High Heat Warnings

In very hot weather it is best to bring your loving animal companion indoors.
Here are some tips for your dog.

• Supply shade. 
• Supply enough water. One quart of water with 1 TBSP raw apple cider vinegar helps people in hot weather and it is safe and helpful for your pets too. Plus it deters fleas and other pests. 
• Use a cold and wet kerchief tied loosely around their neck. 
• Thoroughly wet their ears, and if needed, the area under their legs. 
• Keep off hot concrete as it can burn their paw pads.

Natural Health News: HOT WEATHER TIPS

Jun 19, 2012

Hot Weather Help. Elders and others need to pay close attention in hot weather. This news article has some good information about being older and the current hot heat throughout most of the US. By LINDSEY TANNER - AP .

Natural Health News: Worried About Heat? Hot Weather Help

Jul 20, 2011

Hot Weather Help. Elders and others need to pay close attention in hot weather. This news article has some good information about being older and the current hot heat throughout most of the US. By LINDSEY TANNER - AP ...

Natural Health News: Cooling Down in Hot Climates

Jun 11, 2011

“Cool Wave” towel is a must for all of your warm weather activities! Order Now! . Large 16” x 26” towel . Keeps you cool without getting you wet . Will remain10 to 20 degrees cooler than current air temperature for 4 to 5 hours

Read More

A Different Way of Approaching Drug Resistant TB

Over many years we have covered the topic of vitamin C and its benefits in health and disease.  We have also written on the benefits of garlic for drug resistant TB and how microbiological research proved this.  As this kind of science continues to be rejected by mainstream medicine and Big PhRMA we can only hope the information presented here helps you to be able to speak out to your health care providers about broader care options.  Please use the search function to locate our earlier vitamin C posts and TB related coverage. You can find more about vitamin C on our web site, http://leaflady.org, and our Whooping Cough article on the Seattle PI web site, Natural Notes blog.  Thanks for reading.

Mycobacterium tuberculosis is extraordinarily sensitive to killing by a vitamin C-induced Fenton reaction. 

Nat Commun. 2013;4:1881. doi: 10.1038/ncomms2898.

Vilchèze C, Hartman T, Weinrick B, Jacobs WR Jr.

Source

Department of Microbiology and Immunology, Howard Hughes Medical Institute, Albert Einstein College of Medicine, 1301 Morris Park Avenue, Bronx, New York 10461, USA.

Abstract

Drugs that kill tuberculosis more quickly could shorten chemotherapy significantly. In Escherichia coli, a common mechanism of cell death by bactericidal antibiotics involves the generation of highly reactive hydroxyl radicals via the Fenton reaction. Here we show that vitamin C, a compound known to drive the Fenton reaction, sterilizes cultures of drug-susceptible and drug-resistant Mycobacterium tuberculosis, the causative agent oftuberculosis. While M. tuberculosis is highly susceptible to killing by vitamin C, other Gram-positive and Gram-negative pathogens are not. The bactericidal activity of vitamin C against M. tuberculosis is dependent on high ferrous ion levels and reactive oxygen species production, and causes a pleiotropic effect affecting several biological processes. This study enlightens the possible benefits of adding vitamin C to an anti-tuberculosis regimen and suggests that the development of drugs that generate high oxidative burst could be of great use in tuberculosis treatment.

PMID:

 

23695675

 

[PubMed - in process]

More background information

Drug-Resistant TB “Extraordinarily Sensitive” to Vitamin C

Monday, 24 June 2013 21:00 By John Otrompke, Contributing Writer

Ascorbic Acid (Vitamin C) crystals. Courtesy Visuals Unlimited

Researchers looking for options to control multi-drug resistant tuberculosis were surprised to learn that vitamin C given along with iron, could wipe out a wide variety of strains---at least in vitro.
Reporting in Nature last month, Dr. William Jacobs, Jr., professor of microbiology, immunology & genetics at Yeshiva University, NYC, said, "Mycobacterium tuberculosis is extraordinarily sensitive to killing by a vitamin C-induced Fenton reaction."
The findings suggest that tuberculosis could be prevented or treated in populations with subclinical infections using simple and inexpensive nutritional supplements---an important discovery in a time when antibiotic-resistant strains are on the rise. This has not yet been tested in infected humans, but it's certainly plausible.
"The bactericidal activity of vitamin C against M. tuberculosis is dependent on high ferrous ion levels and reactive oxygen species production, and causes a pleiotropic effect affecting several biological processes," Dr. Jacobs and his colleagues noted.
Making a Killing
"We started our research about two years ago, when we made a surprise discovery," he Dr. Jacobs told Holistic Primary Care. "We predicted that if we added isoniazid and cysteine to isoniazid-sensitive tuberculosis in culture, the bacteria would develop resistance. We knew isoniazid acts as a reducing agent, generating reactive species, so we tried another agent, vitamin C, to replace cysteine, but instead of causing resistance, we ended up killing off the culture--- something totally unexpected."
He cautioned that scientists don't yet know whether patients vulnerable to tuberculosis should take vitamin C. "We know that for this killing to occur, you also need to take the element iron along with vitamin C; this is something that could be explored, maybe in synergy with existing drugs, since one third of the world's population is sub-clinically infected with tuberculosis."
The problem, he says, is that "it would cost a lot of money to research further, and drug companies are not inclined to do that research because they can't get a return on their investment, since vitamin C is not patentable," he explained.
Meanwhile, the researchers at Yeshiva are trying to replicate their findings in vivo. "We've done the experiment in mice just a few months ago, and it did not work," said Jacobs. "But mice metabolize vitamin C differently from humans; mice make vitamin C, whereas humans can't."
Dr. Jacobs' team has also tested Vitamin E, but it didn't kill tuberculosis."
He is hoping to continue the work on vitamin C, suggesting that the combination of ascorbic acid and iron might help boost the efficacy of drug regimens.
"Vitamin C is safe and inexpensive, so drug companies should go head and do a clinical trial, although we don't know how the vitamin C would get to where tuberculosis is, in a macrophage in the patient's lungs," he said.
No Resistance

Mycobacterium tuberculosis. Image courtesy CDC

TB doesn't appear to develop resistance to vitamin C. "In a genetics lab, we typically discover things by isolating resistant mutants. We tried to find resistant mutants to vitamin C numerous times, but we've been unsuccessful, which is exactly what you'd want in a good drug," Dr. Jacobs explained.
However surprising, these findings are not the first time a study has shown that vitamins are helpful in combating TB. "For example, vitamin D actually turns on macrophages to kill TB, but that is a different mechanism; vitamin D actually stimulates an immune response," Dr. Jacobs said. The vitamin C and iron combo has a more direct cytotoxic effect.
"We need more funds to explore this; right now is a very difficult time at the National Institutes of Health to get grants. Typically the NIH will fund 25% of grants, but because of budget cuts they're only funding 6% of grants, and typically to develop a drug for use in people would cost half a billion dollars," explained Dr. Jacobs. However, it shouldn't be nearly as expensive to research the viability of vitamin C as a therapy for TB.
"If I had the money, I would go ahead and think abut doing this as an early bacteriocidal therapy. First, I would just monitor the amount of vitamin C in a patient's blood, when we gave it to them. Before a patient newly-infected with TB started on standard therapy, I would like to do a two-week trial with vitamin C as one of agents. That way, we could test a new regimen, to see if the tuberculosis got killed or not, and then go back and start them on standard therapy."

Read More

Digital Dementia

Can't say Natural Health News did not warn you it was coming

In 2004 I was teaching classes on the topic of EMF induced health risks.  Now we have more than enough proff and this is just one more fact of the problem.

Some teens in South Korea exhibiting 'digital dementia'

Published: June 26, 2013 at 8:51 AM

SEOUL, June 26 (UPI) -- Some teens in South Korea are exhibiting what is being described as "digital dementia," or deterioration of thinking and memory, a psychiatrist says. 

Psychiatrist Kim Dae-jin at Seoul St. Mary's Hospital recently diagnosed a 15-year-old boy with symptoms of early onset dementia due to intense exposure to digital technology -- television, computer, smartphone and video games -- since age 5. He could not remember the six-digit keypad code to get into his own home and his memory problems were hurting his grades in school. 

"His brain's ability to transfer information to long-term memory has been impaired because of his heavy exposure to digital gadgets," the psychiatrist told the Korea JoongAngDaily.com. 

South Korea is highly wired -- 65 percent of teens have smartphones -- and doctors said they were finding a growing number of cases of memory problems, attention disorders and emotional flattening among children and teens who spent a lot of time Web searching, texting and using multimedia. 

"Overuse of smartphones and game devices hampers the balanced development of the brain," said Byun Gi-won, who runs the Balance Brain Center in Seoul, which helps those with cognitive problems related to computers and smartphones. 

Youth might be at more risk than adults because up to age 25, their brains are still developing.

"From the early 2000s, I've seen a drastic increase in patients with reduced memory spans, especially young people. When I looked at it, most of them were exposed to the heavy consumption of digital gadgets," Dr. Kim Young-bo at Gachon University Gil Medical Center's brain research institute in Incheon told the newspaper. 

"The gadgets ease the burden of memorizing tedious information but if we don't use our brain functions, the overall cognitive skills of being aware and perception will ultimately decrease."

Read more: http://www.upi.com/Science_News/Technology/2013/06/26/Some-teens-in-South-Korea-exhibiting-digital-dementia/UPI-69441372251061/print#ixzz2XLS8JNH8

Natural Health News Selections

Natural Health News: Cordless Phones, like WIFI, Boost Heart Risk

Dec 27, 2010

Cordless Phones, like WIFI, Boost Heart Risk. Cordless Phone EMFs Trigger Heart Rhythm Abnormalities. By Erik Goldman / Editor in Chief - Vol. 11, No. 4. Winter, 2010. The controversy continues over the possibility that ...

Natural Health News: WIFI / WIMAX info resource

Jan 12, 2008

Should Hillary Clinton clinch the Democratic nomination, we would be facing a policy proposal of a nation-wide "smart" grid bringing wireless WiFi and/or WiMAX to all places, affecting everyone. I enclose information.

Natural Health News: Hospital First to Recognize Wireless Illnesses

Jun 21, 2012

Since then several schools have removed their wifi systems and the Catholic teacher's union in Ontario has called for a moratorium on wifi installations in classrooms. Read more: http://www.digitaljournal.com/pr/757245# ...

Read More

The Race Is On: Beating the October 1 Deadline

Missouri Gov. Jay Nixon is facing a dilemma.
By Wendell Potter

Should he sign a bill that was intended to help many state residents get coverage for cost-effective health care that insurers often refuse to pay for?

Or veto the bill because it is loaded with amendments that will benefit insurers and force many Missourians to pay far more for medical care than they do now?

Senate Bill 262, introduced by Sen. Kiki Curl, D-Kansas City, would require insurers to pay the same for specialty care delivered via telemedicine as for an office visit. Similar bills have been enacted in other states, including Arizona just last month.

But in Missouri, Democrats are now regretting voting for the bill because of amendments added at the last minute that will result in a financial windfall for insurance companies, agents and brokers at the expense of residents.

SB 262 would enable insurers to achieve one of their top objectives: converting HMOs into high-deductible plans. (MORE)

HMO customers enjoy relatively low copayments when they get care from in-network doctors and hospitals. The bill would remove the current requirement that HMO cost sharing be “reasonable” and allow HMOs to impose high deductibles and coinsurance — up to $3,100 for an individual and $6,250 for a family — in addition to copayments.

If Nixon signs the bill into law, Missourians in HMOs who are unlucky enough to get sick or injured next year will have to shell out thousands of dollars more to pay for their care.

Insurers could avoid paying for necessary care in yet another way under the bill as amended.
HMOs would be able to reduce the size of their provider networks, meaning their enrollees would have far fewer choices of doctors and hospitals. HMO members needing care from a specialist not in the network would not be covered.

Insurers would win in another important way.

The bill would reduce from 60 days to 45 days the amount of time the state’s Department of Insurance would have to review and approve a new or modified health insurance policy. If the department doesn’t act within 45 days, the policy would be deemed approved.

Most state insurance departments already are inadequately staffed and resourced. Cutting the review and approval time by 15 days would mean that insurers would gain a significant advantage by being able to sell policies that do not meet federal and state standards.

As if all of this weren’t bad enough for consumers, the amended bill would also make it unlawful for anyone other than a licensed agent or broker to give advice or recommendations to any Missourian about choosing a health plan.

This would be a major victory for agents and brokers who are concerned that their incomes might take a hit when people start shopping for insurance on the online health insurance marketplaces or exchanges that states must have up and running by Oct. 1.

The amendment is an apparent violation of federal law, which states that individuals other than brokers and agents who complete a certain level of training can serve as “navigators” to help people choose plans that are best suited for them.

As now worded, the bill would bar social service organizations from helping low-income people who can’t afford to hire an insurance agent.

Nixon undoubtedly was eager to sign SB 262 before all the special interest-backed amendments were added. It was the first bill sponsored by Curl, a Democrat, who said she was motivated because of the role telemedicine played in saving the life of her father.

Regrettably, the best thing for Nixon to do now is exercise his veto and ask lawmakers to send him a clean bill during the next legislative session. If he signs it, more people will be hurt than helped by SB 262.

88888

 

Just think on this as you begin to understand what is coming down the pike as October 1st looms closer: CIGNA claim denial rate runs upward of 21%. This is double and triple the denial rates of other HMO insurers.

Read More

Keeping Watch: Health Care Topics and New Health Legislation (3)

Hepatitis B vaccine is known to shut down an infant's liver for at least two weeks following injection.  It is also known to be related to the increasing number of cases of Diabetes 1. There is much, much more.

Excerpt from  Vaccination Is Not Immunization , 3^rd ed. 2013

By Tim O'Shea, DC
 
The most reliable vaccine resource for parents about to make the most important decision of the child's life.
                                 
                                                   "HEPATITIS B
 
Hepatitis B is an inflammatory liver disease, found most often among drug addicts.  Most victims recover on their own within a few months, with no chronic liver disease.  In 1991, however, the CDC and the AAP began including Hepatitis B vaccine for all infants.  (p 172 [199])  Why?

Before 1991, hepatitis B vaccine was only given to high risk groups - health workers, drug users, those with multiple sex partners, and those with a history of the disease. 

The disease is transmissible from mother to infant, but if the mother tests negative, it is very unlikely that the infant will have multiple sex partners or be an IV drug abuser, know what I'm saying?

Especially within the first day of life.  This is the type of common sense notion that gets overlooked when fortunes are to be made.

Efficacy? No long-term studies had been done before the vaccine was forced on the general population.  (Neustaedter, p125) [199] The insert itself says that the vaccine was only monitored for 5 days before it was released on the market! [38]

Merck had been developing the Hep B vaccine since the early 1970s, and testing it on live populations of monkeys and humans.  (p.244) [231] Formaldehyde, a carcinogenic inactivator used in many vaccines, supposedly tones down the Hep B virus so that the vaccine hopefully doesn’t give the person hepatitis.

But the real horror of Hepatitis B vaccine comes into focus when you find out that this mercury-laden vaccine is given on the first day of life.  The EPA safe level of mercury is .1 micrograms per kilogram per day.  For an adult, that is. 

As of 2004, one hepatitis B shot had 30 times that amount! - FDA Hepatitis Control, [246]
Side effects?  The CDC failed to mention any side effects in 8 million people who received the vaccine before 1991.  (p 175) [199] But a number of studies have documented the following adverse reactions to the Hepatitis B vaccine:

            Guillain-Barre                      enlarged spleen

            demyelinating disease     anaphylactic shock

            autoimmune reactions     jaundice [38]

In a statement to Congress, Director of the Association of American Physicians and Surgeons Jane Orient, MD said that deaths and adverse reactions to hepatitis B vaccines are 

 "...vastly underreported, as formal long-term studies of vaccine safety have not been completed.  [176]

 "...for most children the risk of a serious vaccine reaction may be 100 times greater than the risk of Hepatitis B."

By 1999, the number of reported severe adverse reactions to the Hep B vaccine became higher than the actual number of cases of the disease itself! ( Townsend Letter, Sep 2000, p 148) [171]

Hepatitis B vaccination was dropped from the mandatory school program in France in Oct.  1998 after 15,000 citizens filed a class action suit against the government.  The reason: hundreds of neurological and auto-immune disorders.  (Belkin) [233]

PARENTS RESPONSIBLE FOR HEP B REACTIONS

There’s a related story every parent should read, especially those who think they’re doing the right thing to vaccinate a newborn with the dangerous Hepatitis B shot.  If the baby has a reaction, the parents are now the prime target for accusations of Shaken Baby!  Not kidding - this happens all the time.  Look at  [17] (Elber)"

           "The great enemy of the truth is very often not the lie -- deliberate, contrived and dishonest, but the myth, persistent, persuasive, and unrealistic. Belief in myths allows the comfort of opinion without the discomfort of thought."
                                                             ~ John F. Kennedy

to order the new book:  Vaccination Is Not Immunization    –  now in 5 languages.

Read More

Keeping Watch: Health Care Topics and New Health Legislation (2)

As a longtime health care professional and whistle blower I find company in Einer's thoughts as very similar to what I have been telling people for decades. Listen Up!

Another risk is ALEC and their effort to bring about Medicare privatization.   More about ALEC will continue on Natural Health News.

Myths of “Health Reform” 
By Lee Einer
  
The Democratic Party has recently launched a PR push to assure voters of the wonders of the newly enacted “Patient Protection and Affordable Care Act.” It seems to me that the Democratic Party is at least a little concerned that this controversial legislation might be an albatross around their necks come midterm elections. They should be.
I recently attended a public presentation on the Act, a presentation delivered by an aide to Sen. Jeff Bingaman, a Democrat, who sat on the HELP committee which produced this bill in the senate. Bingaman's aide made some glowing claims for the legislation, and while some were true, others were not just inaccurate but outrageously, incredibly false.

Bold-faced lies about matters of public welfare tend to get under my skin, and in this case, they motivated me to take keyboard in hand and address some of the myths and misunderstandings surrounding the Affordable Care Act.

Before I launch into a case by case examination of the claims, I’d like to share with you the role the health insurance industry played in creating this bill.

As many of you know, President Obama's point man in the Senate for health reform was Sen. Max Baucus. A June, 2009 story by Mike Dennison of the Montana Standard revealed that Baucus has received more money from the insurance and medical industries than any other member of Congress, and that money from these sectors accounts for a quarter of his total campaign contributions; Baucus accepted more than three million dollars from Big Insurance and Big Pharma between 2003 and 2008. Picking Sen. Baucus to lead a health insurance reform effort presented a conflict of interest, to say the least. 

But Sen. Baucus did not write the bill, at least not directly. So, who did?  On March 25, 2010, Mr. Baucus thanked the principle author, saying: 

“I wish to single out one person, and that one person is sitting next to me. Her name is Liz Fowler. Liz Fowler is my chief health counsel. Liz Fowler has put my health care team together. Liz Fowler worked for me many years ago, left for the private sector, and then came back when she realized she could be there at the creation of health care reform.”

Yep. Liz Fowler, VP at Wellpoint, a health insurer, left Wellpoint and hired on with Baucus specifically to author the health reform bill! 

Fowler's last stint with Baucus was to assist with the creation of “Medicare Part D,” another instance where an alleged health “reform” was in fact a major giveaway of taxpayer dollars—in that case to Big Pharma.
Fowler's former employer, Wellpoint, is exactly the kind of insurer that health reform purports to regulate. In April, only a month after Baucus' thank you to Fowler, Reuters reported on Wellpoint's practice of post-claims underwriting, or rescission. This is the foul practice upon which I blew the whistle in Michael Moore's documentary, SICKO, and according to Reuters, Wellpoint was cited by Congress as one of the worst offenders! 

Rescission, for those not familiar, is the practice of cancelling an insurance policy retroactive to the date of its inception, rendering it as if it had never existed. Some health insurers in the individual and small claims markets have a practice of targeting patients with expensive claims or potentially expensive conditions, looking to find an inconsistency with the information on their application for insurance, so they can void out the policy  and thereby save money. 

According to Reuters, Wellpoint has nearly 34 million policyholders, more than any other health insurer in the country. And, in this instance, Wellpoint was targeting breast cancer patients for policy termination. As the article said: 

The women paid their premiums on time. Before they fell ill, neither had any problems with their insurance. Initially, they believed their policies had been canceled by mistake.

They had no idea that WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators.

Once the women were singled out, they say, the insurer then canceled their policies based on either erroneous or flimsy information. 

If you haven't figured it out, let me spell out the implications of this. These were women who were being treated for breast cancer, and Wellpoint, instead of paying their claims in good faith, singled them out and rescinded their policies, leaving them, unless they were independently wealthy, with no way to pay for the medical treatment that their doctors prescribed to treat their cancer. 

And it was a Wellpoint VP that wrote the “health reform” bill. Please assimilate that. And note the irony of this last bit from the Reuters article:

In his push for the health care bill, President Barack Obama said the legislation would end such industry practices.
But many critics worry the new law will not lead to an end of these practices. Some state and federal regulators—as well as investigators, congressional staffers and academic experts—say the health care legislation lacks teeth, at least in terms of enforcement or regulatory powers to either stop or even substantially reduce rescission.

The critics are right. Take it from me—a former insurance company insider—the Affordable Care Act's provisions aren't going to stop the practice, or even slow it down much. We'll talk about that later, since the claim that the Act will “end rescission” is a bragging point for the Democrats. 

You may be asking yourself, “Why would the health insurance industry look to reform itself in the first place? Wouldn't they be trying to block reform?” That's an excellent question. The answer, I believe, is that the insurance industry knew that change was coming, and they wanted to insure that the change would be implemented on their own terms. 

There has been a grassroots movement for single payor health reform, spreading like wildfire in this country.  At least ten states have  single payor legislation under consideration. And the documentary SICKO made the horrors of American health insurance the topic of dinner table conversation across the nation. In September, 2008, California governor Arnold Schwarzenegger vetoed a single payor bill passed by the California legislature. It was the second time in three years he had done so. Had “The Terminator” not vetoed the bill, twice, California would have become the first state in the nation to have universal, not for profit, single payor health coverage for its residents. And I am confident that the rest of the states would have followed suit over the next few years. 

Something had to be done to stop the stampede towards single payor. 

The slickest way to do it was to legislate against state-based single payor plans on the federal level, in such a way as to make it look like real insurance reform. And that's exactly what Congress, in collusion with Big Insurance, did. They enacted a “health reform” which cements in place the role of for-profit health insurance through federal statute, and which, as federal law supercedes state law, effectively blocks state-based single payor legislation. The bill as originally written would have blocked single payor forever and always. It was amended due to public pressure, but still blocks state-based reform until at least 2017, at which point the nationally mandated for-profit insurance infrastructure called the “health exchange” will already have been put in place. 

So there's your answer. Had universal single payor coverage been enacted in even one state, it would have been the camel's nose under the tent, and the rest of the camel would soon have followed in the form of other states implementing similar legislation. So Big Insurance worked with Congress to enact a reform bill that would contain some incremental reforms for consumers while blocking single payor legislation,  preserving the role of for-profit insurance and, through the individual mandate, expanding the slice of the pie for Big Insurance by requiring Americans to buy private insurance and subsidizing the purchase with their own tax dollars. 

So now let’s take a look at some of the myths circulating about this bill, and debunk them. 

“It will insure all Americans.” Not even close. The Affordable Care act expands the role of Medicaid somewhat. The biggest expansion happens with the private sector. By subsidizing low income Americans to buy private insurance, and imposing monetary penalties on otherwise uninsured Americans who refuse to buy private insurance, the Affordable Care Act effects a major expansion of the role of private insurance. By doing so, the Congressional Budget Office (CBO) predicts that by 2019 the Act will reduce the number of uninsured Americans from 50 million to 25 million. That's still a far cry from universal coverage. And much of the reduction will be accomplished by compelling Americans by means of monetary penalties to purchase private coverage.

“It will end the objectionable practice of rescission.” Nope. Not in the short term, anyway.  It does restrict the practice somewhat. Here is the pertinent portion of the Act:

SEC. 2712. PROHIBITION ON RESCISSIONS.
  A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not rescind such plan or coverage with respect to an enrollee once the enrollee is covered under such plan or coverage involved, except that this section shall not apply to a covered individual who has performed an act or practice that constitutes fraud or makes an intentional misrepresentation of material fact as prohibited by the terms of the plan or coverage.

Let’s talk a bit about what rescission is, how it works and what it does.
Let’s say you are seeking insurance under an individual, non-group plan, the type of private insurance you can get without being part of an employer group. You will be asked to complete an application that asks you some complex questions about your medical history, questions like “Have you during the past five years been diagnosed or treated for any injury, illness, disease or condition affecting the genito-urinary tract? If so, please explain?” You may also be asked to get a physical exam and provide the results to your prospective insurer. 

OK, fine, so they review the information, issue the policy, and are gladly accepting your premium payments.
But as soon as you get sick and your insurance company receives a bill that either exceeds a set dollar limit or which reports a potentially expensive or chronic diagnosis,  this signals your insurer that their payouts may exceed the amount they are taking in on your policy, making you a money pit as far as they are concerned. So they begin looking for ways to cancel your policy. 

The way they do this is by retrieving a copy of your application, and investigating your medical history over the past several years. The investigation can take as long as a year or even longer, and they are not paying your claims while they are investigating. You may well be unable to both pay your providers and keep paying your premiums, so the very process of the investigation can have the effect of pushing you off the policy. What your insurer is looking for is a discrepancy or inconsistency between your medical history and what you reported on your application for insurance. If they find it, they will use that inconsistency to either issue a rider excluding coverage for anything relating to the condition they discovered, issue a rate increase retroactive to your policy's effective date, or rescind your policy, meaning it is void from the effective date. Behind closed doors, we referred to this as “the three “R”s when I was doing these investigations for a third party administrator.  

What the rescission does is make it as if you never had insurance. If they paid out less than you paid in premiums, they will refund you the difference; if they paid out more than you paid in premiums, they will recover the excess from your health providers leaving you responsible for those bills. 

Does the “intentional misrepresentation” language give you protection if you filled out the application in good faith? Not necessarily. Let’s take the example of the question above addressing the genito-urinary tract. One woman who appeared in SICKO was kicked off her policy and left with thousands of dollars in unpaid bills because she did not disclose a yeast infection she had several years prior to her coverage. Most women, at some time in their life, get a yeast infection, and it is a stretch to call it an illness or injury. Many would not think to report this on an insurance questionnaire. But your insurance company can easily say “she knew she had it, she sought treatment for it, she did not report it, it was obviously intentional,” and rescind the policy. You can try to argue otherwise, BUT the truth is if the insurance company is determined to rescind your policy, in most cases they can make some sort of circumstantial case that your omission or misstatement was intentional and you will probably need to get a lawyer in order to fight it. If you are like most people in that circumstance, you are ill and without medical coverage and cannot afford to pay a lawyer and pay your medical bills at the same time. So they win. 

So the Affordable Care Act does NOT end the practice of rescission; it only restricts it somewhat, and it is disingenuous to claim otherwise. 

An additional note on the Act's “ending” rescission- the Act's language, which requires that resscissions be done only in instances of fraud or intentional misrepresentation of material fact, is ALREADY law in at least seven states, including my home state of New Mexico. In most of those states, this law has been on the books for years. So if you live in one of these states, the Act not only doesn't end the practice of resciscission, it makes absolutely no change to the status quo.

The Act does, beginning in 2014, implement “guaranteed issue,” which means they can't refuse to cover you on the basis of your past medical history. That should effectively do away with rescission on policies issued on or after the effective date of the guaranteed issue provision. If your policy was issued before 2014 then your insurer may still be able to rescind your policy. 

“It will end abuses and injustices by insurance companies.” Definitely not. And it's cruel to even suggest such a thing. An estimated 18,000 Americans die each year from “death by denial,” their insurers' refusal to cover lifesaving care. That's three times the number of deaths suffered in the September 11th World Trade Center attack, every year. The Act does little to change that, and, given that it greatly expands the slice of the coverage pie given to for-profit insurers, we may well see that number rise. Perhaps most significantly, as health industry whistleblower Wendell Potter recently pointed out, the Act does nothing to rein in the ERISA “protections” that deprive many Americans of their right to sue. 

ERISA, the Employee Retirement Income Security Act of 1974, bars those roughly 130 million Americans covered under employer health benefit plans from suing their insurance company or their employer for refusal to cover a treatment or procedure. They can bring suit in federal court, but if they do, there will be no punitive damages, and no pain and suffering. The only thing that they can win from their lawsuit is the monetary value of the denied service. This means that there is no meaningful downside for such plans if they decide to deny your desperately needed care even for the flimsiest of reasons – ultimately, the most you can do, if you are one of the few who fight it in court, is compel them to pay what they should have paid in the first place. 

So let’say that your husband and the father of your children needs a kidney transplant, your  employer's ERISA plan refuses to cover it, and the love of your life dies as a direct result.  Assuming that you sue, and win (and this would be you and your lawyer against the insurer's legal team, a David and Goliath battle from the onset), the Judge would award you nothing to compensate for the loss of your spouse, for your child's loss of a father, for the lifelong loss of income and child support. Not because he doesn't want to, the judge's hands are tied by ERISA and he can only order the plan to pay what they should have paid in the first place.
The Act doesn't change that. Not now, not in 2014, not in 2017, not ever.

The Act does limit a few egregious practices—but it doesn't keep your insurance company from refusing to cover your care because it is medically unnecessary, experimental, investigational, not a plan benefit, out of network, or any of the other 30 to 50 listed exclusions listed in the average health insurance coverage certificate. And it doesn't do much of anything to improve your options if your insurance does deny your claim, either. All that the Act does in this respect is require all insurance plans to HAVE an appeals process which would satisfy the ERISA requirements for such. That means no change for those insured through their employer, and little to no improvement over most state laws. 

All of the claims for the Act effectively ending ANY abuses, including bad-faith rescissions, are merely feel-good gestures in the absence of a regulatory body empowered to intervene in individual cases. Read the act carefully, and good luck finding any mention of a regulatory body empowered to do this.   I have to tell you, there are plenty of well-intentioned laws already on the books which for-profit insurance companies flout with impunity. Regulation in the absence of oversight and enforcement is simply ink on paper.
So expect those thousands of deaths by denial to continue, year after year, until more meaningful reform is implemented, or until we kick for-profit insurance to the curb in favor of a publicly administered system. 

“It limits insurance company profiteering.” To be exact, what the Act does do is limit the insurer’s loss ratio. The “loss ratio” is the split between the amount the insurance company pays out in benefits and the amount which goes to overhead and profit. The Act requires at least 80 cents of the premium dollar for individual and small group plans to go to medical expenses, and at least 85 cents on the premium dollar for other plans to go to medical expenses. Insurers with less than the mandated medical loss ratios would be required to issue a rebate to customers.  

By way of contrast, public plans such Medicare and state Medicaid plans typically have a MLR better than 95/5. 

In order to increase profits under a capped medical loss ratio, an insurer would need to either manipulate their business and accounting practices, decrease actual overhead, or increase both premiums and payouts so that profit-taking can also increase. You can bet that insurance executives were already strategizing how to game this one before the ink was dry on the legislation. 

You can bet on any variety of administrative expenses being reclassified as medical care on the insurance company’s balance sheets. For example, expect to see some portion of their advertising budgets being reclassified as “medical education.” 

Obviously, the devil is in the details with this provision of the Act. What are the details?  We don't know yet. The National Association of Insurance Commissioners was tasked with fleshing out this provision, determining what constitutes a medical versus a non-medical expenditure, and was given a December 31 (2010) deadline under the Act. The American Hospital Association, in a June 2 letter to the NAIC, called for close scrutiny in this area, stating that

Regulations implementing the new MLR provision should ensure that the allocation of
costs incorporates the following three principles:
* only payments to licensed professionals and entities that deliver health care services should be classified as health care services;
* costs and expenses that are classified as activities that improve health care quality need to meet specific criteria; and
* loss adjustment activities should be counted as administrative costs because they do not provide health care services or improve quality.

These are good recommendations. But it is hard to conceive of the final regulations being written so tightly and in such detail as to effectively eliminate the countless loopholes which insurance companies might otherwise exploit. Whether the final regulations will be meaningful, and how the Feds will enforce the regulations without an army of accountants and auditors remains to be seen. 

“It will lead to single payor.” As I explained earlier, it will effectively THWART grassroots efforts to enact single payor legislation, until at least 2017, and perhaps forever. The Act is written in such a way that its provisions must be waived in order for single payor reform to be enacted. The Act has a provision allowing that to happen, but not until 2017. But that's not all. Back to that pesky ERISA. 

Employee Health Benefit Plans (EHBPs) are exempted by ERISA from state laws governing insurance, and currently about half of all people insured through their workplace are insured through such EHBPs.  That's roughly 130 million Americans, nationwide. Because the waiver language in the Affordable Care Act does not waive this ERISA exemption, states can NEVER enact true single payor legislation. A true single payor plan would have to insure all individuals, and in doing so would necessarily replace the current network of employer-based health coverage. But it can't replace these EHBPs because they are shielded by ERISA from any state law which would do so.

That's it in a nutshell. There are some good things about the bill, which I haven't touched on in this column. I think the media and the Democratic Party have told that story. There are also some more bad things about it which I haven't even touched on here. But for those of us worried about the big-picture issues, the “Patient Protection and Affordable Care Act” falls tragically short of living up to its name. Under the Act, we can continue to expect death by denial to take thousands of American lives every year.  We can expect to still have 24 million uninsured Americans, even a decade from now. We can expect that medical expenses will continue to be the leading cause of foreclosures and bankruptcies for working families, and we can expect our health insurance system, in short, to be the most expensive, the most profitable, the most dysfunctional and the least humane medical reimbursement system in the developed world.

Read More

Keeping Watch: Health Care Topics and New Health Legislation (1)

The Laws of the Pharmaceutical Industry



Posted with permission from my colleague, Dr Arthur Evagelista, formerly with the FDA.

The main principles governing the pharmaceutical "business with disease" are:

..."It is not in the financial interests of the pharmaceutical industry to prevent common diseases - 

the maintenance and expansion of diseases is a precondition for the financial growth of this industry.."

1  The pharmaceutical industry is an investment industry <http://qualityassurance.synthasite.com/laws/law01.htm>  driven by the profits of its shareholders. Improving human health is not the driving force of this industry.

2  The pharmaceutical investment industry was artificially created and strategically developed over an entire century by the same investment groups that control the global petrochemical and chemical industries.

3 The huge profits <http://qualityassurance.synthasite.com/laws/law03.htm> of the pharmaceutical industry are based on the patenting of new drugs. These patents essentially allow drug manufacturers to arbitrarily define the profits for their products.

4  The marketplace for the pharmaceutical industry is the human body - but only for as long as the body hosts diseases. Thus, maintaining and expanding diseases  <http://qualityassurance.synthasite.com/laws/law04.htm>  is a precondition for the growth of the pharmaceutical industry.

5  A key strategy to accomplish this goal is the development of drugs that merely mask symptoms
<http://qualityassurance.synthasite.com/laws/law05.htm> while avoiding the curing or elimination of diseases. This explains why most prescription drugs marketed today have no proven efficacy and merely target symptoms.

6  To further expand their pharmaceutical market, the drug companies are continuously looking for new applications <http://qualityassurance.synthasite.com/laws/law06.htm>  (indications) for the use of drugs they already market. For example, Bayer's pain pill Aspirin is now taken by 50 million healthy US citizens under the illusion it will prevent heart attacks.

7  Another key strategy to expand pharmaceutical markets is to cause new diseases with drugs. While merely masking symptoms short term, most of the prescription drugs taken by millions of patients today cause a multitude of new diseases as a result of their known long-term side effects
<http://qualityassurance.synthasite.com/laws/law07.htm> . For example, all cholesterol-lowering drugs currently on the market are known to increase the risk of developing cancer - but only after the patient has been taking the drug for several years.

8  The known deadly side effects of prescription drugs are the fourth leading cause of death in the industrialized world, surpassed only by the number of deaths from heart attacks, cancer and strokes (Journal of the American Medical Association, April 15, 1998). This fact is no surprise either, because drug patents are primarily issued for new synthetic molecules. All synthetic molecules need to be detoxified and eliminated from the body, a system that frequently fails and results in an epidemic of severe and deadly side effects.

http://qualityassurance.synthasite.com/resources/drugs%20kill%20more%20Ameri
cans.gif?timestamp=1318370943767.circa 1999 statistics

9  While the promotion and expansion of diseases increase the market of the pharmaceutical investment industry - prevention and root cause treatment of diseases decrease long-term profitability; therefore, they are avoided or even obstructed by this industry.

10  Worst of all, the eradication of diseases is by its very nature incompatible with and diametrically opposed to the interests of the pharmaceutical investment industry. The eradication of diseases now
considered as potential drug markets will destroy billions of investment dollars and eventually will eliminate this entire industry.

11  Vitamins and other effective natural health therapies that optimize cellular metabolism threaten the pharmaceutical "business with disease" because they target the cellular cause of today's most common diseases - and these natural substances cannot be patented.

12  Throughout the more than one hundred year existence of the pharmaceutical industry, vitamins and other essential nutrients, with defined functions as cofactors in cellular metabolism, have been the fiercest competition and the greatest threat to the long-term success of the pharmaceutical investment business.

13  Vitamins and other effective natural health therapies that effectively prevent diseases are incompatible with the very nature of the pharmaceutical "business with disease."

14  To protect the strategic development of its investment business against the threat from effective, natural and non-patentable therapies, the pharmaceutical industry has - over an entire century - used the most unscrupulous methods, such as:

(1) Withholding life-saving health information from millions of people. It is simply unacceptable that today so few know that the human body cannot produce vitamin C and lysine, two key molecules for connective tissue stability and disease prevention.

(2) Discrediting natural health therapies. The most common way is through global PR campaigns organized by the Pharma-Cartel that spread lies about the alleged side effects of natural substances - molecules that have been used by Nature for millennia.

(3) Banning by law the dissemination of information about natural health therapies. To that end, the pharmaceutical industry has placed its lobbyists in key political positions in key markets and leading drug export nations.

15  The pharmaceutical "business with disease" is the largest deception and fraud business in human history. The product "health" promised by drug companies is not delivered to millions of patients. Instead, the "products" most often delivered are the opposite: new diseases and frequently, death
<http://qualityassurance.synthasite.com/laws/law15.htm> .

16  The survival of the pharmaceutical industry is dependent on the elimination, 'by any means', of effective natural health therapies. These natural and non-patentable therapies have become the treatment of choice for millions of people despite the combined economic, political and media
opposition of the world's largest investment industry.

Stay INFORMED ..

 

Read More