Page 1


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 41 Published in house by the RI ARA

October 14, 2018 E-Newsletter

Nominee for Social Security Administration Commissioner Falls Far Short The President recently nominated Andrew Saul to serve as Commissioner of the Social Security Administration (SSA), a role that has been filled by Acting Commissioner Carolyn Colvin since 2013. At his hearing before the Senate Finance Committee yesterday, Saul left open the option of closing more Social Security field offices and replacing more in-person contact with their website.

During Saul’s confirmation hearing, Senator Ron Wyden (OR) asked him if he would commit to “maintaining the field office option” for seniors who need or want to meet with an actual person. Saul replied that before decisions are made regarding field offices, he will “understand what the conditions are in that locale,” avoiding a clear answer. Saul served as the chairman of the Federal Retirement Thrift

Investment Board, but lacks a background in Social Security. He used to serve on the board of the Manhattan Institute, a rightwing think tank. The Manhattan Institute is known for their position advocating for drastic cuts to Social Security, saying that current benefits are “too generous.” Saul was forced to drop out of a New York congressional race in 2007 for taking questionable campaign donations.

“Andrew Saul’s background simply does not make him fit to serve as the Rich Fiesta Social Security Administration Commissioner,” said Richard Fiesta, Executive Director of the Alliance. “Having a commissioner who will defend Social Security from dangerous cuts and provide for beneficiaries must be our priority.”

President Stretches Truth to its Breaking Point in Medicare Op-Ed “Medicare for All” would Reduce Health Care Costs Overall Statement from Richard Fiesta, Executive Director of the Alliance for Retired Americans, in response to Donald Trump’s Wednesday USA Today op-ed: “President Trump’s op-ed published in USA Today is factually incorrect on multiple levels. While attacking the idea of Medicare for All, he falsely claims that Democrats are to blame for cuts to this important program. In fact, Medicare’s solvency was extended and benefits were expanded as part of the Affordable Care Act

(ACA). “The reality is that this administration and a Republican-controlled Congress are taking aim at Medicare to cover the whopping deficits created by the 2017 Tax Scam. White House economic advisor Larry Kudlow on September 17, 2018 plainly stated that so-called “entitlement” spending, code for Medicare and Social Security, would be cut in 2019. “The President also claims that he would protect patients with pre-existing conditions and work to lower health insurance premiums. In fact, he has done

the opposite. Rather than opposing the lawsuit brought by GOP attorneys general seeking to end those protections specified in the Affordable Care Act, the Trump administration declined to defend the law in court. Health insurance premiums are on the rise, and credible experts agree that sabotaging the ACA directly adds to the cost increases. Seniors receive annual wellness exams and preventive screenings for diseases such as colorectal cancer, diabetes and many others without co-pays or deductibles, and prescription drug discounts, because of the ACA.

“The claim that Medicare for All will hurt seniors is simply untrue. Current versions of the Medicare for All bills include important new benefits for seniors, such as vision, dental and hearing coverage. They would also lower the cost of premiums and deductibles, lessening the financial burden that health care can bring to older Americans. “President Trump has not defended or protected Medicare. Older Americans have good reason to be concerned about the future of Medicare if his advisors have their way, not if Medicare for All

No More Secrets: Congress Bans Pharmacist ‘Gag Orders’ On Drug Prices

For years, most pharmacists couldn’t give customers even a clue about an easy way to save money on prescription drugs. But the restraints are coming off. When the cash price for a prescription is less than what you would pay using your insurance plan, pharmacists will no longer have to keep that a secret. President Donald Trump was

expected to sign two bills Wednesday that ban “gag order” clauses in contracts between pharmacies and insurance companies or pharmacy benefit managers — those firms that negotiate prices for employers and insurers with drugstores and drugmakers. Such provisions prohibit pharmacists

from telling customers when they can save money by paying the pharmacy’s lower cash price instead of the price negotiated by their insurance plan. The bills — one for Medicare and Medicare Advantage beneficiaries and another for commercial

employer-based and individual policies— were passed by Congress in nearly unanimous votes last month. A spokesman for Sen. Susan Collins (R-Maine) said her office had been told the president would sign the bills Wednesday. The White House declined to comment….Read More

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

Why Social Security’s annual increase doesn’t actually keep up with cost of living Social Security recipients are losing ground financially, despite receiving an annual cost-of-living (COLA) increase. On Oct. 11, the Bureau of Labor Statistics will release inflation data that determines how much more Social Security beneficiaries will receive in 2019. That adjustment is pegged, by law, to the cost-of-living increase for households for whom half or more of their income comes from clerical work or hourly wages. It not only excludes households of unemployed, self-employed, part-time, professional and salaried workers, but also — crucially for seniors — households with no one in the labor force, which includes retirees.” Senior Citizens League analyst Mary Johnson estimates that next year’s increase for will be roughly 3 percent. The Motley Fool predicts an even lower adjustment of 2.7 percent. Social Security benefits have lost 34 percent of buying power since 2000, according to a study released earlier this year by The Senior Citizens League. And in the past year alone, Social Security recipients fell 4 percent behind the rise in their actual cost of living, according to Johnson. “The loss occurred even though beneficiaries received a 2Second, with the baby boom, seniors will have the numbers. percent annual cost-of-living adjustment (COLA) for 2018,” she As you can see in the graphic below, the baby boomers who explained. are now aged 54 to 72 (highlighted in yellow) are some 70 The main culprit? Medical expenses. million strong, and, of course, those below age 18 (red line) More than half of the 1,057 respondents who participated in the are not eligible to vote. annual Senior Citizens League study reported that “their monthly expenses went up by more than $79. Yet 50 percent of survey respondents said that their COLA increased their benefits less than $5 per month, after the increased [Medicare] Part B premium for 2018 was deducted from their Social Security benefits,” the study Second, with the baby boom, seniors will have the numbers. As you can see in the graphic below, the baby boomers who are now aged 54 to 72 (highlighted in yellow) are some 70 million strong, and, of course, those below age 18 (red line) are not eligible to vote. said. Most of the 59 million Americans who receive Social Security depend on it for at least 50 percent of their total income, according to the study. One third rely on it for 90 percent or more. But can this trend possibly continue? Won’t seniors, with budgets falling further and further behind inflation, raise a ruckus? Probably. And remember two things about U.S. politics and seniors.

First, seniors vote at a much higher rate than the population as a whole.

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

CMS Extends Important Relief Opportunity, Creates Permanent Fix for those Affected The Centers for Medicare & Medicaid Services (CMS) recently announced a year-long extension, through September 30, 2019, of a critical relief pathway for current and former Marketplace enrollees who mistakenly delayed Medicare enrollment. The agency also agreed to develop a more permanent solution for people who are affected. Under this policy, people who are eligible for Medicare and have Marketplace coverage can apply to enroll in Medicare Part B without penalty. Those who have already transitioned to Medicare can request that any Part B late enrollment penalties they may have received be reduced or eliminated. The year-long extension is

welcome news to those who are eligible but have not yet learned about or successfully accessed this opportunity, as well as those who are currently relying on incomplete or inaccurate federal materials to understand how the Marketplaces and Medicare interact and make an informed enrollment choice. Importantly, CMS’s decision to clarify that there is no time limit on the availability of equitable relief for those who are eligible will allow those affected to apply for that relief at any point in the future. As recently discussed, the Medicare Rights Center recently joined nearly 80 national and state organizations in urging

CMS to take these steps. We applaud the agency’s decision to heed the call of consumer advocates, insurers, and health care providers who agreed these changes were necessary to improve the health and economic security of people with Medicare and their families. Medicare Rights looks forward to working with our agency partners, State Health Insurance Assistance Programs (SHIPs), local Social Security Offices, and others to help people access this critical relief. For more information about equitable relief for Marketplace enrollees and how to apply, see Medicare Rights’ online resource, Medicare Interactive,

and: Read the  Fact Sheet updated by CMS  Read the Social Security Agency’s Emergency Message reflecting these policy changes  Call the Medicare Rights Center’s free national helpline at 1-800-333-4114  Call the State Health Insurance Assistance Program (SHIP) at 1-877839-2675 or visit the  Contact the Social Security Administration at 1-800-7721213, or go to, or visit your local Social Security office.

Responding to Advocates, CMS Makes Needed Changes to the 2019 Medicare & You Handbook This summer, the Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees the Medicare program, released a draft version of the annual “Medicare & You” Handbook that contained several glaring inaccuracies that alarmed advocates, including Medicare Rights. The agency recently released the final 2019 Handbook, which addresses many of our concerns. The handbook is an official government publication that is designed to provide people with Medicare with information about the Medicare program, their choices for obtaining coverage, and the benefits they can expect. Distributed to millions of homes each year, it is one of CMS’s most widely accessed resources among people with Medicare. In response to the draft Handbook, in May Medicare Rights joined the Center for Medicare Advocacy and Justice in

Aging to send a letter to CMS to point out our observed inaccuracies and request vital edits to ensure the information in the Handbook remains useful and objective. Importantly, the letter highlighted specific areas where the Handbook improperly promoted Medicare Advantage (MA) while downplaying the benefits of traditional Medicare. Our three organizations were invited to discuss the issue further with CMS and the resulting finalized 2019 Handbook is a significant improvement over the draft. This week, Medicare Rights, the Center for Medicare in Advocacy, and Justice in Aging sent another letter to CMS, this time expressing our thanks to the agency for its responsiveness to our concerns and for correcting the draft’s most serious errors in the final version.

We particularly appreciate CMS including in the final 2019 Handbook a revised comparison chart that more accurately outlines the differences between traditional Medicare and MA, in part by clarifying that access to providers is one of the most significant differences between the two coverage options. We also appreciate the agency removing several references in the draft that inaccurately cast prior authorization requirements in MA as an added benefit, rather than a utilization management tool that can hinder MA members’ access to services. We thank the agency for correcting these and other provisions, and for publishing a revised, more accurate Handbook. Doing so will put beneficiaries and those who help them navigate Medicare in a

better position to understand their options and make the best coverage decisions for their unique situations. While more can be done to improve future versions of the Handbook and other CMS materials on which people with Medicare rely, the revised 2019 Handbook is a strong first step. We look forward to continuing to work with our organizational partners and with CMS to ensure all of the agency’s communications to beneficiaries best achieve balance and objectivity, make Medicare understandable, and maximally support beneficiary decisionmaking.  Read more about our original concerns with the “Medicare & You” Handbook.  Read our thank you letter to CMS as a response to the changes to “Medicare & You.”

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

Congress Eyes Giving the Pharmaceutical Industry a Gift after the Elections The pharmaceutical industry is lobbying Congress in hopes of receiving a $4 billion windfall in the lame-duck session following the midterm elections, after losing an attempt to secure the money as part of the bipartisan opioids package passed last week. According to drug company executives, the money is designed to correct a technical error for the $11.8 billion Congress required them to pay over 10 years in a budget deal earlier this year in the fight over the Medicare Part D doughnut hole. That money was

to go toward seniors’ medicines. Consumer advocates are calling the potential windfall an industry buyout, arguing that the money would do nothing to lower drug prices. Pharma lobbyists are some of the most powerful in Washington, and many drug makers have formed alliances with lawmakers who would otherwise push back against skyrocketing drug costs. The drug industry has reason to worry if Democr ats secur e control of the House after the election. Many Democratic representatives have promised

investigations into rising drug prices, and will push to allow Medicare to negotiate for lower prices. Republican committee chairs and leadership have been friendly to drug companies, something that could change with new leadership. Democrats would also like to allow drug importation from other countries in order to make drugs more affordable. However, the newly negotiated US-Mexico-Canada Agreement includes intellectual property protections for American drug makers that shield them from

foreign competition and prevent importation. “The voices of Robert seniors who are Roach, Jr struggling to afford their prescriptions should outweigh those of pharmaceutical CEOs who just want to line their pockets with more profit,” said Alliance President Robert Roach, Jr. “We must elect representatives who will fight for lower drug prices, not billion dollar windfalls for PhRMA.”

Medicare Advantage Plans Shift Their Financial Risk To Doctors STUART, Fla. — Dr. Christopher Rao jumped out of his office chair. He’d just learned an elderly patient at high risk of falling was resisting his advice to go to an inpatient rehabilitation facility following a hip fracture. He strode into the exam room where Priscilla Finamore was crying about having to leave her home and husband, Freddy. “Look, I would feel the same way if I was you and did not want to go to a nursing home, to a strange place,” Rao told her in September, holding her hand. “But the reality is, if you slip at home even a little, it could end up in a bad, bad way.” After a few minutes of coaxing, Finamore, 89, relented and agreed to go into rehab. Keeping patients healthy and out of the hospital is a goal for any physician. For Rao, a family doctor in this retiree-rich city 100 miles north of Miami, it’s also a wise financial strategy. Rao works for WellMed, a physician-management company whose doctors treat more than 350,000 Medicare patients at primary care clinics in Florida and Texas. Instead of being reimbursed for each patient visit, WellMed gets a

fixed monthly payment from private Medicare Advantage plans to cover virtually all of their members’ health needs, including drugs and physician, hospital, mental health and rehabilitation services. If they can stay under budget, the physician companies profit. If not, they lose money. This model — known as “full -risk” or “global risk” — is increasingly used by Medicare plans such as Humana and UnitedHealthcare to shift their financial exposure from costly patients to WellMed and other physician-management companies. It gives the doctors’ groups more money upfront and control over patient care. As a result, they go to extraordinary lengths to keep their members healthy and avoid expensive hospital stays. WellMed, along with similar fast-growing companies such as Miami-based ChenMed, Boston -based Iora Health and Chicagobased Oak Street Health, say they provide patients significantly more time with their doctors, same-day or nextday appointments and health

coaches. These doctors generally work on salary. ChenMed doctors encourage their Medicare patients to visit their clinic every month — for no charge and with free door-todoor transportation — to stay on top of preventive care and better manage chronic conditions. If patients are not feeling well after-hours, ChenMed even will send a paramedic to their home. “We can be much more creative in how we meet patient needs,” said Iora CEO Rushika Fernandopulle. “By taking risk, we never have to ask … ‘Do we get paid for this or not?’” A Way To ‘Provide Less Care’ Some patient advocates, pointing to similar experiments that failed in the 1990s, fear “global risk” could lead doctors to skimp on care — particularly for expensive services such as CT tests and surgical procedures. “At the end of the day, this is a way to keep costs down and provide less care,” said Judith Stein, executive director of the Center for Medicare Advocacy. Dr. Brant Mittler, a Texas cardiologist and trial attorney

who has followed the issue, said Medicare Advantage members should be suspicious. “Patients don’t know that decisions made on their behalf are often financially based. There may be pressure on doctors to cut corners to save money and that may not be in the best interests of a patient’s health,” he said… The insurers and physician groups disagree. They said limiting necessary care would only exacerbate a patient’s health problems and cost the doctors’ group more money. Noting that Medicare members stay with Humana an average of eight years, Roy Beveridge, the insurer’s chief medical officer, said the plan would be unwise to skimp on care because that would eventually leave the company with sicker patients and longer hospitalizations. “It makes even less sense for physicians at financial risk to skimp on care because patients are typically with their physicians much longer than they are with a health plan,” he said..Read More

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

Congress Targets Misuse Of Hospice Drugs Hospice workers would be allowed to destroy patients’ unneeded opioids, reducing the risk that families misuse them, according to one little-noticed provision in the bipartisan opioids bill headed to President Donald Trump’s desk for his likely signature. The bill would empower hospice staff to destroy opioid medications that are expired, no longer needed by the patient because of a change in treatment or left over after the patient dies. A spokesperson for Massachusetts Sen. Elizabeth Warren, one of the Democrats who pushed for this provision to be included in the overall opioid package that the Senate passed Wednesday, said the idea was sparked by Kaiser Health News’ reporting. Last August, a KHN investigation found that as more people die at home on hospice, some of the addictive drugs they are prescribed are being stolen by neighbors, relatives and paid caregivers —

contributing to an opioid epidemic that kills an average 115 people a day in the U.S. The article quoted a Washington state woman named Sarah B. who stole hundreds of pills — Norco, oxycodone and morphine — that were left on her father’s bedside table after he died at home on hospice care. The hospice staff never talked about addiction or how to safely dispose of drugs after a person dies, she told KHN. Hospices have largely been exempt from crackdowns in many states on opioid prescriptions because people may need high doses of opioids as they approach death. Under current law, hospices cannot directly destroy patients’ unneeded opioid medications in the home. Instead, they direct families to mix them with kitty litter or coffee grounds before throwing them in the trash (flushing them down the toilet is considered environmentally

unsound). Hospice, available through Medicare to those who are expected to die within six months, sends staff and medication to care for patients wherever they live. About 45 percent of hospice patients receive care in a private home. In a statement, the National Hospice and Palliative Care Organization (NHPCO), an industry group, applauded the proposed change in policy: “Granting appropriate hospice professionals the legal authority to dispose of unused medication after a hospice patient’s death would not only alleviate grieving families of this responsibility but also help prevent potential diversion or illicit use of these drugs.” “Families dealing with the loss of a loved one shouldn’t also have to worry about leftover medication ending up in the wrong hands,” Warren said in a statement. “I’m glad to be working with my colleagues to

help reduce the number of opioids in circulation by allowing hospice employees to step in and help families safely dispose of these medications.” The bill requires hospices to document policies on the disposal of opioid medications, and to discuss those policies with families. It also calls for the Government Accountability Office to study hospices’ disposal of controlled substances in patients’ homes. The bill does not specify, however, what happens if a family refuses to give up the drugs. By federal law, medications are considered property of the patient or whoever inherits that person’s property after they die. According to the bill, a hospice worker would not need formal written consent from families to destroy the medications, NHPCO spokesman Jon Radulovic said, but if a family objects, the worker would leave the drugs alone.

Medicare Eases Readmission Penalties Against Safety-Net Hospitals Penalties will total $566 million for all hospitals. But many that serve a large share of low-income patients will lose less money than they did in previous years. On orders from Congress, Medicare is easing up on its annual readmission penalties on hundreds of hospitals serving the most low-income residents, records released last week show. GET THE DATA READMISSION PENALTIES BY HOSPITAL AND STATE Medicare is penalizing hospitals that see patients return to the hospital too soon after being discharged. Medicare reduces what it pays each hospital per patient, per stay. Medicare Readmission Penalties By Hospital (.csv)

Medicare Readmissions By State (.csv) Questions about republishing our content? Click here. Since 2012, Medicare has punished hospitals for having too many patients end up back in their care within a month. The government estimates the hospital industry will lose $566 million in the latest round of penalties that will stretch over the next 12 months. The penalties are a signature part of the Affordable Care Act’s effort to encourage better care. But starting next month, lawmakers mandated that Medicare take into account a long-standing complaint from safety-net hospitals. They have argued that their patients are

more likely to suffer complications after leaving the hospital through no fault of the institutions, but r ather because they cannot afford medications or don’t have regular doctors to monitor their recoveries. The Medicare sanctions have been especially painful for this class of hospitals, which often struggle to stay afloat because so many of their patients carry lowpaying insurance or none at all. In a major change to its evaluation, the federal Centers for Medicare & Medicaid Services (CMS) this year ceased judging each hospital against all others. Instead, it assigned hospitals to five peer groups of facilities with similar

proportions of low-income patients. Medicare then compared each hospital’s readmission rates from July 2014 through June 2017 against the readmission rates of its peer group during those three years to determine if they warranted a penalty and, if so, how much it should be. The broader issue is whether medical providers that serve the poor can be fairly judged against those that care for the affluent. This has been a continuing topic of contention as the government seeks to accurately measure health care quality. It is particularly a concern in efforts to consider patient outcomes in setting pay rates for doctors, nursing homes, hospitals and other providers….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


This Surprising Symptom Could Be a Sign of a Heart Attack in Women Middle-aged, overweight men aren’t the only ones who should be worried about heart attacks. In fact, women under 55 are equally (or more!) likely to suffer from heart disease, according to a study published in the Journal of the American College of Cardiology. Despite the risks, a 2016 statement issued by the American Heart Association (AHA) has revealed that women are often undertreated for this deadly condition. The reason? Most fail to recognize the silent signs of a heart attack that apply

exclusively to females. While chest pain or pressure is one of the most common signs of a heart attack, there’s a more surprising symptom you should recognize. Women are more likely to experience jaw pain, too, according to Laxmi Mehta, MD, clinical director of the Women’s Cardiovascular Health Program at Ohio State University’s Wexner Medical Center and lead author of the AHA’s statement. Other femalespecific symptoms include upper back pain, arm pain, intense

fatigue, heartburn, or “just not feeling right,” Mehta told Prevention. Poor circulation from the heart can cause pain in a woman’s jaw, neck, or back, the AHA reports. However, doctors have yet to find a scientific reason why jaw pain and upper body discomfort affect women and not men. Here are the physical and emotional ways heart disease is different for women, too. If you experience any of these symptoms, visit a doctor right away. Research shows that

women tend to wait longer to seek the treatment they need; however, doing so could lead to irreversible consequences. “Women tend to develop cardiogenic shock,” which occurs when your heart suddenly can’t pump enough blood, Mehta said. And the most aggressive treatments may no longer be effective if you wait for too long. Bottom line: It’s always better to be safe than sorry. Keep an eye out for the most common heart conditions in women, and learn how to prevent heart disease.

You Definitely Want To Get Your Flu Shot Before The End Of October Definitely don't mean to sound like your mom here, but...have you gotten your flu shot yet? Just asking because, you know, the flu was super-deadly last year -an estimated 80,000 people died of the flu and its complications last winter, according to the Associated Press. (J ust as a baseline, the flu can cause 12,000 deaths per year during a mild season, and up to 56,000 deaths per year during a severe bout, per the Centers for Disease Control and Prevention.) But if you're hesitant to get jabbed by a needle, I get it: The flu shot was kind of a crapshoot last year after a ton of people went under the needle

but got the flu anyway because of a "vaccine mismatch," according to a commentary in The New England Journal of Medicine. Still, that doesn’t mean you should be thinking about skipping this year’s injectionwhich you should get by the end of October, suggests the CDC. (Flu seasontypically starts in October, peaks in December, and can stick around until May, so you want to be covered for all of it.) According to Amesh Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security, the flu shot usually provides about a 65 percent

protection rate against contracting the flu-and that number is nothing to sneeze at. (FYI: The effectiveness rate of last year's flu shot? Just 36 percent, per the CDC.) “Just because the vaccine isn’t 100 percent [effective] doesn’t mean it’s worthless,” says Adalja. “And even if you do get the flu, [if you’re vaccinated] you are much less likely to have a severe case requiring hospitalization, less likely to have major destruction to your life, and less likely to spread it.” Plus, there’s some good news about the 2018-2019 flu shot: Researchers think it will be more successful than last year’s

vaccine. According to the CDC, this year's vaccines are a better match to circulating viruses than last year's. TG, right? But still, there's really no way yet to predict how bad this year's flu will be, as the virus is always changing, per the CDC. Another thing to note: Rumors of the shot’s many side effects are greatly exaggerated. It can’t actually give you the flu, and while there are some possible side effects, Adalja says most are rare. Click here to read through this list and then roll up your sleeve anyway, because flu season is coming and the vaccine is still your best defense.

Iowa to sell health plans that can disqualify people based on pre-existing conditions New health plans sold through Iowa’s Farm Bureau will be able to ask applicants if they have any pre-existing conditions. According to a checklist posted online by the Farm Bureau, applicants will be asked about a list of conditions related to mental health, blood pressure, reproductive system, lungs or the respiratory system,

among others. In an interview with the Des Moines Register, Farm Bureau Vice President Steve Kammeyer said some applicants for the new coverage could be turned away or face higher premiums if they have pre-existing health issues.

He could not say which conditions would trigger those actions. According to the checklist, if an applicant says they have been treated for any of the 16 conditions in the past five years, they will be required to provide detailed explanations of the

treatments, medications and current status. The plans were made legal under a law signed by Iowa Gov. Kim Reynolds (R) in April that allows the Iowa Farm Bureau to collaborate with Wellmark Blue Cross Blue Shield on self-funded “health benefit plans...Read More

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

FDA approves over-the-counter hearing aid from Bose The US Food and Drug Administration has, for the first time, approved a hearing aid that can be fit, programmed and controlled by the user instead of a healthcare provider. The device comes from Bose and users can make adjustments to its settings in real time through a mobile app. "Hearing loss is a significant public health issue, especially as individuals age," said Malvina Eydelman, director of the

Division of Ophthalmic, and Ear, Nose and Throat Devices at the FDA's Center for Devices and Radiological Health. "Today's marketing authorization provides certain patients with access to a new hearing aid that provides them with direct control over the fit and functionality of the device. The FDA is committed to ensuring that individuals with

hearing loss have options for taking an active role in their health care." This new usercontrolled hearing aid was made possible through a law passed last yearthat appr oved over the-counter hearing aids. It aims to provide adults with mild to moderate hearing loss access to hearing aids without them having to go through a physician first. The FDA says around 37.5

million adults report hearing loss ranging from "a little trouble" to "deaf." Though they're not approved by the FDA as hearing aids, a number of companies have developed wireless earbuds that can manipulate and augment sound. Bose, Nuheara and the now defunctDoppler Labs have all released assistive hearing devices in the past.

Statins' benefits beyond heart health aren't clear-cut, analysis says Despite some studies suggesting that statin drugs have benefits beyond cardiovascular health, for such issues as cancer and Alzheimer's, a broad new analysis says there's a lack of compelling evidence linking such benefits to statins -- and, thus, little reason to change recommendations for who gets these cholesterol-lowering meds and why. The drugs are commonly prescribed to prevent heart disease in individuals above a certain risk level, but the new analysis -- published Monday in the journal Annals of Internal Medicine -- looked at 278 other health conditions and effects. "I was surprised by the amount of outcomes we identified to have been linked with statins," study author

Evropi Theodoratou, a researcher at the University of Edinburgh, wrote in an email. "However, we only identified a dearth of convincing evidence that statins had a major role" in these outcomes. The analysis found limited evidence of positive outcomes related to cancer, dementia, kidney disease and chronic obstructive pulmonary disease, known as COPD. But only one of these outcomes was significant in a randomized trial -- lower all-cause mortality in patients with chronic kidney disease -- and the authors say it could still be driven by the drugs' impact on cardiovascular disease; the two often go hand in hand. "Clinical guidelines already

recognize the benefits of statins in preventing cardiovascular events in patients with chronic kidney disease who are not receiving dialysis. On the other hand, clinical guidelines currently do not indicate the use of statins to improve cancer prognosis or COPD," Theodoratou said. "I am not aware of any serious efforts by doctors to redefine these guidelines." More testing needed More than a quarter of Americans over 40 take a statin, the most common type of cholesterol-lowering medication, according to a 2014 report from the US Centers for Disease Control and Prevention. Different statins are sold under brand names such as Lipitor and

Crestor. Michael Pencina, vice dean for data science and information technology at the Duke University School of Medicine, said the analysis was important because people will invariably be on statins for long periods of time for their heart health, but the question remains: What else could those statins be doing, good or bad? "I think what we are generally missing in the whole statin discussion is the fully integrated risk-benefit analysis," said Pencina, who was not involved in the new study. Researchers say this doesn't mean these outcomes aren't necessarily null; they just haven't been sufficiently tested yet….Read More

Seniors, Take Steps to Reduce Your Risk of Falling One in four Americans 65 and older falls each year, with some ending up in hospitals or even dying. But new research suggests that it's possible to avoid some of these serious injuries. When seniors who are at risk of falling have a prevention plan, they're less likely to suffer a tumble-related hospitalization, the study found. "We saw statistically significant change that reduced

fall risk in people at risk of falls to almost the same as those who weren't at risk of a fall [at the start of the study]," said the study's lead author, Yvonne Johnston, an associate professor at the Binghamton University School of Nursing in New York. "Considering the cost of one hospitalization for fall, avoiding just one hospitalization compared to the cost of the

program makes it a worthwhile program," she noted. In 2014, 29 million older adults reported a fall, and 7 million of those resulted in an injury, according to the study. Johnston said that many falls go unreported, so these numbers may underestimate the extent of the problem. In 2016, falls were responsible for 29,000 deaths in the United

States, the study authors said. Medical costs related to falls may be as much as $50 billion. The current study looked at a U.S. Centers for Disease Control and Prevention fall prevention initiative. It included screening to identify older people who are at risk of falling. This assessment looked at vision problems, low blood pressure, medications, home hazards and functional ability such as leg strength….Read More

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

Do I have a cold or the flu? One infectious illness comes on slow, the other hits you like a truck. One of the biggest differences between the two viral infections is how fast the sickness sets in. Fall is upon us, and that means the kids are finally back in school and the hot, humid summer days are all but behind us (hopefully). But the cooler air also signals the start of the inevitable cold and flu seasons that run rampant through close-packed classrooms, and circulate back out to parents and coworkers. When the sneezes start, though, they can set off a moment of panic—is this just an average cold-weather cold, or the more serious flu? One of the biggest differences between the two viral infections is how fast the sickness sets in, says Cynthia Benson, the assistant medical director of the emergency department at Overlook Medical Center in New Jersey. With a cold, someone might wake up with a bit of a sore throat and runny nose, and slowly start to feel worse over the course of a day or two. The flu, on the other hand, has a fast onset. “You’re fine when you go into work, and by lunch, you’re really sick,” Benson says. “You feel like you get hit with a ton of bricks.” Some of the symptoms do

overlap—the sore throat, the stuffy nose—but a cold tends to be concentrated in the upper respiratory system, with sneezing and watery eyes. The flu is less likely to come along with a runny nose, but instead will cause muscle aches and chills. Depending on the particular strain of the flu circulating, it can also cause an upset stomach or diarrhea. The real hallmark of the flu, though, is a high fever, Benson says. A cold might cause a low grade, borderline fever, she says, but with the flu, body temperature spikes. Can you diagnose yourself? Adults usually know when they have the flu, as opposed to a run-of-the mill cold, Benson says. “People know themselves. They can differentiate between feeling just crappy and run down, and having the flu,” she says. Benson says there tends to be more incorrect self-diagnoses of the flu when it’s a particularly bad season: People have colds, but are more likely to be worried that they have the flu. For kids, though, it can be harder to tell what virus is causing their sniffles. Babies and toddlers can’t necessarily

identify what they’re feeling. Kids tend to have more nausea when they’re sick, both from a cold or from the flu. “That’s why we tend to do more flu testing in those ages,” Benson says. The flu is particularly dangerous for young kids, who can become dehydrated quickly and suffer more complications, so it’s more important to know for sure if they have it. Keep an eye on their breathing patterns and activity levels if they start to seem ill, Benson says. “A two year old who is listless, and has decreased energy—that should be a big red flag the child is really sick. For healthy adults, the flu and colds can generally be treated the same way—with hydration, over-the-counter medications, and rest. Taking Tylenol (brand name for acetaminophen) or another non-prescription analgesic like Advil or Motrin (both ibuprofen) to bring down a fever can also help cut down on the misery of a flu. Keep an eye on the active ingredients in your medications of choice, though: many contain acetaminophen, which can be toxic to the liver at high doses. Doctors and pharmacists can help with cold medicine

selection, and field questions or concerns. Benson also says that flusufferers should stay home, at least for the first few days. “[The flu is] not the kind of thing you should push through,” Benson says. “You expose other people, and it makes it harder to recover.” Even if someone just has a cold, if they can, they should stay home from work for the first day or so, she says. “If you take off the first day of [a] cold, you will probably get better a little faster,” she says. The first few days of any illness are also when you’re most contagious, so staying in bed can help protect those around you. The best treatment, though, is to prevent sickness from striking in the first place. “Hand washing is key,” Benson says. “As kids go back to school, I’ve seen more and more parents in with upper respiratory infections. Hand washing is super important if someone in your household comes down with a sickness. I tell them to wash hand towels, change out toothbrushes.” Stay away from people who are already sick, and don’t share cups and utensils. And most importantly, Benson says, get a flu shot. “Vaccination, vaccinate, vaccinate—I can’t say it enough.”

Osteoarthritis: New compound may stop the disease New research, published in the journal Annals of the Rheumatic Diseases, shows that an innovative blocking agent can stop the degeneration of the cartilage when injected into the joints. Osteoarthritis is a progressive condition that affects the bones and cartilage within the joints. Although it occurs most often in the hands, hips, and knees, osteoarthritis can also affect the body's spine. Currently, at least 30

million adults in the United States are living with osteoarthritis, making the condition the most prevalent form of arthritis. While there are a variety of ways in which people can manage this long-term, chronic condition, there is currently no cure for it. However, scientists may have now found a treatment that promises to stop the disease from progressing. The

researchers started by focusing on a molecule that they previously found to cause inflammation, break down the cartilage, and deplete the body of collagen. In the new study, the scientists developed a compound that blocks this molecule. Mohit Kapoor, Ph.D., arthritis research director at the University Health Network in Toronto, Canada, and senior scientist at the

Krembil Research Institute, also in Toronto, led the team. 'Discovery could be a game changer' Kapoor and his colleagues have recently discovered that a molecule called microRNA181a-5p has a "critical" role in the destruction of the joints. In the present study, the team wanted to see if a blocking agent can counter this damaging molecule….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 October 14, 2018 E-Newsletter  

RI ARA October 14, 2018 E-Newsletter  

Profile for riara0