GBO NEWS: Wiser Fools; NPF Reporting Fellowship Deadline; CJR’s Trudy Lieberman; Palliative Care Resource Gap; & More
GENERATIONS BEAT ONLINE NEWS
E-News of the Journalists Network on Generations
April 1, 2015 — Volume 15, Number 6
Editor’s Note: GBO News, e-news of the Journalists Network on Generation publishes alerts for journalists, producers and authors covering generational issues. Send your news of important stories or books (by you and others), fellowships, awards or pertinent kvetches to GBO News Editor Paul Kleyman. You can subscribe to GBONews.org at no charge simply by sending a request to Paul with your name, address, phone number and editorial affiliation or note that you freelance. You’ll receive the table of contents as e-mail, just click through to the full issue at www.gbonews.org.
IN THIS ISSUE: “Thou shouldst not have been old till thou hadst been wise.” (Fool to King Lear)
1. EYES ON THE PRIZE: The National Press Foundation’s (NPF) 11th Fellowship Application Deadline, April 14
2. HEALTH CARE REFORM SCHOOL: Trudy Lieberman’s Must-Read Columbia Journalism Review Blog on Health Policy Coverage
3. THE STORYBOARD: Homes on the Range Gets First PBS Airdates on Green House Care Alternative; *** “Learning to Say No to Dialysis,” by Paula Span, New York Times “New Old Age”
4. RESOURCES: California Health Care Foundation’s Searchable Online Map Shows Gaps in Palliative Care Resources
1. EYES ON THE PRIZE
***The National Press Foundation’s (NPF) 11th Annual Fellowship, “Reporting Retirement: Finding New Angles” is an all-expenses-paid, four-day look at retirement in Washington, D.C. Open to all U.S.-based journalists in print, broadcast, online or other media, the application deadline is Tues., April 14, by 5 p.m. EDT. (Funding for the program comes from Prudential Financial.)
The program, which will take place June 7-10, will feature thought leaders, journalists and other experts. The NPF website notes, “Boomers are flooding out of the full-time workforce, taking with them a generation of skills and institutional knowledge. But many are moving right back into second careers, creative endeavors, part-time work or full-time volunteer roles. How are they managing pension, 401K, Social Security and other income? And what about the generations behind them? Millennials are actually saving more than expected despite lower incomes – but maybe not enough.”
The application link is shown above. Those with questions can contact Jenny Ash-Maher, NPF Studio and Program Manager, jenny@nationalpress.org; 202-663-7285.
2. HEALTH CARE REFORM SCHOOL
Trudy Lieberman’s Must-Read CJR Blog on Health Policy Coverage
The Columbia Journalism Review’s (CJR) nifty new website provides an easy way to get a weekly story feed by e-mail (one quick button to subscribe to it). That’s something long a mainstay of many sites, but that we’re glad to see at CJR. In particular, this and other changes give GBONews an occasion for checking in more easily on what our favorite CJR contributor, Trudy Lieberman, is thinking about.
Formerly the chief investigative health editor at Consumer Reports and a past president of the Association of Health Care Journalists, Lieberman’s blogs (in this case, really insightful, well researched, no-nonsense, critiques of health care coverage) continue to be must reading for reporters following health- and income-insecurity issues, often but not only about seniors. She is the lead writer for The Second Opinion, on CJR’s healthcare desk, and she also blogs for Health News Review. Following are links to some of her recent pieces.
*** “How to Cover Medicaid During Campaign Season” (March 25) highlights the recent piece by Christopher Flavelle [http://tinyurl.com/q784kz3] for Bloomberg View showing that Jeb Bush’s Medicaid program when he was Florida’s governor was “a mess.”
Flavelle, writes Lieberman, “examined a number of health indicators and found that in 2013 the Medicaid plans taking part in Bush’s reform program ranked below the national Medicaid average on 21 of the 32 quality indicators reported by the state.”
Under Bush III, “Almost one-third of pregnant women got no prenatal care in the first trimester and only 50 percent had a postpartum visit between three and eight weeks after giving birth. Half of adults ages 46 to 85 diagnosed with high blood pressure did not get adequate treatment. Fewer than half the children covered by Medicaid plans saw a dentist.” Lieberman adds, “Yet Bush, campaigning in Iowa in early March, told his audience Obamacare should be replaced and proposed his own Medicaid program as a model.” Oh, yeah, Bush III calls his Medicaid plan, “empowered care.” George lives, everyone Orwell, that is. Or maybe Richard III, at a time when he seems to be getting some non-Shakespearean respect.
Lieberman urges reporters “to investigate how their state compares with others when it comes to spending. Flavelle found Florida did cut spending, but that this affected the health of Medicaid recipients.” She goes on, “Reporters who know how their state’s Medicaid programs are actually working will be better prepared when the 2016 campaign truly revs up. When they hear vague campaign talk about ‘reforming Medicaid,’ ‘needing flexibility,’ ‘personal responsibility,’ they’ll be equipped to ask sharp questions. (Also see Lieberman’s “How to report on Medicaid in 2015: Health Affairs editor-in-chief Alan Weil examines what’s ahead.”
*** “A FOIA find for CPI: Government study identified inflated payments in Medicare Advantage”: In this recent blog, Lieberman gives a shout-out to investigative reporting veteran Fred Schulte of the Center for Public Integrity. His story, she says, “reminds us why reporting on Medicare, which has largely fallen out of the news cycle, remains important.”
Schulte’s lede: “Federal health officials were advised in 2009 that a formula used to pay private Medicare plans triggered widespread billing errors and overcharges that have since wasted billions of tax dollars, newly released government records show.” But the report by the Centers for Medicare and Medicaid Services remained unpublished on a government website. Schulte and company had to pry it loose through a Freedom of Information Act request.
Lieberman also links to the three-part series Schulte and crew did last summer revealing “how some sellers of Medicare Advantage plans have taken advantage of the program’s structure to overcharge the government” from 2008-2013—to the tune of $70 Billion.
2016 Campaign Relevance: Lieberman explains, that the debate over Medicare Advantage—and the apparent lack of interest in overbilling concerns from some quarters—“is also important in the broader context of Medicare’s future. Paul Ryan’s budget plans haven’t made headlines in awhile, but in a year-end interview the chair of the House Ways and Means Committee said, ‘The best days are yet ahead on comprehensive Medicare reform and premium support. It’s an idea whose time is coming.’ That’s a reference to plans that could make traditional Medicare look a lot more like the Obamacare exchanges—saving the government money, and likely making many seniors and disabled people pay more for their healthcare.” (Note her bipartisan criticism.)
*** “How to build on ProPublica’s powerful workers’ comp investigation”: looks into and beyond the great exposé, “Insult to Injury,” by ProPublica’s Michael Grabell and NPR’s Howard Berkes, who revealed “one unsavory detail after another in a powerful package of stories, interactives and photos, describing how ‘over the past decade, state after state has been dismantling America’s workers’ compensation system with disastrous consequences for many of the hundreds of thousands of people who suffer serious injures at work each year.’” It’s a story that also goes to the bone-hard reality for many of those boomers past age 50—and their Gen X kids also now surpassing the Big Five-Oh!
Lieberman writes, “I asked Grabell what was the most unfair practice he found. He said it was the ‘geographic lottery’ captured in the project’s second story, ‘How Much Is Your Arm Worth?’ which describes how variations in state laws resulted in a man in Georgia receiving compensation of $740,000 over his lifetime [GBO’s emphasis] for the loss of an arm and an Alabama man receiving only $45,000. ‘Just because a worker is born or happens to live in one state, he’s stuck with a workers’ comp law that sentences him and his family to a life of poverty,’ he explained to me.”
After scrutinizing interactive tools ProPublica developed for the series, Lieberman teased out a number of additional questions and investigative avenues for reporters to pursue. For instance, she writes, “The idea of letting employers opt out of the workers’ comp system, now allowed in Texas and Oklahoma, is spreading to other states. What protections would workers have if the idea catches on?
Lieberman continues, “If injured workers are stymied collecting on workers’ comp claims, where else can they turn? Do they have private disability insurance, which is usually expensive? Can they get Social Security disability benefits, which are also under attack?” Scan over her recent blogs, if you aren’t already.
3. THE STORYBOARD
***Homes on the Range Gets Oregon PBS Airdate: A funny thing happened on the way to another independent documentary production – in this case after a nearly half century’s experience as award-winning producers. For Hollywood and PBS vets, Dale Bell and Harry Wilend have found once again that not much has changed on the funding front. Well, with one exception.
The Homes team’s usual slog through the foundation world at least now has the advent of social media. Their current project, an hour-long production on Dr. Bill Thomas’ Green House alternative to nursing home care, is climbing the last stretch to the national PBS broadcast summit with the help of an IndieGogo campaign. (The producers need to raise funds to help defray marketing expenses necessary to secure the time slots in stations’ schedules. So Bell, the program’s producer and director, and his colleagues are using crowd sourcing for that cost.)
In any case, Oregon Public Broadcasting is only the first of around 200 stations currently scheduling Homes… to run during May in most cases. Additional raised funds, said Bell, will help to implement community-engagement activities they have pioneered with many productions, including local town hall meetings, websites, or phone banks to call for free expert advice on something like caregiving, and so on.
Homes…, also with Beverly Baroff as produce/editor/writer, will air on Oregon Public Broadcasting (OPB PLUS), Wed., May 20, 7 p.m. (Wiland is executive producer.) Bell says other public television stations will soon follow with their times and dates throughout May, which is Older Americans Month.
The documentary follows up on their 2002 production (and companion book) on caregiving in the United States, And Thou Shalt Honor. The two-hour special, among many other elements, introduced Dr. Thomas’ first innovative Green House – a small, residential and wonderfully humane home (nothing like a “facility”) in Tupelo, Miss.
The new program follows the 12-year journey of a group in Sheridan, Wyo., to get a Green House independently funded and built, including their successful effort to change state law allowing them to waive customary fire and safety rules that were so prescribed as to dictate any nursing home to be built in a cold, institutional setting.
When you see an elderly women wheeled in to her new home, docile and uncommunicative from a nursing facility, and then coming alive in the truly homey environment and at the first taste of real food in years, it’s difficult not to choke up along with her daughter’s tears. The underlying message will be one familiar to many generations-beat writers—we need to change a system that still favors institutional funding for long-term care—before we need if for our families and ourselves. But Homes … clearly shows why and how it can be done, and over a dozen years. That’s the same time span as Boyhood, but Homes–think of it as Elderhood–is nonfiction.
Homes on the Range (subtitled, “How One Community Transformed Caregiving for Their Elders and Frail”) has already been shown regionally in Wyoming, with a strong enough response for the general manager of WYO-TV pledging, “We will air it again as the documentary goes out nationally.”
For more information, or to schedule an interview with Bell, please contact Leon Schatz at 307.399.1386 or e-mail at waywardfilms@gmail.com.
*** “Learning to Say No to Dialysis,” by Paula Span, New York Times “New Old Age” (March 31), raises new questions about the U.S. practice of almost routinely placing very elderly kidney-disease patients on dialysis. Span writes, “People over age 75 are the fastest-growing segment of patients on dialysis, and the treatment’s benefits and drawbacks add up differently for them than for younger patients. A growing number of nephrologists and researchers are pushing for more educated and deliberative decision making when seniors contemplate dialysis.”
Span continues, “Unquestionably, dialysis has helped save lives.” But for those age 75 or older, about 40 percent of end-stage renal disease or advanced kidney failure patients die within a year, and only 19 percent survive beyond four years, according to data from the renal data system.
A Canadian survey of patients, Span writes, revealed that six in 10 regretted starting dialysis, “a decision they attributed to physicians’ and families’ wishes more than their own.” Span quotes Stanford University School of Medicine geriatrician V. J. Periyakoil, MD, “People drift into these decisions because they’re presented as the only recourse.”
An expert on palliative care and multicultural aging, Periyakoil produced a moving video showing an African American elder deciding to stop dialysis after 12 years. (“If I would get a kidney now, it would be a waste… I’m not the person I used to be,” says Christopher Whitney.)
Periyakoil will also appear at the Association of Health Care Journalists Health Journalism 2015 conference in Santa Clara later this month on a panel titled “Connecting with Your Audience About End-of-Life Care.” GBONews Editor Paul Kleyman will be moderating.
4. RESOURCES
***A Searchable Online Map on Palliative Care was just released by the California Health Care Foundation (CHCF), and should be replicated nationally. This simple data tool shows each California county with data on the estimated palliative care need there, as calculated from death records, versus the supply of end-of-life services—and the gap between the two. Explanations of criteria and other linked resources are on this web feature, titled, “Uneven Terrain: [http://tinyurl.com/njn9ayy] Mapping Palliative Care Need and Supply in California.” It shows clear disparities in service and resource distribution county-to-county. Reporters outside of California might still look it over, because it suggests questions they could raise in any locality–and where to look for answers.
The tool’s researchers stipulate that the availability of specialist palliative care services in hospitals and community settings has increased in California, “but is still insufficient to meet the demand.”
For the study, they initially estimated the need for palliative care among individuals in the last year of life based on the number of annual deaths in each county. They especially looked at the number of patient who died from seven very serious medical conditions most likely to call for palliative care.
The study’s authors emphasize that although in recent years hospital-based and community-based palliative care programs have increased dramatically, due to greater appreciation among insurance payers, providers and consumers, it “is not available to many Californians due to a general shortage in supply and uneven distribution of services across the state.” But while California law now requires Medi-Cal (the state’s low-income Medicaid program) health plans to provide palliative care services, those plans may find themselves in a bind without enough trained professionals and resources to do the job.
More generally, the CHCF website on “End-of-Life and Palliative Care” [[http://tinyurl.com/o74gxbo] is an important stop for anyone writing/producing about these issues. It’s chock full of links to their own research and many connections for resources outside of California.
WORDS FROM THE WISE
Two truths approach each other
One comes from within,
one comes from without — and
where they meet you have the chance
to catch a look at yourself.
–-Tomas Transtromer, Nobel Laureate (1931-2015)
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