We all know that the healhcare industry is in flux right now and for Californians, it is even more uncertain. The annual California Employer Health Benefits Survey was released last Wednesday by the California HealthCare Foundation, a research and grant-making nonprofit organization. Among the findings, it seems fewer California companies offered their workers health insurance last year, and the ones that did charged employees more for their coverage.

A recent article from the Los Angeles Times by Marc Lifsher reports the findings and what the survey means for California Healthcare.

California leads nation in residents without health insurance
Coverage gap changes little, tops rest of U.S.
Friday, December 30, 2011

California had more residents without health insurance in 2010 — about 7 million — than any other state in the nation, according to a new study.

About 6 million adults younger than 65 and 1 million children lacked health coverage, according to data released this month by the California HealthCare Foundation. Over three years ending in 2010, an average of about 21 percent of the state’s nonelderly population was uninsured. That ranked eighth highest nationally on a list topped by Texas, where 27.3 percent lacked insurance.

Some of California’s numbers are almost exactly the same as in 2009. In both years, 21.5 percent of residents were uninsured, according to the nonprofit foundation’s annual tracking.

“You’ve had some disturbing trends not just over years but over decades of a gradual erosion of employer-based coverage and public programs picking up some but not all of the slack,” said Anthony Wright, executive director of the consumer advocacy group Health Access.

According to the study, 23.7 percent of working Californians were uninsured in 2010, higher than the national rate of 19.6 percent. Small businesses struggled the most to offer insurance, but 22.1 percent of people employed by private companies with 100 to 499 employees also were uninsured.

Steve Bower, who owns a truck-driving school in Oxnard, is covered through his wife. That will end when his divorce is finalized.

“No way I can afford it,” he said of getting a new policy. The 41-year-old Oak View resident worries about what would happen if he had an injury or illness and couldn’t run the school from day to day.

“I would be going in debt while I was in the hospital, and I would lose my company,” he said.

To read the rest of the article, go to http://www.vcstar.com/news/2011/dec/30/california-leads-nation-in-residents-without/

Although allergies peak in the spring and fall, the holidays may surprise sensitive sufferers with a gift of unexpected triggers, from dusty decorations and potent potpourri to even-say it ain’t so-the Christmas tree. Here are seven yuletide allergens, and expert tips to help you stay focused on shopping and wrapping, not sneezing and scratching:

1. Trigger: The tree
That’s right-the one and only, the centerpiece of all things Christmas, that perfect fir you found hiding in the lot of freshly-cut trees that’s now twinkling with the lights you spent hours untangling-may be to blame for your stuffy nose, watery eyes and rash-y skin. “Mold is the biggest problem with live Christmas trees,” says Marilyn Li, MD, an asthma and allergy specialist with the Los Angeles County + University of Southern California Medical Center. “Often, they are cut in advance and kept in humid environments, promoting spore growth.” Within just two weeks of bringing a tree into your home, indoor mold counts can increase significantly, according to one study. Other tree-related allergens: The sap contains terpene and other substances that can irritate skin and mucous membranes; and pollen stuck to the tree may be released inside and lead to reactions, adds Nathanael S. Horne, MD, clinical assistant professor of medicine at NYU school of Medicine and fellow of the American Academy of Allergy, Asthma & Immunology. What about the artificial versions? They could harbor dust and mold from their time in storage, also triggering allergies.

Prevent it: Slip on gloves and wear long sleeves when handling your fresh tree to avoid the sap coming into contact with your skin. Before schlepping your tree inside, give it a good shake (or a blast with a leaf blower) and spray it down with a garden hose (especially the trunk) to help remove some of the pollen and mold, suggests Horne. Then sit the stump in a bucket of water and let the tree dry for few days on a covered porch or in a garage. For an allergen-free fake tree, give it a good wipe-down before decorating with lights and ornaments.

2. Trigger: Decorations
For eleven months out of the year, all your ornaments, lights, and holiday chotchkes sit stored out of sight, collecting dust and maybe developing mold. When the boxes of red, green, and gold goodies come out, the symphony of sneezing, coughing and nose-blowing commences.

Prevent it: Before decking your halls, mantels, windows and trees, wipe down each item thoroughly; when it’s time to repack, store your holiday trimming in airtight containers, and in a dry spot if possible. Also, go easy on the spray snow-you may love the look of frosted windows, but any aerosolized chemical can cause irritant reactions in the eyes, nose or lungs of a sensitive person, says Horne.
3. Trigger: Your aunt’s homemade pie
The fact that she makes “Why aren’t you pregnant yet?” the topic of Christmas dinner is enough to make you break out in hives-but the nuts that she baked into her dessert crust could be to blame, too. If you have food allergies, the holidays in particular are a ripe time for reactions, simply because you’re around so. much. food. The most common food allergens are milk, eggs, soy, fish, shellfish, peanuts, tree nuts, and wheat. “Of those, peanuts and tree nuts will most often make it into holiday dishes without people knowing, and have the potential to cause severe reactions,” says Horne.

Prevent it: It’s a good idea to let your holiday host know about your food allergies; it’s important to ask about the ingredients in each dish; and it’s very nice to volunteer to bring something that’s safe for you, and shareable with others. But what’s crucial is to be prepared with an epinephrine auto-injector (Epi Pen®), an emergency dose of antihistamine, and an inhaler if you have asthma-just in case, adds Li, director of the USC Breathmobile®, a pediatric clinic that travels to schools and provides ongoing asthma and allergy care to children. Learn which foods and recipes are unexpected sources of allergens at FoodAllergy.org and AAAAI.org.

4. Trigger: Cocktails
You raise a glass to your loved ones, your boss and colleagues, friends and neighbors, and even the strangers sitting next to you at a bar. There’s lots of cheers-ing this time of year, but be mindful of what you’re using to toast. Some people may experience mild wheezing or other symptoms from the sulfites in wine, for example, and certain alcoholic concoctions contain major food allergens.

Prevent it: There aren’t good tests for sulfite sensitivity, but your reaction to dried fruit-high in this sulfur-based preservative-could be an indicator, says Horne. Pay attention if you have asthma, as sulfites can trigger symptoms. Maraschino cherries contain small amounts of sulfites, as well. Stick with organic wine for a sulfite-free sip. Other triggers to be aware of: Tree nuts may be found specialty beers, particularly seasonal ales; milk is in Irish crème and white chocolate liqueurs; and egg whites may be used to add froth to specialty drinks.

5. Trigger: Poinsettia
This festive plant is a member of the rubber tree family and contains compounds similar to those found in latex, so stay away if you have a latex allergy. Certain groups of people-such as healthcare workers and people with spina bifida who have had numerous surgeries-are more likely to be allergic to latex, says Li, and one study showed that 40 percent of latex-allergic individuals were also allergic to poinsettias.

Prevent it: If you have a latex allergy, keep the iconic plant out of your house-not only can it give you a rash if you touch it, but inhaling the allergen can lead to serious respiratory problems, like shortness of breath and wheezing.

6. Trigger: Smelly stuff
Pine-infused potpourri, dessert-scented candles, cinnamon air sprays-while they will make your house smell like Christmas, they can irritate the nose and throats of allergy-sensitive people. “Candles in particular are an increasingly recognized source of indoor air pollution,” says Horne. “The same is true for air sprays and other types of air fresheners-they can release many different types of noxious compounds, which can generate adverse reactions in sensitive patients.”

Prevent it: If skipping the scents feels Grinch-like, try making your own potpourri with cinnamon sticks and cloves so you know what’s in the mixture, says Horne. And choose candles made of soy or beeswax, suggests Li. There’s not much smell, but you can still enjoy the warm glow. By the way, fireplaces are an absolute no-no for asthmatic patients-the ash and smoke can trigger an attack, so keep the log unlit.

7. Trigger: Shopping on December 24
Stress doesn’t cause allergies or asthma by itself, but it can hinder your immune system and be a trigger for asthma attacks, says Horne. Chemicals released by the body during stressful times can cause the muscles around your airways to tighten, making it difficult to breathe.

Prevent it: All the deep breathing in the world probably can’t calm the chaos that comes with the season, but what you can do is make sure you take the steps to stay healthy: Stick to your controller medication regimen and get a flu shot, advises Li.

–By Teresa Dumain, Prevention
For full article, go to http://shine.yahoo.com/healthy-living/allergic-christmas-163700044.html

“Recent data show that total spending by insurers, government agencies and individuals amounted to $6,238 per resident in 2009, well below the national average of $6,815. That puts California on a bottom tier with Arkansas, Georgia, Texas, Utah, Nevada, Arizona, Colorado and Idaho.”

Healthcare analysts blame the low spending largely on the fact that the state has more than 7 million people who are uninsured, equaling about 1 in 5 Californians. As a result, many of these people seek medical treatment only when they are severely ill or injured.

Another factor is the low reimbursement rate the state Medi-Cal insurance program pays doctors and hospitals to treat the poor. California spent a smaller amount on low-income care than any other state in 2009, the federal report shows. Healthcare providers are suing the state to block a 10% cut in reimbursements.

The article continues to identify other reasons for the state’s low ranking. California has a relatively young and healthy population compared with other parts of the country, and these people generally don’t need to go to the doctor very much. And California has a larger proportion of residents covered by health maintenance organizations than most other states, and that helps keep costs lower for more than 21 million Californians.

Regardless, the report can be viewed as another sign that “California faces profound challenges because of growing poverty and dwindling public resources.”

The study found that spending was generally higher in states with older populations, relatively high incomes and larger-than-average groups of women ages 20 to 44, those most likely to use maternity services. The Northeast was home to many of the highest-spending states, including New York, Rhode Island, New Hampshire, Connecticut, Maine and Pennsylvania.

Lower-spending states tended to have low incomes, high uninsured rates and younger populations. These factors, along with a large immigrant population, help explain the low spending figures in California. And few expect the situation to improve anytime soon as poverty rates climb at a time when the state is cutting back insurance programs for the poor.

To read the complete, LA Times article click here.

5 Strange Predictors of Good Health
When it comes to judging someone’s chances at living a long, healthy life, some clues are more obvious than others. Most of us would put our money on the guy who runs two miles a day and eats plenty of vegetables over the seriously overweight smoker, for instance. But some predictors of longevity you might not guess as easily. Here are a few unusual ways that may determine your likelihood of getting seriously sick.

1. Finger length. Other researchers at ICR compared more than 1,500 men with prostate cancer to more than 3,000 random men. Ignoring family history and other factors, men older than 60 years with an index finger that was longer than their ring finger were 33 percent less likely on average to develop prostate cancer. Younger men with a longer index finger fared even better, with an 87 percent average reduction in risk.

2. Birth order. While there’s no definitive proof, several studies indicate that first-born boys are exposed to higher levels of estrogen at birth, increasing their risk of testicular cancer. Older siblings also seem to have a greater risk of developing childhood leukemia. “There are suggestions that it may have to do with exposure to viruses and bacteria. Siblings aren’t around to give them as much exposure,” Elizabeth Rapley, a molecular geneticist and spokesperson for the Institute for Cancer Research (ICR) in London told gizmodo.com.

3. Grip strength. According to a 25-year study of more than 6,000 men aged 45 through 68, grip strength was the best predictor of how well they’d avoid being incapacitated later in life. The weakest-gripping men suffered twice the disabilities of ones with hands of steel. And in a separate study of older men and women, good grip strength was correlated with longer lifespan.

4. Hair loss. Studies done by researchers from the Harvard Medical School and Brigham and Women’s Hospital have shown that pattern baldness-particularly significant hair loss at the crown-is associated with an increased chance of heart disease. Men who were completely bald at the crown had the most reason to worry-they were up to 36 percent more likely to show signs of trouble than those full heads of hair. “We found men with extensive baldness that involves the top of their heads have the greatest risk of heart disease,” said JoAnn Manson, professor of medicine at Harvard Medical School.

5. Religion. The oldest group of people in the country is a community of Seventh Day Adventists residing in Loma Linda, California. They have an average life expectancy of 88 years (a full ten years longer than the U.S. average). One reason may be that Adventists don’t drink or smoke, and many follow the vegetarian diet the church advises. But not all members do, and even the meat-eaters live significantly longer than average. Dr. Gary Fraser, a researcher with the Loma Linda University School of Public Health who is researching the community, told the BBC. “At this moment we don’t really know, but people who go to church regularly- whatever faith they have- live longer, and there’s no question about that.”

Sources: gizmodo.com, JAMA, ehow.com, BBC News

Tony Cenicola/The New York Times

In a recent study, “blood thinners and diabetes drugs cause the most emergency hospital visits for drug reactions among people over the age 65 in the United States.”

A New York Times article this week reported that either used alone or together, there are four medications or medication groups responsible for two-thirds of emergency hospitalizations among older Americans, according to the study. At the top of the list was warfarin, also known as Coumadin, a blood thinner. It accounted for 33% of emergency hospital visits. Insulin injections were next on the list, accounting for 14% of emergency visits.

Aspirin, clopidogrel and other anti-platelet drugs that help prevent blood clotting were involved in 13% of emergency visits. Following them were diabetes drugs taken by mouth, called oral hypoglycemic agents, which were implicated in 11% of hospitalizations.

All these drugs are commonly prescribed to older adults, and they can be hard to use correctly. One problem they share is a narrow therapeutic index, meaning the line between an effective dose and a hazardous one is thin. Some require blood testing to adjust their doses, and a small dose can have a powerful effect.

The sheer extent to which they are involved in hospitalizations among older people, was not expected, said Dr. Dan Budnitz, an author of the study and director of the Medication Safety Program at the Centers for Disease Control and Prevention.

“We weren’t so surprised at the particular drugs that were involved,” Dr. Budnitz said. “But we were surprised how many of the emergency hospitalizations were due to such a relatively small number of these drugs.”

One thing that stood out in the data, the researchers noted, was that none of the four drugs identified as frequent culprits are typically among the types of drugs labeled “high risk” for older adults by major health care groups. The medications that are usually designated high risk or “potentially inappropriate” are commonly used over-the-counter drugs like Benadryl, as well as Demerol and other powerful narcotic painkillers. And yet those drugs accounted for only about 8% of emergency hospitalizations among the elderly.

To read the full New York Times article, click here.

The Supreme Court building in Washington (Bill Heinsohn, Getty Images)

A hot topic this week, making front page news in the New York Times and Los Angeles Times, addresses the question, “If the federal government can require people to purchase health insurance, what else can it force them to do? More to the point, what can’t the government compel citizens to do?” The NY Times article goes on to say these “questions have been the toughest ones for the Obama administration’s lawyers to answer in court appearances around the country over the past six months. They are likely to emerge again if, as expected, the Supreme Court… agrees to be the final arbiter of the challenge to President Obama’s signature health care initiative.” The case focuses on whether Congress overstepped its constitutional authority in enacting parts of the law.

It was stated in the LA Times article, that “after a year and a half of legal skirmishing, President Obama’s embattled healthcare law has arrived at the Supreme Court riding a surprising winning streak and carrying a constitutional stamp of approval from prominent conservative judges. Only three of the 12 appellate judges who have reviewed the law have decided it is unconstitutional to require all Americans to have health insurance,” and “not a single appeals court judge has said the entire law must be tossed out, the position advocated by Florida and 25 other Republican states leading the legal assault.” The Supreme Court “is expected to announce as soon as Monday” that it will hear the Florida case, “the largest and broadest challenge” to the law. The article notes that, “not since the 1930′s has the Supreme Court faced such a distinctly partisan challenge over national regulation. The court’s four liberals, all Democratic appointees, will almost certainly uphold the law. The outcome depends on its five Republican appointees, conservatives who cherish the idea that the Constitution puts limits on federal power that the court is duty-bound to enforce.”

To read the complete New York Times article, click here. To read the Los Angeles Times article, click here.

A new LA Times article discusses a new proposed initiative submitted by the Santa Monica advocacy group Consumer Watchdog  to the state attorney general’s office that would require insurance companies, health maintenance organizations and preferred-provider organizations to get prior approvals from the California Department of Insurance for proposed rate hikes.

This is the same consumer group that brought regulation of auto insurance rates to California now wants to do the same for healthcare coverage. While there is some opposition saying that the initiative is flawed, both sides can agree that some reform to State Healthcare rate regulations needs to be adressed.

The article continues:
The petition, once cleared for circulation, would need about 505,000 signatures from registered voters to appear on the statewide ballot in November 2012. The initiative, if it qualifies for the ballot, is expected to garner fierce opposition from insurance and related healthcare providers. Backers said they are prepared to fight a one-sided campaign with an industry that could easily spend $100 million.

The health insurance measure would be an update of Proposition 103, an initiative approved by California voters in 1988 that made auto and homeowner insurance the most highly regulated in the nation.

“This applies rate regulation, prior approval (of rates), transparency provisions and refund authority to health insurance,” said Jamie Court, president of Consumer Watchdog.

Also under the draft initiative, health insurance executives could be prosecuted for perjury if they provide untruthful information about the need for higher rates for individual and small-group health insurance coverage.

To read the rest of the article, go to http://latimesblogs.latimes.com/money_co/2011/11/proposed-health-insurance-rate-regulation-initiative-submitted.html

In the lawsuit, the California Hospital Association said that “cuts to the Medi-Cal insurance program will threaten the ability of many hospitals to continue operating skilled nursing facilities” and that “patients, particularly those in rural communities and other medically underserved areas, will likely face delays or gaps in healthcare services.”

Hospital association President C. Duane Dauner was quoted saying, “the filing of this lawsuit is a regrettable but necessary step to protect access to care for California’s most vulnerable patients. California’s hospitals cannot stand by and allow these cuts to take effect.”

The 10% cuts, part of the 2011-2012 budget deal signed by Gov. Jerry Brown, are retroactive to June 1 and required federal approval, which the Obama administration gave last week.

To read the complete article, click here.

Anna Gorman of The Los Angeles Times reports that the Obama administration will allow California to cut hundreds of millions of dollars from Medi-Cal, a move doctors and experts say .

California plans to reduce rates by 10% to many providers, including physicians, dentists, clinics, pharmacies and most nursing homes, the Centers for Medicare and Medicaid Services announced Thursday.

The cuts “will have a real impact on Medi-Cal patients” because fewer doctors will be willing to see those covered by the program, which serves 7.6 million poor and disabled Californians, said Anthony Wright, executive director of Health Access, a consumer group. The head of the California Medical Assn., which represents doctors, echoed the concern.

Cindy Mann, deputy administrator of the Centers for Medicare and Medicaid Services, told reporters the action gives California the flexibility it had requested to address its budget shortfall. “We know that the reductions that are being approved today will have significant impact on affected providers, and we regret the very difficult budget circumstances that have led to their implementation,” she said.

The cuts are expected to save the state $623 million. California spends $14 billion on Medi-Cal, the state’s Medicaid program.

To Read the full article, go to http://www.latimes.com/news/local/la-me-medicaid-20111028,0,4273464.story