Category: Health

This summer the West Midlands is hosting the Commonwealth Games.

Preparing for and managing the Games is a massive undertaking involving a diverse range of agencies from across the UK and the Commonwealth.

One of the most important tasks partners have is keeping the 6,600 competitors and their teams from 72 nations, around 40,000 volunteers, spectators (one million tickets have been sold) and the local community healthy during this huge event.

At UKHSA we’re key to this, and it will be the first time our new agency has managed public health risks at an event of this scale, though through predecessor organisations we have long experience of dealing with “mass gatherings” such as the 2012 Olympics.

UKHSA’s Field Service Epidemiology Team has a crucial role in detecting, preventing, and managing infectious disease outbreaks that could be linked to major events such as the Commonwealth Games.

Our team consists of consultants, scientists and analysts who investigate any patterns and causes of disease and how they affect communities.

As field epidemiologists, we carefully examine surveillance data from reports of infections and this acts as an early warning system for evidence of infectious diseases, such as COVID, norovirus or measles.

If an early warning is identified, we then take action to prevent the further spread of infection to visitors and athletes at the Games or local West Midlands residents.

We don’t do this work in isolation. Our team has been preparing for the Games for two years working with colleagues from across UKHSA and multi-agency partners to ensure we are equipped to deal with whatever challenges we may face.

Key partners include NHS and UKHSA laboratories who are primed to give us results in a timely manner so we can monitor laboratory reports of infectious diseases.

We also work with UKHSA’s Real-time Syndromic Surveillance team. Syndromic surveillance indicators give us important situational awareness. These include, for example, attendances at emergency departments with specific respiratory conditions or calls to NHS 111 reporting diarrhoea or vomiting.

A benefit of this syndromic surveillance is that we don’t have to wait for formal laboratory diagnoses – symptoms presented by patients can give us an early warning that something is going on. This type of surveillance was used really effectively during the London 2012 Olympics and has now become routine for mass gatherings.

We also work very closely and have good relationships with the Games’ organising committee and the key to all of our partnerships is ensuring we have access to good data and awareness of any health-related incidents in a timely manner so we can support the response.

For instance, if athletes are sick during the Games they can report to polyclinics located in the athletes’ villages, or they may see their own team doctor and both of these options have a system of reporting that allows us to monitor the data we need.

As well as providing surveillance we provide epidemiological support to any incidents and outbreaks. This is like detective work, describing the cases in terms of time, place and person to inform our risk assessment, any control measures needed and then monitoring the effect of these measures to ensure they are working.

Planning for an event like this brings many challenges, including of course the ongoing COVID-19 pandemic where we’ve needed to anticipate the guidelines that will be in place to help everyone live safely with COVID at the time of the Games.

In addition, the nature of a major event like this poses challenges for surveillance with Games venues being geographically dispersed across nine West Midlands local authorities and one London local authority (where the velodrome cycling events are held).

But all of this is rewarding work for a health protection professional, as it’s great to play our part in working to ensure the Games is a success.

Whether an occasional smoker or a seasoned stoner, you’ve likely heard of the term “BC bud” at least once throughout your cannabis journey. For decades, it has developed a worldwide reputation for being some of the best, dankest, and most potent weed on the market – but what sets it apart from the rest? In this guide, we’ll walk you through everything you need to know about BC bud and where you can get your hands on some.

What is BC Bud?

The term “BC bud” originated in the 1970s and referred to marijuana grown in the Canadian province of British Columbia. BC-grown weed accounts for nearly 40% of Canada’s cannabis production and has become one of BC’s most valuable cash crops raking in a whopping six billion dollars annually! Most notable for its superior quality and extreme potency, it has earned a reputation for being some of the finest cannabis in the world. Several strains bred within British Columbia, such as UBC Chemo, BC Big Bud, and Romulan, have won awards at the annual Cannabis Cup. 

What Makes BC Bud So Good? 

British Columbia’s climate and natural resources separate BC bud from the rest of the pack. Providing some of the most optimal growing conditions, BC’s weather acts as an incubator allowing cannabis plants to thrive year-round.

During the warm summer seasons, cities within British Columbia receive sun exposure lasting up to 16 hours per day. This extra sunlight helps plants grow taller and stronger. During the cool and breezy fall, frequent rainfall helps plants develop resilience against harsh conditions. Nutrient-rich soil and access to fresh water all contribute to cultivating some of the world’s best kush.

British Columbia’s laid-back political climate is also a major factor contributing to BC bud’s evolution. Upon discovering this perfect location to harvest weed, countless cannabis cultivators worldwide poured into BC in the 1970s. They brought along their fair share of top-quality seeds and diverse genetics and have been experimenting ever since.

British Columbia has acted as a growers’ haven and has incubated some of the most talented growers with decades of experience in which they have built their reputation behind. “I think it stems from the legacy of probably the last 30 years of breeding,” says Dan Sutton, CEO of Tantalus Labs. “British Columbia has always been a pretty liberal environment in terms of its cannabis legal enforcement, and so growers who might have experienced a more hostile policing environment in California found a home here, and they just started experimenting.”  

Noteworthy BC Strains

UBC Chemo

UBC Chemo is an Indica-dominant strain developed in the 1970s by Dr.David Suzuki at the University Of British Columbia. It was designed to effectively help cancer patients fight chemotherapy’s side effects, including nausea, appetite loss, and chronic pain. Since then, this potent BC bud has won prizes such as “World’s Best Indica” at the Cannabis Cup. 

God Bud

God bud is an Indica-dominant strain first created by BC Bud Depot, a seed company originating in British Columbia. Despite consisting of Sativa genetics, the effects are almost entirely from its Indica side. Consisting of up to 27% THC, it’s no surprise that this strain is a dispensary favorite in Vancouver, BC, and has won numerous awards, like the High Times Indica Cup in 2004.

Blue Dynamite 

Featured in the 2007 edition of High Times “Top 10 Strains Of The Year”, this Indica-dominant BC strain is most beloved for its combination of flavourful terpenes and resinous potential. This powerhouse of a bud averages 24% THC and is primarily used by patients battling depression and anxiety.

Where To Buy BC Bud

Following Canada’s decision to legalize pot in 2018, it has become more and more convenient for the average Canadian to get their hands on some of BC’s high grade cannabis. Gone are the days of meeting shady street dealers as legalization has opened the doors for physical storefronts and online cannabis retailers such as Natural Releaf, specializing in same-day weed delivery in Vancouver. As more and more online dispensaries set up shop, countless Canadians now have unlimited access to buy craft BC cannabis in Canada.

Closing Thoughts

So, if you’re looking to try some of the best weed in the world, check out BC, bud. With its perfect potency, flavor, and all-around quality, this guide has shown you everything you need to know about this world-renowned cannabis.

 

COVID-19 is a highly contagious disease that has inflicted over 94 million people in the United States. As death rates soar, many are desperate to find ways to reduce adverse symptoms. Many patients have tried the NAD drip for COVID to feel better fast.

In this post, we will look at how NAD works and aids with COVID recovery. We will also guide you on how to get a NAD IV treatment.

What happens to NAD levels when you have COVID? 

Nicotinamide adenine dinucleotide, or NAD, is an integral coenzyme in the human body. It’s mainly responsible for DNA repair, aiding immune responses, and metabolic processes.

So how does it relate to COVID recovery? When you get infected with COVID, your body will increase the production of NAD-consuming enzymes. The body’s NAD supply will be used for viral processes when this happens.

As NAD levels decrease due to the infection, the person’s immune system will weaken. This could result in severe COVID symptoms and prolonged recovery.

Aside from that, the patient will experience increased inflammation and DNA damage. This could lead to the so-called ‘long COVID’ and life-threatening symptoms.

Still, the Food and Drug Administration has yet to evaluate the NAD treatment. The good news is that clinical trials have shown accelerated long COVID recovery. It can fight COVID-related NAD depletion to enhance the patient’s overall wellness.

How NAD IV therapy works for COVID 

Many medical practitioners have tried NAD IV therapy for COVID-19 patients. It’s administered intravenously to boost NAD levels immediately.

Unlike NR supplements, intravenous administration offers faster results with up to a 100% absorption rate. Also, NAD IV drips can be blended with added amino acids and nutrients for more benefits.

Here’s how NAD IV Therapy can help patients recovering from COVID:

• Decrease hyperinflammation
• Flush out bodily toxins
• Boost cellular repair
• Replenish lost NAD supply
• Increase hydration
• Improve immune response, especially in elderly patients
• Provide preventive disease benefits

NAD IV vs. monoclonal antibodies

Monoclonal antibodies or mAb (bebtelovimab) is another treatment explored to reduce the adverse COVID symptoms.

This treatment is given to infected or exposed patients at a high risk of severe symptoms. It’s a preventive treatment to reduce the risk of hospitalization and death.

Moreover, it’s given an emergency use authorization by the FDA. Still, access is highly regulated, and patients must meet the criteria first.

So if you don’t qualify for monoclonal antibodies treatment, you can still enhance your immunity with a NAD IV infusion.

Both NAD IV and monoclonal antibodies can decrease your COVID recovery time. Make sure that you get these treatments from certified and licensed medical professionals. This ensures that you’ll get the proper dosage that suits your needs.

Who can get NAD IV for COVID? 

Anyone can receive NAD IV infusion after a thorough consultation with a medical professional. Here at IV Concierge, we conduct a comprehensive assessment before the treatment. This is to ensure that we give the proper infusion to each patient.

Moreover, you can get NAD IV drips whether you have COVID or as a preventive treatment. You can receive multiple sessions based on your needs.

Where to get NAD IV therapy for COVID 

NAD IV Therapy is a powerful infusion that can speed up your COVID-19 recovery. For you, we can make a personalized NAD IV drip at the IV Concierge. We will help you strengthen your body to get rid of COVID symptoms quickly.

Whether you’re actively infected or in the post-COVID phase, our NAD IV therapy can help. We also have a COVID Recovery IV Drip made to empower patients’ immune systems against the disease.

You can book your appointment anytime, and we will send a dedicated nurse to your location. We observe the highest safety standards to ensure the safety of everyone.

Summary

NAD IV therapy improves immunity and overall wellness. It can also reduce COVID symptoms and speed up recovery.

Still, it’s important to remember that NAD drips aren’t a cure for any disease. If you’re already experiencing adverse symptoms, it’s best to contact a physician. Nevertheless, you can still take NAD as a complementary treatment upon your doctor’s clearance.

How To Ensure Your Parents Are Properly Cared For

It’s never easy to realize that your parents are becoming elderly, and it can be even harder to recognize that they will need consistent care. Nobody wants to accept that their parents are reaching the end of their lives, after all.

However, this article aims to make it as easy as possible for you to provide your parents with the best care possible. To that end, you can take a handful of essential steps to keep your parents well looked after.

Identify Their Needs

The very first thing you will need to do if you want to help your parents effectively is to identify their needs. After all, the only way to ensure you are doing everything you can for your folks is to figure out what they will need immediately.

A great way to do this is to sit down and do some research to ensure you know what to look out for and the best steps to take. Fortunately, you’re already on the right track since you’re here.

Ask the Difficult Questions

One of the most important and difficult things you can do when your parents become elderly is asking yourself and your family difficult questions. The best way to deal with hard truths is often to meet them head-on. So, take some time to sit down with your loved ones and work through the most difficult questions you can think of.

For example, the question of who will care for your parents can often be difficult to broach, mainly when they insist that they don’t need the care. However, answering this question is crucial to ensuring that your parents can live their lives to the fullest.

Are you going to care for your parents? Would they be better off in a professional care society, such as supportive living Effingham, IL? Or do you have other family members who can provide the care they need? The only way to know is to ask the question and push for an answer.

Keep Things Social

An ever-growing sense of isolation is far and away the worst part of growing older, as you slowly lose touch with everyone that matters in your life. Of course, the best way to counteract this is to ensure that you keep in touch with your parents as they age.

Simply keeping in touch with your folks yourself can do them a world of good, but if you are looking to help them even more, then there are plenty of ways for you to help your parents become even more social.

One of your best options is to get them involved in any locally-based social groups around the area your parents are living. Not only can these be a great way to keep your parents social, but they can also be a fantastic way to keep them active and healthy.

Youthful skin is always a self-reflection of your overall well-being. We all love to have baby-soft, smooth, glowing skin, and we try using many chemical-infused drugs, cosmetic surgeries, ointments, creams, and lots to our skin.

Why are you so harsh on your skin when you have countless natural ways to enhance your skin tone and texture? The rapidly emerging cosmetic enterprises and changing skin care crazes exemplify the significance of caring for and improving skin textures to achieve radiant, supple, smooth skin for a lifetime.

However, sadly, many worsening skin conditions bias the excellent texture of our skin. So, being too harsh on our skin is inappropriate for our cells. Fortunately, some great natural ways such as coconut oil, Green Thai Kratom strains, and good skin care routines may help you break out all your stress related to skin and improve skin tone and its radiance.

Well, are you ready to become a warrior to fight and retrieve back your golden skin days? Here we pick some surprising and practical solutions to enhance skin texture naturally.

What Worsens Our Natural Skin Texture?

Maintaining a perfect, glowing natural skin texture is also a kind of self-care, and we invest a lot in it. Unfortunately, some factors badly worsen normal skin conditions, such as environmental, genetic, emotional, and aging.

The smoke, dust, and dirt from the atmosphere naturally clog up the skin pores and leave your skin with acne and dry skin. Plus, the harmful ultraviolet sun rays cause premature aging, sagging, and the formation of wrinkles on the skin’s surface. When discussing genetic disorders, skin diseases such as eczema, psoriasis, keratosis pilaris, and ichthyosis may worsen the skin condition more.

Moreover, the chemical-hormone imbalance due to menopause and perimenopause can adversely affect the skin’s tone and softness in women. And additionally, the accumulation of keratinized and dead cells also worsens skin conditions. The lack of adequate moisturization and hydration can also contribute to bad skin.

Transform Your Skin Texture Using These Natural Ways

All you have to do is shower some love and natural care into your face and body. Being chemically harsh on your skin is not suitable for your well-being. So, here we have curated some beneficial, natural, and simple ways to enhance your skin quality and texture. Please read it all and try to incorporate it into your daily skincare routine.

Focus On Your Diet

Proper nourishment and body-wise nutrients are critical for our healthy physique. Yes, our skin needs superfoods and nourishments! However, our current unhealthy eating habits and practices, such as consuming processed foods, alcohol, and refined carbs, destroy and imbalance the gut microbiomes, leading to severe body inflammations.

Thus, incorporating essential vitamins, minerals, and antioxidant-rich food into the diet can boost your autoimmunity power against free radical damage. You can also include fish and vegetables in your diet as they are a good source of omega-3 fatty acids, vitamins, and zinc, which aid in maintaining flow-less, vibrant skin and inevitably contributes to skin repair and health.

Get Quality Sleep

Stress and burnout can give you restlessness and chronic insomnia at night. However, your skin breathes whenever you rest calmly. So, quality sleep or rest may aid you in building a good skin condition and prevent acne and dry skin. Moreover, sleeplessness can leave dark eye circles, skin pigmentation, wrinkles, premature skin aging, etc. Hence, having a good amount of rest and sleep daily is critical, which may aid in fast skin repair and recovery. Therefore, leave your daily stress and headaches aside and relax better to treat your skin naturally.

Use Coconut Oil

As we know, coconut oils are rich in antioxidants and anti-bacterial qualities. Moreover, it acts as an excellent skin moisturizer for dry skin. You can consume it in your food or topically apply it over your skin, hair, nails, and all body parts. The raw or virgin coconut oil can deeply nourish the whole skin membrane and sets them incredibly glowy and smooth. Plus, these coconut oils are excellent with antimicrobial characteristics.

Get Right Moisturizers

Selecting suitable moisturizers to suit skin types is the primary thing in a good skincare routine. Hence, it is vital to moisturize your face and body daily. That is, proper moisturization balances sebum production in our skin membranes and treats and prevents dry flakes and patches in the skin and hair. Hence, these products help to remove dead cells from the surface and give a glowing effect and good skin texture in the long run.

Aloe Vera For Healthy Skin

Aloe vera gel is a super remedy for many skin disorders, and it is a natural remedy for dry skin, hair loss, acne, eczema, etc. Fortunately, these super gels’ natural anti-inflammatory, anti-bacterial, and antioxidant traits give a soft, calm, and soothing effect on our skin. Plus, it makes the skin moisturized and supple for hours.

Use Green Thai Liquid Kratom Shots For Skin

Green That Kratom is a rejuvenating herbal product for your skin and body. As we know, this rare, versatile herb is also a celebrity in the cosmetic industry. Luckily, it has skin texture-enhancing qualities and does wonders to our skin and hair. Moreover, these green strains have excellent therapeutic advantages with food and topicals.

The natural alkaloids, essential minerals, and nutrients in these MIT45 liquid kratom shots may provide quick fixation and skin repair. Also, it accelerates collagen secretion in its users. And it aids in balancing the skin elasticity and prevents the formation of wrinkles and premature aging. In addition, the rich antioxidant traits of these liquid kratom shots initiate free radical production. Hence, it may be a powerful anti-aging agent in enhancing skin tone, health, texture, and glossy skin.

Regular Workouts

Consistant workouts and exercise are vital for a good skincare routine. Regular body workouts and practices can help remove the dead cells in the skin and make you feel refreshed and energetic. Moreover, these daily chores help maintain the healthy natural pumping of oxygen and blood to your cell bodies. Thus, it increases blood flow to your skin membranes and gives you radiant, vibrant, and naturally shiny skin. So, always incorporate a regular exercise routine in your skincare regimen and have a healthy skin texture.

Final Thoughts!

Having a natural shiny skin texture is an asset for all your well-being. However, properly maintaining good skin is inevitable, and you must invest quality time caring for it. So, we have discussed some efficient natural ways to enhance skin texture and health. Always avoid harsh chemical products on your skin and try mild, natural products like Green Thai Kratom for the best, smoother, and youthful skin. We hope you enjoyed it and try these hacks and improve your skin.

 

Massachusetts has become the latest state to settle with health insurance giant Centene Corp. over allegations that it overbilled the state’s Medicaid program for pharmacy services, KHN has learned.

Centene, the nation’s largest Medicaid managed-care insurer, will pay $14.2 million, according to Massachusetts Attorney General Maura Healey. An official announcement is expected later Thursday.

“This settlement is a significant result in our work to protect taxpayer dollars and the integrity of our MassHealth program,” Healey said in a statement. “We are pleased to secure these funds to help control Medicaid costs and ensure that state resources are directed to the best possible uses in our health care system.”

Centene on Wednesday denied wrongdoing in Massachusetts, as it has in previously announced settlements. KHN reported earlier this month that Centene agreed in July to pay Texas nearly $166 million.

“This no-fault agreement reflects the significance we place on addressing their concerns and our ongoing commitment to making the delivery of healthcare local, simple and transparent,” Centene said in a statement emailed to KHN. “Importantly, this allows us to continue our relentless focus on delivering high-quality outcomes to our members.”

Centene provides health insurance to 15.4 million Medicaid enrollees across the country by contracting with states to cover people who have disabilities or are in low-income families. The St. Louis-based insurer earns about two-thirds of its revenue from Medicaid, which is jointly funded by state and federal taxpayers.

In many states, insurance companies such as Centene also administer Medicaid enrollees’ prescription medications through what is called a pharmacy benefit manager. These benefit managers act as middlemen between drugmakers and health insurers and as intermediaries between health plans and pharmacies.

Centene’s CeltiCare subsidiary offered insurance to Massachusetts Medicaid enrollees until the state began to overhaul its program. Centene also administered pharmacy benefits for the state Medicaid program, MassHealth, according to the attorney general’s office.

A review by Healey’s office found “irregularities in the pricing and reporting of pharmacy benefits and services” by Centene’s pharmacy benefits manager, Envolve Pharmacy Solutions, its statement said.

Multiple states have settled with Centene’s pharmacy manager business over allegations that it overbilled their Medicaid programs for prescription drugs and pharmacy services. But the total number of states is not publicly known because many of the settlement negotiations are conducted behind closed doors. Some states, such as California, have been investigating the company, KHN first reported in April.

Before the Massachusetts agreement, Centene had settled with Arkansas, Illinois, Kansas, Mississippi, New Hampshire, New Mexico, Ohio, Texas, and Washington for a total of $475 million, according to news releases and settlement documents from attorneys general in those states. The Massachusetts settlement, which was signed Sept. 23, brings Centene’s pharmacy services settlement total to at least $489 million. Other states have also settled with Centene, but the settlement amounts — and the states themselves — have not been publicly disclosed.

Centene set aside $1.25 billion in 2021 to resolve the pharmacy benefit manager settlements in “affected states,” according to a July filing with the U.S. Securities and Exchange Commission that did not specify how many states.

Florida and South Carolina have signed legal agreements with a Mississippi-based firm, Liston & Deas, that has represented other states in their pharmacy benefit inquiries into Centene.

Pharmacy benefit managers in general have drawn increasing scrutiny and criticism. The Federal Trade Commission announced in June that it was launching an investigation into the pharmacy benefit management industry and its impact on consumer access to prescription drugs and medication costs.

This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

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Beware cataract surgery price-gouging: Private equity groups are scooping up eye care physician practices nationwide as money-making opportunities grow in medical eye care. By @LaurenWeberHP #healthcare @FortuneMagazine https://t.co/M2Ih4EZibA via @khnews

— Catherine Arnst (@cathyarnst) September 19, 2022

— Catherine Arnst, New York City

Seeing Eye Care for What It Is

Thank you for telling the story of EyeCare Partners and others (Patients for Profit: “Private Equity Sees the Billions in Eye Care as Firms Target High-Profit Procedures,” Sept. 19). I went to EyeCare once. All I will say is I will never go back. I also went to a private-practice ophthalmologist. He should be ashamed of himself.

Unfortunately, doctors themselves are ruining their profession’s reputation. Please continue your stories to help us get at least halfway-decent care. I have no hope of it ever returning to good care.

Your story brings out one old-time fact: Patients need to know that an overly busy doctor does not necessarily mean a “good” doctor. Thank you again.

— Hazel M. White, St. Louis

Yet another reminder that natural doesn’t mean safe.https://t.co/oz17ubIKbz

— Julie Doll (@JulieDoll_Ks) August 25, 2022

— Julie Doll, Garden City, Kansas

American Herbal Products Association Weighs In on White Mulberry Leaf

The article written by Samantha Young on the untimely death of Lori McClintock, the wife of California congressman Tom McClintock, used this tragic event to challenge the robust regulation of dietary supplements by the federal government, despite there being no information in the report showing that Lori McClintock consumed white mulberry leaf as a dietary supplement (“Congressman’s Wife Died After Taking Herbal Remedy Marketed for Diabetes and Weight Loss,” Aug. 24).

White mulberry leaf is normally administered for therapeutic use in the form of a tea or powdered extract, and the leaf is also used as a food ingredient. The two most comprehensive and authoritative English language compendia of traditional Chinese medicine — “Chinese Herbal Medicine” and “Chinese Medical Herbology and Pharmacology” — do not list any significant cautions or contraindications associated with mulberry leaf use.

Most clinical trials studying white mulberry leaf report no adverse events, although some placebo-controlled studies have reported minor gastrointestinal issues — such as an upset stomach. A pooled analysis of these studies found no statistically significant difference in adverse events between participants receiving mulberry leaf and a placebo.

The scientific consensus on the safety of white mulberry leaf is also reflected in the “Botanical Safety Handbook,” maintained by the American Herbal Products Association and subject to strict standards of expert review. The contributing experts placed white mulberry leaf in the reference’s safest classification based on an extensive review of the scientific literature. This classification process included a systematic literature review covering acute, short-term, and sub-chronic toxicity studies as well as in vitro, human, and animal research. The reviewers also searched for, and did not identify, any case reports in which white mulberry leaf produced a suspected drug or dietary supplement interaction.

Lori McClintock’s death certificate and the accompanying coroner’s report identify the cause of death to be dehydration due to gastroenteritis due to adverse effects of white mulberry leaf ingestion. The coroner’s report states that “a partial plant leaf” was present in the stomach and that “portions of tablets and capsules [were not] discerned in the stomach.” A University of California-Davis botanist identified the material as white mulberry leaf and stated, “White mulberry is not toxic.”

While the death certificate declares “an autopsy with toxicology testing confirmed the cause of death,” there is no toxicology test for white mulberry, and none of the toxicology testing performed for other unrelated drugs or common toxins revealed anything linking the death to white mulberry.

The coroner’s report did not explain whether or not there was evidence of any specific product(s) the deceased might have been taking, and ultimately how a conclusion was drawn to implicate white mulberry. Without this information, it is not possible to corroborate the coroner’s findings and conclusions.

Moreover, nearly half of the article is presented as a criticism of the robust federal regulation of dietary supplements, claiming that “McClintock’s death underscores the risks of the vast, booming market of dietary supplements and herbal remedies.” The article reports that two cases of people “sickened by mulberry supplements” have been reported to the FDA since 2004 and that “[a]t least one of those cases led to hospitalization.” AHPA has reviewed the publicly available records of these two cases and notes the following significant details omitted from the article:

• A 77-year-old woman was hospitalized in July 2008 with conditions described as including diabetes mellitus, gallbladder disorder, hypotension, myocardial infarction, renal disorder, and thrombosis; whether these conditions were preexisting is not clear in the currently available public record. This record identifies 31 dietary supplements (including a mulberry leaf product) associated with this case.
• In the other case, a 63-year-old woman was reported as taking four products — goji berry; a combination of cinnamon extract, Gymnema sylvestre leaf, and mulberry leaf; a multivitamin; and fish oil. She was diagnosed with hypoesthesia (numbness) and was hospitalized in December 2009.

AHPA has obtained these two adverse event reports through a Freedom of Information Act request. The conclusion drawn by the KHN article that either of these reports represents an individual who was “sickened by mulberry supplements” is simply not substantiated by the FDA’s database.

Given that consumption of white mulberry leaf was unlikely to have been a direct or indirect cause of Lori McClintock’s death, the Sacramento County Coroner’s Office should seriously consider conducting additional investigations and, as appropriate, revising the death certificate.

— Michael McGuffin, president, American Herbal Products Association, Silver Spring, Maryland

It’s interesting to me how many government agencies refuse to talk about any of this. They all have policies against transparency and everyone just accepts it. “Yep, that’s how it has to be.” It’s not how it has to be. A woman is dead. https://t.co/EPPPXnq6ol

— Montel Courvoisier III (@REvolt3d) August 26, 2022

— Keith Vance, Gaithersburg, Maryland

Two Ways to Cut Medical Debt

Your recent article “Upended: How Medical Debt Changed Their Lives” (Aug. 18) was very powerful and informative. Thank you very much for your efforts.

There are two reforms that would greatly relieve the financial suffering of your subjects:

1. We need a law stating that if a health insurance claim is denied, and if the patient was not aware this could happen, then the patient is not liable for the charges. Medicare has had this rule for decades. With such a rule, the providers and insurers can fight out their disputes and the patient will not be harmed.

2. Patients with large medical debts should have access to a low-cost, federally funded bankruptcy attorney. Some of your subjects seem not to have been aware of the bankruptcy option. Others made tragic mistakes like cashing in retirement accounts, when that is unnecessary in bankruptcy. Most hospitals are ready to negotiate and reduce large bills, if a halfway-aggressive attorney or consultant approaches them on a timely basis. Your subjects were, sadly, isolated and unadvised.

Thanks again for your work.

— Bob Hertz, St. Paul, Minnesota

Only in #America where even doing the right thing isn’t enough! 😡 This is wrong and definitely not #ProLife! #MedicareForAll #Universal #healthcare https://t.co/0w3288UUXf

— Lee Moss, FAANP, FAAN (@LeeMossNP) July 9, 2022

— Lee Moss, Salt Lake City

Homelessness and Social ‘In’-Security

I read your story on the Supplemental Security Income program and the woman in the homeless shelter (“A Disability Program Promised to Lift People From Poverty. Instead, It Left Many Homeless,” Sept. 16). I lived in homeless shelters in St. Louis and Mobile, Alabama, and there is something you left out of your article: If you live in a homeless shelter, the Social Security Administration may lower your SSI benefit even more because they figure you’re not paying rent so you’re not entitled to full benefits. It did that to me when I was in Mobile. It also happened to a friend of mine in St. Louis. The agency reduced hers by $200. That’s exactly the time we need our entire benefits, so we can find a place.

— Lauralee Wiltsie, Bay Minette, Alabama

Critically important issue to homelessness. Most unhoused people are old aged or disabled. This safety is broken and Congress needs to fix it. High rents outpace federal disability payments, leaving many homeless https://t.co/Dn121kJUAP

— Dennis Culhane (@DennisCulhane) September 22, 2022

— Dennis Culhane, Philadelphia

Seniors in Need of a Lifeline

I’m a senior living in affordable housing and am so sad. Not just because I can’t afford to take care of my personal needs the way I used to, but because I feel as if no one cares about seniors anymore. I read in one of your stories it’s too expensive to stay alive (Navigating Aging: “‘It’s Becoming Too Expensive to Live’: Anxious Older Adults Try to Cope With Limited Budgets,” Sept. 7). During the height of the pandemic, people were so kind and I did have enough food to eat. Now that things are almost back to normal, people have started acting mean again. They just don’t care about us seniors. Help us.

— Barbara Little, Atlanta

A quote that should haunt us all, “It’s becoming too expensive to be alive…” In this new piece by ⁦@judith_graham⁩ w/ ⁦@KHNews⁩ the numbers just don’t add up, illustrating why many older women live one crisis away every day. https://t.co/LeNSEOJoVY

— Ramsey Alwin 🦞 (@Ramsey_Alwin) September 8, 2022

— Ramsey Alwin, Washington, D.C.

Only One Side of the Story?

I listened to Dr. Elisabeth Rosenthal’s comments on CBS News this morning (Bill of the Month: “Watch: Crashing Into Surprise Ambulance Bills,” Aug. 24).

First, her comments about coverage for ground ambulances being excluded from the federal No Surprises Act, which purportedly guards against surprise medical bills. She said: “There’s some speculation that ground ambulances are revenue generators for many local fire departments.” While that may be true in rare cases, most emergency medical services that are nonprofit barely get by. Why? Because insurance companies do not pay ambulances correctly.

Have a heart attack and EMS might bill you $1,100. Insurance companies pay $400. Medicare pays around $300 for the same call. Medicaid pays $200 for the same call.

Let me put it another way: You own a restaurant. You offer a dinner for two for $100. You bill the person’s dinner insurance. It pays $40. It costs the restaurant $60 to put the meal together, including staff pay and utilities. You just lost $20 and made nothing to put back into the business. How long are you going to stay in business?

Ambulance agencies do not join insurance companies’ networks because they are offered a lower pay rate to be in-network — so why should we join?

Let me put it another way: The fire department is run by the municipality and the taxpayer pays for it. You pay approximately $600 per household in taxes for fire protection each year. So over 10 years, many taxpayers have paid $6,000 for fire protection they never used. But most municipalities do not fund EMS.

If you’re going to treat this story fairly, maybe have all the facts about EMS — not just one side of it.

And as for surprise billing, you called 911 to get a ground ambulance to come. How is the bill a surprise?

— Anthony Tucci, West Lawn, Pennsylvania

The Ambulance Chased One Patient Into Collections https://t.co/kx1yebMgqC via @khnews Message: Try not to get into accidents, attacks, shootings, and other body-damaging events!

— JonWallner (@JonWallner) July 27, 2022

— Jon Wallner, Montgomery County, Pennsylvania

This article was very one-sided. Nonprofit ambulance services are being lumped into this mix unfairly. In addition, some states have enacted their own ground portion of the federal No Surprises Act. I have seen commercial insurance companies sticking the patient with a greater responsibility for the cost of emergency services than before the No Surprises Act and yet the insurance companies themselves now reimburse at only around 67%, when they used to pay nearly 100% of claimed charges.

In addition, more ambulance companies would join commercial insurance companies’ networks if they received fair, timely reimbursement. There are so many ground ambulance companies going out of business due to insurance company games, inappropriate denials, and lack of payment.

— Jennifer Costello, Columbus, Ohio

Story illustrates 2 key problems: inability of patients to get accurate price data before procedures, and higher costs paid by those with high deductible plans vs if no insurancehttps://t.co/R2GoHfljjt

— Kathryn A Phillips PhD (@KathrynP_phd) September 6, 2022

— Kathryn A. Phillips, San Francisco

If It’s Broken, Fix It

I’m a family practice physician. Spinning off of your Bill of the Month series, I think it would be very beneficial to publish more stories on what health care and costs look like abroad. Hospitals and providers are simply functioning within a broken system. Of course, costs are astronomical when many of the mainstays on the Fortune 500 list are insurance companies. I think people (i.e., voters) need to hear more about what health care would look like if Medicare and Medicaid were the only payers. The broken system exists, and people need to know how to work through that, but people also need to hear that there are other equally effective ways of delivering health care.

— Dr. Justin Riederer, Asheville, North Carolina

This story is about a standard medical procedure done at a hospital here in SC.Had she paid in cash, she would’ve owed ~$1400. Because she had insurance, “negotiated” rates had her paying over $5,000 out of pocket. Something’s seriously broken here.https://t.co/9C3TXnqxzf

— Bill Kimler for SC State House 13 🇺🇸 (@Kimler4SanitySC) September 2, 2022

— Bill Kimler, Greenwood, South Carolina

An ‘Inherently Abusive and Ineffective’ Treatment for Autism

As a member of the autistic community (and a trained journalist myself), I am deeply disturbed by the recent article “‘So Rudderless’: A Couple’s Quest for Autism Treatment for Their Son Hits Repeated Obstacles” (July 21), by Michelle Andrews.

This article appears to be a follow-up to an article written by Andy Miller and Jenny Gold and published on March 30. Both articles uncritically promote applied behavior analysis (ABA) and falsely portray families unable to access ABA as victims of the pandemic and/or health care bureaucracy.

You should be aware that both articles taint KHN’s reputation as a reliable source for medical/health care news and information and do not meet even basic journalistic standards.

ABA is an inherently abusive and ineffective pseudoscience designed not to enhance the lives of autistic people, but rather to force us to suppress our autistic traits and perform neurotypical ones. Among the critics are survivors of ABA (Julia Bascom of the Autistic Self Advocacy Network and Amy Sequenzia of the Autistic Women & Nonbinary Network being two prominent examples). Further, for the past several years, the Department of Defense Office of Inspector General has found that ABA is largely ineffective, even by its own standards. None of this was mentioned in either article.

Your articles also did not mention the origins of ABA, including the fact that the practice was pioneered by O. Ivar Lovaas, the same man who helped pioneer gay/trans conversion therapy and was infamous for “treating” autistic children with electric shocks and corporal punishment. They also did not mention critics’ specific concerns about currently practiced ABA, including that it teaches autistic individuals that they have no right to say no and that, if they do say no, they’ll be physically and verbally bulldozed into compliance.

I also did not see any reference in your articles to the 2018 survey conducted by autistic researcher Henny Kupferstein, which found that autistic individuals exposed to ABA were 86% more likely to exhibit symptoms consistent with post-traumatic stress disorder.

The few points I’ve mentioned above barely scratch the surface regarding the controversy surrounding ABA. However, your reporters chose not to reach out to any prominent critics of ABA for a quote or to cite any of their specific concerns.

Further, your reporters didn’t reach out to a single autistic source, despite both articles being about the autistic community. Despite how the autistic community is infantilized and portrayed as incompetent by various prominent “charities,” like Autism Speaks, our community as a whole is fully capable of stating our opinions and engaging in self-determination.

I would appreciate a response to this letter. Hopefully, you realize the seriousness of this matter and intend to publish a follow-up article examining ABA’s rampant abuses.

— Matthew Zeidman, New Hyde Park, New York

An anecdotal example of the challenges encountered by parents/caregivers of children with Autism Spectrum Disorder as they seek effective services for their children. https://t.co/ZuHRKna5GB

— CYSHCNetwork (@CyshcNetwork) August 15, 2022

— The Children and Youth With Special Health Care Needs National Research Network, Denver

RIALTO, Calif. — Ana Gonzalez grew up watching the Inland Empire transform from citrus groves and grapevines into warehouses and retail distribution centers. The booming region east of Los Angeles now comprises 4.65 million people — and 1 billion square feet of warehouse space.

In 2015, one of those warehouses was built right in front of her old house, blocking her view of her suburban neighborhood. Soon thereafter, her son battled bronchitis and pneumonia. “It got so bad that I ended up taking him to the ER about three to four times a year,” she said. Her son, now 16, like so many others in the region developed asthma due to air pollution. She grew concerned that state policies were overlooking predominantly Hispanic and low-income residents in her community.

Gonzalez, 35, has evolved from a concerned parent into an environmental advocate. Her years as an educator specializing in bilingual and special education, along with a bout of homelessness, fuel her passion for advocating for marginalized communities. Today, she serves as executive director of the Center for Community Action and Environmental Justice, which works on air quality and environmental justice issues on behalf of the region.

Gonzalez and the organization have endorsed Proposition 30 on the November ballot. Funded primarily by the ride-hailing company Lyft, it would impose an additional 1.75% tax on what Californians earn above $2 million per year to fund zero-emission vehicle purchases, electric charging stations, and wildfire prevention programs.

While the initiative would provide subsidies for low-income consumers, it would also subsidize businesses, such as Lyft and other ride-hailing companies, by helping them add clean cars to their fleet. Lyft and other ride-hailing companies are under a mandate to make at least 90% of their vehicle fleets electric by 2030.

The once-popular measure has slipped into toss-up territory. A September poll by the Public Policy Institute of California found 55% of likely voters back the measure, down from 63% in April. And it has divided environmentalists and Democrats.

The measure would generate an estimated $3.5 billion to $5 billion a year, growing over time, according to the nonpartisan Legislative Analyst’s Office. Of that, 45% would primarily subsidize zero-emission vehicles and 35% would boost construction of residential and public charging stations, with at least half of each category directed to low-income households and communities. The remaining 20% would fund wildfire suppression and prevention.

The state Democratic Party and the American Lung Association endorsed Proposition 30, calling it an innovative measure that will expand access to electric vehicle chargers for every Californian, regardless of where they live or work.

But opponents include the California Teachers Association and Democratic Gov. Gavin Newsom, who recently called the measure “a Trojan horse that puts corporate welfare above the fiscal welfare of our entire state.”

California is a leader in pushing — and paying for — clean energy, but the state has been criticized for failing to distribute California’s clean-car subsidies equitably. For example, a 2020 study found wealthier communities in Los Angeles County had more electric and plug-in hybrid vehicles than its disadvantaged communities. And state Assembly member Jim Cooper, a Black Democrat from Elk Grove who will become Sacramento County sheriff next year, has said the state’s push for electric vehicles fuels “environmental racism.”

Gonzalez points to studies, such as a report by Earthjustice, showing how people who live close to warehouses are more likely to be low-income and at higher risk of asthma due to the air pollution generated by diesel trucks.

KHN reporter Heidi de Marco met with Gonzalez at her new home, where a development is proposed behind her property, to discuss why she and her organization endorsed Proposition 30. Gonzalez said she has not been paid by Lyft. The interview has been edited for length and clarity.

Q: Why is Proposition 30 important for your community?

Our families are dying, and nobody is doing anything about it. We’re seeing all the illnesses that are connected to pollution, such as asthma, pneumonia, lung cancer, COPD [chronic obstructive pulmonary disease], and even diabetes.

We just decided to support it because we felt, as a team, that it was the right thing to do given how impacted we are by car and truck pollution. There are layers upon layers of pollution.

Along with the influx of warehouses bringing tons of trucks and their diesel exhaust emissions, the Inland Empire is unique when it comes to pollution. We have all the polluting industries that you can think of, from rail yards bringing more diesel emissions, from the trains to gas plants, which are emitting a lot of pollution. We have toxic landfills, airports, and all the car traffic from the intersections of the 10, 60, 215, and the 15 freeways.

Q: Proposition 30 is funded by Lyft, and Newsom opposes it, calling it a “cynical scheme” by the company to get more clean cars for its fleet. Lyft has been criticized by labor groups for lowering compensation through gig work instead of paying fair wages and benefits. Why are you siding with Lyft?

I see it two ways. One, yes, we need to hold Lyft accountable for the way they treat their drivers and making sure they’re paying them fair wages. I do believe Lyft should do better. But the way that I see it, the fact that they’re transitioning into clean-energy vehicles is where I have to give them props.

Even the developers in our communities have the money to transition their diesel trucks to clean energy, but they’re not investing in that. We have a climate change crisis, and I don’t necessarily see them as the enemy. I see them as folks trying to be part of the solution and transitioning to clean energy.

Q: Will the initiative make a difference when so much of the Inland Empire’s pollution is from Los Angeles and the warehouse industry?

It will make electric vehicles and clean energy vehicles more affordable. And it would create those incentives that our low-income community needs, especially our small-business owners like our self-employed truck drivers that cannot afford to transition to a clean-energy vehicle or a truck. This program would give them those subsidies that they need so they can afford to transition.

This proposition will also give money to expand the clean-vehicle infrastructure that we need. Because here we are telling everybody to change to clean-energy vehicles, but we don’t have the infrastructure. Where are they going to charge their cars when they go to work? Or when they go to school? Or even in their own homes?

So, this campaign would put us in the right direction because I don’t see any other efforts being done, including with the state. I feel like sometimes the governor is a little hypocritical because here he is trying to be a champion for climate change, but he’s not showing a real plan to transition compared to this proposition, where they at least have a plan in place to tackle that transition.

Q: The state and federal governments have already invested billions in clean-car programs. Why is Proposition 30 needed?

It’s going to take a while before the money gets to the appropriate agencies. Another thing that I see that the government fails at is that they always leave out the most affected, marginalized, disenfranchised communities such as the Inland Empire. We have been overseen for so long, and every time the government creates these programs, all this investment and infrastructure, local agencies sometimes don’t know about it — or they don’t do the work to ask for the money.

And what this program does through Prop. 30 is that it’s taxing the rich, the people that make over $2 million. We always give the tax breaks to the rich and it’s about time that the rich pay their fair share.

This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

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