AARP – Selling to you AND advocating for you at the same time

Am I just slow on the uptake? How can you simultaneously be an advocate for someone, and also sell them something very expensive and important? If at some point in time, these two tasks conflict, will AARP drop out of the healthcare industry to ensure that its role as advocate does not get compromised? I think not, the conflict of interest simply boggles the mind. How can you write a whole article about this issue and not have CONFLICT OF INTEREST flashing in big bold letters!!

For example, if it is proven that single payer, universal healthcare was the most effective way to ensure that people 50-64 (before they hit medicare, which used to work very much like single payer healthcare without drug coverage until a really complex and crazy drug insurance was written on top of it) were insured and healthy, how would this affect the AARP? They are now in the business of selling you the health insurance that would be rendered less necessary by said policy, what would the AARP do? Somehow, I don’t see them saying “Yeah, we’ll close our multimillion dollar profit making business because it is the right thing to do”.

This is ridiculous!

AARP Says It Will Become Major Medicare Insurer While Remaining a Consumer Lobby – New York Times

AARP, the lobby for older Americans, announced Monday that it would become a major participant in the nation’s health insurance market, offering a health maintenance organization to Medicare recipients and several other products to people 50 to 64 years old.

The products for people under 65 include a managed care plan, known as a preferred provider organization, and a high-deductible insurance policy that could be used with a health savings account.

When the new coverage becomes available next year, AARP will be the largest provider of private insurance to Medicare recipients. In addition to the new H.M.O., AARP will continue providing prescription drug coverage and policies to supplement Medicare, known as Medigap coverage.

William D. Novelli, the chief executive of AARP, said, “In launching these initiatives, we are driven by our mission to create a healthier America.”

The group also said it would use its leverage to reshape the health insurance market. The organization has 38 million members, and Mr. Novelli said it hoped to have 50 million by 2011.

The new Medicare product will be marketed with UnitedHealth Group. Policies for people under 65 will carry the AARP name and will be marketed with Aetna.

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  • Is Chronic Occupational Pain a Class Issue?

    Americans in households making less than $30,000 a year spend nearly 20% of their lives in moderate to severe pain, compared with less than 8% of people in households earning above $100,000

    Millions of Americans in Chronic Pain – TIME

    Based on a study published in the Lancet (much moolah required to read, funny that the authors of an article on the class/money based nature of pain would publish in a journal that requires all kinds of money to read, heard of PLOS?), one would have to say yes. People in low paying service jobs don’t have the luxury of mid afternoon yoga, or that once a week massage, or being able to take a “mental health” day, or any such luck. Also, the work is physically demanding, long hours of standing, heavy lifting, and repetitive motions the body was not designed for.

    Krueger notes that the type of pain people reported typically fell on either side of the rich-poor divide. “Those with higher incomes welcome pain almost by choice, usually through exercise,” he says. “At lower incomes, pain comes as the result of work.” Indeed, Krueger and Stone found that blue-collar workers felt more pain, from physical labor or repetitive motion, while on the job

    It is very sad, but a lot of this pain is avoidable. Next time you go to the grocery store, notice that the people at the check out counter stand all the time. Why? What about their job requires continuous standing? I’ve been to other countries, Germany for instance, where they are provided with high chairs that help them move the items from the conveyor through the scanner to the bagging area with much less effort. How many chairs have you seen in a grocery store lately?

    Why can’t this very simple system be implemented? It would provide much relief. Three major issues:

    1. Lack of bargaining power: Unions are a dirty word. Last I heard, the unionization rate in the states was 12%. No one speaks for the cashier. It is considered a low paying, low skill occupation where people can be replaced easily and without “pain”. So, you’re on your own, ask for a chair, and you’ll be seated in one very soon (at home, your ass fired and tired).
    2. Money: And this is linked to point 1. Implementation of any programs designed to make workers’ lives a little easier costs money up front. Since workers are expendable and have no voice, it’s easiest to steal from them and deny them basic comforts.
    3. The American notion of individualism: You deserve what you get based on how hard you work and how intelligent you are. Grocery store cashiers must be lazy and dumb to be where they are. they “deserve it”

    I don’t see it changing at all. But next time you walk into a grocery store and find a rather sullen clerk, it’s not that she’s lazy or has a bad attitude, she may just be in a lot of pain.

    Happy Sunday!

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    Black Lung – Miners pay so you can get more coal

    The Pump Handle alerts us to a special report on coal miners and their lungs, not for the faint of heart, but something to keep in mind when you hear the phrases “Cheap Energy” and “coal” in one sentence, it’s not so cheap for these people.

    Black Lung: Dust Hasn’t Settled on Deadly Disease « The Pump Handle

    Louisville-Courier Journal reporters Laura Unger and Ralph Dunlop offer us the voices and faces of miners who are suffering from coal workers’ pneumoconiosis. Their special report, Black Lung: Dust Hasn’t Settled on Deadly Disease, includes an on-line version which features five compelling videos featuring 40- and 50-year old coal miners who are now suffering with the disabling lung disease. Mr. Danny Hall, 56, for example, who is still severely impaired despite receiving a lung transplant says “if I had to do over, I wouldn’t ever go into coal mining.”

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    DuPont sets goal of eliminating Teflon processing chemical

    See, it wasn’t too hard to come up with safe alternatives, improved processes and a decent timeline!

    DuPont sets goal of eliminating Teflon processing chemical

    One year after accepting a government challenge to work toward eliminating the use of a potentially dangerous chemical used to make Teflon and other products, the DuPont Co. said Monday it plans to stop using the chemical by 2015.

    The Environmental Protection Agency asked the Wilmington-based chemical giant and seven other companies last year to commit to a 95 percent reduction in environmental emissions and product content levels of perfluorooctanoic acid, or PFOA, and associated chemicals by 2010.

    DuPont makes the chemical at a plant near southeast Ohio in Parkersburg, W.Va.

    The companies also were asked to work toward the elimination of PFOA and associated chemicals from emissions and products by 2015.

    On Monday, DuPont said technological advances have allowed it to remove more than 97 percent of trace levels of PFOA and associated chemicals from surface protection fluorotelomers used in products such as oil-resistant paper packaging and stain- and water-repellent textiles.

    DuPont also has been able to reduce PFOA content by at least 97 percent in fluoropolymer coatings used in Teflon cookware, architectural coatings and electronics applications.

    “We have been working for a long time, but particularly over the last year, on alternative technologies to PFOA,” said David Boothe, business manager for DuPont fluoroproducts. “We believe that work is going to allow us to eliminate the need to make, buy, or use PFOA by 2015… That’s firmer language than ‘work toward.'”

    For previous posts on this subject, see here. Who says a little pressure doesn’t help change even the all powerful Dupont!

  • | |

    Colonialism: Environmental Edition

    Does put recycling in context…

    Independent Online Edition > Environment

    Regardless of how carefully you separate your waste, there is a good chance a disposal firm will dump it all in together with other kinds of plastic trash and ship it to the developing world to be dealt with by a family of migrant workers earning a pittance. They will deal with the salad-bar container, the pistachio ice-cream container and the superfluous bag for carrots in your shopping basket in a variety of different ways – it may be recycled, it may become landfill or it may simply be burnt. Whatever happens, it is generally not a priority for the waste disposal company. Britain dumps around two million tonnes of waste in China every year, everything from plastic mineral water bottles to shopping bags and other forms of superfluous packaging from some of the country’s biggest supermarkets.

    Same for India as well. The article says that all of this “recycling” is illegal. But how do you hide 200,000 tonnes of plastic waste?

    Read the whole article, it is tragic. Some highlights:

    So too are the many and varied health complaints suffered by the local population, who risk multiple skin ailments and exposure to potent carcinogens as they touch the contaminated materials. Poisonous chemical effluents stream into their water supply, turning it black or lurid red, and studies by Greenpeace show that acid rain is the norm in this region. Children are prone to fevers and coughs. Their skin is often disfigured by the toxic plastic waste they have to process.

    A report by the University of Shantou on the town of Guiyu, another Guangdong recycling hub, showed that more than 80 per cent of local children suffer from lead poisoning.

  • | |

    What can the U.S learn from homeopathy?

    Homeopathy was all around me growing up in India, so I read this article with interest as it jogged many memories of visiting the family homeopath with my parents.

    Faith Healing with Homeopathy — In These Times

    Homeopathy rests on three unproven tenets: First, “Like treats like.” Because arsenic causes shortness of breath, for example, homeopaths prescribe its “spirit” to treat diseases such as asthma. Second, the arsenic or other active ingredient is diluted in water and then that dilution is diluted again and so on, dozens of times, guaranteeing—for better and worse—that even if the dose has no therapeutic value, it does no harm. And third, the potion is shaken vigorously so that it retains a “memory” of the allegedly curative ingredient, a spirit-like essence that revives the body’s “vital force.”

    Fooey, the description of the science is hilariously pseudoscientific, but homeopathy is no laughing matter in India. It is estimated to be a Rs. 250 Crore (that is 2.5 billion rupees or about $58 million) industry as of 2002-2003.  I do not think this includes doctors and clinics. This website lists 158 colleges in India offering the  valid (it is like an MD!) degree of Bachelor of Homeopathic Medicine and Surgery, or BHMS. My parents swear by it, most of my family living in India has either visited, or regularly visit one. It is hugely popular for hepatitis and liver disease, more so than conventional medicine in India.

    What’s the deal? Why is it so popular? I think Terry Allen is on the right track, this sentence here, buried in the middle, hits the nail on the head…

    Part of the effect comes from the ritual of consultation with a practitioner who treats the patient like a person rather than a body part on an assembly line.

    Allen does not quite grasp the significance of this sentence and tracks away into placebo effects and evil pharma. But here’s the deal: A lot of Indians (who can afford $4-$5 consultation fee) visit their homeopath every month. When I tagged along with my parents, we would go on a Sunday afternoon at 2 PM to this homeopath’s office, which was a wing of his house (a big house, I might add!). It was a relaxed and leisurely time, he spent 10-15 minutes with each of us (yes, my parents made me!) talking about the previous month, what we were up to, how stressed we’d been, how our ailments from the previous month were doing, had we noticed any changes to our health over the month, etc. We would be interrupted occasionally by his little kid, or his assistant relaying a message from his wife, it was as far removed from a doctor’s visit as possible. And yes, he would take your blood pressure, run simple blood tests, etc. At the end of it, he would give you little sugar pills/sugar coated powder formulations to take home. The formulations were individually dosed, it was all categorized and labeled for you.

    This is like having a mini physical every month. Surely, just the act of talking to someone made you feel better, the act of ritually opening up little packets of “medicine” and following detailed instructions for 5 days helped, surely the homely and relaxing atmosphere of visiting a family friend helped, I don’t know.

    Metrics? both my parents occasionally had their hypertension treated with homeopathy. This worked as long as they were borderline, and simple stress management would get the numbers down. This doctor was/is very good at stress management because he talked calmly, yet firmly, he would listen and tease their little everyday stressors out of them and that was probably good for a 10 point reduction. But I remember the homeopath sending mom off to a doctor for a more conventional treatment regimen as soon as she hit 160.

    It never ever worked for me because I was way too sceptical to buy into the process, so I would not listen, or relax enough to talk. I would take my pills, but it would make absolutely no difference whatsoever. Of course, he was trying to treat me for severe sinus related issues probably brought on by pollution, and by sleepless nights spent on a beach looking for turtles!

    I am sure that for every good homeopath, there were two bad ones who just handed out pills of sugar. But my parents’ homeopath was, and continues to be part Dr. Phil, part candyman, part cheerleader!

    Homeopathy probably “works” because it makes people take the time to think about their life and what’s ailing them. It’s a lesson that American primary care providers could do well to learn.

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    A Company that Specializes in Profiting from Harm

    The LA Times has an interesting investigation on the activities of Amvac.

    Pesticide maker sees profit when others see risks – Los Angeles Times

    Amvac is a leading maker of organophosphates, a class of older, highly toxic pesticides that has been under regulatory scrutiny since the late 1980s. As larger firms have stopped manufacturing some of their organophosphates, Amvac has bought the rights to make or sell 10 of them since 1989, according to company records and interviews. One of them, mevinphos, was banned in the U.S. in 1994 after a study by the U.S. Environmental Protection Agency found that it was responsible for poisoning more field workers in California than any other agricultural chemical. Amvac continues selling the product overseas, according to company officials. Amvac is by no means the largest producer of pesticides that have attracted regulatory scrutiny, but the company stands out for its willingness to embrace chemicals that other firms have abandoned.

    Amvac Slogan

    Love that slogan, don’t ya’! There are so many loopholes in pesticide regulation that a company like Amvac can post impressive profits by using these loopholes, having a significant say in the writing of the regulation, and effortlessly denying and delaying action. It’s a well researched piece, read in full.