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health care

Ten million people still don't have health insurance two years after the Affordable Care Act went into effect.

Some never bought a policy. But 20 percent went to the trouble of signing up on HealthCare.gov, or one of the state insurance exchanges, and even made payments. Then, those 2 million people let their insurance lapse.

NPR asked visitors to our Facebook page to tell us why.

Teal Victoria reads to her 3-year-old daughter Kai at their northeast Seattle home. Kai is on a ventilator and is cared for around the clock at home by her mother and her nurses.
Courtesy of seattlepi.com/Joshua Trujillo

Dozens of young Washington children who are dependent on ventilators could be living at home, but are stuck in expensive hospitals instead.

That's because Medicaid pay for nurses to care for them at home is so low -- about $10 an hour less than the market rate, Seattlepi.com reporter Levi Pulkkinen told KUOW's Jeannie Yandel on The Record.

Most women don't need to start getting an annual mammogram to screen for breast cancer until they turn 45, according to the latest guidelines from the American Cancer Society.

Previously, the society recommended women start annual mammograms at 40 and continue every year for as long they remained in good health.

Flickr photo/sea turtle (CC BY-NC-ND 2.0)

Seattle may be one of the country’s most progressive cities, but it falls short on services for elderly LGBTQ people, according to University of Washington researchers.

So they advise creating a new program to train health and human service providers in caring for older adults who are lesbian, gay, bisexual or transgender.

Department of Veterans Affairs
Department of Veterans Affairs

U.S. Sen. Patty Murray is calling for disciplinary action after a Veterans Affairs investigation found that staffers in Seattle dumped mail about vets’ benefits in a yellow bucket and left it for months. 

If you're struck by a macaw, sucked into a jet engine or are having relationship problems with your in-laws, fear not: Your doctor now has a medical diagnosis code for that.

On Thursday, doctors, hospitals and health insurers must start using the ICD-10, a vast new set of alphanumeric codes for describing diseases and injuries in unprecedented detail.

Until recently, nurses at Los Angeles County Harbor-UCLA Hospital had to maneuver through a maze of wheelchairs, beds, boxes and lights to find surgical supplies in the equipment closet for the operating rooms.

But as public hospitals like Harbor-UCLA try to cut costs and make patients happier, administrators have turned to an unlikely ally: Toyota.

Judy Naillon called her insurer several months ago to find out why she was being charged $35 every month for birth control pills. Her friends said they were getting their pills free under the federal health law.

Why wasn't she getting the same deal?

Online health insurance marketplaces are central parts of the Affordable Care Act. And HealthCare.gov, the federally run exchange, is where 27-year-old Kathryn Ryan, a restaurant server in Philadelphia, turned for health coverage, as soon as the law took effect.

"I was excited because if it weren't for Obamacare, I wouldn't be insured at all," she says. "I wouldn't have the ability to go to the doctor."

She can afford health insurance thanks to a $200 a month subsidy that brings her premium down to $60 a month.

By 2018, the state of Washington should have a treasure trove of data on the cost and quality of health care.

In a leafy suburb of Cleveland, 108-year-old Lakewood Hospital is expected to close in the next two years, for economic reasons. Mike Summers points to the fourth-floor windows on the far left side of the historic brick building. He recalls spending three weeks in one of those rooms. It was Christmas 1965 and Summers had a broken hip.

"I remember hearing Christmas bells from the church across the street," he says.

Maria Fabrizio

It’s a discussion that most people avoid: end-of-life planning.

Doctors say it’s important to have these conversations while you’re still able. But let’s face it, talking about advanced directives can be uncomfortable, even terrifying.

Alice Beaty watches her son Adam work on speech exercises at their home in Bellingham, Wash., on March 27, 2015. Adam is recovering from a severe car accident. It was initially unclear if he would survive.
KUOW Photo/Mike Kane

Palliative care has often been associated with elderly people who are dying.

Not anymore. Today, palliative care is more than that. It means supporting patients and their families, no matter their age. And it doesn’t mean that death is imminent.

Mark and Alice Beaty learned this first hand. A year and a half ago, they received a phone call that every parent dreads. Their son Adam had been in a rollover car accident on Interstate 5. He was 27 years old.

Greta Austin's family faced the issues surround end-of-life care when her father, George Austin, was diagnosed with cancer. He is pictured here with his wife, Shirley, On Easter Day, 2013.
Courtesy of Greta Austin

Greta Austin has spent a lot of time in medical waiting rooms.

Two years ago last fall, her father came to Seattle from Wisconsin for treatment, and she sat with him at the Seattle Cancer Care Alliance.

Anne Koller was diagnosed with late-stage colon cancer in 2011 and has been fighting it since.

But it's not just the cancer she's fighting. It's the bills.

"Think of those old horror flicks," she says. "The swamp creature ... comes out and is kind of oozy, and it oozes over everything."

When she was able to work, Koller, who just turned 65, was in the corporate world and safely middle-class, with health insurance and plenty of savings.

At first, she was too sick to deal with the bills. They piled up.

At an Institute for Family Health center near Union Square in New York City, medical student Sara Stream asks a new patient named Alicia what brings her in. The 34-year-old woman arrived last summer from Guatemala, and says she hasn't been seen by a doctor in many years.

Her list of ailments is long.

"I have trouble seeing, headaches, problems with my stomach," says Alicia, who declined to use her full name, because she is in the country illegally. "I feel depressed."

Maybe You Should Skip That Annual Physical

Apr 6, 2015

It's a warm afternoon in Miami, and 35-year-old Emanuel Vega has come to Baptist Health Primary Care for a physical exam. Dr. Mark Caruso shakes his hand with a welcoming smile.

Christina Costanzo was 32 when she had her first heart attack. It all started on a Friday.

"I had chest pain. I had pain in my jaw, pain going down my left arm. I had some shortness of breath," Costanzo recalls.

But Costanzo who is a nurse practitioner in New Haven, Conn., didn't realize right away that these were symptoms of a heart attack. She figured this was just her body reacting to stress, and she didn't want to overreact.

This tax season, for the first time since the Affordable Care Act passed five years ago, consumers are facing its financial consequences.

Whether they owe a penalty for not having health insurance, or have to figure out whether they need to pay back part of the subsidy they received to offset the cost of monthly insurance premiums, many people have to contend with new tax forms and calculations.

Washington state Insurance Commissioner Mike Kreidler says Premera Blue Cross has been cooperating with an investigation of a cyberattack that exposed data on millions of customers.

Kreidler hopes the investigation will reveal exactly how 11 million customers had their social security numbers and medical information compromised.

Doctors are much more likely to level with patients who have cancer than patients who have Alzheimer's, according to a report released this week by the Alzheimer's Association.

When children are diagnosed with acute lymphoblastic leukemia now, they have more than a 90 percent chance of survival.

But when James Eversull was told he had leukemia in 1964, there wasn't much hope.

He was just 18 months old when his parents discovered what was wrong.

Ella Barnes-Williams is dealing with a lot right now.

For starters, her government-subsidized house in Northeast Washington, D.C., leaks when it rains. She points at a big brown splotch on the ceiling.

"It's like mold, mold, mold all over," she says. "I've got to clean that now 'cause that just came back."

Barnes-Williams is 54 and lives with her 30-year-old daughter and three young grandchildren. All three grandkids have severe asthma, which makes the mold a serious problem. And she and her daughter are diabetic.

When we think of Alzheimer's disease or other dementias, we think of the loss of memory or the inability to recognize familiar faces, places, and things. But for caregivers, the bigger challenge often is coping with the other behaviors common in dementia: wandering, sleeplessness and anxiety or aggression.

Melissa and her husband started trying to have a baby right after they got married. But nothing was happening. So they went to a fertility clinic and tried round after round of everything the doctors had to offer. Nothing worked.

"They basically told me, 'You know, you have no chance of getting pregnant,' " says Melissa, who asked to be identified only by her first name to protect her privacy.

But Melissa, 30, who lives in Ontario, Canada, didn't give up. She switched clinics and kept trying. She got pregnant once, but that ended in a miscarriage.

Oregon's troubled health insurance exchange is one step closer to being dismantled.

Veterans Affairs Puget Sound will get $22 million over the next two years and plans to hire more than 120 additional medical personnel for specialties like mental health and geriatric care. 

The money is part of more than $15 billion set aside by Congress to fund the Veterans Access, Choice and Accountability Act. The bill is designed to help veterans access health care more quickly. 

Flickr Photo/Greg McMullin (CC-BY-NC-ND)

Ross Reynolds interviews journalist and author Steven Brill about his new book, "America’s Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Health Care System."

While finishing the book Brill had his chest sawed open for emergency heart surgery. A dream he had the night before the operation revealed a truth about the health care system. 

New Kidney Transplant Rules Aim For Equity

Jan 22, 2015

More than 100,000 people in the U.S. are waiting for a kidney transplant. That’s a longer waiting list than for any other organ. Each year, only about one-sixth of those patients will get one.

Who’s next in line is a delicate and high-stakes question and the answer has recently changed. From the Here & Now Contributors Network, Joanna Richards of WCPN reports from Cleveland.

Doctor
Flickr Photo/Alex Proimos (CC-BY-NC-ND)

For the past two years primary care doctors who saw Medicaid patients were given a pay increase. The extra money was an incentive for doctors to take in new patients who became eligible under Medicaid expansion. But starting January 1, 2015, that pay increase expires. Marcie Sillman talks to KUOW’s healthcare reporter Ruby de Luna about how this change might impact Medicaid patients.

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