Health

Prescription drug abuse can start with a routine problem, like lower back pain. A doctor will prescribe medication for the patient, but the pain doesn't go away. So the patient takes more medicine. 

And this behavior could lead to an addiction, said Len Paulozzi, an epidemiologist for the CDC. He finds patterns of drug abuse. 

There is a long list of to-do’s when applying for a medical license in Missouri. Applicants have to provide detailed verification of their degrees, residency and previous work experience. Tack on several months for the state medical board to review all these items, and the whole process can take a lot of time.

Most physicians go through this process when they are first applying for a medical license. But the Federation of State Medical Boards (FSMB) found that many doctors don’t stop at one license.

When Mary Ratliff moved to Columbia from Mississippi in 1959, she was leaving one of the epicenters of American segregation and the burgeoning civil rights movement. But that doesn’t mean she escaped experiences of racism and segregation in her new home.

“It was subtle here when I first came," Ratliff said. "In fact I've made the comment many times, that Columbia is 'Big Little Dixie.' It wasn’t a whole lot different from Mississippi.”

The Affordable Care Act included a temporary bump in the Medicaid fees paid to physicians for certain primary care services. The intention behind the two-year, federally-funded increase was to encourage more physicians to participate in Medicaid to accommodate an expanding pool of Medicaid patients anticipated by the law.

But a 2012 Supreme Court decision opened a window for states to reject Medicaid expansion – Missouri is one of 23 states that have chosen not to expanded coverage – and as of Jan. 1, the Medicaid fee bump is expired as well.

I spoke with Dave Dillon and Andrew Wheeler of the Missouri Hospital Association (MHA) about the impact the fee increase expiration will have on Missouri hospitals.

The Missouri Association of Local Public Health Agencies (MoALPHA) was founded in 1994 to support the  city and county public health agencies in the state. I spoke with the incoming chair of the association, Gary Zaborac, about the public health challenges facing Missouri in 2015.

As the use of telemedicine expands it is also growing the footprints of medical professionals, and when doctors licensed in one state begin consulting in another, it presents a problem for state medical boards. KBIA’s Hope Kirwan spoke with Jonathan Linkous, CEO of the American Telemedicine Association, about how states are regulating telemedicine.

This week the EPA will make a final decision on a proposed new rule for the disposal of coal combustion residuals, called CCRs, or coal ash.

If you’ve ever lived in - or even visited - a small town, you know they can be pretty quaint. And Milan, Mo, population 1,881, is no exception.

Milan’s local hospital, Sullivan Country Memorial, has been around since 1953. Joe McCarty, a local resident and now patient in Sullivan’s long-term care unit, has lived in Milan almost his entire life – he’s turning 100 this year. Joe made his living as a cartoonist and up until just a few months ago he worked for the local newspaper.

  Dr. Karen Edison is a dermatologist with the University of Missouri Health system. She has been using telemedicine for over 20 years to see patients at clinics in underserved areas of the state, and to follow-up with her rural patients in their homes. She can see photos of her patient’s skin, answer their questions through email, as well as talk with them through video calling.

Edison says telemedicine is a useful tool because it can save rural patients a trip to her office.

But rural patients aren’t only the ones looking to save time and money.

  Open enrollment for health coverage in 2015 is underway, and some Missourians satisfied with their current health insurance may be surprised to learn that parts of their plans, including premiums, are changed for the coming year. The Cover Missouri Coalition, a program of the Missouri Foundation for Health, is encouraging consumers to review their options during this year’s open enrollment period.

I spoke with Ryan Barker, Missouri Foundation for Health’s Vice President of Health Policy, about changes in this year’s health insurance marketplace.

  Last week marked the beginning of open enrollment for the federal health insurance marketplace, and on the surface it appears not much has changed. By some measures premiums before tax credits are just as affordable as last year - decreasing on average by about one percent according to a report by the Kaiser Family Foundation. But to be a savvy shopper, many consumers should give the marketplace a second look.