2011: San Diego's Top Health Stories

CAVANAUGH: Is this KPBS Midday Edition. I'm Maureen Cavanaugh. Prescription drug abuse, the early stages of healthcare reform, and natural childbirth. Those were just some of the provocative topics on the health beat in 2011. Joining us to discuss these and other stories is KPBS health reporter, Kenny Goldberg. Welcome, Kenny. GOLDBERG: Thanks, Maureen. CAVANAUGH: Now, Kenny, just last week, you brought our attention to what federal officials are calling America 'fastest rising drug problem. Prescription drug abuse. What's going on here in San Diego? GOLDBERG: Well, which we've seen in San Diego, and in the rest of the country, is an enormous rise in the number of people who are, becausing prescription pain killers likoxy contin, Vicodin, Valium, methadone. And what we're also seeing is an increase in unintentional deaths from these drugs. As a matter of fact, in San Diego County, prescription drug abuse is the leading cause of accidental death. CAVANAUGH: Now, how did this whole problem of prescription drug abuse come to pass? GOLDBERG: Well, back in the 90, health officials decided to take on the issue of chronic pain. There were a lot of people reporting to doctors a chronic pain, and there weren't very many treatments for that. They wanted to make a concerted effort to treat this pain, and then the drug companies came up with some medications, others were newly formulated. And now we fast forward 19, 20 years later, and we've got this overabundance of these pain killers out there. And some is doctors may be misprescribing them, people are doctor shopping, doing all sorts of stuff to fet thirds requirement hands on these drugs CAVANAUGH: A couple years ago, we heard about prescription drug abuse by young people who were popping their parents' pills at parties. But the most recent San Diego statistics show the deaths are actually of middle aged people. So these are accidental deaths brought about by just taking too much of their prescribed medicine; is that right? GOLDBERG: That's right. And most of these deaths in the accidental category, in the 40 to 60-year-old range. There's another category of people who are intentionally taking overdoses from pain killerce and other drugs. When you talk about prescription deaths, it was the NO. 1 cause of accidental death in the county. It surpassed car accidents, firearm deaths, it surpassed deaths by alcohol. So is this a big deal CAVANAUGH: Are narcotics like Vicodin and Oxycontin inherently bad? GOLDBERG: Some doctors say they're very effective. Doctor Robert wails, here's what he had to say about it. NEW SPEAKER: They provided tremendous assistance for these people in chronic pain. Used correctly, they're wonderful. It's how they're utilized, and the people that use them. CAVANAUGH: So what are some steps that are being taken to try to curb this abuse? GOLDBERG: Federal health officials are talking about trying to educate doctors on how to better prescribe these kinds of pills for chronic pain. Pain specialists do it every day, like this Robert wails gentleman. Primary care physicians, GPs, they're not that very well educated about it. There's very little education in medical school to understand about prescription pain killers, per se. They want to better educate doctors. What we're also seeing in San Diego County and other communities is these prescription drug takeback days, where a couple times a year, law enforcement officials are advertising and inviting people to come down to the sheriff's office, to post office, what have you, they set up a temporary box to have people drop off their unused prescriptions. Part of the problem is, these drugs are sitting at somebody's home. They have a tooth extracted, they get a prescription for Vicodin, and then they've got, you know, 20 to 30 pills laying around their medicine cabinet, and that can get in the wrong hands. So we're having these takeback day, and also in San Diego County, at all of the sheriffs' substations, they have permanent drug collection boxes. You can drop off the drug, no questions asked. They also have these collection boxes the two stations in the San Diego police department CAVANAUGH: Your next top story of 2011 was healthcare reform. Some provisions have already kicked in. Tell us about that. GOLDBERG: Some of the provisions that have already kicked in are you can have your child up to age 26 on your health policy. There's also free preventive services now. No cost preventative services. If you go to the doctor for recommended immunizations, breast cancer screening, that's free. No cost. Baby checkups, some of the baby stuff is free now. And what we're really waiting for is 2014. That's when some of the really big provisions are going to kick in. CAVANAUGH: One of the problems with this rolling out year we year is that people keep waiting for things like lower cost health insurance. And apparently health reform really isn't addressing that yet. GOLDBERG: It's certainly not doing it yet. And I spoke to I gentleman named Billy Stevens in North County. Here's what he had to say about health reform and saving money. NEW SPEAKER: When I heard about health reform, I thought I was going to get a break. It might go down. But it has just kept on going up and up. It's just gotten to the point that it's unaffordable. There's no end in sight. CAVANAUGH: Do we know why that is, Kenny? GOLDBERG: Well, particularly with people who have individual health insurance policies, people who aren't with groups or company provided health insurance, they have to buy insurance on the individual market. And really, the sky's the limit. You've got blue cross and blue shield, and some of the other insuriers in California raising rates 3 or 4 times a year, double digit rate increases. And there's really no relief in California because California is one state where health insurance rates are not regulated. In some other states in more than three-dozen other states, as a matter of fact, state regulators have the ability to review rate increases, and they can reject them if they consider them to be excessive. We can do that in California with autoinsurance, with home insurance. Auto insurers when they raise rates, they have to get permission from California regulators. That's not the case with health insurance CAVANAUGH: What's coming up next in 2012? GOLDBERG: There's not a lot happening in 2012. The next mile stone will be in 2014. That's when people will be required to have health insurance, when tal California and other states will introduce these health exchanges, people who don't have company provided insurance can onto this online marketplace, get discounted plans, make it easier for the people who are on the individual market to get low-cost health insurance. But still at this point in California, as we look now, when we project in 2014, there still be no limits on what insurers can charge. That's really an issue. And last year in the legislature, they tried to pass a bill that would give the regulators to reject rate increases that they rejected. CAVANAUGH: The U.S. Supreme Court accepted a challenge to healthcare reform law, and they're going to take a whole week to hear arguments at the Supreme Court in March. That could possibly put all of healthcare reform into limbo, basically. What is that all about? GOLDBERG: That's right. There have been a number of court challenges already to the healthcare reform law. A number of states don't want to participate in it at all. They don't even want to take government money to roll out some of these preliminary stages of health reform. There's a real challenge. One of the basic challenges is that requirement, the individual man date that everybody has to have health insurance. Either it has to be provided by their company or they have to purchase it themselves. So I think that's what the case is going to ride on. That basic issue, that's a real fundamental issue for a lot of people. And that's what they're going to be fighting out in the Supreme Court. The decision may come down right around the presidential luncheon. And won't that be something? CAVANAUGH: It certainly would. Now, we have to move onto the story that brought you some of your most feedback of the year. And it sounded like this. NEW SPEAKER: (Audio Recording Played) CAVANAUGH: Oh, Kenny, what is this? GOLDBERG: All right. Now, this is a woman in ecstasy, but she's not having sex. This is a woman who's in childbirth. And this is a segment from a movie called orgasmic birth. MAUREEN CAVANAUGH: Why did you choose to coa story on this in the first place? GOLDBERG: Well, somebody pitched it to me. And the e-mail came in, orgasmic birth, and I said what is this? And I -- I read it, I called the people, and I said -- when I found out about it, I said this is going to make a good story. What this was, this is ray documentary on whelm who have natural childbirth. And the premise of the movie is that women can have a natural childbirth, no natural intervention, and it can be a wonderful, fulfilling, pain free experience, and can even be sexually fulfilling. And I said, man, that's provocative. So that's what prompted this. There was a screening of this documentary at cal state San Marcos. So I went to it, and the story flowed from there CAVANAUGH: And you spoke with some of the advocates for all-natural birth, and the advantages of all-natural birth. Tell us about that. GOLDBERG: I spoke to a number of mid-wives in San Diego, including a mid-wife named Michele Freud, who talked about some of the advantages of having an all-natural childbirth. NEW SPEAKER: Women who experience natural birth, it's an imprint in a woman's life. It's rewarding. And for the baby as well. When the birth is a gentle birth experience, the bonding is uninterrupted, their connection is more enhanced. CAVANAUGH: I couldn't help but wonder, what happens if there's complications during a natural childbirth? GOLDBERG: There's the rub. And that's what medical professionals say -- that's one of the reasons why they like to have women give birth in hospitals, even if they're in the alternative birth centers in hospitals. At UC San Diego medical center in Hillcrest, they have alternate birth centers where they can have a duala there, a mid-wife, what have you. But if something bad happens, they can rush you down to the med surge floor, have a doctor there at moment's notice. That kind of stuff. So when you're on your own, that's another story. If you're having birth at home, and something bad happens, you're in an ambulance right away. But that's not always instantaneous, of course CAVANAUGH: Do doctors disagree with the argument that we've medicalized birth in this country? GOLDBERG: I don't think they do disagree with it. But they say there are some reasons for it. Women now who are giving birth are older than they used to be. So that results in more complications, doctors say. We're also getting more multiple births. We're also getting women who are over weight and obese giving birth. Much more than we used to. All these things complicate the birth process and make it riskier. What it doesn't answer is why -- and this is a topic for another day, why have we gotten such an enormous rise in C-section births in the United States. Right now, almost 1/3 of all births across the country are by C-section, 40 years ago, it was 7%. There's something going on here other than just medical necessity. CAVANAUGH: I want to move onto the last story that we've highlighted from your year covering health in San Diego. And that is 2011 marked the 30th year since the beginning of the AIDS epidemic in America. You did a series on HIV/AIDS in San Diego. In what ways did you find that the treatment has changed? GOLDBERG: In the early days of the epidemic, you'll recall that doctors didn't even know what the disease was. They had no idea what it was. They didn't know how it treat it. People were dying left and right, and it was frightening. It was really frightening for everybody. Medical professionals let alone the people who were becoming infected. Well, since those early days, now HIV has become a chronic condition that can be treated, like diabetes. It can be managed. And people can live healthifully with HIV for years if it's treated early enough, and if they stay on their medication. If they're -- self aware of their health and stay in touch with their doctors. That's really the big transformation. People can live with HIV now. CAVANAUGH: And one of the big things about your series was a new program that San Diego is implementing to encourage more people to get tested GOLDBERG: Right. And the reason behind that is the centers for disease control says about one in five Americans who have HIV don't know it. And these people are responsible for about half of all new infections. And so there's a pilot program going on in San Diego in the Hillcrest area in four different Zip Codes where people are going door to door and offering people an HIV test. And the concept is if we really get a broader base of people being tested, then we'll get a truer picture of what the epidemic is. CAVANAUGH: Right. Kenny, thank you so much. I appreciate it. Very fascinating look back on our health stories. I've been speaking with KPBS health reporter Kenny Goldberg. Thanks a lot. GOLDBERG: Thank you.