Health and Wealth | KBIA

Health and Wealth

Photo provided by Mat Reidhead

In 2017, the Missouri legislature expanded Medicaid managed-care organizations, or MCOs, state-wide, putting third-party contractors in charge of hundreds of thousands of patients. Advocates say managed care programs allow for more personalized care for patients and more predictable budgeting. But hospitals have criticized MCOs, saying they cover less and take longer to reimburse for care than traditional Medicaid.

Now, a new study from the Missouri Hospital Association suggests switching from traditional Medicaid to MCOs could be linked to increased risk of suicide in teens. Mat Reidhead is the Hospital Association's lead researcher.


Photo provided by Mei-Ling Wiedmeyer

The language barrier can cause  a lot of problems when it comes to refugees getting health care, but there are other obstacles as well.

Mei-Ling Wiedmeyer, a family physician who grew up in Columbia, but now works with refugees in Vancouver, Canada and is on the faculty of the North American Refugee Health Conference. She spoke with Health and Wealth about the other barriers to care, and how communities can get around them.


At a pediatric clinic in Kirksville, Missouri, a young boy is waiting in an exam room to be vaccinated. A nurse explains the shots to his mother, and Lisette Chibanvunya translates.

Chibanvunya is one of two Congolese interpreters the Northeast Health Council has hired to help the clinic care for refugees and immigrants from central Africa. She first came to town to study at Truman State University in 2013.

Chibanvunya says, "When I came I faced discrimination, because they didn’t have a lot of black people." But now, she says, "They start accepting people because they finally understand that people kind of decided to make it home." 

A study of more than 2,000 children in Missouri whose coverage switched from traditional Medicaid to managed-care organizations or MCOs, found suicide risk among them nearly doubled.

The Missouri Hospital Association study analyzed a group between the ages of five and 19 whose coverage switched after the state expanded MCOs in 2017.

Sebastián Martínez Valdivia / KBIA

About 15 miles southwest of St. Louis, is Fenton City Park. It’s pretty unremarkable, with picnic shelters, softball fields, and flags waving gently from a memorial to fallen soldiers. It's also where Kevin Mullane sought refuge as he struggled with an opioid addiction.

"Anybody that knew Kevin knew he loved Fenton Park," Kevin's mother Kathi Arbini said, recounting how her song became increasingly isolated. Mullane turned to prescription opioids to deal with depression. He eventually started stealing medications from friends and family members, and doctor-shopping for more.

Ashoor Rasho has spent more than half of his life alone in a prison cell—22 to 24 hours a day. The cell was so narrow he could reach his arms out and touch both walls at once.

Research published in a major medical journal concludes that a parachute is no more effective than an empty backpack at protecting you from harm if you have to jump from an aircraft.

But before you leap to any rash conclusions, you had better hear the whole story.

The gold standard for medical research is a study that randomly assigns volunteers to try an intervention or to go without one and be part of a control group.

Smoking looks a lot different these days. It’s been on the decline, due to restrictions at work and in bars and restaurants. But there is one segment—teenagers who use e-cigarettes—that is growing fast. And health experts are worried about the consequences.

 


Physicians across the country have a message for the National Rifle Association: Gun violence is our concern. It's part of a battle being fought vigorously on Twitter in recent weeks.

Alisha Floyd bounces her son Chance on her lap. He giggles and pulls her hair.

“He’s the fattest baby here,” she says, laughing.

Ryan Famuliner / KBIA

“You can’t be worried about what other people are thinking all the time. “

In this episode, co-hosts Madi and Becky and executive producer Aaron Hay answer a few listener questions during a recent launch party in Columbia and give listeners a look behind the scenes of “The Obvious Question.”

They discussed the editorial process, how Madi selected her guests, which episodes were personal favorites and what’s next.

A new Illinois statute aims to boost flu shot rates among healthcare workers by making it harder for employees to decline the vaccine.

Lawmakers say this is important in light of last year’s flu season that killed more people than car crashes and drug overdoses. But some on the frontlines of public health worry that a law that’s not enforced will have little effect.


Paulina Nieto, who grew up in Columbus, Indiana, was only 2 months old when she started to have heart problems due to a narrow artery.

Ohio’s first transgender and gender non-conforming health and community center is a cross between a funky '80s apartment and a modern doctor’s office.

There are a few couches gathered around a TV, a kitchen, a small stage and a few exam rooms. Mikayla Robinson, the center's engagement specialist, wears a "Miss Gay Ohio" sash, which matches the brightly colored walls.

When Matthew Timion needed to get his son treatment for mental illness, he did not anticipate it would be so hard to get the insurance company to pay for it.

Steve Dillman thinks he can trace his prostate cancer back to August 1, 1985.

It’s late summer, and the drone of insects is a sound that Lonnie Kessler has come to dread. A similar chirping means he’s minutes away from another seizure.

“It sounds like a thousand crickets all at once in my head. And so that really alerts me this is going to happen right now,” Kessler said. “And then I lose consciousness.”

Nearly 100,000 people are waiting for a kidney transplant in the U.S., but many will never get one. Instead they’ll stay on dialysis for the rest of their lives. A team of doctors in Philadelphia have found a possible solution to this problem, by infecting patients with a potentially fatal virus.

The Obvious Question

Sep 17, 2018
A portrait of Madi Lawson.
Jessie King / For KBIA

Get ready to throw your assumptions about disability out the window!

In "The Obvious Question," Madi Lawson, a 21-year-old journalism student who has two rare forms of muscular dystrophy, takes on the assumptions, misconceptions and just plain ignorance others have about people with disabilities.

Can you even have sex?

Sep 17, 2018
Host Madi Lawson poses with Lexi Mortimer in front of a museum exhibit.
Tony Huynh / For KBIA

"Just call me 'pretty'."

In this episode, Madi and Becky look at the world of dating, relationships and...sex. Madi sat down with Lexi, one of her best friends who also has SMA, and Lexi's boyfriend, Tyler, to talk about the way the world perceives their relationship.

Whether it's the world over-sexualizing and under-sexualizing them at the same time, asking their able-bodied companions to talk for them or the physical realties of sex-this is a conversation about disability that you've never heard before (but have probably wondered about).

Tobie Roberts measures and pins a dress on Madi Lawson.
Rebecca Smith / KBIA

When was the last time you saw a model with a disability? Or a person with a disability featured in an advertising campaign? On a runway? Or even a mannequin in a store that showcased a different ability? It might be hard to recall even one.

In this episode, Madi and Becky take a look at the world of fashion-Madi's #1 love. She talks with fashion designer Tobie Roberts about how to design for disabled bodies, their experiences working together for Kansas City Fashion Week and what the fashion industry can do to be truly inclusive.

Madi Lawson / For KBIA

More than once, Madi has been asked if her friends-who look nothing like her-are her sister or caretaker.

In this episode, Madi and Becky take a look at the crossroads of friendship and caretakers. Madi talks to her younger roommates, Tonesha and Haley, who are still learning what it's like to have a friend with a disability, and her best friend, Jessie, who's old hat and muses about how being Madi's friend has turned her into a fierce advocate for the rights of those with disabilities.

Hosts: Madison Lawson, Rebecca Smith

How do you pee?

Sep 17, 2018
Madi Lawson / For KBIA

There’s no party quite like a pee party.

In this episode, Madi and Becky talk all things bathroom with her best friend, Sabrina or “Bean.” These girls have been through it all – the rocky road of high school, prom dress shopping and more bathroom trips than either can count. 

Madi and Bean talk about bathrooms, about the way others have asked Madi to make her body more accommodating to them and about the perception of disabled bodies in public spaces. 

Hosts: Madison Lawson, Rebecca Smith

Rebecca Smith / KBIA

Pink. Blue. Icy Blonde. You name a color, Madi’s hair has been it. But what about finding a salon that can accommodate her needs?

In this episode, Madi and Becky explore the multi-colored world of hair salons. Madi and her stylist, Amber, talk about their relationship, working with clients who’s needs are different and about what salons can do to be more welcoming to all people of all abilities.

Hosts: Madison Lawson, Rebecca Smith

Reporting By: Taylor Kinnerup, Rebecca Smith

Stephanie Cosenza / For KBIA

Madi says people often feel sorry for her for the wrong reasons. It's not the fact that she has SMA or uses a wheelchair that make her sad, it's the same things as any 21-year-old: boys, school or simply a bad hair day. 

In this episode, Madi and Becky take a look at the world of disabilities and mental health. Separated into two different chunks, the first part of the episode questions the assumptions others have about the mental health of people with disabilities through reflections on a local TEDx talk done by Hayden, a friend of Madi's.

Every day, Amanda Moller scoops powdered formula out of a can and shakes it up with water from her kitchen sink. It's like mixing a cocktail, she said, "but not that much fun."

The formula doesn’t taste great – like watery pudding with a biting, cheesy aftertaste. But it’s something Amanda needs to treat a rare metabolic condition she’s had since she was born. After 30 years, she’s gotten used to it.

Amanda’s employer-based insurance plan (through her husband’s employer) doesn’t cover it. Like many treatments for rare diseases, the lack of well-funded research and the tendency of insurers to focus on the bottom line mean sometimes patients can’t afford necessary medical supplies. Many of the 16,000 people in the United States who need the formula spend close to $1,000 a month to buy it.

Nicole Smith-Holt’s son Alec was 23 when he started feeling sick. His muscles cramped. He was lethargic. He woke up multiple times every night to use the bathroom. After two weeks, Smith-Holt encouraged him to go to urgent care.

Lee Ann Stuart still wears her nursing scrubs, even though the only work she’s been doing since Twin Rivers Regional Medical Center closed June 11 is to pack boxes of medical supplies to be hauled away.

“It’s strange walking those halls, and they’re empty and the lights are down,” Stuart says. She’s been a nurse at the hospital in rural Kennett, Missouri, for 22 years.

DeVonte Jones began to show signs of schizophrenia as a teenager. His first public episode was nine years ago at a ball game at Wavering Park in Quincy, Illinois.

“He snapped out and just went around and started kicking people,” said Jones’ mother Linda Colon, who now lives in Midlothian in the Chicago suburbs.


U.S. Sen. Claire McCaskill is calling for a federal investigation of billing practices at Putnam County Memorial Hospital, which was the subject of a highly critical state audit last year.

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