Gov. Mary Fallin on OETA: Health care numbers explained
Gov. Mary Fallin was the guest on OETA’s weekly political roundtable show Oklahoma Forum this past weekend.

Among other things, she discussed the future of health care in Oklahoma. I’ve written an attempt of a transcript of what she said.
It’s worth noting that, during her answer to host Dick Pryor, Fallin misstates the percentage of the cost that the federal government would pay if Oklahoma were to expand its Medicaid program. Fallin says in her answer that the federal government would cover 90 percent of the new costs in the first three years. However, the law says that 100 percent of the expansion will be paid by the federal government from 2014 through 2016. (more…)
Domo arigato, Dr. Roboto — Maybe

Hospitals across Oklahoma City have invested in a da Vinci surgical robot, a highly marketed robot that can be used to perform a variety of surgeries. I’ve interviewed several doctors who use the robot to perform surgeries, and many of them rave about it.
They say patients recover faster, have fewer complications and leave the hospital faster than patients who don’t have the same kinds of surgeries using the robot.
But there’s a catch to some of their claims — comprehensive data to back it up.
As this article points out, recently published medical research has found that robotic surgery might not always prove to be more beneficial.
In the dozen years since the Da Vinci robot has been approved for surgeries in the United States, it’s been embraced by health care providers and patients alike. Surgeons routinely use the multi-armed metal assistant to remove cancerous prostate glands and uteruses, repair heart valves and perform gastric bypass operations, among many other procedures.
Lately a key study and reports of problems have raised questions about robotic surgery’s safety and cost-effectiveness, leading to a review of the Da Vinci system by the Food and Drug Administration and causing some experts to wonder whether the benefits of undergoing robot-assisted surgery may have been overstated.
To make any claim in medicine that one approach works better than the other, you need a study published in a medical journal that says “Yes, this is very, very true.” Actually, you probably need several studies by different academic institutes that agree and say, “Yes, that study is very, very true, and here’s what we found that says it’s still very, very true.”
Surgeons I’ve talked to with say the da Vinci robot allows them to operate inside a patient and affect the least amount of tissue while inside. And so far, the debate continues, with the U.S. Food and Drug Administration currently reviewing the system.
Complications can occur with any type of surgery, and so far it’s unclear if they are more common in robotic operations. That’s part of what the FDA is trying to find out.
Intuitive Surgical disputes there’s been a true increase in problems and says the rise reflects a change it made last year in the way it reports incidents.
The da Vinci system “has an excellent safety record with over 1.5 million surgeries performed globally, and total adverse event rates have remained low and in line with historical trends,” said company spokeswoman Angela Wonson.
But an upcoming research paper suggests that problems linked with robotic surgery are underreported. They include cases with “catastrophic complications,” said Dr. Martin Makary, a Johns Hopkins surgeon who co-authored the paper.
West Nile virus: An ongoing struggle
This past summer, Oklahoma saw more residents die from West Nile virus than ever before.
West Nile virus season ended a few months ago in Oklahoma, but many Oklahomans are still working to recover from the virus.
For the past few months, I’ve been writing about Bob Matthews, an Oklahoma City resident who contracted West Nile virus and was paralyzed because of it.

Bob Matthews is comforted by his wife, BJ Matthews, as he continues to recover from the effects of West Nile Virus in Oklahoma City, Friday, August 10, 2012. Photo by Bryan Terry, The Oklahoman
Thank God for Mississippi … or Oklahoma?
There’s a phrase that is sometimes uttered among Oklahoma’s public health leaders: “Thank God for Mississippi.”

Because if it weren’t for Mississippi — and generally, West Virginia and Louisiana — Oklahoma would come in last in a variety of health rankings.
But, really — Are we doing that much better? Let’s take a look. (more…)
Medicaid expansion: What’s the rest of the country doing?
So far, leaders from about 13 states, including Oklahoma’s Gov. Mary Fallin, have said their states will not expand Medicaid.
Medicaid expansion is one of the key elements of the Affordable Care Act, or “Obamacare.” (Want to know more about the health care debate? Here’s a graphic novel we created that explains the basics)
Most leaders have been quoted as saying expanding Medicaid would be too expensive for their states and that they didn’t trust the federal government to hold its end of the bargain.
So what’s the alternative plan?
Vintage smoking ads: A look back at the history of smoking advertisements
Whenever I interview public health officials about smoking rates among any population, they always discuss how cigarettes are marketed.
They argue cigarette companies target young people and minority populations. For example, Project SCUM was recently brought up in an interview I did about high smoking rates among people with mental illness. As a side note, here’s Philip Morris explaining its marketing strategy.
I wanted to look back at cigarette ads throughout the past several decades.
Here are some ads that were published in the Oklahoman. (more…)
Smoking in Oklahoma: Five states that have gone smoke-free
One of the biggest debates at the Oklahoma Capitol right now is whether the state will pass a law allowing cities to pass their own smoking laws.
Health advocates, including Gov. Mary Fallin, argue that passing this law would have a major impact on the state’s health. They also argue that only Oklahoma and Tennessee have this type of restrictive law on the books regarding cities and smoking ordinances.
Opponents say that cities passing their own smoking laws would be confusing to business owners and also would trample on individual rights. Others voice concerns that a smoking ban could have a negative impact on business.
I’m not here to argue who’s right. I’ll leave that to, well, non-journalists. However, I was curious about other states that have made similar efforts. So, here’s a list of five states that have recently gone “smoke-free” in some regard.
America is setting up children to fail, organization says
The United States is in a “generational emergency,” with more and more children facing obstacles related to their health and education, according to Too Small To Fail.
The campaign, launched in November, focuses of on issues that “undermine the well being of children.”
For example, in the U.S., “black and brown kids” are three times more likely to be impoverished, according to the organization. That means their educational attainment is likely to be lower, and health outcomes are likely to be worse.
“You think, ‘Well, that’s too bad for them,’” Van Jones, president of Rebuild the Dream, said in the video posted below. “No, too bad for all of us, because we’re on our way to being a country by 2050 where the majority of Americans are black and brown. If we let all these kids slip through the cracks, we’re letting the country slip through the cracks.”
Too Small campaign leaders argue that health impacts education, and family income affects both a child’s education and health. But, according to this infographic from the campaign, money and race alone do not account for many challenges that children face:

Roe v. Wade: 40 years later
Today marks the 40th anniversary of the Supreme Court’s decision on Roe v. Wade.
This past weekend, Carla Hinton and I finished our project about the anniversary.
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In one of Carla’s stories, she wrote about a large group of young people who will participate in the March for Life on Friday. A total of 220 high school and college-age Oklahomans will participate in the march.
These young people are apparently in the minority of people younger than 30 who even know what Roe v. Wade is about.
The Pew Research Center recently found that there seems to be an age gap in who knows what the case was about:
Decades after the Supreme Court rendered its decision, on Jan. 22, 1973, most Americans (62%) know that Roe v. Wade dealt with abortion rather than school desegregation or some other issue. But the rest either guess incorrectly (17%) or do not know what the case was about (20%). And there are substantial age differences in awareness: Among those ages 50 to 64, 74% know that Roe v. Wade dealt with abortion, the highest percentage of any age group. Among those younger than 30, just 44% know this.
I’m not sure how surprising those numbers are. The poll also revealed that:
Most Americans remain opposed to overturning the controversial U.S. Supreme Court decision in Roe v. Wade, which 40 years ago legalized abortion at least in the first three months of pregnancy, according to a poll released Wednesday.
For the anniversary, The Daily Beast created a map of the 724 remaining abortion clinics and the closest clinic in every part of the country. The map also provides information about state laws regarding wait times, medication restrictions, ultrasound provisions and insurance restrictions.
There’s a white stripe through the middle of the U.S. where no clinic is within between 200 and 300 miles. The map becomes even more interesting when you choose “Show female population, ages 15-44″ on the map and see where most women in that age group live.
The Oklahoma Legislature regularly sees bills regarding abortion, and this session will be no different. For example, this session, another “personhood” bill has been filed:
One of the most divisive issues of the 2012 legislative session apparently will be revisited this spring, with at least one “personhood” bill already filed.
State Rep. Mike Reynolds, R-Oklahoma City, is author of House Bill 1029, the Personhood Act of 2013. As written, the bill appears to be virtually identical to one that led to a bitter fight in the House before failing to get a vote on the floor.
The Oklahoma Supreme Court struck down a similar bill last year.
Vegan for 30 Days: Day No. 4
Four days ago, my household began its attempt at 30 days of veganism. If after 30 days, we like our vegan life, we’ll keep on keepin’ on.
But first, I’m going to have to stop craving everything. When I say, “I’m craving everything,” I mean everything, and nothing at the same time.
Let’s back up for a moment, and I’ll explain how I became OK with the concept of not eating cheese or ice cream for 30 days.
I’ve thought about trying to be a vegetarian or vegan for a while. No, I’m not going to go on a spiel about animal cruelty. I would rather discuss health and what led me to my decision.
I heard Dan Buettner speak in November at the Oklahoma Hospital Association convention about Blue Zones. What he said kind of blew my mind:
Buettner discussed Blue Zones, places where a high percentage of people are living to 100 and not suffering from several chronic diseases.
In the U.S., we spend most of our health care dollars in the last years of our lives, trying to make the best of those final years.
Patients with chronic illness in their last two years of life account for about 32% of total Medicare spending, with much of it going toward physician and hospital fees (Medicare Part A and Part B) associated with repeated hospitalizations.
Meanwhile, in Blue Zone cultures, many people die of old age. In his talk, Buettner outlined how people in Blue Zones live longer:
People in the Blue Zones nurture strong social networks, consume a plant-based diet, eat in moderation and incorporate daily, natural physical activity into their lives.
Buettner wasn’t advocating becoming a vegetarian or vegan, but his talk made me think a lot about the types of food I consume. So many of my meals consist of some sort of meat with a bit of vegetables on the side.
Thus far, being vegan has forced me to really think about what I’m going to eat. That might sound silly, but it’s so easy to not think about the foods we’re buying or ordering at restaurants. It’s easy to just look at something, think “That sounds good,” and then eat it.
Over the past four days, I have enjoyed what we’ve eaten. We ate at Matthew Kenney on Friday night and enjoyed the lasagna and tacos.
But I do find myself craving things. It’s not like the typical “I want ice cream” or “I want pizza” cravings. These are like, “I want to eat something that I cannot describe, but I want it right now.” I’m not sure when these cravings subside, but I’m just keeping fruits and vegetables handy for whenever I get hungry at my desk.
Regardless of whether we stick to our vegan diet, I want to continue being more conscience of the things I eat. I joke about living to 100, but the idea does sound pleasant, especially if I can skip the heart disease, diabetes and Alzheimer’s.
We’ve got about a month to go, so if you know of any simple and quick vegan recipes, please share them. And feel free to share your thoughts on whether you would ever want to become vegetarian or vegan.
