Helping make the health care system work for you

A cautionary tale: Former addict developed 'gigantic addiction' to Vicodin

sharyn morrow via Flickr Creative Commons

As the nation struggles with an epidemic of opioid abuse, KPCC is launching an occasional series in which we’ll share your stories of dealing with pain, and offer experts’ advice on how best to manage it. Share your story and insights through the Public Insight Network.

"Mary" knew opioid painkillers were highly addictive and, as a former heroin addict, she knew she was at an elevated risk for a relapse. So even though she had been sober for decades, she pushed back when her doctor prescribed Vicodin for an injured rotator cuff and a couple of cracked ribs.

"I said, 'I'm really leery of taking Vicodin because I used to be a junky,'" says Mary, a 65-year-old who spent most of her life in California and now lives in Florida. She asked that we not use her real name due to the sensitive nature of her story.

Read More...

FAQ: How California's new vaccination law works

bandage band-aid shot vaccine immunization measles

Photo by Redcorn Studios [Matt] via Flickr Creative Commons

Believe it or not, the new school year is just around the corner. This year, for the first time, some parents will no longer be able to skip vaccinating their kids based on their personal beliefs. It's all because of a law that took effect last Friday.

What does the law do?

This law requires all kids who go to day care or school in California to be vaccinated. It eliminates vaccine exemptions based on personal belief or religion, while maintaining the medical exemption. The law also allows parents of special needs kids to forgo immunizing their children. More on that below.  

The law, authored by State Sens. Richard Pan (D-Sacramento) and Ben Allen (D-Santa Monica), was spurred by the measles outbreak that started at the Disney theme parks in Anaheim in December 2014. Experts say the highly contagious disease was able to spread due to pockets of people who don't vaccinate their kids, and this law is intended to close those gaps.

Read More...

It's mosquito season: Who should wear insect repellent, and when

Morag Riddell via Flickr Creative Commons

Mosquitoes like it hot. As temperatures increase, so does the potential for the insects to bite - and possibly transmit diseases. That's a nationwide concern this summer, as the Zika virus rages through much of the Americas.

But health officials in Los Angeles and Orange counties are not currently recommending that everyone slather themselves in mosquito repellent all day long. At this point, they are mainly pushing people to protect themselves when they go outside at dawn and dusk.

The rationale is that for Southern California residents, the more pressing mosquito-borne disease is not Zika, but West Nile virus.

Here's why: While the Aedes aegypti mosquitoes, which carry Zika and several other infectious diseases, are in Southern California, none of the Aedes mosquitoes found so far in the state or nationwide were carrying Zika.

Read More...

Lawmakers renew push to block surprise medical bills

urbanbohemian via Flickr Creative Commons

Even when patients make concerted efforts to see doctors covered by their insurance plans at in-network facilities, they run the risk of unknowingly being treated by other out-of-network providers during that visit. A new state bill would protect people from paying hefty surprise medical bills stemming from such out-of-network charges.

The proposal, AB 72, says that when consumers are unknowingly treated by out-of-network radiologists, anesthesiologists or other providers, they would only pay what they would for doctors within their insurance network. These payments would also count towards their out-of-pocket maximums.

The legislation comes on the heels of an effort last year, AB 533, that was also intended to curb surprise out-of-network bills. That bill would have made consumers responsible only for in-network rates. Insurance companies would then have been required to reimburse the out-of-network doctors at the rate they would get from Medicare.

Read More...

A financial case for expanding access to costly hepatitis C drugs

The newly approved Harvoni tablets bring several advances to the fight against hepatitis C, but they also have a steep price tag, reported at $1,125 for a single dose.

/Gilead Sciences

The newly approved Harvoni tablets bring several advances to the fight against hepatitis C, but they also have a steep price tag, reported at $1,125 for a single dose.

When the very expensive - and very effective - hepatitis C medications hit the market more than two years ago, private health insurers limited prescriptions to the very sickest people.

Two new analyses now say that approach is shortsighted. Researchers, writing in the American Journal of Managed Care, argue that treating people during earlier stages of the disease has long-term health and economic benefits.

"Unfortunately, the conventional wisdom is, if there's an expensive drug, the way to ration it is to treat people who are sickest," says Darius Lakdawalla, a health economist and professor at the USC Schaeffer Center for Health Policy and Economics. "But it turns out that's kind of backwards from where the value really lies."

Lakdawalla and other researchers find that expanding hepatitis C treatment benefits private insurers in the long-term; by paying for the drug now, they avoid paying for costly complications from hepatitis C, like liver transplants, down the road. Curing patients' hepatitis C infections and avoiding future liver transplants has another benefit, they write: It frees up liver transplants for other people who need them.

Read More...