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Medical Marijuana 101: What It’s Like Inside A Colorado Dispensary

COLORADO SPRINGS, Colo. — Jars labeled butterscotch, chocolate mint and caramel macchiato tea glisten inside the lit refrigerator. The shelf above is stacked with pizza, flatbreads and butter. The one below has lemon bars, brownies and cookies.

The fridge could be in any higher-end grab-and-go lunch stop. But to shop here, you must present a medical marijuana patient card. And the ingredient list includes the type of pot, along with flour, sugar, milk, etc.

This is Trichome Health Consultants, a medical marijuana dispensary tucked into a line of glass storefronts on a semi-commercial strip in Colorado Springs, Colorado. As Massachusetts prepares to open its first dispensary, possibly in April, this is a glimpse into the future. Continue reading

Gov. Baker Forces Resignation Of 4 Health Connector Board Members

Gov. Charlie Baker sought and received the resignations of four member of the state’s Health Connector board, including MIT economist Jonathan Gruber, who came under fire for saying it was “the stupidity of the American voter” that led to the passage of President Obama’s 2010 heath care law.

The move helps Baker consolidate his authority over the agency responsible for helping Massachusetts residents find affordable health care plans.

Gruber became a political lightening rod following his comments and was chastised by opponents of the law. He was called to testify before Congress in December, when he told lawmakers he was “inexcusably arrogant” when he made the statement.

Besides Gruber, Baker also asked for the resignations of board members George Gonser, John Bertko and Rick Jakious — all appointees of former Gov. Deval Patrick. Continue reading

Partners HealthCare Drops Bid To Acquire South Shore Hospital

Partners HealthCare is withdrawing its bid to acquire South Shore Hospital, state Attorney General Maura Healey’s office announced Tuesday.

The move comes less than a month after a judge rejected a deal Partners had struck with former Attorney General Martha Coakley’s office that would have allowed Partners to acquire South Shore and two other local hospitals in exchange for some limits on price and staff increases.

In a statement Healey’s office said the state would continue to evaluate Partners’ bid to acquire Hallmark Health Corp.’s Lawrence Memorial and Melrose-Wakefield hospitals “if and when Partners and Hallmark complete pending federal regulatory obligations.”

“We appreciate the thoughtful process that Partners engaged in while making this important decision, and believe it is the right choice for Partners and the Commonwealth,” Healey, who opposed the deal Partners had reached with Coakley, said in the statement. “We are thankful for the valuable input that was provided by the health care community throughout this process to help reach this result.”

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Health Connector Extends Sign-Up Deadline By A Week

The Massachusetts Health Connector is extending the deadline to complete an application and pick a health plan until Feb. 23.

The deadline had been Feb. 15, but officials pushed it back a week because heavy snowstorms have made it hard for some people to sign up for insurance.

Officials say the extreme weather also led to a number of days this month when the call center was short-staffed, leading to long wait times.

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Mass. Defines ‘Affordable’ Health Insurance

What’s affordable when it comes to health insurance?

Any figure that comes to mind right now is probably less than you actually pay every month.

The federal government says Americans should be able to spend 8.05 percent of their income on health coverage this year. Massachusetts cuts low-income residents some slack.

Here’s the new affordability rate for individuals. The Health Connector board also approved affordablity rates for couples and families today.
Connector Affordability individuals copy

The 2016 rates for individuals, couples and families were set today too.

But there’s some tension the Connector will have to resolve in future years. It boils down to, well, what the definition of “affordable” is.

“Do we define affordability as a constant percent of income or do we define affordability as burden sharing between people and the government?” asks MIT economist and Connector board member Jon Gruber.

There’s a difference because health care costs are rising much faster than your income or mine, and future affordability rates will factor in health care costs.

As he speaks, Gruber looks across the board table at Harvard School of Public Health professor Nancy Turnbull. She looks troubled. The state hasn’t adjusted the affordable rate since 2012. The numbers approved today will hurt people who have little, if any, disposable income.

“We’re saying to somebody, ‘your income has not changed, you’re very low income, and yet we think you can afford a 5.4 percent increase at a time when inflation is virutally nothing,” Turnbull says.

The two have a rolling, mostly friendly, duel on this topic. It may heat up well before the debate on 2017 rates, because Massachusetts will spend tens of millions of dollars (looking for the exact number) this year to keep those affordability rates below 8.05 percent for low income residents. And with a tight budget, some folks on Beacon Hill are asking: “Can we afford to do this?”

If Gov. Charlie Baker or the Legislature decide that the additional subsidies are not affordable for the state, you’ll hear some health care reform champions withdraw their support for the individual mandate. A retreat from the individual mandate in the first state to use it would trigger some interesting political waves.

2/13 Update: Does Massachusetts offer more generous health insurance for low income residents? Take a look at this comparison of Massachusetts and Connecticut, prepared by Bob Carey at RLCarey Consulting (click to enlarge):

Mass./Conn. comparison

Biggest Gene Study Finds New Clues To Obesity, Apple Vs. Pear Shapes

(Wikimedia Commons)

(Wikimedia Commons)

You might think the link between genes and weight is simple: Fat tends to run in families, right? But as researchers tease apart the underlying genetics of body weight, it becomes ever clearer that it is a complex trait. Very complex, with ultimately perhaps hundreds of genes involved in what you see when you step on the scale.

Today, the biggest-ever study of the genetics of obesity, involving genetic samples from nearly 350,000 people, reveals dozens of new spots on the human genome that are involved with body weight and body shape, according to two papers (here and here) published in the journal Nature.

My dominant impression: The data tend to implicate the brain as a powerful influence on overall body weight, but point more towards hormones and the fat cells themselves as strong determinants of whether we’re shaped like “apples” — with more upper body fat — or “pears,” with more fat concentrated below the waist.

Dr. Joel Hirschhorn, of Boston Children’s Hospital, the Broad Institute and Harvard Medical School, leads the Genetic Investigation of Anthropometric Traits consortium, or GIANT, the friendly collaborative of hundreds of researchers around the world who contributed to the studies. Our conversation, lightly edited:

How would you sum up the findings that come out in “Nature” today?

We did a very large genetic study looking at two different kinds of obesity: Overall obesity measured by body mass index and central obesity — fat around the belly — measured by waist circumference and hip circumference. And what we found was that there are a lot of genes that influence both types of obesity, but, really interestingly, the types of genes that influence overall obesity are actually quite different than the types of genes that influence where the fat goes on the body.

Interesting. So what does that tell us?

That tells us that even though both types of obesity are bad for your health, that it may be very important to understand what kind of obesity you have, because if the biology is different, that means the way we can treat that obesity, or prevent it effectively, is probably going to be different for the two kinds of obesity.

So it may matter even more than we thought whether you’re shaped like an ‘apple or a ‘pear’?

That’s right. It matters both whether you’re an apple or a pear and it matters just how big you are in general. But the way you get to be big in general is probably different than the way you get to be an apple or a pear.

So it’s different pathways? Perhaps whole different mechanisms at work?

That’s right. The overall obesity seems to have more to do with what’s going on in the brain, maybe controlling appetite or whether you get full or how quickly you get full. And the apple vs. pear seems to have more to do with your fat cells and hormones that your body makes, things like insulin.

So does all this translate into any action points for the general public? Continue reading

Heroes And Zeroes Of Snowpocalypse 2015: The Good, The Bad And The Ugly

A plow rolls down the street as people trudge on foot down Joy Street on Beacon Hill Monday. (Jesse Costa/WBUR)

A plow rolls down the street as people trudge on foot down Joy Street on Beacon Hill Monday. (Jesse Costa/WBUR)

Snow can mean stress. Especially relentless snow that leads to cancellations, gridlock, cabin fever, hard labor with a shovel.

“The continual frustrations of managing kids at home, battling the commute to work, and dealing with the ongoing uncertainty around new crippling snowfall would make even the most easygoing person irritable,” says Massachusetts General Hospital psychiatrist Dr. Gene Beresin.

But stress is a test. It can bring out the best in a person, or the worst — the hero or the zero.

What have you witnessed in blizzard-ridden Boston? A hero — a neighbor who snow-blows out five other neighbors’ sidewalks? Or a zero — a neighbor who blows the snow off his car, right onto your car’s hood?

Tell us your story about an act of kindness and/or ruthlessness during these snowstorms in the comments below. We posted this query on WBUR’s Facebook page and it has already yielded a bonanza of vignettes that reflect the great range of human behavior, including:

My neighbor plows us out every storm and refuses payment of any kind. They’re always there for us. A few weeks ago after the Boy Scout pinewood derby, my car got stuck and they sanded and pushed my car until it was freed. Today, I’m stuck at home with 3 boys, 2 with the flu and my husband is at work so getting outside for clean up has been hard. All of a sudden I heard a noise..they had pushed their snowblower down the street to my house to dig us out!!! Great friends and neighbors…..

We live in a condo/house with four apartments. We own, most of the others are rentals and the garage is common area. For the last three storms, the guy downstairs takes off to his girlfriend’s and does not come back until everything is cleaned. The other person just sits and waits it out until we are done cleaning. The third is a 92 year old man (God love him) who will go out but I worry about him so I will do his share. I wish we could leave it once to show the slackers how it feels but we have to get the kids to school.

If he’s not working, my neighbor will unfailingly come over and snowblow us out. He knows that I’m at home with two kids and that my husband works long hours. I use it as a lesson for my two year old – “look, our neighbor is using the snow machine in our yard! What can we do that’s nice for him?” We bake if we can, or even just make a card – I want my little guy to learn that you pay goodness forward however you can.

Our street in Dorchester is all about snow heroes. Whoever is out with a snowblower at the moment will do the full length of the sidewalk, a group of kids has been traveling the block clearing steps and driveways, and everyone just chips in to finish off the tough spots. Even neighbors who are away have made sure their snowblowers are accessible for others to borrow. When my husband was traveling last storm, our neighbor came by and took out my dog every time he went out with his dog! It makes the snow much more tolerable when we’re all in it together.

Just saw the snow plow go by and the guy across the street was clearing his driveway. Snow plow backed up cleared out the end of the driveway. My neighbor was so happy, he was almost dancing.

The woman across the street shoveled out her sidewalk by dumping on my sidewalk. Which meant walking it all across the street to do so. She has a backyard. And a neighbor shovels their snow into another neighbors fenced yard that is now high enough for her dogs to get out. That’s definitely a zero.

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Groups Resist Baker Push On MassHealth

Updated at 4:30 p.m.

BOSTON — Groups representing people dependent on state health insurance programs are resisting Gov. Charlie Baker’s push for authority to make major changes in the MassHealth program.

Advocacy groups on Monday were delivering letters to Baker administration officials and legislative leaders expressing opposition to powers sought by Baker in his emergency legislation (H 49) to balance the state budget. Baker has requested authority to restructure MassHealth benefits “to the extent permitted by federal law.” Continue reading

Earlier:

As Health Incentives Rise, Many Get Paid To Work Out And Eat Kale

Laura Smith uses her Nutrisavings app to check the healthy score of pasta sauce at a Shaw's in Waltham. (Martha Bebinger/WBUR)

Laura Smith uses her Nutrisavings app to check the healthy score of pasta sauce at a Shaw’s in Waltham. (Martha Bebinger/WBUR)

Laura Smith scans a wall of pasta sauce jars at a Shaw’s in Waltham, and reaches for her favorite.

“It looks like it would be fantastic for you,” Smith says, showing off the label. “It looks like someone just plucked a bunch of tomatoes and put them in a jar.”

But when Smith scans the jar’s bar code, using an app on her phone, her smile fades.

“It’s a 33,” she says and then pauses. “Wow, 33?”

The Nutrisavings iPhone app

The Nutrisavings iPhone app

That’s 33 out of 100 on a healthy food scoring system developed by Newton-based Nutrisavings. Not good. Smith types pasta sauce into the Nutrisavings app and finds one that scores much better, at 75.

“Francesco Rinaldi,” Smith says, turning the jar in her hand. “No salt added, it’s a healthier option, that’s what I’m going to go with.”

Nutrisavings scores more than 200,000 foods on a scale of zero to 100. Sodas are typically a zero. Many fresh fruits and vegetables are up near 100. The company has partnerships with 80 supermarket chains around the country, including Shaw’s, where the score for everything Smith buys is totaled when she checks out.

Smith earned $10 this month just for using the program. She’ll get another $10 every month that her average score is 60 or higher.

“That’s $20 essentially free money just by making modestly healthy decisions and going to the store, which are things I’m going to do anyway,” Smith says.

Who pays? Her health insurance plan, Harvard Pilgrim Health Care.

The goal is “to get people to understand the value of what they’re putting in their mouths,” says Sue Amsel, a senior product portfolio manager at Harvard Pilgrim. Continue reading