♪ good evening and welcoming to kqed. governor jerry brown released a cautiously optimistic new space budget. >> we have a new budget that is balanced and we can keep it that way, but it will require self discipline and real prudence. >> there were not too many surprises. he previously hinted at what would be the fourth and final term focuses. he is focusing on climate change and building high speed rail that broke ground on tuesday. john meyers was asked about what is generating because in sacramento as the new year begins. >> first of all give us the big picture here, characterize the governor's budget what stands out for you? >> i would call it a budget that is more of the same. in a lot of ways that's good news. tax revenues have been doing in california in the last few years which means more money for programs and specifically in this budget about $8 billion more for k through 12 schools and community colleges. i think it's more the same in the governor's approach to governing which is spend a little in a couple places he wants to and hold back from giving legislative democrats what they want. we don't see big increases there and i think it will be a point again this year. >> let me ask you about the tuition freezes that the gov is touting for college students, that flies in the face of what janet napolitano wants to do. so are they on a collision course? >> i mean, the short answer is it looks like it right? both of them are making their statements. i ultimately think that someone will find a way around this, but you know in this budget, the governor says okay great we will give the university of california $120 million more than it is getting now, that is not as much as us wanted as you said just a minute ago, and the governor said the only way you will get that is if you don't have a tuition hike and if you agree to sit down and talk about the long term funding. i don't know where it comes down but i will tell you this. the governor appoints regents. he is the leader of the board of regents regents. i don't think we're going to get to hiring and firing but i think we will have a spirited discussion about the ideas for budget and the future of the uc and the spending plan. >> it is interesting to have a head that was a former governor. let me ask you about local control. the governor has been a big proponent of that in things like criminal justice, is that plays out at all in this budget as far as education goes? >> there is a lot that the governor has done in the last two years. yes, the public safety money where you realign programs and try to divert people from going into prison into local programs is still something to be worked on. this budget building on what the governor has done with schools which is give schools more flexionflex flexability on how to spend their dollars. they lay out something for school construction that we have never done before. it has been a partnership in the past, and the governor doesn't want to do those any more. he wants to move to a system where the locals have more control and responsibility for finding the money to build school facilities. i think that will be a big source of discussion in the capital this year and i think it will be hard for local schools that think the state should play more of a role. >> the other big story is barbara boxer saying she will not run for reelection. the attorney general harris, how do you see it playing out in the coming weeks and months? >> the feeling i have is more like who is not being considered. eric garcetti is not going to run. some dark horse candidates. i think members of the -- people talk about jackie spear in the south bay, could she be a potential candidate? i think this is fascinating and the bigger story is that this is generational change in politics. the older politicians in office now exiting the stage, and this generation of democrats that want their own shot. >> and republicans may have something to say about who runs and wins what is at stake for them in that election? >> i think it would be hard for a republican to win. we'll see who the candidates are, but i think the party again needs a bit of a brand. i think this would be a brand on the national stage too. they had hard times, maybe this is their chance. >> john meyers, editor for "politics and government." thanks a lot. >> you're welcome. coming up new frontiers in health and technology. first, legally assisted dieing. it hit home when a bay area teacher britney bernard received a terminal brain cancer diagnosis. she died last november after taking fatal medications. now other states are considering similar laws. the 2011 hbo documentary, how to die in oregon showed terminally ill patients making their decisions. >> it's a curious limbo. you don't know what will happen, but with death with dignity, you have some control over what will happen. >> she says the cancer has come back and things will be fine that sounds like the opposite of fine. and goining me now for a closer look at this issue is dr. stephanie harman, medical director of the medical patient care service. katie butler author of "knocking on heaven's door." i want to begin with you, tony, how is aide in dieing defined? >> it's a specific end of life option among many options available in many states that mentally competent terminally ill patients so they can get a prescription for medication that will help them end their dieing process should that process become unbearable or before they lose ontonomy. >> do they have to be reviewed by doctors that all agree they have less than six months to live and they're all in final critical stages. >> it doesn't always mean you have a terminal prognosis. what we're looking at here is when you get to the point in your illness that you're really entering the final stages it is typically about the same time people would be referred to hospice. do they want medication to help end their dieing process if necessary. >> so there is five states where this is legal, are you working with other states to legalize death with dignity laws. >> yes the first was passed in oregon. it was titled death with dignity law. we talk about it a little differently now, but the specifically medical aide in dieing is when you request medication to help you end the dieing process. after britney menard's story made international headlines, there has been so much interest from legislatures, and we know a majority of americans respect this option being available. >> does that include california in the 12 states? >> yes, it includes california. >> there are many critics of this as you know, the catholic church various doctors, the california medical association, disability rights groups. pope francis said these laws give a false sense of compassion and that it is a sin. i want to talk to you about that, what are you views on that? is the discussion being framed properly in your mind? >> i think the death with dignity laws are addressing the suffering of patients and their families in the process of dieing. i think it shows that in our health care system we don't do a good job helping patients and families go through this process. we have so much attention when we bring life into this world, and we're so fragmented at the time of when we exit this world. i think the death with dignity is addressing that need, but i think that it is not near enough to address the issues that we have enormous problems around how clinicians are communicating about this process -- >> what are some of those problems? >> i think a lot of it stems from how we communicate about an illness, and an illness that may, unfortunately cannot be cured. we have a lot in the medical culture around what we can do and continue to do and less attention to what we should do and how that aligns with patients and families values. >> for example, 70% of people with a terminal cancer, who are getting chemo that is only designed to prolong their life and will not cure them, 70% of them believe there is a possibility they will be cured. there is a tremendous failure. sometimes the patients or the families don't the to area, and sometimes the doctors are just tongue tied and have no language to talk with patients. people get treatment after treatment that only destroys their quality of life and sometimes doesn't even extend their life at all. some people in hospice live longer than people getting aggressive chemo or late stage heart surgery. >> katie you wrote a very personal book about what you went through with your father in his final days and that his pacemaker kept him alive longer than he might have wanted. >> he said very clearly i'm living too long. he had dementia, he was deaf, he was going blind. he had a lot of stroke damage, he could barely talk. he was given a pacemaker with no discussion about these huge questions that we were really addressing. what makes life worth living to you. do you want to live under circumstances that benefits are no long erer available to you. sometimes doctors don't want to talk about it or family is clinging. i think we're confused about what the loving thing is to do. >> we have a baby boomer generation now who is dealing more and more with these issues. so when do you have those very difficult conversations, and how do you go about that? >> i think we need to start like five years before we think we need to start. >> five years? >> i think so like five years before you think you need to start talking about it. a lot of people say just take me out and shoot me if i get like that, but it is not an end of life plan. instead people end up at the door of the intensive care unit with a doctor they have never met, and the doctor is saying it is time to disconnect the machines and people are shocked. i think it is better to start too soon than too late. >> we agree with that at compassionate choices. we encourage people to do that and i would say even earlier. i think one of the interesting things about britney menard is that she was so young, and at a point where she should have been starting her family, she is thinking about how to die. and so i know we encourage families to talk about it not only for the oldest members of their family, but for everyone. you never know what decisions will have to be made and the more you think through what you want done and let your loved ones know the better chance that you're going to get good, quality care. >> we think about that as advanced care planning and also a way that you're imparting a gift to your loved ones so they're not in a position, like you were mentioning, katie, you're making decisions around discontinuing life prolonging therapies in a very artificial technology oriented environment of an intensive care unit where you have not had that conversation before then. it's such a gift for loved ones to know that this is what they always told me. you're not getting into that kind of situation where you're making decisions around duress and crisis. >> i have to ask you this. there are those that feel that if you have, if you legitimate this and make it legal to have physician assisted dieing, you're going down a slippery slope. it opens the risk of abuse, and there may be no going backwards from that how do you respond to that. >> the interesting thing is that we have two decades now of data from oregon the death with dignity law. a lot of attention was paid to making sure there is a process for people to go through, that you are mentally competent, it's not just depression, your doctor has to -- you have to make multiple requests, you're encouraged to talk to your family et cetera but ultimately the decision is about the patient and the patient's values. but i think what we're seeing emerging is this is a moment when it's very important to be patient centers. there is a difference between prolonging life and prolonging death. we need to understand the patient's values and what's going to work best. >> we will have to leave it there then. thank you for joining us today. we are going to move on to a lighter topic now, wearable digital devices. they're getting a lot of buzz at the consumer show in las vegas this week. we have andrea kissick taking a look at how some of these tools are changing health care. >> are you ready to get started? >> a 25-year-old tech worker in san francisco. her trainer tracks her progress. clara is also getting digital help. >> i tried losing weight throughout my life since i was a little kid. i tried different methods and nothing worked until u i started wearing a wearable device. >> it records and tracks her fiszcal activity and sleep. google, samsung and apple are creating technology that could reshape medical research and change our relationship with our doctors. >> it happens over and over and over again whether it was in the banking industry when atms coming in you no longer needing tellers, i think you will be able to get to a point where you have a right to get to your data without your body without having to go to a dr. >> larry set out to get fit, but he did more than track the pounds he shed, he started tracking the changes in his body. >> within the sea of numbers he spotted a spike. >> i had one variable, a protein, and i found out that when you take healthy people, and theirs is less than 7, mine was 900. >> he learned that might signal a auto immune disease. >> i took it in to see the doctor and he said what's that? it's not useful that's not medicine. i said yeah but it's science. >> he got a new doctor one that listened to him and confirmed that he had crone's disease. >> let start with checking your blood pressure. >> some doctors are studying how this big data may help fight a deadly disease. >> it is an electronic clinical study where we can validate and test if mobile health activities. >> people use wireless activity trackers and apps that measure vital signs. >> we're collecting ekg's. and it is just a case that fits on your smart phone and by starting the a and touching the electrodes in the back it will record a ekg and it is sent automatically through the internet to the lab. >> it is show unusual rhythms. >> we gave out the devices and in a week we had 30000 ekgs. it could take years to collect thousands of ekgs previously because people would have to come in and get the recording done. >> they want to recruit a million study participants around the world that may help reveal what health benefit, if any, they have on health. >> the type of person that goes out to buy a device to track their health is a different sort of person than someone who doesn't. >> then there are privacy concerns around the data collected and stored by the companies making these devices and apps. >> we have a mask here -- >> the consumer demand for easy to use self-tracking tools keeps growing. in 2013 investors spent $3 billion on new digital health start ups and services. for one based in redwood city, the next wave of technology could come from sensors you swallow. >> i took one just before 7:00 this morning and one here at 2:00 in the afternoon. >> meet the world's first fda approved ingestible senator. >> it's about the size of a grain of sand. >> the company's chief medical officer thinks this technology can help imagine patient care between visits especially for chronic diseases like alzheimer's disease. >> it is helpful because right now half of all patients take their medicines at all correctly. >> while it remains to be seen how this will change health care, patients can now play a more active role. >> the tools emerging put the patient in a driver's seat by giving them information and their response to therapy. it will transform how we care for ourselves and our loved ones. >> that was from andrea kissick. let's go to other news with scott schaffer. next week workers will go on a strike that work in the memberal health field, what is prompting this? >> mostly a lack of staffing. they say they don't have enough people to see everyone that needs mental health therapy. they were fined last week for failing to provide timely mental health care. >> beside a plan to hire more people are they doing anything else to address bigger issues? >> they dispute that the group therapy sessions that a lot of patients get steered too -- that there is no difference. they're saying we have lots of those kinds of groups for people who have things like eating disorders. >> the other big story is san francisco city college. the schools funding was threatens saying it was poorly managed. they turned around and sued the commission, what's going on with that now? >> they sued, the judge heard that and he can make a decision at any point and he probably will in january. they could get a reprieve, they could be off of the hook. if he sides for the commission they can pull their funding right away. >> it is also turning out to be a big month for the obama administration. he announced a plan to make the first two years of community college essentially free. >> it's hard to say we don't know the details, it would have to be approved, california would have to opt in. >> certainly much at stake. the biggest city college in all of california. >> sure is. >> all right scott, thank you. >> it's been a day of dramatic developments in the paris attack has police track down the suspects. it has touched so many of us and this week people gathered to remember the victims. we leave you now with a few images, good night. support for science programming is provided by thes >> announcer: the following kqed production was produced in high-definition. >> the beef torta was out of this world. >> i actually don't discriminate against pizza. >> this is a temple to where we eat. >> sort of like a meat -- >> we couldn't see it, and we couldn't hear it. >> like, "whoa! i'm actually in san francisco?" >> this is amazing! 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