June 24, 2013
Host: Ted Simons
Health Care Study
- The University of Arizona Integrative Health Center in Phoenix is undertaking a new study to determine the effectiveness of a whole-person approach to health care. The three-year Integrative Medicine Primary Care Trial (IMPACT) will compare outcomes for patients treated using integrative care with patients treated using solely conventional medical care. Dr. Heidi Rula, medical director for the U of A Integrative Health Center, will discuss the study.
- Dr. Heidi Rula - U of A Integrative Health Center, Medical Director
| Keywords: medical
Ted Simons: The University of Arizona integrative health center in Phoenix is starting a new study to compare outcomes for patients treated using integrative medical care with patients treated only using conventional care. Here to talk about the study is Dr. Heidi Rula, medical director for the integrative health center at U of A. Thank you for joining us. Is that what you're going to be looking at, a compare?
Heidi Rula: What we want to look at is to compare the health outcomes for patients who are receiving integrative care, primary care, versus those who are receiving conventional medical care. To date there have been no well-designed research studies comparing integrative medicine to conventional medicine. It's our belief patients will have better outcomes, both health and health care financially, and so we really are looking to put together a study to be able to develop data to prove this information.
Ted Simons: Define integrative medical care.
Heidi Rula: Integrative medicine is whole person medicine. It is really addressing the person's mind, body, spirit, really going into lifestyle issues, developing a partnership with a patient. Where the patient and the physician work together as partners. It is also a medicine where we have collaborative care, working together as a team versus having the physician direct the patient's care.
Ted Simons: With that in mind, define conventional medical care.
Heidi Rula: So conventional medical care is generally accepted as being kind of western standard medical care that's delivered here in the United States.
Ted Simons: So how -- When you do this study, you have the integrative care, the whole person is how you described it, the whole person care with conventional care. -- Don't they mix often, or do they not necessarily mix?
Heidi Rula: Integrative medicine is about combining evidence-based therapies both from the conventional and from either complementary or alternative medicine worlds. So it's really saying there's value in all these forms of healing, and looking for the best. And looking for options for patients because not everybody is going to have the same treatment plan. So the more that you can have in terms of different healing modalities, the more likely you are to have a match for that patient.
Ted Simons: Basically, sounds like it opens up the horizon, opens up possibilities that may not have been opened before?
Heidi Rula: Absolutely. Obviously giving you more as well as seeing the patient as a whole. So seeing the patient as not only he's -- Energy medicine, things like acupuncture, and healing touch, and things like that. So we are acknowledging that there's an energetic piece to a patient's health, we are acknowledging that there's a spiritual aspect to a patient's health. Those are things that in conventional medicine we tend to look at the -- At a patient more on a biochemical level that if this is out of whack we give this. A drug for this, and so this is understanding that there is kind of more to health than just the biochemistry.
Ted Simons: Have there been a reluctance in conventional medicine, American medicine, if you will, to consider seriously integrative medicine?
Heidi Rula: I think there's a lot -- There's been some pushback on really looking at this as evidence-based medicine. Some of these things are really outside of the realm of what most people have been experienced in their medical school training. So to kind of accept some of the concepts, just like energy medicine that that play as role in health, these are things that most physicians haven't interfaced with. To look at that piece sometimes can sometimes people might see it as more WOO-WOO medicine, and not really based in science. But the wonderful thing about integrative medicine is that there's more and more research being developed looking at the effects of these different forms of healing and how they really alter a patient's biochemistry. So that I think more of the conventional physicians can start understanding it as to how it's going to impact the patient's health when you actually have a study showing that impact.
Ted Simons: So talk about the study. How long is it going to be, who's going to be involved and how exactly do you compare and contrast?
Heidi Rula: So this study has been designed by the University of Arizona center for integrative medicine to really measure the both financial and health impact of integrative medicine in the primary care setting. We are looking to study a number of different health measures, looking at not only things like how well our patients chronic medical conditions handle, what is the patient's satisfaction in receiving integrative medicine versus conventional medicine, what their quality of life, what is their health care utilization, where their health care costs? And so that's going to be accomplished by looking right now Maricopa County and police are eligible to be voluntarily enrolled in our study and we're also looking at working with other corporate settings where they could do something similar. But what we're going to do is look at those measures and compare them to the claims data on patients -- Which is all an anonymous type of setting, but we're going to look at the claims data at patients receiving conventional care, be able to look at how somebody does in the integrative arena versus how somebody does in the conventional arena.
Ted Simons: When it's all said and done, when you get your facts, your figures, how do you utilize this information? How do you implement -- Will it mean implementing changes?
Heidi Rula: Well, the reason we really wanted to do this study was that we feel that the current model of health care is broken. That right now health care costs are skyrocketing. To an unsustainable level. We have developed a new model of health care that we feel patients will have better outcomes with. But we really needed the evidence to be able to demonstrate that. So this is going to serve as collecting that initial data to take to policymakers, to be able to have a conversation to say that, yes, if you really spend money on the front side, if you look at prevention and having patients be able to spend time with their physicians and this whole-person medicine, those patients will do better and cost the system less. Right now we're very much a disease kind of oriented type of health care system. So we wait until people get sick. And then we go out and spend a lot of time money on delivering care once they've developed a disease. We want to roll that back and really kind of focus on prevention, so that patients don't develop a disease. There's a lot that can be done in the prevention arena that we think can have a huge impact on this health care epidemic that we're having with obesity, heart disease, infant mortality, all of these things we see as being a problem with our system and really kind of having a real lifestyle issue to our country that is not being addressed in our current model of health care.
Ted Simons: We'll keep an eye on this. It sounds like fascinating information. Thank you so much for joining us.
Immigration Reform Process
- The United States Senate is considering what could become the first comprehensive immigration reform law in decades, but such controversial legislation encounters procedural pitfalls along a path to potential success. Patrick Kenney, Dean of the Arizona State University School of Social Sciences and a political science professor, will discuss the bill’s path to becoming law.
- Patrick Kenney - Arizona State University School of Social Sciences, Dean and a political science professor
| Keywords: immigration
Ted Simons: Good evening, welcome to "Arizona Horizon." I'm Ted Simons. The U.S. Supreme Court said a -- Sent a Texas case back to appeals. It leaves affirmative action programs in place but sets the stage for future challenges. The high court reinstated a death sentence of an Arizona man convicted of killing another man years ago. The court overturned a ninth circuit court of appeals ruling that tossed out the death sentence of Edward Schad. For a full recap join us next Monday as ASU law professor Paul Bender reviews the decisions. The U.S. senate today voted on a border surge amendment to the comprehensive immigration reform bill. Or at least vote order whether or not to continue to debate the amendment. Here to talk about the vote and other procedural moves, we welcome Patrick Kenney, dean of ASU's school of social sciences and a political science professor. Good to see you again.
Patrick Kenney: Thank you.
Ted Simons: Today's vote basically in a debate.
Patrick Kenny: The senate is unique. And for a long time, throughout its history, senators have the right to talk as long as they want to debate a topic on the floor of the senate. And it got so difficult to get to a vote, the senate put in rules, the last change about 30 years ago, where you could vote to end the debate, debating nonstop debating is known as a anybody, you can vote -- Filibuster. It's called a cloture. You need 60 votes to end the debate. And that's what they did.
Ted Simons: This allows for future votes here coming up I would imagine right quickly, on the first of all the amendment, talk about the amendment to the big bill.
Patrick Kenney: So the amendment to the big bill is to tighten or increase dramatically actually border security to the tune of something like $30 billion. They call it a surge, kind of reminiscent of what we did in Iraq, we'll send more border security agents there, more fencing. And the reason, the main reason the senate is interested in this is to encouraging Republicans to come on board with the broader immigration bill. Because Republicans in particular conservative Republicans have been very concerned about the bill, certain aspects of it, especially the path to citizenship. And they have always argued all along they want the border secured first, so this is an effort to secure the border first and then move on the broader bill.
Ted Simons: And today's cloture vote suggests enough Republicans have gotten on board.
Patrick Kenney It looks like -- There's democrats in the senate, so they had to pick up Republicans to get to 67, we quickly glanced before it looks like there's votes, so they have picked up anywhere from 12 to 15. I haven't seen the actual votes, but anywhere from to Republicans.
Ted Simons: And we're talking unmanned surveillance drones, doubling the border patrol agents, I guess doubling the 350-mile fence.
Patrick Kenney: Right.
Ted Simons: Correct me if I'm wrong, it sounds like they're being put in place over the same amount of time it would take for some of the permanent resident card folks to actually get their cards.
Patrick Kenney: Exactly. So implementation of this kind of thing is going to take quite a while. And part of this notion is that this has to be in place before we can actually start activating a lot of paths to citizenship. It delays things a little bit, and I think a lot of the people that are concerned about it that helps them a little bit.
Ted Simons: Where did this idea for this surge come from? It sounds as though money was found with the congressional budget office, said, look at the big bill, it means more money?
Patrick Kenney: There's been a lot of people estimating what it costs. One of the most reputable estimates often comes from the CBO, the congressional budget office, it's known as a nonpartisan. They've got a lot of talented analysts there that work for the CBO, and their estimates over the long haul is that the immigration bill will reduce government spending over the long haul. So they're arguing some of that could come from this. It won't be revenue neutral, but it's a way for Republicans concerned about the size of the government spending to go on board with this much spending towards the surge.
Ted Simons: I'm curious from the Republican angle, that's a lot of money. For anything.
Patrick Kenney: Right.
Ted Simons: And yet it's being used to justify moving forward with this legislation.
Patrick Kenney: Right. So this is a really important step, I think, in the negotiations. So the gang of eight, four Republicans, four democrats V. moved this debate much further than we had even back in ‘06. Most likely the reason the senate is very interested in this is because of the election results that we saw in the last two presidential elections. Latino vote is growing in the country, and it -- Especially last time was whoppingly lopsided for the democrats. And there's certain areas in crucial states like California and a lot of the southwest, if the Republicans don't work at least work on immigration, these blocks of states start to move out of their possibility of winning that, it starts to change their dynamic. So I think a lot of forward-looking Republicans, John McCain, Jeff Flake in particular, are saying, wait, we need to engage in this debate and start thinking about this issue.
Ted Simons: So this is bipartisanship, maybe out of necessity for some, but bipartisanship nonetheless. Encouraging signs?
Patrick Kenney: Yes, probably. Because this is a hard issue. And those of us that study American politics argue election does make a difference. And sometimes they make more dramatic differences than others. And this is a case where I think the election made a dramatic difference. And it's forcing a lot of senators to sit down and talk that haven't done before. And you're right, bipartisanship has been in fit and starts over the last years, but after some elections you've seen these kinds of activities.
Ted Simons: With that in mind, we still have the house to go through. Now, first of all, what do you see -- Rand Paul, senator Rand Paul basically said I know what goes on in the house and this is dead on arrival. Has he got a point?
Patrick Kenney: He has a point. The votes they need 218 in the house to pass this, and the Republicans have more than 218. If the Republicans want to stand in the way of this they can, without any real big difficulty. At least at the moment. It doesn't mean they might not have problems later but they can if they want. This kind of amendment is aimed not only at the senate, but at the house as well. So they're hoping to build some coalitions in the house.
Ted Simons: In terms of just in general politics, back on the hill, when the senate shows this much bipartisanship, does it not often seep over into the house.
Patrick Kenney: Yes. Historically, yes. The last 15 years it's harder to predict. Historically yes. There is a group of Republicans in particular in the house, in particular who have been opposed to this legislation all along, dating back, eight, 10, years, and they're in larger numbers than they were. So the question for the Republicans is can -- The question for the democrats or for the senate in some kind of -- Is, can they put together a coalition of mostly democrats and some Republicans? That's what they'll be trying to do in the house. I think it's probably possible given what we're seeing in the senate.
Ted Simons: Yeah. OK. So I guess we'll have to see. Bottom line, if this goes through, McCain, Flake, President Obama, all considered winners?
Patrick Kenney: I think so, yeah. I think -- Most likely, yes. And if it goes through, there's many Republicans who can vote against it and have it still go through. So they will be OK in their own constituencies if that's needed, but I think overall if you take the long historical look, we needed to do something on this issue, this is a very long, complicated border with Mexico, Mexico is an ally of ours, we need to figure this out over the long haul this, is probably a good thing.
Ted Simons: Very quickly, will democrats be hurt more? I know a lot of liberals aren't happy with this border surge quote unquote. Will democrats be hurt more by the border surge, or will Republicans who vote for this be hurt more? We're talking next primaries.
Patrick Kenney: That's exactly where the problem occurs, in the primaries. Because the primaries tend to be more ideal logically concentrated, so we'll have to see. But that is exactly their worry. It's hard to predict, we're a little too far out. But you are seeing compromise on a complicated issue and I think that's probably a good thing.
Ted Simons: Good to have you here. Thanks for joining us.
Patrick Kenney: You're welcome.
- Two different routes are being considered for a new Tempe streetcar. Councilwoman Shana Ellis will discuss the trolley and the possible routes.
- Shana Ellis - City of Tempe, Coucilwoman
| Keywords: tempe
Ted Simons: The federal government recently approved a 2.7 mile streetcar track for downtown Tempe. The city is considering two different routes for the streetcar line, and here to tell us more is Tempe city council member Shana Ellis. Good to see you again.
Shana Ellis: Good to see you.
Ted Simons: This is definitely going to happen. Correct? This is not so much of a proposal, but how are we going to do it.
Shana Ellis: Well, that's how we believe. We have been working with the federal government, the FTA, hand in hand, and we were submitted for a project development, and so that means that they're holding our hand through this process, we have a couple more steps that we need to do before our final submittal, but we believe it will happen.
Ted Simons: OK. We're talking a streetcar, not a light rail system. Define the difference.
Shana Ellis: Correct. A streetcar, it does look a little bit like light rail. If people have seen the modern streetcar in Portland, this is the model we're using. It actually runs in the lane of traffic, so in that aspect it is different from our light rail system, the stops are much closer, and the stations are much smaller. The construction also will be a lot less.
Ted Simons: So basically not so much of an impact on businesses down there while this is being constructed.
Shana Ellis: Correct. Portland's experience has been they could do three blocks in three weeks and open the lanes of traffic during the evenings for people to be able to still travel on.
Ted Simons: So what is, before we get to the routes, what is the streetcar designed to do? What is this project designed to do?
Shana Ellis: There's a lot of pieces of value we believe it will add to our community. 1st and foremost, it will be able to offer additional mobility options to our residents, it will be connected to our existing transit system, it will be run by metro rail that runs our light rail system, and also will integrate with our bus system. We've seen those numbers go through the roof. People are riding transit in record numbers, so this is just a piece of the transit network that's out there.
Ted Simons: So is this a people mover? A student mover? Or a downtown mover?
Shana Ellis: Yes.
Ted Simons: Yes, OK. It's all of those. So let's talk about the routes. I find this is fascinating stuff, planning a city here. The first one is called the Apache Rio Solado option. What are we looking at here?
Shana Ellis: The first option we're looking at is shaped more like a C. So it starts behind the ASU stadium at Packard drive, and then it would turn south down mill Avenue, and then it would turn east at Apache, which is where Gammage is, and go all the way to rural road. The second option that we're looking at starts at Rio Soldao and Mill, goes south to Apache and again turns east, but it would connect to light rail at terrace, which is just east of rural.
Ted Simons: Where we're looking right now, the red line, Apache, on both -- Both angles for Apache, Rio Solado, and the one stop for terrace, are those turn-arounds?
Shana Ellis: The downtown area is an actual loop. It runs counterclockwise, and that is to avoid utilities that are in the street. So it makes it a lot less expensive. The other line that you see through there is the existing light rail line. So people can see how it does go in a circular motion.
Ted Simons: And benefits, pluses and minuses of each option. What are you hearing?
Shana Ellis: Well, we are gathering public input on this now. We've had an open house that had about 80 people attend, and they gave some input and online we're collecting some input, people can go to valley metro.org/Tempestreetcar, and that's through June 30. But there's additional studies that need to be done too. We need to find out how expensive it is to move existing things under the street, so the council will be weighing in all of those options in the fall, and then making a recommendation to the region and ultimately to the federal government.
Ted Simons: Originally I know that the streetcar line was supposed to actually go farther down Mill Avenue, I think to Southern around those lines? That didn't seem to last very long. What happened?
Shana Ellis: It lasted quite a few years, but we received feedback once we summited our application to the federal government, that that area wasn't an area that was ripe for economic development or for additional population growth. It's mainly single-family homes. And because it's federal government money, we need to abide by their criteria and they felt either one of these routes would have a higher chance of being funded with their dollars. The main -- Another main thing that a streetcar would do is economic development potential that it has.
Ted Simons: I think everyone who's been along Apache Boulevard can see what light rail has done for that area. It's almost ridiculous how that --
Shana Ellis: Yeah. 1.4 billion dollars in investment and we have 7 billion back already. So we know that with permanent infrastructure actually putting tracks in the street, that we do have additional businesses and residents that will be located along the streetcar route.
Ted Simons: Traffic concerns, especially on mill Avenue with the streetcar in the street? Studies done, what are you seeing?
Shana Ellis: Well, because it shares a lane of traffic, we don't believe that it will have much of an impact there. There are buses going up and down Mill Avenue now that have stops, and we're hoping that people will take the streetcar instead of traffic. One of the things I think is great are those billboards that are out there that say you're not stuck in traffic, you are traffic. If people have an additional option for transportation, their trip doesn't seem to take as long.
Ted Simons: Last question here, it looks as though I would guess there would you be opportunities for expansion, the one that stops at Packard I can't see why you wouldn't go all the way to Tempe marketplace and maybe the one that stops at rural, maybe on the way to Mesa -- Is there any talk of that?
Shana Ellis: Yes. Actually, we've had conversation was officials in Mesa, they would love to see it go to their Cubs stadium. ASU would love to see it go through their stadium district. We've talked to Chandler, they would love to see it there. And additionally, Phoenix is doing a study south on Central from their light rail line to see if a streetcar could be something they could do in the future.
Ted Simons: Alright. We'll keep an eye on that. Thank you so much for joining us.
Shana Ellis: Thank you.