Page 1


Affiliated with the Rhode Island AFL-CIO “Fighting for the future of our members.” “NOW, more than ever!!!” Publication 2018 Issue 34 Published in house by the RI ARA

August 26, 2018 E-Newsletter

All Rights Reserved RI ARA 2018©

Administration Nominates a Social Security Privatizer as a Trustee The administration announced the nomination of James Lockhart to be one of the two public trustees for the Social Security and Medicare Trust Funds. If confirmed by the Senate, he would serve for four years. Lockhart served as the Deputy Commissioner of the Social Security Administration under President George W. Bush. During that time, he advocated

for privatizing Social Security benefits into personal accounts, and suggested investing Social Security in the stock market during a congressional hearing. He also ser ved as the Executive Director of the Pension Benefit Guaranty Corporation (PBGC) under President Ronald Reagan. In addition to his long history of support for privatization of earned benefits, Lockhart has also proposed raising the retirement age and making cuts by slowing the growth of

benefits. He is now co-chair of the Bipartisan Policy Center, which promoted “back door privatization” in the form of benefit cuts and expanding subsidies for private savings. The commission’s latest report suggests creating retirement savings accounts through a third -party for employers who don’t want to offer pension plans, raising the age of eligibility for receiving benefits, and shifting responsibility from the government and employers to individuals.

“It is crucial that we fight to protect Social Security and its beneficiaries,” Joseph Peters, Jr. said Joseph Peters Jr., Secr etar y-Treasurer of the Alliance. “James Lockhart’s nomination is another step in the misguided strategy by many of our leaders to raise the Social Security retirement age, privatize it and take away earned benefits for which retirees worked their entire lives.”

Earned Benefits, Not Entitlements President Franklin D. Roosevelt signed the Social Security Act into law 83 years ago today, August 14, 1935. Here are some key facts about the program, courtesy of the Center on Budget and Policy Priorities:  About 62 million people received Social Security checks in June of this year.  The average monthly check was $1,343.  Benefits for the average worker are only about half those in other developed countries.  Social Security lifts about 15 million elderly Americans out of poverty.  About 1 in 5 seniors rely on Social Security for virtually all of their income (more than 90 percent).  Administrative costs for the program are just 0.7 percent of annual benefits. Social Security’s trust funds will be exhausted by 2034. If policymakers do not act by then, payments will be reduced by about 25 percent.

It’s Medicare’s 53rd Birthday—It’s Time Everyone Had It Medicare for All is coming. It is coming because it is profoundly wise policy and profoundly winning politics. "The American people are divided on many issues, but this is not one of them. Sixty-four percent of voters are more likely to back candidates who support expanding Medicare, versus only 22 percent who are less likely." "The only entities who benefit from continuing to have a private system are the for-profit insurance corporations."

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

FDA approves the first generic version of EpiPen The Food and Drug Administration approved the first-ever generic version of EpiPen Thursday — a move the agency says could help lower costs for the drug, which can carry a price tag of more than $600. It isn’t clear how much the new version, which will be sold by Teva, will cost. But it may be a lower-cost option for individuals with allergies, who need to keep this lifesaving medicine with them at all times. Right now, a two-pack of EpiPen, marketed by Mylan, currently lists for $608.61. Mylan also makes its

own “authorized generic” version, which it sells for $300 per pair. The approval comes about two years after Mylan landed in hot water for drastically raising the price of its medicine while using its monopoly power to keep competitors out of the market. Since 2004, the company raised the price of EpiPen over 450 percent. The decision is a long-awaited victory for Teva, which has been trying to bring a generic EpiPen to the market for years.

It settled a patent infringement lawsuit with Mylan in 2012, agreeing to wait until mid-2015 to bring a generic onto the market. And then the FDA rejected its application in 2016. When asked, a Teva spokesperson did not specify how much the new medicine will cost. The medicine is not yet available for patients. The FDA cast the approval as a way to help patients with a cheaper alternative. The decision “is part of our longstanding commitment to

advance access to lower cost, safe and effective generic alternatives once patents and other exclusivities no longer prevent approval,” FDA Commissioner Scott Gottlieb said in a statement. People who need epinephrine auto-injectors can already look to several competitors. One, Auvi-Q, lists for $4,900 per two-pack, but the company has devised arrangements whereby both insured and uninsured individuals pay much less in cash. Another, Adrenaclick, comes in both a brand and generic version.

Tell your Members of Congress to Support Medically Necessary Dental Care People with Medicare face significant health risks because they do not have access to medically necessary dental care. There is an ongoing effort to urge CMS to use their existing administrative authority to allow this coverage, and we need your help! Ask your members of Congress to sign on to letters asking CMS to provide Medicare coverage for medically necessary dental care, as authorized by law.

Medically necessary dental care refers to care that is needed to resolve dental infections or diseases that risk complicating or standing in the way of receiving important, Medicare-covered treatments like chemotherapy, radiation, organ transplants, immunosuppression, and cardiac surgery. Currently, if a beneficiary

needs dental work done in order to undergo such a medical procedure, Medicare won’t cover the oral health work. This lack of treatment can exacerbate beneficiaries’ health conditions and increase Medicare’s costs for treating their illnesses. CMS has the authority to allow coverage for dental care in such medical circumstances. We need members of Congress to

urge CMS to exercise that authority. This effort has the support of a broad coalition, including 80 prominent organizations (AARP, ADA, Families USA, Medicare Rights Center, and numerous medical societies and associations) that understand just how important this coverage is. You can learn more by reading the coalition’s community statement.

Take action today.

Quick lessons to combat spin As pundits and politicians continue to discuss the deficit, misinformation and confusion about Medicare and the Affordable Care Act abound. All too often, facts seem to be drowned out by fiction. Particularly since the Supreme Court upheld the Affordable care Act, we are hearing a lot of misinformation about the law and its impact on Medicare. As these Myths make news — and old Myths make news again — the Center will

respond with facts and information The truth is, Medicare works. By and large it has been a resounding, cost-effective success. Nonetheless, Rep. Ryan and some candidates continue to propose changing Medicare into an individual voucher system that will hurt beneficiaries and their families, ignoring options for substantial savings that would not harm beneficiaries or eliminate the

Medicare program. This is particularly worrisome since half of all people with Medicare have annual incomes below $24,150, and already pay more out-of-pocket for health care than people with private insurance. To help dispel misinformation and try to set the discussion on a factual foundation, we’ve rounded up erroneous statements and countered them with the truth.

Help us set the record straight, shine light on fair, financiallysound policies, and demonstrate how Medicare works for millions of Americans – including your family and neighbors. Spread the word with our handy reference chart below, or from the more detailed articles that follow…..Read More

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

New Marketing Guidance Leaves Too Many Unanswered Questions Last week, the Medicare Rights Center submitted comments on new federal marketing guidance that will apply to Medicare Advantage (MA) and Part D prescription drug plans in 2019. The Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees the Medicare program, updates and releases marketing guidance every year so that MA and drug plans have current, uniform rules for marketing their products safely and accurately, without discriminating against people with Medicare. Some years see minor tweaks to the rules, but other years, like this one, see wholesale changes in how plans may be marketed. We have significant concerns

about next year’s guidance, in part, due to what it fails to address. Starting in 2019, MA plans will have access to new flexibilities that may make the already complex plan selection process even more confusing. One example that we have discussed in the past is a new option for MA plans to offer a wider array of supplemental benefits. This is a brand-new opportunity for plans that will have significant implications for consumers – yet the updated guidelines do not address it at all. In not doing so, CMS has lost a valuable opportunity to establish firm guardrails to protect people with Medicare.

We also believe that the availability of supplemental benefits must not become just a sales tool and sponsors must not be permitted to use them as a marketing device to persuade beneficiaries into their plans. To the contrary, MA plans need guidance on how they can market plans with such benefits without cherry-picking and inappropriately steering potential enrollees. There are other points throughout the guidance where CMS appears to be easing marketing restrictions that were put in place to protect people with Medicare, and in response to persistent, documented abuses.

It was important for us to respond to this new guidance to inform the development of future guidelines. Our comments register our objections to any changes that may loosen or remove consumer protections, or leave gaps for harmful, misleading, or coercive marketing practices. More and more, people with Medicare need tools to find the right coverage for their individual circumstances. This requires robust oversight to protect beneficiary access to care, economic stability, and wellbeing. Read more about supplemental benefits. Read our comments. Read the new marketing guidelines.

New Documents Show Federal “Election Integrity Commission” was Sham President Donald Trump’s Election Integrity Commission, formed to investigate voter fraud, had pre-determined the findings of that report, according to documents made public last Friday. After a series of lawsuits, the commission was disbanded. Despite this, one of the commission’s members, Maine Secretary of State Matthew Dunlap, feared he was being excluded from the commission’s work, which he suspected was being conducted entirely by commission chairman and Kansas Secretary of State Kris Kobach. Dunlap sued to for ce Kobach to turn over commission materials. Dunlap won, and on

Friday, he released those records to the public. The records show that prior to the beginning of the investigation, Kobach and others had created a draft of the final report complete with several different sub-headings on voter fraud, with conclusions listed and evidence to be filled in later. They also show that the commission, which requested the personal information of every voter in the country over the objections of several secretaries of state, intended to seek confidential information from jury rolls from clerks of courts around the country.

Kobach further intended to promote his Crosscheck program, which independent experts have found to be wrong in 99% of purported matches. “A rigged investigation is just another in a long line of attempts to ‘fix’ a non-existent problem at the cost of voters’ rights,” said Executive Director Fiesta. “This investigation clearly hoped to make it more difficult for thousands of seniors and people of color to vote. We must remain vigilant about stopping attempts to purge lawful voters from the rolls prior to the midterm elections in

November.” To confirm your voter registration, contact your local board of elections or visit If you have recently moved or changed an address, you must contact your local board of elections to update your information. It is especially important to confirm your registration if you have not voted within recent election cycles. can provide specific information on your polling location, absentee ballots and voting, and set up election reminders. For those who have not registered to vote, you can do so online or by contacting your local board of elections.

A leading Republican urges reform for Medicare and Social Security as deficits balloon after the GOP's tax cut Rep. Steve Stivers , R-Ohio, has the toughest job in politics right now: trying to stop a Democratic "blue wave"at the polls this fall. Stivers, chairman of the National Republican Congressional Committee, sat down to talk to CNBC's John Harwood about the campaign and other factors. Here is an excerpt from the interview: Read the interview here Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

Key Findings: Prevalence of Disabilities and Health Care Access by Disability Status and Type Among Adults — United States, 2016 Update: In our continuing endeavor with the CC=A (Citizens Coalition for Equal Access) to pledge to make Universal/Inclusive Design a guiding principle for all infrastructure bills and projects and will continue working to identify and remove the barriers that prevent all people of the United States from having equal access to the services provided by the Federal Government. People with Disabilities and Access to Health Car The Morbidity and Mortality Weekly Report (MMWR) published a report describing adults with disabilities in the United States, as well as the differences in health care access by disability type. Using 2016 Behavioral Risk Factor Surveillance System (BRFSS) data, CDC scientists analyzed the survey responses of those adults 18 years of age and older who had any of the following six types of disabilities:  Hearing (serious difficulty hearing);  Vision (serious difficulty seeing);  Cognition (serious difficulty concentrating, remembering, or making decisions);  Mobility (serious difficulty walking or climbing stairs);  Self-care (difficulty dressing or bathing); or  Independent living (difficulty doing errands alone). They found that 1 in 4 adults in the United States, or 61 million people, have at least one of these disabilities. Anyone can have a disability, and a disability can occur at any point in a person’s life. However, this report found disabilities more common among adults 65 years of age and older; approximately 2 in 5 adults in this age group have a disability. Disability was more

commonly reported by women, nonHispanic American Indians/ Alaska Natives (AI/AN), adults with income below the federal poverty level, and adults living in the southern region of the United States. Researchers also found that, in general, adults 65 years of age and older with any disability reported better access to health care compared to younger adults with a disability. However, disability-specific disparities in health care access were common, particularly among young and middle-aged adults. Generally, adults with vision disability reported the least access to health care (i.e. health insurance coverage, usual health care provider, unmet health care need because of cost, and routine check-up within past 12 months) and adults with selfcare disability reported the most access to care. Research on the number of people with disabilities, their characteristics, and their disability-specific differences in health care access might enable health care professionals to address disability-specific barriers( ncbddd/disabilityandhealth/ disability-barriers.html) to health care, ensure inclusivity ( disabilityandhealth/disabilityinclusion.html) of health programs, and improve the health of people with disabilities. Main Findings Disability Findings  Mobility disability was the most common disability, reported by approximately 1 in 7 adults, followed by cognition (1 in 10), independent living (1 in 15), hearing (1 in 17), vision (1 in 21), and self-care (1 in 27).

 Among young adults, cognitive disability (1 in 10) was the most common. Mobility disability was the most common among middle-aged (almost 1 in 5) and older adults (about 1 in 4).  Percentages of adults with disability increased as poverty increased. In fact, mobility disability was nearly 5 times as common among middleaged adults living below the poverty level compared to those whose income was twice the poverty level.  All disability types were most often reported by women, with the exceptions of serious difficulty hearing (most often reported by men) and self-care (equally reported by men and women).  Among adults aged 65 years and older, half of all AI/ANs (54.9%), Hispanics (50.5%), and those who reported that they are “other non-Hispanic race or multi-racial” (49.9%) reported a disability. Health Care Access Findings Researchers looked at the responses, given by people with disabilities, to four health care access questions:  Health insurance coverage;  Usual health care provider;  Receipt of a routine check-up; and  Cost barrier to health care need. They found that, for each disability type, having health insurance coverage, a usual health care provider, and receiving a routine check-up increased with age, while having an unmet health care need because of cost decreased with age. Findings for specific age groups are outlined in the table below:  Percentages of older adults

reporting having health insurance coverage, a usual health care provider, and receipt of a routine check-up in the past 12 months were similar by disability type. Among older adults, unmet health care needs because of cost were most commonly reported by those with self-care disability and least commonly reported by those with serious difficulty hearing.  The lowest percentages of middle-aged adults reporting having health insurance coverage and a usual source of health care were among those with vision disability.  Among middle-aged adults, unmet health care needs because of cost were most commonly reported by those with vision disability and least commonly reported by those with serious difficulty hearing. Receipt of a routine check-up during the past 12 months among middle-aged adults was most often reported by adults with a self-care disability, and least often reported by adults with serious difficulty hearing.  The lowest percentages of young adults reporting having health insurance coverage, a usual health care provider, and a routine check-up in the past 12 months were among those with vision disability.  Receipt of a routine check-up during the past 12 months was most often reported by young adults with a mobility disability. Among young adults, unmet health care needs because of cost were most commonly reported by those with independent living disability and least commonly reported by those with serious difficulty hearing….Read More

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

RI ARA HealthLink Wellness News


Epilepsy Affects People of All Ages, Including Seniors The neurological condition starts more often in old age than in middle age. IF YOU OR A LOVED ONE are experiencing epilepsy for the first time after age 65, you're not alone. Among seniors, epilepsy is one of the top three most common neurological conditions. In fact, epilepsy starts more often in old age than in middle age, reflecting the parallel increase over time of some of its causes – such as stroke, Alzheimer's disease and brain tumors. Epilepsy poses special challenges for seniors. The first may be receiving the correct diagnosis. Gathering a clear description of the epileptic seizures may be difficult for seniors who live alone or in a residential care facility. Even if

the seizures are witnessed or recorded on a smartphone, it may be difficult to recognize the signs, because seizures tend to look different in seniors than in younger people. They may be easily mistaken for other conditions that are common in seniors, such as stroke, dizziness and memory lapses. A neurologist can help uncover the problem and will likely perform an electroencephalogram, or EEG, and a brain MRI. Once epilepsy is diagnosed, the next step is treatment with medication. For seniors, this also raises some special issues. As we age, our liver and kidneys become less efficient at eliminating drugs from the body, and we require lower and more

frequent doses and more careful monitoring for side effects. Seniors with balance problems, fatigue, confusion, slow thinking or tremor may be especially sensitive to drug side effects. It's important to communicate any concerns to your doctor so that the medication can be adjusted as needed to keep side effects at bay. Many seniors experience multiple health challenges at the same time, and this further complicates the epilepsy management. Some seizure medications can aggravate conditions such as kidney stones, thinning of the bones, blood clotting disorders or depression, and care must be taken to choose the best seizure

medication for each individual. In addition, people with multiple conditions usually take multiple medications, each of which must be carefully managed to avoid harmful drug interactions. Close communication with every caregiver on your health care team is the key to early identification and correction of any drug-related problems that may emerge. If seizure control remains imperfect despite everyone's best efforts, you may wish to consult with an epilepsy center to consider whether specialized surgery could be beneficial. The good news is that with careful management, seizures can be completely controlled for most seniors who experience epilepsy.

Vitamin B-3 may treat and prevent acute kidney injury New research suggests that taking vitamin B-3 orally might soon become an effective way to treat or even prevent acute kidney injury. In acute kidney injury, the kidneys suddenly stop functioning — usually as a result of complications during hospitalization. Approximately 10 percent of

adults who are hospitalized in the United States reportedly develop it. Though temporary, the condition can be fatal. In fact, the National Institutes of Health (NIH) say that 9.5 percent of the adults who had the condition in 2013

died as a result. Acute kidney injury occurs when waste products accumulate in the blood and the kidneys struggle to maintain a good balance of fluids in the body. Seniors, people already hospitalized, and patients in intensive care units are particularly vulnerable to the

condition. New research led by Dr. Samir M. Parikh — a kidney specialist at the Beth Israel Deaconess Medical Center (BIDMC) in Boston, MA — suggests that a form of vitamin B-3 may be used to prevent acute kidney injury in vulnerable people….Read More

When to See a Doctor About That Weird Chest Tightness When you suddenly experience chest tightness, it’s easy to jump to the most extreme conclusion: This is it, you’re having a heart attack. But there are plenty of conditions that can make it feel like an elephant’s sitting on your chest, some of which are as serious as a heart attack while others are nowhere near that dire. Here’s some information about what might be causing your chest tightness, plus when you should see a doctor.

In order to know when chest tightness is an emergency, you have to understand a little bit about the conditions most likely to bring on this symptom. Here are some of health issues that often cause chest tightness to alert you that somethings up.  Acid reflux  Asthma  Panic attacks  A collapsed lung

 A pulmonary embolism  A heart attack or angina Again, if you’re healthy and young, it’s unlikely that your chest discomfort is due to a serious heart problem. That doesn’t mean you can just put off persistent chest tightness, though. You should talk to your doctor about chest tightness, no matter how it presents, but there are a

few red flags that you need to seek help immediately. “I always tell people that, no matter what, if you are having chest tightness you need to see your doctor. It’s never really normal,” Dr. Haythe says. Of course, these are loose guidelines. No matter when your chest tightness happens or how intense it feels, seek medical help if you’re concerned. A few of your most important organs are packed in there, so it’s OK to play it safe. ...Read More

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

Genetic Testing for Cancer Lacking for Women on Medicare: Study Testing for gene mutations linked to breast and ovarian cancer is rare among some Medicare patients who have the cancers and qualify for such tests, a new study finds. Researchers analyzed data from 12 southeastern states between 2000 and 2014. Only 8 percent of 92 women who met Medicare criteria for BRCA1 and BRCA2 gene testing received it within five years of their cancer diagnosis, the study found. No patients in Arkansas, Louisiana, Tennessee, Virginia and West Virginia got the tests, according to the study published Aug. 14 in the Journal of the

American Medical Association. Breast cancer patients with BRCA mutations are more likely to develop cancer in a second breast and are also at increased risk for ovarian cancer. Ovarian cancer patients with the gene changes are more likely to get breast cancer. Relatives who also have the mutations also face a higher cancer risk, the Vanderbilt University Medical Center researchers said. "Women who carry one of these mutations but don't know their mutation status are not able

to take advantage of preventive or early detection interventions that we have available, so they miss out on the opportunity to reduce their risk for these cancers and potentially reduce their overall mortality," study author Amy Gross said in a university news release. "They are also not able to inform family members who might be affected," Gross added. She is an epidemiologist at the Vanderbilt Institute for Clinical and Translational Research in Nashville. The study covered a broad age range: More than half of the

women were under age 65 and qualified for Medicare due to disabilities. The researchers said lack of patient interest and physician recommendations might explain the low genetic testing rate. None of the patients had received a doctor referral for genetic counseling, they added. More information The U.S. National Cancer Institute has more on BRCA gene mutations. SOURCE: Vanderbilt University Medical Center, news release, Aug. 14, 2018

Here's a Part of Aging That Really Stinks Unpleasant phantom odors haunt many older Americans, a new study finds. Of more than 7,400 people over age 40 who took part in a federal health survey, 6.5 percent said they experience nasty odors -- such as burning hair or the reek of an ashtray -from nowhere. That's 1 in 15 people. As folks age, their ability to identify odors tends to decrease, but their detection of phantom odors increases. Why this happens is a mystery, but smelling something that isn't really there can be life-changing, the researchers said. "Problems with the sense of smell are often overlooked, despite their importance. They can have a big impact on appetite, food preferences, and the ability to smell danger signals such as fire, gas leaks

and spoiled food," said Judith Cooper. She's acting director of the U.S. National Institute on Deafness and Other Communication Disorders (NIDCD). It led the study. Lead researcher Kathleen Bainbridge said overactive odorsensing cells in the nasal cavity or a malfunction in the brain area that understands odor signals may be involved. The new study lays the groundwork for further research. "A good first step in understanding any medical condition is a clear description of the phenomenon. From there, other researchers may form ideas about where to look further for possible causes and ultimately for ways to prevent or treat the condition," Bainbridge said in an institute news release.

She is an NIDCD epidemiologist. Study co-author Dr. Donald Leopold is a clinical professor of surgery at the University of Vermont Medical Center in Burlington. He said many people who experience strong phantom odors have a poor quality of life. They may also have trouble maintaining a healthy weight. The new research follows a Swedish study that reported 4.9 percent of people older than 60 experienced phantom odors. It said the rate was higher among women than men. This new study found a similar rate among Americans over 60, but an even higher rate among those between 40 and 60. Roughly twice as many women as men reported experiencing phantom odors, and the gender

gap was greatest in the younger group, the NIDCD study found. Besides gender, other risk factors for experiencing phantom odors include head injury, dry mouth, poor overall health, and being poor, the researchers said. They said poor people may have greater exposure to environmental pollutants and toxins, or have health conditions that contribute to the problem, either directly or because of medications they take. The study was published Aug. 16 in the journal JAMA Otolaryngology-Head and Neck Surgery. More information The U.S. National Institute on Deafness and Other Communication Disorders has more on smell disorders.

Don't sleep in your contact lenses. Here's why. One man wore his contact lenses overnight while hunting. He ended up needing a corneal transplant to save his eye. Ditto for another man who did not bother to take his lenses out for two weeks.

Two teenagers who remind people not to slept in their lenses — sleep in their contact bought without lenses, and they put prescriptions — ended together six grisly stories up with permanent scarring. to demonstrate why. The Centers for Disease "Sleeping in contact lenses is Control and Prevention wants to one of the most frequently

reported contact lens risk behaviors and one with a high relative risk for corneal infection," the team wrote in CDC's weekly report...Read More

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

Profile for RI ARA

RI ARA August , 2018 E-Newsletter  

RI ARA August , 2018 E-Newsletter  

Profile for riara0