Teens living in US states allowing medical marijuana smoke less cannabis

According to a large-scale study of American high school students, legalizing medicinal marijuana has actually led to a drop in cannabis use among teenagers. The study used the results of an anonymous survey given to more than 800,000 high school students across 45 states to calculate the number of teens who smoke cannabis.
Teen Health News — ScienceDaily

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Texans Can Appeal Surprise Medical Bills, But The Process Can Be Draining

In Texas, a growing number of patients are turning to a little-known state mediation program to deal with unexpected hospital bills.

The bills in question often arrive in patients’ mailboxes with shocking balances that run into the tens or even hundreds of thousands of dollars.

When patients, through no fault of their own, are treated outside their insurers’ network of hospitals, the result can be a surprise bill. Other times, insurers won’t agree to pay what the hospital charges, and the patient is on the hook for the balance.

The Texas Department of Insurance’s mediation program can intervene when Texans complain about an unexpected bill — often after an emergency in which a patient is rushed for treatment at an out-of-network hospital.

Historically, the state program had many restrictions that left few consumers eligible for help. But the Texas Legislature expanded it in 2017.

Since then, more patients have been filing complaints. In 2014, the department was asked to mediate 686 medical bills. During the 2018 fiscal year, however, it received 4,445 bills, more than double the 2,063 bills received in 2017.

Even after the changes, the mediation program could be a lot more robust and is likely addressing only a fraction of these problematic bills, consumer advocates say.

The Road To A Surprise Medical Bill

Brad Buckingham had to deal with a surprise medical bill after a bicycle accident in 2016.

Buckingham sent his bill to Kaiser Health News and NPR’s “Bill of the Month” portal last year.

The Austin, Texas, dentist said he was on a ride with friends in December 2016 when he crossed train tracks at an angle to avoid a pileup. His wheel slipped out from under him, and he landed hard on his left hip.

“All I could do was scream,” he said. “I couldn’t even make words.”

His friends called an ambulance, and Buckingham was taken to the nearest hospital: St. David’s South Austin Medical Center.

“I specifically remember I gave them my health insurance information in the ambulance,” he said. “And they put me in the ER, and from the ER they took my insurance information again.”

Buckingham had insurance through Baylor Scott & White Health, which he bought through the Affordable Care Act marketplace. St. David’s was out of his plan’s network, but no one told him that — at first.

Buckingham had broken his hip, and doctors took him into surgery the same day.

“They held me in the hospital for three days just for recovery and never told me I was out of network until the time of my discharge,” he said.

A few weeks later, Buckingham got a bill that said he owed $ 71,543.

The total bill eventually came to $ 75,346. Baylor Scott & White, which left the ACA marketplace the following year, paid only $ 3,812.

Buckingham thought it was a mistake, he said. He called the hospital and the insurer to sort it out. But after weeks of inquiring about it, there was no resolution.

Both the hospital and insurer insisted payment was his responsibility.

“I’m sitting there thinking to myself that there is no way — there is no way — this is right,” he said.

Baylor Scott & White said it couldn’t discuss Buckingham’s bill “due to confidentiality requirements.”

After Buckingham gave St. David’s permission to discuss his case with the media, the hospital released a statement saying his bill was actually the amount he owed from his deductible and coinsurance — not a balance bill.

The hospital also said the bill was so large because of his “high deductible plan.”

Those plans “may be attractive to some people because they cost less, though they place more financial responsibility on the patient,” the statement from St. David’s said.

Buckingham said his policy had a deductible of $ 5,000 for in-network care and $ 10,000 for out-of-network care. He still doesn’t know how his bill got to be so high, he said.

Buckingham didn’t know about the state’s mediation program. But even if he had known, he wasn’t eligible for the program at the time. His bike accident and the billing dispute with the hospital happened months before the Texas Legislature decided to expand the pool of eligible patients. So he hired his own lawyer to help him negotiate with the hospital.

Buckingham now owes a couple of thousand dollars to St. David’s, he said, but he remains frustrated by the experience.

“You know, whenever I tell my story to anybody, they kind of agree — like, ‘Oh my gosh, this is ridiculous,’” he said. “But then when you talk to the people that have any control over it, it’s the exact opposite. It’s: ‘You owe it; we don’t.’”

‘A Total Roll Of The Dice’

A surprise bill can happen to anyone who makes an urgent trip to the nearest emergency room.

“It’s a total roll of the dice,” said Stacey Pogue, a senior policy analyst with the Center for Public Policy Priorities in Austin. She has been looking into balance billing for years. “The medical emergency that’s going to send you to the hospital where you could get a surprise bill — is that emergency room going to be in or out of network?”

Pogue said the Texas Department of Insurance’s mediation process forces an insurance company and the hospital or medical provider to negotiate a fair price for services. Ninety percent of the time those negotiations happen over the phone, she said.

There are two big reasons the number of bills sent for mediation more than doubled from 2017 to 2018, Pogue said.

“One is just increased awareness,” she said. “There is constant media attention now to surprise medical bills because the stories are so shocking, right? We see them covered more, so people are more aware that when they get one, they could do something about it.”

The second reason is that, in 2017, the Texas Legislature opened the mediation program up to more people, including teachers.

Stacey Shapiro got a $ 6,720 bill after being treated in the hospital for a hypoglycemic attack.(Gabriel C. Pérez/KUT)

Can’t Wish It Away

Stacey Shapiro, a first-grade teacher in Austin, also received a surprise bill from St. David’s South Austin Medical Center after she landed in the emergency room last March.

The marathon runner said she woke up one Saturday for an early run and wasn’t feeling well.

“All of a sudden the whole room started spinning. … I started sweating, sweating like buckets,” she said. “It was terrible, and then all I remember is that my ears started popping, my vision got blurred and then the next thing I knew, I had passed out.”

Shapiro’s boyfriend heard her hit the bathroom floor. He found her passed out, with her eyes open and hardly breathing. He took her to St. David’s because it was the closest hospital.

Shapiro was taken care of in a few hours, she said. Hospital staff gave her fluids and anti-nausea medication. Doctors found she had a dramatic change in her blood pressure that was likely due to a spell of hypoglycemia, or low blood sugar.

Two months later, a bill for $ 6,720 came in the mail.

Like many teachers in Austin, Shapiro gets her health insurance from Aetna.

In a statement, the insurer said Austin school district employees are supposed to use the Seton Accountable Care Organization network, comprising several Catholic hospitals in the area. The parent company for St. David’s, the for-profit hospital chain HCA, doesn’t participate in that network.

“Unfortunately, HCA is not currently accepting payments through Aetna’s [contracted payment] program, which provides set payment fees for non-participating providers. This has resulted in Ms. Shapiro being balance billed for her emergency room visit,” Aetna wrote in a statement.

Shapiro said she had heard of other Austin Independent School District employees dealing with high hospital bills. In fact, Shapiro reached out to radio station KUT after hearing the story of Drew Calver, an Austin high school teacher who was balance-billed for nearly $ 109,000 by St. David’s after a heart attack. Calver’s story was part of Kaiser Health News and NPR’s “Bill of the Month” series last year.

In her case, Shapiro said, Aetna told her not to pay what the hospital was charging her. She was told to pay only her deductible ($ 1,275), which she did right away, she said. But St. David’s kept sending her bills for the remaining balance, which was more than $ 5,000.

“I guess I just thought that it was going to go away,” Shapiro said.

But it didn’t. For a public school teacher, $ 5,000 would have been a huge blow to her budget, she said.

Shapiro applied for financial assistance, but St. David’s told her she didn’t qualify. She felt out of options, she said — until a friend told her about the state’s mediation program.

After she contacted the program, a state mediator set up a scheduled call with Aetna and St. David’s. But before it took place, a KUT reporter asked St. David’s for a comment on the situation. Shortly afterward, Shapiro said, St. David’s told her she no longer owed anything.

St. David’s later told KUT that Shapiro had “already satisfied her financial obligation.” It also denied that she was balance-billed to begin with.

Shapiro called the whole experience exhausting. “It’s just very frustrating because this has been very time-consuming,” she said.

More Work To Do

Pogue, of the Center for Public Policy Priorities, has been arguing that the state needs to find more ways to get involved. The current mediation process is pretty good, she said, but not enough people know it’s an option.

“Because first, the instructions for how to do it are on your medical bill and your explanation of benefits — the most indecipherable documents you are going to get,” she said.

And even if people understand they have a right to mediation, they might get scared off by the concept and think they need a lawyer, Pogue added.

When people do use the program, though, it tends to work by saving patients money.

In fiscal year 2018, the initial complaints amounted to $ 9.7 million worth of medical bills, according to the state insurance agency. After mediation, the final charges had been negotiated down to $ 1.3 million.

Mediation is helpful, Pogue said, but it still puts a big burden on the patient, who may be confused. “Why didn’t this happen in the first place?” she said. “How come I had to, while recovering from an emergency, decipher medical bills, fill out paperwork with the state department of insurance, jump through all these hoops, when all that needed to happen was a phone call?”

The ideal solution to surprise medical bills would remove consumers from this confusing web altogether, she said.

States like New York, California and Florida have systems that make things easier for consumers, Pogue said, and Texas should, too.

In 2015, New York became the first state to pass a law aimed at protecting patients from surprise medical bills from out-of-network hospitals. Its Emergency Medical Services and Surprise Bills Law holds consumers harmless if they are treated by an out-of-network doctor at a participating hospital, among other things.

In 2016, Florida lawmakers passed legislation protecting consumers from receiving surprise medical bills “from doctors and hospitals that don’t have a contract with the patient’s insurance plan,” the Miami Herald reported.

And in 2017, California passed a law shielding patients from balance billing. The law kicks in if someone visits an in-network provider, including a hospital, imaging center or lab. Under the law, patients would be responsible only for their in-network share of the cost, even if they’re seen by an out-of-network provider.

In the meantime, Pogue said, more Texans should take advantage of what’s already in place in the state.

The number of people who seek mediation is “tiny compared to the number of people who get surprise bills,” she said, “so there is a ton of work to be done.”

This story is part of a partnership that includes KUT, NPR and Kaiser Health News.

Kaiser Health News

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Kaiser Permanente Moanalua Medical Center Receives Women’s Choice Award for Excellence in Bariatric Surgery

HONOLULU — For the fourth straight year, Kaiser Permanente Moanalua Medical Center has been recognized as one of America’s Best Hospitals for Bariatric Surgery by the Women’s Choice Award®. Presented by WomenCertified Inc., this evidence-based designation scored Moanalua Medical Center in the top 8 percent of 4,797 U.S. hospitals reviewed.

The America’s Best Hospitals for Bariatric Surgery award is given to hospitals recognized by the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery. To be eligible for consideration, hospitals must be accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, which indicates the highest standards for patient safety and quality care in the treatment of severe obesity. The award also takes into account patient safety data from the Centers for Medicare and Medicaid Services, and patient recommendation ratings from the Hospital Consumer Assessment of Healthcare Providers and Systems survey.

“Nearly 24 percent of Hawaii’s adult population is obese, living with an increased risk of developing diabetes, hypertension, heart disease, arthritis and obesity-related cancer,” said Peggy Latare, MD, co-chief of the bariatric surgery department at Kaiser Permanente Hawaii. “Our bariatric team focuses on offering high-quality, integrated care and support that includes surgery, medication and meal replacements to treat obesity and its many associated risks, as well as education and resources that help patients improve their overall health and quality of life.” Kaiser Permanente Hawaii members who are interested in these services can call 808-432-7830.

America’s Best Hospitals for Bariatric Surgery combines national accreditations, HCAHPS survey results and hospital outcome scores with primary research about women’s health care preferences. It is the only award recognizing excellence in bariatric surgery based on robust criteria that consider female patient satisfaction and clinical excellence.


About the Women’s Choice Award®
The Women’s Choice Award sets the standard for helping women to make smarter choices for themselves and their families. The company and its awards identify the brands, products and services that are most recommended and trusted by women. The Women’s Choice Award is the only evidence-based quality designation that drives consumer and patient appreciation through education, empowerment and validation. Additionally, they recognize those that deliver a recommendation-worthy customer experience. Visit www.WomensChoiceAward.com to learn more.

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 12.2 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to kp.org/share.

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The U.S. Has Never Needed Paid Family and Medical Leave More

The Family and Medical Leave Act (FMLA) turned 26 this week, just as President Trump was preparing to talk paid leave during his State of the Union address.

The Family Medical Leave Act was an important first step. Now it’s time to pass the FAMILY Act. (MomsRising)

As the most female Congress in history gets to work, lawmakers have an urgent imperative to adopt comprehensive paid family and medical leave that allows all workers to care for their families without risking their jobs or financial security. No issue is more important to moms across the country.

Moms need paid leave to care for new babies, for sure, but also to care for a spouse or sibling who is battling heart disease or a parent struggling with dementia, or to recover from illness or injury.

Not just any paid leave program will do: The U.S. needs a comprehensive, meaningful paid leave program that covers all workers, addresses the range of caregiving needs families face, expands the definition of family, provides wage replacement sufficient to allow workers with low wages to take leave and ensures that the same or comparable jobs will be there when workers return from their leave.

We expect that, as with last year’s State of the Union, Trump’s lip service to paid leave will be followed with sparse details. In the past, his paid leave proposals have fallen far short of what working families need—providing only parental leave, doing nothing for workers who need leave to care for a sick family member or to recover from illness—and the benefits they would offer would not be meaningful, and would be especially inadequate for workers with lower incomes and wages. Their eligibility rules may even exclude the new parents who need leave the most.

That is not what the country needs.

Similarly, some Republican lawmakers have offered proposals that are deeply, even fatally, flawed—because they would reinforce stereotypes about women, require workers to trade future Social Security benefits for paid leave and/or provide inadequate job protections.

That would not be what our country needs.

Twenty-six years ago, the FMLA required certain employers to provide workers with 12 weeks of unpaid job-protected leave to welcome a new child, care for an ill family member or recover from a serious illness. It was a vitally important starting point, but it does not meet the needs of working families or our economy today.

We need the Family and Medical Insurance Leave (FAMILY) Act to boost moms and families, strengthen our economy, improve our health and make our workplaces more equitable.

The FAMILY Act, which we expect will be introduced in both the House and Senate very soon, would create a social insurance fund with small contributions from employees and employers; provide all workers with a meaningful amount of leave to meet the full range of caregiving needs; and be affordable, cost-effective and sustainable for workers, employers and taxpayers.

We want to be clear: A paid leave program that provides only parental leave is a non-starter for the millions of MomsRising members across the country who see paid family and medical leave as top priority issue.

Congress must pass the FAMILY Act, and President Trump must sign it into law. It’s time for the U.S. to finally give moms, and all workers, access to paid family and medical leave.

Kristin Rowe-Finkbeiner is the author of Keep Marching and Executive Director and CEO of MomsRising—an on-the-ground and online grassroots organization of more than a million people who are working to increase family economic security, decrease discrimination against women and moms and build a nation where businesses and families can thrive. 

Ruth Martin is the Vice President of Workplace Justice Campaigns at MomsRising.

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Curbing surprise medical bills draws rare bipartisan interest

President Trump said taming unexpected bills would be a top priority.
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http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News

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CBS Rejects a Medical Marijuana Ad Ahead of the Super Bowl | The Daily Show

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http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News

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CBS Blocked a Medical Marijuana Commercial From Playing During the Super Bowl

(Bloomberg) — The Super Bowl isn’t ready for medical marijuana.

Acreage Holdings, the multi-state cannabis company backed by John Boehner, says CBS rejected a television advertisement that calls for the legalization of medical marijuana. The network, which is airing the game on Feb. 3, nixed the proposed spot after seeing a rough outline, according to the company.

While medical marijuana is now legal in more than 30 states, the federal prohibition on cannabis has restricted research and made it difficult for some potential patients to get their hands on a drug that proponents say helps treat seizures, pain and other ailments.

The advertisement aimed to “create an advocacy campaign for constituents who are being lost in the dialogue,” Acreage President George Allen said. Super Bowl airtime would have been the best way to achieve this, he added.

“It’s hard to compete with the amount of attention something gets when it airs during the Super Bowl,” Allen said in a telephone interview.

CBS didn’t immediately reply to a request for comment on Monday, which was a federal holiday.

The Super Bowl is typically the most-watched television program of the year, and it’s an opportunity for brands to get in front of millions of Americans. Companies typically debut new publicity campaigns and air their most creative commercials during the event. Some viewers eagerly anticipate the advertisements that run during stoppages in play.

In past years, some advertisers have also grabbed the spotlight for offering up commercials that weren’t likely to be approved.

Injuries, Seizures

Acreage, one of the most valuable U.S. weed companies with a market value of more than $ 2.4 billion, had hoped to raise its profile and push for increased access to medical marijuana. The proposed ad features two subjects who have benefited from medicinal cannabis: a veteran with combat injuries and a child with seizures.

Super Bowl ads are expensive, reportedly costing more than $ 5 million for an average 30-second spot last year. Acreage, which went public in Canada last year, was prepared to pony up, and created the ad thinking it had a legitimate chance of getting onto the air. The company said it was careful to position the spot as a “call to political action” rather than a pitch for its brand, which now has cannabis operations in roughly 15 states.

“We certainly thought there was a chance,” Allen said. “You strike when the chance of your strike has the probability of success — this isn’t a doomed mission.”

Sports – TIME

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CBS sacks Super Bowl ad for medical marijuana

CBS has sacked a Super Bowl ad by a cannabis company that calls for the legalization of medical marijuana. Acreage Holdings, the US-based company backed by former House Speaker John Boehner, said the network nixed the proposed 30-second spot after seeing a rough outline, according to Bloomberg News. The ad aimed to “create an advocacy…
Sports | New York Post

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http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News

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Kaiser Permanente Moanalua Medical Center Receives Women’s Choice Award for Cancer Care

HONOLULU — For the second consecutive year, Kaiser Permanente Moanalua Medical Center has been named one of America’s Best Hospitals for Cancer Care by the Women’s Choice Award®. This evidence-based designation places Moanalua Medical Center in the top 9 percent of 4,797 U.S. hospitals offering cancer care services.

The America’s Best Hospitals for Cancer Care award is based on criteria such as the comprehensiveness of diagnostic and treatment services offered, low rates of infection compared to the national average, national accreditations, and female patient satisfaction and preference ratings on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.

Kaiser Permanente’s multidisciplinary, team-based approach focuses on all stages of cancer care, from prevention through treatment. The organization holds an annual Cancer Screening and Prevention Fair where medical specialists and counselors provide screening and lifestyle education to hundreds of attendees. Kaiser Permanente also recognizes that women have specialized health care needs. Moanalua Medical Center’s cancer care services include a breast care clinic, which provides cancer patients with a coordinated team made up of oncologists, geneticists, radiologists, surgeons and support staff who provide comprehensive care under one roof.

“Every year, thousands of people in Hawaii receive a cancer diagnosis,” said Jennifer Carney, MD, chief of oncology and hematology at Kaiser Permanente Hawaii. “Getting that news is never easy. We strive to provide coordinated care that takes into account our patients’ total picture of health so we can deliver safer, more effective care that is also more convenient for our members. We’re grateful to be able to make a difference in the lives of our many members, who survive cancer every year.”

In 2016, Kaiser Permanente Hawaii was ranked first in the state on breast and colorectal cancer screenings by the National Committee for Quality Assurance, a national quality assurance organization. In 2017, Moanalua Medical Center received a 3-year accreditation, the longest available, from the American College of Surgeons Commission on Cancer (ACS CoC) based on quality measures including early diagnosis, cancer staging, optimal treatment, rehabilitation and end-of-life care.


About the Women’s Choice Award®
The Women’s Choice Award sets the standard for helping women to make smarter choices for themselves and their families. The company and its awards identify the brands, products and services that are most recommended and trusted by women. The Women’s Choice Award is the only evidence-based quality designation that drives consumer and patient appreciation through education, empowerment and validation. Additionally, they recognize those that deliver a recommendation-worthy customer experience. Visit www.WomensChoiceAward.com to learn more.

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 12.2 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to kp.org/share.

 

###

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1.9.19 LIVE from CES: Clark discusses keyless door locks, smartphone developments, eliminating porch pirates, medical devices and more!

LIVE from CES: Clark discusses keyless door locks, smartphone developments, eliminating porch pirates, medical devices and more!

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Insured But Still In Debt: 5 Jobs Pulling In $100K A Year No Match For Medical Bills

Robert and Tiffany Cano of San Tan Valley, Ariz., have a new marriage, a new house and a 10-month-old son, Brody, who is delighted by his ability to blow raspberries.

They also have a stack of medical bills that threatens to undermine it all.

In the months since their sturdy, brown-eyed boy was born, the Canos have acquired more than $ 12,000 in medical debt — so much that they need a spreadsheet to track what they owe to hospitals and doctors.

“I’m on these payment arrangements that are killing us,” said Tiffany Cano, 37, who has spent her lunch hours on the phone negotiating payoff plans that now total $ 700 a month. “My husband is working four jobs. I work full time. We’re a hardworking family doing our best and not getting anywhere.”

The pair, who earn nearly $ 100,000 a year, are insured and have had no major illnesses or injuries. Still, the Canos are among the 1 in 4 Americans who report in multiple polls that the high cost of health care is the biggest concern facing their families. And they’re at risk of joining the 62 percent of people who file for bankruptcy tied to medical bills.

“Oh, yes, that worry is always in the back of my mind,” Tiffany said.

The family is part of a struggling group: middle-class folks who have followed the rules and paid for employer-based medical insurance, only to find that soaring health care costs — combined with high deductibles, high copayments and surprise medical bills — leave them vulnerable.

“I thought we’d be covered, and it’s just not enough coverage at all,” she said.

Robert Cano, also 37, had family health insurance for 2018 through his job as a manager at a large-chain retail store, for which he pays nearly $ 500 per month. The plan’s $ 3,000 annual deductible and 40 percent coinsurance fees have added up faster than the Canos anticipated.

First came the nearly $ 4,000 bill from the in-network hospital where Brody was born Jan. 2, followed by separate fees from the anesthesiologist and the doctor who performed the routine delivery. Then, at 2 months, Brody was hospitalized with breathing problems doctors said could be related to allergies or asthma. In May, Tiffany came down with a stomach virus that sent her to the emergency room for drugs to treat nausea and dehydration. In October, the baby developed a bad case of bacterial conjunctivitis, or pinkeye.

“It’s been, like, $ 300 here, $ 700 there,” said Tiffany. “We had a hospital bill for him being sick of, like, $ 1,800.” Unable initially to find a pediatrician she liked, Tiffany has agonized over whether to use the ER when Brody gets sick. When he had pinkeye, she debated whether to take him in, hoping it would get better on its own.

Then he got worse, she said, pulling up a photo on her phone of her son with half-moons of red, puffy flesh under his dark eyes.

“I let him suffer for a day like that,” she said.

The Canos lost their first child, a girl, midway through her pregnancy in 2016. Tiffany acknowledges that experience has left her more anxious than the average first-time mom.

“It gave me so much fear that something would happen to him,” she said.

As for their own health care needs, the couple put themselves lower on the priority list. Tiffany has used a prosthetic limb since childhood, when her lower left leg was amputated because of a birth defect.

She needs a new prosthesis because her body changed during pregnancy, but she can’t see how to afford it.

Tiffany Cano with her son, Brody. Cano was born with birth defects that left her with only three fingers on her right hand and a left leg that had to be amputated below the knee during childhood. Because of physical changes during pregnancy, her five-year-old prosthetic leg no longer fits, but she can’t afford her share of the cost of the new limb.

A model suitable for the busy life of a working mom would easily cost $ 10,000 to $ 15,000, according to Tom Fise, executive director of the American Orthotic & Prosthetic Association.

“I try to push through,” Tiffany said. “I put on that brave face of just walking, but it’s so painful to walk. I have bruises all over my leg. I get blisters all the time.” Lately, she’s been wearing an old prosthesis, one she used in high school, because it’s more comfortable.

The Canos don’t know how exactly they fell into such debt, since they tried hard to make responsible decisions. After meeting three years ago, they knew quickly that they wanted to marry and have a family.

“I waited until I found the right guy,” said Tiffany, who was thrilled when, in 2016, they were able to afford a 2,500-square-foot, two-story home in one of the stucco-and-tile neighborhoods an hour outside Phoenix.

But, taken together, the medical payment plans and premiums are almost as much as their $ 1,300 monthly mortgage. All told, the Canos spend about 15 percent of their annual income on health care, almost three times the average for non-Medicare households in the U.S.

That leaves too little for day care, car payments, gas, food and dozens of other domestic expenses, Tiffany said.

For 17 years, Robert Cano had comprehensive health insurance through his job as a soldier in the Army Reserve and paid little or nothing for medical care. He left the Army in 2017, however, after he learned he would be deployed for an extended time away from his wife and new son.

“I told them, ‘I have to be at home,’” he recalled. The Army insurance ended on Dec. 31, 2017, two days before Brody was born.

That meant moving to his employer’s insurance plan. Like more than 40 percent of 152 million Americans who get health insurance through work, the Canos are enrolled in a plan that demands thousands of dollars before any coverage kicks in.

The couple discovered that they earn too much to qualify for financial assistance from medical providers, or for subsidies if they shifted their insurance to a plan under the federal health insurance exchange. She is a full-time bank compliance officer. He is a full-time store manager.

Tiffany wrote to KHN after seeing stories about sky-high medical bills on TV. Dr. Merrit Quarum, the chief executive of WellRithms, a health care consulting firm, reviewed the family’s medical bills and the responses from their health care providers.

Though Quarum had questions about some of the fees in the itemized bills — $ 4 for a 600-milligram ibuprofen tablet? $ 3,125 to place an epidural? — he found the charges were legitimate under the terms of the contract between the hospital and the Canos’ insurer. Tiffany’s only recourse was to set up the five payment plans she navigates each month.

“I wish I could say it wasn’t so, but it is,” Quarum said.

Robert Cano plays with his 10-month-old son, Brody, before leaving for work on a recent Saturday morning.(Heidi de Marco/KHN)

Robert Cano of San Tan Valley, Ariz., gets ready for work on Oct. 20, 2018. He estimates he works up to 120 hours a week, mostly to cover the extra costs of his family’s health care. In addition to his retail job, he is a substitute teacher and a nighttime security guard, and delivers sandwiches for a fast-food chain.(Heidi de Marco/KHN)

Tiffany Cano feeds 10-month-old Brody on Oct. 20, 2018. She works 40 hours a week at a local bank as a compliance officer, commuting more than 90 minutes each way, while Brody attends a local day care center. Because her husband works so much, she says, she often feels as if she’s raising their son alone.(Heidi de Marco/KHN)

Mostly to pay off that health care debt, Robert has taken several part-time gigs this year — he works as a substitute teacher and a nighttime security guard and delivers sandwiches for a fast-food chain in Scottsdale, 40 miles away, where tips are better. He said he sometimes works up to 120 hours in a week.

“I’m not ashamed or embarrassed, even as old as I am, to deliver sandwiches,” he said, pulling on his retail chain polo shirt before rushing to a Saturday morning shift.

He continued: “I know people, they’d rather get food stamps and feel sorry for themselves. But I’m a fighter. I will not give up. … If I can bring in an extra $ 400 a week or $ 800 a month, she can get what she needs for the baby.”

Often getting home after midnight, he keeps shampoo and shaving cream in his car and naps in parking lots between jobs, relying on Red Bull and aspirin to stay alert.

That means on many nights, when Tiffany picks up Brody from day care after her 90-minute commute, she handles most of the chores at home.

“Sometimes I feel like a single mom because my husband is never around,” she said.

She carefully tracks the family’s medical expenses, trying to juggle them with ordinary outlays that can’t wait — like $ 500 for the brakes that went out on her car this month.

At the rate they’re going, the bills won’t be paid until Brody is 3, Tiffany said. The Canos are getting older and they’d like to have another baby before it’s too late, but, for now, that seems impossible.

For 2019, the couple have decided to switch to a different plan offered through the regional bank where Tiffany works. The premium is higher — $ 650 a month — but the deductible is $ 1,500 with just 10 percent coinsurance.

“It is going to be a lot more per paycheck, which is going to hurt us,” Tiffany said. “But after what just happened, I want to make sure we are prepared in case anything does occur.”

How to fix a health care system that burdens middle-class families so heavily is beyond her, she said.

“The only thing we can do is just keep working,” Tiffany said. “I always wonder: How does everybody else do it?”


KHN’s coverage of children’s health care issues is supported in part by the Heising-Simons Foundation.

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Doctors question medical care given to migrant boy who died Christmas Eve

Days after a Guatemalan boy died in US custody on Christmas Eve, infectious disease experts say it appears Felipe Alonzo-Gomez likely had the flu, a potentially deadly illness that can often be treated if caught early enough.


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Charity buys and erases past-due medical debt

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Massachusetts Stroke Patient Receives ‘Outrageous’ $474,725 Medical Flight Bill

Kristina Cunningham was in stable condition on an evening in June, when EMTs lifted her gurney into a medical flight, bound for Boston.

The 34-year-old couldn’t use her right arm or speak clearly after a stroke six days earlier, and still had two blood clots at the base of her brain. Cunningham’s dad, Jim Royer, remembers doctors at the small hospital in Wichita, Kan., where Cunningham had attended a family wedding, saying she needed to see a neurosurgeon.

“There was discussion of flying her to St. Louis, there was discussion of flying her to Chicago, there was discussion of flying her to Dallas,” Royer recalled, but “we don’t have family in any of those locations.”

So the doctors arranged to transfer Cunningham, via an Angel MedFlight Learjet, to Massachusetts General Hospital, where she would be diagnosed with a rare blood vessel disease of the brain. MGH is about an hour from Cunningham’s home in Berlin, Mass. — and her 7-year-old son. Cunningham’s doctors and her insurer, CareFirst BlueCross BlueShield, based in Maryland, agreed the transfer was medically necessary.

“We assumed it would be [covered],” Royer said, “because it was supposedly preapproved by the insurer before any flight took place.”

Royer said he and Cunningham didn’t think about the Angel MedFlight piece of her health scare again until a letter arrived in August. It was a one-page “explanation of benefits” with a jaw-dropping total in a column labeled “other amounts not covered.”
“When I got the bill for $ 474,725, I’m thinking six or seven flights, and you can buy a whole new jet,” Royer said with a wry laugh.

That nearly half-million dollars is the total of four items, the largest of which is a per-mile charge. That figure, $ 389,125, breaks down to $ 275 a mile.

“It’s larger than any surprise medical bill I’ve personally seen,” said Chuck Bell, program director for the advocacy division at Consumer Reports. “It’s really outrageous.”

In a study last year, Consumer Reports detailed some of the reasons excessively high air ambulance bills have become more common. Use of air ambulances is rising as more rural hospitals close, baby boomers age and the use of telemedicine increases.

“The industry has really grown by leaps and bounds over the last 15 years and prices have doubled or tripled,” Bell said. “Most of the operators of air ambulances now are for-profit, Wall Street-type corporations reporting very large profits to investors.”

The Association of Air Medical Services (AAMS), a trade group, counters that it is not unique, that many hospitals and health insurers across the country are also for-profit and that some are owned by private equity firms.

AAMS said a key reason bills for patients with private insurance plans are often high is this: Companies have to make up for the money they lose transporting other patients.

“Medicare pays about 60 percent of the cost of the flight. Medicaid pays 35 percent or less. Self-paid patients pay a few cents on the dollar. And that has led to a crisis of being able to sustain the service,” Christopher Eastlee, AAMS vice president for government relations, said in a statement, stressing that he has cost data only for emergency helicopter transports, not jets like the one in which Cunningham traveled.

In 2018, Medicare paid $ 8.65 per mile for a fixed-wing aircraft like the Learjet that transported Cunningham. That’s a stark contrast to Angel MedFlight’s $ 275 charge per mile. There are no guidelines for determining reasonable charges in this case.

Cunningham’s insurer, CareFirst, initially paid $ 14,304.55, leaving about $ 460,420 unpaid. In Massachusetts, a ground-based ambulance could not demand that Cunningham pay the balance, as state law doesn’t allow so-called balance billing. But air ambulances are governed by federal aviation laws. There are numerous cases of companies demanding payments from patients. A few states have tried to intervene but been unsuccessful, with courts saying that federal law prevails.

Cunningham has been focused on recovering her speech and preparing for surgery. In January, she will meet with her doctors to decide which type of surgery they recommend for removing or bypassing the blood clots at the base of her brain.

But Cunningham and her father have another worry: what the mail may bring.
“I don’t know, we’ll see,” Cunningham said, with a shrug.

“It’s a big bill to be sitting out there wondering what’s going on,” said Royer, who contacted KHN-NPR’s Bill of the Month on his daughter’s behalf. “It would force her into bankruptcy.”

Angel MedFlight COO Andrew Bess told WBUR the company is negotiating with CareFirst and will not demand payment from Cunningham.

“We’re quite confident we’ll come to a clear resolution despite the insurer placing the patient in the middle of the dispute,” said Bess.

Royer said it was a letter from Angel MedFlight that sounded threatening. As he read it, the company told Cunningham she must sign over the rights for Angel MedFlight to negotiate with CareFirst or risk being held liable if the insurer did not pay. Cunningham signed the request.

Bell, with Consumer Reports, said agreeing to such terms can be risky. Some air ambulance companies ask for detailed information about the patient’s personal finances, information they then use to determine how much the patient can pay if the insurance reimbursement is deemed inadequate.

During inquiries for this story, CareFirst told WBUR it would increase the proposed payment to Angel MedFlight. The insurer said it had discovered an error in its initial reimbursement to Angel MedFlight. CareFirst is now proposing to pay $ 70,864.90, or about one-seventh of the original charge.

“Unfortunately, exorbitant charges like these by air ambulance providers are not uncommon,” said Scott Graham, a spokesman for CareFirst, in an email. “This is an issue because companies like Angel MedFlight typically do not contract with health insurers on negotiated rates.”

WBUR forwarded this update to Bess, who called it a “meaningful offer” in his emailed response.

“We provide a valuable service, and for that providers should be fairly compensated and reimbursed,” Bess said. “We strive to work with our patients and advocate on behalf of them to get coverage rightfully owed to them under their insurance plans.”

Royer, a retired Air Force air traffic control systems manager, knows something about the cost of operating jets. To him, it looks like Angel MedFlight inflated the bill, hoping the insurer would agree to a generous settlement.

“I guess that the way things work nowadays. You ask for the moon and if you only get a large island, that’s what you get,” Royer said.

Bess responded to Royer’s claim in a statement.

“Staffing what is essentially an Intensive Care Unit at 30,000 feet presents unique medical and aviation challenges that may not be apparent to those outside of the medical aviation industry,” Bess wrote. “The amount we receive per flight is a fraction of the billed charge.”

Patients caught up in an air ambulance billing dispute can file a complaint with the U.S. Department of Transportation.

A recent push for stricter federal billing regulations was stripped out of the Federal Aviation Reauthorization Act, passed in October. The legislation did establish a council of industry representatives, including air ambulance providers and insurance company representatives, among others, to write and re-evaluate consumer protections, including balance-billing practices. It did not add a requirement for more price and other data transparency called for in a Government Accountability Office report on the air ambulance industry.

The National Association of Insurance Commissioners says federal legislation is needed so that states can intervene to oppose unreasonable air ambulance charges. Lawmakers from rural states, including Sen. Jon Tester, a Montana Democrat, said they’ll reintroduce such legislation.

The air ambulance trade group says any such change would create “borders in the sky” that would interfere with lifesaving air rescues across state borders.

This story is part of a partnership that includes WBUR, NPR and Kaiser Health News.

Do you have an interesting or outrageous medical bill you’d like KHN and NPR to examine? Tell us about it!

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‘Widespread and dangerous’: Facing medical uncertainty, doctors tell patients it’s all in their heads

When 7-year-old Bailey Sheehan arrived at a hospital in Oregon partially paralyzed, a doctor said the girl was faking her symptoms to get her parents’ attention because she was jealous of her new baby sister.


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Gently stroking babies before medical procedures may reduce pain processing

Researchers found that gently stroking a baby seems to reduce activity in the infant brain associated with painful experiences. Their results suggest that lightly brushing an infant at a certain speed — of approximately 3 centimeters per second — could provide effective pain relief before clinically necessary medical procedures.
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Birth Justice: Where #MeToo and Medical Sexism Intersect

Never before have conversations about sexual harassment and violence been so commonplace. Around the world, feminists are declaring that they #BelieveWomen and women are telling their #MeToo stories. Despite a wave of fierce backlash to the feminist movement, we have broken the silence around the interpersonal and systemic violence that so frequently faces women, female-bodied, queer and trans people.

But I can’t help but notice a huge blind spot around birth.

Thousands of birthing women experience violence every day. (George Ruiz / Creative Commons)

UNICEF estimates that about 353,000 babies are born each day around the world—and in the process, thousands of birthing women experience violence. Birthing people are often coerced, threatened and violated during and after labor; they are separated from their babies, ignored by their doctors and forced into numerous other inhumane acts perpetrated by the patriarchal hospital system.

Doulas often say there is a “hidden epidemic” of doctors abusing women in labor—and in the last five years alone, women have begun to speak up about obstetrical violence. Caroline Malatesta won a lawsuit against the hospital where she gave birth after she suffered from PTSD and permanent nerve damage in response to the nurse forcefully holding her baby in her vagina while she waited for the doctor to come into the room. A woman known by the pseudonym “Kelly” sued her obstetrician for assault and battery after he conducted a multiple-cut episiotomy after she explicitly refused the procedure. 

But there are still millions of cases globally where the rights of birthing people are ignored—where their genitals are touched or cut without their consent, or their bodies are used in ways they explicitly refused. It is not uncommon to see doctors forcefully conduct vaginal exams on women during labor, even while they explicitly tell them to stop, for no medical reason whatsoever—a course of action that is, by definition, rape.

The #MeToo movement has openly grappled with the issues of privilege that shape its explosion. It takes privilege to stand up and say that one has suffered sexual harassment, abuse and rape. It is, in some ways, still a privilege just to be believed once you have spoken up. For every story told with the hashtag, thousands of stories go untold by women around the world because they fear greater violence or disenfranchisement. 

While every woman is vulnerable to obstetric violence, we are not all affected equally. Immigrants, people of color and poor folks are the least likely to be heard, and in many cases the most likely to be impacted, by birthing violence. In the U.S., black birthing people are dying in childbirth three to four times as often as white women. Latinx birthing people are dying twice as often as white women. 

My partner’s mother was raped when she went to her doctor for a routine prenatal checkup; she stopped going to that doctor, but didn’t report him to the hospital because race and class dynamics made her feel that nobody would listen. My grandmother is more willing to talk about the horrible atrocities she suffered during the Holocaust as a teenager than her first birth experience in a Brooklyn hospital in 1962—in which she was strapped to a bed, verbally abused and locked in a room alone during labor, and then separated from her baby for a week and discouraged from breastfeeding.

Unfortunately, although the vast majority of doctors have good intentions and want to take care of their patients as best they can, they work in a system that does not prioritize consent, that positions their patients as less knowledgeable about their own bodies than they are and that sets up a power dynamic where doctors can exploit their knowledge to get inappropriate access to their patient’s bodies. 

This violence is rooted in the history of the field: James Marion Sims, known as “the father of modern gynecology,” conducted experiments against female slaves without their consent and without anesthesia; today, medical students are still sometimes taught to perform pelvic exams on anesthetized women without their knowledge or consent—a practice that is only illegal in four states.

The midwifery model of care offers a much-needed alternative to western obstetrics. Midwifery, a century-old craft which means “with woman,” utilizes a model that prioritizes holistic female well-being. It is not only about keeping the birth safe—it is about keeping the birthing person feeling safe, and thus protecting the physiological process of birth.

We are all born, and medical research has concluded that birth affects us in deep, lasting and powerful ways. If mothers feel unsafe, violated or abused during births, their newborn babies will store those experiences in their nervous systems. Whether we are born through a cesarean section, vaginally in a hospital with an epidural or at home, our birth experiences affect us for the rest of our lives. 

Birth justice is finally becoming a part of the conversation, with states like New York and California creating initiatives to attempt to address the birth disparities facing communities of color—but we have so much more to do. We need to start calling obstetric violence what it is, and we need to start connecting the dots between #MeToo and medical sexism.

Men who are true allies to women need to be actively engaging with other men to end rape culture, and obstetricians must band together to stop obstetric violence. Men need to stop thinking that they deserve control over female bodie, and doctors need to stop thinking that they can do anything they want to our bodies under the guise of practicing medicine.

Marea Goodman is a home-birth midwife practicing in Oakland, California. 

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Kaiser Permanente Opens New Beaverton Medical and Dental Office

PORTLAND, Ore. — Today, Kaiser Permanente opens its new Beaverton Medical and Dental Office. The new facility is our vision for the future of health care: person-centered care for body, mind and spirit, powered by innovation.

The three-floor, 90,000-square-foot facility replaces the current Beaverton facility that opened nearly 50 years ago, and is the first Kaiser Permanente facility outside of California that was built from the ground up to harness design, technology and workflow to create an intuitive and convenient experience for members and care teams.

This state-of-the-art care facility features a public square at its heart to educate, engage and inspire wellness, and appointment notification text alerts allowing patients to relax, enjoy something from the café, or take in the Northwest-created art displayed throughout the building. Larger exam rooms are designed to be less clinical and more conversational, and digital screens let providers share notes and display other medical information.

Medical and dental — together

One of the innovative ways that Kaiser Permanente is a national leader in care delivery is with medical and dental integration, which leads to improved health outcomes. For example, clinicians can look ahead at the dental patients on their schedule to see whether they’re due for any medical procedures, such as flu shots, immunizations or blood pressure checks, which can be taken care of during their visit. Because of Kaiser Permanente’s integrated medical record, a dental team provider can then, for example, send a message directly to the patient’s primary care doctor.

“Kaiser Permanente is unique in our movement toward integrated medical and dental care, and our new Beaverton office was built from the ground up to offer a convenient and highly personal total health experience,” said Curt Lemrick, DMD, the lead dentist at the new office. “Dental health can often give clues about a person’s overall health, and we strongly believe that the future state of medicine will be one where the two are integrated. We’re excited our Beaverton neighbors can now receive all of their medical and dental care in this state-of-the-art facility.”

Key Services

  • Primary care for adults and children
  • Dental care and dental hygiene services for adults and children
  • Imaging
  • Laboratory
  • Occupational Health
  • Nurse Treatment Center
  • Pharmacy
  • Urgent Care
  • Vision Essentials/Optometry

The new medical and dental office is adjacent to the old building at the corner of Western Avenue and Beaverton Hillsdale Highway. (The old building will be razed in 2019.)


About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 12.2 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to kp.org/share.

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This patient’s medical record said she’d given birth twice — in fact, she’d never been pregnant

Medical record errors are extremely common and can be life-threatening. For 20-year-old patient Morgan Gleason, it took many hours to fix a glaring mistake. 
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Kaiser Permanente Moanalua Medical Center Maintains “A” Grade for Patient Safety

HONOLULU — The Leapfrog Group, a nonprofit advocate for health care transparency, has awarded Kaiser Permanente Moanalua Medical Center its seventh straight “A” grade in the Fall 2018 Leapfrog Hospital Safety Grade. The Hospital Safety Grade, administered in the spring and fall every year, measures the overall performance of more than 2,500 hospitals nationwide in keeping patients safe from preventable medical errors. Moanalua Medical Center is 1 of 4 hospitals in Hawaii honored with the Straight A distinction of receiving five or more consecutive A grades.

The Hospital Safety Score uses hospital performance data collected by national health care organizations, including the Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services. Scores are calculated based on 27 types of publicly available hospital data related to patient care, medication errors and infection prevention. It’s published as a free resource to help patients and their families make informed health care decisions. Only 32 percent of hospitals in the U.S. have received an A grade in the Fall 2018 report.

“Patient safety is a top priority at Kaiser Permanente, and we’re proud of our doctors, providers and staff who work together to create a healthy healing environment for patients,” said Linda Puu, RN, vice president of quality, safety and care experience at Kaiser Permanente in Hawaii. “Our integrated electronic health record system and coordinated care approach helps reduce errors and safety risks, which improves patient outcomes and ensures a higher quality of care.”


About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 11.8 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to kp.org/share.

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Flipped classroom enhances learning outcomes in medical certificate education

The quality of medical certificates written by students of medicine was better when they were taught by using the flipped classroom approach instead of traditional lecturing. A randomly selected student from the flipped classroom group had an 85 percent probability to receive a better total score than a student from the traditional teaching group, according to a new study.
Literacy News — ScienceDaily

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Thai lawmakers back medical marijuana amendment

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Keiki Patients Enjoy Halloween Fun at Kaiser Permanente Moanalua Medical Center Trick-Or-Treat Event

HONOLULU — Kaiser Permanente Moanalua Medical Center held its annual trick-or-treat event for the hospital’s youngest patients today, celebrating Halloween with festive costumes, decorations and healthy treats. Eight pediatric patients ranging in age from toddlers to teens traveled through nearly every floor of the facility, showing off their costumes in exchange for stickers, coloring books and healthy snacks from physicians and staff.

Baby shark and friends enjoyed the healthy treats from staff.

Baby shark and friends enjoyed the healthy treats from staff.

Dressed as superheroes and movie characters, keiki visited General Surgery, Cardiology, Food & Nutrition and other departments to take in the hospital’s Halloween decorations and meet physicians and staff in costume. Five young patients who were unable to leave the pediatrics floor received a special delivery of Halloween treats delivered to their rooms by staff members.

“Our annual Halloween trick-or-treat event is a favorite for physicians, staff and parents, because it allows our young patients to celebrate the holidays without leaving the hospital,” said Kathryn Martin, RN, manager of pediatrics at Moanalua Medical Center. “We look forward to brightening the spirits of all our keiki with healthy treats and festive Halloween fun.”


About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 12.2 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.

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California’s Medi-Cal program paid $4B to recipients who may have been ineligible, audit shows

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http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News

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‘Weed the People’ Explores Medical Marijuana for Kids With Cancer

Marijuana, both medicinal and recreational, is growing more mainstream. Medical marijuana is now legalized in a majority of states, and 62% of Americans support legalizing it outright — but in the political realm, the plant has long been controversial.

Now, a new documentary called Weed the People, which opens in some theaters in October, explores the potential of medical marijuana for childhood cancers and the regulatory hurdles facing people who want to use cannabis. The film, which was executive produced by former talk-show host Ricki Lake, follows five families using cannabis oils to treat pediatric cancers. Some of the children used cannabis alongside treatments like chemotherapy, while others turned to the drug after conventional treatments had failed.

Lake became interested in medical marijuana when her late ex-husband, Christian Evans, began researching cannabidiol (CBD) — a compound in marijuana that does not cause a high —for his own health issues, including chronic pain and ADHD. (Evans died by suicide last year.) The two met a young girl with a tumor disorder whose family was desperate to get her off chemotherapy, and they helped connect her with a doctor who specializes in medical marijuana. Lake and her production partner, director Abby Epstein, were inspired to find other families in similar situations and tell their stories on screen. They made Weed the People to explore the potential of medical marijuana, and the regulatory challenges families and researchers must overcome to use it.

“I want to get people seeing it as a medicine, seeing what it was able to do for these children, and fight for this medicine to be available to everyone who needs it,” Lake says. “It’s a human rights issue.”

The film paints a rosy, anecdotal picture of the effectiveness of cannabis oils; some of the children featured had their tumors shrink substantially or disappear entirely, even if they were using cannabis oils in place of chemotherapy and other conventional treatments. “You can’t say the ‘cure’ word,” Lake says, “but how else do you explain it?”

But the concept is far from proven and could even be dangerous. While there is some evidence that marijuana can ease chronic pain and chemotherapy side effects, the American Cancer Society (ACS) warns that “relying on marijuana alone as treatment while avoiding or delaying conventional medical care for cancer may have serious health consequences.” And while some studies have shown that compounds in marijuana can slow growth of or kill tumor cells in animals or lab dishes, evidence in humans — particularly around marijuana oils — is lacking, the ACS says. While conventional treatments like chemotherapy are still the standard, pediatric cancer providers are increasingly voicing their support for the use of medical marijuana, particularly in palliative or end-of-life care when other treatments may not be necessary.

More research is needed to learn about the potential effects and limitations of cannabis-derived medicines for both adult and pediatric cancers. As the families and experts in Weed the People see it, this lack of evidence is precisely the problem — and it’s exacerbated by current regulations around medical marijuana.

Marijuana, like heroin and LSD, is classified by the Drug Enforcement Administration (DEA) as a Schedule I drug, meaning it has “no currently accepted medical use and a high potential for abuse.” But in June, the FDA approved the first drug derived from marijuana, a purified version of CBD called Epidiolex, for kids and adults suffering from two rare forms of epilepsy; the DEA then rescheduled Epidiolex (but not CBD as a whole) to schedule V, the lowest restriction classification for controlled substances. Researchers who wish to study cannabis need a Schedule I drug license and must submit to background checks and site visits from the DEA.

The DEA also only permits one institution, the University of Mississippi, to grow marijuana for study, though DEA spokesperson Melvin Patterson says it is planning to grant additional licenses to other growers, which would “increase access to marijuana for researchers, potentially increase the number of available strains for research, and may foster additional research on marijuana.”

This means scientists are limited to studying only the products and formulations available from the University of Mississippi, which doesn’t include popular consumer products like vapes and edibles, says Dr. Jeff Chen, director of the University of California Los Angeles Cannabis Research Initiative. “At my office at UCLA, I look out my window and I can count two dispensaries that I can see,” Chen says. “We can’t touch that cannabis—not even to understand what’s in it.”

As a result of these challenges, many families who wish to use cannabis, including those in the documentary, are forced to buy it from sources outside the conventional medical system, and must trust that what they’re using is safe. “I just find it absolutely staggering to accept that in this day and age, with the billions of dollars that are spent on cancer research, the medicine we were relying on was made in somebody’s kitchen,” says Angela Smith in the film, whose son, Chico, uses cannabis oils to treat his soft tissue cancer.

Chen, who was not in the film but shares its frustration with current marijuana regulations, became swayed by the medical potential of cannabis compounds early in his career, when he encountered a young patient with epilepsy whose parents were treating her with CBD. Unfamiliar with CBD, Chen and his colleagues almost called Child Protective Services to intervene—until Chen looked into the compound further and saw how much he didn’t know.

“That’s when I realized that science had completely left cannabis in the dark,” Chen says. “It was time for science to step up and really to push on this issue. I felt a duty.” Today, Chen works to understand the health benefits and risks of marijuana and its many compounds, including CBD.

The film also touches on funding challenges associated with marijuana research, an impediment Chen has encountered with his own research. While the government does fund some marijuana research, Chen says the “vast majority” of federal dollars go toward understanding the harms of cannabis, not the potential benefits. Researchers who wish to study how marijuana may improve treatment for conditions ranging from cancer to chronic pain are largely left to find the money themselves, Chen says.

These roadblocks have led many researchers, including those quoted in the film, to call for looser marijuana scheduling, but the DEA denied two such petitions in 2016. Dr. Igor Grant, director of the Center for Medical Cannabis Research at the University of California San Diego, who was not in the film, agrees that current regulations have made research more difficult, and says marijuana probably doesn’t belong in schedule I. But he says he doesn’t believe that the government is actively trying to stifle cannabis research, as many people—including some in Weed the People—have alleged.

Grant says there’s some evidence that the barriers are becoming fewer. His lab recently made history by importing research-approved marijuana from Canada, a move that suggests U.S. researchers may soon have greater access to the plant. That access, combined with lighter regulations from the government, could open new doors, Grant says.

“You would have to both reschedule it and increase the availability of manufacturers,” he says. “This could be a joint effort between states, manufacturers, academia and federal [regulators].”

This type of collaboration is crucial, Lake says, and she hopes her documentary will garner public support for it. “I’m really hoping to reach the people who really have this idea that this drug is bad,” Lake says. “It’s a matter of just changing mindsets and having them fight to have access to this plant. I do believe change is coming.”


Entertainment – TIME

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