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Affiliated with the Rhode Island AFL-CIO “Fighting for the future of our members.” “NOW, more than ever!!!” All Rights Reserved RI ARA 2018©

Publication 2018 Issue 46 Published in house by the RI ARA

November 18, 2018 E-Newsletter

Midterm Elections: House Democrats Gain Ground with Retirees Democrats gained control of the U.S. House of Representatives in the midterm elections Rich Tuesday, with Fiesta Republicans retaining control of the Senate. As of early Friday, Democrats had flipped 31 House seats, with more gains possible. Several House and Senate races had yet to be called. More than 47% of eligible voters turned out to cast a ballot, the highest number in a midterm election since 1966. Fifty-six percent of the electorate was comprised of

voters over 50, and older voters shifted their votes significantly toward the House Democrats. 49% of voters over 65 cast ballots for the Democrat for the House and 50% for Republicans, an increase of 8% for Democrats over 2014, according to national exit polls. The exit polls showed that health care was a main issue on voters’ minds this year. Older voters crossed traditional party lines to vote for candidates who supported retirement security and health care. Senate Majority Leader Mitch McConnell had said he would try again to repeal

the Affordable Care Act after the elections, but Democrats’ winning the House appears to have stalled that effort. McConnell had also announced that he would seek cuts to Social Security, Medicare, and Medicaid to pay pay for the deficit created by the tax scam, a notion voters rejected. Democrats captured governorships in seven formerly Republican-held states and 323 Republican-held legislative seats across the country. This shift will be important when congressional districts are redrawn following the 2020 census. Ballot measures

in Idaho, Utah and Nebraska to expand Medicaid passed, increasing access to affordable health care for over 320,000 Americans. “For the last two years we’ve seen unprecedented political engagement by retirees, with more attending candidate events and rallies, contacting their representatives, and donating to candidates,” said Alliance Executive Director Richard Fiesta. “Now we must go to work to bring drug prices down, expand Social Security and make health care more accessible and affordable.”

Study Shows How 401(k) Accounts Contribute to Income Inequality New evidence shows that the design features of the nation’s retirement income security system perpetuate and worsen inequality. Gayle Resnik from the Social Security Administration (SSA), Stevens Institute of Technology professor Joelle Saad-Lessler and retirement expert Teresa Ghilarducci published an article recently in the Social

Security Bulletin about inequality during Americans’ life courses that again show 401(k)– type accounts to be more favorable to higher income people with stable jobs and lives. Among the findings: lower earners experienced more weeks of non-employment during the period studied (2009–2011) and more years with earnings losses of 10 percent or more in their

lifetime. Second, lower earners had less diversified retirement account portfolios. Third, higher earners had higher defined contribution plan employee and employer contribution rates than lower earners. “Time and again, we see that 401(k) plans cannot match defined benefit pensions when it comes to providing a stable retirement,” said Joseph Peters,

Jr., Secr etar yTreasurer of the Alliance. “Lowerincome people are more likely to face Joseph unemployment, Peters, Jr. and their employers often do not contribute what they need to live comfortably in their golden years.”

One in Three Americans Aged 58 Have Zero Retirement Savings More than onethird of baby boomers had no money saved for retirement at age Robert Roach, Jr 58, according to a new report fr om Stanford University. On average, they're more than $110,000 in the red, a burden more than 50% higher than the amount carried by people born in the 1930s. A third of people over 65 are still paying off a mortgage, and

more than 2.8 million people over 60 are straddled with student debt. Health care costs have skyrocketed for older Americans, amounting to 40% of the average Social Security income in 2013. Meanwhile, just over 50% of older wor ker s ar e ineligible or were not offered a work retirement savings plan, making saving enough even more difficult. Such a large number of older workers retiring while

unprepared financially could have drastic consequences for the generation and society as a whole. Running out of financial resources near the end of life could force seniors to rely on their children, exacerbating the problem for generations to come. Many workers try to work longer in order to make up for the savings gap, but some are forced into retirement due to other factors such as health considerations or age

discrimination. “As our leaders strive to expand Social Security, we must strengthen and protect our existing benefits so that the burden of saving for retirement isn’t so cumbersome,” said Alliance President Robert Roach, Jr. “We must also fully fund pension plans. Hopefully the results of Tuesday’s elections will help make all that happen.”

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

Guidance for Advocates to Help People Move from Expansion Medicaid to Medicare Last week, the Medicare Rights Center and the National Council on Aging (NCOA) released a new resource on the expansion Medicaid-toMedicare transition process. Our Expansion Medicaid Transitions Guide is designed, in part, to help advocates learn about their state’s transition process and better assist clients when they need to switch from expansion Medicaid to Medicare. The guide includes terminology, an overview of select state processes, and some troubleshooting steps advocates can consider when encountering problems. The Affordable Care Act (ACA) gave states the option to expand their Medicaid programs to cover low-income adults aged 19-64. To date, 34 states and the District of Columbia have officially expanded their programs, and voters in three states—Idaho, Nebraska, and Utah—recently approved ballot initiatives to do. Expansion

Medicaid rules explicitly forbid individuals from being enrolled in both this form of Medicaid and Medicare. This means that as a person becomes Medicare eligible, they lose their eligibility for expansion Medicaid and must leave that program and enroll in Medicare. Advocates in many states report problems with helping people make this transition. Some states have relatively seamless processes while others do little to smooth the way. Inadequate state efforts to facilitate these transitions can leave people confused and, in the worst scenarios, in a coverage gap or with premiums or cost sharing they cannot afford. Given inconsistent state involvement and the high stakes for enrollees, help for advocates is long overdue. This new guide is a continuation of an earlier issue brief from Medicare Rights and NCOA, “Toward Seamless

Coverage: Expansion Medicaid to Medicare Transitions,” which laid out many of the problems people with expansion Medicaid and their advocates can face in understanding these transitions. The difficulties in moving into Medicare from expansion Medicaid are just one example of the many issues people can encounter as they approach Medicare eligibility. The rules and timing for enrolling in Medicare are surprisingly complex and can result in people missing their enrollment windows, having coverage gaps, or facing a lifetime of late enrollment penalties. Since thousands of people become eligible for Medicare every day, this means the number of people at risk for confusion and mistakes is growing. In addition to developing resources like the advocates guide, Medicare Rights supports efforts to address the challenges

created by Medicare’s complex enrollment rules through legislative solutions, like the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act. This commonsense legislation would empower beneficiaries to make optimal enrollment choices, while modernizing and simplifying the process itself. We also support adequately funding community-based organizations that provide outreach and benefits enrollment assistance to lowincome Medicare beneficiaries and State Health Insurance Assistance Programs (SHIPs) that provide one-onone counseling to help people make informed Medicare coverage choices. Read the new Expansion Medicaid Transitions Guide. Read our issue brief Toward Seamless Coverage.

Seniors Voted to Protect & Expand Social Security, Medicare, and Medicaid During this election cycle, Social Security Works PAC endorsed 75 candidates, all of whom support expanding Social Security, Medicare, and Medicaid along with taking on big pharma to bring down the outrageous cost of prescription drugs. The vast majority of these candidates are Democrats

in tight races, many of whom have already declared victory tonight. Jon “Bowzer” Bauman of Sha Na Na fame, President of Social Security Works PAC, held 57 in-person endorsement events across the country. Below is a statement from Bauman in response to the news

that Democrats have won a majority of seats in the House of Representatives: “Tonight, nearly half of seniors supported Democrats, voting to protect and expand Social Security, Medicare, and Medicaid. That is a massive shift from the 2014 midterms, when older

voters overwhelmingly backed Republicans. This election presented the clearest contrast between the two parties in decades, with Democrats united in support of expanding benefits while Republicans used their $2 trillion tax handout to the wealthy as an excuse to demand cuts.”

2018 ARA National Membership Meeting in Las Vegas, NV. Delegates from Connecticut and Massachusetts join RI ARA Vice-president Roger Boudreau who represents the New England region on the ARA national Executive Board. The three-day membership meeting focused on post-election planning for legislative action on Medicare and Medicaid, as well as protecting and expanding Social Security. Protecting pensions and intergenerational communication were addressed in plenary sessions. Delegates were also treated to a luncheon keynote speaker, NFL Players Association Nolan Harrison, Senior Director of Former Player Services. The New England caucus also met over lunch to discuss ways to expand and strengthen the chapters in our region. Two very important resolutions that were submitted by the New England Regional Chapters, were passed 1. Resolution Opposing the Government Pension Offset and Windfall Elimination Provision 2. RESOLUTION WITH RESPECT TO ACCESSIBILITY AND THE INFRASTRUCTURE on behalf of the Citizens Coalition for Equal Access Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

Trumpeted New Medicare Advantage Benefits Will Be Hard For Seniors To Find For some older adults, private Medicare Advantage plans next year will offer a host of new benefits, such as transportation to medical appointments, homedelivered meals, wheelchair ramps, bathroom grab bars or air conditioners for asthma sufferers. But the new benefits will not be widely available, and they won’t be easy to find. Of the 3,700 plans across the country next year, only 273 in 21 states will offer at least one. About 7 percent of Advantage members — 1.5 million people — will have access, Medicare officials estimate. That means even for the savviest shoppers it will be a challenge to figure out which plans offer the new benefits and who qualifies for them. Medicare officials have touted the expansion as historic and an innovative way to keep seniors healthy and independent. Despite that enthusiasm, a full listing of the new services is not available on the web-based “Medicare Plan Finder,” the gover nment tool used by beneficiaries, counselors and insurance agents to sort through dozens of plan options. Even if people sign up for those plans, they won’t all be eligible for all the benefits. Advantage members will need a recommendation from a health care provider in the plan’s network. Then they may need to have a certain chronic health problem, a recent hospitalization or meet other eligibility requirements. Medicare counselors from California to Maine say key details are not included on the government’s website. In some cases, if insurers offer the new benefits, the plan finder “will indicate ‘yes’ or ‘no,'” said Georgia Gerdes a health care choices specialist at AgeOptions, the Area Agency on Aging in Oak Park, Ill., outside Chicago. That’s hardly enough, she said. “There is a lot of information

on the plan finder, but there is a lot of information missing that requires beneficiaries to do more research,” said Deb McFarland, Medicare services program supervisor at the Southern Maine Agency on Aging. Nonetheless, officials say the added benefits will help Advantage members prevent costly hospitalizations. Federal approval of additional benefits is “one of the most significant changes made to the Medicare program,” Seema Verma, the head of the Centers for Medicare & Medicaid Services, told an insurers’ meeting last month. She said she expects plans to expand services in coming years. Medicare Advantage plans, which are an alternative to traditional Medicare, serve 21 million beneficiaries and limit their out-of-pocket expenses. But they also restrict members to a network of doctors, hospitals and other medical providers. They often offer benefits not available in traditional Medicare, such as dental and vision care, hearing aids and gym memberships. The federal government pays a set amount to the plans to help cover the cost of each member. The Trump administration gave insurers more money to spend on benefits next year — an average pay raise of 3.4 percent, seven times more than the rate of increase in 2018. Enrollment is underway for Medicare Advantage plans, as well as for people in traditional Medicare who want to buy a policy for drug coverage. The deadline for choosing either type of plan is Dec. 7. Among the new benefits that some Medicare Advantage plans said they will offer are:  Trips to the pharmacy or fitness center in addition to doctor’s appointments for plan members, depending on where they live or their health

conditions.  A monthly or quarterly allowance for over-the-counter pharmacy products such as cold and allergy medications, eye drops, vitamins, supplements and compression stockings.  House calls by doctors or other health care providers, under certain conditions.  A home health care aide for a limited number of hours to help with dressing, eating and other daily activities, possibly including household chores and light housekeeping. However, plans offering these and other services will likely have only some of the options and will have different eligibility criteria and other limitations. The same services likely won’t be available in every county the plan serves. For example, next year an estimated 150,000 Humana Medicare Advantage members in Texas and South Florida — two of the 43 states Humana serves — who cannot be left alone at home will be able to get a free in-home personal care aide for up to 42 hours a year, so that their regular caregiver can get a break. And more than half of the members in Cigna-HealthSpring Advantage plans will have access to free transportation services in all but five of the 16 states and the District of Columbia where the company sells coverage. To find these supplemental benefits, seniors can use the online plan finder. After they enter their ZIP code and get a list of plans available locally, they can click on a plan name. That will take them to another page that offers more details about coverage, including a tab for health and drug plan benefits. That page might say whether the new services are offered. But often the website will simply indicate that specific benefits are available — and

perhaps not name them — and advise consumers to contact the plan for more information. A Medicare spokesperson confirmed that there is currently not an indicator on the plan finder for plans offering these expanded health-related supplemental benefits. In addition to extra benefits, other variables should be considered when choosing an Advantage plan, such as which health care providers and pharmacies participate in a plan’s network, which drugs are covered and the costs. Where available, several insurers say the new services will be free with no increase in monthly premiums. “We certainly believe that all of the ancillary benefits we provide will help keep our members healthy, which is good for them, and it’s good for us in the long run,” said Steve Warner, head of the Medicare Advantage product team at UnitedHealthcare, which insures about 5 million seniors or 1 in 4 Medicare Advantage members. Insurers are betting that services will eventually pay for themselves. Dawn Maroney, consumer president at Alignment Healthcare, which serves eight counties in Southern California, said it’s much cheaper to give an air conditioner to someone with congestive heart failure to keep that patient healthy than to pay for more expensive medical treatment. But if the new benefits are such a good idea, they should be available to the majority of older adults in traditional Medicare, said David Lipschutz, a senior policy attorney at the Center for Medicare Advocacy.

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

What the Midterm Elections Mean for Medicare, Medicaid, and the ACA 2018 midterm elections mean big changes are coming to Washington. When the 116th Congress convenes in January, it will be a divided one: Republicans will continue to control the Senate, but Democrats will have a majority in the House of Representatives for the first time in eight years. With split-party control, any legislation will require bipartisan support in order to pass. The need for such consensus greatly decreases the likelihood that radical, disruptive bills will reach the President’s desk in the coming years, and effectively eliminates the acute threats to Medicare, Medicaid, and the Affordable Care Act (ACA) that have dominated congressional conversations since 2017. With efforts to repeal the ACA, overhaul Medicare, and restructure Medicaid temporarily off the table—what does the future hold for these programs? Below, we outline our top takeaways from the midterms and our predictions for the 116th Congress: Medicare Prescription Drug Prices Addressing the high cost of prescription drugs for people with Medicare is a likely priority for the next Congress. It’s been a

key issue for both parties throughout 2018, and skyrocketing costs remain a top concern for many Americans. House Democrats are expected to work to build consensus for a legislative package. In the Senate, Chuck Grassley (R-IA) —an architect of Medicare Part D—is the favorite to lead the committee with jurisdiction over these issues, taking over from retiring Sen. Orrin Hatch (RUT). As these debates and decisions unfold, both chambers may position themselves to consider a range of sweeping changes to the current system. However, any eventual bipartisan, bicameral agreement would likely be relatively modest in scope and impact. Medicare Coverage Expansions Whether Democrats in either chamber will move forward with various “Medicare for All” proposals or seek more modest Medicare coverage expansions— or pursue a combination of the two—is not yet clear. In the House, the new Democratic majority may seek to reintroduce legislation that would improve Medicare by filling coverage

gaps and reducing costs for beneficiaries. Legislation championed by retiring Rep. Sander Levin (D-MI) that would expand the Medicare benefit package to include dental, vision, and hearing care could serve as a guide, as could efforts to improve affordability by imposing an out-of-pocket cap in Original Medicare and expanding eligibility for Medicare Savings Programs. ACA Stabilization With Democrats in control of the House of Representatives, the lower chamber is expected to focus on opportunities to stabilize the ACA. Recent legislation from Reps. Richard Neal (MA), Frank Pallone (NJ), and Bobby Scott (VA)—leading Democrats on the House health care committees—is a likely starting point. That bill would roll back recent Trump Administration changes, encourage state outreach and coverage expansions, and make coverage more affordable. Medicaid Expansion Voters in Idaho, Utah, and Nebraska approved ballot initiatives for Medicaid expansion, making an additional

363,000 low-income people eligible for the program next year. These states had previously declined to extend Medicaid coverage to adults earning up to 138% of the federal poverty level, as envisioned in the ACA. Medicaid expansion is also likely to move forward in Maine, as Democrat Janet Mills will take over for outgoing Gov. Paul LePage, who fought to block the voter-approved expansion. Looking ahead, Wisconsin and Kansas—two other Republicanled states that have resisted Medicaid expansion to date— may soon be more open to it, as Democrats won those gubernatorial races on Tuesday. While January will usher in new lawmakers with new priorities, the current Congress returns next week for the lame duck session. We anticipate a busy agenda in November and December, as Republicans look to take advantage of their timelimited House and Senate majorities, and outgoing lawmakers work to pass longstanding priorities. Throughout the upcoming session and beyond, Medicare Rights will continue to advance policies and identify opportunities to strengthen and improve Medicare.

What Is Assisted Living? What to know about this longterm care solution that could help you retain your independence longer. FOR MANY OLDER ADULTS, advancing age means they'll face a time when living alone is no longer feasible. Certain aspects of daily living become more challenging, and if you find that you often need assistance to do things like caring for your home and yourself, it might be time to consider moving into an assisted living facility. But what does that mean and what can you expect? Here, we explore the basics of

what you need to know about assisted living facilities and how they can help older adults with difficult tasks while offering social contact and activities that stimulate and support. What does assisted living mean? Depending on the state and the individual facility, assisted living can mean different things and it may go by other names such as residential care settings or personal care homes. By-andlarge, the concept of assisted

living is simply that: Older adults move to a facility where they can receive assistance with the daily tasks of living. These facilities can be large or small, privately owned or corporate, not-for-profit or forprofit, but they all offer some level of care or assistance to older adults who are unable to manage the tasks of living on their own, such as cooking, bathing or toileting. A Place for Mom, a senior care referral service based in Seattle, reports that "an assisted living

residence is a long-term senior care option that provides personal care support services such as meals, medication management, bathing, dressing and transportation." The National Center for Assisted Living reports that "there are 30,200 assisted living communities with 1 million licensed beds in the United States today. The number of licensed beds within a community range from 4 to 499, and the average number of licensed beds is 33." Each state has its own regulatory agency that handles licensing of these facilities….Read More

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

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Untreated Hearing Loss Can Be Costly for Seniors Having hearing loss and not knowing it might translate into higher medical bills and other health problems for many seniors, two new studies suggest. In one study, researchers analyzed data from more than 77,000 U.S. patients with untreated age-related hearing loss, and compared them to people without hearing loss. Among the patients with hearing loss, average total health care costs were 46 percent higher over 10 years. That amounted to more than $22,000 per person, with about $20,000 of that amount paid by a health plan and $2,000 in out-of-pocket costs for each patient. Only about $600 of that $22,000 was due solely to hearing loss-related care, the findings showed. The study also found that over 10 years, patients with untreated

hearing loss had 50 percent more hospital stays and a 44 percent higher risk for hospital readmission within 30 days. They were also 17 percent more likely to have an emergency department visit, and had 52 more outpatient visits compared to those without hearing loss. "Knowing that untreated hearing loss dramatically drives up health care utilization and costs will hopefully be a call to action among health systems and insurers to find ways to better serve these patients," said study leader Nicholas Reed, who's with Johns Hopkins' Cochlear Center for Hearing and Public Health. The study by Reed and his colleagues didn't reveal why untreated hearing loss is associated with greater use of health care services, but a second

study shows that these patients are more likely to have other serious health issues. Over 10 years, patients with untreated hearing loss had a 50 percent greater risk of dementia, a 40 percent greater risk of depression, and an almost 30 percent higher risk for falls than those without hearing loss, the second study found. "We don't yet know if treating hearing loss could help prevent these problems," said study author Jennifer Deal, an assistant scientist in the Johns Hopkins Bloomberg School of Public Health's department of epidemiology. "But it's important for us to figure out, because over twothirds of adults age 70 years and older have clinically significant hearing loss that may impact

everyday quality of life," she added in a Hopkins news release. "We need to better understand these relationships to determine if treatment for hearing loss could potentially reduce risk and help maintain health in older adults," Deal added. However, the studies did not prove that hearing loss causes other health problems. The studies were published Nov. 8 in JAMA Otolaryngology -Head and Neck Surgery. Hearing loss affects 38 million Americans, and that number is expected to double by 2060. Hearing loss affects one-third of Americans aged 65 to 74, and two-thirds of those 70 and older have clinically significant hearing loss, according to background information in the news release.

New guidelines suggest a 'lifespan approach' to battle high cholesterol Doctors should look beyond typical risk factors for high cholesterol, creating detailed personal plans for individuals to examine risks early, suggest new guidelines published Saturday. The guidelines, available in the journal Circulation, say health factors such as family history should be taken into account when examining a person's risk for high cholesterol. The guidelines for treating high cholesterol, which affects nearly one in three American adults, were pulled together by experts from the American Heart Association and 11 other health organizations. Experts suggest a "lifespan approach" to treating cholesterol, said Dr. Sarah D. de Ferranti, chief of outpatient cardiology and director of preventive cardiology at

Harvard Medical School's Boston Children's Hospital, in a statement. The guidelines suggest doctors consider screening for kids as young as two years old with a family history of early heart disease and high cholesterol. "It's important that, even at a young age, people are following a heart-healthy lifestyle and understanding and maintaining healthy cholesterol levels," said de Ferranti. For younger people, guidelines advise doctors emphasize healthier lifestyles and maintaining the right weight to keep their cholesterol in check. For people 40 and older without heart disease, doctors should discuss taking statins — drugs which help control cholesterol levels — based on

their risk. "The truth about clinical medicine is there is no black and white. It's all gray," said Dr. Donald Lloyd-Jones, a writing committee member and chair of the department of preventive medicine at Northwestern University in Chicago, in a statement. "That's why the emphasis in this document is making sure the patient and doctor are having well-informed discussions about the benefits and the potential risks of drug therapy." According to the AHA, the optimal level of LDL, or "bad" cholesterol, is less than 100 mg/dL. The last time the AHA and American College of Cardiology updated their guidelines was 2013, which made twice as many Americans

eligible to take statins. A week after those guidelines were published, two Harvard Medical School professors questioned whether formulas used to determine high cholesterol might overestimate people's risk. Dr. Steven Nissen, chairman of the department of cardiovascular medicine at The Cleveland Clinic and critic of the 2013 guidelines said the latest revisions represent a "great improvement" over the guidelines issued five years ago. Nissen said the key additions include thresholds for treating patients with high cholesterol, and better guidance for treating people over 75 years old and under 40. "It’s much more in line with what a lot of us think should have been done in 2013," he said.

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

Cancer surpasses heart disease as leading cause of death in many US counties An important transition is happening across the United States: Cancer was the leading cause of death in more counties in 2015 than 13 years earlier, a new study finds. However, the opposite was true for heart disease during that period; fewer counties reported it as the top killer. In fact, cancer will replace heart disease as the leading cause of death in the United States within two years, according to US Centers for Disease Control and Prevention projectionsreferenced in the study, published Monday in the medical journal Annals of

Internal Medicine. "We're just on the cusp of the transition from heart disease to cancer as the leading cause of death," said Dr. Latha Palaniappan, lead author of the study and an internist, professor and clinical researcher at Stanford University Medical Center. Shifts in socioeconomic, ethnic groups A decadesold theory described a shift that occurred in health and disease patterns in the United States during the last century. Early in the 100-year period, infectious diseases including tuberculosis,

diphtheria and flu took more American lives than other illnesses. Yet by the end of the century, chronic diseases, including heart disease and cancer, had become the leading cause of death. The theory described these complex patterns and suggested that such shifts stemmed from economic and social conditions. Recent data suggests that the nation is experiencing a new transition, this time within the chronic disease category itself. To understand these changes, Stanford Medical School researchers examined more than

32 million death records across 3,143 American counties for 2003 through 2015. The research team looked not only at medical information but at demographic data, including income and race. Over the 13-year study period, the mortality rate decreased in the total population by 12%, from about 823 deaths per every 100,000 people to roughly 724 deaths per 100,000. In more than three-quarters of all counties (79%), heart disease was the leading cause of death in 2003, yet this remained true for only 59% of counties in 2015….Read More

Blood pressure drug recall expands again The US Food and Drug Administration says another heart medicine is being voluntarily recalled after tests showed that it was tainted with a potential cancer-causing chemical. The recall includes one lot of Sandoz's losartan potassium hydrochlorot hiazide 100 milligram/25 milligram tablets with the lot number JB8912. Patients use these drugs to keep their high blood pressure in check. The drug is being recalled because the active ingredient has tested positive for NNitrosodiethylamine or NDEA, a suspected human and animal carcinogen that is used in gasoline as a stabilizer for industry materials and as a lubricant additive, according to the National Institutes of Health.

The ingredient was made by Zhejiang Huahai Pharmaceutical Company Co. Ltd. The FDA placed the Chinese company on an import alert at the end of September, meaning all of its active pharmaceutical products and finished products will not be permitted to enter the United States. The FDA made that decision after an inspection of the facility. Several pills that contain valsartan, another drug used by heart patients, have been under a recall since July. The drugs were tainted with NDEA or NDMA, Nnitrosodimethylamine, an impurity that is also considered a possible carcinogen by the US Environmental Protection Agency. NDMA is an organic chemical

used to make liquid rocket fuel and is a byproduct of manufacturing some pesticides and processing fish. It can be unintentionally introduced into manufacturing through certain chemical reactions. The FDA is testing all heart drugs known as ARBs for these impurities. Not all medicine containing valsartan is recalled. The FDA keeps an ongoing list of products that are recalled and a list of the valsartan products that are not recalled. The latest recall impacts less than 1% of the total losartan drug products in the US market, according to the FDA. If your drug is on the recall list, the FDA suggests taking it until your doctor or pharmacist provides a replacement. Because

not all valsartan and irbesartan drugs are involved in the recall, you might be able to switch to a version by another company. It's unclear exactly what the cancer risk is if you take the contaminated valsartan pills; the FDA believed that the risk was low with the valsartan recall. It estimated that if 8,000 people took the highest dose of valsartan (320 milligrams) containing NDMA from these recalled batches daily for four years, there may be one additional case of cancer over the lifetimes of 8,000 people. Many patients take a much lower dose of valsartan, and therefore their risks are theoretically much lower. The FDA said it will continue to test all products containing valsartan and similar drugs for the presence of impurities.

Safely enjoy your Thanksgiving Meal

CDC: Don’t let a pesky salmonella scare keep you from your Thanksgiving turkey Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

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RI ARA November 18, 2018 E-Newsletter  

RI ARA November 18, 2018 E-Newsletter  

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