Posts Tagged ‘Medical’

“Pharmacists interviewed say they legally cannot tell the customer they’re getting ripped off”

February 2, 2018

Sen Cassidy slams drug cost clawbacks, demands transparency

Documents uncovered by FOX 8 News show real-life examples of patients going to the pharmacy and getting charged a premium on their medication.  We showed you several cases Wednesday night of customers paying more in copay for drugs than the drugs themselves actually cost.

Now one of the most powerful politicians in Washington wants to get our documents.

“Lee, give me copies of those,” says U.S. Senator Bill Cassidy of Louisiana. “That’s [the information] we’ve been putting together as we intend to build support for what we’re trying to do.”

Pharmacists we interviewed say they legally cannot tell the customer they’re getting ripped off.  But we have examples of four healthcare providers, including a company linked to UnitedHealthcare, paying nothing toward some of their customers’ drug costs.

The insurance company labels it a copay. But in some cases only one person pays – you.

Senator Cassidy (R-Baton Rouge) is a physician and a member of the U.S. Senate Committee on Health, Education, Labor & Pensions.  He says that committee tackles the topic of drug pricing.

“It’s an incredibly complicated topic,” Cassidy tells us.  “And there’s not a silver bullet that’s going to address it.  But when you have something like that, it just drives home the need to address it.  And that’s what we’re attempting to do.”

Cassidy says he’s eager to get our information “Absolutely – everywhere I go, people are talking to us about drug costs,” he says.

Patients and customers should know more, Cassidy insists.

“We are building a case that we have to have this transparency of pricing,” he says.

None of these patients knew, even after paying a monthly insurance premium, more money was being taken from them when they went to the pharmacy.  Pharmacists call it a clawbackpatients getting charged more than the cost of the drug, and that money being clawed back from the patient and pharmacy.

The senator agrees, these patients would be better off buying these medications without insurance – but they don’t know that.

“If you give them transparency, then they start to know it,” Cassidy tells us. ”It’s not there right now. Until we have real-life examples… That explains so beautifully what I otherwise struggle to explain – this receipt is worth a thousand words.  Clawback for the person… they would have been better off paying without insurance.”

La. Insurance Commissioner Jim Donelon calls the clawback an additional fee or premium on customers – more money leaving people’s hands, going to large companies to help pad their bottom line.

“The patient is subsidizing the entity which is supposed to be their advocate,” Cassidy notes. “Makes no sense whatsoever.  The patient’s getting hammered.  We have to give the patient the power. We have to mandate that she knows what the insurance company knows and what everyone else knows.  As long as it’s hidden from her, it’s another person’s game.”

Thursday, FOX 8 received statements from Optum, UnitedHealthcare’s pharmacy benefits manager, in response to our request for comment on the apparent clawbacks:

“OptumRx’s pharmacy reimbursement program helps ensure the millions of people we serve have affordable access to the drugs they need by ensuring they pay the lowest price available to them for prescription drugs… Those recouped overpayments are returned to the health plan to reduce overall health plan costs.”

A company spokesman also told us that here is no difference in cost to consumers as a result of its pharmacy benefit program. But local pharmacists we interviewed tell us that is not true, and they say in some cases consumers would save money by buying their medication without insurance.

In Baton Rouge, a bill in the Louisiana State Senate would allow pharmacists to begin telling patients if their medication would be cheaper to buy without insurance. That bill, filed by Lake Charles Sen. Ronnie Johns, has stalled. 

Sources tell FOX 8 that Johns has received pressure from the insurance industry to pull the bill. Sources say Johns used to be a pharmacist, but is now an insurance agent.

http://www.fox8live.com/story/31902373/zurik-cassidy-slams-drug-cost-clawbacks-demands-transparency

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Drug consumers seek relief as PBM’s make money hand over fist

February 2, 2018

I stumbled across this article and I thought it would be VERY helpful for anyone who takes meds monthly!  I’m going to sign-up and see what’s going on too!

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A few taps on Carol Shoemaker’s phone saves her hundreds of dollars in the pharmacy.

“It’s crazy, it’s distressing,” Shoemaker says, “the amount of money you pay for insurance. I pay between $600 and $700 a month for a premium because I’m a single person, I don’t have a company, you know, getting any discounts with big group insurance policies. So, it’s very distressing – you’re already spending a ton of money on insurance, but you still have to pay for, you know, all of the extra.”

Shoemaker almost paid a lot more for one drug; it cost $613 with her insurance. But instead of using that insurance, Shoemaker logged on to one of those cost-saving prescription apps – in this case, GoodRx – and paid just $272 for the medication.

“For me, that’s just too much money to be throwing out the window,” Shoemaker tells us.

She shows us a printout – her family’s medications, with the savings she found online. Shoemaker says those annual savings add up. “It could be a thousand bucks,” she says.

And last year she could have saved even more: She used her insurance for a $277 cream, but only later found out she could have paid just $11.72 via an app.

“My husband’s going to kill me for that,” she jokes, noting the $260 in missed savings would have bought “a nice pair of shoes.”

Pharmacy benefit managers, or PBM’s, control these costs for your prescription drugs.

“The PBM’s in everyone’s pocket,” warns Doug Hoey, who heads National Community Pharmacists Association. “I mean that literally and figuratively because, in every wallet or purse, that prescription drug card that people carry around, somewhere in the fine print, it’ll usually say the name of the PBM, the pharmacy benefits manager.”

The three biggest PBM’s are CVS/Caremark, Express Scripts and Optum, which is owned by United Healthcare.

“They’re huge,” Hoey says. “They’re probably companies you’ve never heard of. But they’re bigger than the drug manufacturers.”

Here at WVUE/FOX 8, Caremark manages our prescription medication. We compared some of the prices our colleagues were being charged.

We found one antibiotic, Ciprofloxacin that costs $15 through our insurance at the Walmart pharmacy. Using GoodRx, the same medication can be bought for just $4. And we found similar savings on an arthritis drug, Meloxicam.

“It doesn’t make sense,” Hoey says. “It’s counterintuitive. I mean, you stroke a check each month to pay your premium and you expect that to give you some value. And the reality is that, in increasing numbers of cases, if you just did it the good old-fashioned way of paying cash, you might pay less for your prescription.”

FOX 8 investigators reached out to Caremark for comment on this report. They sent us this statement:

Without knowing who the CVS Caremark members are or the details of their prescription transactions, it is not possible for us to look into their situations in order to either explain their experience under their specific coverage plan, or clarify any incorrect or incomplete information you may have been provided.

CVS Caremark is committed to ensuring that our PBM clients and members have access to affordable medications to improve health outcomes.  To that end, our PBM plan members receive the lower price when covered prescriptions are filled by a pharmacy that participates in their plan’s applicable pharmacy network. For example, we set a negotiated rate for generic medications with pharmacies, but if a pharmacy in our network has a cash price for a medication that is less expensive than our negotiated rate, the pharmacy is required to submit that lower price when it processes the prescription claim through Caremark.

We found plenty instances where drug costs on insurance were cheaper than those without. But the lesson remains: A smart consumer needs to shop around, ask for the cash prices on their medications, look online and on apps, and ask the insurance prices, too.

A big case in point: We received a list of medications for employees of the Orleans Parish School Board. In 2016, employees paid $28 for a high blood pressure drug, Lisinopril. But through GoodRx, it would have cost them just $8.

“It does not make sense and it happens a lot,” says Gerald Michel. He runs two pharmacies and he says customers frequently come in and save money paying cash for medication.

Michel wonders if there’s more savings out there.

Take the Orleans Parish School Board – all of those prescriptions add up. Just like your employer may do, taxpayers subsidize part of school employees’ prescription expenses. In 2016, they cost taxpayers $1.5 million.

But savings exist by bypassing those high-priced pharmacy benefit managers or PBM’s. Michel also sits on the Terrebonne Parish Council. Two years ago, he urged the council to dump its PBM and search for a new one.

They found one right here in Louisiana, in Natchitoches. Terrebonne dumped its PBM, Optum; Southern Scripts signed a deal with the parish and saved taxpayers $1.2 million on pharmacy costs last year.

“Ultimately, it’s the person getting the insurance that’s going to be saving the money,” Michel says.

“When you think about $1.2 million for… 3,000 people in that county, or 3,000 employees, and if you extrapolate that over 200 million workers in the United States… I’m not that good a whiz to figure out what that number is, but it has a lot of zeroes,” Hoey says. “It starts at least with a ‘b’, as in billions. And that’s the type of potential savings that’s out there, that’s right under our counties’, employees’, school districts’… That’s right under their noses right now, by not using transparent PBM.”

The head of the pharmacists group says he knows another story of a company saving even more on prescription costs. “They saved 30 percent,” Hoey tells us, “30 percent off their prescription drug spend, which is a lot of money.”

In the meantime, PBM’s are raking in lots of cash; Americans are spending about $400 billion on prescription drugs every year.

“These are very profitable companies,” Hoey notes. “They’re all traded on Wall Street, they have shareholders they have obligations to. And so, yes, they’re going to make sure they’re profitable and are rewarding those shareholders.”

Unless consumers start shopping around, experts warn, those growing profits will come at the expense of pharmacies, consumers and taxpayers.

If you do pay cash for a medication…. It could impact whether you reach your deductible.  so be sure to investigate that.

http://www.fox8live.com/story/37406869/zurik-drug-consumers-seek-relief-as-pbms-make-money-hand-over-fist

  You can read much more in our “Medical Waste” investigation at this link

Medical Waste

Stop the Bleed

January 27, 2018

Several years ago I was dating a New Orleans Fireman.  We were caught in traffic due to an accident.  He looked at me and asked if I had any tampons or maxi-pads.  I replied yes to both.  I said I worked in a bar and had lots of young ladies who were never prepared so I kept a box of each in my trunk.  I popped the trunk and he rummaged, then ran to help.  He used two tampons in the cut and bandaged them into the wound.  They also contain a clotting agent that helped slow the blood drainage.

I learned several things that day 1) in Louisiana ALL EMS, Fire, Police personnel are required to offer/render aid they are LEGALLY liable and 2) always keep feminine products with you.  What is their main purpose….absorb blood.  While menstrual blood is thicker than arterial blood, these products still do their job.

~~~~~~~~~~~~~~~~

Bleeding can be caused by a wide variety of issues. Minor injuries such as a scraped knee will need to be cleaned and bandaged. More major injuries could lead to hemorrhaging or massive blood loss. These wounds will need to be treated immediately if the person is going to survive. If possible head to a hospital right away. Call 911 for help, especially if you suspect internal bleeding. It is vital to stop the bleeding as much as possible while you wait for professional medical assistance. Hemorrhaging can cause death in a matter of minutes if not controlled.

Bombings and shootings are sadly becoming the norm. Having a bleeding control kit on the wall near the fire extinguisher or other well-marked areas will save lives. The kit should have a bleeding control dressing, trauma sheers, a permanent marker, tourniquet, gloves, gauze, CPR mask, and an instruction card.

  • Call 911
  • Find a first aid kit or bleeding control kit
  • Keep pressure on the wound
  • Place a tourniquet above the wound to stop the bleeding
  • Maintain pressure until help arrives

You won’t always have a bleeding control kit with you. Jeff Bauman was injured during the Boston Marathon bombing. Someone used a shoelace to tie a tourniquet around his leg and it saved his life. Tourniquets have been used to control bleeding since Alexander the Great. In 1785 Sir Gilbert Blane insisted that all members of the Royal Navy carry a tourniquet with them. Tourniquets control blood loss and save lives. 

How to Make a Tourniquet 

  1. Make sure the area is safe
  2. Put on gloves if available
  3. Clear the wound of clothes or debris
  4. Place firm constant pressure on the wound with gauze or clothes
  5. Use a belt, shoelace, or even a bra to make a tourniquet
  6. Find a stick, flashlight, or pencil to tighten the tourniquet
  7. Wrap the tourniquet above the wound, never on a joint
  8. Tie the stick to the tourniquet and turn it once the bleeding stops tie it in place
  9. Treat the injured person for shock until help arrives
  10. Never move a person with an injury to head, neck, back, or leg

Photo Credit: https://www.artofmanliness.com/2016/09/21/make-use-tourniquet/

Source: https://www.healthline.com/symptom/hemorrhag

http://www.sandiegouniontribune.com/news/health/sd-me-stopthebleed-vegas-20171002-story.html

https://www.thereadystore.com/food-storage/18162/stop-the-bleed/

Chinese government admits one-fifth of farm lands heavily contaminated with toxic heavy metals like cadmium, arsenic and lead

December 26, 2016

http://www.naturalnews.com/044950_China_heavy_metals_soils_contamination.html

For the past few months, Natural News has been warning the world about toxic heavy metals found in foods, superfoods and dietary supplements grown in China. Our Natural News Forensic Food Lab has produced breakthrough results showing, for example, that rice protein imported from China is significantly contaminated with lead, cadmium and tungsten — all industrial heavy metals.

Some greed-driven promoters of rice protein initially insisted all these heavy metals were “naturally occurring,” but now the Chinese government has gone on the record confirming the truth: China’s farm lands are heavily contaminated with toxic heavy metals, and this has now been scientifically documented and proven by Chinese researchers and publicly released by Chinese authorities.

19.4% of China’s farm lands contaminated with toxic heavy metals

According to this statement by the Ministry of Environmental Protection in China, 19.4% of the nation’s arable land has been heavily contaminated by toxic heavy metals.

82.8% of the contaminants found on farms are “inorganic” contaminants which include cadmium, mercury, arsenic, copper and lead — all toxic heavy metals we’ve been investigating in foods and superfoods at the Natural News Forensic Food Labs.

This confirms my detailed video explanation where I destroy the absurd “naturally occurring” argument being pushed by importers of contaminated foods and superfoods from China. Click here to watch the video now.

The false argument being made by heavy metals denialists was that when heavy metals are released by industrial smoke stacks, they begin as “pollutants,” but after they settle on farms, they become “natural.” Therefore, the deniers claimed, lead and cadmium in rice protein was “naturally occurring.”

I have personally conducted the scientific research to document cadmium levels at over 2.5 ppm in certified organic rice protein products sold in the USA (and imported from China) as “certified organic.” These levels have been independently confirmed by rice protein manufacturers. None of the lab results published at Natural News have ever been disputed. In fact, they have been confirmed by numerous third-party laboratories.

Now we know why: “China released a report April 17 disclosing that 16.1 percent of the country’s soil and nearly 20 percent of its arable land has been contaminated, largely by heavy metals such as cadmium, nickel and arsenic. This is the price the country is paying for its meteoric rise over the last 35 years, with little thought given to protecting the environment,” reports the Japan Times (1).

“The latest report suggests that the situation has greatly worsened since the 2006 report, with twice the amount of arable land now being contaminated… Clearly much of China’s soil is contaminated and heavy metals are entering the food chain, with dire consequences for consumers,” Japan Times added.

The BBC chimes in with the headline, “Report: One fifth of China’s soil contaminated.” (2)

Americans being poisoned by toxic heavy metals imported from China

To my knowledge, no one in America other than Natural News is currently sounding the alarm on this issue of heavy metals in organic superfoods and natural products. There are thousands of certified organic proteins, superfoods, herbal supplements and other products being imported into the United States and sold as “organic” even though they are heavily contaminated with toxic heavy metals.

In my own ICP-MS laboratory, I’m seeing very high levels of lead and cadmium in all sorts of products imported from China, including rice protein and Ginkgo Biloba herbal supplements.

According to the Chinese government, 82.8% of the non-organic produce grown in China exceeds the government’s heavy metals limits. (You have to read the Chinese announcement to get this.)

That means four out of five fruits and vegetables grown in China are so toxic that they’re sold in violation of the government’s own limits!

These are the same soils in which “organic” herbs, superfoods and dietary supplements are grown before they are imported into the USA. And yet herbs, proteins and “superfoods” produced in China can be imported into the USA regardless of their heavy metals content. That’s because neither the FDA nor the USDA has any limits whatsoever on heavy metals contamination of foods. So products that are heavily contaminated with industrial heavy metals are imported into the USA every single day and sold on the shelves of health food retailers like Whole Foods.

Alarming levels of cadmium and lead found in products purchased at Whole Foods earlier this week

As part of my own scientific testing of heavy metals contaminants in the food supply, I purchased rice protein products from Whole Foods in Austin Texas on 4/28. Here are just the highlights of what I found (more details coming on this story in the next two weeks with full lab results):

• “Raw” Protein (Vanilla) at over .3 ppm lead and nearly 2.0 ppm cadmium

• “Truganic” Protein at over .3 ppm lead and nearly 1.8 ppm cadmium

• Grass superfood powder at over .4 ppm lead and over .8 ppm cadmium

• Brown rice protein powder at over .3 ppm lead and over 1 ppm cadmium

I’ve also found Ginkgo Biloba herbs grown in China and sold in the USA to contain over 5.0 ppm lead. (The Whole Foods brand of ginkgo capsules, however, turns out to be very clean with less than .04 ppm lead.)

The debate is over: Foods, superfoods, herbs and organics from China are heavily contaminated with toxic heavy metals

There is no longer any debate on this issue of heavy metals in products imported from China. The Chinese government has now publicly admitted one-fifth of its farm lands are heavily contaminated with toxic heavy metals.

Even the BBC has covered the story, reporting (2):

About 82.8% of the polluted land was contaminated by inorganic materials, with levels noticeably higher than the previous survey between 1986 and 1990… The report had previously been classified as a state secret because of its sensitivity. “Due to long periods of extensive industrial development and high pollutant emissions, some regions have suffered deteriorating land quality and serious soil pollution.”

That this information even came out was nothing short of a political miracle in China. As the New Straits Times is now reporting (3):

Premier Li Keqiang signed a directive ordering officials not to use “state secrets” as an excuse to avoid disclosing information that should be public knowledge. The release of the soil contamination report appears to be a direct result of this directive.

Awareness is rapidly spreading on this issue across the USA, too. Natural News has spearheaded this effort and has already worked with leading rice protein manufacturers to reach agreement on voluntary heavy metals limits for their products.

Companies like Jarrow Formulas, however, have so far refused to agree to those limits. The latest batch of Jarrow Formulas Brown Rice Protein, Lot# 50696014, shows lead at .312 ppm and cadmium at 1.015 ppm with the heavy metal tungsten also detected at significant levels.

Jarrow Formulas, like nearly every other rice protein manufacturer, is right now selling products that contain toxic, cancer-causing heavy metals contaminants. This fact is irrefutable. The Chinese government’s admission that its farm lands are widely contaminated with toxic heavy metals explains where much of this is coming from.

Natural products retailers remain in a state of total denial

The natural products industry, encompassing many independent online retailers as well as brick-and-mortar stores, remains in a state of total denial about the toxic heavy metals they are selling to their customers.

To my knowledge, not one retailer has yet pulled any of these contaminated products off their shelves. Where there’s money to be made by moving products contaminated with heavy metals, there’s one thing you can count on from natural products retailers: SILENCE.

Fearful of a wave of refunds (or even class action lawsuits), everyone’s lips are sealed on this hidden epidemic of heavy metals poisoning. And through this silence, retailers continue to sell contaminated products containing alarming concentrations of known poisons without alerting their customers to the facts.

It seems that every retailer currently selling rice protein in the USA is, knowingly or unknowingly, complicit in this cover-up. The toxic metals they are selling are fully known to cause kidney damage, heart disease, skin disorders, cancer, bone disorders and brain disorders. The lead found in these products is widely known to damage developing brains and lower IQs. Virtually no one in the industry seems to think their customers should be alerted to this fact. To me, that’s disgusting and grossly immoral.

Right now, I believe that every retailer of contaminated products from China has an ethical and social obligation to stop selling contaminated products and warn their customers about products which are contaminated.

Continued denial of this industry-wide problem is highly unethical and possibly even legally negligent. Those who continue selling these heavily contaminated products should be heavily pressured by the health-conscious community to clean up their act!

How the cover-up continues

Sadly, there is no law in the USA requiring herbs, supplements, proteins or other products be labeled with their country of origin.

Manufacturers routinely import raw materials from China, then label them with amazing-sounding descriptions that often mislead consumers.

Case in point: Take the Warrior Food product from Warrior Force, a company I really admire for their positive intentions, by the way. They are also working hard on improving their formula and I expect they will have substantially cleaner product available soon. But their current label on their current product is simply misleading, claiming the product is “NON-TOXIC” and “100% TruGanic” with the claim that it is “a purist, hard-core, quality standard significantly beyond Organic standards, with much more stringent criteria and actual verification via testing that Organic does not have.”

Yet when I tested Warrior Food Lot #31105010, purchased from Whole Foods on 4/28/2014, I found this product to contain:

• .3 ppm lead
• 1.791 ppm cadmium
• Substantial levels of tungsten

On the good news side, the great people at Warrior Force are working hard on new formulations and I expect to see these numbers drastically improve in the near future. Warrior Force has enthusiastically signed on with our voluntary heavy metals limits, and I fully expect they will be one of the first manufacturers to introduce a low-metals rice protein into the marketplace.

Yet, at the same time, I have to honestly and authentically ask how could these levels of contaminants exist in their product in the first place if they have “a purist, hard-core, quality standard significantly beyond Organic standards, with much more stringent criteria and actual verification via testing” as they claim?

It doesn’t add up. Somewhere along the line, someone made a decision that these levels of lead and cadmium were okay for customers to eat. That’s a huge error and it strongly contradicts the stated philosophy of the company. This is NOT okay! If it’s so much better than organic, why does it still contain heavy metals at such levels?

If you bought products from China, take action now

There are all sorts of products you’ve probably been purchasing from China without knowing it. Rice protein is just one, but China also produces a huge percentage of the herbs, vegetable powders, grass powders and even many superfruits sold across the natural products industry. Most of the grass powders sold in the USA, for example, are actually grown in China. Many of the “bulk herbs” sold on Amazon.com and other retailers are also heavily contaminated with toxic heavy metals because they are imported from China.

For example, when I tested Ginkgo Biloba herbs grown in the USA, lead and cadmium levels were near zero. But when I tested Ginkgo imported from China, it showed an alarming 5 ppm of lead, a level that would raise alarm with anyone educated in food contamination issues.

The bottom line in all this? If you don’t want to poison yourself with toxic heavy metals from China, you need to immediately start taking these steps on the foods, proteins, supplements and herbs you consume:

STEP 1) Ask the manufacturer for the country of origin.

STEP 2) Ask the manufacturer for heavy metals lab results for YOUR lot number (printed on every bottle).

STEP 3) Reject retailers that continue to sell heavily contaminated products. Demand that retailers set quality control standards which encompass heavy metals contamination issues.

What levels are okay? A good starting place is the site I created, LowHeavyMetalsVerified.org which offers a generous grading system for heavy metals concentrations. I personally reject all raw materials worse than grade “A.” Many rice proteins sold today are grade “B” which is entirely unacceptable given the huge quantities that people consume (serving sizes are typically around 23 grams).

Right now, just one scoop of contaminated rice protein can expose you to over 15 – 20 times the daily lead limit of Proposition 65 in California. That’s unacceptable. Rice protein companies need to be at grade “A” or better, in my view as a food science researcher.

The good news is that companies are rapidly moving in that direction, and I fully expect to see some cleaner rice proteins on store shelves by this August (and possibly even in July).

Until then, I strongly recommend you switch to some other protein. 365 brand Whey Protein Powder from Whole Foods contains almost zero lead or cadmium, and a brand called “Tera’s Whey” was super clean, clocking in at just .012 ppm lead and .078 ppm cadmium (with zero tungsten detected). These are about the best numbers you’ll ever find.

Life’s Basics Plant Protein Mix (from LifeTime) sold at Whole Foods (Lot #3793) was also remarkably clean for a plant-based protein, turning in lead number of just .023 ppb and cadmium of just .068 ppm. Both are extremely low — among the lowest you’ll find in plant protein.

I’ll be bringing you more official, detailed reports on all this in the coming weeks. Watch for many more explosive reports on heavy metals during the month of May.

See all lab results we’ve published so far at:
http://labs.naturalnews.com

Sources for this article include:
(1) http://www.japantimes.co.jp/opinion/2014/05/…

(2) http://www.bbc.com/news/world-asia-china-270…

(3) http://www.nst.com.my/opinion/columnist/chin…

Also see this report from China (PDF):
http://www.mep.gov.cn/gkml/hbb/qt/201404/W02…

Protein hype: shoppers flushing money down the toilet, say experts

December 26, 2016

https://www.theguardian.com/lifeandstyle/2016/dec/26/protein-hype-shoppers-flushing-money-down-the-toilet-say-experts

Consumers fuelling demand for high-protein products unlikely to see any benefits as people already eat more protein than they need, say dietitians

The UK’s rocketing demand for high-protein products is being fuelled by consumers buying foods unlikely to deliver the benefits they are seeking, experts have said.

Weetabix, Shreddies, Mars, Snickers and Batchelors Cup a Soup were among the brands that launched enhanced protein versions this year as the trend hit the mainstream.

Many supermarkets have introduced dedicated sections for higher-protein products and, according to Euromonitor, the market for sports protein products alone – which excludes most of the mainstream brands – is expected to hit £413m this year and almost £750m (in today’s money) in five years’ time.

But experts have warned that consumers, particularly gym-goers, are falling victim to clever marketing.

Anna Daniels, a dietitian and British Dietetic Association spokeswoman, said: “People have a misconception they do need more protein whereas actually the majority of us are getting adequate protein – our requirements are quite low. If you’re an athlete you will have higher requirements but you can still get it from eggs, yoghurt, meat. The majority of us who go to the gym for an hour a couple of times a week, there’s no need to be having additional protein we [already] get from a balanced healthy diet.”

Public Health England (PHE) guidelines suggest a protein intake for 19- to 64-year-olds of 55.5g for men and 45g for women, although experts say this will vary according to weight (the US Institute of Medicine stipulates a minimum of 0.8g per kg of body weight per day).

The PHE guidelines equate to getting approximately 11% of the recommended number of calories from protein, whereas according to the National Diet and Nutrition survey, the actual figure for adults is 17% to 18%.

Dr Alison Tedstone, PHE chief nutritionist, said: “The majority of people are consuming much more than the recommended daily allowance of protein through their everyday diet. So even if you hit the gym regularly, spending money on protein supplements is unlikely to bring any additional benefit.”

According to the Euromonitor figures, which cover ready-to-drink beverages, protein powders and protein bars with a minimum of 20g of protein, the sports nutrition market has grown by about 160% since 2011. Another market analyst, Nielsen, said there was a 63% rise in sales of protein bars in 2015, compared with the previous 12 months, while Mintel figures, published in August, said there had been 40% more launches of high-protein products this year compared with 2015.

Tom Sanders, professor emeritus of nutrition and dietetics at King’s College London, said people were being taken in by “nutri-babble”. “There’s been a lot of hype in gyms pushing high-protein shakes, there’s also a need to get rid of a waste product from the dairy industry, which is whey protein,” he said. “It’s a lot of crap, a way of selling a cheap product at a high price.”

Danny Commane, a lecturer in nutritional science at the University of Reading, said while there was some evidence suggesting that eating more protein could help increase muscle mass, the fact that people were already eating so much more than they needed made supplements unnecessary. He has worked with the successful GB rowing team, some of whom he said do not take protein supplements despite consuming 6,000 calories a day.

It’s clever marketing,” said Commane. “Unless you’re doing extreme exercise or pursuing extreme lifestyle goals, you don’t need extra protein.”

As excess protein is excreted through urine, people who are consuming too much are effectively flushing their money down the toilet, according to the experts.

This also makes it unlikely that they are doing themselves harm – unless they already have kidney disease – but it could be problematic if high protein consumption replaces other foods important for good health such as fruit, vegetables and wholegrains, they said. “A lot of the products are high in sugar, low in fibre, they’re not healthy choices for consumers,” said Daniels.

Darren Beale – founder of musclefood.com, which specialises in lean meats but also sells high-protein pizzas, chocolate and even beer – said gym-goers increasingly want to control what they put in their body.

“Are people eating too much protein? Depends on their health or fitness goal,” he said. “There’s research showing that a diet high in protein can help build muscle mass, but there has to be a macro balance with carbs and fat. Our entire aim is to provide products which make it easier for customers to stick to their healthy eating plan.”

None of the manufacturers of products mentioned in the article addressed the issue of the high amount of protein already in UK diets when contacted by the Guardian.

A Food and Drink Federation spokesman said: “Food manufacturers are responding to an increasing demand from consumers for high-protein food and drinks, which can be consumed as part of a healthy lifestyle. There is also some evidence that foods high in proteins can help us feel full for longer – increasing satiety and aiding appetite control – and this may be helpful for people trying to balance their energy intake. Protein content will always be clearly labelled, usually alongside how much of an adult’s recommended intake this represents, to help consumers make informed choices.”

A Mars spokeswoman said its bars were designed to be “a post-workout treat, to be enjoyed as part of a balanced diet”. Weetabix said protein at breakfast “helps regulate appetite and daily food intake”.

Indonesia’s nationwide healthcare plan stumbles at first hurdle

May 20, 2013

http://uk.mobile.reuters.com/article/idUKBRE94I0CN20130519?irpc=932

When a sick Indonesian baby died after 10 hospitals in Jakarta turned her family away in February, critics blamed a pilot health insurance scheme that had overwhelmed the city’s public hospitals.

The programme, introduced in November, gave health insurance to around 5 million people in Jakarta categorised as poor. Long queues quickly formed at already stretched hospital emergency rooms as many patients, some who were not even ill, sought to take advantage of being covered for the first time.

Some health experts said it was a sign of the chaos to come when the government begins rolling out a nationwide health insurance programme early next year, especially since Jakarta, a city of 10 million people, has the country’s best public hospitals and doctors.

“If Jakarta itself is not ready, I don’t know how we can say other less advanced cities can be ready,” said Palmira Bachtiar, senior researcher at Indonesia’s private SMERU Research Institute, which focuses on health and poverty issues.

Lisa Darawati said her family sought treatment for her one-week old daughter Dera across the Indonesian capital over a four-day period. The 10 hospitals were either too crowded or lacked the equipment to treat Dera, who had been born one month premature, Darawati said. Dera later died from respiratory complications.

Her death triggered an outcry in local media, which listed the 10 hospitals. Some editorials said the pilot scheme had been implemented too hastily. Under the scheme, the poor are eligible for free or subsidised hospital care. Previously, patients without insurance had to pay for treatment on the spot.

Jakarta governor Joko Widodo and the Indonesian health minister have defended the programme.

Widodo said thousands of people in Jakarta had been dying at home because the lack of insurance stopped them seeking medical treatment in the first place.

“If we did not start in November, there would be 500,000 people sick, but at home,” Widodo told Reuters during a recent interview.

NATIONWIDE HEALTHCARE A “GAME-CHANGER”

The nationwide healthcare plan and the Jakarta pilot scheme has caught the attention of the private sector, which senses an opportunity to tap into demand for better health services from Indonesia’s rapidly growing middle class.

Local companies with an interest in health care such as PT Lippo Karawaci and Kalbe Farma are investing in new private hospitals and clinics, anticipating that Indonesians who can afford it will pay more to avoid the queues and dilapidated equipment at public facilities when the national scheme gets under way.

“Universal healthcare is a game-changer … and if companies are not prepared for that then they are going to lose out,” said Emmanuel Wehry, chief Indonesia marketing officer for French insurer AXA Financial.

The nationwide programme also includes a plan to sharply increase the number of hospitals beds. That would reverse decades of underfunding which has left Indonesia, a sprawling archipelago of 240 million people, with one of the worst ratios of hospital beds per capita in Asia.

The initial insurance roll-out begins in January, with the aim to cover all Indonesians by 2019 from the 52 percent who currently have some form of insurance.

The programme will integrate various public healthcare schemes into one. It will give free or subsidised coverage to 86.4 million poor and so-called “near poor” Indonesians in 2014, 10 million more than who are covered now. Around 35 million Indonesians who get health insurance from employers, the military and police will also be included.

The World Bank estimates the insurance scheme would cost $13-$16 billion each year once it is fully implemented. The government has said it would double its spending on health to 16 trillion rupiah ($1.64 billion) next year to cover the poor and the “near poor”.

GOVERNOR SAYS NEEDS MORE HOSPITAL BEDS

The Jakarta pilot scheme encourages residents to go to a clinic first, then get a referral from a doctor if they need to visit a hospital. The aim is to prevent hospital overcrowding.

But this had not been fully explained, said researcher Bachtiar, adding people were flocking to hospitals instead.

Governor Widodo acknowledged there was not enough beds in hospitals and clinics to meet the demand. He said he had asked hospitals to try to make more beds available to the poor.

“It is better to start it and then when there is a problem, we improve it,” said Widodo, who won office last year in a landslide and is one of Indonesia’s most popular politicians.

The number of patients at Jakarta’s hospitals had jumped by up to 70 percent, local media quoted him as saying in March.

Dera was born at a small Jakarta hospital that didn’t have the necessary neo-natal medical equipment. She died there after her family failed to get her treated at another hospital, Darawati, 20, told Reuters recently.

“At these other hospitals, we didn’t know what actually was happening. I could have burst into anger but I would have felt bad with people around me. I had to let go,” said Darawati, fighting back tears at her daughter’s grave in a poor neighbourhood in south Jakarta.

The local media attention on Dera’s death has put pressure on Jakarta’s hospitals, said Parulian Simanjuntak, executive director of the International Pharmaceutical Manufacturers Group, an industry body in Indonesia that represents multinational pharmaceutical firms.

A few weeks after Dera’s death, local media reported that a teenage girl had died from an intestinal infection after hospitals in Jakarta denied her treatment because they were too crowded.

“If you look at what is happening after these deaths, hospitals are now afraid of it being reported that babies are not being well taken care of. It is quite chaotic,” said Simanjuntak.

Jakarta’s Cipto Mangunkusumo Hospital, one of Indonesia’s top public hospitals, was one of the 10 that rejected Dera. It has only 10 beds in its intensive care unit and they were all being used when she was brought in, said its president director, Dr. C.H. Soejono.

The number of patients at Cipto had jumped more than 25 percent since the pilot programme was introduced, he added.

Health Minister Dr Nafsiah Mboi said few patients were missing out on treatment.

“Not many patients have been turned away. More patients have received treatment and good treatment,” Mboi said.

COMPANIES WANT TO CATER FOR THE WEALTHY TOO

Indonesia has six hospital beds for every 10,000 people, according to the World Bank. That is four times below the global average and less than the 42 beds in China and nine in India.

Out of 100 countries, Indonesia ranked ninth from bottom despite its strong economic growth. GDP growth this year is forecast at 6.2 percent, steady from 6.23 percent in 2012.

Indonesia wants to increase its bed capacity to 10 per 10,000 people by next year. That translates into 96,000 more beds. To meet global standards, U.S. business consultancy Frost & Sullivan estimated it would need to add 400,000 by 2015.

Private companies also have their eye on the 1.5 million Indonesians who seek medical treatment overseas each year, spending more than $11.5 billion, according to government and industry groups.

Indonesians were the biggest group of foreigners visiting Singapore hospitals, IHH Healthcare Berhad, Asia’s largest hospital operator, said recently.

PT Lippo Karawaci’s Siloam Hospitals, Indonesia’s biggest private hospital operator, plans to invest $500 million by 2015 to build 20 hospitals, more than double its current number of 13. It plans to raise at least $200 million by listing its hospital division this quarter.

Kalbe Farma, Indonesia’s largest listed pharmaceutical firm, plans to invest as much as 20 billion rupiah annually to build 20-25 clinics each year in Jakarta for the next five years.

For Darawati, it all comes too late.

Not long after Dera died, Cipto hospital admitted her twin sister Dara, who was also ill. She died a month later from a blood infection. ($1 = 9,737.5 Indonesian rupiah)

When doctors are bullies, patient safety may suffer

April 23, 2013

http://www.usatoday.com/story/news/nation/2013/04/20/doctor-bullies-patients/2090995/

Every workplace has bullies. But when the workplace is a hospital, it’s not just an employee problem.

The worker, according to court documents, felt threatened: His superior came at him “with clenched fists, piercing eyes, beet-red face, popping veins, and screaming and swearing.” He thought he was about to be hit. Instead, his angry co-worker stormed out of the room.

But it wasn’t just any room: It was in a hospital, adjacent to a surgical area. The screamer was a cardiac surgeon, and the threatened employee was a perfusionist, a person who operates a heart/lung machine during open heart surgery. In 2008, the Indiana Supreme Court ruling inRaess v. Doescherupheld a $325,000 settlement for the perfusionist, who said he was traumatized.

It’s enough to make any patient wonder: Just how well does my health care team get along?

The question is worth pondering, say experts in what is commonly called “disruptive behavior.” Every workplace, like every schoolyard, has its bullies. But when the workplace is a doctor’s office, hospital room or surgical suite — when doctors throw charts at nurses or nurses throw insults at trainees — it isn’t just a workplace problem. It’s a patient-safety issue, these experts say.

“The impact in health care is significant because you are dealing with patients’ lives,” says Peter Angood, CEO of the American College of Physician Executives in Tampa.

Health executives have paid increasing attention to the problem since 2009, when the Joint Commission, which accredits hospitals and other health care organizations, published standards on preventing and dealing with what it calls “behaviors that undermine a culture of safety.” The commission says such “intimidating and disruptive behaviors” can include “verbal outbursts and physical threats,” but also can include using a condescending tone or refusing to answer questions or perform duties. Co-workers or patients may be on the receiving end.

But no matter who is the immediate victim, “most organizations are beginning to understand that this is about patient safety,” says Marty Martin, a psychologist based at DePaul University in Chicago. He co-wrote a guide book, Taming Disruptive Behavior recently published by the physician executive group. The book details growing evidence linking bad behavior with patient harm.

For example, in one survey of more than 4,500 health care workers, 77% reported disruptive behavior by doctors and 65% reported it among nurses. More than two-thirds said such behaviors led to medical errors; nearly one-third said they contributed to patient deaths. A smaller West Coast survey of labor and delivery nurse managers found disruptive behaviors were widespread and had contributed to “near-misses and adverse occurrences.”

The link between bullying and medical mistakes lies in human nature, Martin says. “Say, for example, you are going to get a colonoscopy. You are now sedated, and you don’t know what’s going on. Now let’s say the gastroenterologist and the nurse get into a verbal conflict. One or both of them is likely to be distracted.” If you end up with a perforated colon, he says, it may be because of that distraction, rather than any lack of medical skill.

Various studies based on staff reports and patient complaints suggest 3% to 5% of physicians are disruptive, according to a report in the Annals of Internal Medicine in 2006. Studies also have found that 5% of physicians in any health care organization account for more than a third of complaints from patients and for 40% of malpractice claims, says Gerald Hickson, director of the Center for Patient and Professional Advocacy at Vanderbilt University Medical Center in Nashville.

Many such physicians will improve after some basic counseling from their peers, Hickson says. But a few need a formal intervention program. A model “distressed physicians” program launched at Vanderbilt in 2004 has been reproduced at several other centers. More than half of physicians who attend them return to work, Hickson says.

William Swiggart, a therapist who co-directs Vanderbilt’s intervention program, says: “Sometimes when a physician stays in an institution, that’s a success. Sometimes when he leaves it’s a success.”

Swiggart says at least 80% of physicians sent to the program are male, and a majority are surgeons. They often are highly competitive perfectionists, he says, who see themselves as having high standards and looking out for patients.

“Often their patients love them, but the staff hates them,” he says. Sometimes, he adds, it’s the other way around.

Patients who experience or witness boorish behavior have every right to speak up, Martin says, because the quality of their medical care may depend upon it.

He suggests going to hospital or clinic administrators and “sharing what you observed and how it made you feel.” If you plan to switch doctors or take other action, let them know that, too, he suggests.