Better Health Care Newsletter - December 2023

As the year draws to a close, seasonal thoughts turn to charitable giving and goodwill towards all people, especially those in need.

Gratitude for our own gifts and the wish to share good fortune with others, research suggests, creates its own mental and physical health benefits for us.

So, in keeping with welcome warm wishes, here are a few thoughts on where the generous might consider helping in the days ahead.

Many shortfalls persist in the U.S. health and medical systems. They can be relentless in draining the spirit and resources of the sick, poor, and hungry. These are a few of many options to consider donating:

Blood. The Red Cross warned this fall that the nation’s supply plunged to critical levels. Donors answered the call. But the agency said it would take weeks for supplies to rebound, and the need for donors is constant.

Donated blood becomes an instant, urgent need for those involved in terrible vehicle wrecks. Or for those who must undergo major surgery. It is a big, sustained demand for patients with chronic illnesses, including certain cancers.

As the American Red Cross advises, “every 2 seconds someone in the U.S. needs blood and or platelets.“ Approximately 36,000 units of red blood cells are needed every day in the U.S. But insufficient numbers of Good Samaritans give blood and do so regularly, leaving the nation’s health care system — and countless patients across the country — in constant worry about supplies.

Not everyone may give blood, and there are eligibility requirements to safeguard donors and the supply. These changed this year, as the Red Cross notes, “for those who spent time in Europe, and [with] the elimination of questions based on gender and sexual orientation in our Eligibility FAQs. More information [is available] also on our LGBTQ+ Donors page.”

Giving is painless. And hospitals, clinics, and blood-banking institutions, with a boost from charitable organizations, try to make the process as convenient as possible.

For more information on donating blood, please click here.

Assistance with medical debt. This scandal of the U.S. medical system afflicts as many as 100 million regular folks, with an estimated quarter of adults owing more than $5,000, according to news reports. Patients’ indebtedness to doctors, hospitals, and others forces far too many to forgo needed medical treatment and prescription medications, as well as causing “families to cut spending on food and other essentials. Millions are being driven from their homes or into bankruptcy.”

Despite the efforts exerted too often by doctors, hospitals, and other providers to squeeze patients — especially the poor, working poor, and uninsured or underinsured — for every penny they possess, collection efforts frequently go for naught. That leaves financial institutions to aggregate, buy, and sell medical debt with what can be cruel abandon for those who find these stressful obligations hanging over their lives.

Enter RIP Medical Debt, a New York-based 5013(c) founded by, yes, two former debt-collection executives. They have shown how gifts from the charitable can wipe out substantial medical debts, with a $100 contribution, for example, eliminating $10,000 in others’ obligations.

Churches and other groups, as well as politicians and governments, have stepped up to help erase medical debt that saps patients and their loved ones so much that 1 in 5 fear they never will pay off their medical bills.

The efforts to erase medical debt have gotten increasing public attention, including by HBO satirist John Oliver (see his piece by clicking here) and in a poignant New York Times article about a terminal cancer patient with a last wish to help others — effectively clearing an estimated $20 million owed by people she did not know.

For more information on RIP Medical Debt, please click here.

Food insecurity. Hunger and lack of food is an unrelenting problem, not only after disasters and not just in the developing world. As the experts and advocates underscored in the 2022 White House Conference on Hunger, Nutrition, and Health, the first such event in a half century: “Millions of Americans are afflicted with food insecurity and diet-related diseases — including heart disease, obesity, and type 2 diabetes — which are some of the leading causes of death and disability in the U.S. The toll of hunger and these diseases is not distributed equally, disproportionately impacting underserved communities … Lack of access to healthy, safe, and affordable food, and to safe outdoor spaces, contributes to hunger, diet-related diseases, and health disparities …”

Since 2010, a novel group of people with expertise in food have tried to ensure that nutritious meals, a fundamental of human welfare, get to those in the worst circumstances. Chefs around the globe have answered the emergency calls and rallied around José Andrés and the World Central Kitchen charity he founded with his wife.

Andrés, who launched his superstar culinary career in Washington, D.C., has defined the group’s global mission: “WCK is a nonprofit organization that is first to the frontlines providing fresh meals in response to crises, while working to build resilient food systems with locally led solutions. Applying our model of quick action, leveraging local resources, and adapting in real time, WCK has served more than 200 million nourishing meals around the world.”

The organization in recent times has fed the hungry in Ukraine, Armenia, Afghanistan, Israel, Gaza, Morocco, Turkey, Hawaii, and Florida. The group welcomes volunteers, as well as donations of many different kinds.

To learn more about battling food insecurity nationally and in the region, click on these links (they represent a slice of the many charitable groups involved in the struggle): D.C. Central Kitchen, Maryland Food Bank, SOME (So Others Might Eat), Capital Area Food Bank, and D.C. Hunger Solutions.

Gun safes. Let’s not argue the Second Amendment during the holidays. But with firearm purchases having skyrocketed during the coronavirus pandemic, so, too, have tragic results — soaring deaths and injuries to our children and others, as well as spiking suicide rates.

The rising tide of evidence shows that keeping weapons in a home makes its residents less safe. Those who insist on arming themselves for personal protection can, research is showing, protect others by ensuring their firearms are kept securely — locked away, unloaded and with ammo stored separately, and far from curious kids and those who, in a momentary crisis, might cause themselves serious harm.

Go kits (and emergency plans). It’s impossible now to ignore just how susceptible so many of us are to disastrous conditions due to weather extremes, wildfires, earthquakes, and who knows what other calamities. With all the loved ones gathered, and in an appropriate time, take a few moments to ensure that everyone you care about knows about emergency planning and resources.

Do you have a household “go” or “ready” kit that can be grabbed in a flash and sustain the medical and health needs of you and yours for a few days or more? Do you have ready an emergency supply of prescribed medications, water, food, flashlights, cell phone chargers, and more?

It isn’t an endorsement of the products, research, and testing by the New York Times’ “Wirecutter” section and its editors and reporters. But the consumer-focused section recently published useful information on thinking about goods and services that folks may need in a hurry for various problematic situations. Looking at the material (available by clicking here) can, if nothing else, give buyers an idea of potential purchase prices.

Over-the-counter opioid overdose “antidotes” and fentanyl testing strips. The United States has been besieged by opioid overdoses and deaths,. CNN reported that the associated fatalities “reached another record level in the United States this spring …data from the US Centers for Disease Control and Prevention shows [with] 2023 .. on track to be another devastating year amid the drug epidemic. More than 111,000 people died from a drug overdose in the 12-month period ending in April [2023}, according to the new estimates.”

With this persistent threat relenting little, federal authorities have sought to respond by making the drug Narcan this fall “the first opioid overdose reversal medication approved for over-the-counter purchase,” the New York Times reported.

Major pharmacy chains have said they will stock the nasal-spray medication and make it available for OTC sale at a cost of less than $50. Those who head households with young people can go through the appropriate discussion and decision-making on the significance of having Narcan in the medicine cabinet. But it may be helpful to know that many schools, libraries, and public facilities already have chosen to respond to the opioid crisis by having this medication at the ready for all-too-common overdose emergencies.

With law enforcement officials also warning that evil criminals are tainting even “lesser” street drugs like marijuana with fentanyl — the highly potent and risky synthetic opioid — it may be prudent to have inexpensive test strips on hand. These can be purchased online, though public health, educational, and anti-drug organizations also are trying to make the test strips more readily and widely available, especially for the young. In the District of Columbia, a handful of scattered vending machines dispense Narcan and condoms.

The firm maintains a list of charities we support. Check it out by clicking here.

Over the years, the newsletter has offered various annual suggestions on ways to help others, including all you need to know about:

Becoming an organ donor.
Participating in medical research.
Donating leftover prescription medications, no longer needed durable goods, and eyeglasses and hearing aids

My colleagues and I enjoy a great gift all year long, of course — the opportunity to work with terrific clients and all the wonderful folks who make the firm a success.

Our thanks and best wishes to all for safe, happy, and healthy holidays and a superb new year and beyond!

While grownups work themselves into a frenzy to buy youngsters the perfect, hot toys of the season, experts have important advice for the holidays:

Ease up, folks. The kids, especially the younger ones, benefit more from simple, familiar, and imagination-building toys. Consider giving age-appropriate books, blocks, easy puzzles, coloring and drawing materials, safe dolls, and balls
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Think hard about adding an adorable pet to the household for the holidays. Animals require a lot of care and resources, and, the kids’ begging notwithstanding, grownups must conscientiously assess the commitment required. If you have pets, keep in mind how the holidays affect them, too.

Safety must be a prime consideration for children’s presents. The federal Consumer Product Safety Commission has posted excellent information online on this topic (click here to see it).

The agency and others advise this: Avoid toys with parts that can be broken off or with pieces that can be put in the mouth and swallowed or that can choke a child. Look out for items with sharp edges or loose strings, ribbons, or cords. Use caution about ordering from vendors online. Some of them may be overseas, where product laws are lax on issues like flammability of clothing or durability of goods. Be wary of gifts that make lots of noise or feature bright lights.

Batteries, especially of the button variety, pose high hazards — not only for tots who may ingest them but also with charging and fire hazards in devices fancied by older kids.

The pleading by the young — or worse — may crescendo at this time of year for video games, cell phones, tablets, and other electronic gadgets and gear. If you’re old enough to know why the barn door gets shut ahead of trouble, then you’ll also appreciate how vital it is to set rules and boundaries about e-devices and their use in advance of young folks getting hold of them.

The New York Times has posted information on this challenging topic, as has the Mayo Clinic (which also offers a self-guided program on screen-time slimming).

With increasing attention on potential harms inflicted on vulnerable young folks by social media and its misuse, grownups must pay special attention to this problem — both as kids get new devices to access online material and as youths spend the holidays at home.

How much do adults know about what the kids are up to, especially during the seasonal vacation? Here’s a way to get a better handle: Why not dedicate this special time of the year to family activities? Ask yourself and your peers what you remember from your own growing-up time. Do you talk about all the coolest toys and gizmos you got? Or do your fondest memories turn to special times spent with siblings, parents, aunties, uncles, grandparents, and others in the family?

In contemporary times, people have different views on what constitutes family. Getting these important people in our lives together isn’t always easy or without its potential challenges. But spending quality time with those we cherish and who cherish us can be moving, powerful, and memorable as a real seasonal gift.

Let’s not let the next few weeks undo a year’s hard work at staying healthy.

The holidays can be stressful, so keep moving. Go for lots of walks. Keep hitting the gym and the pool. Try to get that restful seven or eight hours of sound sleep — and do so by maintaining a healthy evening schedule that shuts down devices and anxiety-arousing activities well ahead of when everyone in the house puts head to pillow.

The year is ending, not the world, so determine what’s a reasonable amount of work and other important stuff you can get done — and what will just have to wait until 2024. Stop trying to be superhuman.

While the evidence diverges on whether most of us pack on five or more pounds by overeating from Thanksgiving until after the new year, it is clear that some weight gain not only occurs but is tough to shed. This is especially true because the weather typically turns so gnarly that many folks stay in and get too sedentary in chilly January and February.

Experts say that totally denying yourself the seasonal eats that we all love so much isn’t a workable strategy. Instead, they urge moderation. Take the small snack plate or just use a napkin, so you don’t load a platter full of sugary, calorie-laden treats.

During holiday feasts, sample the delights without going overboard. Focus on eating the plant foods that are prepared in the healthiest fashion, loading up on salads and vegetables and going easy on the potatoes, stuffings, rice, and noodles. Look for lean proteins, not fatty portions or those that carry excess salt.

Please be responsible with intoxicants (booze or dope or whatever), and do not drive while under the influence — an action that can carry dire consequences. Be aware if you are taking prescription medications that these can interact with “fun” substances. Let the people you love know that they can call for a ride or you will help pay for one for them if they are unsafe to get behind the wheel.

While some people are popularizing the notion that easing way up on their prohibitions during the holidays can be magically remediated with “dry January” or other similar pledges, be aware that getting drunk or high to excess can offer a powerful warning of serious substance abuse problems. Alcohol consumption soared during the coronavirus pandemic, experts say, and too many Americans find themselves with real problems with the substance now.

Those who pursue amorous activities beyond a smooch under the mistletoe should know that an epidemic of sexually transmitted diseases is raging now. The sexually active must take appropriate steps to avoid unplanned pregnancies and STD infections, for which testing is a key step and increasingly can occur in the privacy of the home with federally approved over-the-counter products.

Recent Health Care Developments of Interest

Here are some recent health and medical news articles that might interest you:

It’s something older and sicker Americans discover, pronto. But is anybody addressing the baleful state of the nation’s long-term care? KFF Health News, an independent and nonprofit media organization, the New York Times have investigated this nightmare, finding in their “Dying Broke” series that: “The financial and emotional toll of providing and paying for long-term care is wreaking havoc on the lives of millions of Americans. Paid care, either at home or in a facility, is often so expensive that only the wealthy can afford it, and many of the for-profit companies providing care raised their prices sharply during the pandemic. The ongoing shortage of health care workers is also worsening the situation. The project found that nearly three million older Americans who need long-term help are not receiving it, in large part because of the high costs of assisted living facilities, nursing homes and aides at home. The United States spends less on long-term care than do most wealthy countries.” Click here to see the series’ start and to access other its parts.

While state lawmakers have passed a passel of health insurance-related protections for consumers, the officials responsible for enforcing the regulations are too few in number and capacity — leaving patients in the lurch on important coverages, according to the Pulitzer Prize-winning site ProPublica. The news organization found in its investigation that: “Over the last four decades, states have enacted hundreds of laws dictating precisely what insurers must cover so that consumers aren’t driven into debt or forced to go without medicines or procedures. But health plans have violated these mandates at least dozens of times in the last five years … In the most egregious cases, patients have been denied coverage for lifesaving care … a ProPublica investigation traced how a Michigan company would not pay for an FDA-approved cancer medication for a patient, Forrest VanPatten, even though a state law requires insurers to cover cancer drugs. That expensive treatment offered VanPatten his only chance for survival. The father of two died at the age 50, still battling the insurer for access to the therapy. Regulators never intervened.”

As the nation keeps graying so rapidly, experts say increasing numbers of Americans, especially women, not only are grappling with the huge burdens of being unpaid caregivers. While they may garner high praise on occasion for their selfless sacrifice, caregivers struggle, too, with high frustration, anger, and even rage, according to the New York Times, which reported: “There’s this myth of the loving caregiver,” said Allison Lindauer, an associate professor of neurology with the Oregon Health & Science University School of Medicine. But she and other experts said that anger and frustration are inevitable parts of the caregiver experience, and that it is important to normalize those feelings.” Experts quoted by the newspaper urged caregivers to find ways to blow off steam, including just finding a private place to scream. As the New York Times noted, “Long-term caregiver stress has been tied to health issues, like diabetes, arthritis and heart disease.” Know any of the tens of millions of folks who must deal every day with caring for another? The holidays are a great time to give them a shout and a hand.

Tens of millions of older Americans enrolled in Medicare Advantage believing the promises of extensive benefits. A furor is growing, however, among doctors and hospitals with the insurers who run these programs, the Washington Post has reported. Critics accuse the insurers of profiteering on Medicare Advantage by requiring advance approvals for too many services and procedures — then denying or delaying them, as well as holding up payments. Battles among insurers and providers are not new in medicine. But patients are getting caught, as always, in the crossfire and roughly half of seniors have chosen advantage programs over regular coverage.

Don’t give your employer an unwarranted gift. Instead, give yourself and the folks closest to you a December health boost. Check with your human resources department. But many companies have use-it-or-lose-it rules for tax-advantaged, health-saver accounts. This is more true of the variety known as FSAs or flexible spending accounts, though companies have tried to stretch out spending deadlines. Any money left in the accounts past clear, specific deadlines reverts to your company. Businesses have collected jaw-dropping sums this way — billions of dollars annually. The federal government, in the meantime, has broadened to a long list (click here to see) of items and services on which holders may expend their HSAs. By the way, you have made important decisions for next year about your health insurance coverage (under Obamacare and Medicare), right?