- California Healthline Original Stories 3
- Covered California Announces Modest Premium Hikes For Small Businesses
- Candidates Decry High Drug Prices But Have Few Options For Voters
- How Can Pediatricians Discuss Guns With Parents?
- Covered California & The Health Law 1
- State's Move To Cover Undocumented Immigrants Follows Cost-Savings Trend
- Sacramento Watch 2
- Law Would Limit Surprise Billing For Medical Care
- 'Dense Breast' Notification Law Poses Challenges For Doctors And Patients
- Around California 2
- Medical Groups Taking Over Vacant Storefronts In San Francisco Neighborhoods
- Water May Be To Blame For Oral Infections Of 10 Children In Anaheim
- Campaign 2016 2
- Prop 61: Most Voters Support Prescription Drug Pricing Measure, Poll Shows
- Trump Releases Doctor's Note; Takes Positions On Medicaid, Birth Control And Abortion
- Hospital Roundup 1
- Oakland's Highland Hospital To Get High-Tech Diagnostic Equipment Thanks To Grant
Latest From California Healthline:
Officials call the 5.9 percent premium increase “moderate,” but many small businesses still shy away from the state’s insurance exchange. (Ana B. Ibarra, 9/16)
Drug prices rise for a variety of reasons but opportunities for the government to control them is limited. (Julie Rovner, 9/16)
Research suggests pediatricians shy away from the topic, but parents generally are open to discussing firearms in the context of safe storage. (Shefali Luthra, 9/16)
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More News From Across The State
The Christian Science Monitor reports on why California is requesting the waiver. In other news about Covered California, premiums for the small-business exchange are expected to increase by 5.9 percent.
The Christian Science Monitor:
Why California Wants Health Insurance For Undocumented Immigrants
The plan would formalize a strategy already employed by states and counties across the country that have a large population of undocumented immigrants. In March, The Wall Street Journal noted that many such areas have instituted preventative care programs for the low-income uninsured that don’t ask about patients’ immigration status, with some county politicians calculating that such programs are both cheaper and more effective than leaving treatment for emergency rooms. (Iaconangelo, 9/15)
Sacramento Business Journal:
Covered California For Small Business Rates To Rise
Covered California, the state's health insurance exchange, announced a 5.9 percent rate increase for its small-business plans. The increase, which is a statewide weighted average, will take effect Jan. 1. It is lower than last year's 7.2 percent increase for plans under the small-business program, known as Covered California for Small Business. The program is available to businesses with up to 100 employees. (Anderson, 9/15)
In national news on the health law —
Obama Steps In To Save Obamacare
Deep into the final year of his presidency, Barack Obama is working behind the scenes to secure Obamacare’s legacy, struggling to bolster a program whose ultimate success or failure will likely be determined by his successor. With no lifeline coming from the divided Congress, Obama and his administration are redoubling their pleas for insurers to shore up the federal health care law and pushing uninsured Americans — especially younger ones — to sign up for coverage. The administration is nervously preparing for its final Obamacare open-enrollment season just a week before Election Day, amid a cascade of headlines about rising premiums, fleeing insurers and narrowing insurance options. (Demko, 9/16)
The problem, known as balance billing, happens when patients are treated by an out-of-network professional at an in-network facility. Gov. Jerry Brown is expected to sign the legislation. In other news from Sacramento, regulators could learn lessons from Colorado if recreational marijuana use becomes legal in California.
Kaiser Health News/NPR:
California Aims To Limit Surprise Medical Bills
The unexpected charges come when patients are treated by an out-of-network provider at an in-network facility. After several failed attempts in recent years, the California legislature passed AB-72, which aims to protect patients’ pocketbooks when they’re hit by these surprise bills. Gov. Jerry Brown has until the end of September to sign or veto the legislation. He is expected to sign it into law. (O'Neill, 9/16)
What Stoned Driving Looks Like And How California Might Regulate It
Marijuana legalization advocates suggest impacts of pot use on driving danger may be even harder to quantify. They argue that the 5 nanograms measure – an investigative threshold in Colorado and a legal standard in Washington, another state where voters approved recreational marijuana use in 2012 – has little scientific reliability. The problem, they say, is that THC detected in blood may apply to a stoned motorist who got in the car after smoking a joint as well as a sober driver who has pot metabolized in fat from using marijuana days or even weeks earlier. (Hecht, 9/16)
California is among the states that require such notices. But, women "don't understand that this is a warning letter," says Dr. Barbara B. Hayden, a Santa Monica-based breast reconstruction surgeon. "That mammography isn't good enough for you and may not help you at all."
Detecting More Cancer In 'Dense Breasts' With Automated Ultrasound Screenings
An estimated 40 percent of women have dense breasts. In recent years women have become more familiar with the term as states have passed laws requiring doctors to notify women in writing when mammograms show they have dense tissue. Capello's own non-profit has pushed for such laws, and so far, 27 states have them, including California. But it's unclear what women do differently after receiving such a letter. (O'Neill, 9/16)
The influx of retail chains is part of a community-based health care movement, but the trend worries some merchants and residents.
San Francisco Chronicle:
Health Care Chains Taking Root In SF Residential Neighborhoods
In the Ingleside neighborhood, Presidio Heights, Noe Valley and North Beach, medical services chains — some aimed at the well-off, some at the poor — are taking root in spaces that previously had housed everything from hardware stores to toy shops to pizza joints. Combined, four groups — North East Medical Services, One Medical Group, GoHealth Urgent Care and Golden Gate Urgent Care — have opened more than 30 health care service centers in the hearts of residential districts over the past five years. (Dineen, 9/15)
In other health news from around the state, a Santa Rosa homeless man says that a denial of medical care in jail led to his amputations. And an uplifting story of an Orange County runner who competes despite cerebral palsy.
Orange County Register:
Anaheim Dental Clinic Ordered To Stop Using Water After 10 Kids Hospitalized
Orange County’s Health Care Agency on Thursday ordered Children’s Dental Group in Anaheim to stop using water for procedures after 10 root canal patients were hospitalized with serious infections. The agency said its lab has confirmed that multiple samples taken from the dental office’s water system have tested positive for mycobacteria similar to the kind believed to have sickened the children, who all underwent pulpotomies since May. (Perkes, 9/15)
The Press Democrat:
Santa Rosa Homeless Man Claims Sonoma County Jail Denied Care, Caused Amputation
A Santa Rosa homeless man who says he was forced to have both feet and part of a leg amputated after being denied medical treatment in the Sonoma County Jail is suing for negligence and civil rights violations. Bryce Lemmons, 56, alleges in the suit filed last month in the U.S. District Court in San Francisco he languished in a cell for more than two days after his arrest Dec. 26 by Santa Rosa police for sleeping outside a grocery store. In the suit, Lemmons said he was exposed to extreme cold while sleeping outside and complained of excruciating pain in his feet and legs when arrested about 9 p.m. After being diagnosed with hypothermia at Kaiser Permanente Medical Center in Santa Rosa, he was booked into the jail on an outstanding warrant early Dec. 27 and not allowed to see a doctor. (Payne and Johnson, 9/15)
Orange County Register:
Determined Trabuco Hills Runner Michelle Cross Refuses To Be Slowed By Cerebral Palsy
Michelle, now 16, was born with cerebral palsy, which has left her with limited balance and movement on her right side, including limited to no mobility in her right arm. Simple things, like tying shoes and putting her hair up, become daunting. However, in the world of athletics, her competitive fire burns bright. (Percy, 9/15)
The new survey finds that 66 percent approve of the plan to restrict the prices that state-run health agencies pay to same caps as the U.S. Department of Veterans Affairs.
Poll Shows 66 Percent Of California Voters Favor Drug Price Initiative
An initiative on California's November ballot aimed at reining in prescription drug prices is favored by 66 percent of state voters, according to a new poll released on Thursday. The California Drug Price Relief Act, also known as Proposition 61, seeks to restrict state-run health programs from paying more for medications than prices paid by the U.S. Department of Veterans Affairs, which is billed about 25 percent less for drugs than other government agencies. (Beasley, 9/15)
While discussing his own health statistics with Dr. Oz, Donald Trump also comments on expanding Medicaid and access to over-the-counter birth control, like in California. Later, he says he supports permanently prohibiting federal funds from being used for abortion and appointed a new head to his anti-abortion coalition.
Los Angeles Times:
Trump's Doctor Says He's In 'Excellent Physical Health' But Shares Few New Details
Donald Trump released a one-page doctor’s letter Thursday saying he is “in excellent physical health” while pressing his case that he has more strength and stamina than Hillary Clinton. The letter from Harold N. Bornstein, a Manhattan doctor who has treated Trump since 1980, said the Republican presidential nominee takes low-dose aspirin and a statin drug to lower his cholesterol. (Finnegan, 9/15)
The Associated Press:
Amid Tighter Race, Clinton And Trump Trade Barbs Over Health
Hillary Clinton returned to campaigning without offering apologies for keeping her pneumonia a secret, focusing on criticizing opponent Donald Trump instead of how she handled her health problem and the three-day rest ordered by her doctor. (Pace and Lerer, 9/16)
Trump Says He’d Use Medicaid To Expand Insurance Coverage
Republican presidential nominee Donald Trump said that as president he would use Medicaid to cover poor people who can’t afford private health insurance, and make birth control available without a prescription. The comments appeared to differ both with what some Republicans have proposed in the past, and -- in the case of Medicaid -- aspects of Trump’s own policy proposals on his website. Republicans generally opposed the expansion of Medicaid to higher income levels under Obamacare, for example. (Cortez and Tracer, 9/15)
The Associated Press:
Trump Supports Birth Control Without A Prescription
Donald Trump says he believes women should be able to obtain birth control without a prescription. Speaking on an episode of "The Dr. Oz Show" airing Thursday, the Republican nominee suggested that, for many women, obtaining a prescription can be challenging. "I would say it should not be prescription," he told the audience, adding that many women "just aren't in a position to go get a prescription." (Colvin and Sharp, 9/15)
Trump Announces 'Pro-Life Coalition,' Supports Making Hyde Amendment Permanent
On Friday Trump reinforced his commitment to three anti-abortion platforms and announced he would also back making the Hyde Amendment permanent law... The Hyde Amendment withholds certain federal funds from being used for abortion. There are exceptions to protect the life of the woman or if the pregnancy is the result of rape or incest. (Collins, 9/16)
The facility will buy MRI equipment with $6 million from the Kaiser Permanente Community Fund. In other news, Stat's report on a trend toward "bedless hospitals" features the Los Angeles-area clinics of UCLA Medical Center.
East Bay Times:
Kaiser Buys Highland Some High-Tech Help
Highland Hospital, with a $6 million grant from the Kaiser Permanente Community Fund, is buying magnetic resonance imaging equipment that will double the number of patients who can be tested for cancer, disease and health problems. Early detection is key to keeping them healthy and alive. Highland Hospital in East Oakland is the flagship for Alameda Health System, a public health consortium that runs several hospitals and clinics. (Hedin, 9/15)
Bedless Hospitals Treat Patients And Send Them Home The Same Day
As treatments get less invasive and recovery times shrink, a new kind of hospital is cropping up — the “bedless hospital." They have all the capabilities of traditional hospitals: operating rooms, infusion suites, and even emergency rooms and helipads. What they don’t have is overnight space. ... The growth in outpatient healthcare is a fundamental shift in US medicine. MetroHealth, which gets part of its funding from taxpayers and serves a large Medicaid population, has expanded outpatient visits from 850,000 to 1.2 million in the last four years, a 40 percent increase. (Ross, 9/16)
One solution to the EpiPen controversy, some advocates say, is classifying it as preventive care so consumers wouldn't have to pay anything for the life-saving drug. But while the suggestions seems to favor consumers, a New York Times report finds Mylan is pulling the strings.
The New York Times:
EpiPen Maker Mylan Quietly Steers Effort To Protect Its Price
Against a growing outcry over the surging price of EpiPens, a chorus of prominent voices has emerged with a smart-sounding solution: Add the EpiPen, the lifesaving allergy treatment, to a federal list of preventive medical services, a move that would eliminate the out-of-pocket costs of the product for millions of families — and mute the protests. ... A point not mentioned by these advocates is that a big potential beneficiary of the campaign is Mylan, the pharmaceutical giant behind EpiPens. The company would be able to continue charging high prices for the product without patients complaining about the cost. (Lipton and Abrams, 9/16)
The New York Times:
What Happens If EpiPens Get The ‘Preventive’ Label?
Mylan, the maker of EpiPens, an injection device for severe allergy attacks, is trying to persuade the United States Preventive Services Task Force to add the product to the group’s list of preventive medical services. That could make EpiPens available to patients with no insurance co-pay. It could also benefit the company by allowing it to raise prices on the product while limiting complaints from the public. The higher prices would be pushed to the government, insurers or employers. (Abrams, 9/16)
In other national public health stories, researchers find evidence strengthening the link between Zika and microcephaly; and a New York prison program trains therapy dogs for veterans with PTSD and other disabilities.
The Washington Post:
Brain Cancer Replaces Leukemia As The Leading Cause Of Cancer Deaths In Kids
It's official: Brain cancer has replaced leukemia as the leading cause of cancer deaths among children and adolescents. In 1999, almost a third of cancer deaths among patients aged 1 to 19 were attributable to leukemia while about a quarter were caused by brain cancer. By 2014, those percentages were reversed, according to a report published Friday by the National Center for Health Statistics, which is part of the Centers for Disease Control and Prevention. (McGinley, 9/16)
Los Angeles Times:
Researchers Strengthen Link Between Zika And Microcephaly
A first-of-its-kind study is strengthening the case that Zika is the culprit behind Brazil’s mysterious surge in babies born with microcephaly. Preliminary results from a study commissioned by the Brazilian Ministry of Health found that 13 out of 32 newborns with microcephaly tested positive for the Zika virus. Meanwhile, none of the 62 newborns in a comparison group who had normal-sized heads showed any sign of infection. (Kaplan, 9/15)
The Wall Street Journal:
Inmate-Trained Dogs Give Veterans Some Love
Ms. Stoga’s “classes” typically produce six dogs that are ready to be service animals. She refers to them as “geniuses,” and she should know—she owns two that failed the program. Ones that don’t make the grade are held for further training or released for adoption. Successful graduates learn over 90 commands and acquire astonishing skills, from pulling off their owner’s socks and placing them in a laundry basket to waking them from post-traumatic-stress-related nightmares by turning on a closet light or pulling the sheets off their bed. (Gardner Jr., 9/15)
Commentators analyze how the election could affect health care and policy in California.
Los Angeles Times:
Yes On Proposition 52 To Keep Medi-Cal Funded
About 1 of every 6 Californians lives in poverty, which helps explain why almost 12 million state residents are enrolled in Medi-Cal — the state’s version of Medicaid, the health insurance program for impoverished Americans that’s jointly funded by federal and state taxpayers. California’s enrollment is by far the largest in the country. Yet because the state is relatively wealthy, California has to pick up a larger share of its Medicaid costs than almost every other state does. The higher a state’s median income, the smaller the fraction of Medicaid costs that the federal government will pay. (9/13)
It's Time To Raise California Tobacco Tax
Generally speaking, Californians shun tobacco. Smoking has been banned in workplaces here since 1994. So few adults smoke that it is socially unacceptable. Because of new legislation, Californians must be 21 to legally buy a pack of smokes. And yet tobacco industry lobbyists, reinforced by tobacco company contributions to Democratic and Republican politicians, are able to snuff any legislation to raise tobacco taxes. So once again, voters are being asked to do what legislators have failed to do: raise taxes on cigarettes and other tobacco products, including increasingly popular nicotine-containing e-cigarettes, with the revenue earmarked for anti-tobacco efforts and health care. (9/12)
Prop. 60: How Hardcore Do We Want To Get In Policing Porn?
For as long as X-rated entertainment has existed, it has exploited the vulnerable and troubled. So we sympathize with the intentions behind Proposition 60, which would crack down on unsafe sex in the production of pornography. Unfortunately, this initiative is a bit like its Los Angeles-based proponent, activist Michael Weinstein of the AIDS Healthcare Foundation – well-meaning, but so litigious that even sympathizers are unsettled. Most mainstream AIDS organizations and both major political parties in California oppose it. So must we. (9/12)
San Diego Union-Tribune:
Yes On Prop 61 For Affordable Medications
As nurses, we see families who can’t afford the medications they or their children need, or they have to give up other basic necessities. We see patients who have been admitted to the hospital with elevated blood glucose levels because they couldn’t afford the medications that control their diabetes. In 2013 alone, insulin prices jumped by 200 percent. It’s heartbreaking and it’s unconscionable. Californians can take some control back by voting yes on Proposition 61. Proposition 61 would require the state to negotiate with the drug companies for prices that are no more than the amounts paid for the same medications by the U.S. Department of Veterans Affairs. (Malinda Markowitz and Dahlia Tayag, 9/15)
The San Diego Union-Tribune:
Prop 61 Would Hurt Veterans
As the commander of the Veterans of Foreign Wars (VFW), Department of California, my duty is to work with and represent veterans throughout California. That’s why I’m deeply concerned about the harm Proposition 61 would inflict on veterans. ... Proposition 61 is a deeply flawed measure that would hurt our nation’s veterans by increasing drug costs to the U.S. Department of Veterans Affairs (VA) and, consequently, increasing the price veterans pay for prescription drugs. And the increase in costs to veterans would be significant. (Dale Smith, 9/15)
A selection of opinions on health care developments from around the state.
The Mercury News:
San Jose Must Deliver On Managing Medical Marijuana
There is no question that San Jose residents want legal medical marijuana delivery. In fact 69 percent of residents polled are in favor of delivery. The real question is whether policymakers will do anything about it. The poll, commissioned by Eaze and completed by Tusk Ventures, asked more than 500 San Jose residents their opinions regarding medical marijuana. The results revealed a desire for common sense medical marijuana policies, particularly when it comes to delivery. (Keith McCarty, 9/13)
East Bay Times:
Opioid Epidemic From Primary Care Doctors’ View
In my primary care clinic in Oakland, I can often change the mind of the patient before me. But I cannot sway the opinion of entire communities where opioid use is so common that prevalence confers a veneer of safety and normality. To overcome the opioid epidemic, everyone, not just doctors, must see opioids for what they can be: dangerous substances that destroy lives. (Blake Gregory, 9/12)
The Bakersfield Californian:
Liver Transplants Hard To Come By In California
And here in the Golden State, getting a liver is apparently harder than winning the Super Lotto. Too much demand, too little supply. Hence, the rules for who can qualify are stacked against Laura [McKay], who’s married to local conservative radio host Jaz McKay. It’s all about the MELD score. MELD stands for Model for End-Stage Liver Disease and is a numerical ranking that goes from six (less sick) to 40 (gravely ill). In California, a person’s MELD has to be in the red, so to speak, to get priority on the transplant waiting list. (Lois Henry, 9/13)
Could Foundations Have Mounted A Better Defense Of The ACA?
In hindsight, President Obama’s signing of the Affordable Care Act (ACA) on March 23, 2010, was not the cheerful ending point that some might have expected. Rather, the ACA debate would play on long after—a center-stage feature for toxic partisanship that had begun years earlier. ... Yet even as advocates and lawmakers were struggling to build their new craft, opponents kept busy trying to tear it apart. Given the ongoing vulnerability of the ACA, what could philanthropy have done differently to better support advocacy around implementation and to help shore up this nascent law? (9/15)