Helping make the health care system work for you

Still too many C-sections at California hospitals

Phoebe ! via Flickr Creative Commons

For some pregnant women, giving birth by Cesarean section is critical, even life saving. But at far too many hospitals in California and across the nation, lots of women are having C-sections when the procedure is not medically indicated, according to newly released data.

The Leapfrog Group is trying to measure how often women are having these unnecessary C-sections. Last week, it released statewide and hospital-level statistics detailing how often first-time moms with lower-risk pregnancies – defined as those that have reached the 37th week or later and consist of one fetus in the head-down position – give birth via C-section.

The group's findings come at a time when experts are cautiously optimistic that the country's C-section rate might be on the decline. Nationwide, the C-section rate among first-time moms with low-risk pregnancies jumped by 44 percent over a decade, from 19.5 percent in 1999 to 28.1 percent in 2009. Since then, it's been slowly dropping, hitting 26.9 percent in 2013.


Are cash-only doctors better for consumers?


Wellness GM via Flickr Creative Commons

A lot of people consider health insurance to be a necessary evil.

Yes, it can be expensive and frustrating to use. But when patients need medical care, they're generally glad they're insured.

Some doctors, though, are bypassing insurance all together.

These physicians are setting up cash-only offices with the goals, they say, of regaining financial control over their practices and spending more time with their patients.

"Medicine can become so much more accommodating to the consumer when you get all of the strange effects of the way the payer system works out of the way," says Tom Blue, chief strategy officer for the American Academy of Private Physicians, the professional society for cash-only doctors.

What is a cash-only office?

This model comes in several names and forms. It's sometimes known as concierge medicine or direct primary care. It's most common among primary care doctors, but some specialists are going this way, too.


Can prescription drugs be priced on their 'value'?

Following the money trail is pretty easy with doctors, but nurses are another story.

Adrianna Williams/Getty Images

Last week the New York Times reported that a drug company, Turing Pharmaceuticals, had raised the price of one of its drugs from $13.50 a tablet to $750.

The drug, called Daraprim, is used to treat a deadly parasitic infection. It's been on the market for more than 60 years. So why did the price skyrocket overnight?

The Washington Post reported that the company’s 32-year-old CEO, Martin Shkreli, defended the price hike on Twitter, saying, "it's a great business decision that also benefits all of our stakeholders."

In other words, the company raised the drug's price because it was good for business.

The price increase – and Shkreli's defense of it – sparked outrage online. It also put a spotlight on how drug prices are set in America.

Drug prices today

In the United States, experts say, drug companies essentially have free reign to set prices. Those prices are generally based on what the market can bear. The market, in this sense, is not consumers but intermediaries who buy large quantities of drugs, like insurance companies, employers and the government.


To boost vaccination rates, the flu shot needs a PR makeover

Student Nursing

Greg Black/Flickr Creative Commons

Each fall, as pumpkin-flavored items start hitting store shelves, doctors implore people to get a flu shot.

This has been a major public health push since 2010, when the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices updated its flu vaccination recommendation to recommend that everyone 6 months and older should get the shot each year.

(Previously, the agency recommended the shot for a more limited group, including health care workers, pregnant women, people over 50, and those coming in contact with kids under 5.)

Since then, CDC data show that flu vaccination rates among adults have slowly ticked up a percentage point or so each year, from 40.5 percent during the 2010-2011 season, the year the universal recommendation took effect, to 43.6 percent in the 2014-2015 season.


California unveils web tool to help consumers shop for health care

Health Care Costs

Photo by 401(K) 2012 via Flickr Creative Commons

This summer, KPCC asked our audience members to share their childbirth costs with us. The effort was part of a project – called #PriceCheck – where we crowdsource the costs of certain medical procedures.

#PriceCheck has allowed us to see the wide variation in charges by hospitals and clinics, as well as in how much insurance covers. We hope that, by bringing transparency to these costs, the database has served as a resource for people who are trying to shop around for medical care.

On Monday, California's Department of Insurance unveiled a similar tool, called California Healthcare Compare. It lets consumers look up the costs of more than 100 medical procedures and conditions in their region. It also cracks a nut that #PriceCheck could not: For certain procedures, like childbirth and colon cancer screening, the website also includes quality information about the hospitals and medical groups providing care.