG4uc-fEG3zH-fEYAgE-fEYB55-fEYC2W-fEYAgb-fEG3A4-fEG3y2-fEG3xP-7Qw4Yw-7Qw4LN-7QsJKt-7QsJDV-7QsJFP-7Qw4QQ-7QsJCD-7Qw4P1-7Qw4SC-KSPPn-KSPXp-KSEEj-KSEU5-KSQ5T-KSQ4K-KSPNc-KSEM3-KSPRM-KSENE-KSQdX-KSEKE-KSPLX-KSEA1-KSQbe-KSPTg-KSESY-KSPYk\">\u003cimg class=\"size-large wp-image-15872\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/4566653777_3def509bde_o-640x426.jpg\" alt=\"Exercise helps build strong bones for a lifetime, says one expert. (KG Sand Soccer/Flickr)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Exercise helps build strong bones for a lifetime, says one expert. (KG Sand Soccer/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Patti Neighmond\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2013/10/28/240553878/the-recipe-for-strong-teenage-bones-exercise-calcium-and-d\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>It's really only a sliver of time when humans build the bulk of their skeleton. At age 9, the bones start a big growth spurt. And by the time puberty ends, around 14 or 15 years old, the adult-sized skeleton is all but done, about 90 percent complete.\u003c/p>\n\u003cp>But doctors say a lot of children aren't getting what they need to do that. Calcium and vitamin D are essential, sure, but so is lots of time jumping and running.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It's the magic window of time when bone is built.\"\u003c/aside>\n\u003cp>\"It's the magic window of time when bone is built,\" says \u003ca href=\"http://www.childrensnational.org/departmentsandprograms/default.aspx?Id=6112&Type=Program&Name=Bone%20Health%20Program\">Dr. Laura Tosi\u003c/a>, an orthopedic surgeon who directs the pediatric bone health program at Children's National Health system in Washington, D.C. And when it comes to bones, \"bigger is definitely better,\" she says. \"The wider and thicker the bone, the harder it is to break or tear.\"\u003c/p>\n\u003cp>Just about everybody knows that calcium and vitamin D are essential to build strong bones. But children and teenagers are all too often shunning the foods that would help them get enough calcium and vitamin D to build those bones.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Federal health officials recommend that children between the ages of 9 and 18 get 1,300 milligrams of calcium every day. That translates into four to five glasses of milk or the equivalent. According to \u003ca href=\"http://med.stanford.edu/profiles/Neville_Golden/\">Dr. Neville Golden\u003c/a>, an adolescent medicine specialist at the Stanford University School of Medicine, most teens are not drinking anywhere near that amount.\u003c!--more-->\u003c/p>\n\u003cp>Only about 15 percent of high school students are drinking milk, according to a 2011 federal\u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6104a1.htm\">survey\u003c/a>. And only about 9 percent of girls do. In part that's because milk drinking is viewed as \"uncool,\" says Golden, and teens, particularly girls, often think of milk as fattening.\u003c/p>\n\u003cp>But that's not true, he says. One glass of skim milk contains no fat and approximately 80 calories, about the same caloric content as an apple.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cp>Now of course there are other sources of calcium — yogurt and cheese, for example. But lots of kids think those are fattening, too, Golden says. And while vegetables can be a source of calcium, you'd have to eat an awful lot of them to reach the recommended levels — one cup of broccoli has just 42 mg of calcium. Fortunately, there are other food sources, including fortified orange juice, breakfast cereals and tofu.\u003c/p>\n\u003cp>Calcium supplements are often recommended for adults to meet their recommended daily requirement. But for kids, Golden says, it's far better to eat calcium-rich foods. That's because the body absorbs calcium better from food than it does from supplements.\u003c/p>\n\u003cp>Even if boys and girls get the recommended amount of calcium, if they're not also getting vitamin D it won't make a difference. \"You can drink as much calcium as you like, but if you don't have enough vitamin D, you're not going to absorb it,\" Golden says. The vitamin, which is actually a hormone, interacts with the lining of the stomach and intestines to help calcium get absorbed.\u003c/p>\n\u003cp>In 2010, the Institute of Medicine \u003ca href=\"http://www.iom.edu/Reports/2010/Dietary-Reference-Intakes-for-calcium-and-vitamin-D.aspx\">said\u003c/a> that children and most adults need 600 international units of vitamin D a day. They found no evidence of widespread vitamin D deficiency, though people these days spend much less time out in the sun, which stimulates the body's production of vitamin D.\u003c/p>\n\u003cp>Vitamin D is found in foods like fatty fish such as salmon and sardines, but teenage girls were least likely of all age groups to get enough vitamin D in food, according to a 2010 \u003ca href=\"http://jn.nutrition.org/content/140/4/817.full?sid=462ff172-96d3-455d-8958-cf4941c10251\">study\u003c/a>. One interesting point, says Golden: Farmed salmon is not as vitamin D rich as wild-caught salmon. And like calcium, vitamin D is added to foods like milk and orange juice.\u003c/p>\n\u003cp>If a teenager still isn't getting enough vitamin D from fish, milk and other healthy foods, Golden says, a reasonable workaround is taking supplements of about 400 international units per day.\u003c/p>\n\u003cp>Perhaps the secret ingredient to building strong bones for a lifetime is exercise, says orthopedic surgeon Tosi. One \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1359/jbmr.061205/full\">study\u003c/a> found that when children jumped up and down between classes, totaling about 15 minutes a day, they added mass to their leg bones.\u003c/p>\n\u003cp>The bounce is what's important, Tosi says. \"We think the bounce probably sends an electrical or other signal right up the skeleton, saying, 'OK, time to give more, time to build more bone.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So, jumping, jogging, tennis and basketball are all good options. Federal health officials suggest kids get at least one hour of exercise every day.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "FDA Seeks to Tighten Control on Hydrocodone Painkillers Like Vicodin",
"title": "FDA Seeks to Tighten Control on Hydrocodone Painkillers Like Vicodin",
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"content": "\u003cfigure id=\"attachment_15859\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/futurowoman/2078779116/sizes/o/in/photolist-4aGhBf-aizjc-4hY77L-uzoVo-7AiW3J-a7qSLU-6jLHog-7jzuLK-7o4K6z-9fJg9L-34AqJA-xQqvb-di7a17-bN8gn-6pY7b9-aKvL8R-8cVFUS-dpQdQm-6EKeq-bvc7PH-9aSWRR-4YyDKp-6cNjxC-NyYHn-8Shq6Y-7JZqE7-4r4gk9-9hs7AG/\">\u003cimg class=\"size-full wp-image-15859\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/2078779116_b734772edc_z.jpg\" alt=\"(futurowoman/Flickr)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/2078779116_b734772edc_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/2078779116_b734772edc_z-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/2078779116_b734772edc_z-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(futurowoman/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Rob Stein,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/health/2013/10/24/240569516/fda-seeks-to-tighten-controls-on-hydrocodone-painkillers\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>The Food and Drug Administration Thursday \u003ca href=\"http://www.fda.gov/Drugs/DrugSafety/ucm372089.htm\">announced\u003c/a> that it wants the federal government to impose tough new restrictions on some of the most widely used prescription painkillers.\u003c/p>\n\u003cp>The FDA said it planned to recommend that Vicodin and other prescription painkillers containing the powerful opioid hydrocodone be reclassified from a \"Schedule III\" drug to a \"\u003ca href=\"http://www.justice.gov/dea/druginfo/ds.shtml\">Schedule II\u003c/a>\" drug, which would impose new restrictions on how they are prescribed and used.\u003c/p>\n\u003cp>OxyContin, another opioid painkiller, is already a Schedule II drug, defined by the Drug Enforcement Administration as \"potentially leading to severe psychological or physical dependence\".\u003c/p>\n\u003cp>In a statement posted on its website, the agency said it was taking the step after becoming \"increasingly concerned about the abuse and misuse of opioid products, which have sadly reached epidemic proportions in certain parts of the United States.\"\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The DEA has been asking the agency to recommend reclassifying the drugs for years, citing soaring numbers of Americans becoming addicted to the drugs and dying from overdoses.\u003c/p>\n\u003cp>Pain specialists and their patients, however, have been fighting the move, saying that any new restrictions would make it too difficult for those suffering from chronic, debilitating pain to get the drugs they need to survive.\u003c/p>\n\u003cp>The agency acknowledged the \u003ca href=\"http://www.npr.org/blogs/health/2013/01/23/169963431/painkiller-paradox-feds-struggle-to-control-drugs-that-help-and-harm\">emotional debate\u003c/a>, saying it \"has been challenged with determining how to balance the need to ensure continued access to those patients who rely on continuous pain relief while addressing the ongoing concerns about abuse and misuse.\"\u003c/p>\n\u003cp>Among other things, reclassifying the drugs would reduce the number of refills patients could get before having to go back to see their doctor. Doctors would not be able to simply call prescriptions into pharmacies.\u003c/p>\n\u003cp>The FDA said it would submit its recommendation to the Health and Human Services Department by early December, and anticipated that the National Institute on Drug Abuse would concur with the recommendation. That will begin a process that would lead to a final decision by the DEA.\u003c/p>\n\u003cp>More than 136 million prescriptions for these products are dispensed every year, making them the most widely used prescription drugs in the country. Vicodin is probably the best-known hydrocodone-containing product, but there are many others, sold under brand names such as Lortab and Norco.\u003c/p>\n\u003cp>While powerful painkillers, opioids are highly addictive and are abused by millions. The number of Americans overdosing from these drugs has been increasing rapidly in recent years, and more than 15,000 now die every year, according to the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>But about 100 million Americans suffer from chronic pain, and many of them and their doctors fear the change would make it difficult, if not impossible, for these patients to get drugs they need.\u003c/p>\n\u003cp>The move comes after an \u003ca href=\"http://www.npr.org/templates/transcript/transcript.php?storyId=170255897\">FDA advisory panel recommended the change\u003c/a> in January.\u003c/p>\n\u003cp>Advocates for pain patients immediately reacted with concern to the announcement.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The concern we have is that it may unintentionally make access for people with pain even more of a challenge than it is now,\" wrote Bob Twillman of the \u003ca href=\"http://www.aapainmanage.org/\">American Academy of Pain Management\u003c/a> in an email to Shots. \"This could necessitate millions more office visits, with attendant costs approaching a billion dollars a year. The access issues will need to be addressed or we will have a lot more people with a lot more uncontrolled pain.\"\u003c/p>\n\n",
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"description": "By Rob Stein, NPR The Food and Drug Administration Thursday announced that it wants the federal government to impose tough new restrictions on some of the most widely used prescription painkillers. The FDA said it planned to recommend that Vicodin and other prescription painkillers containing the powerful opioid hydrocodone be reclassified from a "Schedule III" drug to",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15859\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/futurowoman/2078779116/sizes/o/in/photolist-4aGhBf-aizjc-4hY77L-uzoVo-7AiW3J-a7qSLU-6jLHog-7jzuLK-7o4K6z-9fJg9L-34AqJA-xQqvb-di7a17-bN8gn-6pY7b9-aKvL8R-8cVFUS-dpQdQm-6EKeq-bvc7PH-9aSWRR-4YyDKp-6cNjxC-NyYHn-8Shq6Y-7JZqE7-4r4gk9-9hs7AG/\">\u003cimg class=\"size-full wp-image-15859\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/2078779116_b734772edc_z.jpg\" alt=\"(futurowoman/Flickr)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/2078779116_b734772edc_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/2078779116_b734772edc_z-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/2078779116_b734772edc_z-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(futurowoman/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Rob Stein,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/health/2013/10/24/240569516/fda-seeks-to-tighten-controls-on-hydrocodone-painkillers\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>The Food and Drug Administration Thursday \u003ca href=\"http://www.fda.gov/Drugs/DrugSafety/ucm372089.htm\">announced\u003c/a> that it wants the federal government to impose tough new restrictions on some of the most widely used prescription painkillers.\u003c/p>\n\u003cp>The FDA said it planned to recommend that Vicodin and other prescription painkillers containing the powerful opioid hydrocodone be reclassified from a \"Schedule III\" drug to a \"\u003ca href=\"http://www.justice.gov/dea/druginfo/ds.shtml\">Schedule II\u003c/a>\" drug, which would impose new restrictions on how they are prescribed and used.\u003c/p>\n\u003cp>OxyContin, another opioid painkiller, is already a Schedule II drug, defined by the Drug Enforcement Administration as \"potentially leading to severe psychological or physical dependence\".\u003c/p>\n\u003cp>In a statement posted on its website, the agency said it was taking the step after becoming \"increasingly concerned about the abuse and misuse of opioid products, which have sadly reached epidemic proportions in certain parts of the United States.\"\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The DEA has been asking the agency to recommend reclassifying the drugs for years, citing soaring numbers of Americans becoming addicted to the drugs and dying from overdoses.\u003c/p>\n\u003cp>Pain specialists and their patients, however, have been fighting the move, saying that any new restrictions would make it too difficult for those suffering from chronic, debilitating pain to get the drugs they need to survive.\u003c/p>\n\u003cp>The agency acknowledged the \u003ca href=\"http://www.npr.org/blogs/health/2013/01/23/169963431/painkiller-paradox-feds-struggle-to-control-drugs-that-help-and-harm\">emotional debate\u003c/a>, saying it \"has been challenged with determining how to balance the need to ensure continued access to those patients who rely on continuous pain relief while addressing the ongoing concerns about abuse and misuse.\"\u003c/p>\n\u003cp>Among other things, reclassifying the drugs would reduce the number of refills patients could get before having to go back to see their doctor. Doctors would not be able to simply call prescriptions into pharmacies.\u003c/p>\n\u003cp>The FDA said it would submit its recommendation to the Health and Human Services Department by early December, and anticipated that the National Institute on Drug Abuse would concur with the recommendation. That will begin a process that would lead to a final decision by the DEA.\u003c/p>\n\u003cp>More than 136 million prescriptions for these products are dispensed every year, making them the most widely used prescription drugs in the country. Vicodin is probably the best-known hydrocodone-containing product, but there are many others, sold under brand names such as Lortab and Norco.\u003c/p>\n\u003cp>While powerful painkillers, opioids are highly addictive and are abused by millions. The number of Americans overdosing from these drugs has been increasing rapidly in recent years, and more than 15,000 now die every year, according to the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>But about 100 million Americans suffer from chronic pain, and many of them and their doctors fear the change would make it difficult, if not impossible, for these patients to get drugs they need.\u003c/p>\n\u003cp>The move comes after an \u003ca href=\"http://www.npr.org/templates/transcript/transcript.php?storyId=170255897\">FDA advisory panel recommended the change\u003c/a> in January.\u003c/p>\n\u003cp>Advocates for pain patients immediately reacted with concern to the announcement.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The concern we have is that it may unintentionally make access for people with pain even more of a challenge than it is now,\" wrote Bob Twillman of the \u003ca href=\"http://www.aapainmanage.org/\">American Academy of Pain Management\u003c/a> in an email to Shots. \"This could necessitate millions more office visits, with attendant costs approaching a billion dollars a year. The access issues will need to be addressed or we will have a lot more people with a lot more uncontrolled pain.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Teens Slurping More Sugary Drinks ",
"title": "California Teens Slurping More Sugary Drinks ",
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"content": "\u003cfigure id=\"attachment_15792\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\">\u003cimg class=\"size-full wp-image-15792\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\" alt=\"Arizona Green Tea is popular with teens, but this 23.5 ounce can has 51 grams -- or more than one-third of a cup -- of sugar.(Jane Meredith Adams/EdSource)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Arizona Green Tea is popular with teens, but this 23 ounce can has 51 grams -- or more than one-third of a cup -- of sugar. (Jane Meredith Adams/EdSource)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jane Meredith Adams\u003c/strong>, \u003ca href=\"http://www.edsource.org/today/2013/more-teens-drinking-sugary-beverages-study-finds/40531#.UmFrIxZRYRk\" target=\"_blank\">EdSource\u003c/a>\u003c/p>\n\u003cp>As the clock ticks toward a 2014 federal ban on the sale of sports drinks at high schools, California teenagers are showing an increasing fondness for the sugary beverages, with an alarming 23 percent spike in the consumption of sports and energy drinks since 2005, according to a \u003ca href=\"http://www.publichealthadvocacy.org/_PDFs/stillbubblingover/PolicyBrief.pdf\" target=\"_blank\">new study\u003c/a>.\u003c/p>\n\u003cp>At the same time, consumption of sugary drinks by young children is declining sharply, according to the study by researchers at the California Center for Public Health Advocacy and the UCLA Center for Health Policy Research. The study tracked youth consumption of the beverages from 2005 to 2012.\u003c/p>\n\u003cp>Both trends – the surge in teens guzzling sugary drinks and the drop in consumption for younger children – are tied to regulations governing the sale of the beverages in California schools, said Harold Goldstein, executive director of the California Center for Public Health Advocacy.\u003c/p>\n\u003cp>“Taking sodas out of schools contributed to a precipitous drop in consumption among younger kids,” he said, “while older kids have switched to sports drinks and energy drinks, and those products are available in schools.”\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In California, soda sales have been banned in elementary and middle schools since 2006 and in high schools since 2009, but \u003ca href=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=49001-50000&file=49430-49436\" target=\"_blank\">a loophole \u003c/a>in the state education code allows the sale of electrolyte replacement beverages, otherwise known as sports drinks, in high school cafeterias, vending machines, snack bars and other on-campus venues. That loophole will close on July 1, 2014, when \u003ca href=\"http://www.fns.usda.gov/cnd/Governance/Legislation/allfoods_beverages.pdf\" target=\"_blank\">new regulations\u003c/a> from the U.S. Department of Agriculture take effect to ban the sale on school campuses of sugary sports and energy drinks that have more than 40 calories in 8 ounces or 60 calories in 12 ounces.\u003c/p>\n\u003cp>“That means your typical 20-ounce Gatorade won’t be in schools,” said Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, a nonprofit organization.\u003c/p>\n\u003cp>Some 65 percent of adolescents drink at least one sugary sports drink or soda a day, an 8 percent jump since an earlier survey tracking consumption habits, researchers said.\u003c/p>\n\u003cp>\u003cstrong>Sodas, sport drinks should be \"treats,\" advocates say\u003c/strong>\u003c/p>\n\u003cp>Given the close association between daily sugary beverage consumption and obesity, the rise is cause for alarm for schools that are working to address the effects of obesity on student attendance, self-esteem and health.\u003c/p>\n\u003cp>“California has made real progress in reducing the consumption of sugary beverages among young children,” said Susan Babey, the report’s lead author. “But teens are in trouble.”\u003c/p>\n\u003cp>She said sodas and sports drinks should be regarded as occasional “treats,” not part of a daily meal plan.\u003c/p>\n\u003cp>The study’s most encouraging finding was that young children are consuming markedly fewer sugary beverages. About 19 percent of 2- to 5-year-olds drink a sugary beverage every day, the study said, a 30 percent decline since the earlier survey. Among 6- to 11-year-olds, 32 percent are daily consumers, down 26 percent since 2005-2007.\u003c/p>\n\u003cp>The study was based on data collected in the \u003ca href=\"http://healthpolicy.ucla.edu/chis/about/Pages/about.aspx\" target=\"_blank\">California Health Interview Survey,\u003c/a> the nation’s largest state health survey. Researchers completed interviews with more than 40,000 households.\u003c/p>\n\u003cp>\u003cstrong>Snapshot from one \"open campus\" high school\u003c/strong>\u003c/p>\n\u003cp>Still, banning the beverages from schools won’t stop teenagers from finding the drinks. Some 75 percent of high school campuses in California are “closed” and don’t allow students to leave the grounds without supervision during the school day. “It’s the 25 percent we need to worry about it,” said Wootan at the Center for Science in the Public Interest.\u003c/p>\n\u003cp>At Oakland Technical High School – which has an open campus policy allowing students to leave during lunch – many students sitting on the front lawn at lunchtime Thursday drank from water bottles, while other students returned from local stores with pizza and sugared beverages, including Arizona iced tea, Shasta Cola and a 7-11 Slurpee.\u003c/p>\n\u003cp>Many were well aware of the amount of sugar they were consuming, but didn’t feel it was a serious problem. One student said bottled water was more expensive than his canned iced tea.\u003c/p>\n\u003cp>“I buy it because it tastes good,” said Will, a freshman carrying a can of Shasta Cola.\u003c/p>\n\u003cp>His friend, Ethan, had a 23.5-ounce can of Arizona Green Tea containing 51 grams of sugar. “This has a lot of sugar, but it’s better than soda,” Ethan said. “It’s Arizona and it’s green tea.”\u003c/p>\n\u003cp>Public perception may hold that iced teas and fruit drinks are a better choice than sodas, yet high concentrations of sugar in the beverages make them something to consume in moderation, experts said.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.publichealthadvocacy.org/_PDFs/stillbubblingover/PolicyBrief.pdf\" target=\"_blank\">counties \u003c/a>with the largest declines in percentage of youth drinking soda or other sugary beverages every day included Ventura County, with a 37 percent decrease since 2005; Yuba County, with a 32 percent decrease; and Napa County, with a 31 percent decrease.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Counties with the largest increase in daily sugary drink consumption among youth of all ages were Lake County, with a 36 percent increase; Monterey County, with a 29 percent increase; and Solano County, with a 24 percent increase.\u003c/p>\n\n",
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"excerpt": "As the clock ticks toward a 2014 federal ban on the sale of sports drinks at high schools, California teenagers are showing an increasing fondness for the sugary beverages, with an alarming 23 percent spike in the consumption of sports and energy drinks since 2005, according to a new study.\r\n\r\nAt the same time, consumption of sugary drinks by young children is declining sharply, according to the study by researchers at the California Center for Public Health Advocacy and the UCLA Center for Health Policy Research. The study tracked youth consumption of the beverages from 2005 to 2012.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15792\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\">\u003cimg class=\"size-full wp-image-15792\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\" alt=\"Arizona Green Tea is popular with teens, but this 23.5 ounce can has 51 grams -- or more than one-third of a cup -- of sugar.(Jane Meredith Adams/EdSource)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Arizona Green Tea is popular with teens, but this 23 ounce can has 51 grams -- or more than one-third of a cup -- of sugar. (Jane Meredith Adams/EdSource)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jane Meredith Adams\u003c/strong>, \u003ca href=\"http://www.edsource.org/today/2013/more-teens-drinking-sugary-beverages-study-finds/40531#.UmFrIxZRYRk\" target=\"_blank\">EdSource\u003c/a>\u003c/p>\n\u003cp>As the clock ticks toward a 2014 federal ban on the sale of sports drinks at high schools, California teenagers are showing an increasing fondness for the sugary beverages, with an alarming 23 percent spike in the consumption of sports and energy drinks since 2005, according to a \u003ca href=\"http://www.publichealthadvocacy.org/_PDFs/stillbubblingover/PolicyBrief.pdf\" target=\"_blank\">new study\u003c/a>.\u003c/p>\n\u003cp>At the same time, consumption of sugary drinks by young children is declining sharply, according to the study by researchers at the California Center for Public Health Advocacy and the UCLA Center for Health Policy Research. The study tracked youth consumption of the beverages from 2005 to 2012.\u003c/p>\n\u003cp>Both trends – the surge in teens guzzling sugary drinks and the drop in consumption for younger children – are tied to regulations governing the sale of the beverages in California schools, said Harold Goldstein, executive director of the California Center for Public Health Advocacy.\u003c/p>\n\u003cp>“Taking sodas out of schools contributed to a precipitous drop in consumption among younger kids,” he said, “while older kids have switched to sports drinks and energy drinks, and those products are available in schools.”\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In California, soda sales have been banned in elementary and middle schools since 2006 and in high schools since 2009, but \u003ca href=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=49001-50000&file=49430-49436\" target=\"_blank\">a loophole \u003c/a>in the state education code allows the sale of electrolyte replacement beverages, otherwise known as sports drinks, in high school cafeterias, vending machines, snack bars and other on-campus venues. That loophole will close on July 1, 2014, when \u003ca href=\"http://www.fns.usda.gov/cnd/Governance/Legislation/allfoods_beverages.pdf\" target=\"_blank\">new regulations\u003c/a> from the U.S. Department of Agriculture take effect to ban the sale on school campuses of sugary sports and energy drinks that have more than 40 calories in 8 ounces or 60 calories in 12 ounces.\u003c/p>\n\u003cp>“That means your typical 20-ounce Gatorade won’t be in schools,” said Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, a nonprofit organization.\u003c/p>\n\u003cp>Some 65 percent of adolescents drink at least one sugary sports drink or soda a day, an 8 percent jump since an earlier survey tracking consumption habits, researchers said.\u003c/p>\n\u003cp>\u003cstrong>Sodas, sport drinks should be \"treats,\" advocates say\u003c/strong>\u003c/p>\n\u003cp>Given the close association between daily sugary beverage consumption and obesity, the rise is cause for alarm for schools that are working to address the effects of obesity on student attendance, self-esteem and health.\u003c/p>\n\u003cp>“California has made real progress in reducing the consumption of sugary beverages among young children,” said Susan Babey, the report’s lead author. “But teens are in trouble.”\u003c/p>\n\u003cp>She said sodas and sports drinks should be regarded as occasional “treats,” not part of a daily meal plan.\u003c/p>\n\u003cp>The study’s most encouraging finding was that young children are consuming markedly fewer sugary beverages. About 19 percent of 2- to 5-year-olds drink a sugary beverage every day, the study said, a 30 percent decline since the earlier survey. Among 6- to 11-year-olds, 32 percent are daily consumers, down 26 percent since 2005-2007.\u003c/p>\n\u003cp>The study was based on data collected in the \u003ca href=\"http://healthpolicy.ucla.edu/chis/about/Pages/about.aspx\" target=\"_blank\">California Health Interview Survey,\u003c/a> the nation’s largest state health survey. Researchers completed interviews with more than 40,000 households.\u003c/p>\n\u003cp>\u003cstrong>Snapshot from one \"open campus\" high school\u003c/strong>\u003c/p>\n\u003cp>Still, banning the beverages from schools won’t stop teenagers from finding the drinks. Some 75 percent of high school campuses in California are “closed” and don’t allow students to leave the grounds without supervision during the school day. “It’s the 25 percent we need to worry about it,” said Wootan at the Center for Science in the Public Interest.\u003c/p>\n\u003cp>At Oakland Technical High School – which has an open campus policy allowing students to leave during lunch – many students sitting on the front lawn at lunchtime Thursday drank from water bottles, while other students returned from local stores with pizza and sugared beverages, including Arizona iced tea, Shasta Cola and a 7-11 Slurpee.\u003c/p>\n\u003cp>Many were well aware of the amount of sugar they were consuming, but didn’t feel it was a serious problem. One student said bottled water was more expensive than his canned iced tea.\u003c/p>\n\u003cp>“I buy it because it tastes good,” said Will, a freshman carrying a can of Shasta Cola.\u003c/p>\n\u003cp>His friend, Ethan, had a 23.5-ounce can of Arizona Green Tea containing 51 grams of sugar. “This has a lot of sugar, but it’s better than soda,” Ethan said. “It’s Arizona and it’s green tea.”\u003c/p>\n\u003cp>Public perception may hold that iced teas and fruit drinks are a better choice than sodas, yet high concentrations of sugar in the beverages make them something to consume in moderation, experts said.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.publichealthadvocacy.org/_PDFs/stillbubblingover/PolicyBrief.pdf\" target=\"_blank\">counties \u003c/a>with the largest declines in percentage of youth drinking soda or other sugary beverages every day included Ventura County, with a 37 percent decrease since 2005; Yuba County, with a 32 percent decrease; and Napa County, with a 31 percent decrease.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Counties with the largest increase in daily sugary drink consumption among youth of all ages were Lake County, with a 36 percent increase; Monterey County, with a 29 percent increase; and Solano County, with a 24 percent increase.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Why Some Are Seeing Premiums Go Up As Affordable Care Act Goes Into Effect",
"title": "Why Some Are Seeing Premiums Go Up As Affordable Care Act Goes Into Effect",
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"content": "\u003cfigure id=\"attachment_13022\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/96226495-e1382074913159.jpg\">\u003cimg class=\"size-full wp-image-13022\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/96226495-e1382074913159.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/05/96226495-e1382074913159.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/96226495-e1382074913159-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/96226495-e1382074913159-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>In late September, Peter Lee, the executive director of Covered California — the state's health insurance marketplace — was a guest on\u003ca href=\"http://www.kqed.org/a/forum/R201309270900\" target=\"_blank\"> KQED's Forum\u003c/a>. It was just days until the Oct. 1 opening of the exchange. Lee touted the benefits of the Affordable Care Act, saying that many people would pay less for health insurance, but he cautioned that for some people, \"rates may go up a little bit.\"\u003c/p>\n\u003cp>Pretty soon Mark Brown of San Jose called the show to say his premiums were going up -- and much more than a little bit. Brown, who buys health insurance for himself and his wife, said his premiums were going up a whopping 90 percent.\u003c/p>\n\u003cp>When I heard Brown on the air, I hurried to the control room to get his phone number and later got his full details:\u003c/p>\n\u003cul>\n\u003cli>In 2013, Brown's plan with Kaiser has a $5,000 deductible and a $6,000 out-of-pocket maximum. It costs him $272 a month.\u003c/li>\n\u003cli>In 2014, Kaiser offered him a plan with a $4,500 deductible and a $6,350 out-of-pocket max. But the premium is $519 a month.\u003c/li>\n\u003c/ul>\n\u003cp>It's very similar coverage for almost double the cost.\u003c!--more-->\u003c/p>\n\u003cp>Brown's story was so astonishing that Glenn Melnick, a health economist at the University of Southern California, simply didn't believe it when I called him to ask how this big of a rate increase could be happening. \"A 90 percent increase just doesn't make sense to me,\" he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Melnick encouraged me to double-check the facts, saying that there must be something Brown was missing. But Brown provided his documents from Kaiser, I reviewed them and forwarded them to Melnick, who confirmed that Brown's analysis — a 90.9 percent increase for similar coverage — checked out.\u003c/p>\n\u003cp>\"You've got my attention,\" Melnick said.\u003c/p>\n\u003cp>In fairness to Kaiser, the other plans available on Covered California to Brown were roughly the same cost and since all plans on the marketplace must offer the same benefits, the coverage for any other plan would be equivalent. Brown says he does not qualify for a subsidy, so he and his wife will be paying for the entire premium themselves.\u003c/p>\n\u003cp>Brown, 56, said he supports the Affordable Care Act and assessed his situation somewhat philosophically. \"Everybody should have medical coverage,\" he said, \"and there are going to be winners and losers whenever they deploy something like this, and I'm in the loser category at this point.\"\u003c/p>\n\u003cp>The big question right now is how many people are in that category with him. At the end of the week after Covered California opened, I wrote about \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/04/obamacare-downside-reports-of-premiums-going-up/\" target=\"_blank\">another person\u003c/a> whose premiums were going up, and that post is now filled with comments from other frustrated people who are experiencing premium increases.\u003c/p>\n\u003cp>In that post, Larry Levitt of the Kaiser Family Foundation attributed the increases to the cost of adding people with pre-existing conditions to the pool. But how and why that happens is an interesting look at California's individual market now and the one expected to take shape as we move into 2014.\u003c/p>\n\u003cp>Before we get there, a bit of background. Of California's 38 million people:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Roughly 80 percent\u003c/strong> have either employer-based insurance or are covered by a public program such as Medicare or Medi-Cal, the state's version of Medicaid. They are largely not affected by the rollout of the ACA.\u003c/li>\n\u003cli>\u003cstrong>Another 14 percent\u003c/strong> of Californians lack health insurance. That's more than \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/H/PDF%20HealthReformTranslationInfographic1.pdf\" target=\"_blank\">5.5 million people\u003c/a>.\u003c/li>\n\u003cli>\u003cstrong>And 6 percent\u003c/strong> of Californians — or about 2 million people — buy insurance for themselves, on the individual market.\u003c/li>\n\u003c/ul>\n\u003cp>Bear with me here for a few more numbers:\u003c/p>\n\u003cp>Of those 2 million people who currently buy their own insurance, somewhere between \u003ca href=\"http://laborcenter.berkeley.edu/healthcare/resources/CalSIM_Statewide.pdf\" target=\"_blank\">37 percent\u003c/a> and \u003ca href=\"http://kff.org/health-reform/issue-brief/quantifying-tax-credits-for-people-now-buying-insurance-on-their-own/\" target=\"_blank\">51 percent\u003c/a> (depending on whose numbers you choose) will pay\u003cem> less\u003c/em> for their coverage in 2014 because of the subsidies available under the Affordable Care Act. (Subsidies are available to people with incomes up to 400 percent of poverty — capping out at $46,000 for an individual or $94,200 for a family of four.)\u003c/p>\n\u003cp>So that leaves roughly 1 million people whose premiums are potentially subject to change under Obamacare. The questions are: in what direction and by how much? It'll be awhile before we have global numbers. So for now we're left with anecdotes.\u003c/p>\n\u003cp>\u003cstrong>Premiums up for some, down for others\u003c/strong>\u003c/p>\n\u003cp>Kevin Knauss, an insurance broker in the Sacramento area, analyzed a small sample of his clientele and found that about a quarter of them were seeing their premiums go down. And, no, these people were not eligible for the ACA subsidies, he said. So, for at least some people the ACA is saving them money.\u003c/p>\n\u003cp>But what about Mark Brown and others who are seeing significant increases? What are the drivers?\u003c/p>\n\u003cp>An\u003ca href=\"http://www.healthexchange.ca.gov/Documents/Factors%20Affecting%20Individual%20Premiums%20FINAL%203-28-2013.pdf\" target=\"_blank\"> extensive report \u003c/a>back in March from Milliman, a global actuarial firm, has some answers. It got widespread \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/28/health-care-overhaul-to-dramatically-reduce-premiums-for-many-individuals-study-finds/\" target=\"_blank\">media attention\u003c/a> at the time. Remember that this report came out well before Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/23/californias-health-insurance-exchange-sets-plans-premiums-no-apparent-rate-shock/\" target=\"_blank\">announced\u003c/a> its 2014 plans and premiums, at a time when there was concern of significant rate shock, that premiums would skyrocket for everyone due to Obamacare. The report found that many people would pay significantly less, largely due to subsidies. But the report included estimates that premiums would go up, on average, 20 percent for people who earn too much to qualify for subsidies. In other words, some people will pay less, some people will pay the same and some people -- like Brown -- will pay much more.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/06/obama-supporters-canceled-by-obamacare/#more-16124\" target=\"_blank\">San Francisco Obama Supporters, Cancelled by Obamacare\u003c/a>]\u003c/p>\n\u003cp>Part of that increase — about 9 percent — would have happened anyway, the report said. That's because health care costs keep rising. But much of the rest of the increase, the report shows, is because those 2 million people in the individual insurance pool have tended to be healthier (and therefore less expensive to insure) than the average population.\u003cstrong> \u003c/strong>The makeup of those in the individual pool is likely to change under the Affordable Care Act, as the uninsured gain insurance. Covered California hopes to enroll 1 million people by the end of 2014, increasing the individual insurance pool by 50 percent.\u003c/p>\n\u003cp>\u003cstrong>Individual insurance pool in California a healthier group\u003c/strong>\u003c/p>\n\u003cp>Why is the current pool healthier? Because in California, like many other states, insurers offered products based on your health history, or medical underwriting, in the industry parlance. People in good health generally pay less than those with worse health. Most people have heard the stories of individuals being denied coverage -- at any cost -- because of pre-existing health conditions. So that means people who needed health care the most weren't in the individual insurance pool. Now they will be.\u003c/p>\n\u003cp>\"I know that people are going to feel like they are getting the short end of the stick because they are having to pay more for their health insurance. Unfortunately there are winners and losers under the ACA,\" said Gerald Kominski at the UCLA Center for Health Policy Research, echoing Mark Brown. \"When we weigh everything, the reforms benefit many more people than they harm, but these are the most disadvantaged in the marketplace.\"\u003c/p>\n\u003cp>One of those people disadvantaged in the pre-ACA marketplace is \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/04/enrolling-in-covered-california-experience-from-one-san-franciscan-san-francisco-obamacare/\" target=\"_blank\">Paul Cello\u003c/a> of San Francisco. He has an essentially benign heart condition, but it left him uninsurable 10 years ago, after he left his job and his COBRA ran out. He did get into the state's high-risk pool where his premiums are a little over $500 a month, he said, but benefits are capped at $75,000 annually. While Cello's health costs have never approached $75,000, he was worried they could. “It always felt like if anything big happened, I was going to be in trouble,” he told me.\u003c/p>\n\u003cp>On the second day the Covered California was open, he enrolled in a Blue Shield plan with no lifetime maximum (as required by the ACA) and with more comprehensive benefits than his current plan. His premium has gone down slightly to $483 -- plus Cello qualified for a subsidy, bringing his costs down further.\u003c/p>\n\u003cp>I could list more anecdotes, but it will be awhile before Milliman or other analysts can issue a new report. In the meantime, Kominski views the situation societally.\u003c/p>\n\u003cp>\"It's unfortunate that some people are going to have to pay more. Some people who currently have lower cost insurance will have to,\" Kominski said. \"On balance a lot more people will be better off, but there's a small portion who would have been better off just keeping things as they are.\"\u003c/p>\n\u003cp>\u003cstrong>Learn more: \u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cstrong>\u003c/strong>For you wonks out there, the California Health Care Foundation has a \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/H/PDF%20HealthReformTranslationActuarialValue.pdf\" target=\"_blank\">great explainer on actuarial value,\u003c/a> which represents the share of health care expenses a plan covers for a typical group of enrollees. Most plans now have an actuarial value of 55 percent. Bronze level plans under the Affordable Care Act are at 60 percent. This is another driver of premium increase.\u003c/p>\n\n",
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"description": "In late September, Peter Lee, the executive director of Covered California — the state's health insurance marketplace — was a guest on KQED's Forum. It was just days until the Oct. 1 opening of the exchange. Lee touted the benefits of the Affordable Care Act, saying that many people would pay less for health insurance,",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_13022\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/96226495-e1382074913159.jpg\">\u003cimg class=\"size-full wp-image-13022\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/96226495-e1382074913159.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/05/96226495-e1382074913159.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/96226495-e1382074913159-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/96226495-e1382074913159-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>In late September, Peter Lee, the executive director of Covered California — the state's health insurance marketplace — was a guest on\u003ca href=\"http://www.kqed.org/a/forum/R201309270900\" target=\"_blank\"> KQED's Forum\u003c/a>. It was just days until the Oct. 1 opening of the exchange. Lee touted the benefits of the Affordable Care Act, saying that many people would pay less for health insurance, but he cautioned that for some people, \"rates may go up a little bit.\"\u003c/p>\n\u003cp>Pretty soon Mark Brown of San Jose called the show to say his premiums were going up -- and much more than a little bit. Brown, who buys health insurance for himself and his wife, said his premiums were going up a whopping 90 percent.\u003c/p>\n\u003cp>When I heard Brown on the air, I hurried to the control room to get his phone number and later got his full details:\u003c/p>\n\u003cul>\n\u003cli>In 2013, Brown's plan with Kaiser has a $5,000 deductible and a $6,000 out-of-pocket maximum. It costs him $272 a month.\u003c/li>\n\u003cli>In 2014, Kaiser offered him a plan with a $4,500 deductible and a $6,350 out-of-pocket max. But the premium is $519 a month.\u003c/li>\n\u003c/ul>\n\u003cp>It's very similar coverage for almost double the cost.\u003c!--more-->\u003c/p>\n\u003cp>Brown's story was so astonishing that Glenn Melnick, a health economist at the University of Southern California, simply didn't believe it when I called him to ask how this big of a rate increase could be happening. \"A 90 percent increase just doesn't make sense to me,\" he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Melnick encouraged me to double-check the facts, saying that there must be something Brown was missing. But Brown provided his documents from Kaiser, I reviewed them and forwarded them to Melnick, who confirmed that Brown's analysis — a 90.9 percent increase for similar coverage — checked out.\u003c/p>\n\u003cp>\"You've got my attention,\" Melnick said.\u003c/p>\n\u003cp>In fairness to Kaiser, the other plans available on Covered California to Brown were roughly the same cost and since all plans on the marketplace must offer the same benefits, the coverage for any other plan would be equivalent. Brown says he does not qualify for a subsidy, so he and his wife will be paying for the entire premium themselves.\u003c/p>\n\u003cp>Brown, 56, said he supports the Affordable Care Act and assessed his situation somewhat philosophically. \"Everybody should have medical coverage,\" he said, \"and there are going to be winners and losers whenever they deploy something like this, and I'm in the loser category at this point.\"\u003c/p>\n\u003cp>The big question right now is how many people are in that category with him. At the end of the week after Covered California opened, I wrote about \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/04/obamacare-downside-reports-of-premiums-going-up/\" target=\"_blank\">another person\u003c/a> whose premiums were going up, and that post is now filled with comments from other frustrated people who are experiencing premium increases.\u003c/p>\n\u003cp>In that post, Larry Levitt of the Kaiser Family Foundation attributed the increases to the cost of adding people with pre-existing conditions to the pool. But how and why that happens is an interesting look at California's individual market now and the one expected to take shape as we move into 2014.\u003c/p>\n\u003cp>Before we get there, a bit of background. Of California's 38 million people:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Roughly 80 percent\u003c/strong> have either employer-based insurance or are covered by a public program such as Medicare or Medi-Cal, the state's version of Medicaid. They are largely not affected by the rollout of the ACA.\u003c/li>\n\u003cli>\u003cstrong>Another 14 percent\u003c/strong> of Californians lack health insurance. That's more than \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/H/PDF%20HealthReformTranslationInfographic1.pdf\" target=\"_blank\">5.5 million people\u003c/a>.\u003c/li>\n\u003cli>\u003cstrong>And 6 percent\u003c/strong> of Californians — or about 2 million people — buy insurance for themselves, on the individual market.\u003c/li>\n\u003c/ul>\n\u003cp>Bear with me here for a few more numbers:\u003c/p>\n\u003cp>Of those 2 million people who currently buy their own insurance, somewhere between \u003ca href=\"http://laborcenter.berkeley.edu/healthcare/resources/CalSIM_Statewide.pdf\" target=\"_blank\">37 percent\u003c/a> and \u003ca href=\"http://kff.org/health-reform/issue-brief/quantifying-tax-credits-for-people-now-buying-insurance-on-their-own/\" target=\"_blank\">51 percent\u003c/a> (depending on whose numbers you choose) will pay\u003cem> less\u003c/em> for their coverage in 2014 because of the subsidies available under the Affordable Care Act. (Subsidies are available to people with incomes up to 400 percent of poverty — capping out at $46,000 for an individual or $94,200 for a family of four.)\u003c/p>\n\u003cp>So that leaves roughly 1 million people whose premiums are potentially subject to change under Obamacare. The questions are: in what direction and by how much? It'll be awhile before we have global numbers. So for now we're left with anecdotes.\u003c/p>\n\u003cp>\u003cstrong>Premiums up for some, down for others\u003c/strong>\u003c/p>\n\u003cp>Kevin Knauss, an insurance broker in the Sacramento area, analyzed a small sample of his clientele and found that about a quarter of them were seeing their premiums go down. And, no, these people were not eligible for the ACA subsidies, he said. So, for at least some people the ACA is saving them money.\u003c/p>\n\u003cp>But what about Mark Brown and others who are seeing significant increases? What are the drivers?\u003c/p>\n\u003cp>An\u003ca href=\"http://www.healthexchange.ca.gov/Documents/Factors%20Affecting%20Individual%20Premiums%20FINAL%203-28-2013.pdf\" target=\"_blank\"> extensive report \u003c/a>back in March from Milliman, a global actuarial firm, has some answers. It got widespread \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/28/health-care-overhaul-to-dramatically-reduce-premiums-for-many-individuals-study-finds/\" target=\"_blank\">media attention\u003c/a> at the time. Remember that this report came out well before Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/23/californias-health-insurance-exchange-sets-plans-premiums-no-apparent-rate-shock/\" target=\"_blank\">announced\u003c/a> its 2014 plans and premiums, at a time when there was concern of significant rate shock, that premiums would skyrocket for everyone due to Obamacare. The report found that many people would pay significantly less, largely due to subsidies. But the report included estimates that premiums would go up, on average, 20 percent for people who earn too much to qualify for subsidies. In other words, some people will pay less, some people will pay the same and some people -- like Brown -- will pay much more.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/06/obama-supporters-canceled-by-obamacare/#more-16124\" target=\"_blank\">San Francisco Obama Supporters, Cancelled by Obamacare\u003c/a>]\u003c/p>\n\u003cp>Part of that increase — about 9 percent — would have happened anyway, the report said. That's because health care costs keep rising. But much of the rest of the increase, the report shows, is because those 2 million people in the individual insurance pool have tended to be healthier (and therefore less expensive to insure) than the average population.\u003cstrong> \u003c/strong>The makeup of those in the individual pool is likely to change under the Affordable Care Act, as the uninsured gain insurance. Covered California hopes to enroll 1 million people by the end of 2014, increasing the individual insurance pool by 50 percent.\u003c/p>\n\u003cp>\u003cstrong>Individual insurance pool in California a healthier group\u003c/strong>\u003c/p>\n\u003cp>Why is the current pool healthier? Because in California, like many other states, insurers offered products based on your health history, or medical underwriting, in the industry parlance. People in good health generally pay less than those with worse health. Most people have heard the stories of individuals being denied coverage -- at any cost -- because of pre-existing health conditions. So that means people who needed health care the most weren't in the individual insurance pool. Now they will be.\u003c/p>\n\u003cp>\"I know that people are going to feel like they are getting the short end of the stick because they are having to pay more for their health insurance. Unfortunately there are winners and losers under the ACA,\" said Gerald Kominski at the UCLA Center for Health Policy Research, echoing Mark Brown. \"When we weigh everything, the reforms benefit many more people than they harm, but these are the most disadvantaged in the marketplace.\"\u003c/p>\n\u003cp>One of those people disadvantaged in the pre-ACA marketplace is \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/04/enrolling-in-covered-california-experience-from-one-san-franciscan-san-francisco-obamacare/\" target=\"_blank\">Paul Cello\u003c/a> of San Francisco. He has an essentially benign heart condition, but it left him uninsurable 10 years ago, after he left his job and his COBRA ran out. He did get into the state's high-risk pool where his premiums are a little over $500 a month, he said, but benefits are capped at $75,000 annually. While Cello's health costs have never approached $75,000, he was worried they could. “It always felt like if anything big happened, I was going to be in trouble,” he told me.\u003c/p>\n\u003cp>On the second day the Covered California was open, he enrolled in a Blue Shield plan with no lifetime maximum (as required by the ACA) and with more comprehensive benefits than his current plan. His premium has gone down slightly to $483 -- plus Cello qualified for a subsidy, bringing his costs down further.\u003c/p>\n\u003cp>I could list more anecdotes, but it will be awhile before Milliman or other analysts can issue a new report. In the meantime, Kominski views the situation societally.\u003c/p>\n\u003cp>\"It's unfortunate that some people are going to have to pay more. Some people who currently have lower cost insurance will have to,\" Kominski said. \"On balance a lot more people will be better off, but there's a small portion who would have been better off just keeping things as they are.\"\u003c/p>\n\u003cp>\u003cstrong>Learn more: \u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003c/strong>For you wonks out there, the California Health Care Foundation has a \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/H/PDF%20HealthReformTranslationActuarialValue.pdf\" target=\"_blank\">great explainer on actuarial value,\u003c/a> which represents the share of health care expenses a plan covers for a typical group of enrollees. Most plans now have an actuarial value of 55 percent. Bronze level plans under the Affordable Care Act are at 60 percent. This is another driver of premium increase.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Teens Turned Away from Tanning Salons, That's the Good News …",
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"content": "\u003cfigure id=\"attachment_15708\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/evilerin/3096163337/in/set-72157608357937086\">\u003cimg class=\"size-large wp-image-15708\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/TANNING-1-640x425.jpg\" alt=\"Exposure to ultraviolet tanning devices before age 30 increases the risk of skin cancer by 75 percent. (Evil Erin/Flickr)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Exposure to ultraviolet tanning devices before age 30 increases the risk of skin cancer by 75 percent. (Evil Erin/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Angela Hart\u003c/strong>\u003c/p>\n\u003cp>California was the first state to \u003ca href=\"http://www.leginfo.ca.gov/pub/11-12/bill/sen/sb_0701-0750/sb_746_bill_20111009_chaptered.pdf\">ban people under 18-years-old\u003c/a> from using tanning salons, and now new research takes a look at how well the law is working.\u003c/p>\n\u003cp>In \u003ca href=\"http://www.jaad.org/article/S0190-9622(13)00967-5/abstract\">the study\u003c/a> researchers, including a team at UC San Francisco, surveyed hundreds of tanning salons and found roughly three-quarters of them were adhering with key aspects of the law, although many also misrepresented health benefits of indoor tanning.\u003c/p>\n\u003cp>\"The good news was that the majority of salons were complying with the law,\" said Jack Resneck, the study's senior author and an associate professor of dermatology at UCSF. \"The bad news was that we got rampant misinformation — a lot of which is prohibited by law.\"\u003c/p>\n\u003cp>Resneck said tanning beds can have significant health consequences for young people. Exposure to ultraviolet tanning devices before age 30 increases the risk of skin cancer by 75 percent, and nationally, the tanning industry aggressively targets minors in advertising.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The researchers said that despite what they called clear evidence of cancer risk, \"indoor tanning remains popular in the United States.\"\u003c/p>\n\u003cp>Nationwide, more than 3.5 million cases of skin cancer are diagnosed each year, according to the study.\u003c!--more-->\u003c/p>\n\u003cp>The survey was conducted in May, 2013. A female medical student who identified herself as a 17-year-old called a random sample of salons in California that advertised on Yellowpages.com, the majority of which were clustered in metropolitan areas. She told respondents that she wanted a base tan before summer, asked how frequently she could tan, whether there were any dangers, and if tanning was good for her.\u003c/p>\n\u003cp>Of the tanning salons she called, 77 percent — 260 out of 338 — told the female caller that she could not use their tanning beds.\u003c/p>\n\u003cp>But some said she could use their tanning beds with a doctor's note, and some told her she could use their facilities with parental consent. In addition, researchers said out of the 338 salons, 61 percent \"made unlawful claims of specific health benefits,\" including vitamin D production, skin disease treatment, prevention of future sunburns, and remedies for depression.\u003c/p>\n\u003cp>\"That was extremely troubling, because we have overwhelming evidence that tanning, especially at an early age, causes cancer, and it's killing people,\" Resneck said. \"When you're young and invincible and there's people telling you tanning is safe, that information is going to be much more believable, even if it's not backed up by facts.\"\u003c/p>\n\u003cp>\"There's a common misconception that tanning helps your health, and is better or the same as the sun,\" Resneck added. \"So we thought this was critical to look at, knowing that the tanning industry is marketing to teenagers, and knowing that early tanning exposure causes cancer.\"\u003c/p>\n\u003cp>Researchers attributed the misinformation to salons workers not being familiar with the law -- or with lack of law enforcement.\u003c/p>\n\u003cp>Resneck said despite lack of education and enforcement, that the study's results were a big leap forward in an industry that doesn't have a lot of good data and that hasn't accurately tracked enforcement of laws that prevent or restrict tanning among minors.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California lawmakers were the first to pass an outright ban on minors using indoor ultraviolet tanning salons in 2011. Since, California passed its ban on minors using indoor tanning beds, eight other states have passed similar laws. Statewide, salons that violate the law are required to pay a civil violation fine of $2,500 a day.\u003c/p>\n\n",
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"excerpt": "California was the first state to ban people under 18-years-old from using tanning salons, and now new research takes a look at how well the law is working. \r\n\r\nIn the study researchers, including a team at UC San Francisco, surveyed hundreds of tanning salons and found roughly three-quarters of them were adhering with key aspects of the law, although many also misrepresented health benefits of indoor tanning.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15708\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/evilerin/3096163337/in/set-72157608357937086\">\u003cimg class=\"size-large wp-image-15708\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/TANNING-1-640x425.jpg\" alt=\"Exposure to ultraviolet tanning devices before age 30 increases the risk of skin cancer by 75 percent. (Evil Erin/Flickr)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Exposure to ultraviolet tanning devices before age 30 increases the risk of skin cancer by 75 percent. (Evil Erin/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Angela Hart\u003c/strong>\u003c/p>\n\u003cp>California was the first state to \u003ca href=\"http://www.leginfo.ca.gov/pub/11-12/bill/sen/sb_0701-0750/sb_746_bill_20111009_chaptered.pdf\">ban people under 18-years-old\u003c/a> from using tanning salons, and now new research takes a look at how well the law is working.\u003c/p>\n\u003cp>In \u003ca href=\"http://www.jaad.org/article/S0190-9622(13)00967-5/abstract\">the study\u003c/a> researchers, including a team at UC San Francisco, surveyed hundreds of tanning salons and found roughly three-quarters of them were adhering with key aspects of the law, although many also misrepresented health benefits of indoor tanning.\u003c/p>\n\u003cp>\"The good news was that the majority of salons were complying with the law,\" said Jack Resneck, the study's senior author and an associate professor of dermatology at UCSF. \"The bad news was that we got rampant misinformation — a lot of which is prohibited by law.\"\u003c/p>\n\u003cp>Resneck said tanning beds can have significant health consequences for young people. Exposure to ultraviolet tanning devices before age 30 increases the risk of skin cancer by 75 percent, and nationally, the tanning industry aggressively targets minors in advertising.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The researchers said that despite what they called clear evidence of cancer risk, \"indoor tanning remains popular in the United States.\"\u003c/p>\n\u003cp>Nationwide, more than 3.5 million cases of skin cancer are diagnosed each year, according to the study.\u003c!--more-->\u003c/p>\n\u003cp>The survey was conducted in May, 2013. A female medical student who identified herself as a 17-year-old called a random sample of salons in California that advertised on Yellowpages.com, the majority of which were clustered in metropolitan areas. She told respondents that she wanted a base tan before summer, asked how frequently she could tan, whether there were any dangers, and if tanning was good for her.\u003c/p>\n\u003cp>Of the tanning salons she called, 77 percent — 260 out of 338 — told the female caller that she could not use their tanning beds.\u003c/p>\n\u003cp>But some said she could use their tanning beds with a doctor's note, and some told her she could use their facilities with parental consent. In addition, researchers said out of the 338 salons, 61 percent \"made unlawful claims of specific health benefits,\" including vitamin D production, skin disease treatment, prevention of future sunburns, and remedies for depression.\u003c/p>\n\u003cp>\"That was extremely troubling, because we have overwhelming evidence that tanning, especially at an early age, causes cancer, and it's killing people,\" Resneck said. \"When you're young and invincible and there's people telling you tanning is safe, that information is going to be much more believable, even if it's not backed up by facts.\"\u003c/p>\n\u003cp>\"There's a common misconception that tanning helps your health, and is better or the same as the sun,\" Resneck added. \"So we thought this was critical to look at, knowing that the tanning industry is marketing to teenagers, and knowing that early tanning exposure causes cancer.\"\u003c/p>\n\u003cp>Researchers attributed the misinformation to salons workers not being familiar with the law -- or with lack of law enforcement.\u003c/p>\n\u003cp>Resneck said despite lack of education and enforcement, that the study's results were a big leap forward in an industry that doesn't have a lot of good data and that hasn't accurately tracked enforcement of laws that prevent or restrict tanning among minors.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California lawmakers were the first to pass an outright ban on minors using indoor ultraviolet tanning salons in 2011. Since, California passed its ban on minors using indoor tanning beds, eight other states have passed similar laws. Statewide, salons that violate the law are required to pay a civil violation fine of $2,500 a day.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Lead-Based Paint Still a Hazard for California's Most Vulnerable Children",
"title": "Lead-Based Paint Still a Hazard for California's Most Vulnerable Children",
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"content": "\u003cfigure id=\"attachment_15716\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/antonioncropped.png\">\u003cimg class=\"size-large wp-image-15716\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/antonioncropped-640x395.png\" alt=\"hree year old Antonio suffered hearing loss after eating lead-based paint chips as a toddler. (Lauren M. Whaley/CHCF Center for Health Reporting)\" width=\"640\" height=\"395\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Three year old Antonio suffered hearing loss after eating lead-based paint chips as a toddler. (Lauren M. Whaley/CHCF Center for Health Reporting)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Kelley Weiss\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>Children’s advocates are hoping for a big Christmas present this year – a billion dollars to remove toxic lead paint from homes. A Santa Clara Superior Court judge has until the end of the year to decide if paint companies should pay to get rid of lead paint still in thousands of older homes around the state.\u003c/p>\n\u003cp>While California’s lead poisoning cases have declined, especially over the last two decades, children's advocates say the most vulnerable children are still at risk because they don’t have enough money to reach the finish line.\u003c/p>\n\u003cp>Two counties are trying to fix the problem with the resources they have.\u003c/p>\n\u003cp>Alameda County is one of the ten counties and cities involved in the lawsuit.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Two years ago Nathaniel Stone was living in an East Oakland apartment with one-year-old Antonio. Stone is Antonio's legal guardian and is in the process of adopting him. The home they lived in had a lot of peeling paint.\u003c/p>\n\u003cp>One day when Stone was cooking in the kitchen from across the room he saw that Antonio seemed to be eating something. Stone checked it out and found Antonio with paint chips in his mouth.\u003c!--more-->\u003c/p>\n\u003cp>Stone had no idea the peeling paint was lead-based -- or that it's not so surprising that small children like to eat it. Lead paint tastes sweet. Soon, Stone noticed a change in Antonio's behavior.\u003c/p>\n\u003cp>“From there he was kind of a little sick and restless, sleeping bad at night and kind of crying and a mood that normally wasn’t him,” Stone says.\u003c/p>\n\u003cp>So Stone took Antonio to the doctor and discovered that Antonio had a high level of lead in his blood.\u003c/p>\n\u003cp>“From that he ended up with loss of hearing in his ear,” Stone says.\u003c/p>\n\u003cp>Immediately Alameda County stepped in to help Stone find a new place to live. Today they live in an apartment that is free of lead paint. But because of that early exposure to lead, Antonio, now three-years-old, has major hearing loss. He goes to a center for children with disabilities.\u003c/p>\n\u003cp>Stone says Antonio has a speech therapist, because his words are \"slow and twisted.\"\u003c/p>\n\u003cp>It takes a variety of county experts to handle a case like Antonio’s. This is easier for Alameda County because as part of its lead\u003cstrong> \u003c/strong>poisoning prevention\u003cstrong> \u003c/strong>program, the public health, environmental health and housing departments are integrated. The county program also has more resources than most.\u003c/p>\n\u003cp>Property owners of houses built before 1978 pay the county a $10 annual fee to respond to lead hazards. It’s one of the only assessments of its kind in California. With stable funding, the County tries to be more proactive.\u003c/p>\n\u003cp>Peter Belanger is a state certified lead project designer with the \u003ca href=\"http://www.achhd.org\">Alameda County Healthy Homes Department\u003c/a>.\u003c/p>\n\u003cp>To get a better understanding of the issues he drove me around West Oakland – an area with industrial factories, art studios and he says, “a lot of older homes.”\u003c/p>\n\u003cp>In Oakland, 90 percent of houses have lead paint. Belanger says it’s not cheap to remove with an average cost of $5,000 per unit.\u003c/p>\n\u003cp>If the lead can’t be removed he’ll help move the family out, as happened in Antonio’s case. But whatever the approach, Belanger says the key is getting the children away from the toxic lead.\u003c/p>\n\u003cp>But for many families in California that level of support isn't available.\u003c/p>\n\u003cp>Los Angeles County is also a plaintiff in the lead paint trial. But unlike in Alameda, in LA County, it can take six months to resolve a case like Antonio’s.\u003c/p>\n\u003cp>Dr. Jonathan Fielding, director of the Los Angeles County Public Health Department, points to three main reasons for this lag.\u003c/p>\n\u003cp>The first: the sheer size of the county and the problem.\u003c/p>\n\u003cp>“We have roughly one and a half million residences that have lead paint,” he says.\u003c/p>\n\u003cp>Second, unlike Alameda County, LA’s Public Health and Housing Departments are not integrated. Fielding says that lack of integration can delay action.\u003c/p>\n\u003cp>And, the third reason: money. LA County doesn’t have a dedicated property tax like Alameda County. It relies mainly on state funding and that amount has varied over the years. In addition, the county took a hit last year when \u003ca href=\"http://www.usatoday.com/story/news/nation/2013/09/16/lead-poisoning-prevention-cuts/2817329/\">Congress cut almost all of its funding for the Centers for Disease Control’s lead program\u003c/a>. That money goes out to county health departments for outreach and education.\u003c/p>\n\u003cp>Fielding says this resulted in LA County’s lead program losing about $600,000 a year.\u003c/p>\n\u003cp>At the same time the CDC reported that even \u003ca href=\"http://www.cdc.gov/nceh/lead/ACCLPP/blood_lead_levels.htm\">lower levels of lead can cause permanent brain damage\u003c/a> than had previously been known. Yet Fielding says there’s less and less funding to protect children from lead exposure.\u003c/p>\n\u003cp>“It is really catastrophic to see literally tens of thousands of kids having a level of poisoning that’s going to affect their ability to succeed in high school or to succeed in college,” he says.\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>[youtube //player.vimeo.com/video/74674216]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://vimeo.com/74674216\">Lead poisoning in California's kids: Antonio's story\u003c/a> from \u003ca href=\"http://vimeo.com/user5638243\">CAhealthReport\u003c/a> on \u003ca href=\"https://vimeo.com\">Vimeo\u003c/a>.\u003c/p>\n\n",
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"description": "By Kelley Weiss, CHCF Center for Health Reporting Children’s advocates are hoping for a big Christmas present this year – a billion dollars to remove toxic lead paint from homes. A Santa Clara Superior Court judge has until the end of the year to decide if paint companies should pay to get rid of lead paint",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15716\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/antonioncropped.png\">\u003cimg class=\"size-large wp-image-15716\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/antonioncropped-640x395.png\" alt=\"hree year old Antonio suffered hearing loss after eating lead-based paint chips as a toddler. (Lauren M. Whaley/CHCF Center for Health Reporting)\" width=\"640\" height=\"395\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Three year old Antonio suffered hearing loss after eating lead-based paint chips as a toddler. (Lauren M. Whaley/CHCF Center for Health Reporting)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Kelley Weiss\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>Children’s advocates are hoping for a big Christmas present this year – a billion dollars to remove toxic lead paint from homes. A Santa Clara Superior Court judge has until the end of the year to decide if paint companies should pay to get rid of lead paint still in thousands of older homes around the state.\u003c/p>\n\u003cp>While California’s lead poisoning cases have declined, especially over the last two decades, children's advocates say the most vulnerable children are still at risk because they don’t have enough money to reach the finish line.\u003c/p>\n\u003cp>Two counties are trying to fix the problem with the resources they have.\u003c/p>\n\u003cp>Alameda County is one of the ten counties and cities involved in the lawsuit.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Two years ago Nathaniel Stone was living in an East Oakland apartment with one-year-old Antonio. Stone is Antonio's legal guardian and is in the process of adopting him. The home they lived in had a lot of peeling paint.\u003c/p>\n\u003cp>One day when Stone was cooking in the kitchen from across the room he saw that Antonio seemed to be eating something. Stone checked it out and found Antonio with paint chips in his mouth.\u003c!--more-->\u003c/p>\n\u003cp>Stone had no idea the peeling paint was lead-based -- or that it's not so surprising that small children like to eat it. Lead paint tastes sweet. Soon, Stone noticed a change in Antonio's behavior.\u003c/p>\n\u003cp>“From there he was kind of a little sick and restless, sleeping bad at night and kind of crying and a mood that normally wasn’t him,” Stone says.\u003c/p>\n\u003cp>So Stone took Antonio to the doctor and discovered that Antonio had a high level of lead in his blood.\u003c/p>\n\u003cp>“From that he ended up with loss of hearing in his ear,” Stone says.\u003c/p>\n\u003cp>Immediately Alameda County stepped in to help Stone find a new place to live. Today they live in an apartment that is free of lead paint. But because of that early exposure to lead, Antonio, now three-years-old, has major hearing loss. He goes to a center for children with disabilities.\u003c/p>\n\u003cp>Stone says Antonio has a speech therapist, because his words are \"slow and twisted.\"\u003c/p>\n\u003cp>It takes a variety of county experts to handle a case like Antonio’s. This is easier for Alameda County because as part of its lead\u003cstrong> \u003c/strong>poisoning prevention\u003cstrong> \u003c/strong>program, the public health, environmental health and housing departments are integrated. The county program also has more resources than most.\u003c/p>\n\u003cp>Property owners of houses built before 1978 pay the county a $10 annual fee to respond to lead hazards. It’s one of the only assessments of its kind in California. With stable funding, the County tries to be more proactive.\u003c/p>\n\u003cp>Peter Belanger is a state certified lead project designer with the \u003ca href=\"http://www.achhd.org\">Alameda County Healthy Homes Department\u003c/a>.\u003c/p>\n\u003cp>To get a better understanding of the issues he drove me around West Oakland – an area with industrial factories, art studios and he says, “a lot of older homes.”\u003c/p>\n\u003cp>In Oakland, 90 percent of houses have lead paint. Belanger says it’s not cheap to remove with an average cost of $5,000 per unit.\u003c/p>\n\u003cp>If the lead can’t be removed he’ll help move the family out, as happened in Antonio’s case. But whatever the approach, Belanger says the key is getting the children away from the toxic lead.\u003c/p>\n\u003cp>But for many families in California that level of support isn't available.\u003c/p>\n\u003cp>Los Angeles County is also a plaintiff in the lead paint trial. But unlike in Alameda, in LA County, it can take six months to resolve a case like Antonio’s.\u003c/p>\n\u003cp>Dr. Jonathan Fielding, director of the Los Angeles County Public Health Department, points to three main reasons for this lag.\u003c/p>\n\u003cp>The first: the sheer size of the county and the problem.\u003c/p>\n\u003cp>“We have roughly one and a half million residences that have lead paint,” he says.\u003c/p>\n\u003cp>Second, unlike Alameda County, LA’s Public Health and Housing Departments are not integrated. Fielding says that lack of integration can delay action.\u003c/p>\n\u003cp>And, the third reason: money. LA County doesn’t have a dedicated property tax like Alameda County. It relies mainly on state funding and that amount has varied over the years. In addition, the county took a hit last year when \u003ca href=\"http://www.usatoday.com/story/news/nation/2013/09/16/lead-poisoning-prevention-cuts/2817329/\">Congress cut almost all of its funding for the Centers for Disease Control’s lead program\u003c/a>. That money goes out to county health departments for outreach and education.\u003c/p>\n\u003cp>Fielding says this resulted in LA County’s lead program losing about $600,000 a year.\u003c/p>\n\u003cp>At the same time the CDC reported that even \u003ca href=\"http://www.cdc.gov/nceh/lead/ACCLPP/blood_lead_levels.htm\">lower levels of lead can cause permanent brain damage\u003c/a> than had previously been known. Yet Fielding says there’s less and less funding to protect children from lead exposure.\u003c/p>\n\u003cp>“It is really catastrophic to see literally tens of thousands of kids having a level of poisoning that’s going to affect their ability to succeed in high school or to succeed in college,” he says.\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003cp>null\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://vimeo.com/74674216\">Lead poisoning in California's kids: Antonio's story\u003c/a> from \u003ca href=\"http://vimeo.com/user5638243\">CAhealthReport\u003c/a> on \u003ca href=\"https://vimeo.com\">Vimeo\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Future of Healthy San Francisco Unclear in Face of Obamacare",
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"content": "\u003cfigure id=\"attachment_15684\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/SCALAS-2.jpg\">\u003cimg class=\"size-large wp-image-15684\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/SCALAS-2-640x387.jpg\" alt=\"Many San Francisco restaurants pass along at least part of their cost of Healthy San Francisco to patrons. (Angela Hart/KQED)\" width=\"640\" height=\"387\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Many San Francisco restaurants pass along at least part of their cost of Healthy San Francisco to patrons. (Angela Hart/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Angela Hart\u003c/strong>\u003c/p>\n\u003cp>San Francisco is scrambling to figure out how the Affordable Care Act will impact the city's own landmark universal health legislation, less than three months before the full rollout of Obamacare.\u003c/p>\n\u003cp>Barbara Garcia, who runs the Department of Public Health, is leading a task force of health experts, business groups and labor leaders who have until the end of November to decipher what health experts are calling confusing and complex details in both the local and national health laws.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"How do you make these two laws correspond?\" \u003c/aside>\n\u003cp>\"The question for the task force is how do you make these two laws correspond,\" said Ken Jacobs, chair of the Labor Center at UC Berkeley who specializes in health policy, and who is also on the task force. \"In my view, they correspond quite well, though there's some work to do around the edges.\"\u003c/p>\n\u003cp>Healthy San Francisco rolled out in 2006 to provide universal health access to the city's 85,000 uninsured. Today, it covers about 60,000 people.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Now, health experts and city leaders are floating the idea of using Healthy San Francisco monies to help uninsured residents pay their Covered California premiums. Even with federal subsidies available under Obamacare, the cost of insurance may be out of reach for many, they say.\u003c/p>\n\u003cp>And, experts familiar with Healthy San Francisco say additional financial incentives for consumers will increase the number of young healthy people who sign up for insurance under Covered California, the state's new health insurance marketplace.\u003c!--more-->\u003c/p>\n\u003cp>Businesses fund Healthy San Francisco through an “employer spending requirement,” which was bitterly fought by some groups when the law passed. Any business employing 20 or more workers must pay between $1.55 and $2.33 per hour, per employee, as long as the worker puts in at least eight hours a week.\u003c/p>\n\u003cp>Some businesses can pass off part of that cost. People who eat in San Francisco restaurants, for example, might see this as a line item on their restaurant bill.\u003c/p>\n\u003cp>\"There are some who feel the employer spending requirement should go away,\" said San Francisco Supervisor David Campos. \"We believe eliminating the employer spending requirement would be a major disaster.\"\u003c/p>\n\u003cp>But prominent business groups such as the San Francisco Chamber of Commerce say they're worried that using Healthy San Francisco funds could create a different problem —making workers ineligible for Covered California.\u003c/p>\n\u003cp>\"We all want to ensure people get the benefits they're entitled to under the Affordable Care Act,\" said Jim Lazarus, with the San Francisco Chamber of Commerce \"But we're concerned about how the employer spending requirement interacts with the Affordable Care Act.\"\u003c/p>\n\u003cp>Lazarus said the Chamber and other business groups worry that money employers set aside for workers to spend on their health care costs could count as minimum essential coverage, which they say could fulfill the individual mandate under Obamacare guidelines. City leaders are \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/07/how-healthy-san-francisco-matters-and-doesnt-in-obamacare/\" target=\"_blank\">already on the record\u003c/a> as saying Healthy San Francisco will not fulfill the Obamacare individual mandate. But there are more questions than answers at this point around meshing Healthy San Francisco with the Affordable Care Act.\u003c/p>\n\u003cp>\"All we've been asking for is the city to give us guidance on what employers can do,\" Lazarus said. He's especially concerned about the businesses which do not offer health insurance, but want to comply with the ACA.\u003c/p>\n\u003cp>Jacobs, the UC Berkeley health policy analyst, says the national health law allows for states and cities to offer additional subsidy programs – exactly what the task force is considering for Healthy San Francisco.\u003c/p>\n\u003cp>He pointed to similar programs underway in Vermont, Massachusetts and New York that offer financial help for workers who find paying their insurance premium too expensive, even with the federal subsidies.\u003c/p>\n\u003cp>\"Healthy San Francisco could go far in filling in the gaps in the Affordable Care Act,\" Jacobs said. He's especially concerned about low- and middle-income people who can't afford the premium in the face of the high cost of living in San Francisco. Additional premium subsidies from Healthy San Francisco \"could help lower their cost and increase the uptake for Covered California insurance required under ACA.\"\u003c/p>\n\u003cp>Campos has argued since the task force started meeting in July that \"what we're doing in San Francisco is complementary to the Affordable Care Act.\"\u003c/p>\n\u003cp>Yet another key issue is what to do in place of health reimbursement accounts, which are no longer allowed under federal guidelines.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The task force plans to evaluate Healthy San Francisco funding over the next two months. The next meeting is Thursday, Oct. 24. The City says it should have guidance for San Francisco businesses by the end of November.\u003c/p>\n\n",
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"description": "By Angela Hart San Francisco is scrambling to figure out how the Affordable Care Act will impact the city's own landmark universal health legislation, less than three months before the full rollout of Obamacare. Barbara Garcia, who runs the Department of Public Health, is leading a task force of health experts, business groups and labor",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15684\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/SCALAS-2.jpg\">\u003cimg class=\"size-large wp-image-15684\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/SCALAS-2-640x387.jpg\" alt=\"Many San Francisco restaurants pass along at least part of their cost of Healthy San Francisco to patrons. (Angela Hart/KQED)\" width=\"640\" height=\"387\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Many San Francisco restaurants pass along at least part of their cost of Healthy San Francisco to patrons. (Angela Hart/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Angela Hart\u003c/strong>\u003c/p>\n\u003cp>San Francisco is scrambling to figure out how the Affordable Care Act will impact the city's own landmark universal health legislation, less than three months before the full rollout of Obamacare.\u003c/p>\n\u003cp>Barbara Garcia, who runs the Department of Public Health, is leading a task force of health experts, business groups and labor leaders who have until the end of November to decipher what health experts are calling confusing and complex details in both the local and national health laws.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"How do you make these two laws correspond?\" \u003c/aside>\n\u003cp>\"The question for the task force is how do you make these two laws correspond,\" said Ken Jacobs, chair of the Labor Center at UC Berkeley who specializes in health policy, and who is also on the task force. \"In my view, they correspond quite well, though there's some work to do around the edges.\"\u003c/p>\n\u003cp>Healthy San Francisco rolled out in 2006 to provide universal health access to the city's 85,000 uninsured. Today, it covers about 60,000 people.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now, health experts and city leaders are floating the idea of using Healthy San Francisco monies to help uninsured residents pay their Covered California premiums. Even with federal subsidies available under Obamacare, the cost of insurance may be out of reach for many, they say.\u003c/p>\n\u003cp>And, experts familiar with Healthy San Francisco say additional financial incentives for consumers will increase the number of young healthy people who sign up for insurance under Covered California, the state's new health insurance marketplace.\u003c!--more-->\u003c/p>\n\u003cp>Businesses fund Healthy San Francisco through an “employer spending requirement,” which was bitterly fought by some groups when the law passed. Any business employing 20 or more workers must pay between $1.55 and $2.33 per hour, per employee, as long as the worker puts in at least eight hours a week.\u003c/p>\n\u003cp>Some businesses can pass off part of that cost. People who eat in San Francisco restaurants, for example, might see this as a line item on their restaurant bill.\u003c/p>\n\u003cp>\"There are some who feel the employer spending requirement should go away,\" said San Francisco Supervisor David Campos. \"We believe eliminating the employer spending requirement would be a major disaster.\"\u003c/p>\n\u003cp>But prominent business groups such as the San Francisco Chamber of Commerce say they're worried that using Healthy San Francisco funds could create a different problem —making workers ineligible for Covered California.\u003c/p>\n\u003cp>\"We all want to ensure people get the benefits they're entitled to under the Affordable Care Act,\" said Jim Lazarus, with the San Francisco Chamber of Commerce \"But we're concerned about how the employer spending requirement interacts with the Affordable Care Act.\"\u003c/p>\n\u003cp>Lazarus said the Chamber and other business groups worry that money employers set aside for workers to spend on their health care costs could count as minimum essential coverage, which they say could fulfill the individual mandate under Obamacare guidelines. City leaders are \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/07/how-healthy-san-francisco-matters-and-doesnt-in-obamacare/\" target=\"_blank\">already on the record\u003c/a> as saying Healthy San Francisco will not fulfill the Obamacare individual mandate. But there are more questions than answers at this point around meshing Healthy San Francisco with the Affordable Care Act.\u003c/p>\n\u003cp>\"All we've been asking for is the city to give us guidance on what employers can do,\" Lazarus said. He's especially concerned about the businesses which do not offer health insurance, but want to comply with the ACA.\u003c/p>\n\u003cp>Jacobs, the UC Berkeley health policy analyst, says the national health law allows for states and cities to offer additional subsidy programs – exactly what the task force is considering for Healthy San Francisco.\u003c/p>\n\u003cp>He pointed to similar programs underway in Vermont, Massachusetts and New York that offer financial help for workers who find paying their insurance premium too expensive, even with the federal subsidies.\u003c/p>\n\u003cp>\"Healthy San Francisco could go far in filling in the gaps in the Affordable Care Act,\" Jacobs said. He's especially concerned about low- and middle-income people who can't afford the premium in the face of the high cost of living in San Francisco. Additional premium subsidies from Healthy San Francisco \"could help lower their cost and increase the uptake for Covered California insurance required under ACA.\"\u003c/p>\n\u003cp>Campos has argued since the task force started meeting in July that \"what we're doing in San Francisco is complementary to the Affordable Care Act.\"\u003c/p>\n\u003cp>Yet another key issue is what to do in place of health reimbursement accounts, which are no longer allowed under federal guidelines.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The task force plans to evaluate Healthy San Francisco funding over the next two months. The next meeting is Thursday, Oct. 24. The City says it should have guidance for San Francisco businesses by the end of November.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Enroll by Valentine's Day to Avoid Obamacare Fines",
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"content": "\u003cfigure id=\"attachment_15604\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172765550.jpg\">\u003cimg class=\"size-large wp-image-15604\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172765550-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>When it comes to Obamacare, the big date we've heard for a long time is Jan. 1, 2014. That's the day the Affordable Care Act takes full effect, requiring most Americans to be covered, or pay a fine.\u003c/p>\n\u003cp>We've also heard that there's a grace period -- that in this first year, people have until March 31 get covered before the fine will kick in.\u003c/p>\n\u003cp>But, whoops! It turns out that Mar. 31 date is wrong, the Obama administration confirmed to the Associated Press on Wednesday. In order to have coverage by March 31, you need to enroll by Feb. 15 -- in other words, the day after Valentine's Day -- to avoid the penalty.\u003c/p>\n\u003cp>Here's why: It takes about two weeks to process applications. Insurance takes effect on the first of the month. You need to enroll by Feb. 15, for the insurance to take effect March 1. Insurance on April 1 is too late, and you will pay the fine.\u003c/p>\n\u003cp>The Jackson Hewitt tax preparation company first pointed out the wrinkle with the health care law's least popular requirement.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>An administration official confirmed it. The official was not authorized to speak publicly and insisted on anonymity. \u003c!--more-->\u003c/p>\n\u003cp>Brian Haile, senior vice president for health policy at Jackson Hewitt, said government agencies initially had different interpretations of the enrollment deadline. The Health and Human Services department, which is taking the lead in implementing the law, kept referring to a March 31 deadline. But the Internal Revenue Service, which handles most of the financial aspects, suggested that the deadline had to be in February.\u003c/p>\n\u003cp>Leave it to the IRS to figure it out.\u003c/p>\n\u003cp>\"There were inconsistencies,\" said Haile, adding it took several inquiries by Jackson Hewitt over the last few weeks to clear up the uncertainty.\u003c/p>\n\u003cp>Starting next year, the law requires virtually all Americans to have insurance or face a tax penalty, triggered after a coverage gap of three months. (That's why Apr. 1 is too late to avoid the fine, if that's the day your insurance starts.) The penalty starts as low as $95 for 2014, but escalates in subsequent years. There are exemptions for financial hardship and other defined circumstances.\u003c/p>\n\u003cp>The purpose of the penalty is to nudge as many people as possible into the insurance pool. That would help keep premiums in check, since the law also forbids insurers from turning away people with health problems.\u003c/p>\n\u003cp>Haile said an earlier enrollment deadline around Valentine's Day may turn out to be a blessing in disguise for the administration, because it creates a natural opportunity to market to young, healthy people, whose premiums are needed to offset medical costs of older generations.\u003c/p>\n\u003cp>\"When thinking about how to attract young people, a Valentine's Day message may be very salient,\" he said.\u003c/p>\n\u003cp>The administration says the deadline is actually Feb. 15, the day after Valentine's Day.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That's close enough that the government might be able to make the pitch work.\u003c/p>\n\n",
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"excerpt": "When it comes to Obamacare, the big date we've heard for a long time is Jan. 1, 2014. That's the day the Affordable Care Act takes full effect, requiring most Americans to be covered, or pay a fine. We've also heard that there's a grace period -- that in this first year, people have until March 31 to enroll before the fine will kick in. \r\n\r\nBut, whoops! Turns out that Mar. 31 date is wrong, the Obama administration confirmed to the Associated Press on Wednesday. In order to have coverage by March 31, you need to enroll by Feb. 15",
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"description": "When it comes to Obamacare, the big date we've heard for a long time is Jan. 1, 2014. That's the day the Affordable Care Act takes full effect, requiring most Americans to be covered, or pay a fine. We've also heard that there's a grace period -- that in this first year, people have until March 31 to enroll before the fine will kick in. \r\n\r\nBut, whoops! Turns out that Mar. 31 date is wrong, the Obama administration confirmed to the Associated Press on Wednesday. In order to have coverage by March 31, you need to enroll by Feb. 15",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15604\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172765550.jpg\">\u003cimg class=\"size-large wp-image-15604\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172765550-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>When it comes to Obamacare, the big date we've heard for a long time is Jan. 1, 2014. That's the day the Affordable Care Act takes full effect, requiring most Americans to be covered, or pay a fine.\u003c/p>\n\u003cp>We've also heard that there's a grace period -- that in this first year, people have until March 31 get covered before the fine will kick in.\u003c/p>\n\u003cp>But, whoops! It turns out that Mar. 31 date is wrong, the Obama administration confirmed to the Associated Press on Wednesday. In order to have coverage by March 31, you need to enroll by Feb. 15 -- in other words, the day after Valentine's Day -- to avoid the penalty.\u003c/p>\n\u003cp>Here's why: It takes about two weeks to process applications. Insurance takes effect on the first of the month. You need to enroll by Feb. 15, for the insurance to take effect March 1. Insurance on April 1 is too late, and you will pay the fine.\u003c/p>\n\u003cp>The Jackson Hewitt tax preparation company first pointed out the wrinkle with the health care law's least popular requirement.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>An administration official confirmed it. The official was not authorized to speak publicly and insisted on anonymity. \u003c!--more-->\u003c/p>\n\u003cp>Brian Haile, senior vice president for health policy at Jackson Hewitt, said government agencies initially had different interpretations of the enrollment deadline. The Health and Human Services department, which is taking the lead in implementing the law, kept referring to a March 31 deadline. But the Internal Revenue Service, which handles most of the financial aspects, suggested that the deadline had to be in February.\u003c/p>\n\u003cp>Leave it to the IRS to figure it out.\u003c/p>\n\u003cp>\"There were inconsistencies,\" said Haile, adding it took several inquiries by Jackson Hewitt over the last few weeks to clear up the uncertainty.\u003c/p>\n\u003cp>Starting next year, the law requires virtually all Americans to have insurance or face a tax penalty, triggered after a coverage gap of three months. (That's why Apr. 1 is too late to avoid the fine, if that's the day your insurance starts.) The penalty starts as low as $95 for 2014, but escalates in subsequent years. There are exemptions for financial hardship and other defined circumstances.\u003c/p>\n\u003cp>The purpose of the penalty is to nudge as many people as possible into the insurance pool. That would help keep premiums in check, since the law also forbids insurers from turning away people with health problems.\u003c/p>\n\u003cp>Haile said an earlier enrollment deadline around Valentine's Day may turn out to be a blessing in disguise for the administration, because it creates a natural opportunity to market to young, healthy people, whose premiums are needed to offset medical costs of older generations.\u003c/p>\n\u003cp>\"When thinking about how to attract young people, a Valentine's Day message may be very salient,\" he said.\u003c/p>\n\u003cp>The administration says the deadline is actually Feb. 15, the day after Valentine's Day.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That's close enough that the government might be able to make the pitch work.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"soldout": {
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