Shattering the myths about health reform

In a USA Today editorial today, Steven Findlay, senior health policy analyst at Consumers Union, sheds some light on the myths about health-care reform, many of which have frightened Americans. In it he debunks the notion that our system is headed toward socialized, government-run medicine with a side of rationed care:

"Cookbook and rationed care? This fear stems from concerns that the government aims to dictate what doctors do and cut costs by limiting access to care. These notions are wrong. Rather, what [President] Obama and both Democratic and Republican leaders want to do is aggressively measure the quality of care that doctors and hospitals deliver and change the way those providers get paid so quality of care—rather than quantity—is rewarded. That's hardly a socialistic notion."

So what must be done to fix the system? Findlay urges creative thinking and proposes that the medical industry be challenged to cut costs and change its "General Motors gas-guzzler mindset" by reducing waste and inventing more efficient systems.

FDA confirms E. Coli in Nestlé Toll House cookie dough

A sample of raw cookie dough collected at a Nestlé plant in Danville, Va. has tested positive for E. coli O157:H7. The sample was taken last week, the Food and Drug Administration reported this week.

Earlier this month, Nestlé recalled all its Toll House refrigerated cookie dough after it was suspected as the cause of a foodborne illness outbreak that so far has sickened 69 persons in 29 states, according to the Centers for Disease Control and Prevention.  Of those, 34 have been hospitalized and nine have developed hemolytic uremic syndrome, a serious complication.

Read this full post on our Safety blog, and read more on how to protect yourself from foodborne illness. For more on the recall and what you should do if you've recently eaten a recalled Nestlé product, see the FDA's Q&A.

Q&A with CU President, Jim Guest: Consumers should help decide which issues need medical research

An initial list of 100 research priorities and recommendations* for the future was sent to Congress and the Administration today by the Institute of Medicine, an independent group that advises the government on health policy. The list will serve as a guidepost for spending the $1.1 billion that Congress authorized for "comparative effectiveness research" as part of this year’s stimulus bill. This type of research compares two or more medical treatments or approaches for a given condition. The results help doctors, patients, and caregivers weigh the benefits, harms, and value of various treatments and prevention methods.

Jim Guest, Consumer Union’s President, was part of the committee that chose the priorities. We sat down with him today to discuss what comparative effectiveness funding means for consumers, patients and health-care providers.

What was it like to be a consumer rep amid all the medical experts helping to set priorities for medical research?

I was one of a small group of consumer representatives on a 23-member committee that included professors, medical school chancellors, health-care providers, and other research experts. At first I wasn’t sure how receptive the group would be to the consumer point of view. A lot of experts take a "just leave it to us" attitude. But I found the group really listened and realized the value of input from consumers, patients, and caregivers in deciding what topics to tackle and how to maximize the practical impact of research. In the future, I’d also like to have periodic surveys of consumers and practicing doctors to find out what disease areas and treatment options they think would be most valuable to evaluate and compare in order to make well-informed medical decisions.

Summer safety: Don’t leave your child in a hot car

It may only take a few minutes to park your car and run into the supermarket to buy a gallon of milk. But the next time you park—even if it’s for “just a minute,” don’t leave your child in the car. Sunlight and heat get trapped inside a parked car, and in direct sunlight on an 80-degree day with no ventilation, the temperature can rapidly reach up to 131 degrees, according to the American College of Emergency Physicians (ACEP). In just 10 minutes, a child’s body temperature can go as high as 106 degrees F, leading to damage to the brain and vital organs, heat stroke, dehydration, seizures, and death.

According to our Safety blog, six children this year already have died in overheated cars. In one case, a child died after his father forgot he in the back seat and left him in the car all day. The temperature outside was only in the 60s, but reports say the air in the car topped 100 degrees.

Follow these important tips from the ACEP to keep your child safe:

Readers weigh in on lower-back pain

Readers who have lower-back pain have written us a lot since the Consumer Reports Health Ratings Center Survey results were released in April. We’ve heard from chiropractic fans and chiropractic detractors, readers who have problems with opioid medications and readers who use such narcotics without a problem.

Many writers remarked that our coverage had failed to mention treatments that worked well for them. There was a spinal decompression success story as well as a "compression shirt" success story. There were those who were helped by a therapy called the Feldenkrais Method® and those who swore by another called the Alexander Technique. There was a reader who touted the book "Healing Back Pain: The Mind-Body Connection," by John E. Sarno, M.D., and another who touted Esther Gokhale’s "8 Steps to a Pain-Free Back." There was even a reader who advised patience: "Mother Nature's treatment method was just as effective as that provided by the medical professionals, and she didn't charge a fee."

Letters also reminded us that our survey had neglected to ask about a variety of practitioners, including pain psychologists, physiatrists (physicians who specialize in physical medicine and rehabilitation), pain management doctors, muscular therapists, and osteopaths.

U.S. seniors have better memories than English counterparts

Everyone worries about memory problems as they get older. But U.S. seniors may have less reason to worry than their peers in England—they do a whole lot better on a standard memory test.

Several thousand people over the age of 65 were given the test, in both countries. The test consisted of listening to a list of 10 common words, then repeating them back immediately and again after 5 minutes.

The Americans did far better on the delayed memory test than the English. Researchers said the difference was what you'd normally expect to see over the course of a decade—so Americans age 75 had the memory of English people age 65.

The point of the study wasn't just to crow, however. The researchers are looking hard at the rest of the data from the surveys to try to spot the causes for the difference.

So far, they've found that American seniors were on average wealthier, and had more years of education, than English seniors. That accounted for some of the difference, because wealth and education usually coincide with less of a decline in memory with age. English seniors were more likely to report symptoms of depression, which can affect memory. Another study suggested that depressed older people in the United Kingdom were less likely to be treated with antidepressants than they would be in the U.S.

Health Weekender: Picking better strawberries—does size matter?

I buy strawberries year-round and now that they’re in season, my refrigerator is stocked up. I add them to breakfast cereal, salad greens, and—on a less healthful note—to vanilla ice cream. And I’m not alone—one in five households reported eating more strawberries in the last year, according a survey by the California Strawberry Commission. Those respondents said strawberries are "one of the most healthy fruits you can eat", and are "one of the fundamentals of a healthy diet."

Strawberries are an excellent source of vitamin C, a good source of fiber and folate—a crucial nutrient for pregnant women. Strawberries also have quite a bit of potassium and are one of the richest sources of disease-fighting antioxidants. Studies are being conducted on the effects of strawberries on age-related cognitive functioning and on reducing high blood pressure.

Not all strawberry news is good news, though, particularly if you have allergies. Strawberries contain a common allergen as well as natural salicylate, an aspirin-like compound. And they contain oxalic acid, which can aggravate kidney and bladder stones for some.

Celebrity deaths and drug interactions

To the growing list of celebrities who have died from a mix of perfectly legal prescription drugs—a list that includes Marilyn Monroe, Elvis Presley, Heath Ledger, and Anna Nicole Smith—we might also be adding Michael Jackson.

Right now, there’s little that we know for sure, but there is a lot of speculation about his health and the cocktail of drugs he was likely to have been taking. In the days and weeks to come we’ll hear a lot about the toxic combinations of pharmaceuticals—like anti-anxiety medications, anti-depressants, and painkillers—that may have contributed to his death at 50. Media reports quoting forensic experts and toxicologists will try to unravel the specific drug combinations he was on, why he was on them, how they could have lead to cardiac arrest. And we’ll read about the wisdom of people following doctors’ orders when it comes to mixing potentially lethal drugs.

So what good can come of the death of the world’s most famous pop icon? Do we all need to be starkly and perennially reminded of the potentially toxic nature of drug interactions that happen with commonly-used prescription drugs?

Commuting can pose a hazard to your hearing

If you’ve ever ridden a subway, particularly New York’s aged system, you’ve probably experienced the ear-splitting shrieks as the train takes a fast turn or screeches to a halt. Those sounds are more than just annoying; they can actually contribute to hearing loss, according to a new study published in the August edition of the American Journal of Public Health.

Researchers took sound level readings while waiting for and riding buses, trains, subways and ferries in the New York metro area, and found that subways were the loudest. But they also found that all commuter systems were loud enough to cause noise-induced hearing loss in some riders, given sufficient length of exposure.

How long? The actual risk varies from person to person. But according to the researchers the highest maximum sound level of 102 decibels, recorded at a subway platform, could cause hearing loss over time for some people within just two minutes a day—based on guidelines from the Environmental Protection Agency. The average sound level for the entire New York subway system of 80.4 decibels could cause hearing loss if regular exposure exceeds about an hour and 40 minutes a day, or just 18 minutes per day on some of the noisiest platforms averaging 90.2 decibels.

And with iPods and cell phones now ubiquitous, subways themselves may not be the only in-transit exposure. "Imagine someone on a subway who is getting 80 decibels of exposure in the car," explains Rick Neitzel, a research scientist at the University of Washington in Seattle and one of the study’s lead investigators. "Most people would turn their MP3 player up at least a few decibels above the background noise, if not five or six. So now their exposure isn’t 80, it’s 86. And when we start getting up to sustained levels in the mid-80s that’s a concern because your recommended daily exposure duration is pretty short at those levels—less than an hour based on recommendations from the EPA."

FDA calls on Consumers Union for transparency input

The new Food and Drug Administration (FDA) Commissioner, Margaret Hamburg, is not wasting any time trying to restore the agency’s tarnished reputation and restore its public health and consumer protection missions.

The agency held a public hearing and listening session this week to get input on how it can better communicate with the public about food and drug safety issues and become more open and transparent in all it does. I was one of those testifying, along with about 15 other speakers, and each of us praised the goal of a more open and accessible agency.

There was a substantial emphasis on using the Web as a vehicle for open communications, including quick posting of all actions—for example letters to drug companies that order them to change a drug ad because it’s misleading or inaccurate. Many speakers said the agency had made a good effort to make its Web site better in the last year, but more needs to be done to make it still easier for consumers to navigate.

Consumers Union called for the agency to:

• Make information on the agency’s interactions with industry, the data and analysis the FDA generates internally, its' path to decisions, and all clinical trial data fully public.

• Release the names and addresses of retail outlets where a recalled food product was taken off the shelves as soon as this information can be gathered. This enables local media outlets to report practical information to consumers who can then identify if they have possibly tainted products in their kitchens.

Q&A: Are refined carbohydrates linked to cancer?

Is it true that eating white flour and sugar fuels cancer growth? —B.T., El Macero, Calif.

It’s unclear. Many population studies have examined the possible link between the intake of refined (white) carbohydrates such as flour and sugar and various types of cancer, with mixed results. The largest review we could find, involving 39 studies, found an association between refined-carb intake and colorectal and endometrial cancer, but not breast or pancreatic cancer. But a smaller review of 23 studies found no increased risk of colorectal cancer.

Regardless of any possible cancer risk, there are other good reasons to limit your intake of refined carbs: They provide plenty of calories and have little nutritional value. Instead choose healthful, complex carbohydrates such as whole grains, brown rice, and vegetables.

Find out why successful dieters recommend restricting refined carbs.

Wall Street-run health care

On Wednesday, I traveled to Washington, D.C., to testify in front of Senate Commerce Committee* on one of the things that outrages me the most about our health care system: insurers who deliberately fool customers into thinking they’re getting good coverage when they’re really getting junk insurance that won’t pay their medical bills when they get sick.

But enough about me. The star of the hearing was the conservatively-dressed, quiet-spoken middle-aged guy who sat next to me at the witness table. Wendell Potter, a courageous former senior executive at Cigna, the big national health insurer, used this hearing to go public with his insider knowledge* about how health insurers "confuse their customers and dump the sick—all so they can satisfy their Wall Street investors."

Why did he take this step? Because, he said, he realized that "the industry’s charm offensive—which is the most visible part of duplicitous and well-financed PR and lobbying campaigns—may well shape reform in a way that benefits Wall Street far more than average Americans."

"The top priority for for-profit companies is to drive up the value of their stock," he explained, and to do that, they must meet Wall Street’s demands to spend as little as possible on what the industry calls the "medical loss ratio," but which you and I call "our health care."

Rating the House health reform proposal

In testimony before the House Education and Labor Committee yesterday, Consumers Union’s senior policy analyst, Bill Vaughan rated the House Tri-Committee Draft Proposal for Health Care Reform on how well it met our criteria for meaningful reform for consumers. As explained in a seven-page editorial in the August Consumer Reports, we’re looking for health reform that:

• covers everyone,
• makes insurance simple,
• provides information on quality of care,
• helps employers to offer protection for workers,
• rewards good care—not just more procedures,
• frees doctors to practice medicine,
• and gives you the freedom to choose your plan.

So how does the house proposal rate? Here’s some of what Vaughn told the house committee, including suggestions for what can be improved.

The Tri-Committee proposal will bring us to the goal of affordable, quality dependable health care for all. But we also know that even more savings are possible and can be directed toward spurring breakthrough research if we all work together.

Covers everyone: The House proposal would create a national health insurance exchange that consumers can use to find guaranteed health insurance, regardless of pre-existing conditions. Private plans would compete with the option of a public plan to keep insurance affordable. Subsidies for those making less that 400 percent of the poverty level would expand access to health care to millions of Americans who can’t afford it today.

How quick should you be to change your baby's formula?

When parents choose to bottle feed, they often interpret "difficult" behavior as a sign that cow's milk formula doesn't suit their baby. In one study, 30 percent of babies had their feed switched because of feeding difficulties, or because their parents suspected an allergy to cow's milk.

However, a new study suggests that you might not gain much by switching. The study, published free online by Nutrition Journal, looked at 333 healthy babies. Physician-diagnosed intolerance was similar for both ordinary cow's milk formula and partially hydrolyzed whey protein formula (a type of modified formula that removes some of the proteins found in cows’ milk). The study lasted 60 days, and roughly 1 in 10 babies were diagnosed as intolerant, with the figure hardly varying between the different formulas.

Parents often interpret vomiting, crying, or fussiness as signs of intolerance to formula milk, and switch to a different kind, but these behaviors are common regardless of how a baby is fed. Studies show that about half of babies vomit at least once a day, and about one third have moderate or severe episodes of crying, colic, spit-ups, or feeding difficulties. So, the types of behavior that parents interpret as a reaction to formula milk are actually quite common in healthy babies.

Obama’s health forum includes 5 who told us their stories

President Obama will answer the nation’s questions on health care tonight during the much-talked-about “Questions for the President: Prescription for America” forum, which airs at 10 p.m. EDT on ABC. The president will take questions from an audience made up of "Americans selected by ABC News who have divergent opinions in this historic debate" and others submitted via ABCNews.com. Among those participants are five people who contacted Consumers Union to tell us about some of the challenges they've faced getting affordable, high quality health care:

Ken Bragg of Fayetteville, W. Va.: Ken is an insurance agent who knows first-hand how expensive and inadequate health plans can be. Ken says that many of the people who come to purchase health insurance do not qualify because of pre-existing conditions or are only offered expensive policies. He and his wife have experienced ever-increasing premiums with a high deductible for a policy they rarely use. Ken fears that the high cost of health insurance may force him to abandon running his own insurance agency and go back to work for a large company just for the health-care benefits.

David Cress of Gahanna, Ohio: Although he was covered at the time with an individual health-insurance policy, David was left with more than $100,000 in unpaid medical bills after treatment and surgery for a rare disease. When his premiums climbed to $700 per month, he was forced to drop his policy. Now uninsured, David struggles to pay out of pocket for his ongoing care and was forced to file for bankruptcy late last year.