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Think Out Loud

What Does Gluten-Free Mean?

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.

Think Out Loud

State of the Union

President Obama delivered his second State of the Union speech focusing mostly on domestic issues — most notably job creation and the economy. He opened with comments about what sets American apart from the rest of the world and then focused in, more specifically, on deficit reduction, education, the promise of renewable energy, healthcare reform and the country's debt. Did you listen to his speech or the Republican or Tea Party responses that followed? What struck a chord for you?

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Rx: Health Promotion

Few people disagree that the U.S. healthcare system is broken. What's a lot less clear is how to fix it. Last week we began our series on healthcare reform by exploring the disparities between healthcare costs and outcomes. This week we're taking another stab at the huge issue by asking: what role does keeping people healthy have in the future of healthcare? Smoking cessation, weight loss, diabetes education and nutrition programs: do these things actually have a place in the reform lawmakers are working on? Health Promotion Advocates say yes. And they're working hard to lobby Congress to say the same. Meanwhile in Oregon, lawmakers just passed a bill to create a new state agency to coordinate healthcare reform efforts here. What role will health promotion and disease prevention have in their planning? What exactly does health promotion mean? And what programs actually work?

Think Out Loud

Rx: The Final Health Care Bill

Over the past year we've discussed many aspects of possible healthcare legislation on Think Out Loud, from the role of employers in providing health insurance to the region's low Medicare reimbursement rates. We've explored health promotion, doctors' salaries, and personal healthcare values. All that while the country debated the future of healthcare in this country. Now that's coming to an end. On Sunday night Congress passed a major overhaul of the nation's healthcare system. President Obama is expected to sign it into law on Tuesday. The Senate will take up some of the revisions probably this week. Oregon's four Democratic representatives voted yes on the bill. Republican Greg Walden voted no. Congressman Peter DeFazio had a particular hand in getting an adjustment in Medicare reimbursement rates that's kept them particularly low in Oregon. After the vote he told OPB reporter, Rob Manning:

When the administration knew we were serious, and they could lose the whole bill, we negotiated around the clock, and we got something that is justifiable, that’s been studied time and time and time again by experts and panels and commissions saying this system is not fair, it’s not equitable, it doesn’t work. And it penalizes the states that are doing a better job, and rewards states that are doing a worse job, and it’s costing the taxpayers money.

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Mental Health and Homelessness

Eleven days before Jack Dale Collins was shot dead by Portland Police at Hoyt Arboretum, he visited the police bureau, confessed to a 42 year-old crime, and asked for help. He said he had molested a girl at his home when he was a teenager. He had forgotten many of the details, including the victim's name, but the police report shows that during this confession (which as a crime had passed the statute of limitations) he also asked for mental health care. The officer recommended Cascadia Behavioral Healthcare, but there is nothing to suggest that Collins followed up on this suggestion. According to The Oregonian, the officer said he would have driven Collins to Cascadia if he had been asked. What would have happened if the process was different? If Collins had been taken to Cascadia, for example? Or perhaps if a crisis line had been called? What would have happened if he had received more mental health care long before setting foot into the police bureau?

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Urban Versus Rural Health Care Premiums

Diane Lund-Muzikant joins us for an update on health care premiums under the Affordable Care Act, following the Dec. 15 deadline to re-enroll for healthcare coverage.

Think Out Loud

Cover Oregon Transitions To The Federal System

We'll get a progress report on Oregon's switch over from the state's failed health insurance exchange website to the federal

Think Out Loud

Circumcision Decisions

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.

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Oregon Hospital Rankings

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. 

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Our Town: Roseburg

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:

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Results for OPB

Health | local

Oregon Ranks First In Injury Prevention, 47th In Emergency Healthcare

Oregon ranks 47th in the nation in a new report on the availability of emergency healthcare.

Health | Politics | News | local

Inslee Calls Republican Healthcare Plan 'Disaster For Washington'

Washington Gov. Jay Inslee is calling the Republican healthcare plan in Congress “a disaster.” Inslee made his comments Wednesday as new projections on the impact to the state were released.

local | Education | News

Portland College Scores High For Graduates' Earning Potential

New college rankings from the Brookings Institution are shining a light on a lesser-known Portland college. Concorde Career College runs healthcare preparation programs at 16 locations across the country.

Health | Politics | News | local

State Hopes Oregonians Re-enroll By Insurance Deadline

Oregonians who want to keep their Affordable Care Act insurance running without interruption, have one more week to sign up with

Health | News | local

St. Charles Health System Plans New Hospital In Prineville

The board of directors of Central Oregon's largest healthcare provider voted Friday to build a new hospital in the city of Prineville.  Bend-based St. Charles Health System will spend $30 million on what will be St. Charles Prineville.


Kulongoski Announces State-Run Heathcare For All Oregon Children

Governor Kulongoski announced Friday that every child in Oregon now has access to state-run healthcare -- even children with pre-existing conditions.

Economy | Health | Education

PSU, OHSU Unite For New Health Care Management Program

Two of Oregon’s largest universities began a new joint program Friday meant to prepare students to help transform the healthcare industry.


Businesses Meet To Talk About Escalating Heathcare Costs

Some of the country’s leading companies are throwing their weight into the ongoing debate over healthcare.  AT&T, Wal-Mart, and Intel have joined a new coalition called Better Health Care Together.’  The group met in downtown Portland today to talk about how the escalating costs of healthcare are hurting American companies. 


The America Donald Trump Is Inheriting, By The Numbers

Trump will be at the head of a nation with a relatively healthy economy, a healthcare system he has promised to overhaul, and facing a slew of international tensions.


Healthcare expert Katy Votava is the author of "Making the Most of Medicare,"

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