Californians on Tuesday elected a governor who campaigned for a complete overhaul of how people get their health coverage — but they shouldnt hold their breath.
Rather, as Gov.-elect Gavin Newsom and the Democratic-controlled legislature take steps to provide more people with health insurance, theyll likely approach it piecemeal over several years.
Newsom himself is already tempering expectations about Californias move to a single-payer system, saying it will take more than the will of one person to realize.
“Im not going to hesitate to be bold on this issue, and I also want to set expectations,” Newsom told reporters last week at a campaign stop in Sacramento. “Its a multiyear process.”
The Democratic lieutenant governor easily routed Republican John Cox in the governors race Tuesday, with Newsom vowing to stand up to President Donald Trump and restore the “California Dream” by addressing affordable housing, health care and income inequality in the nations most populous state.
Newsoms views are in stark contrast to Coxs, who maintained that government should largely stay out of health care. The free-market businessman said single-payer would send health care costs soaring while diminishing quality, and warned that it “is a sure way to destroy the California economy.”
Like many Democrats, Newsom has described health care as a right and vowed to defend the Affordable Care Act as governor. He also criticized the legislature last year when it held up a single-payer bill that would have created one government-run public insurance program for all Californians.
He won the endorsement from the politically powerful California Nurses Association for vigorously advocating single-payer. Going slow on single-payer could test his relationship with the union, which launched a brutal attack against the Democratic state Assembly speaker when he shelved the measure last year.
It could also upset progressive Democrats and donors who are counting on action.
“This is the governor who has the best shot to get this done,” said Stephanie Roberson, the unions director of government relations. “It takes political will and courage, and Im going to cash in on what he said to my association.”
Now Newsoms attitude is cautious — many say realistic — even in a state that aims to set national trends and relishes its role at the forefront of the resistance to the Trump administration.
Last week, Newsom called single-payer the most “effective and efficient” strategy to achieve universal coverage, but he questioned whether it could be achieved at the state level, given the Trump administrations opposition to the concept.
Trumps top Medicare and Medicaid official, Seema Verma, last summer firmly rejected the idea that the federal government would grant the essential exemptions from federal rules to try single-payer, which she called “unaffordable” and “something thats not going to work.” The exemptions, or waivers, are necessary because the state relies heavily on federal health care dollars that would be needed to pay single-payer costs.
Undaunted, the California Nurses Association said it intends to bring another single-payer bill before the legislature next year and has launched a national campaign to pass single-payer in other states and convince Congress of its merits.
But its unlikely that a single-payer bill will make it to Newsoms desk next year, in part due to the price tag: A single-payer system could cost an estimated $400 billion annually. Lawmakers earlier this year directed a council to study the feasibility of a publicly funded health insurance plan, and its findings arent due until 2021 — giving the new governor and lawmakers time to punt on the issue.
Still, Democrats who head the key legislative health committees see Newsom as a partner who will be more engaged on health care than fellow Democrat Gov. Jerry Brown has been these past eight years.
“Health care has not been one of the issues that hes been particularly focused on,” Assemblyman Jim Wood, chairman of the Assembly Health Committee, said of Brown. “I think weve missed some opportunities to really move forward on some policies that would be good for all Californians.”
Brown this year blocked measures that would have expanded health care coverage to some low-income unauthorized immigrants — not because he philosophically opposed the idea, lawmakers say, but because it would have required new state spending.
He also raised cost concerns about bills that would have provided state-funded tax credits and subsidies to people who buy coverage through Covered California, the states insurance exchange.
With a new governor, those proposals are back on the table. Newsom was, after all, the San Francisco mayor who signed off on the nations first universal health care program for city residents without insurance, including undocumented immigrants. And, as he has reminded reporters, he did it during a recession.
“Its a question of what do you value, what you prioritize,” he said last week when asked how the state could afford both universal health care and his call for universal preschool.
Newsoms campaign did not respond to questions about how he would expand coverage absent single-payer. But, earlier this year, his spokesman told California Healthline that proposals to give coverage to undocumented immigrants and earmarking state dollars to help consumers buy insurance coverage were “two major parts” of his plan to deliver health coverage to all state residents. The states estimated 1.8 million unauthorized immigrants, for example, make up roughly 59 percent of the states remaining uninsured residents, according to Covered California.
The Democratic-dominated legislature would have to approve these moves.
“Were going to be looking at a variety of ways that we might be able to get everyone covered,” Wood said. But, he added, “it will be significantly expensive to do that.”
Wood and state Sen. Richard Pan, chair of the Senate Health Committee, said lawmakers should look at the structural issues in health care — how prices for services and pharmaceuticals are regulated and how efficiencies, improved access and curbs on costly care of chronic diseases might be achieved.
“I think its clear the health care landscape is a focal point for the California legislature,” said Erin Trish, associate director of health policy at University of Southern Californias Schaeffer Center. “They dont have to push for a single-payer system to push for expanded coverage.”
Expanding health care coverage would require more state spending, but that wouldnt necessarily mean a hit to the state economy, experts said.
After California implemented the Affordable Care Act (albeit with significant federal assistance), the states economy continued to grow and the number of uninsured residents fell to 7.2 percent in 2017, according to the U.S. Census Bureau.
“Weve expanded coverage and our economy has continued to flourish,” said Dr. Andrew Bindman, a primary care physician who is also a professor at the Philip R. Lee Institute for Health Policy Studies at the University of California-San Francisco, who helped draft the federal health care law. “These things are achievable, and I think California is a model of that.”
Pan, the chair of the Senate Health Committee, said he looks forward to engaging Newsom, someone who proved he could move beyond rhetoric by signing the San Francisco measure that offered more city residents health coverage.
“Hopefully, we have an opportunity to get something done,” Pan said.
Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.
Officials investigating 252 possible cases of polio-like illness AFM
Officials are now investigating 252 cases of possible acute flaccid myelitis (AFM), including 90 con..
Officials are now investigating 252 cases of possible acute flaccid myelitis (AFM), including 90 confirmed cases in 27 states, according to the Centers for Disease Control and Prevention.
The number of cases under investigation by the CDC is up 33 from last week, and the number of confirmed cases rose by 10, Dr. Nancy Messonnier, the director of CDCs National Center for Immunization and Respiratory Diseases, told reporters Tuesday.
Acute flaccid myelitis is a condition that has polio-like symptoms such as partial paralysis. The virus mostly affects children and young adults. The CDC said they do not know why the condition is impacting these individuals, but many believe it is caused by viruses. The CDC emphasized it remains a rare condition and said there have been no reported deaths from AFM so far in 2018.
The typical symptoms of AFM are similar to those of a severe respiratory illness, along with a fever, but then progress into neurological symptoms. Some patients with AFM feel weakness in their arms or legs, a loss of muscle tone or slower reflexes.
Some patients may also exhibit facial droop or weakness, difficulty moving their eyes and drooping eyelids or difficulty with swallowing or slurred speech. The most severe symptom is respiratory failure.
Messonnier said the CDC doesn't yet have enough information to definitively say what causes AFM and are casting a wide net for information. Part of that is studying the long-term health of AFM patients. Scientists are also looking for a pathogen in AFM patients' spinal fluid, but haven't yet found a pathogen that's a clear cause, she said.
The CDC said it sees an uptick in AFM cases every two years, and so far, the curve of the cases being investigated this year looks very similar to that of 2014 and 2016.
Officials don't expect many more cases in 2018 compared to 2016 and 2014, Messonnier said.
The best advice available is to wash your hands regularly, which lowers the chances of getting sick or spreading germs from many of the viruses linked to AFM, and protect against mosquito bites by using repellent, in addition to staying indoors at dusk and dawn.
The CDC said the vaccines your pediatrician suggests are very effective and children should continue to receive them on schedule even though there is no vaccine for AFM. (more…)
‘Make-a-Wish’ wishes decrease trips to hospital for sick children: Study
A recent study from the Nationwide Childrens Hospital in Columbus, Ohio shows that participation in ..
A recent study from the Nationwide Childrens Hospital in Columbus, Ohio shows that participation in the Make-A-Wish program may give children better quality of life and reduce hospital visits and healthcare costs.
Patients who received a wish were 2.5 times more likely to have fewer unplanned hospital admissions and 1.9 times more likely to have fewer unplanned emergency department visits compared to patients of similar age, gender, disease category, and disease complexity who would also quality for a wish but did not receive one.
What is the Make-A-Wish Foundation?
The Make-A-Wish Foundation is a non-profit organization whose goal is to provide children aged three to 17-years-old who have progressive, life-limiting, or life-threatening medical conditions, with experiences known as “wishes.” These wishes include “I wish to…” “go,” “be (someone for a day),” “meet,” and “have” (i.e. receive gifts.) The foundation is funded by contributions from individual donors, corporations, and other organizations.
What are the goals and mission of the Make-A-Wish Foundation?
The Make-A-Wish Foundation “serves a unique, and vital, role in helping strengthen and empower children battling illnesses.” And, “wishes make life better for kids with critical illnesses.”
How many “wishes” does the foundation grant?
The Make-A-Wish Foundation was founded in November 1980 and the first wish was granted in the spring of 1981 to Frank “Bopsy” Salazar, a 7-year-old who had leukemia. Bopsy had three wishes: to be a fireman, go to Disneyland, and ride in a hot air balloon — all of which were granted to him. Since then, more than 285,000 children in the United States and its territories have benefited from experiencing their wishes. The foundation granted 15,300 wishes last year alone; which means on average, a wish is granted every 34 minutes.
What are the potential benefits of receiving a “wish?"
There is a long-held belief that receiving a wish improves a childs quality of life and potentially improves their familys quality of life, enhances family bonding, reduces stress, increases hope and serves as a distraction from illness. (more…)
To curb STD rise, doctors treat patients’ partners without an office visit
This is a Kaiser Health News story.
If patients return to Dr. Crystal Bowe soon after taking medi..
If patients return to Dr. Crystal Bowe soon after taking medication for a sexually transmitted infection, she usually knows the reason: Their partners have re-infected them.
“While you tell people not to have sex until both folks are treated, they just dont wait,” she said. “So they are passing the infection back and forth.”
Thats when Bowe, who practices on both sides of the North and South Carolina border, does something doctors are often reluctant to do: She prescribes the partners antibiotics without meeting them.
Federal health officials have recommended this practice, known as expedited partner therapy, for chlamydia and gonorrhea since 2006. It allows doctors to prescribe medication to their patients partners without examining them. The idea is to prevent the kind of reinfections described by Bowe — and stop the transmission of STDs to others.
However, many physicians arent taking the federal governments advice because of entrenched ethical and legal concerns.
“Health care providers have a long tradition of being hesitant to prescribe to people they havent seen,” said Edward Hook, professor at the University of Alabamas medical school in Birmingham. “There is a certain skepticism.”
A nationwide surge of sexually transmitted diseases in recent years, however, has created a sense of urgency for doctors to embrace the practice. STD rates have hit an all-time high, according to the Centers for Diseases Control and Prevention. In 2017, the rate of reported gonorrhea cases increased nearly 19 percent from a year earlier to 555,608. The rate of chlamydia cases rose almost 7 percent to 1.7 million.
“STDs are everywhere,” said Dr. Cornelius Jamison, a lecturer at the University of Michigan Medical School. “We have to figure out how to … prevent the spread of these infections. And its necessary to be able to treat multiple people at once.”
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