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health care

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.

Marcie Sillman talks to David Kopacz about his new book, "Re-humanzing Medicine: A Holistic Framework For Transforming Your Self, Your Practice, and the Culture of Medicine."

This time last year, federal officials were scrambling to get as many people enrolled in health insurance through HealthCare.gov as they could before the start of the program on Jan. 1.

Now, with the technical problems mostly fixed, they're facing a different problem: the possibility that the Supreme Court might rule that the subsidies that help people afford coverage are illegal in the 37 states where the federal government is running the program.

The Puget Sound VA has new initiatives focusing on accessibility and quailty of care for veterans.
Flickr Photo/cursedthing (CC-BY-NC-ND)

Jeannie Yandel talks with Pat Justis, rural health manager at the Washington State Department of Health, about the myriad of health issues facing rural areas.

Courtesy of Washington Healthplanfinder

Open enrollment for health insurance started last Saturday. It’s the time for people to buy a health plan, or to renew what they already have. And for the first time this year, the state’s health exchange is offering health plans for small businesses. 

Marcie Sillman interviews KUOW health reporter Ruby de Luna about some of the changes the Washington state Health Exchange has made. Last year more than a million Washington state residents signed up for health insurance through the Washington Health Plan Finder website.  Saturday is the first day of open enrollment. People need to sign up or renew their health care plans by February 15, 2015. 

Flickr Photo/hapal (CC-BY-NC-ND)

Ross Reynolds has a wide-ranging discussion of end-of-life issues with Atul Gawande, author of “Being Mortal: Medicine and What Matters in the End."  

Gawande discusses  several issues such as how medical science views death as a failure, and does not always examine how medical treatments affect people at the end; innovations in assisted living and hospice to not only improve the quality of life, but also allow people to live longer; and how health care professionals are trying to become better at end of life care.

KUOW Photo/John Ryan

If today is a typical day in the United States, about 200 hospital patients will die with an infection they picked up while they were in the hospital.

Only one patient in the United States has ever died of Ebola, and many deadly diseases spread much more easily than Ebola.

Harborview Medical Center in Seattle.
Flickr Photo/camknows (CC-BY-NC-ND)

Ross Reynolds talks to Heather Stephen-Selby about nurses' preparedness for Ebola in Washington state. Stephen-Selby is the assistant executive director of practice, education and research for the Washington State Nurses Association. 

Also Dr. Scott Lindquist, Washington's chief epidemiologist, explains how the state is preparing and what the state still needs to do.

Flickr Photo/Penn State (CC-BY-NC-ND)

Ross Reynolds talks with Group Health family practitioner Dr. Matt Handley about a new report that looks at unnecessary medical testing in Washington state.

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