Dr. Tim Johnson’s Obamacare Podcast: Kerfuffle Over Keeping Your Insurance

Dr. Timothy Johnson, retired Medical Editor for ABC News, in the WBUR studios. (Jesse Costa/WBUR)

Dr. Timothy Johnson, retired Medical Editor for ABC News, in the WBUR studios. (Jesse Costa/WBUR)

Here’s the third in a series of health policy podcasts hosted by Dr. Timothy Johnson, retired medical editor for ABC News, focusing on the new national Affordable Care Act, Obamacare.

Today’s truth-squadding episode offers a little progress report on health insurance exchanges (they’re improving) and also delves into the latest Obamacare kerfuffle: how many folks may lose their current health insurance and be forced to seek alternatives.

Johnson’s guests today are John McDonough, a professor at the Harvard School of Public Health; Dr. Gail Wilensky, a health official under the first President Bush and Larry Levitt, a senior vice president at the Kaiser Family Foundation.

Johnson kicks things off with a question stemming from President Obama’s statement that anyone who likes their health insurance can keep it, which turns out not to be entirely true:

“Either the president didn’t know what was going to happen or he cut a political corner,” Johnson says.

McDonough responds:  “There was an attempt to minimize the opposition and minimize concerns… and the truth is about 98 percent of any Americans who have coverage won’t see a cancellation or a bad choice.” He adds that anyone who is losing their insurance can buy new insurance, which wasn’t necessarily the case before the law. Still, he concedes, that “yes, the president could have been more precise.”

Wilensky is a bit more succinct: “Dumb mistake on the president’s part politically,” she says, noting that Obama might have learned something from George Herbert Walker Bush’s “No New Taxes” debacle. When a president makes a “simple declarative statement,” she says, he better be prepared to honor it.

To hear Johnson’s earlier podcast, listen here.

The Checkup: Talking Back To Your Doctor

Welcome to the The Checkup. Our sixth episode “Talking Back to Your Doctor,” opens with a question: Why do so many of us find it so hellishly hard to speak freely with our doctors? What is it about a white coat that makes even normally assertive people clam up?

(To listen to The Checkup now, click on the arrow above; to download and listen later, press Download; and to get it through iTunes click here.)

We begin with the dramatic story of Alicair Peltonen, an administrative assistant diagnosed with a rare cancer who had to have a chunk the size of a baseball removed from her thigh. Throughout her medical saga, she found that she often had urgent questions echoing in her mind, but felt too inhibited to voice them. She set out to find out why. The Checkup

We speak with Dr. Jo Shapiro of Brigham and Women’s Hospital in Boston about what she calls “Conversation Deficit Disorder” among doctors. And we hear from Dr. Annie Brewster, who has special insight into doctor-patient communication because she’s both a practicing doctor and a multiple sclerosis patient who decided not to follow her doctor’s recommendations about taking a particular medication.

Each episode of the Checkup features a different topic—previous topics included college mental health, sex problems, the Insanity workout and vaccine issues.

This is the closing episode of our first season of The Checkup. Please tell us what you liked and disliked and what you want more of. Like CommonHealth on Facebook or drop a note to podcasts@slate.com.

We’ll keep you posted here on all our plans for future podcasts.

The Checkup: Meltdown U. And Mental Health Tips For Parents Of College Kids

For all those freshman just settling into dorm life this fall, college can be exhilarating, mind-blowing, the best years of their lives. But many parents don’t realize that their children are also facing a potential double whammy. Not only must new students navigate an entirely unfamiliar social, emotional and intellectual landscape, but they’re also entering a time in their lives — the ages between 18 and 21 — when many mental illnesses, from anxiety to depression to eating disorders, peak.

This week, The Checkup, our podcast on Slate, explores the mental health of college students. Here’s one sobering statistic: up to 50% of college-age kids have had or will have some kind of psychiatric disorder. That’s why we’re calling this episode “Meltdown U.” (To listen to The Checkup now, click on the arrow above; to download and listen later, press Download; and to get it through iTunes click here.)

The Checkup

Consider some more scary numbers:

–80% of college students who need mental health services won’t seek them

–50% of all college students say they have felt so depressed that they found it difficult to function during the last school year

–Suicide is the second leading cause of death among college-age youth – over 1000 deaths per year.

–The rate of student psychiatric hospitalizations has tripled in the past 20 years.

We asked Dr. Eugene Beresin, M.D., a child psychiatrist at Massachusetts General Hospital and professor of psychiatry at Harvard Medical School, to offer some guidance on what parents should know about helping their college-age kids cope with the high stress of undergraduate life. Here’s his advice: Continue reading

The Checkup: Yes, Really. One-Third Of Women Have Pain During Sex

A while back we wrote about a national sex survey that found one-third of women experienced pain during sex. There were skeptics back then who thought, nah, that can’t be possible, otherwise we’d be having a nationwide conversation about how to fix such a huge problem. But now, the lead author of that study, Debby Herbenick, a researcher at Indiana University, co-director of the Center for Sexual Health Promotion, and a sexual health educator at the Kinsey Institute, confirms those numbers in a follow-up survey.

The Checkup

We discuss these surprisingly high numbers, and other new findings, in the second episode of our new podcast, The Checkup, which is just out at Slate.com here. (To listen to The Checkup now, click on the arrow above; to download and listen later, press Download; and to get it through iTunes click here.)

The theme of podcast #2: “Matters Below The Waist.” This segment features frank talk about sex problems — and some solutions. We delve into Herbenick’s fascinating research on pain during sex and more (including personal insights from one of our hosts…) and speak with a physical therapist who specializes in various treatment options that can help women deal with this rarely discussed but incredibly widespread problem.

Not to leave men out, we also explore a little-known disorder called Peyronie’s disease, in which the erect penis becomes crooked, sometimes making it difficult to have intercourse. (Yes, this came up during the Bill Clinton impeachment era, and there’s more on that in the podcast.)

Herbenick’s initial survey of sex in America was the largest nationally representative study of sex in the country; her team surveyed 6,000 men and women, ages 14-94, and asked them about their sexual behavior.

Results of the latest survey (which Herbenick says were presented at an International Society for the Study of Women’s Sexual Health annual meeting) are expected to be published in several months.

In the meantime here, lightly edited, is more from my interview last week with Herbenick, also the author of several books, including Read My Lips: A Complete Guide to the Vagina and Vulva and Sex Made Easy: Your Awkward Questions Answered-For Better, Smarter, Amazing Sex:

DH: We did another national survey of sex in America. And this time, knowing that we had this stark difference between how women and men experience pain during sex – only 5% of men reported any degree of pain, and most of theirs was mild, too. We did ask a series of follow-up questions. This time, for people who did experience pain, we collected information about how long the pain lasted, where in their body it was located, whether they told their partner, what they did in response to the pain, and we also separated it by vaginal and anal intercourse.

RZ: What else did you find?

So the first thing that was important is the 30% number is still there. And that’s important because it does show that it’s a stable and reliable estimate, which some people in the media had questioned [whether] it could really be that that number of people experienced pain — Continue reading

Check Out ‘The Checkup’: Our New Health Podcast On Slate

You’ve read our posts. Now we invite you to listen to our podcast.

Beginning today, we’re launching a new podcast called The Checkup, a partnership between WBUR and Slate. (We wanted to call it Goldberg and Zimmerman, but they told us it sounded like an accounting firm.) We’re thrilled to announce that for the next six weeks, Slate will be posting it weekly among its extremely popular “Gabfests” and other ear fodder. (To listen to The Checkup now, click on the arrow above; to download and listen later, press Download and to get it through iTunes click here. )

The Checkup

Regular CommonHealth readers will be familiar with our blend of solidly reported, somewhat opinionated health-related news you can use (at least we think you can use it, since we can and have). Each segment will focus on a different topic — from sex problems and students’ mental health as they head back to school, to fitness snake oil and vaccine controversies.

Our first episode is “Three Myths of Pregnancy and Childbirth,” a subject near to our motherly hearts. It features interesting, relevant new research on bed rest during pregnancy, labor pain and cutting the baby’s umbilical cord, including information you may not read much about in the best-selling pregnancy bible “What To Expect When You’re Expecting.”

So download the podcast, produced by WBUR’s wizardly sound engineer George Hicks, give it a listen and let us know what you think.

Study: Hard To Shop For Hip Surgery, Even With $100K At Stake

(pasm/ Wikimedia Commons)

(pasm/ Wikimedia Commons)

As WBUR’s Martha Bebinger has reported repeatedly, it is hard, hard, hard to compare the price tags on medical procedures — even though the out-of-pocket costs to you could vary dramatically depending on where you get your care.

Now a new study in the journal JAMA Internal Medicine pins down this shopping problem for one particular procedure: elective hip surgery called total hip arthroplasty, or THA.

The researchers called hospitals around the country — and called and called and called, up to five times each — in search of the institution’s lowest price for a 62-year-old grandmother who lacked health insurance but could pay out of pocket. From the paper’s abstract:

Results Nine top-ranked hospitals (45%) and 10 non–top-ranked hospitals (10%) were able to provide a complete bundled price (P < .001). We were able to obtain a complete price estimate from an additional 3 top-ranked hospitals (15%) and 54 non–top-ranked hospitals (53%) (P = .002) by contacting the hospital and physician separately. The range of complete prices was wide for both top-ranked ($12 500-$105 000) and non–top-ranked hospitals ($11 100-$125 798).

Conclusions and Relevance We found it difficult to obtain price information for THA and observed wide variation in the prices that were quoted. Many health care providers cannot provide reasonable price estimates. Patients seeking elective THA may find considerable price savings through comparison shopping.

Oh, except, wait a minute, you can’t comparison shop very well when more than half of hospitals can’t give you their prices.

The latest health reform law in Massachusetts, passed last year, is supposed to address this problem and require greater price transparency from hospitals. Will it? Meanwhile, my friend Jeanne Pinder’s ClearHealthCosts.com uses crowdsourcing to help consumers help each other gather cost data. She blogs about the new study:

This is one of our favorite topics. If you haven’t recently, go to our PriceMap interactive page and play around with the search; for a range of procedures, in cities all over the United States, we show you what the government is paying via Medicare, the program for the elderly and disabled. You’ll be shocked at the range.

Study Finds ‘Protective’ Weight Just As Diet Resolutions Kick In

Whoopsie. Just as all those New Year’s dieting resolutions are kicking in, along comes the latest salvo in the confusing obesity-mortality wars. “Oh, my,” I said this morning when I heard Harvard nutrition expert Walt Willett call this latest study a bunch of “rubbish” on NPR. “They’re playing rough.”

At issue is this simple question: Does being overweight make you die sooner, or might it actually be protective? But of course, very little is simple in the world of nutrition studies, or when links between Body Mass Index and health are concerned.  Here’s the conclusion from the study, that in effect, very obese people tend to die earlier, but more mildly overweight people may tend to live a bit longer:

Relative to normal weight, both obesity (all grades) and grades 2 and 3 obesity were associated with significantly higher all-cause mortality. Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality. The use of predefined standard BMI groupings can facilitate between-study comparisons.

And here’s Walt Willett on NPR today: Continue reading

A Must-Read On Health Insurance If You’re Traveling Abroad

(Kuster & Wildhaber Photography/flickr)

Many of us — for better or worse — are traveling in the coming weeks or months. And if you’ve ever had to bring a sick child to a health clinic in a country where you don’t speak the language, you know how harrowing getting medical care while on “vacation” can be. (Not to mention the sticker shock when you get the bill.) Here’s a really helpful post on Healthcare Savvy by Sue (Sunni) Patterson that offers everything you’ll need to know about health insurance coverage if you’re out of the U.S. The bottom line: plan ahead as best you can.

You may be closing out 2011 with a holiday trip, domestically or internationally. If you plan to leave the country, you may want to consider the following when it comes to your health:

You may not have health insurance coverage for illnesses or injuries that are treated abroad, even if you have U.S. based medical coverage. Confirm with your benefits administrator.

Generally, Medicare does not provide coverage for hospital or medical costs incurred abroad, however, rare circumstances may be covered.

AARP can assist with obtaining foreign medical coverage and offers valuable travel tips.

U.S. consulate personnel will help you locate health care providers and facilities and even contact family members, if necessary.
You can purchase travel insurance that covers health care needs and pays for medical evacuation if you need to be transported back to the US for treatment.

Obtaining medical treatment in another country can be expensive and a medical evacuation can cost over $50,000. Plus, you may encounter challenges with deciphering charges while abroad. Be vigilant, prepared, and follow the same self-advocacy steps you would while receiving medical care in your home state.

If you choose to purchase medical expense coverage while traveling abroad, double check you’ve carefully researched the following:

–Trip cancellation clauses or reasons. You may want to choose an optional ‘cancel for any reason rider’.
–Inclusion of a waiver to a pre-existing condition exclusion.
–Plan coverage exclusions, situations and conditions.
–Save all receipts and document everything from the start of a condition; contact your plan representative immediately.
–Does the policy include medical evacuation coverage? If not, you may want to consider purchasing this optional coverage.
–Purchase travel insurance at the same time you pay for your trip. It’s too late after you’ve had an accident or become sick.

For more information about international travel preparation, visit the U.S. Department of State website.

Physician’s Group Denounces IOM On Health Coverage, Says Financial Conflicts Abound

Physician’s For A National Health Program, a group that advocates a single-payer health system, yesterday charged that the influential Institute of Medicine’s recommendations for “essential” health coverage under the new national health law are “skimpy” and biased and could “cause much suffering” for patients.

In response to the accusations, detailed in a letter sent to U.S. Health and Human Services Secretary Kathleen Sebelius, a spokesperson for the IOM, Christine Stencel, wrote this in an email message:

The committee’s report lays out the solid rationale for each of its recommendations and speaks for itself. We invite all interested people to download a free electronic copy and read it to see exactly what it said in terms of balancing coverage and cost.

Here’s the full news release from the national physician’s group:

More than 2,400 doctors, nurses and health advocates denounce Institute of Medicine’s health coverage recommendations

IOM panel ‘riddled with conflicts of interest’ in violation of agency’s own guidelines, signers of protest letter charge

In a letter sent to Secretary of Health and Human Services Kathleen Sebelius and posted on the Internet today, more than 2,400 physicians, nurses and other health advocates condemn the recommendations of an Institute of Medicine (IOM) committee regarding the “essential benefits” to be mandated under the 2010 federal health reform law. Continue reading

Podcast Friday: Sex After Cancer, New Cystic Fibrosis Drug

In this week’s podcast, audio versions of two recent CommonHealth hits:

  • Sex After Cancer: Among the nearly 12 million cancer survivors in the U.S., many suffer from sexual problems related to their cancer of the treatment to fight it. Rachel Zimmerman details the problems, talks to patients and tracks one psychologist’s efforts to bring pleasure back to patients.
  • New Drug For Cystic Fibrosis: A still-experimental drug, called VX-770, while not a cure, is being called a “major advance” in CF research. VX-770 attacks the basic defect in cystic fibrosis, and right now helps only 4 percent of those living with cystic fibrosis. Carey Goldberg explains what VX-770 does, and how it’s helped one woman do things she’s never done before — like shovel snow.