Monthly Archives for December 2019

Reflecting on a Loved One’s Life Time of Achievements

Published in the Woonsocket Call on December 29, 2019

A few weeks ago, my sister Nancy called to give me the bad news that my brother-in-law, Justin Aurbach, was diagnosed with an aggressive and deadly cancer known as glioblastoma, or more commonly referred to as GBM. This 77 year old Dallas-based endodontist who I knew as relatively healthy, a believer in vitamins and physically active most of his adult life, was now house-bound receiving 24 hour a day care by home health caregivers, along with his daughters Stephanie and Allison, and his partner Ruth who were now all part of a revolving schedule of care.

I booked a quick trip to Dallas to sit with him and show my support and concern. It had been a few years since I had been there and I wondered what the conversation might entail, knowing that our 53-year old relationship could cover a lot of ground. Justin and my sister were always collectors of art, and I soon found myself sitting at a kitchen table, surrounded by colorfully carved images of watermelons, where he and I reminisced as the time flew by.

Justin reminded me that we first met in 1967 when he came to pick-up my older sister Mickie, taking her to dine at Campisi’s Restaurant, a local pizza hangout. Even though it took place over five decades ago, he clearly remembered first meeting my mother as she greeted him from the couch, sitting with her thick soled shoes propped up on the ottoman, smoking a cigarette and wearing her trademark leopard print blouse. He recalls her holding Tony, the family’s three-legged Toy Poodle.

A year later, Mickie and Justin would recruit my twin brother, Jim and me to be ushers at their wedding in 1968. Through the ebb and flow of their life together, from raising children, grandchildren and building a successful dental practice, he reflected on their 41 year marriage, noting ‘how it flew by’ before Mickie passed in 2008.

Justin reminded me of the sage advice he gave me before I entered my freshman year at the University of Oklahoma. “Drink in moderation and put studies before chugging pitchers of beer,” he said. It is funny the things you tend to remember, I thought.

As our conversation became more focused on his health, Justin thought that the symptoms of the tumor might first have appeared over five years ago, when he became dizzy while taking a bike ride. Last August, the symptoms returned while riding again, and a Cat Scan would ultimately reveal his tumor.

Turning 60

In 2003, I had the opportunity to interview Justin about turning age 60 for my weekly senior commentary in the Pawtucket Times. He shared the following thoughts about being at the peak of his career professionally, while only five years shy of reaching retirement age.

In my commentary, Justin said, “It’s great [moving into your 60s], however, far too much [cultural] negativity has been directed at this chronological age.”

At that time, my brother-in-law was in relatively good physical shape. While he would acknowledge that he could not run a four-minute mile, he joked that he never could anyway. As he approached his sixth decade, he admitted that he played a little golf like many of his friends, walked and jogged, and even took time to lift weights.

Dr. Justin E. Aurbach, DDS, had accomplished much in his career by the age of 60. As the first endodontist in the Dallas-Fort Worth area, he was the first in the region to perform endodontic microsurgery, when at that time there were only 78 endodontists in the nation performing such surgery. He is past president of the DFW Endodontic Society, The Southwest Society of Endodontics, and the Dallas County Dental Society. He served as general chairman of the Southwest Dental Conference.

Justin believed strongly that he would still be ‘at the top of his professional game, improving with age’, as he proudly boasted. During my interview with him, he said, “not only am I technically better, but my years of life experience have made me wiser in respect to knowing what can and cannot be done in my life.”

The endodontist attributed much of his success to his wife, children and the many supportive family and friends that were part of his large extended family.

By age 60, his philosophy of looking at the “glass half-full rather than half empty” allowed him to cope with life’s difficulties. This life stage was also a time of excitement and learning for him, while he glided into the years he referred to as “best time of your life.”

Getting to the Big “70”

Ten years later, we would speak again about his approaching the age 70 milestone. He reflected on how so much time had passed, which he noted flew by in “the blink of an eye.” During my 2013 interview with him published in my weekly commentary in this paper, he told me that he would “certainly keep forging ahead at a break-neck pace,” promising that new goals would replace those that were accomplished.

He recalled having attended dozens of funerals, said final goodbyes to his wife, father, father-in-law, mother-in-law, along with many close friends and colleagues. Justin noted that “reading the Dallas Morning News obituary page and constantly attending funerals made him aware of the need to accomplish his set goals with the limited time he had left -” but life goes on,” Justin told me. A year after his wife’s death in 2008, the aging widower again found love and began to date Ruth.

Looking ahead into his 70’s, Justin had no plans to retire. Though financially secure, he aspired to maintain a very full practice until his eighty-fifth birthday. He found added fulfillment teaching endodontic residents at Texas AM Baylor School of Dentistry, a job that he hoped would continue into his 70s, while also staying active in the medical group.

Justin has been an avid bike rider for over 30 years, and despite being 70, he would continue to sneak in a ride when possible, even with his busy schedule. He enjoyed the City of Dallas’s fine restaurants, loved to cook for family and friends, and looked forward to a good play or chamber music performance from time to time. His mantra may well be “Live your life to the fullest, don’t put off tomorrow what you can do today.”

Looking Ahead

Justin says, since the diagnosis of his terminal illness, his house has been flooded with family, friends, referring doctors and even former dental students. “I have made a lot of friends and accept that I have impacted people in a very positive way,” he said, as he cites as an upside of his illness.

As we concluded our talk, he says, “Don’t wait to do things. You never know what the future has in store for you,” adding that he learned this lesson from Ruth.
“Simple things in life are your best bet to living a good life,” Justin tells me, stressing that it doesn’t cost a lot of money to enjoy your life.”

Justin acknowledges that he may live another two to six months with the GBM tumor, but remains optimistic, for there are those who have lived for another 14 years. In his remaining time, he hopes to maintain a “quality of life” that allows him to continue to attend musicals and plays, or perhaps even take short trips.

Final Thoughts

As you reach your 60s and into your 70s, research tells us that exercise, eating a healthy diet, developing a strong social network of family and friends, and continuing to learn and seek out new knowledge all become important in enhancing the quality of your life and increasing your longevity in your later years. However, in our twilight years life can become of full of tough challenges and we may face difficult times.

Ultimately, like Justin, reflecting on personal and professional accomplishments can give you the inner resources necessary to meet the challenges in the final stages of your life.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

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Jenkins: Working Senior’s Priming the Nation’s Economic Engine

Published in the Woonsocket Call on December 22, 2019

In recent years, Senate Majority Leader Mich McConnell of Kentucky, Sen. Marco Rubio of Florida and even former House Speaker Paul Ryan of Wisconsin, have warned that the growing number of seniors is fast becoming an economic drag to the nation’s economic growth, citing the spiraling costs of Social Security and Medicare. As the 2020 presidential election looms, GOP candidates are calling for reining in the skyrocketing federal budget deficit by slashing these popular domestic programs.

In 2015, President Donald Trump declared that he would not touch Social Security and Medicare. But now some GOP insiders are saying he may cut these programs during his second term, if he wins.

But after you read the newly released AARP report, The Longevity Economy Outlook, you may just want to consider these comments about seniors being a drain on the economy as false and misleading claims, just “fake news.”

AARP’s Longevity Economy Outlook report pulls from national data detailing how much people age 50 and older spend, earn working and pay in taxes.

Just days ago, AARP CEO Jo Ann Jenkins penned a blog article on the Washington, DC-based aging group’s website highlighting the findings of this major report. AARP’s top senior executive strongly disputes the myth that people age 50 and over are an economic drain on society. Rather the report’s findings indicate that older workers, who are getting a monthly Social Security check and receiving Medicare benefits, are priming the nation’s economic engine, she says.

“As the number of people over 50 grows, this cohort group is transforming America’s economic markets and sparking fresh ideas, and the demand for new products and services across our economy,” says Jenkins.

Jenkins notes that when older workers delay their retirement they continue to impact the economy by earning a paycheck, purchasing goods and services, and generating tax revenues for local, state and federal government.

“The economic activity of people 50-plus supports 88.6 million jobs in the U.S. generates $5.7 trillion in wages and salaries, and accounts for $2.1 trillion in combined taxes,” says Jenkins.

AARP’s economic impact study, released on Dec. 19, reports that people age 50 and older contribute a whopping $8.3 trillion to the U.S. economy, putting this age group just behind the U.S. (20.5 trillion) and China (13.4 trillion) when measured by gross domestic product. They also create an additional $745 billion in value through being unpaid family caregivers (see my commentary in the November 17/18 issues of the Woonsocket Call and Pawtucket Times).

Jenkins says, AARP ’s major report also projects the economic impact of older works to continue in the coming decades, tripling to more than $28 trillion by 2050 as younger generations (millennials and Generation Z) turn age 50 in 2031 and 2047, respectively.

With the graying of the nation’s population (predicted to be 157 million by 2050), the AARP report predicts that older persons will have more collective spending power, too, says Jenkins. “Fifty-six cents of every dollar spent in the United States in 2018 came from someone 50 or older,” she says, adding that by 2050 this amount is expected to jump to 61 cents of every dollar.

For over six years, AARP has been tracking the economic impact of older adults on the nation’s economy, Jenkins’ penned in her recently published blog article. It’s growing steadily over these years, she says.

“When AARP began researching the economic power of people 50 and older in 2013, we found that they generated $7.1 trillion in economic activity,” says Jenkins, noting that three years later it had grown to 7.5 trillion. “The 2019 report reflects an 11 percent growth in economic impact, a 6 percent growth in jobs created and a 12 percent growth in wages and salaries over the most recent three-year period,” adds Jenkins.

Older Rhode Islanders and the State’s Economy

By virtue of Rhode Island being one of the oldest states per capita in the country we have long been aware of the contribution and buying power older people contribute to the state’s economy,” said AARP Rhode Island State Director Kathleen Connell. “When you add in those 50-64 it becomes a big and powerful percentage of the population,” she says.

Over the years, Connell has observed more engagement with AARP in the younger end of the demographic spectrum because people in their 50s have justifiable concerns about their future. They wonder: “Will they outspend their savings? Will Social Security change in ways that will reduce their benefits? Will out-of-pocket prescription drug expenses sink the savings they hope to put away for retirement?,” she says.

“Waiting for retirement to think about these issues could well be too late,” warns Connell. “This is creating greater interest in government and politics and magnifies the importance of their vote,” she adds.

“At the same time, as older Rhode Islanders remain the workforce longer, they are keep paying taxes – a sizable plus for the state’s economy,” observes Connell. “With their extensive experience, many continue to be movers and shakers, innovators and professionals lending guidance that helps fuel economic growth,” she states.

Connell adds: “Outside the workplace, they are connected in new ways via technology and social media. The great thing is that across the range of 50 and older workers it can be said that more people are sharing the workplace adding to our cultural development and participating in civic engagement more than ever before.”

Wake Up Call to Businesses, Congress

AARP’s report should be a “wake-up call” to businesses and federal and state policymakers to rethink their attitudes, warns Jenkins in the concluding of her blog article. She calls on business leaders to “build strategies for marketing their products and services to older Americans and to embrace a multi-generational workforce.” Jenkins also urges Congress and state law makers to develop policies to support the growing number of uncompensated caregivers.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase “Taking Charge: Collected Stories on Aging Boldly,” a collection of 79 of his weekly commentaries, go to herbweiss.com.

Democratic House Passes Landmark Legislation to Drive Down Spiraling Prescription Drug Costs

Published in the Woonsocket Call on December 16, 2019

Just days ago, the Democratic House leadership successfully pushed for passage of landmark legislation, the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3), that would give Medicare the power to negotiate directly with drug companies to bring down pharmaceutical prices and make those savings available to seniors.

House Democrats passed Speaker Nancy Pelosi’s sweeping legislation on Dec. 12 to lower the cost of prescription drugs on a largely party-line vote. The bill, which passed 230 to 192 with unanimous Democratic support and the backing of two Republicans, Reps Brian Fitzpatrick (R-Penn) and Jamie Herrera Beutler (R-Wash), is considered “dead on arrival” in the Senate. The White House has indicated President Trump would veto H.R. 3 it if it came to his desk.

The House Republicans fought to block passage of H.R. 3 by releasing their own legislative proposal, H.R. 19, to lower drug costs. The bill, consisting of bipartisan legislative provisions to lower drug costs that had already been adopted, would have achieved lower drug prices without imposing government price controls that House Republicans believed would decrease research and development spending for new drug cures.

Although House Republican Whip Steve Scalise called on the Democratic leadership to bring H.R. 19, with 135 sponsors and no Democrats, to the House Floor, the GOP proposal did not receive a vote on its own. It was offered by Rep. Greg Walden (R-Ore.) as an amendment to H.R. 3 and failed by a vote of 201 to 223, getting eight Democrat votes.

The Nuts and Bolts

H.R. 3 would put the brakes of spiraling drug cost by giving power to the Secretary of the Department of Health and Human Services to negotiate directly with drug companies to force real price reductions while also ensuring that seniors never lose access to the medicines they need. The legislation also expands access to the lower, negotiated drug prices to persons with private insurance, not just Medicare beneficiaries.

The 320-page House bill also prevents pharmaceutical companies from price gouging patients by capping the maximum price for a negotiated drug at the average price people in countries similar to the U.S. pay. It would create a brand new, $2,000 out-of-pocket limit on prescription drug costs for Medicare beneficiaries and even delivers vision, dental, and hearing benefits to Medicare beneficiaries for the first time.

H.R. 3 also increases the number of low-income seniors eligible for assistance with their drug costs and cost sharing for hospital and doctor visits. By extending guaranteed issue protections to disabled beneficiaries and to individuals who want to switch from Medicare Advantage to traditional Medicare, the legislation improves access to private supplemental coverage that helps fill in Medicare’s gaps for beneficiaries in traditional Medicare.

“The U.S. House of Representatives resoundingly defied Big Pharma today by-passing historic legislation to lower prescription drug prices for America’s seniors and their families. The Lower Drug Costs Now Act (H.R. 3) accomplishes what we and other advocates have long demanded — that Medicare be empowered to negotiate prices with pharmaceutical companies, which the CBO says will save more than $450 billion in drug costs. It also caps Medicare beneficiaries’ out-of-pocket prescription drug costs at $2,000 per year, says Max Richtman, president and CEO of the National Committee to Preserve Social Security and Medicare, in a statement.

The Pros and Cons of H.R. 3

Richtman says that it is time for the Senate Chamber to act. Drug pricing legislation that passed by the Senate Finance Committee has not been brought up for a vote on the Senate floor. “We insist that the Senate follow the House’s lead and act now to lift the burden of crushing prescription drug prices. Seniors who have been rationing pills or foregoing other necessities in order to afford crucial medications have waited long enough,” he says.

In a statement released following House passage of H.R. 3, AARP Executive Vice President and Chief Advocacy and Engagement Officer Nancy LeaMond, called the legislation” a bold step toward lowering prescription drug prices and high out-of-pocket costs for millions of older Americans.”
“High drug prices disproportionately hurt older Americans, particularly Medicare Part D enrollees, who take between four and five prescription medications each month and have an average annual income of just over $26,000 a year. The average annual price of a specialty drug used on a chronic basis is now $79,000. Medications cannot work if they are unaffordable, says LeaMond.

Adds AARP Rhode Island State Director Kathleen Connell, “Drug companies are price-gouging older Americans and taxpayers– who pay the highest drug costs in the world,” noting that “AARP is proud to support H.R. 3, which would allow Medicare to negotiate drug prices and cap out-of-pocket costs for Part D enrollees. The bill also enhances Medicare by improving access and adding needed dental, hearing, and vision coverage.”

Opposing the passage of H.R. 3, the White House says in a statement, “Heavy-handed government intervention may reduce drug prices in the short term, but these savings are not worth the long-term cost of American patients losing access to new lifesaving treatments.” Noting that lowering the price of prescription drugs is major concern for seniors, the White Houses warned that H.R. 3 is the wrong approach to address this issue, “especially when bipartisan legislative alternatives that encourage innovation while lowering prescription drug

During a briefing with reporters over two months ago, President and CEO Stephen Ubl, of the Pharmaceutical Research and Manufacturers of America (PhRMA), warned the passage of H.R.3 would trigger “nuclear winter” for biotech innovation. Fiercely opposing passage, PhRMA has called on the Senate to “stop H.R. 3 in its tracks.”

Putting the Brakes on Rising Drug Costs in Rhode Island

“We all know someone who has been forced to ration the medication they need to live so that they can afford to keep a roof over their family’s heads or put food on the table. In America, in 2019, this should never be the case,” said Congressman David N. Cicilline (D-RI), who voted to pass the measure. “Pharmaceutical companies have abused American patients and taxpayers to increase their profits hand over fist without recourse for too long. The Lower Drug Costs Now Act will put an end to the price gouging by big pharma that sees American patients and taxpayers paying more for their prescription drugs than people in other countries, says the Rhode Island Congressman representing the state’s first congressional district.

In his 2016 campaign, President Donald J. Trump supported the government to negotiate drug prices. Cicilline calls on the president to honor this promise and urges Republican Senate Majority Leader Mitch McConnell to bring a companion measure to the Senate floor for consideration. At press time more than 300 House passed bills are stuck in the Senate (about 275 are bipartisan).

According to Cicilline, the out-of-pocket savings to Rhode Islanders will be substantial. “This year alone, more than 1,000 women in the state will be diagnosed with breast cancer, 550 people will be told they have prostate cancer, and 190 folks will be diagnosed with leukemia. H.R. 3 will lower the average costs of many popular medications for these and other cancer treatments. The cost of Ibrance for treating breast cancer will be reduced by as much as 65 percent. Zytiga, a common prescription for people with prostate cancer, will be reduced by as much as 66 percent. And the cost of Tasigna, which is commonly prescribed to people with leukemia, will go down by as much as 71 percent,” says Cicilline, who serves as the Democratic Policy and Communication Committee Chair.

Earlier this year, the Rhode Island Congressman released information detailing how much more Rhode Islanders with diabetes pay for their insulin than people in other countries. Currently, 8.6 percent of Rhode Islanders, just over 83,000 people, have diabetes. They pay from $1,200 to $20,000 per year for the most commonly used insulin medications. Under the newly passed H.R. 3, the average total cost of NovoLOG Flexpen, a common insulin medicine, would decrease by as much as 76 percent. Under H.R. 3, Rhode Islanders could spend 3.5 times less on insulin, and some of the commonly used insulins could cost as little as $400 per year.

According to Cicilline, seniors in his Congressional District will see Medicare improvements if H.R. 3 becomes law. At this time, Medicare does not provide coverage for: oral exams for 71 percent of beneficiaries, eye exams for 66 percent of beneficiaries, hearing exams for 66 percent of beneficiaries, dental exams for 75 percent of beneficiaries, eye glasses for 75 percent of beneficiaries, and hearing aids for 86 percent beneficiaries.

Under H.R. 3’s Medicare expansion, 93 percent of beneficiaries (98,800 people) stand to gain from adding a dental benefit, 75 percent of beneficiaries stand to gain from adding a vision benefit, and 97 percent (102,700 people) of beneficiaries stand to gain from adding a hearing benefit.

On December 6, Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) released an updated version of their bipartisan Prescription Drug Pricing Reduction Act of 201. Will McConnell, who controls its legislative fate, allow it to be considered on the Senate floor? Can a conference committee iron out the different between a Senate bill and H.R. 3, that can be pass both chambers and be signed by the president?

The legislative clock is ticking. It’s 324 days until the upcoming 2020 presidential election and the voters are demanding Congress to put aside philosophical policy differences and come up with a compromise that will truly put the brakes on rising drug costs. We’ll see.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.