Friday, November 30, 2012

Medical Imaging ♥ NASA

Here is a gem for the Mars mission naysayers from a clinical perspective. Though we can argue whether the US Preventive Service Task Force (USPSTF) recommendation for routine mammography screenings starting at age 50 is economically justified, translational science seems like a pretty good idea:




Tuesday, November 20, 2012

Improving School Lunches and Curbing Obesity: The Healthy, Hunger-Free Kids Act

As American obesity continues to reach epidemic proportions, there is increasing focus on starting at the source: the kids!

I have previously commented on the complexity of forces at play here. Also worth investigating is The Healthy, Hunger Free Kids Act, which received rare bipartisan support, was signed by President Obama in Dec. 2010, and is being rolled out this academic year across the country. Below is another great graphic from Peter Kim, et al, followed by additional info on the law's implementation:

School Lunch Infographic


So what does the Act actually do?

Improves Nutrition and Focuses on Reducing Childhood Obesity 
  • Gives USDA the authority to set nutritional standards for all foods regularly sold in schools during the school day, including vending machines, the “a la carte” lunch lines, and school stores. 
  • Provides additional funding to schools that meet updated nutritional standards for federally-subsidized lunches. This is an historic investment, the first real reimbursement rate increase in over 30 years. 
  • Helps communities establish local farm to school networks, create school gardens, and ensures that more local foods are used in the school setting. 
  • Builds on USDA work to improve nutritional quality of commodity foods that schools receive from USDA and use in their breakfast and lunch programs. 
  • Expands access to drinking water in schools, particularly during meal times.
  • Sets basic standards for school wellness policies including goals for nutrition promotion and education and physical activity, while still permitting local flexibility to tailor the policies to their particular needs. 
  • Promotes nutrition and wellness in child care settings through the federally-subsidized Child and Adult Care Food Program. 
  • Expands support for breastfeeding through the WIC program.
Increases Access 
  • Increases the number of eligible children enrolled in school meal programs by approximately 115,000 students by using Medicaid data to directly certify children who meet income requirements. 
  • Helps certify an average additional 4,500 students per year to receive school meals by setting benchmarks for states to improve the certification process. 
  • Allows more universal meal access for eligible students in high poverty communities by eliminating paper applications and using census data to determine school-wide income eligibility. 
  • Expands USDA authority to support meals served to at-risk children in afterschool programs.
Increases Program Monitoring and Integrity 
  • Requires school districts to be audited every three years to improve compliance with nutritional standards. 
  • Requires schools to make information more readily available to parents about the nutritional quality of meals. 
  • Includes provisions to ensure the safety of school foods like improving recall procedures and extending hazard analysis and food safety requirements for school meals throughout the campus. 
  • Provides training and technical assistance for school food service providers.
For more information and implementation timelines, visit the USDA Healthy, Hunger-Free Kids Act homepage and the USDA blog.

Monday, September 17, 2012

Health Reform, The Election, and Beyond


Health Reform in 2012 –
Crunch Time, Part Two

By Adam Dougherty, MPH, MS III

This is the second piece in a two-part series on a
decisive year in health care policy.

IN THE WAKE OF THE RECENT Supreme Court
ruling of the Affordable Care Act (ACA) and in
anticipation of the November elections, the
drama of 2012 has only just begun. The future
of our new American health care system remains
an uncertain one, but the potential paths
forward have indeed grown clearer.

Supreme Court Debrief
As the dust begins to settle after the Supreme
Court’s ruling, it is worth recapping what
actually happened and what it means. Starting
in 2014, every qualifying American citizen will
be obligated to have health insurance coverage.
While my correct prediction wasn’t entirely
accurate as far as which justices would vote in
favor,1 I'll point out that I was in the extreme
minority among peers and colleagues in even
coming close! That being said, I will admit I did
not sleep much the night before the ruling, and I
may have PTSD from the moment of sheer
terror when CNN initially botched the call.
In the ruling's supporting opinion, Chief
Justice John Roberts explains that the mandate
does not fall under the jurisdiction of the
Commerce Clause. Rather, he interprets it as
legal through the taxation authority granted to
Congress. In its simplest interpretation, yes, the
mandate is a tax. More accurately, though, it is a
monetary penalty on those individuals who
choose not to purchase health insurance.

Contrary to some doomsday shock jocks,
this is not “the biggest tax increase on the
middle-class in our history,” as the vast majority
of rational Americans would opt for some form
of health insurance anyway. More so, there will
be exemptions from the mandate for individuals
with religious objections or for those who can't
afford insurance even with the exchange
subsidies (e.g. up to three months coverage for
those between jobs).

For the handful of individuals who take
freedom to the extreme by voluntarily foregoing
health coverage, they will see an annual penalty
on their tax returns that will theoretically
subsidize the health care that they eventually
might need. It is also worth noting that the law
explicitly prohibits the IRS from “aggressive
efforts to collect the penalty” (i.e. threatening
jail-time), and will most likely occur through
withholding of tax returns.

The Medicaid aspect of the Supreme Court
ruling was also significant, as the court felt that
obligatory expansion of eligibility to 133 percent
of the federal poverty level ($15,000 for an
individual, $30,000 for a family of four in 2012)
was beyond Congress' authority. This provision
has huge financial implications for states,
counties, businesses, health providers, and
patients as it is almost wholly federally funded.
Despite the Feds picking up the bill, several
conservative governors have jumped on the
opportunity to refuse this piece of Obamacare.
Unfortunately, these are the states which have
some of the highest uninsured rates and would
precisely be the ones to benefit most once
enacted in 2014. While many of the quick
responses from the likes of Rick Perry and
Bobby Jindal might merely be political
pandering, the chorus of local opposition will
undoubtedly rise from county hospitals, health
insurers, state medical societies, and patient
advocacy groups.

Similar knee-jerk reactions took place in the
1960s with the original creation of the Medicaid
program, which all states eventually ended up
implementing despite it being completely
voluntary. I predict that most states will fall into
line to tap into the 2014 revenue stream.

To those who worry that this “investment”
in Medicaid expansion will bury us in debt, the
nonpartisan Congressional Budget Office (CBO)
says otherwise. They now estimate that the ACA
will cost $84 billion less over 11 years than what
was originally forecasted. By expanding the pool
of insured persons and reducing expensive
rescue care, they estimate an overall reduction in
the national deficit by $109 billion over this
time frame.2 Of note, California is expected to
fully implement the expansion, bringing
coverage to over three million previously
uninsured Californians.

The ACA has now survived all three
branches of government, and the Supreme
Court seal of approval will allow the state-based
health insurance exchanges to move full speed
ahead. Many state legislatures will still opt out of
creating their own exchanges, but the law allows
for a national exchange to fill these gaps. In the
meantime, the law continues to quietly roll out
new consumer benefits, with the most recent
being the Medical Loss Ratio standard for health
insurers.

Under this standard, health plans are
required to spend at least 80 cents of every
dollar on actual health care services instead of
on marketing, profits, and overhead. And if they
don't? Then their customers get a rebate check
for the amount they underspend on actual care –
which was the case this year for 12.8 million
Americans to the tune of $1.1 billion averaging
$151 dollars for each family.3

Skimming off fewer health care dollars for
profit or executive compensation probably
appeals to most health care consumers. Of note,
Medicare, despite all its critics, has significantly
lower overhead costs than private insurances.4

November and Beyond
Looking to the November elections, it is not
unrealistic to call 2012 a referendum on health
reform. Public opinion of the law is still largely
divided, half in favor and half opposed.5 In a
one-term presidency scenario (and an
accompanying Republican sweep of the House
and Senate), we would see extensive reversals of
the last two years. While the “Repeal on Day
One” slogan is effective at the podium, laws
cannot be overturned in one swift Executive
Order.

Given the near impossibility of obtaining 60
seats in the Senate (the filibuster-proof level
needed to pass anything anymore), Republicans
would use the Reconciliation Process to
overturn/augment many budget-related items,
including the mandate penalties, Medicaid
expansion funds, and terminating the insurance
exchange subsidies and the Public Health and
Prevention Fund.

If the President prevails (in either a split
legislature or Republican legislature), the vast
majority of ACA provisions would remain, no
matter how many presidential vetoes are
exercised. Hence, 30 million individuals would
still gain insurance coverage, and the Medicaid
program would be fundamentally preserved.
In either scenario, a continued focus on the
deficit will remain, as the post-election lame
duck session requires dealing with the failed
Super Committee and its looming $1.2 trillion
in “sequestration” cuts, which would spell
substantial reductions to Medicare, Medicaid,
and other health programs. Regardless of the
election outcome, harder questions remain with
the biggest drivers of the long-term deficit
including the projected spending in Medicare
and the flawed SGR formula.

Medicare eligibility age extension, assetbased
cost sharing, expanded value-based
purchasing, and the Independent Payment
Advisory Board (IPAB) are a few of the more
controversial but necessary strategies being
considered. Bold steps may be taken in the
ensuing 113th and 114th Congresses to address
long-term health spending as the nation
recovers from the Great Recession, and the
medical profession will continue to have a
central role to play in shaping these decisions.
Now more than ever, it is essential for
current and future physicians to be engaged in
the conversations and deliberations that will
shape our evolving American health care. How
health reform translates from words on paper to
what happens in our exam rooms is a process
still unfolding.

1 Dougherty, A., “Health Reform in 2012 – Crunch Time,
Pt. 1”, SSV Medicine, May/June 2012.
2 Estimates for the Insurance Coverage Provisions of the
Affordable Care Act Updated for the Recent Supreme
Court Decision, Congressional Budget Office, July 24,
2012.
3 Health Care Law saves consumers over $1 billion, US
Department of Health and Human Services, June 21,
2012.
4 Steffie Woolhandler, Terry Campbell, and David U.
Himmelstein, “Costs of Health Care Administration in
the United States and Canada,” The New England
Journal of Medicine, August 21, 2003, 768–75.
5 Kaiser Health Tracking Poll: Early Reaction to
Supreme Court Decision on the ACA, Kaiser Family
Foundation, June 2012.

Thursday, August 16, 2012

What Health Care Fraud is Costing You, and What You Can Do About It

From Peter Kim and colleagues

what healthcare fraud is costing you


...and thanks to the Affordable Care Act, over 1,400 individuals have been charged with criminal fraud, an increase of 75% from previous years, recouping over $10.7 billion in taxpayer dollars since 2009!

 

Thursday, July 19, 2012

The Supreme Court ♥ Health Reform: What it Means and What's Next

As the dust begins to settle after the Affordable Care Act's post-SCOTUS ruling, it is worth recapping what actually happened and what it means for the future of American health care. This can be broken down into a few major themes:

1) The Individual Mandate: Upheld by a 5-4 vote
Starting in 2014, every qualifying American citizen will be obligated to have health insurance coverage. While my correct prediction wasn't entirely accurate, I'll point out that I was in the extreme minority among my peers and colleagues in even coming close! That being said, I will admit I did not sleep much the night before the ruling, and I may have PTSD from the moment of sheer terror when CNN initially botched the call.

In the ruling's supporting opinion, Chief Justice Roberts explains that the mandate does not fall under the jurisdiction of the Commerce Clause. Rather, he interprets it as legal through the Taxation Authority granted to Congress. In it's simplest interpretation, yes, the mandate is a tax. More accurately, though, it is a monetary penalty on those individuals who choose not to purchase health insurance. No, this is not 'the biggest tax increase on the middle-class in our history', as the vast majority of rational Americans desire some form of health insurance (and don't forget that there will be exemptions from the mandate for individuals who can't afford insurance even with the Exchange subsidies, for those with religious objections, and up to three months for those between jobs). For the handful of individuals that take Freedom to the extreme of voluntarily foregoing health coverage, they will see an annual penalty on their tax returns that will theoretically subsidize the health care these individuals will almost certainly receive at some point in their lives. It is also worth noting that the law explicitly prohibits the IRS from 'aggressive efforts to collect the penalty' (i.e. threatening jail-time), and will most likely occur through withholding of tax refunds. The CBO projects around 4 million individuals will forgo insurance and pay the penalty, most likely young healthy individuals who feel they are healthy enough to go without it. Here is a great breakdown from the Kaiser Family Foundation of how this works:




2) Involuntary Medicaid expansion: Overruled by a 2-7 vote
The ACA included language that obligated states to expand their Medicaid eligibility to 133% of the Federal Poverty Level ($15,000 for an individual, $30,000 for a family of four in 2012), potentially expanding eligibility to 16 million more Americans. This expansion would be fully funded by the federal government for ten years, and 90% federally funded thereafter. If states refused, they could lose all existing Medicaid funding. The Court felt that this was beyond Congress' authority, though, and determined that this expansion should thus be completely voluntary. While the provision turns out to be a great deal for states, counties, businesses, health providers, and patients, several conservative governors have jumped on the opportunity to refuse this piece of Obamacare. Unfortunately, these are the states that have some of the highest uninsured rates and would precisely be the ones who would benefit the most. Here is a breakdown of the most recent state-level stances, and go here for the interactive version:


http://www.advisory.com/~/media/Advisory-com/Daily-Briefing/2012/07/DB_medicaid_map_lg_7_12.jpg


While many of the quick responses from the likes of Rick Perry and Bobby Jindal may merely be political pandering in an election season, the chorus of local opposition will undoubtedly rise from county hospitals, health insurers, state medical societies, and patient advocacy groups. These should be interesting developments to watch after the elections.

3) Looking Ahead
The ACA has now survived all three branches of government, and the 'full repeal' mantra will slowly lose steam in the public view. Clearly, the November election will truly determine the fate of the law's effectiveness, as a complete Republican takeover could gut many of the financing mechanisms even without a Senate super majority. For now, the SCOTUS seal of approval will allow the state-based health insurance exchanges to move full steam ahead. Many state legislatures will still opt out of creating their own exchanges, but the law allows for a national exchange to fill these gaps. In the meantime, the law continues to quietly roll out new benefits, with the most recent resulting from the Medical Loss Ratio standard for health insurers, where health plans are required to spend 80 cents of every dollar they spend on actual health care services instead of marketing, profits, and overhead. And if they don't? Then their customers get a rebate check for the amount they underspend on actual care, which was the case this year for 12 million Americans, to the tune of $1.1 billion.

Sunday, June 3, 2012

Health Reform in 2012 – Crunch Time


By Adam Dougherty, MPH, MS II


 This is the first piece in a two-part series on a decisive year in health care policy. 


THE DECISIONS MADE IN 2012 WILL dictate much of the health care landscape for decades to come. At the state level, implementation of the Affordable Care Act (ACA), an uncertain future for Medi-Cal, and a seemingly never-ending state budget struggle are the major foci. The national spotlight includes a Supreme Court ruling on the individual mandate, the “budget trigger,” and the November elections.

As a medical student with an interest in public health policy, I like to follow these developments because my classmates and I worry about the current health care system, how it will sustain the public in the coming years and our role as future physicians.

March 23rd marked the two-year anniversary of the passage of the ACA into law. It is by no means a perfect fix to our health care system, but even at this early stage in its rollout before the major reforms in 2014, health care reform has already lead to real programs helping real people today.

For example, the unethical practice of rescissions and denial of insurance based on pre-existing conditions for children are a thing of the past (and will be for adults in 2014). Over 2.5 million young adults aged 19-25 have gained insurance through their parents’ health plan.1 The Pre-Existing Condition Insurance Plan (PCIP) has provided vital services to nearly 50,000 previously uninsurable individuals, with the California PCIP enrolling over 5,500 people.2

Finally, in 2011 alone, over 54 million Americans (and 6.2 million Californians) received preventive services with no cost sharing because of the ACA, a crucial step forward for public health. Furthermore, preventive medicine outreach to minority populations can be challenging. But nationwide in 2011, an estimated 6.1 million Latinos, 5.5 million African-Americans, 2.7 million Asian Americans and 300,000 Native Americans with private insurance received expanded preventive benefits as a direct result of the new health care law.3


The Golden State has positioned itself as a pacesetter in health reform. The California Health Benefits Exchange (HBEX) will be an innovative, competitive marketplace that will empower millions of consumers to choose the health plan and providers that give them the best value.

California has taken advantage of numerous federal funding streams offered through the ACA. This has pumped millions of dollars into the state for the following activities: dynamic payment and delivery reforms through the Center for Medicare and Medicaid Innovation (CMMI), community clinics and teaching health centers, and local health coverage efforts offered through the 1115 waiver known as the “Bridge to Reform.” Programs like these offer relief to the many county and state programs that have seen their dedicated funding streams evaporate in the last several years.

Yet, just at the moment that “help is on the way,” a perpetually anemic state budget has placed programs like Medi-Cal on the carving table. A looming 10 percent Medi-Cal rate cut for physicians has prompted a federal lawsuit challenging those cuts. The rate cut fight has gained national attention and puts the state and feds between a rock and a hard place.

If the cuts are upheld in federal court, this would essentially allow other states (like the anti-ACA red ones) to get a backdoor to dismantling pieces of the ACA through similar cuts and challenges. If overruled, it would be back to the budget-cutting drawing board for Governor Brown and Company. While unified opposition against the cuts are important for the physician voice, the bigger problem is the FMAP formula that determines how much California gets from the feds for Medi-Cal. As a young, “high-income state” with a large low-income population, we bleed federal tax dollars to states who can enjoy better matching funds. On a positive note, though, 2013 will bring two years of federally funded parity for Medi-Cal to match Medicare reimbursement levels for many services.


Few Supreme Court rulings have had more publicity, anticipation and significance than the challenges against the ACA’s individual mandate. This was exemplified by the unprecedented six hours of oral arguments heard by the Court on March 26-28, the longest in modern history for a case. How the Court ultimately rules in the next month or two will have major implications.

There are several pieces to the lawsuit. Perhaps not to be left out of the “can-kicking down the road” mentality embraced in state and federal legislatures, the Court dedicated two hours of argument to the option of invoking the Anti-Injunction Act. This option essentially states that a challenge to the individual mandate cannot even be heard before the law — or “tax,” so to speak — is imposed in 2014. But both sides of the individual mandate argument would prefer a decision now versus this prolonged uncertainty.

An accompanying challenge put forth to the Court is the Medicaid expansion component on the grounds of undue costs to states. Many experts believe that upholding such a claim would threaten the status quo of numerous federal-state contracts beyond just Medicaid, so the expansion is likely to be upheld.4,5

The next issue to be addressed is whether the mandate is “severable” from the rest of the ACA, and whether the whole law must be invalidated if the mandate is indeed found unconstitutional. While many of the smaller programs in the law can indeed be detached from the individual mandate challenge, the interdependence of guaranteed issue, community rating, health exchange subsidies, and the mandate — the major pillars of the ACA — will likely be seen as inseverable.

Finally, there is the mandate itself. While opponents believe that an individual mandate violates the Constitution’s Commerce Clause and that the “inactivity” (i.e. not buying health insurance) of the American people cannot be regulated, there is ample precedent to the contrary.6 In 1790, the first Congress (encompassed largely by the framers of the Constitution) required all ship owners to provide medical insurance for their sailors. In 1792 came the individual mandate to purchase a firearm (let your Amendment-rights-imagination run wild on that one), and in 1798 sailors were required to purchase hospital insurance for themselves.

Most relevant, though, is the 1942 Supreme Court case that upheld congressional authority to regulate the “noncommercial activity” of wheat growers, or more plainly that wheat which is grown but not sold. This ruling was reaffirmed in a case brought to Justice Roberts’ Court in 2005 regarding medicinal use of home-grown marijuana. Congress only lacks Commerce Clause power when a regulation is not economic in nature.

Few could argue that health insurance is not economic at any local/national or public/private level, as nearly every citizen is guaranteed to access health care at some point in his/her life. If market-based health care is a concept that we, as a nation, wish to preserve, while also assuring this care is eventually paid for, then the grounds for this economic standard become prudent, and more so, self-evident.

Given recent rulings and precedent, I predict Justice Kennedy will join the four liberal Justices in upholding the mandate. Chief Justice John Roberts may also rule in favor in order to improve the Court’s perceived certainty on the issue. Thus, summoning my inner oracle, I predict the 2012 Roberts Court to uphold the law with a final ruling of 6-3!

Tuesday, May 1, 2012

HFCS, Misguided Public Subsidies, and Soda Taxes Oh My!

As I have discussed previously here and here, food costs and health behavior are intimately linked. I expanded on these concepts in a recent edition of SSV Medicine in an article entitled Is it Time to Tax Soda? Below is the article in its entirety. Enjoy!

By Adam Dougherty, MPH, MS II

IN THE LAST LEGISLATIVE SESSION, Assembly member Bill Monning (D-27) introduced AB669, a bill that would have imposed a one-cent-per-ounce surcharge on every soda and sugar-sweetened beverage sold in California.

 The revenue generated would have created the Children’s Health Promotion Fund, raising a projected $1.7 billion a year for programs that have suffered from the state budget crisis — like school lunch programs and physical education programs. Funds could also have been used to develop new programs targeting obesity prevention in children and enhancing community parks and other targeted endeavors.

While the bill ultimately died in Committee, the concept may gain traction over the next several years. Is a soda tax a realistic solution? Here are some numbers to consider from the California Center for Public Health Advocacy (CCPHA), as well as from Michael Pollan, a 2010 member of the TIME 100 Most Influential People roster:


  • Per capita soda consumption has increased nearly 250 percent over the last 30 years.
  • Added sweeteners represent 16 percent of the average daily dietary intake.
  • Since 1985 the percent of personal income spent on food has decreased from 15 percent to 10 percent. Conversely, the real price of fruits and vegetables has increased by 40 percent while the real price of packaged food and soft drinks has decreased by 25 percent.
  • In California, 56 percent of adults and 28 percent of children are obese or overweight.
  • An estimated $41 billion is spent every year in California as a result of chronic disease costs in the obese, most notably diabetes.

It is hard to argue against the fact that obesity rates have reached epidemic proportions. Skeptics of a new levy may see this as just another “tax and spend” maneuver, but it is important to understand that the health and productivity costs associated with complications from obesity are astronomical.

Since the beverage industry has benefited significantly from a rise in consumption, the argument goes that they should pay their fair share to address the epidemic. More so, a concerted effort to target this risk factor would likely pay off in savings in the long term — both in community ratings for health insurance (your premiums) and in Medicare costs (your taxes). Authors of a recent Health Affairs study found that a penny-per-ounce Sugar-Sweetened Beverage Tax would lead to significant reductions in morbidity, mortality, and health care costs, estimating that an ensuing 15 percent decrease in consumption annually would prevent 2.4 million diabetes person-years, 95,000 coronary heart events, 8,000 strokes, and 26,000 premature deaths, while avoiding more than $17 billion in medical costs.1


Also worth exploring is the following premise: Food prices are a significant contributing factor in regard to the above trends; and people, especially low-income individuals, are cost-conscious in what they purchase. Research has shown that food costs play a significant role in diet and consumer behavior, and overall economic factors may be a much larger influence than lifestyle or personal will.2

Simply put, the current system is geared to make the unhealthiest calories in the marketplace “the most-bang-for-your-buck” for the bottom half of all income earners. This is the group who already has the highest obesity rates.

Consider this relationship between energy density of selected foods and energy costs (in $/Megajoule) in the image below.

The question of whether a soda tax is “the right answer” or “another horrible idea” will continue to be debated, but it is difficult to contest that the status quo is unacceptable. Already, tax dollars subsidize an unhealthy system, which public health departments are trying desperately to combat. Specifically, taxpayer-supported agricultural subsidies for products such as corn, soybeans, and wheat have decreased the price of energy-dense foods. As a result, we receive cheaper, ultra-sweetened but lower quality food such as manufactured high fructose corn syrup. The Farm Bill thus subsidizes obesity to the tune of $25 billion a year.



Energy cost
Attractively Dense Foods Are Also The Cheapest:3



In order to truly curb the obesity epidemic, it will be necessary to examine quality and health “costs” in addition to quantity and market costs in food production. The Farm Bill is up for reauthorization in 2012, and it would be smart to make food quality a bigger factor, nutritionally and fiscally. Shifting subsidies to healthier food products would not only promote better choices in the market as a whole, but would effectively link health to social productivity, efficiency, and a proper return on investment on public dollars.

The long-term consequences of the obesity epidemic cannot be understated. The average life expectancy has stagnated for the first time since recording began, and health care costs continue to grow at an unsustainable pace. Strategies to combat the epidemic must be multi-factorial, and occur through strong public-private partnerships.

A modest fee on one of the greatest culprits would not only help raise funds to better target obesity, but also justify the issue as a top priority to reduce future health care costs. The experiment in Denmark is worth watching, where the country recently implemented a surcharge on foods containing more than 2.3 percent saturated fat.


At the very least, there should be recognition that today’s reality of public health dollars spent on fighting an epidemic that is propped up by misguided publicly-funded food subsidies is irrational and wasteful. Consumers will continue to search for the best value (calorie) per dollar. Though ultimately personal choice decides what food is purchased, it is of the utmost importance for future policy to protect and promote our nation’s health and wellness, particularly through the nutritional value and affordability of our food products.

Wednesday, March 14, 2012

This Month in California: Free Health Care and Tax Check-Off for Cancer Research

I am not usually in the advertising business, but below are two timely developments that many in California could benefit from.

As tax filing season is upon us, Californians have an opportunity to contribute to vital cancer research through a tax check-off on your California tax return. The California Breast Cancer Research Fund and the California Cancer Research fund, both administered by the UC Office of the President, are accepting donations through your 540 tax form on lines 405 and 413, respectively. You can learn more about these programs' life saving research, as well as past destinations for these investments here.

The second is a project from the California chapter of Remote Area Medical (RAM), who have organized two events to provide free medical services to individuals in Northern California. On March 22-25, 2012 RAM will be in Oakland at the Oakland Coliseum and on March 30 - April 2, 2012 they will be in Sacramento at Cal Expo providing free medical, dental, and vision services. See below for more information (or download the PDF) and an excerpt from a 2008 60 Minutes episode that highlights the group's work.



Thursday, January 5, 2012

I Am ObamaCare.


Images like the one above that went viral in hours can arguably have a greater effect than any report, chart, or campaign slogan. While the majority of the benefits contained in health reform don't emerge until 2014, and as the public grows increasingly weary and skeptical of the law's ever-growing body of pending regulation, stories like this make crystal clear the fact that there are real programs helping real people today.

The program that this young lady is referring to is the Pre-Existing Condition Insurance Plan (PCIP). The PCIP is a federally funded program for the medically uninsurable, and allows individuals like her to obtain insurance and health care without having to wait for 2014 when the full 'guaranteed issue' law goes into effect nationwide. Here in California, the PCIP has enrolled about 5,000 people since it's inception one year ago, and with an additional $118 million recently awarded to the state, the largest-in-the-nation program can sustain even more subscribers at reduced premium rates.

Find out more about how to enroll in California's PCIP here, and learn about efforts nationwide here.