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Oct. 25, 2013
Oct. 22, 2013
Oct. 4, 2013
President Obama will hold a press conference today at noon. Topics will include Russian relations, Edward Snowden and the state of the economy. We'll have reactions to the speech with our News Roundtable immediately following the press conference.
Aug. 9, 2013
Willamette Valley Community Health, the Salem-area coordinated care organization (CCO), is having trouble getting Salem Health to agree with the financial details of its healthcare plans. Salem Health runs the Salem and Dallas hospitals. Last fall it sued the CCO over what it saw as low reimbursement rates. Now a bill in the legislature could kick Salem Health out of the CCO. But stakeholders in other CCOs worry the law may hurt providers in other parts of the state. We'll check in on the disagreement that could threaten the future of the CCO in Salem.
June 13, 2013
When he's asked to explain how coordinated care organizations (CCOs) work, Oregon Governor John Kitzhaber has a favorite hypothetical example he likes to bring up. The example goes like this: There's a 92-year-old woman with well-managed congestive heart failure who lives in an un-air-conditioned apartment. A heat wave would be enough of a strain on her system to send her to the emergency room, which would cost a lot of money. Under the new CCO system, Kitzhaber argues, a community health worker would be checking in on this hypothetical nonagenarian and would prevent the expensive emergency room visit by providing her with an air-conditioner. Kitzhaber mentioned this example just last month when we interviewed him at the City Club of Portland and a few weeks later when he spoke to the New York Times. He also used it in a 2011 speech on health care reform and when he was on the campaign trail in 2010. This story left us wondering: Who exactly pays for the air-conditioner? Who decides it's medically necessary? And what about the doctors at the emergency room who never see this patient — how do they get paid under this new system focused on preventative care?
April 24, 2013
Portland's largest private employer, Oregon Health & Science University, recently announced a hiring freeze. Chief financial officer, Lawrence Furnstahl says while there will be some select hiring for critical staff, the freeze is necessary to contain costs. Since most federal research money comes from discretionary spending, sequestration is hitting OHSU and other research institutions hard, Furnstahl says. OHSU relies on the federal government for about 40 percent of its two billion dollar budget. Furnstahl told the Portland Business Journal that the uncertainty of federal funds and the rising cost of public employee retirement benefits are prompting OHSU to do some serious belt-tightening.
March 11, 2013
Booth Gardner served as the governor of Washington State from 1985 to 1993. He passed away over the weekend from complications of Parkinson's disease. Having only served as state senator and Pierce County executive before running for governor, he was known for a campaign slogan that winkingly acknowledged his relative statewide anonymity: "Booth Who?" But he overcame his lack of name recognition to become a two-term governor that brought changes to education, healthcare, and land use. After leaving office, he lived a quiet life, until reemerging into political view to advocate for Washington's Death with Dignity Act.
March 19, 2013
After the shootings at Clackamas Town Center and the Sandy Hook massacre of 20 elementary school children, we've been exploring various responses and approaches to preventing such violence in the future. The idea of early assessment and intervention was an aspect of prevention that came up briefly in our show about getting mental health care to transition age youth (16 -24). The basic idea is that along with reading tests grade school kids get, there would also be a formal behavior evaluation. But what would that look like? Who would do it? How early would it start? What are the benefits? We'll ask those questions and more of Jeffrey Sprague, from the University of Oregon, one of the principal researchers in the area. And we'll check in with one of the early adopters of this idea in Corvallis to see how it's working there.
Feb. 19, 2013
In the past decade, the phrase gluten-free has gone from an obscure term to a household one. Supermarkets now devote entire sections to gluten-free products, and even beer makers have gotten into the act. But what exactly does it mean to say something is gluten-free? The answer has significant health implications not just for those diagnosed with Celiac's disease, but many others who experience gluten-intolerance. The FDA defines gluten-free as a product containing no wheat, barley, rye or hybrids of any of these. However, the gluten-free label is a voluntary one, with the only directive that labels not be untruthful or misleading. Some legislators, including Oregon Senator Ron Wyden, have called for universal requirements for gluten-free labels. The FDA has been working on labeling requirements for gluten-free foods since 2005. Recently, they sent recommended requirements to the Office of Information and Regulatory Affairs (OIRA). Gluten-free advocates are anxiously awaiting OIRA's approval now that the 90-day public comment period has expired.
July 11, 2013
For the final day of the Our Town tour this year, we head to southern Oregon: Lakeview and Roseburg. Lakeview The town of Lakeview sits in south-central Oregon a mere 15 miles from the California border. Residents can drive to Reno, Nevada in four hours — half the time it takes to get to Portland. Several schools, ranching, a mill, and a prison provide many jobs for the town. Additionally, natural resource industries are an integral part of Lakeview's economy. A natural gas pipeline finished construction last year, and PGE recently announced plans for its first commercial-scale solar power facility in Lakeview. The town has begun to embrace geothermal energy, though early attempts have sparked some controversy. The town was slated to be the site of an Iberdrola biomass plant, but low energy prices have put the project on hold indefinitely. Lakeview is also home to an FSC-certified timber operation. The surrounding area is known for its prime hang gliding and birding territory. As always, we've put together a companion website for Lakeview. Head over there to check out our interactive map which includes interviews and photographs of the people and places of Lakeview.
Dec. 28, 2012
It's been a big year in a lot of ways. There was the presidential election and the London Olympics, but there was also a lot going on in our neck of the woods. Oregon saw its biggest wildfire in almost 150 years. We dealt with a mass shooting in our own back yard and felt the aftermath of shootings in other parts of the country. Oregonians began implementing changes to the healthcare system by setting up some of the first Coordinated Care Organizations (CCOs). And we saw some new things happening on the individual level as well. Portland author Cheryl Strayed, for example, had a great year. She had not one, but two, books on the New York Times bestseller list: her memoir Wild and a collection of her "Dear Sugar" columns called Tiny Beautiful Things.
Dec. 31, 2012
After the mall shooting deaths of two people at Clackamas Town Center and the incomprehensible loss of 20 young children and seven adults at Sandy Hook Elementary, we're looking into some of the potential ways to prevent such tragedies. We've discussed security in schools, mental health resources for parents and kids, and most recently, gun laws. On this show, we'll find out what kind of mental health care is available to youth ages 16-25, also called "Transition Age Youth." That's generally the age range of those who commit these kinds of unspeakable acts of violence. And it's the age group that several years ago, the state found was 80 percent less likely (pdf) to get the mental health care they need compared with other age groups.
Jan. 9, 2013
The American Academy of Pediatrics released a new policy statement Monday that has reignited the debate over whether or not boys should be circumcised. The AAP stopped short of a blanket recommendation on whether or not to remove the foreskin from the tip of the penis, saying the decision should be left to parents. The academy did say the health benefits of circumcision outweigh the risks. According to the Agency of Healthcare Research and Quality, 55-56 percent (PDF) of newborn American males were circumcised in 2009 (the most recent year for which numbers were available). That rate is even lower in the western United States and the practice has been on the decline nationwide. Some adament detractors protested outside of an AAP chapter office after the academy announced released their statement. In Oregon, arguments over circumcision flared up a few years ago when a custody case evolved into a legal battle over whether or not a 12-year-old boy should be circumcised.
Aug. 30, 2012
In the wake of the recent shootings at the Clackamas Town Center and Sandy Hook Elementary School, we're looking into some of the potential ways to prevent such tragedies in the future. We've discussed security in schools, mental health resources for parents and kids, gun laws and, most recently, mental health care available to "transition age youth." Next we will explore whether or not there is a relationship between violent video games and violence in the real world. As the national conversation around gun violence progresses, video games have been cited as a contributing factor. But while some are blaming violent video games, others assert that there is no link between playing violent games and actually being violent. And while there seems to be agreement that violent behaviors are rarely spurred by a single factor, the role and weight of each factor, including violent video games, is still being debated.
Jan. 16, 2013
We'll talk with the two leading candidates for Portland City Commissioner Position No. 1: incumbent Amanda Fritz and challenger Mary Nolan. Fritz has held the job since 2008. Nolan has spent the last 12 years in the state legislature. They've both made efforts to highlight their leadership in local government during the campaign. Nolan focused on education and healthcare as a state representative from SW Portland. She was also majority leader for the House Democrats. Before being elected to the legislature, she served as head of the Portland Bureau of Environmental Services and co-founded a GPS technology business. She's been criticized for her blunt communication style. Nolan is originally from Chicago. She moved to Portland in 1976. Fritz heads up the Office of Neighborhood Involvement, the relatively new Office of Equity and Human Rights, among other bureaus. She also championed a cheaper way to comply with the EPA regulation requiring Portland to treat its water, a move that's in line with her image as a fiscal watchdog. Fritz has faced some criticism over the Office of Equity, which has a $1 million budget and not much to show for it yet. She has a background as a nurse and a neighborhood activist. She's originally from Yorkshire, England and she moved to Portland from New York in 1986. Fritz successfully used the city's public financing system when she was first elected. This time around, even though that system is no longer in place, she's imposing a $50 limit on individual campaign donations and she's not accepting donations from PACs or corporations. Nolan, who began fundraising last summer and has not set donation limits, has raised far more than Fritz at this point.
April 16, 2012
Roseburg, Oregon is a city of 21,790 in the southwestern part of the state. It's within 100 miles of three of the state's national forests, which is why its history is so closely entwined with the that of the timber industry. After World War II, Roseburg was known as the Timber Capitol of the Nation, due to the abundance of Douglas Fir lumber produced in and around the small city. The spike in demand for housing, and lumber to build it, also made way for the philanthropy that still continues in Roseburg today. Family-owned timber companies still employ many Roseburg residents, but these businesses are no longer the backbone of the community they once were. The recession has been particularly rough for the industry, especially due to the decline in home-building. The choices students are making about what to study at Umpqua Community College (UCC) are a good indicator of what's next for this town. Healthcare, particularly nursing, is a popular field and there's a brand new addition to the Southern Oregon Wine Institute at UCC. The program offers a one-year certificate and an associate's degree. Both paths teach students how to cultivate grapes and how to make them into wine. The local wine industry has experienced a recent growth spurt, but it also has a rich history in the region, which has always been home to fertile farmland. We've put together a companion website for the Our Town series. Head over there to check out our interactive map, which includes interviews and photographs of the people and places of Roseburg. Here are some photos from our live show at Joe Monkey:
June 1, 2012
The August issue of Consumer Reports has ranked Salem Hospital as the safest hospital in Oregon. The hospital was given a composite score of 63 out of 100 in six categories that measured everything from radiation use to mortality rates. The hospital shined particularly when it came to infection-prevention across departments. Dr. John Santas, the director of the Consumer Reports Health Ratings Center, told us Oregon hospitals on average did better than hospitals nationally. Hospitals across the country had an average score of 49. But he also says hospitals in Oregon and around the country have a lot of work to do when it comes to communicating with patients about new medicaitons and discharge policies. He attributes Oregon's above-average score in part to the state's laws requiring hospitals to be transparent about infection rates and other data.
July 18, 2012
The U.S. Supreme Court has ruled on the constitutionality of certain provisions of the Affordable Care Act. Since the arguments three months ago, there has been much speculation about how the ruling could turn out and what that would mean for ordinary Americans as well as presidential candidates. The ruling is far from simple, but the individual mandate that was at the heart of the challenge to the law, has been upheld. The court ruled that the requiring individuals to purchase healthcare or pay a penalty fine is constitutional if it is treated as a tax.
June 28, 2012
The Obama administration has announced a new compromise for contraceptive coverage for women working for religiously affiliated employers. Under the new plan employers like charities or hospitals with religious affiliations will not be required to pay for contraceptive coverage.
Feb. 10, 2012
The Oregon Legislature is 75 percent of the way through its short February session. This last crucial week will bring key decisions about the budget, Governor Kitzhaber's healthcare and education priorities and a slew of other issues on the table. With tensions running high, election year politics seem to be gumming up the works a bit. According to The Oregonian, the governor's legislative priorities are caught up in a partisan fight as lawmakers get ready to start campaigning once they leave Salem. They expect to drop the final gavels Feb. 29.
Feb. 23, 2012
If you're a regular Think Out Loud listener, you already know that the legislature has passed its self-imposed deadline of February 29 for this year's short legislative session. They're now dangerously close to the actual deadline, which is written into the state Constitution. They can only go until March 6, when they have to drop those gavels and declare "sine die" once and for all (until 2013 that is). So, what's the holdup? Lawmakers passed a controversial bill to protect concealed handgun licenses from public records requests and the governor signed his healthcare "transformation" bill Friday. But one of his education policy bills are still on the table, along with a much-discussed law to create a tax credit for compensation to ranchers for livestock killed by wolves.
March 5, 2012
We haven't seen too many bipartisan efforts in the last few months in the rancorous world of national politics — especially for an issue as polarizing as healthcare. But then, on Wednesday, here come Oregon senator Ron Wyden, a Democrat, and Wisconsin congressman Paul Ryan, a Republican, with a plan to overhaul Medicare. The proposal is based on an idea called "premium support," which basically means that Medicare money would subsidize premiums being paid to private insurers. (Seniors would also be able to stick with the traditional fee-for-service model.) The other big part of the plan: the growth of Medicare would be capped, and would have to grow at about the same rate as the economy.
Dec. 16, 2011
A new study conducted by OHSU physicians looks at Oregon's registry for people who have made decisions about what kind of medical treatment they want in a life-threatening situation. The study's findings were published in the Journal of the American Medical Association. It drew on data from the 25,000 Oregonians who registered with the Physician Orders for Life Sustaining Treatment (POLST) program between December, 2009 and December, 2010. The POLST program has been around for two decades to go further than standard "Do Not Resuscitate" orders in making hospitals aware of people's end-of-life wishes. The registry was just instituted in 2009 to help streamline communication among medical professionals about POLST, especially in crisis situations. Since then, several other states have created similar programs. The study found that people who choose not to be resuscitated don't necessarily make the same choices about whether or not to refuse other treatments. Some prefer not to be taken to the hospital or treated for illnesses that could end their lives, while others want everything short of CPR administered in a life-threatening situation. The study found that most people want some combination of treatments available to them. The overwhelming majority of people in POLST are over 65 and many are frail or facing a terminal disease. All of them have chosen to have detailed and often difficult conversations with their doctors and family members about death and dying.
Jan. 6, 2012
The U.S. Supreme Court has agreed to hear a challenge to the Obama administration's health care overhaul. Lower courts around the country have heard the case and decided different ways, with the 11th Circuit Court finding it unconstitutional. The high court will take up the 11th Circuit's decision. In a remarkable move, the Supreme court scheduled five and a half hours (instead of the usual one hour) for the arguments in March. Before the Supreme Court term began, we discussed the possibility of the case being heard with law professor and Supreme Court watcher, Lisa McElroy. Now that the justices have indeed taken the case, we'll check back in with her about the specific issues they'll be looking at and the impact their ruling — one way or the other — is expected to have.
Nov. 15, 2011