Thursday, November 19, 2009

Raging Health Care Debate : Help for Consumers Caught in the Crossfire

Consumers caught in the quagmire of issues in the health care debate can find help from a member-based non-profit organization dedicated to protecting Americans’ rights to choose their practitioner and the practitioner’s right to practice integrative and natural medicine. Washington, DC-In a headline that read ‘Lobbyists Spend Millions to Influence Health Care,’ a Washington Post article reported that the Pharmaceutical Research and Manufacturers of America (PhRMA) spent $6.2 million in lobbying with the American Medical Association spending another $4 million in lobbying efforts to influence the outcome of the current health care plan. That does not include the millions and millions spent by health companies and associations as the article expands upon. That leaves many consumers wondering - who is lobbying for the average consumer? Knowledgeable consumers turn to the Alliance for Natural Health US (ANH-US), formerly known as the American Association for Health Freedom (AAHF) for helpful and forthright information on health care issues including how the new government plan may impact consumers in different areas.

Lisa Lundy — public speaker, health and wellness expert and author of The Super Allergy Girl Gluten-Free, Casein-Free, Nut-Free Allergy & Celiac Cookbook is a strong supporter of ANH-US “Consumers who want to get the real deal on health care issues can rely on ANH-US for representing consumer concerns. They have a wonderful newsletter that highlights not only the important health care issues, but also the small actions consumers can take that will make a difference,” Lundy stated.
Since 1992, the Alliance for Natural Health US (ANH-US) has advocated for practitioners and consumers. Over the years, the organization’s name has changed a few times, but its mission has never wavered — to protect the practitioner’s right to practice and the consumer’s right to choose.

ANH-US,, has grown to be an international voice dedicated to promoting sustainable healthcare and freedom of choice through good science and good law. The organization focuses on shifting the medical paradigm from an exclusive focus on surgery, drugs and other conventional techniques to an “integrative” approach incorporating food, dietary supplements and lifestyle changes — a model that improves health and quality of life while reducing the costs of healthcare to a sustainable level.
Under federal regulations, producers of dietary supplements are prohibited from making any “health claims” for their products unless pre-approved by FDA. Even scientifically proven health benefits are restricted. ANH-US, which believes consumers have the right to receive information and make informed decisions for themselves without government censorship, is actively working to allow manufacturers of dietary supplements to communicate the scientifically proven benefits of their products directly to the consumer.

ANH-US is a 501(c)4 nonprofit organization with headquarters in Washington, D.C. to protect the rights of the consumer to choose and the practitioner to practice by lobbying Congress and state legislatures; educating the public, press and decision-makers on integrative medicine; initiating legal activities; and joining and forming significant coalitions.
“It was the freedom to choose both a physician and a treatment that saved the life of my youngest child” Lundy said. Lundy’s daughter had a life-threatening medical condition - the inability to absorb essential vitamins and nutrients from her food – and a dysfunctional immune system that left her young child living like a modern day bubble child. Thanks to a good medical team, a variety of medical treatments and other interventions and over $100,000 in out-of-pocket medical expenses, Lundy’s daughter, Anne who will turn 8 years old soon, is almost completely well. Lundy, who has no formal relationship or ties to ANH-US, has been recommending them for several years. It is the place she turns to for finding out what is happening in health care from a consumer and freedom perspective.


NOTES TO THE EDITOR: About the Alliance for Natural Health US (ANH-US):
ANH-US is a 501(c)4 nonprofit organization that protects Americans’ rights to access integrative medicine and dietary supplements. Formerly known as the American Association for Health Freedom, ANH-US protects the right of the consumer to choose and the practitioner to practice by lobbying Congress and state legislatures; educating the public, press, and decision-makers on integrative medicine; initiating legal

Update on Last Week's House Healthcare Bill Story

Last week we discussed the difficulty of knowing what is and is not in the nearly 2,000 page House Healthcare bill. Here is a really bizarre example. Some commentators noted that the House bill provided for jail time of up to five years for anyone who failed to buy mandated insurance and also did not pay the financial penalty. Reference was also made to sections 7201 and 7203. Some bloggers immediately responded that this was pure fiction-- nothing about jail terms was in the bill and there were no bill sections 7201 and 7203.

It is true that you won't find Sections 7201 and 7203 in the House healthcare bill. End of story? No. When Nancy Pelosi was asked about the jail terms, she did not deny them. What was going on here? The explanation is as follows. Under the House bill, if you don't buy the particular insurance policy mandated by the government, there is a financial penalty. The legislative language of the bill quite intentionally describes this financial penalty as a tax. Why is that important? Because under sections 7201 and 7203 of the tax code, you can go to jail for not paying a tax. The sponsors of the House bill thus created a jail penalty for non-payment without having to include this specifically in the bill.

Is this the right interpretation? That question was addressed to the Congressional Tax Committee; the Committee’s written response confirmed it. If you don't buy the mandated insurance and you don't pay the tax, you can be put it jail for up to five years. Supporters of the bill still claim that in this case you won't be jailed for not buying the policy. You will be jailed for not paying a tax. Perhaps we can all agree on this language--not buying mandated insurance can lead to jail. And that is exactly what Nancy Pelosi intended.

Conventional doctors claim integrative therapies lack research, study.

The Associated Press recently betrayed its bias in a series denouncing CAM/integrative medicine. Many who value integrated medicine were outraged by the following comment, which preceded each of four articles about complementary and alternative medicine published by AP: “EDITOR'S NOTE: Ten years and $2.5 billion in research have found no cures from alternative medicine. Yet these mostly unproven treatments are now mainstream and used by more than a third of all Americans. This is one in an occasional Associated Press series on their use and potential risks”. Likewise, Dr. Jerome Kassirer — distinguished professor at Tufts University School of Medicine, former editor-in-chief of the New England Journal of Medicine and author of On the Take — has written: “People using alternative medicines are wasting their money and are being fooled into thinking they are getting something that is beneficial for them”.

The truth is, millions of American use integrative medicine and are generally satisfied with the results. Most pay out-of-pocket for these services. If it works for them, what more could taxpayer dollars do to ascertain the effectiveness of integrative medicine?

Americans vote daily with their pocketbooks by buying and using integrative therapies, therapies that are the basis of traditional Chinese and Ayurvedic medicines, disciplines with more than 5,000 years of recorded success. Consumers also know that conventional medicine comes with a significant risk of errors, side effects (even resulting from correctly prescribed drugs), contraindications and hospital-acquired infections. For example, consumers understand that chemotherapy may help their cancer but its risks could outweigh the benefits.

Knowing this, Mimi Guarneri, M.D., medical director of Scripps Center for Integrative Medicine in La Jolla, Calif., has said: “It’s … unreasonable to argue that alternative therapies must be studied as thoroughly as a lot of mainstream medical practices. The research should be as strong as a therapy's potential for risks.” In other words: Conventional medicine may, in fact, require more research than CAM, as its potential for risk can be much greater than that of integrative therapies.

Coca-Cola to bring you advice from one of America’s largest doctor groups!

Incredible as it sounds, the American Academy of Family Physicians (AAFP) has announced a six-figure alliance with the Coca-Cola Co. to fund educational materials about soft drinks, to be posted on the academy’s consumer-health and wellness website. Although the AAFP’s CEO, Dr. Douglas Henley, insists the deal will not influence the group’s public-health message, nutrition educator Walter Willett, M.D., M.P.H., begs to differ, writing: “Coca-Cola like other sodas, causes enormous suffering and premature death by increasing the risks of obesity, diabetes, heart attacks, gout, and cavities”.

Coca-Cola spokeswoman Diana Ciarlante said the criticism leveled at this deal “misses the point of the partnership, which is to provide education based on sound science,” but consumers are not ignorant. They get that sponsors spend dollars to promote their products. The AMA retreated from a deal with Sunbeam Corp., whereby it would endorse Sunbeam’s “Health at Home” products without having tested them; and the American Heart Association suffered a backlash when word spread that companies could buy a heart-check seal of approval for products that were anything but heart-healthy.

Obesity causes 100K cancers annually in the United States.

Two recent, jaw-dropping epidemiology reports barely made a ripple in the sea of healthcare information. According to the American Institute for Cancer Research, every year obesity causes more than 100,000 cases of cancer in the United States; and the Gallup-Healthways Well-being Index reported that more than 11 percent of Americans are diabetic and, given that trend, at least 15 percent or Americans will be living with diabetes by the end of 2015.

Obesity, cancer and diabetes have profound effects on quality of life, and their financial cost — for individuals and the entire healthcare system — is staggering. These three conditions exemplify how lifestyle choices affect genetic expression: that is, we can activate or deactivate genes that determine why one person gets cancer or diabetes and somebody else does not. Healthcare reform without a focus on wellness does little to address why a land of plenty is so ineffective in addressing obesity, cancer and diabetes. As Pulse of Health Freedom pointed out in an article dated Oct. 20, 2009, our dollars are ill spent if we fail to champion medicine that can truly prevent and reverse conditions stemming from lifestyle choices. On the bright side, legislation like S. 1640 (the Take Back Your Health Act of 2009) does support lifestyle therapies that have significant impacts on obesity, cancer and diabetes — diseases that drain us financially while impairing quality of life.

Comment period for NCCAM’s five-year focus ends Nov. 19

Until that date, the National Center for Complementary and Alternative Medicine seeks input on its strategic plan. A column by journalist John Weeks in Integrative Practitioner, “Why we should seek to influence NCCAM’s next 5-year strategic plan” should spur you to voice your opinion.

As Weeks points out on The Integrator Blog, NCCAM has moved away from the congressional mandate by which it was established in 1998. Many believe it is time for NCCAM to return to that mandate: i.e., to "study the integration of alternative treatment, diagnostic and prevention systems, modalities, and disciplines with the practice of conventional medicine as a complement to such medicine and into health care delivery systems in the United States”.

Victory in The Senate

During the past few weeks, we met with most HELP Committee Senate offices to discuss our concerns and request an amendment to the Codex language in the Food Safety bill. Why were we so concerned? Because the original legislative language appeared to commit the US to the concept of harmonization of our food and supplement safety laws with a global standard. This global standard in turn is very likely to reflect European standards which are extremely hostile to dietary supplements.

Thanks to the amendment, the bill no longer requires the development of a plan “to harmonize requirements under the Codex Alimentarius”. Now the bill calls for a plan “on whether and how to harmonize requirements under the Codex Alimentarius" (§306, p. 116).

As will be evident, we have not succeeded in eliminating the Codex provision entirely. This is because the Senate wants to keep open the option of adopting some Codex rules while protecting dietary supplements from the harsh European regime. The language of the amendment means that we will have to remain very vigilant and probably refight the same battle over again in the future. But at least the US has avoided committing itself to the concept of Codex harmonization. And this is a very important legislative victory.

US law on dietary supplements is currently governed by The Dietary Supplement Health and Education Act (DSHEA). Senators Harkin and Hatch, strong supporters of natural health and the use of supplements, have assured us that asking the FDA to review Codex standards will not be allowed to threaten DSHEA. This is vital of course because of the FDA’s well known hostility to dietary supplements.

In his opening remarks in the mark up, Senator Harkin, chair of the HELP Committee, emphasized this message of protecting DSHEA. As the Senate moves forward with the legislation, Senators Harkin and Hatch have also promised to see what else can be done to make absolutely clear that none of its provisions will impact our access to high quality, potent dietary supplements.

There is more good news. The Senate Food Safety bill has eliminated many of the provisions in the House bill that most troubled us. However, we can’t forget that after the Senate passes it’s version of the Food Safety bill, the House and Senate will go to conference. There they will work behind closed doors to combine the Senate and House versions of the bill. This means that the worst provisions of the House bill could return.

Perhaps the most troubling aspect of the House bill is the increase in jail sentences (from three to ten years) and fines (to $100,000 for individuals and $7.5 million for corporations) for "adulterating" or "misbranding" food or supplements. If a food or supplement company cites scientific, peer-reviewed studies in support of a health benefit of a product, this would be deemed by the FDA to be misbranding and could trigger the penalties. Likewise, as defined in the current Good Manufacturing Practices, even minor paperwork violations could, per the FDA, represent adulteration and lead to draconian fines or jail sentences. These penalties are particularly worrying because of the FDA’s well established record of intimidation and legal harassment of innocent parties. It often seems that the FDA’s primary concern is to protect drugs from competition. Drug companies of course pay a significant portion of the FDA’s salaries.

The House bill also imposes new fees on food operations of all sizes, from the very smallest to the largest; imposes record keeping, hazard analysis, food safety plans, and more on farms as well as businesses, small and large; gives the FDA control of farming standards and practices, despite the Agency’s ignorance of these matters; permits the FDA to conduct random, warrantless searches; and ignores the recommendations of a government report on the failings of the FDA and the urgent need for reform at the Agency.

We will continue to work with members of Congress to ensure that the final version of the Food Safety bill does not compromise your access to healthy, natural and sustainable healthcare options, including high quality food and food supplements.

We’ll keep you updated!

Friday, November 13, 2009

Privacy, Science at Risk

In 2006, then President George W. Bush signed into law the dietary supplement and OTC bill dealing with reporting on adverse events. Now, the French food safety agency, AFSSA (Agence française de sécurité sanitaire des aliments), has launched a program to monitor the consumption of dietary supplements and any adverse events associated with their use.

Dr Robert Verkerk, our scientific director, told that although government-led efforts to accumulate reports of adverse events through practitioners, health stores and other suppliers of supplements is in principle sound, there is great potential for such data to be misused:

“We have seen both in Europe and the USA, numerous cases where food supplements have been flagged as causative agents of particular adverse effects when further scrutiny demonstrates they were simply among large lists of products, often including medications and even alcohol and recreational drugs, consumed. It is utterly misleading to misrepresent the role of food supplements in such instances and the only way around the problem is to ensure absolute transparency in reporting, access to medical records and in the drawing of conclusions as to the potential contributory role of specific food supplements.”

Although very few adverse events following the use of dietary supplements are reported to the FDA, too often media frenzy focuses on the use of supplements when, in fact, other factors — including the use of medications and recreational substances, such as alcohol — have a more profound role to play. Kudos to Dr. Verkerk!

FDA’s Lax Ways

Despite increasing calls for transparency at the FDA, the agency’s sloppy performance continues to put consumers at risk both medically and financially.

On October 26, 2009, the Government Accountability Office (GAO) released a report indicating the FDA has often allowed drugs to remain on the market after follow-up studies showed a lack of any benefit. The “fast-track drug-approval process,” which the FDA instituted in 1992, was the ready-set-go! for drugs to be rushed to market on the basis of meager, preliminary laboratory study. For example, Viagra, tested in just two studies on 200 volunteers, was approved by the FDA and soon prescribed to millions of patients. Adverse reactions and deaths associated with the use of the drug were noted only when Viagra was prescribed to many more patients than those who had participated in the original clinical trials. A number of drugs designed to treat cancer and HIV were approved in a similar fast-track fashion with the proviso that the manufacturers conduct follow-up trials to document their drugs’ effectiveness. And yet, the FDA often fails to police this requirement. Equally distressing is the fact that FDA, rather than insisting on independent, third-party studies, uses the manufacturer’s own data to determine effectiveness.

Congressional investigators have revealed that the federal law directing the FDA to bar researchers already convicted of fraud from engaging in further research is all but ignored. A congressional report released October 22, 2009, noted that the FDA pays “so little attention to its responsibilities to ban researchers convicted of fraud and is so disorganized about carrying them out that its actions take an average of four years to complete”. The GAO’s analysis of 18 proceedings regarding researchers convicted of fraud found that the FDA took between one and 11 years to complete the process. Congressman Joe Barton, R-Texas, has promised to introduce legislation to give the FDA more power to ban convicted researchers. Why is there no pressure on the agency to enforce existing federal law?

The standardization of food-labeling by the FDA is all over the news. For example, USA Today has publicized criticism leveled at the nation’s largest cereal maker, Kellogg’s, whose box of Cocoa Krispies trumpets: “Now helps support your child’s IMMUNITY”. A careful review of the label reveals this claim to be misleading, even fraudulent, because Kellogg’s is referring not to the cereal but to an added ingredient. Kelly Brownell, Ph.D., of Yale University’s Rudd Center for Food Policy and Obesity, notes: “By their logic, you can spray vitamins on a pile of leaves and it will boost immunity.”

Shame on the FDA for being so lax when it comes to important issues affecting consumer safety! Have you signed the petition calling for reform of the FDA? If not, please do so now.

Your Body—Your Right to Choose!

The Massachusetts Public Health Emergency Preparation and Response Act (H4275) passed the House on 10.08.09. This piece of legislation articulates the authority granted to the Commissioner of the Department of Public Health during a ‘declared emergency’ and is companion legislation to S2028, which passed in April of this year. The two bills will now go through a reconciliation process in an appointed Conference Committee. Both bills have been in the spotlight due to recent H1N1 scares and hysteria, and the loss of rights during a pandemic.

In order to have an accurate understanding of the two bills, we dissected both and the following is our summary:

    S2028 is an incredibly broad piece of legislation that:
    • does not define what constitutes a ‘public health emergency;
    • strips the citizens of Massachusetts of core constitutional rights such as your right to be free from unreasonable searches, your right to protect your property, and your right to privacy; and
    • authorizes the Commissioner to ‘take immediate possession from any source’ anti-toxins, serums, vaccines, immunizing agents, antibiotics … necessary to respond to the emergency.'

    H4275 is more reasonable and includes provisions that protect individual rights. Highlights are as follows:
    • Commissioner needs Governor approval “to take action and incur such liabilities as the commissioner may consider necessary for the maintenance of public health and the prevention of disease.”
    • A ‘public health emergency’ is defined;
    • Prior to administering a vaccination or medication, a medical professional or volunteer shall inform the consumer of any possible side effects. If no side effects are known at the time of the administration of the vaccination or medication, the consumer shall be informed of that as well;” and
    • a judicial review process for isolation and quarantine orders.

To learn more about these two pieces of legislation download our comparative analysis: Massachusetts_Comparative_Analysis

If you are a resident of Massachusetts, Contact your Representative to ensure your constitutional rights are protected.

The House has Passed Its Healthcare Legislation by the Narrowest of Margins.

What is and what isn’t in a bill that is nearly 2000 pages and weighs nearly 20 pounds?

The heft of the bill and its unveiling shortly before the vote testify to the deal-making behind the scenes. As the New York Times says: “The medical industry grumbles, but it stands to gain”. It has become clear to consumers that everyone’s interest but theirs are being leveraged through the federal legislature. No wonder Congress’s own healthcare is exempt from the bill.

Former NY Lt. Governor Betsy McCaughey has been reading the bill’s fine print. She reports in a Wall Street Journal article: “While the bill will slash Medicare funding, it will also direct billions of dollars to numerous inner-city social work groups with vague standards of accountability.” What are these groups supposed to do with the billions? Counsel people about the new Federal system?

McCaughey goes on: Section 223 of HR 3962 requires an individual making $44,000 before taxes to pay 17% of his pre-tax income for mandated insurance. Higher earners will be required to pay 20%. How these mandates differ from taxes escapes us, and they are big mandates hitting the middle class.

Section 202 also takes away your freedom to choose. You are required to enroll in a “qualified plan,” The government defines what qualified means and will have lots of help on this from special interests. Natural health and integrative medicine do not have much clout in Congress.

If you have a business to make a living for you and those you employ, section 412 states you must pay 72.5% of the cost for your staff or incur a 8% payroll tax.

Section 222 provides Medicare recipients the “right” to language translation services at all times without co-pay. What about the rights of those who pay taxes to pay for all this?

Section 1302 moves Medicare away from fee for service to a strict managed care model. Section 1158-60 says that Medicare will stop paying more in expensive places. The payment in New York will not be higher than in rural areas.

Other sections require doctors to share your private records with numerous other parties.

The healthcare debate now moves to the Senate. We will keep you posted and ask for your help in shaping that vote.

Friday, November 06, 2009

News vs. Opinion

The natural-products community and nutritionally oriented practitioners are very familiar with media bias. For example, the press often reports that “dietary supplements are not regulated.”

The preparation for the weekly Pulse of Health Freedom requires hours of researching news-wire services, newspapers, Web sites and other publications. A review of the Associated Press health articles on one day, 10/26/09, led to two articles with attention-grabbing titles, “’Bioidenticals’ not FDA-approved, contain estrogen” and “Somers’ new target: conventional cancer treatment”. Both articles were preceded by the following editor’s note:

“Ten years and $2.5 billion in research have found no cures from alternative medicine. Yet these mostly unproven treatments are now mainstream and used by more than a third of all Americans. This is one in an occasional series examining their use and potential risks.”

Separating news from mere opinion is important for every American who seeks to make healthcare choices based upon objective information.

FDA to Standardize Labeling of Food.

Various labeling systems are currently being used by U.S. retailers and food makers to make nutritional claims. Barbara Schneeman, Ph.D., director of the FDA’s Office of Nutrition, Labeling and Dietary Supplements, recently sent an open letter to the food industry stating the agency’s intent to develop a new regulation to define “the nutritional criteria that manufacturers will have to meet for front package ingredient claims regarding nutritional quality”. According to the FDA, the “non-standard labeling approach is likely confusing to consumers and does not help them to make healthy food choices”.

In related news, the “industry-funded” (code for “You can buy the Smart Choice seal”) labeling program was halted 10/23/09 after the FDA warned it was examining the program’s nutritional claims and would take action against false or misleading assertions. The American Heart Association was criticized when manufacturers paid a fee for the heart-check label, which was sometimes applied to foods less than rich in nutrients crucial for heart health.

The FDA hopes to use the approach tested in the United Kingdom, where the British government established criteria for food labeling that were then implemented voluntarily by grocery stores. However, in the United Kingdom there is a consistent public-health message that dietary choices can adversely affect health — as opposed to the United States, where the media bristle with ads pushing sponsors’ products.

Are Federal “Expert Panels” Essential to Overhauling the Nation’s Healthcare System?

Are Federal “Expert Panels” Essential to Overhauling the Nation’s Healthcare System?
We have previously written about the ramifications of the economic stimulus bills that became law in February 2009. Putting aside the economic and security consequences of adding to the nation’s debt, let’s focus on the $1.1 billion for a Comparative Effectiveness Research (CER) program, designed to determine which healthcare treatment options are most effective — and most cost-effective. According to CER supporters, an immediate benefit would be cost savings for government-funded insurance programs. By determining which treatments are most effective, the less effective — and often more expensive — options would (theoretically) no longer be covered by government insurance plans, saving taxpayers money. But as we all know, the devil will be in the details.

Norbert Gleicher, M.D., visiting professor at Yale University School of Medicine, and president and medical director of the Center for Human Reproduction in New York City, wrote in the 10/19/09 Wall Street Journal that “the idea of inserting a government panel between patients and physicians remains contentious and with good reason”. Relating a personal story, Dr. Gleicher said that he recommended HRT to his own mother, to address her risk of osteoporosis. After all, the medical literature of that time advocated HRT for reducing the risk of bone thinning. Happily, Gleicher’s mother’s long-standing doctor did not advise that she use HRT. This turned out to be lifesaving, as she was later diagnosed with breast cancer, a contraindication for HRT.

According to Gleicher, most published studies are written by academics with little practical experience, a policy that allows university-based doctors who have limited patient contact to determine “appropriate clinical care.” He also mentions the bias of medical journals’ policy of peer review, a system he believes is rarely free of conflicts and only rarely objective. Quoting Albert Einstein, Gleicher says: “A foolish faith in authority is the worst enemy of truth.”

After listening to an earnest young family practitioner, just three months out of residency, repeat the old saw “We need more studies before we recommend antioxidants,” it was refreshing to hear a wise, local general practitioner of many years standing remind me, “Speak with a doctor/medical student at the end of the first year in school. They have just completed their study of anatomy, physiology and biochemistry. Nutritional medicine makes sense to them at that point. The following three years, and subsequent internship and residency schools, teach doctors to push prescriptions and procedures.” In a nation overburdened with chronic illness related to unwise lifestyle choices, prescriptions and procedures do little to address obesity, diabetes, heart disease, arthritis and cancer.

Dr. Gleicher is right in saying, “Expert panels would only slow medical progress and delay rejection of false prophecies and dogmas.”

Hospital-acquired Infections Linked to nearly 100,000 Deaths Annually.

Those following the debate over healthcare reform often hear that eliminating waste from the current healthcare system would, in large measure, fund reform. Given the number of dollars wasted, the lives lost and the suffering associated with sloppy healthcare, why do we drag our feet in improving our current system and reducing waste?

A report released 10/26/09 by Thomson Reuters, parent company of the Reuters news service, stated that the current U.S. health system wastes between $505 billion and $800 billion a year, one-third of our current healthcare expenditure. The report cites the following as sources of wasteful spending:

Overuse of antibiotics and lab tests to protect against malpractice lawsuits (Pennsylvania State University estimates that as much as 91 percent of our nation’s healthcare expenditures are related to defensive medicine);
Fraud, which may be as high as $200 billion annually in Medicare claims alone;
Administrative inefficiency and redundant paperwork;
Medical mistakes;
Preventable conditions, such as uncontrolled diabetes.

The report states that the average U.S. hospital spends one-fourth of its budget on billing and administration (twice what is spent in Canada). Eight hours per week and 1.66 clerical staff, on average, are needed for each doctor, again far more than is the case in Canada.

On 10/22/09 Health and Human Services Secretary Kathleen Sebelius announced a $17-million initiative to address HAI or hospital-acquired infections. Thanks to concerned citizens, such as former Lt. Gov. Betsy McCaughey of New York, whose Committee to Reduce Infection Deaths was established in 2004, attention has been drawn to the fact that there are 2 million cases of HAI each year, resulting in 100,000 deaths and an additional $33 billion in healthcare costs ( That is a true national emergency requiring immediate action, so why doesn’t every U.S. hospital adopt the proven techniques developed by the Committee to Reduce Infection Deaths? President Bush’s administration took a huge step forward by stating Medicare would no longer pay for the costs of hospital-acquired infections. Let’s enforce this immediately.

Hannah Wunsch, M.D., of Columbia University Medical Center compared 493,054 patients in the United Kingdom with 704,028 patients from seven U.S. states, all of whom died in 2001. Roughly half of all U.S. hospital deaths involved ICU care, whereas only one in 10 of the British patients had received ICU care prior to dying. As Wunsch said, “What do we get with all the intensive care we’re giving people?” And Wunsch is an intensive-care doctor!

Alert: Healthcare Legislation: last chance to get it right!

Now that the full U.S. House is set to begin debate this week on the merged healthcare bill, it is essential to understand the provisions of the nearly 2,000-page bill and register our opinions with our elected officials. This is the last chance to try to get it right in the house. Contact your Congressperson and let them know that you care about getting healthcare legislation right!

One of the key questions about the bill is its cost. According to the November 2, 2009, issue of the Wall Street Journal, the estimated gross cost of the Democratic House legislation is $1.055 trillion over 10 years. Such estimates in the past have been low—partly because they do not take into account the expansion of healthcare demand that follows an increase in government subsidies. When demand rises while supply stays the same or falls, prices increase, often dramatically.

Before we get to the main problems of the House bill, apart from cost, let’s take a moment to note some positive features. The main thing that is positive about it is a new regard for the concept of wellness and prevention. Even this is far from perfect. These terms are not defined as they should be. Without the right definitions, prevention can be turned into a program of more and more invasive tests and drugs for younger and younger people. Here is how prevention is specifically addressed in the bill:

Prevention: Wellness program grants for small employers (Section 112)
Grants may equal up to 50 percent of the amount of money an employer spends on qualified wellness programs. A program must include three of the following:

1) Education
2) Engagement (i.e., wellness-program components on site)
3) Behavioral change (supportive programs, self-help materials, etc.) linked to nutrition, physical fitness, obesity, etc.
4) Supportive on-site component (i.e., nutritious food available on site)

A program may not be mandated for employees, must be based on current science and approved by the secretaries of HHS and Labor. A program may provide financial incentives for employees and must ensure that personal information remains private.

National Prevention and Wellness Strategy (Section 3121)
A plan will be developed that includes national priorities and utilizes evidence-based clinical and community prevention and wellness activities.

There will be a transparent public comment period designed to give special interests less opportunity to completely dominate.

Composition will include the heads of appropriate health agencies, federal departments, nonprofits and the Task Force on Clinical Preventive Services (see below).

Task Force on Clinical Preventive Services (Section 3131)
Under AHRQ (Agency for Healthcare Review and Quality), the task force shall review and update preventive services as supported by science.

Composition will include experts in related fields, such as disease prevention.

A stakeholders’ board will provide consultation. This board shall include consumers, payers, federal agencies, and both public and private groups with an interest in clinical prevention.

Task Force on Community Preventive Services (Section 3132)
This task force will be similarly constructed and operated as the Task Force on Clinical Preventive Services (see above). Its mission is to review community prevention services and disseminate evidence-based recommendations.

Research grants available to study prevention specifically (Section 3141)

Grant program to study whether subsidizing individual wellness choices is beneficial (Section 3143)
The program will focus on tobacco cessation and obesity. If incentives prove to be helpful, these shall be included in the Essential Benefits Healthcare Package (see below).

Grant program (to states) for delivery of community prevention and wellness programs (Section 3151)

Grants to promote healthy behaviors in medically underserved communities (Section 399V)
Areas of focus include poor nutrition, physical activity, tobacco use, mental-health problems and dangerous sexual behavior.

Community grant program specifically addressing obesity with nutrition and physical activity(Section 399w-1)

Nutrition labeling on menu items at chain restaurants and in vending machines (Section 2572)

Prevention: Essential Benefits (basic mandated healthcare package) includes preventive coverage (Section 222)
CDC-recommended vaccines and preventive measures rated A or B by the Task Force on Clinical Preventive Services shall be covered. Note that although nutrition counseling, for example, is covered for those who have indications toward certain disease (a positive step), they are the only consumers covered. Truly preventive medicine, including a focus on maintaining optimal health with diet, supplements, and exercise, is not covered.

Prevention covered for Medicare, Medicaid and CHIP plans defined as above.

Money available for preventive training in medical school (Section 2234)
Note: There is no definition of prevention.

Cost-Sharing is prohibited for preventive services.
The intent seems to be to ensure that consumers are not burdened with co-pays and deductibles for covered preventive services. The term “cost sharing” includes deductibles, coinsurance, copayments, and similar charges, but does not include premiums, balance billing amounts for non-network providers, or spending for non-covered services. (General Definitions) A strict reading of the definition of “cost-sharing” may prevent out-of-pocket payment for medical services otherwise covered by qualifying health insurance, as is already the case with Medicare. You may not be able to pay privately for your healthcare options of choice!

With regard to prevention, it is as if Congress has heard the music, but still can’t carry the tune. In other areas, Congress is not even hearing the music, for example in requiring but not protecting the privacy of personal electronic health records (EHR).

EHR – All qualified health-benefits plans are required to use electronic health records (Section 237)
Privacy is gutted and doctors’ use of integrative therapies may be jeopardized.

EHR – Study to determine how best to motivate small providers to use EHR (Section 263)
Concerns about the use of electronic medical/health records (as noted above).

If a practitioner participates in Medicare, they are automatically deemed to participate in public option unless they opt out. (Section 323)
This bill of course brings in a national insurance mandate. A mandate means that government must define health and healthcare and healthcare insurance policies. The problem is that government is not equipped to do these things. Healthcare is a discovery process and needs to keep changing based on new science and what people prefer. The bill specifically includes both:

Employer mandate (Section 413)
Employer must provide coverage or pay a tax equal to 8 percent of the average wages paid by the employer in lieu of coverage. Note that there is a sliding scale for the smallest employers, those with payrolls less than $750,000. Payrolls under $500,000 are exempted from taxes.

Consumer mandate
Individuals must purchase qualified health benefits through the state exchange system unless grandfathered in with existing coverage. There are three different levels from which to choose. Those who have difficulty paying can apply for credits. Note that employer-offered healthcare plans cannot be grandfathered, and that individual plans, although they can be grandfathered, must not be altered in any way. The public option will be offered through the state exchange system.

Individuals who do not have qualifying coverage will be taxed at 2.5 percent of their AGI divided by an amount specified by the IRS. (Section 59B)

Catastrophic and similar packages will no longer be available. These packages have enabled people to buy natural healthcare on their own while still being covered for major medical. This vital option will disappear.

Excise tax on the wealthy (Section 59c)
For those filing jointly, a modified AGI exceeding $1 million will be taxed at 5.4 percent. If filing separately, AGI exceeding $500,000 is taxed at 5.4 percent. The trouble with this plan is that money pulled into healthcare from outside healthcare will just drive up prices. As prices rise, the money will in effect disappear. And of course if new taxes are used for healthcare, they can’t be used for deficit reduction. Millionaires in the US control about 10% of the income. No amount of taxes on 10% of the income will pay for healthcare and reduce government deficits.

Comparative Effectiveness Research is supposed to ensure that healthcare money is not wasted. But how can government decide what is effective and what is not? Will government just listen to special interests?

Comparative Effectiveness Research (CER) is not a transparent process and doesn’t include representation of integrative medicine, subjecting the process to abuse by special interests
CER says that there must be a transparent process but does not specify public comment for all steps in the process. (This is required in the Senate finance bill.) Any entity can submit research, making it likely that companies with the most money will dominate.

Cap on Flex-Spending Account (FSA) contributions at $2,500 (Section 532)
Currently, the contribution level is unlimited. This is another way to make natural medicine more expensive for consumers.

Medicine Cabinet Tax (Section 531)
Americans would no longer be able to purchase over-the-counter medicines with their FSA, Health Savings Account (HSA) or Health Reimbursement Arrangement (HRA).

Increase in the non-qualified Health Savings Account (HSA) distribution penalty from 10 percent to 20 percent (Section 533)
This makes HSAs less attractive and paves the way for HSA pre-verification. In other words, “big brother” tells you how to use them.

School-based health clinics to include mental screening and mental-health treatment programs (Section 2511)
Prozac for those children deemed socially anxious is a likely outcome.

No child left unimmunized against influenza (Section 2524)
Grants to help ensure all young schoolchildren are immunized – through schools. Vaccine safety ignored.

Natural medicine along with the freedom for consumers to choose and practitioners to practice should not be a casualty of the current healthcare debate. Make sure your elected officials hear from you regarding this critical legislation. Let’s preserve healthcare freedom of choice at all costs.

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