Fitness, well-being, disease, medical research and issues related to Seton and St. David's Healthcare, Austin Regional Clinic and other health care providers in Austin and Central Texas

Under a federal determination released today, insurers in Texas will have to abide by spending rules set forth in President Obama’s signature health care reform package. 

One of the provisions in the Affordable Care Act stipulates that insurers must spend 80% of customers’ premium dollars on medical care, and not overhead costs. Any overhead spending over 20%, and insurance companies would be required to issue rebates to their customers.

That said, states can apply for an adjustment of to increase the amount they spend on overhead. The Texas Department of Insurance applied to do just that, requesting to ramp up medical care spending more slowly: 71% for (current) reporting year 2011, 74% for 2012, and 77% for 2013.

Image courtesy

You can add another entry to the list of big city amenities Austin is missing: a professional sports team, a subway system, and now – ubiquitous public toilets.

The Atlantic Cities blog has a paean to the Portland Loo, a standalone toilet free to the public, as the Rose City prepares to launch their fifth public restroom with – what else? – an inaugural flush.

To what does Atlantic Cities attribute the Loos’ success? A minimal, “defense-first design” that puts a spigot for washing up outside; sturdy, reinforced doors; and bars at the top and bottom of the structure.

Starting in 2012, health insurance plans in Texas — and most of the rest of the country — may have to cough up millions of dollars in rebates to customers.

The rebates will come from health plans that spend too much on administrative costs instead of medical care. The change is part of the national health overhaul law, the Affordable Care Act.

But state officials in Texas and 16 other states have asked to push back the requirement for a few years.

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A ruling in a New York federal court is requiring the Social Security Administration to restore benefits to eligible people who may have a warrant out for their arrest.

According to the National Senior Citizens Law Center, an advocacy group for low-income seniors, as many as 100,000 people could benefit from the ruling in Clark v. Astrue that was issued earlier this month. The government had denied Supplemental Security Income (SSI) and Supplemental Security Disability Income (SSDI) benefits to people with outstanding warrants for alleged parole or probation violations.

Photo by lissalou66

Austin Community College students and staff who make a New Year’s resolution to stop smoking will have an added incentive when they head back to school: ACC’s smoke-free policy takes effect on January 2.

The policy was adopted by the ACC board in October and bans smoking anywhere on college grounds or inside ACC-owned vehicles. Signs reminding people about the new policy will be set up over the winter break.

Photo by Todd Wiseman, Texas Tribune

The U.S. Department of Health and Human Services has turned down Texas’ request to run a family planning program that excludes certain providers — namely Planned Parenthood — saying it’s a violation of the federal Social Security Act.

Photo by Todd Wiseman

The cuts could take effect on January 1st and would make Texas’ Medicaid spending on par with other states. But therapy providers worry it could leave many patients without services.

According to Stephanie Goodman, spokesperson with the Texas Health and Human Services Commission, the organization reviews its rates from time to time.

"Recently we looked at our therapy rates and found out that in Texas, for some reason, we’re paying substantially higher than other states.”

Physical, occupational, and speech therapy services would all be affected, including both out-patient and in-home care. Mary Hennigan with the Texas Occupational Therapy Association says it should come as no surprise that those types of treatment are expensive.

Elena Adams lives in East Austin and has three children. Her youngest was born prematurely with cerebral palsy, a group of disorders that affect the brain and nervous system.

Adams was shocked when she found out, because her other two kids are healthy. Doctors told Adams her son Smith would not be able to walk or talk.  

But Smith is slowly proving them wrong. He can speak and is trying to walk on his own. 

Adams has a hard time affording treatment, but she gets a little bit of state money and help from organizations like Any Baby Can.

Now, she's optimistic about the future.

“You can’t really stress about a lot of problems,” she said. “You just have to let them go the way they’re supposed to go.”

Jeff Heimsath shot and edited KUT's video interview with Adams. Check it out above. 

Photo by Graham via

Tomorrow is World AIDS Day. Since 1988, December 1st has been observed around the globe as a day to draw attention to the continuing battle against HIV and AIDS, as well as to those who've lost that battle.

According to Austin/Travis County Health and Human Services, about 200 people contract HIV in Central Texas each year. There are a handful of events around Austin Thursday, giving people a chance to learn about the struggles of living with HIV and also to honor those who have died of AIDS.

One all-day event, World AIDS Day: Austin Remembers, Austin Responds, will take place at the For the City Center at 500 E. St Johns Ave. from 8:30 am until about 9:00 pm. 

Photo courtesy of M.D. Anderson Cancer Center

The University of Texas is committing $75 million to kick start the new Institute for Applied Cancer Science, which will focus on speeding up the discovery and delivery of effective cancer drugs at a time when pharmaceutical companies have scaled back research and development.

Gov. Rick Perry, taking a break from his busy pursuit of the GOP presidential nomination, was on hand for the announcement at the south campus of M.D. Anderson Cancer Center, site of the new facility, in Houston on Monday. Perry said the institute would help Texas cement its position as a leader in cancer research and scientific innovation.

“I believe this state represents a unique crossroads, a place where academic research can come together with a very vibrant private sector to tap into this steadily growing biosciences sector. We’re just scratching the surface of its potential,” Perry said. “We’re creating a culture that will help ensure that great ideas that are born in Texas will stay in Texas, from the laboratory to the marketplace, and then we will export them around the world.”

Who didn't see this coming?

The Supreme Court has added a case challenging the constitutionality of the provision of last year's health overhaul requiring nearly every American to have health insurance beginning in the year 2014 to the list of cases it will hear this term.

This morning on KUT, we reported on the challenges people with autism face when trying to find gainful employment. The Centers for Disease Control and Prevention reports increases in the prevalence of autism. Meanwhile, the state legislature slashed spending that would help people afflicted by the disorder.

One of the people we talked to was Daniel Shackelford. He has Asperger’s Syndrome but was able find gainful employment at Seton Medical Center through a privately run program called Project SEARCH. You can hear more from Shackelford in the video above, shot and edited by Jeff Heimsath for KUT News.

Photo by Daquella Manera

Five obstetrics and gynecology (OB/GYN) groups in the greater Austin-area hope to reduce costs and improve their quality of care by merging into a single network called Central Texas OB/GYN Associates or CTOA for short.

The five OB/GYN groups are Austin Area Obstetrics, Gynecology & Fertility, Oakwood Women’s Centre, Renaissance Women’s Group, the OB/GYN Group of Austin, and Women Partners in Health.

Photo by Erika Aguilar for KUT News.

Austin Groups for the Elderly held a Medicare workshop Saturday, the first day of the annual Medicare enrollment period. This year the annual enrollment period is earlier than usual. It also ends earlier, December 7th.

Photo by Rosemary

Medicare payments to doctors are scheduled to be slashed by almost 30 percent in January unless Congress does something to stop that from happening. A new poll of Texas doctors shows that half of them would stop taking Medicare patients if the cuts take effect.

Medicare is a federal program that provides health insurance to about 47 million people over the age of 65. It also costs taxpayers $452 billion a year.

“Our Medicare patients are like family to us, but most doctors in Texas run small businesses,” former Texas Medical Association (TMA) president Sue Bailey told KUT News. “We have employees to pay. We have rents and utilities to pay just like any small business.”

Photo by Linda Tanner

A disease transmitted by blood sucking parasites may be more common in Texas than scientists previously thought. New research released by the College of Natural Sciences at the University of Texas at Austin suggests suggest South Texas in particular is an area of high risk for Chagas infection.

The tropical parasite triatomine is known commonly as the "kissing bug" because it loves biting faces. Here’s a of one of the bugs to give a sense of scale. 

Photo by Jarekt

Texas joined 25 other states today in asking the U.S. Supreme Court to rule that the the health care overhaul championed by President Obama is unconstitutional. The U.S. Department of Justice filed its own appeal of a lower court ruling, arguing the Patient Protection and Affordable Care Act should stand as is. The showdown could provide an up-or-down vote on the law in the middle of the 2012 campaign season.

The filling from the 26 states targets three core provisions of the act:

Photo by Images of Money

More than two out of five children with cancer in Texas rely on Medicaid for health care, according to an analysis of Medicaid in Texas by Families USA, a non-profit organization that advocates for affordable health care. The report comes as a showdown looms in Washington over how to manage costs of the chronically underfunded program.

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Services for sexual assault victims are significantly lacking in Texas, according to a new survey out of the UT-Austin. 

The study said, for example, that emergency room wait times for sex assault victims are so long that they often leave before receiving treatment and reporting the assault.

"Sexual assault crimes persist as a social problem in Texas and the need to propel this issue to the public's attention is pressing," the study's lead investigator, Dr. Noël Busch-Armendariz said in a press release.

Daniel Reese/KUT News

Lawmakers and local leaders are hopeful a plan unanimously adopted at Thursday's University of Texas System Board of Regents meeting means they could finally get what they've long been waiting for: a new medical school.