KPBS Health Reporter Kenny Goldberg traveled around the world to cover the top health-related stories of 2010. Goldberg joins us to recap some of the biggest stories he's worked on over the last year. What impact is the federal health care reform bill having in San Diego? How might a new vaginal microbicide gel play a significant role in the fight against HIV/AIDS in Africa? And, why did a team of local doctors perform brain surgery on a patient that was awake during part of the procedure?
Guest
Kenny Goldberg, KPBS Health Reporter
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This is a rush transcript created by a contractor for KPBS to improve accessibility for the deaf and hard-of-hearing. Please refer to the media file as the formal record of this interview. Opinions expressed by guests during interviews reflect the guest’s individual views and do not necessarily represent those of KPBS staff, members or its sponsors.
Good morning, I'm Dwane Brown, Maureen Cavanaugh is off this week. You're listening to These Days on KPBS. A quick reminder, we will not be taking any phone calls on today's program. This morning we're looking back at the top health stories of 2010. KPBS health reporter Kenny Goldberg has covered the world AIDS conference in Vienna, he's given us a local perspective on how healthcare reform will affect people in San Diego. He also took us into the operating room where doctors actually performed brain surgery on the woman who was awake during most of the procedure. Now, Kenny, that was really amazing. We'll get to that in a little bit this morning. Kenny joins us to discuss some of the most interesting health stories he covered this year. Let's start with healthcare reform. Kenny, it got a lot of -- a lot of media attention this year. But most of the reform efforts haven't really kicked in. What did begin this year?
GOLDBERG: Well, a couple important provisions have kicked in already. Parents can now keep their children on their health insurance until they're 26. Doctors and other healthcare providers have to offer preventive services like vaccinations, colonoscopies, Pap smears, mammograms, free of charge. So in other words, if you go into your doctor to get routine vaccinations or one of those preventive tests, there's no copay, there's no charge at all. There's also no lifetime limits anymore for insurance coverage. Some insurance plans have a million dollar, a $3 million lifetime cap, once you reach that, they won't be covered anymore. That's an eliminated. So some of these things have already taken effect.
BROWN: And the dependent coverage covers what age? Until what age.
GOLDBERG: Until 26. So you can keep your young adult child on your policy until they're 26 years old.
BROWN: And what kind of impact did the healthcare bill have directly on people here in San Diego?
GOLDBERG: Well, it's slowly starting to take effect. There's a lot of -- is ignorance the right word? Perhaps so. Or unawareness about health reform even on providers' standpoints. I hosted a forum on healthcare reform a few months ago, and you'd be surprised at how many nurses and doctors don't know exactly what happens when, and when they're supposed to go about things of so the federal government acknowledges they need to do a better job of emphasizing what health care reform is all about and when the different provisions take effect.
BROWN: Now, let's of people have no insurance, health insurance in California, including here in San Diego. How does the reform bill affect them?
GOLDBERG: So far, it doesn't. But it will slowly as more community clinics get federal money from the healthcare reform bill. They're be able to expand their coverage. And in a few years, California will offer these low cost health insurance exchanges where people will be able to pool their purchasing power in effect to get cheaper insurance. The requirement that people have health insurance doesn't kick into 2014 but by that time, California and other state it is eight have these health insurance exchanges set up, they'll also command Medicaid coverage, Medi-Cal coverage.
BROWN: Largest state in the nation, and we're leading the way in getting this process going, right.
GOLDBERG: Right.
BROWN: What can we anticipate in the new year.
GOLDBERG: There's not going to be a lot that'll affect consumers in the new year. The federal government will start funding these health insurance exchanges for the different states. So as I said, California's got a waiver, they've gotten a jump start on it, so they'll start getting their infrastructure in place. There's also sort of a bureaucratic thing that'll go into effect, but it will have an impact on hospitals. The Medicaid program will no longer pay hospitals or reimbursement for certain hospital acquired infections of a lot of people get infections when they're cared for in a hospital. They get hospital acquired pneumonia, they get some sort of other staph infection. The federal government won't reimburse hospitals for that anymore which forces hospitals to clean up their act and make sure their procedures are sterile, and they're taking care of business and they don't get sick when they're in the hospital.
BROWN: Well, moving on beyond the healthcare reform bill, and staying on the lines of infections, there were some big breakthroughs in treating HIV in this year. In July, you flew to Vienna for the world's AIDS conference. Tell us about this vaginal gel that a California company produced to help women avoid transmitting HIV in Africa.
GOLDBERG: Yeah, this was an incredible break through that they announced at the Vienna conference. And I was there when they announced it, and there were 10000 people in this hall, and they gave a standing ovation. It was just unbelievable. Tears in people's eyes. This is a vaginal gel that women in South Africa used before sex and after sex. And they found that compared to a placebo, it reduced the chance of a woman becoming infected by HIV by 39 percent. So that's a big, big deal. The reason why it's so important is this, in a lot of the countries where HIV is ramp act like South Africa, women don't have any control over their sexual experiences. In the culture, they can't demand that their husband or partner wear a condom. So this microbicide, this vaginal gel, for the first time offers hope that a woman could have her own discreet way of protecting herself against HIV.
BROWN: Uh-huh. This is still in the test phase?
GOLDBERG: That's right. This was a clinical trial of about 900 women in South Africa, but it was so successful that now they're moving on to trying to test it with a wider population.
BROWN: So could this eventually become something that will become public.
GOLDBERG: Yes. What they're going to have to do is do further testing and try to duplicate these results. And if they do that, I think they're gonna ramp it up fairly quickly. Especially in Sub-Saharan Africa where the HIV virus is so prevalent.
BROWN: Kenny, is there are any work being continue to study if this drug can also be delivered in pill form?
GOLDBERG: There is. And there was a that was completed earlier this year. They announced the results just a couple months ago. And this was also pretty remarkable. It was a pill that men who have sex with other men took every day, it had two antiretroviral drugs in the pill, also made by the company up in San Francisco, and it found that daily use of this pill, men who have sex with other men that took it, had a 43 percent lower chance of getting infected with HIV. Now, what's significant about this trial is that it was conducted all over the world, men in tie land, men in Brazil, men in the U.S., men in other southeast Asian countries. And what's distinctive about that is that the HIV virus varies in each country. So to find that there was one drug that was effective all over the world is a real break through.
BROWN: And it's been how many years now since HIV hit the scene?
GOLDBERG: About 30 years.
BROWN: About 30 years. Wow. Well, you've talked about a couple of important stories you covered this year. What was one of the most interesting stories for you?
GOLDBERG: Working on this brain story. I was invited by UCSD medical center to watch a surgery where they were trying to remove a tumor from a woman's brain. And they kept her awake during the surgery. Now, this is -- it's called awake brain surgery. The reason why they to it is sometimes a tumor is located close to an area in the brain that controls speech or motor skills. So the surgeons want to know how chose they can get to the tumor and yet not damage some of these other functions in the body. And I'm gonna play you a little segment of the surgery where theres are asking this woman questions while they're operating on her brain, and you'll hear some electric shocks they're applying to her while they ask her questions. And you'll see what the effect is.
(Audio Recording Played)
(DOCTOR): Here we go. Let's try the next one. Can you speak for me.
(PATIENT): No, couldn't speak.
(DOCTOR): You couldn't speak. Can you count for me?
(PATIENT): 1, 2, 3, 4, 5, oh --
BROWN: And Kenny, why did the doctors want her to be awake during part of this procedure again?
GOLDBERG: Well, because the tumor that she had was very close to the area in the brain that controls speech. So they want to see how close they can get to the tumor and yet not damage the areas of the brain that controls speech. So by talking to her during the surgery and stimulating that part of the brain with an electric shock, they can tell if they're getting close or not, and as you could hear on that cut, she was faltering in her speech which they shocked this particular part of the brain. So they know they can't trend on that area right near the tumor.
BROWN: And I'm looking right now on KPBS.org at the story. Because you not only did it on the radio, but you did a television version. So those who are listening right now could actual high go on-line to KPBS.org and see for themselves this amazing procedure.
GOLDBERG: And it was not grizzly at all. I have to say. I mean, I'm no stalwart when it comes to blood and guts. Buff I went in there, and it wasn't that bad. It really wasn't. It's very controlled. They staunched the bleeding, it's not spurting all over the place. It's not all grotesque.
BROWN: Yeah, you've got a strong stomach. KPBS took the lead in covering the whooping cough epidemic here in California. Why was it such a big story here locally?
GOLDBERG: Well, we have had more than a thousand cases in San Diego county. It's by far the largest outbreak of whooping cough in 50 years. And my colleague, Joanne Faryon, did a lot of groundbreaking work on it. What they found is that two out of three people in San Diego who have been infected with whooping cough have been fully vaccinated.
BROWN: Two out of three?
GOLDBERG: Two out of three. So Joanne Faryon said, hey, wait a minute, this doesn't sound right. So she did some thorough investigative work, even travelled to Holland to interview this one researcher over there, and what she came to find out that some doctors expect that the virus has mutated since they came up with this whooping cough vaccine, and perhaps the vaccine is no longer giving people adequate protection against the infection.
BROWN: Well, speaking of viruses, as we begin to wrap up our conversation here, you did a story yesterday about the recent increase in local flu cases. What are doctors telling you about this year's flu season?
GOLDBERG: This year's flu season is looking like a much more conventional one than last year. Of last year, as a result, Hone N1, was the rage, it was practically the only one that was flowing around. Right now, it's an old style A strain and two B strains, and doctors say it's more of a typical flu season that's usual.
(Audio Recording Played)
(DOCTOR): This is really looking like a regular old flu reason, and so far one that's relatively mild. Although last week we did see an increase in number of cases compared to the previous weeks.
GOLDBERG: That's doctor Mark Sawyer, who's an infectious disease specialist at Children's Hospital.
BROWN: So, Kenny, are flu vaccines still available locally?
GOLDBERG: They are, and they're protecting against all the strains that are out this now. Of it's available. Doctors, clinics, pharmacies. There's an ample supply this year.
BROWN: And it's amazing to think, for about 18 months, we fought against the swine flu which actually began in San Diego County, in the Imperial County, and then spread across the country. And today? Where is it?
GOLDBERG: Well today it's still -- there's a more virulent strain happening in Europe. A couple of people have died from it recently. It's at very low levels now in the United States. Upon and we're back to this more typical mix of the flu strains.
BROWN: Well, Kenny, Kenny Goldberg, we look forward to hearing more of your stories in 2011 or 2011. Anything that you're working on that you want to tell us about quickly?
GOLDBERG: Well, I'm working on a piece about baby boomer as they go into the Medicare system, how there's a likelihood that more of them will be looking for substance abuse treatment, drug and alcohol treatment. So I'm exploring what the Medicare system offers them and to see what's likely to happen.
BROWN: KPBS health reporter Kenny Goldberg. Thank you so much.
GOLDBERG: Thank you.
BROWN: Coming up next on These Days, find out how some of the world's most famous street artists are using San Diego's landscape as a palette for their work.
