Medicare, Alternative Medicine, and Quality of Senior Health Care

In 1992, a Congressional mandate established the Office of Alternative Medicine, a small

office in the National Institutes of Health. They were tasked with reviewing the wide range

of alternative treatments, methods, and practices outside mainstream Western Medicine. Some of these are Acupuncture, Biofeedback, Chiropractic, Naturopathy, and Homeopathy. Until recently, alternative medical treatments and practices have not been reimbursed by medical insurance companies, or used in hospitals.

In a report on recent research, John A. Astin, "Why Patients Use Alternative

Medicine,"(Journal American Medical Association 279(19), May 20, 1998, pp. 1548-1553),

reported on the characteristics of people who use these forms of treatment. He reported that

First, individuals with college or graduate degrees were found to be more likely to use

alternative medicine than those with high school education or less. Second, individuals

reporting serious health problems were more likely to use alternative medicine than

healthier individuals. Furthermore, the majority of individuals who used alternative

medicine did so largely because they viewed these practices as being compatible with their

own values, beliefs, and philosophy toward life and health.

"Some health plans and employers have begun to voluntarily cover different types of

alternative medicine. In January 1997, Oxford Health Plans became the first major health

care plan in this country to offer comprehensive coverage for a range of alternative care

services, including acupuncture, chiropractic, naturopathy, and other specialties (e.g.,

nutrition, yoga, massage therapy). Policy holders, if they choose to pay an additional three

percent premium, are reimbursed for these alternative services. Unlike other health plans

that offer some coverage for alternative medicine, Oxford does not require a referral by a

patient's primary care physician (PCP) to use these services." AARP,Alternative Medicine: An

Overview Fact Sheet, Craig Caplan, AARP Public Policy Institute.

Still, Medicare does not recognize nor reimburse for expenses which are incurred in

Alternative Medicine Health Care. With over 9% of the workforce currently unemployed, with

the increase in health care costs escalating, and with the dubious effects of this current

Administration's proposed Health Plan, including rising copay percentages in Medicare, many

will be uninsured or underinsured and need these alternative methods.

Alternative medicine may reduce primary health care costs and provide more effective care;

it is difficult to generalize about the usefulness and effectiveness of alternative medicine

as a whole. While acceptance of an alternative approach has grown in parts of the medical

community, diehard skeptics will still abound. More research will make acceptance easier for

insurers, providers, employers, and others to evaluate which treatments effectively

complement traditional medicine. Hopefully, this Administration has allocated new funds for

this research.

Do You Really Want Fries With That?

Science Daily (Apr. 25, 2008) — "America's aging citizens are facing a health care workforce

too small and unprepared to meet their needs, according to a new report from the Institute

of Medicine (IOM) titled 'Retooling for an Aging America: Building the Health Care

Workforce' ." This warning from last year has not been heeded. As we head further into this

recession, as medical costs increase and co-pay deductibles increase, medical care for the

aging "boomers" dwindles dangerously.

According to the Gerontological Society of America (GSA), a labor pool of adequate size and

competency to care for a rapidly increasing over-65 population is mandatory. In their

report, they said that there is ".. a much-needed strategy for developing a network of

health professionals and frontline workers to avert a crisis in quality care for older

persons. Complex chronic illness is an issue that we all will face with age. The current

fragmented system of care desperately requires an increase in better-prepared personnel to

sustain itself.The combination of the aging of the Baby Boom generation and the increase in life expectancy is going to yield a doubling of the numbers of older people , and it's important to

understand that older people themselves account for a disproportionate amount of the

utilization of health care resources."

Marie Bernard, MD, president of The Association for Gerontology in Higher Education (GSA's

educational unit), said "..policymakers must act quickly to address these problems.

To meet the needs of our aging parents and grandparents, we need to increase the number of

geriatric health specialists — both to provide care for those older adults with the most

complex issues and to train the rest of the workforce in the common medical problems of old

age," Bernard said.

We "Boomers" must act in our own interests to insure that we are subjected to the fewest

number of age related illnesses as possible, and this begins with the WEIGHT EPIDEMIC in our

age group ( a reported 1 in 4 is OBESE!) The bottom-line message from a decades-long study

of monkeys on a restricted diet is simple: Consuming fewer calories leads to a longer,

healthier life.

Writing July 10 in the journal Science, a team of researchers at the University of

Wisconsin-Madison, the Wisconsin National Primate Research Center and the William S.

Middleton Memorial Veterans Hospital reports that a nutritious but reduced-calorie diet

blunts aging and significantly delays the onset of such age-related disorders as cancer,

diabetes, cardiovascular disease and brain atrophy.

"We have been able to show that caloric restriction can slow the aging process in a primate

species," says Richard Weindruch, a professor of medicine in the UW-Madison School of

Medicine and Public Health who leads the National Institute on Aging-funded study. "We

observed that caloric restriction reduced the risk of developing an age-related disease by a

factor of three and increased survival. In terms of overall animal health", Weindruch notes,

"the restricted diet leads to longer lifespan and improved quality of life in old age. There

is a major effect of caloric restriction in increasing survival if you look at deaths due to

the diseases of aging," he says.

In the following picture, see what person these brave cousins of ours look like, and how old

do they appear? This is visual proof of the effectiveness of a healthy diet and moderate

exercise (how much room does the monkey have to move?). Start making the corrections

today...the number of years you have left is up to you!

Medicare Recipients Challenged By Health Insurance Companies

"Insurance Commissioner Jim Long urged Medicare recipients - particularly senior citizens -

and their families to be aware that some health insurance companies are employing aggressive

marketing tactics to sell Medicare Advantage products which may mislead consumers. According to the Department's respected Seniors' Health Insurance Information Program (SHIIP), many Medicare beneficiaries are receiving bad financial advice leading them to make decisions which are not in their best interest". So wrote Health Plan One in a recent article.

Commissioner Long further said: "..companies are fighting for business. If the number of complaints fielded by SHIIP staff is any indication, some of these companies have resorted to using questionable tactics to win customers ". (Medicare Advantage is HMO, PPO, Medicare Medical Savings Accounts and Private- Fee-for-Service products)

Boomer Generation and older citizens are particularly at risk. Aggressive marketing tactics

ranging from insurance agents soliciting seniors at discount stores to "cold calls" by

agents wishing to set up sales appointments in homes are being used, even recommendations of

canceling other insurance policies to sell theirs. Commissioner Long and the staff at SHIIP

are extremely concerned that this type of solicitation may lead citizens to make poor

decisions that could negatively affect their insurance coverage.

The following recommendations are outlined by Long as things that Medicare recipients should

know about Medicare Advantage (also known as Medicare Health) plans:

You should fully understand the details and terms regarding Medicare Advantage plans, and

the plan you are looking at specifically. Some things to note include:

1. These plans are part of the Medicare program and provide Part A, Part B and sometimes

additional benefits. You may have to pay a monthly premium, or you may have out-of- pocket costs such as co-pays.

2. Medigap or Medicare Supplement policies do not coordinate with any Medicare Advantage

plan.

3. Not all doctors or hospitals accept all Medicare Advantage plans. Make sure your

healthcare providers will accept the plan you are considering before you buy it, or you may

be stuck paying for all your charges yourself! Call your doctor and ask before you buy.

4. Insurance agents cannot come to your home without permission. If they call you to

schedule an appointment, first do the following:

Get the agent's name, the company name, and a phone number.

Call back to verify the person is who he says he is. If you have any doubts, SHIIP can

tell you if that person is a licensed agent; call 1-800-443-9354.

Try to schedule the appointment for a time when a trusted family member or financial

advisor can be with you. Someone you trust can help you make a decision in your best

interest without giving in to any sales pressures from the agent.

If you have other health insurance, such as your employer plan through retiree coverage,

check with that plan before you enroll in a Medicare Advantage plan.

The main thing which every senior should remember- Do not be pressured into making quick

decisions. The agent can wait for you to think this over, discuss it with someone else, call

your doctor and/or call SHIIP for assistance. SHIIP counselors are specifically trained to

assist you with your health insurance questions. Call 1-800-443-9354.

Senior Medical Dilemma: Western or Alternative Medicine?

In a recent article by Djehuty Ma'at-Ra of Dherbs. com (“First Consult Your Physician?”, April 6, 2009), he discused the strength of Western Medicine or allopathy and the reasons for weakness in Alternative Medicine in America. He said :

“No matter what the alternative health product, modality, or therapy, you will always find a disclaimer on the bottle, box, machine, or advertisement, stating: "CONSULT YOUR PHYSICIAN BEFORE USE" as though Western medical physicians actually study up on all the new alternative health products, therapies, procedures, and gadgets/technology on the market today. Physicians don't even study basic nutrition so what makes anybody think they are going to study up on any alternative measures (products, therapies, procedures, and technology) that poses a threat to their linear and specific modality of health (if you can in fact call it a health modality), and their profits?”

While Western Medicine has made significant strides due in part to Federal Grants for research and advances made in Space Medicine from NASA's efforts, Alternative Medicine and its deep ancestral roots cannot should not be overshadowed and ignored. Long before RNA or DNA, practitioners were curing with herbs and plants, minerals, metals, and mixtures which are just as effective today as then. Homeopathy is not NEW, it is our past and should not be forgotten.