Author Archives for Herb Weiss

How to Keep Social Security off the GOP Chopping Block

Published in Woonsocket Call on April 6, 2015

One of the first political skirmishes to protect the nation’s Social Security program, 589 days before next year’s Presidential election, took place on March 24th in the U.S. Senate during budget debate. Leading the charge, Rhode Island Senator Sheldon Whitehouse called up Senator Wyden (D-OR)’s budget amendment, requesting a Senate point of order against legislation to cut benefits, raise the retirement age, or privatize Social Security.

During the debate, “Social Security benefits are a solemn promise that our seniors have earned over a lifetime of work,” said Whitehouse, a founding member of the Senate’s Defend Social Security Caucus. “Sadly, Republicans have made it their mission for decades to dismantle that promise, attempting to turn it over to Wall Street and cut benefits through misguided ideas like the so-called ‘chained-CPI’,” he charges, noting that the Democratic sponsored amendment protects Social Security from right-wing attacks and ensure that retirees can count on their earned retirement benefits.

Republican Senator Enzi from Wyoming raised a point of order, calling Wyden’s amendment non germane to the budget resolution being debated. With the Democrats rallying 51 Senators to vote yea, 60 votes were required to wave Enzi’s point of order.

Although his attempts to protect Social Security in the Senate budget failed, Richard Davidson, Whitehouse’s Rhode Island Press Secretary, tells this columnist that the Senator plans to continue his efforts to keep Social Security off the GOP budget chopping block and from being privatized by supporting legislation like the Keeping Our Social Security Promises Act, legislation that would raise the income cap on the payroll tax to ensure the program’s solvency.

Davidson also states that the Social Security trust funds are projected to be fully solvent though 2033, and there’s no immediate funding crisis. But, in the longer run, Whitehouse believes the program must be bolstered by applying the payroll tax, which currently only applies to income up to $118,500, to higher levels of income, he says.

Protecting SSDI

One month before the Senate Budget debate, the GOP-controlled Senate Budget Committee put a spotlight at a hearing on the impending insolvency of the nation’s Social Security Disability Trust Fund (SSDI). The federal government has predicted that SSDI fund reserves will run low by the end of 2016, at which point millions of disabled beneficiaries could see up to a twenty percent cut in benefits.

At the Senate hearing, entitled “The coming crisis: Social Security Disability Trust Fund Insolvency,” Democrats called for an easy quick fix to the problem, specifically the shifting of a small percentage of the Social Security payroll tax from the retirement trust fund to the disability trust fund. No big deal, they say, because these transfers have occurred 11 times in the past with bipartisan support without political bickering. But, from this hearing it seemed clear that GOP Senators, who control the Senate, now see things differently and are threatening to block the infusion of funds to SSDI.

Approximately 10.2 million Americans received SSDI benefits in 2013, including roughly 42,000 Rhode Islanders. In order to qualify, beneficiaries are required to have worked in a job covered by Social Security, and must have been unable to work for a year or more due to a disability.

A February 9 posting on the Plum Line blog, penned by Greg Sargent for the Washington Post web site, takes a look a look at this SSDI entitlement debate.
In his opinion blog, Sargent says that GOP lawmakers claim that a “restricting a fund transfer is all about forcing a necessary discussion on how to improve Social Security’s long term finances, rather than merely “kicking the can down the road.” On the other hand, the Washington Post blogger believes Democrats see the Republicans as “exaggerating the sense of crisis to realize one of two political goals. Either they want to force immediate, and unnecessary, cuts – or they want to hold the disability fund hostage, in order to have another run at cuts to the broader program [Social Security].”

Gathering the Troops

At a March 23rd panel discussion hosted by the Providence-based Headquarters of Community Action Partnership , Whitehouse and Congressman Jim Langevin with Rhode Island Senator Donna Nesselbush, a disability attorney, along with SSDI recipients, disability groups, and the Social Security Administration, came to discuss the solvency of SSDI and its impact on the Ocean State. The lawmakers called for shifting Social Security payroll taxes to financially shore up the ailing SSDI program. Both lawmakers also supported a long-term solution, fully funding the federal retirement and disability programs by lifting the cap on the amount of income that is subject to the payroll taxes that fund the program.

“Right now, a millionaire hedge-fund manager pays the same amount of taxes into the Social Security system as someone who makes $118,500,” said Whitehouse. He called for “wealthiest Americans to pay a fair share into the program, so that it’s not funded disproportionately on the backs of middle-class workers.”

Congressman Langevin stressed “SSDI is not only a critical safety-net for disabled workers, their children and spouses, it is also a promise we make to everyone who pays into the Social Security trust fund that they won’t be impoverished if they are left with a debilitating condition or disability.”
Although Whitehouse’s efforts to protect the nation’s Social Security and Disability programs were derailed in the Senate Budget debate because of a GOP procedural call, it’s only the first of many political skirmishes to come. The upcoming 2016 Presidential elections will firmly put this entitlement issue on the nation’s radar screen, hopefully to address once and for all.

But, here’s my message to Whitehouse: Even if you lose a skirmish, or battle, you can always win the war. Keep pushing.

Herb Weiss, LRI ’12, is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

Putting the Brakes on Testosterone Prescriptions

Published in Pawtucket Times on March 30, 2015

Sophisticated mass marketing pitching testosterone to combat age-related complaints combined with lax medical guidelines for testosterone prescribing can be hazardous to your physical health, even leading to strokes and death, warns an editorial in this month’s Journal of the American Geriatrics Society.
The March 2015 editorial coauthored by Dr. Thomas Perls, MD, MPH, Geriatrics Section, Department of Medicine, Boston Medical Center in Boston, and Dr. David Handelsman, MBBS, Ph.D., ANZAC Research Institute, in New South Wales, Australia, expressed concern over commercial-driven sales of testosterone, effectively increasing from “$324 million in 2002 to a whopping $2 billion in 2012, and the number of testosterone doses prescribed climbing from “100 million in 2007 to half a billion in 2012.”

Pitting Patients Against Patients

The editorial authors see the “40 fold” increase of testosterone sales as the result of “disease mongering,” the practice of widening the diagnostic boundaries of an illness and aggressively promoting the disease and its treatment in order to expand the markets for the drug. Glitzy medical terms, like “low T” and “andropause,” showcased in direct-to-consumer product advertising pit aging baby boomers against their physicians, who demand the prescriptions, say the authors.

“Clearly, previous attempts to warn doctors and the public of this disease mongering that is potentially medically harmful and costly have not been effective, says co-author Dr. Perls.

The epidemic of testosterone prescribing over the last decade has been primarily the proposing of testosterone as a tonic for sexual dysfunction and/or reduced energy in middle-aged men, neither of which are genuine testosterone deficiency states,” observes Dr. Handelsman.

According to the National Institutes on Aging (NIA), the nation’s media has increasingly reported about “male menopause,” a condition supposedly caused by diminishing testosterone levels in aging men. “There is very little scientific evidence that this condition, also called andropause or viropause, exists. The likelihood that an aging man will experience a major shutdown of testosterone production similar to a woman’s menopause is very remote.”

The authors agree with the NIA’s assessment, but go further. They point out in their editorial that for many men, testosterone does not decline with age among men retaining excellent general health, and if it does, the decline is often due to common underlying problems such as obesity and poor fitness. Those who hawk testosterone have developed advertising that focus on common complaints among older men such as decreased energy, feeling sad, sleep problems, decreased physical performance or increased fat.

But, many times a testosterone level won’t even be obtained and the patient is told that, simply based on these common symptoms alone or with minor reductions in serum testosterone, they have “late onset hypogonadism” or that their erectile dysfunction may be improved with testosterone treatment, say the authors. But the authors also point out the true hypogonadism is the cause in fewer than 10% of men with erectile dysfunction.

FDA Enters Debate

The U.S. Food and Drug Administration’s (FDA) recent dual commission findings concluded that testosterone treatment (marketed as ‘low T’) is not indicated for age-associated decline. The benefits of this “deceptive practice” remain unproven with the risks far outweighing the perceived benefits,” says the agency. Pharmaceutical companies are now required to include warning information about the possibility of an increased risk of heart attacks and stroke on all testosterone product labels.

Health Canada, Canada’s FDA, recently echoed the FDA’s committee findings that age-related hypogonadism has not been proven to be a disease-justifying treatment with testosterone. Both agencies warn of an increased risk of blood clots in the legs and lungs and the possibility of increased risk for heart attack associated with testosterone use.

In a statement, James McDonald, the chief administration officer for the Board of Medical Licensure and Discipline, says: “There is a concern in healthcare regarding direct-to-consumer prescribing of medication. At times, the prescription is not evidence-based, and can lead to misuse. There is concern with Testosterone, a schedule 3 controlled substance,that can be used as a performance-enhancing drug. The Rhode Island Board of Medical Licensure (BMLD) investigates complaints regarding all types of misuse of prescription medications as well as complaints regarding over-prescribing.”

Drs. Handelsman and Perls also warn about another drug commonly hawked for anti-aging, growth hormone. The FDA requires that doctors perform a test to demonstrate that the body does not produce enough growth hormone. “Those who market and sell HGH for these common symptoms nearly never perform the test because if they did a properly performed test, it would almost never be positive because the diseases that cause growth hormone deficiency in adults, such as pituitary gland tumors, are very rare,” said Perls. Growth hormone is well known for its side effects, including joint swelling and pain and diabetes. Ironically, opposite of anti-aging claims, growth hormone accelerates aging, increases cancer risk and shortens life span in animal studies.

In the editorial, Perls and Handelsman call upon professional medical societies and governmental agencies to take definitive steps to stop disease mongering of growth hormone and testosterone for conjured-up deficiencies.
“These steps include the banning of ‘educational’ and product advertising of testosterone for these contrived indications,” said Perls. “Furthermore, the FDA and Health Canada should require a physician’s demonstration of a disease process proven to benefit from testosterone administration in order to fill a lawful prescription for testosterone.”

Tightening Up Prescription Guidelines

The issue of prescribing testosterone is firmly on the medical profession’s radar screen with the FDA’s recent committee’s findings and Perls and Handelsman’s pointed editorial calling for the medical profession to seriously tighten up the lax consensus guidelines in order to stop the medically inappropriate prescribing of testosterone.
Rather than pushing testosterone, wouldn’t it be a “mitzvah – a good deed- if the nation’s pharmaceutical companies ran public service commercials stressing the importance of losing weight, exercising and eating nutritious meals as a way to effectively combat age-related problems, like low libido. But, this won’t happen because it is not a revenue generator or good for the company’s bottom line.

Herb Weiss, LRI ’12 is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

Study Shows Meal Deliveries Positively Benefit Seniors

Published in Woonsocket Call on March 22, 2015

In 2013, Dr. Kali Thomas, an assistant professor at Brown University’s Center for Gerontology and Healthcare Research, published a study that found home delivered meals can keep persons age 60 and older at home, allowing them to age in place.  The study’s data also indicated that some states would experience cost savings if they expanded meals on wheels because that could delay a Medicaid recipient’s entry into costly nursing home care.

The “More Than a Meal” pilot research study, conducted by Thomas, was released on March 2, 2015 the Alexandria, Virginia-based Meals on Wheels America, the oldest and largest national group representing over 5,000 community-based senior nutrition programs. The gerontologist found benefits far beyond basic nutrition identified by her earlier 2013 study — health and psychological benefits, too, particularly for those seniors who live alone.

Details of Groundbreaking Research Study

Thomas, contracted by Meals on Wheels America with funding provided by AARP Foundation, designed and executed the 15-week pilot study, involving over 600 older participants, in eight sites around the country, including the Ocean State.  Study participants either received personally delivered fresh meals daily, or weekly bulk deliveries of frozen meals, or just simply remained on a waiting list.

The Brown University researcher found those living alone who received meals showed statistically significant reductions in feelings of isolation, an effect that was greater if they received meals daily rather than weekly.  They also felt significantly less lonely, were less worried about staying in their homes, and said they felt safer. Those also receiving meals experienced fewer falls and hospitalizations.

Thomas said that based on her personal experience as a driver for Meals on Wheels of Rhode Island and as the family member of a meals recipient (her 98-year old grandmother), she was not at all surprised to see the positive benefits she observed anecdotally emerge as significant in a rigorous research study.

Elle Hollander, President and CEO on Wheels America, notes that her members have “faced tough choices forced by limited funding, rising costs, unprecedented demand and need, and increasingly for-profit competition.”  Hollander says, “We now have the research-backed evidence that confirms what we’ve all know for decades anecdotally through personal experience: that Meals on Wheels does in fact deliver so much more than just a meal.”

AARP State Director Kathleen Connell agrees.  “It really has been no secret that home-delivered meals are a critical for the older population, as well as the disabled. With  Kali Thomas’s earlier Brown data released in 2012 in our award-winning senior hunger documentary Hungry in the West End, the newest research reinforces what Thomas said in film: the nutritional benefits and relief from food preparation allows people to live in their homes longer and to stay healthier. And so, there are long term healthcare benefits as well as savings to the state if the investment in home-delivered meals delays someone’s transition from independence or home-based care into a Medicaid-supported nursing facility.”

A Call for More State Funding

Heather Amaral, Executive Director of Meals on Wheels of Rhode Island agrees with the benefits of visiting volunteers to the recipients, but stressing that the volunteer benefits, too, from the bond that develops. “There are many studies that show volunteering is good for your health and spirit, she says.

Amaral expresses pride that Rhode Island was selected as one of eight pilot sites in the study.  “This study proves what we’ve observed through the years—Meals on Wheels deliveries keeps people out of nursing homes and in their own homes longer,” she says.

According to Amaral, in 2014 Meals on Wheels of Rhode Island’s Home Delivered Meals program provided 316,524 meals to 2,298 individuals.  Over the years she has seen federal funding remain stagnant, while state funding has declined.  Last year’s budget allocated $200,000 to Meals on Wheels, down from $530,000 that was allocated by the General Assembly in 2006.   But, Governor Raimondo’s submitted budget does reinstate $ 330,000 more in funding, if approved by the Rhode Island General Assembly, she says.

Clearly, Governor Gina Raimondo recognizes the importance of Meals on Wheels as she begins to reshape Rhode Island’s long-term care continuum.  The Governor states, “Programs like Meals on Wheels are important investments. These programs are one of the strategies in our toolbox to keep people healthy and in their own homes. Particularly as we work to reinvent Medicaid to support better health outcomes and provide better value to taxpayers, we will continue to support programs like Meals on Wheels that help our most vulnerable seniors stay in their homes and in the community.”

The Rhode Island General Assembly must not be penny-wise and pound foolish.  Support the Governor’s budget to ratchet up funding for Meals on Wheels.  It is a sound policy move to put the breaks to spiraling Medicaid costs, by making the system more efficient and rooting out fraud and waste.   We must balance the State’s limited budget funds to keep older Rhode Islanders at home as long as possible.  But, if nursing home care is need, the Rhode Island General Assembly must allocate the necessary Medicaid funding to provide efficiently delivered quality of care.

Herb Weiss, LRI ’12 is a Pawtucket-based writer who covers aging, health care and medical issues.  He can be reached at hweissri@aol.com.