Misleading Medicare Advantage TV Advertising

By Ron Iverson, President of the National Association of Medicare Supplement and Medicare Advantage Producers

Sick of the Medicare TV commercials yet?  They’ve made their way into major network programming and still keep appearing in senior interest market networks.  I don’t expect they will subside until after [the January 1 – March 31 Open Enrollment Period] OEP, if then.  Either TV advertising is too cheap, or the people who run the ads are making a lot of money off of them–enough to keep running them.

Forbes ran an interesting article by Forbes Contributor, Diane Omdahl, last week headlined, “Half-Truths and Medicare Advantage Commercials.”  She spent a lot of time fact-checking the statements and started her story like this:

“If you watched any television in the last several months, you probably saw a slew of commercials for Medicare Advantage plans.  One that pops up frequently features a former professional football player who once did a commercial wearing pantyhose.  His commercials must be working so well that another former NFL star has also started promoting Medicare advantage plans.  All the commercials, no matter the narrator, talk about the Medicare benefits you deserve and that you should be getting.  They list those benefits in a very big and bold font and encourage you to call the toll-free number and sign up today.”

“According to federal law, whatever we see or hear in an advertisement must be truthful and not misleading.  I spent some time the last few days closely watching several different commercials.  Everything that was said about the cost and benefits was true, to the extent that it was said.  But there was much left unsaid, and that’s important information you need to make a smart decision.”

“First, the benefits: ‘Get the benefits you deserve, including rides to medical appointments, private home aides, nurse and doctor visits by telephone.’  Medicare describes these as benefits for daily maintenance and doesn’t cover them. However, because of policy [and funding] changes, Medicare advantage plans can now provide them. The plan, not Medicare, must cover these costs.  This is a new program and not that many plans offer these benefits.  Based on my preliminary plan research, here are some important points not mentioned in the commercials:”

  1. These benefits appear to be more common in health maintenance organization (HMO) plans. Except for an emergency, the benefits are only available through a network of selected providers, which can limit the individual’s choice.
  2. The plan likely requires prior approval or authorization. Before receiving care, the plan must review and approve the physician’s order.
  3. There are limits on these benefits. For example, two meals a day for five days after hospitalization with a limit of four hospitalizations, and a private home aid four hours a day for no more than 31 days a year.
  4. And, most important, the plans we researched require members to select only one benefit per calendar year.

“In some commercials, there were two more benefits that require clarification.  ‘Free preventive screenings.’  Medicare covers a long list of preventive and screening services.  You don’t need to enroll in one of these plans to get preventive services.  ‘A 75% discount on prescription medications in the Coverage Gap.’  You see this and think, ‘Wow! A big discount on drugs!  Where do I sign?  However, as with preventive services, this benefit is not unique to Medicare advantage plans.”

“The coverage gap is more commonly known as the donut hole.  In 2020, the donut hole closed.  Beneficiaries are responsible for 25% of the cost of medications in this payment stage.  In other words, they get a 75% discount.  Anyone with Part D prescription drug coverage will qualify automatically for this discount when their total drug costs hit $4,080. This benefit comes with the plans in the commercials, some other Medicare advantage plan with drug coverage, or a stand-alone Part D drug plan.” Note: this is like extolling a certain make of automobile because it comes with four wheels.

“Second, the costs.  ‘All these benefits may be available at no additional cost to you.’  The commercials focus on zero-premium plans and benefits available for no added cost.  However, at the moment the narrator says this, a small line of type appears on the bottom of the screen.  It’s there for only four seconds, while the list of benefits continues.  The small type reads, ‘Plan premiums, co-payments, and coinsurance can apply.’ ”

“Not all Medicare Advantage plans are zero-premium.  And for those that are, it’s important to know that zero-premium does not mean zero costs.  There are out-of-pocket costs for most services.  Plan members will pay their share of costs until they reach the plan’s out-of-pocket maximum limit.  That’s how much a person could write in checks when something happens, like a cancer diagnosis or a major car crash.  In 2019, the average limit was $5,059.”

“Third, the call.  The narrators talk about the help you will get when you call the toll-free number.  But, once again, the small print is revealing.  Dial the number and you’ll be transferred to a licensed insurance agent.  One commercial noted that the agent may or may not offer Medicare advantage plans.  Another said the person you talk with may not offer plans in your area.”

Then, Omdahl, who has written about health matters for thirty years, asks a question.  “The facts, as presented, are true but then the question becomes, “Are these commercials misleading?”  According to the Macmillan dictionary, misleading means something that is intended or likely to make someone believe something that is incorrect or not true.  She then refers to the American Medical Association (AMA), which in the fall of 2019 passed a resolution.

“Whereas, Medicare Advantage plans are heavily marketed to seniors by insurance companies, with less than ideal transparency in advertising; …and “Whereas, Presentations by insurance company officials to seniors can overemphasize the value of different options and can create confusion; therefore be it “RESOLVED, That our American Medical Association encourages AARP, insurance companies and other vested parties to develop simplified tools and guidelines for comparing and contrasting Medicare Advantage plans.”

“The AMA identified the need for tools to help individuals go beyond the TV commercials and get the information they need to make a smart decision.”

“Keep in mind that these Medicare Advantage plans are offered by for-profit entities, corporations not unlike your cable provider, department store, or neighborhood used car lot.  The purpose of the TV commercials is to get you to act, to call the number on your screen to make a purchase.  First, do your research.  Be an informed shopper.  Go beyond the commercials to the whole truth.  Your Medicare coverage is too important.”

End

Fed up with Telemarketers?

In anti-fraud effort, feds to probe how telemarketers get hands on seniors’ Medicare info

This article is a summary of a recent CBS News post.

The best thing to do when your phone rings from a “Medicare” telemarketer or one who claims to be a “Medicare specialist” is to treat it like a rattling rattlesnake. Yep, stay away from it and don’t get bitten.

Background: Insurance companies, pharmacies, and other interested parties can electronically access Medicare and Medicare’s records of any Medicare beneficiary. This can be done for legitimate purposes. For example, there might be some confusion on a claim of your date of birth or your Medicare number. However, there is also a nefarious use of this database.

The watchdog agency’s decision comes amid a wave of relentlessly efficient telemarketing scams targeting Medicare recipients and involving everything from back braces to DNA cheek swabs.

So how are these telemarketers getting access to your personal information? Answer: It’s from some entity that is accessing Medicare’s database for an illicit purpose.

Key personal details gleaned from Medicare’s files can then be cross-referenced with databases of individual phone numbers, allowing marketers to home in with their calls.

Put another way, a pharmacy may be accessing Medicare’s database when they have no business doing such.

But investigators found that some pharmacies submitted tens of thousands of queries that couldn’t be matched to prescriptions. In one case, a pharmacy submitted 181,963 such queries but only 41 could be linked to prescriptions.

In one report, 98% of the queries from a group of 25 pharmacies “were not associated with a prescription.” This also puts an individual’s privacy at risk.

Inappropriate use of Medicare’s eligibility system is probably just one of many little-known paths through which telemarketers can get sensitive personal information about beneficiaries, investigators said.

If a telemarketer contacts with seeming private information that he/she should not have had access to, do not let yourself be mesmerized by such. Know that your information was illegitimately obtained. Do not engage these people

Hang up immediately! Do not allow them to set their hook into you.

COVID-19 Scams

Sadly, the fraudsters are taking advantage of the COVID-19 situation. Hang up on any telemarketing schemes dealing with the virus or government paychecks. Likewise, delete any emails attempting to click-bait you into to clicking on something. Those are to be treated as venomous snakes, as that’s what they are. Stay clear and social-distance yourself from them.

The Connection Between Your Diet and COVID-19

For several years we have published articles, book reviews, transcripts of YouTube videos and other articles all discussing this central theme: The over-consumption of sugar, high fructose corn syrup (HFCS), and refined carbohydrates leads to what’s called metabolic syndrome.

These refined carbohydrates elevate your blood sugar, which triggers your pancreas to secrete more insulin to bring down your elevated blood sugar levels. Eventually, your cells become more resistant to the effects of insulin, and your doctor then tells you that you have developed insulin resistance.

The doctor prescribes metformin to head off your incipient type 2 diabetes. Hypertension meds follow. Next, it’s statin drugs, Now, you’re being treated for full-fledged metabolic syndrome, and the door is now wide open to a panoply of degenerative illnesses. Among these are type 2 diabetes, obesity, hypertension, heart disease, strokes, kidney problems, vision diseases, cancer, and others.

Then the metformin doesn’t work as well as it used to, and your doctor now prescribes insulin. The costs go up, and you are hit with high copays. Things keep progressing downhill.

The above scenario can seriously compromise your immune system. We’re now seeing many reports that in addition to respiratory issues, type 2 diabetes, hypertension, obesity, and heart illness are co-morbidity factors aggravating one’s coronavirus illness. Put bluntly, you are more likely to die if you contract the COVID-19 virus.

What seems to be the trigger mechanism for these degenerative illnesses? From my readings and personal experience my answer is this: Sugar and HFCS. They may taste good, but they also tickle your dopamine receptors as well as being addictive.

To get a better understanding as to how sugar consumption compromises your immune system, here is an abbreviated transcript of the first ten minutes of Dr. Shiva’s YouTube video titled, This Event Was A Coordinated Last Ditch Effort By The [DS], Moves & Countermoves: Dr. Shiva.

Note: I recommend stopping at the 10:45 mark. After that point, Dr. Shiva starts going off on politics and conspiracy theories.

Dr. Shiva’s Presentation

3:40-4:14 He explains the parable of the six blind men and the king to illustrate the reductionist way of thinking.

4:21 Dr. Shiva explains in detail the reductionist way of thinking, and he uses the elephant in the room example.

4:30 People in power want to use science to hide the larger piece.

4:38 To look at this issue we need to look at the whole issue. The elephant in the room is the immune system.

4:43 Is the immune system so frail that a virus can destroy it? That’s the central question.

4:55 If you look at medical education, it’s built on the big pharma model.

5:10 With all the years of study, they really don’t understand the immune system. How does this all work?

5:40 The immune system is a very complex system. He expands in detail just how complex it is.

6:02 It’s much more complex than what was understood when the national vaccine act was passed in 1962.

6:20 He explains in more detail how the immune system works.

6:55 The body is fighting back against these pathogens and it resolves itself. It’s called resilience.

7:05 However, if people are not running on all six cylinders [assuming a 6 cylinder engine] and if a couple of them have been knocked out through bad eating, lots of high sugar diets [Ed: My emphasis] which creates candida, creates gleo-toxins which takes out your macrophages or T-cells; well guess what happens?

7:24 Your body in its infinite wisdom tries to self-protect itself. So, it will start using two of its cylinders, and they overreact. It’s the overreaction of a weakened and dysfunctional immune system.

7:38 It not only tries to attack the virus particle by trying to explode its cell wall and break it up. He further explains this process and references the Ebola virus.

8:06 In the case of the coronavirus, it goes to the epithelial cells in your lungs. It’s your over-reaction of your own body.

8:18 Why does that over-reaction occur? It could be genetic…. It could be that you have been eating garbage most of your life…you’ve compromised your immune system

8:28 It could be your diabetes…

8:36 Or as you age… As you age, your thyroid function goes down. Why’s that an issue? When your thyroid function goes down, you don’t produce enough vitamin A

8:42 And guess what vitamin A is? It’s a hormone which builds a wall around your cells to protect any pathogens from coming in.

8:55 And on top of that, if you’re not getting enough vitamin D…vitamin D is an amazing nutrient…  your body uses it to create a very powerful chemical called cathelicidin.

9:10 These are like bullets. These bullets poke holes in the walls of bacteria or in the walls of viruses, and it basically destroys them.

9:25 What you’re really looking at is that the immune system needs certain nutrients. When it has those nutrients your body functions beautifully. It takes care of itself. If you deplete yourself of these nutrients, your body become immuno-suppressed, or you have other types of diseases.

9:45 None of the people around the president are studying [this] at all. It’s vaccines, vaccines, vaccines… forgetting the immune system in most of is fine. We get viruses every day. We build anti-bodies every day, and we move forward.

10:00 We have millions? of viruses in our bodies right now.

10:05 He explains that the coronavirus is a variation of the SARS virus. It has a higher infectivity rate and a lower mortality rate. It is a virus, and our body knows how to deal with it.

10:06 However, if you have immune-compromised people like older people. He references Italy with an older population.

10:42 He then rhetorically asks, “Why are we shutting down the country for this phenomenon when we don’t shut the country down when 600,000 people die of heart disease?”

Mr. Comments: The takeaway here is that consuming sugar trashes your immune system. In addition to social distancing and staying at home, one of the very best things you can do for yourself is to eat healthily and avoid foods that trash your immune system

More Evidence of Co-morbidity Factors

HUGE! Infectious Disease Expert Says His Clinic Has Not Seen ANYONE UNDER 70 Who was not Obese or Pre-Diabetic Get Seriously Ill with COVID-19 (VIDEO)  …The title to this article says it well.

Here is a key quote from Dr. Stephen Smith’s interview:

The more we see this disease, the more we understand that severe rapid COVID disease especially is in diabetics or prediabetics. We have 19 or 20 patients who are intubated. And 18 of the 20 are diabetic. And two are prediabetic. We don’t have anybody who’s been intubated in our group of over 80 now that was not diabetic or pre-diabetic that was intubated. We’ve seen younger patients with severe disease that have a very high BMI. We have patients that are over 300 pounds. We’ve seen a lot of it. And just now I think the world is catching up to this. A Seattle group published their data in the New England Journal of Medicine saying 58% of their ICU code patients were diabetic and that their average BMI was 33 which is morbidly obese. That fits with our data. What people haven’t focused on yet is that pre-diabetics are also at risk, especially if they have a high BMI. We haven’t had anyone under 70 who didn’t have a high BMI or was pre-diabetic get seriously ill. (Ed: I bolded key points.)

In the video, here a key quote from another contributing physician, Dr.Ramin Oskuoi:

Clearly those with diabetes and pre-diabetes are to a much, much higher risk…

My Comments. Please connect the dots. What are the primary causes of the type 2 diabetes and obesity that Dr. Smith references? Answer: It’s sugar, HFCS, and other refined carbohydrates.

Dr. Duc Vuong

Dr. Duc Vuong explains that type 2 diabetes, hypertension, and obesity are aggravating factors regarding the virus.

The following is an abbreviated transcript from Dr. Duc Vuong’s YouTube video, HOW COVID-19 KILLS–I’m a Surgeon–And Why We Can’t Save You.

Caution: Dr. Vuong uses some profanity is his video.

3:24 There is no immunity, which means what? Everybody who comes in contact with the virus will catch it and will have some sort of symptoms.

3:35 It can be mild…there might be some asymptomatic carriers…80% will have a mild case of corona virus.

3:40 Mild means you don’t need to be hospitalized. This is not the regular flu.

4:04 Twenty percent of the people will need to be hospitalized. Of those, about half will need to be in the ICU. Of those, about half will need to be on respirators.

4:20 Why am I talking about respirators? That has to do with how coronavirus kills.

4:33 Coronavirus is a respiratory illness. That’s important, because if anyone has a respiratory issue, he’s at a higher risk.

4:40 He names various respiratory issues…

4:50 You’re at risk guys….

4:54 There’s a direct correlation with coronavirus and bad outcomes…

4:58 If you have high blood pressure…that’s a bunch a Americans right there…I’ll explain why that’s important.

5:06 High blood pressure…it’s related. I promise you; it’s related.

5:11 Morbid obesity. That’s most of my following. If you lost the weight, you’re at normal risk. If your BMI is over 40, you’re at a higher risk.

5:25 Older age, but it’s coming down. We’re warning 60 year-olds.

5:44 He starts diagramming on his white board and explains how the virus illness progresses.

13:45 He references ACE inhibitors (for regulating blood pressure).

14:05 He demonstrates how the coronavirus targets the ACE protein. [Ed: it’s a little technical at this point.] ***

He describes how the lungs fill with fluid when infected by the virus.

24:00 The treatment [once the illnesses has seriously progressed] is to put you on a ventilator.

24:27 Half the time they’re put them on a ventilator, they don’t make it.

*** Dr. Vuong’s point is that taking ACE inhibitors seems to aggravate the lung illness caused by the COVID-19 virus. For further information, please consult this article from Science Daily: ACE inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19, paper suggests.

Some common ACE inhibitors are lisinopril, enalapril, fosinopril, quinapril, and ramipril.

Some common angiotensin receptor blockers are losartan, candesartan, telmisartan, and valsartan.

Warning: DO NOT MAKE ANY CHANGES WITH YOUR BLOOD PRESSURE OR ANY OTHER PRESCRIPTIONS ON YOUR OWN. PLEASE CONSULT YOUR MEDICAL PROFESSIONAL. THE INFORMATION PRESENTED IN THIS ARTICLE IS FOR EDUCATIONAL PURPOSES ONLY.

Obesity: Major COVID-19 Risk Factor

Finally, I read another article titled, Obesity Major COVID-19 Risk Factor, Says French Chief Epidemiologist.

The opening paragraph:

Being overweight is a major risk for people infected with the new coronavirus and the United States is particularly vulnerable because of high obesity levels there, France’s chief epidemiologist said on Wednesday.

Conclusion and Takeaways

There appears to be overwhelming evidence that obesity, hypertension, type 2 diabetes, and heart illness are co-morbidity factors for those that have contracted the COVID-19 illness. These situations are a result of metabolic syndrome, which to a great extent is caused by consuming sugar, HFCS, and other refined carbohydrates. Additionally, these behaviors are avoidable if you so desire.

If this is you, here is what can you do NOW!

  • Eliminate sugar, HFCS, and refined carbs from your diet. Yes, you can do this!
  • Lose weight if overweight.
  • Exercise more.
  • Eat real foods, not processed garbage!

Your best defense to ward off nasty viruses and nefarious bugs is to maintain your immune system and overall health! End

Fat Heals—Sugar Kills: Chapter 2, Modern Diets and Degenerative Disease

by Dr. Bruce Fife

A Big Fat Lie

Dr. Fife gets right to the point:

The warning to reduce consumption of fat, specifically saturated fat and cholesterol, is found everywhere we look. Doctors advocate low-fat diets to help fight heart disease and other degenerative conditions.

Here is the real irony about this situation. Doctors are offering dietary advice that is more of the same as what likely has caused these degenerative diseases (DDs)in the first place. Health insurance companies are on the same misguided bandwagon. I have seen in the “health tips” from my Medicare company promoting the same worn out bad advice: “Reduce your intake of saturated fat.” Sadly, the American Heart Association (AHA) spews out the same, horrible advice.

Dr. Fife explains that fat is a necessary component of our lives, and without it we would be dead. Consider just how important fat is:

  • Fat provides a protective cushion for our delicate organs.
  • Fat helps insulate our bodes when exposed to cold temperatures.
  • Fat is involved with the production of vital hormones.
  • Fat provides energy when food is restricted or when physical activity. Is increased.
  • Several vitamins and other import nutrients are only found in fat (lipids) from animal and vegetable sources.
  • Fats are an important part of the structure of our cells and particularly our cell membranes.

Fat provides necessary calories between meals and helps keep our blood sugar levels much more even compared to eating carbohydrates, particularly refined carbohydrates. Fife explains that one of the most important lipids is cholesterol, and without it, we would die.

My comment: Previously, we spent over a year digesting Dr. Stephen Sinatra’s book, The Great Cholesterol Myth. We learned just how essential is a proper level of cholesterol is in our bodies for optimal health.

Continuing: Dr. Fife points out that without cholesterol, we would be sexless, meaning that our bodies transform cholesterol into important hormones such as estrogen, progesterone, testosterone, cortisol, and others.

He continues by saying that if we do not consume enough cholesterol in our diet, our liver will produce the shortfall. If we eat too much cholesterol, it is broken down by the liver and stored as fat.

Dr. Fife broaches a subject that has been the topic of entire books: Not all fats are the same; in fact, some fats are downright dangerous. He reminds us that “health” professionals condemn good fats and advocate consuming bad fats. We still have the AHA condemning saturated fats and promoting fats from oils such as soybean, canola, corn, etc.

The Food Revolution

Our ancestors ate fresh, local food right off the farm. These were real foods with only a minimal amount of refining and additives. As societies urbanized, foods become packaged and canned for longer shelf life. This resulted in food becoming less nutritious and containing more and more questionable additives.

Nutritional diseases were rare in these primitive cultures as well as the panoply of degenerative diseases (DDs) that we see today. Infectious diseases such as tuberculosis were the dreaded diseases of the day but certainly not coronary artery disease.

The food habits of our ancestors changed. Wholesome brown rice was polished into starchy white rice. Whole wheat was milled into white flour. Sugar consumption dramatically increased.

  • 1800: Sugar consumption was about 15 pounds per person per year
  • 1900: 85 pounds per person per year
  • 1999: 150 pounds per person per year
  • Today: About 130 pounds per person per year. The drop isn’t necessary good as it’s due to the increased use of artificial sweeteners.

The increase in refined carbs wasn’t the only problem. The fats our ancestors ate were lard, beef tallow, butter, coconut and olive oils. Except for olive oil, the other fats are all saturated. Thanks to the invention of hydrogenation and seed oil presses, seed oils (soybean, canola, corn, etc.) were processed into cheaper Crisco shortening and margarine containing dangerous trans-fats.

These refined foods were then packaged to make them look appealing. The processing of whole wheat into white flour removes 22 nutrients and vitamins. Four or five synthetic ones are put back. So now we have “enriched” flour.

My Comments: the easiest way to remember this trifecta of cheap, refined foods is the acronym SORF:

Sugar — Oils (derived from seeds) – Refined – Flour  =  SORF

Continuing: The important thing to remember is that as fats, particularly saturated fats, were demonized, we transitioned from a high fat diet to a high carb diet.

My Comments: Think of a breakfast of pancakes (refined flour) slathered with fake butter (margarine) and fake syrup (a high fructose corn syrup concoction) all washed down with frozen orange juice (mostly sugar). That’s a high carb, SORF-loaded breakfast that will shoot anyone’s blood sugar level through the roof!

By contrast, our ancestors enjoyed bacon, fresh farm eggs, and raw, whole milk. Degenerative diseases (DDs) such as heart attacks, strokes, and type 2 diabetes were a rarity among these people.

Knowing that societies that consumed large amounts of saturated fats and having an absence of degenerative diseases should make one wonder why the AHA condemns these healthy fats while at the same time promoting unhealthy, refined fats. Stay tuned!

Continuing: Traditional Diets

Dr. Fife uses pages 18-27 highlighting various groups of people that used to eat, an ancestral, real food diet. He also discusses a constant theme: When these people transitioned to Western, refined foods, they began developing the list of DDs.

As soon as a population starts to adopt modern foods, degenerative disease sets in. Diseases such as heart disease, cancer, Alzheimer’s, asthma, bronchitis, diabetes, allergies, obesity and the like are referred to “diseases of Western civilization.”

He first discusses Dr. Weston A Price. Dr. Price, a dentist who practiced in the first half of the 20th century, noticed a decline in the general health of his patients through the years. The correlated with the introduction of more and more refined foods, particularly after WW I.

Dr. Price set out to study foods from various cultures across the globe. He noticed that the more isolated these people were, the better was their dental health (lack of cavities) along with a virtual absence of DDs.

He also noticed that even unborn children from parents who ate processed foods were affected as their pallets were less well developed. People in the more isolated cultures had room for their wisdom teeth.

Here is one of the most important observations made by Dr. Price:

One of Price’s most frightening discoveries was that it didn’t take much of a change in the people’s diets to cause notable changes in health. While their diet remained primarily the same as it had always been, the additives of even a small quantity of sugar and white flour made dramatic differences in their health. [Ed: my emphasis]

My Comments: How many fad diets suggest that you keep your head to the grindstone five days per week only to capitulate to your cravings for that doughnut, bagel, Danish, or whatever the other two days. Not only is this advice bunk, it’s dangerous to your health. Imagine telling a smoker not to smoke during the weekdays, but it’s okay to smoke on the weekends. Imagine telling the alcoholic to stay dry during the week, but happy hour Friday and Saturday night is okay! Think how well that advice would go over at an AA meeting.

The problem is that most everyone is an alcoholic (meaning addicted) to refined, processed foods. To further complicate matters, these addictive, processed foods tease our dopamine receptors. We like them and get a buzz from eating them. The best solution is to purge our homes of SORF, refuse to buy it, and refuse to consume it even in social situations. Doing so will help prevent us from succumbing to the “some is okay” mentality. According to Dr. Price’s observations, some is not okay.

Continuing: Are High-Fat Diets Harmful?

Dr. Fife recounts several cultures that ate a high fat, low carb (HFLC) native diet while at the same time were remarkably free of DDs. There are groups in east Africa whose diet is primarily meat and milk. Pacific islanders ate saturated coconut meat and fish. The Innuit’s (Eskimos) diet was mostly meat and fat. 80% of their calories were from fat!

In every situation when these cultures were exposed to Western refined foods, DDs started occurring. The slim and trim Innuits became paunchy.

Whenever a people have adopted modern, processed foods, diseases of modern civilization have quickly followed. The transition from moderate to high fat diets to a modern low-fat diet has always resulted in declining health. When fat is removed from the diet, it is invariably replaced with carbohydrates, so now we have a high carb, low-fat diet. These carbohydrates are primarily refined flour and sugar. Fat is necessary for optimal health.

You Can’t Outrun a Bad Diet

There are those who contest the HFLC concept and instead suggest that the reason these isolated cultures were virtually disease-free was because they were physically active. Their argument is that exercise overcomes and “burns up” refined, processed foods. Dr. Fife points out that even high carb athletes suffer from heart attacks, strokes, diabetes, and other chronic illnesses just like everyone else.

He then references the 1977 best selling book, The Complete Book of Running by the running guru, Jimmy Fixx. The only problem is that Fixx died at age 52 from a massive heart attack. His autopsy revealed that his coronary arteries were plugged up.

Dr. Fife cites another study of 36 runners dying an early death due to heart disease. Their mean age of death was 43.8 years. Getting regular exercise and being physically fit did not protect them from heart disease. He concludes by saying that the belief suggesting that the isolated cultures stayed healthy due to their physical activity doesn’t hold up.

Dr. Fife references the concept of carbohydrate-loading. High endurance athletes would load up on carbs (pasta, bread, etc.) for several days before an event. The belief was that this technique was to store up as much glucose in the body as possible. Meanwhile, fat was declared a useless nutrient. With these runners dying off like flies, it appears that this theory wasn’t such a smart idea after all.

Dr. Fife mentions Peter Attia MD, a physician specializing in preventative medicine. Dr. Attia, too, was on the high carb, low fat bandwagon. Despite avoiding junk foods and fast food restaurants, his health continued to decline. Worse, he was developing insulin resistance, the marker for type2 diabetes. His intense exercise could not overcome the negative effects of his supposed healthy, low-fat diet.

My Comments: I was not familiar with Dr. Attia, so I did an internet search to learn more about him. I cam across this YouTube video titled Dr. Peter Attia: Readdressing Dietary Guidelines. While it runs over an hour, it packs in plenty of fascinating information about fats and cholesterol.

Continuing: Frustrated, Dr. Attia started cutting out the sugar from his diet. He switched from relined grains to whole grains foods. He reduced his protein consumption. Over a two-year period, he gradually transitioned to a high fat, low carb (HFLC) diet. During this timeframe his markers continued to improve. His LDL dropped and his HDL (good cholesterol) went up. His waistline shrank from 38 to 32 inches. Lastly, he was able to exercise less to maintain his same level of fitness.

Conclusion: No amount of running or exercise will protect you from a bad diet. …Regular physical activity is not the magic bullet that protects primitive societies from degenerative disease. It is the sugar-free diet that does that. (Ed: My emphasis) End

SORF, What Is It and Why you Want to Avoid It

by Lance D. Reedy

Starting in 1981 I became very interested in diet and nutrition. The first major book I read about this subject was The Pritikin Permanent Weight-loss Manual by Nathan Pritikin. 

Pritikin advocated an extremely low-fat diet with fat being about 10% on one’s caloric intake. He was also a strong proponent of consuming complex carbohydrates. Refined sugar and white flour were also verboten in his diet scheme.

Pritikin’s contention, and he is spot on here, is that refined carbohydrates such as sugar and white flour concentrate the calories in one’s diet. Refining wheat into white flour removes the bran and wheat germ, leaving just the starch, or white flour.

Drinking fruit juice does the exact same thing. An 8-ounce glass of apple juice contains about the same number of calories as two, medium sized apples. One can down the eight ounces of apple juice in a few seconds, but it takes a while to chew up and swallow two apples. The concentrating of carbohydrates elevates your blood sugar much faster causing your body to go into overdrive to bring it down.

Dr. Stephen Sinatra in his book, The Great Cholesterol Myth, posed this question in chapter 5, The Truth about Fat, It’s Not What You Think, “If we need an adequate amount of healthy fats in our diet, why then, did the Pritikin ultra-low-fat diet still work to reduce people’s heart disease?” Sinatra’s answer was that the Pritikin diet cut out refined sugar.

In every worthwhile book I have read about diet and nutrition there is one over-riding theme. Excess sugar consumption is really bad for your health. Added to this mix is high fructose corn syrup (HFCS), which is nothing more than sugar derived from corn. These concentrated sugars can be from fruit juice and even dried fruit. A handful of raisins contains much more sugar than a handful of grapes. In 2019, I reviewed the first nine chapters of Dr. Robert Lustig’s The Hacking of the American Mind. Chapter 9 is titled What You Eat in Private you Wear in Public. Let’s look at some excerpts from my review of that chapter.

SORF is my acronym for the trifecta of…

Sugar

Oils, meaning those manufactured from seeds

Refined

Flour

“Okay, sugar is a problem; I get that, but I thought some of these oils, like canola oil, are heart healthy,” you may think. Dr. Sinatra enumerated in his book four chief causes of heart disease. Here they are:

Sugar—Inflammation—Oxidation–Stress

Because of the way these seed oils (incorrectly called vegetable oils) are manufactured, they are already oxidized when they are filled into their plastic bottles. These oxidized oils contribute to transforming the harmless and light, fluffy low-density lipo-proteins into bad cholesterol.

This bad cholesterol, in turn, causes inflammation of the endothelial cells that line our coronary arteries. The low-density lipo-proteins are just fine, and nature made them that way for a purpose. However, if they get transformed due to a faulty diet, they are still not the culprit. The culprit lies in what contaminated them—oils derived from seeds. These are soybean oil, canola oil, cottonseed oil, etc.

To further explore the problems with these edible oils, please refer to this article titled The Great Con-ola from the Weston A. Price Foundation’s website. Another excellent article is titled Good Fats, Bad Fats: Separating Fact from Fiction.

There is also a potential link with the ever-increasing consumption of these seed oils and skin cancer and even perhaps cancer in general. Please review this article titled Fats and Oils and Their Impact on Health, again from the Weston A. Price Foundation’s website.

One of the key points Dr. Lustig makes in book, The Hacking of the American Mind, is that seed oils (soybean, canola, cottonseed, etc.), which are high in omega-6 fatty acids, inhibits your natural serotonin production. Inadequate amounts of serotonin lead to anxiety and depression.

In contrast, omega-3 fatty acids, found in fish, eggs, olive oil, and other healthy fats, contribute to the normal production of the neurotransmitter, serotonin. Serotonin is responsible for creating a sense wellbeing, mental equilibrium, and contentedness.

I seek to avoid consuming food items made with these damaging seed oils. For example, I was given a package of nuts that were roasted in either soybean, canola, or cottonseed oil. While I appreciated the gesture, I had to toss them. Likewise, I avoid salad dressings, margarine, and other food products made with these unhealthy oils.

There are further problems with the seed oils being genetically modified and doused with herbicides such as Roundup. A detailed discussion of this issue is beyond to scope of this article.

Lastly, what about refined flours? Once you strip away the germ and bran from grains, you are left with the starch or pure carbohydrate from the grain seed. It’s a straight repeat of the problems with sugar. If a pastry is made from sugar, refined flour, and seed oils, you now have a triple whammy.

Conclusion: Some people will object and say that they will have nothing left to eat if they remove SORF from their diet. Nothing could be further from the truth. In future articles we’ll explore incredibly tasty foods that are SORF free. End

Remember, You Can Change Your Medicare Supplement Plan Any Month of the Year

by Lance D. Reedy

Unfortunately, many people still mistakenly believe that they can’t change their Medicare supplement plan after the December 7th AEP deadline. As such, we have updated this article for 2020.

The good news is that you can change your Medsupp plan any month of the year, providing that you medically qualify. If your Medsupp rate increases have been above normal, you may be able to qualify for a lower premium plan.

Yes, you can change your Medicare supplement plan any month of the year as long as you medically quality with the new company.

We work with most of the Medicare supplement companies and can assist you in shopping for lower rates. Please call us first!

Remember, medical qualification applies. More about this shortly.

Another smart move, if possible, is to change your plan letter. For example, if you have an increasingly spendy Plan F with Company X, a good solution is to switch to Plan G. Another good reason to move out of Plan F is that people turning 65 after January 1, 2020 are not able to sign up for Plan F. Note: This does not need to be done right away, but it’s something to think about for the future. As these existing Plan F’s age, they will continue to go up.

How do I qualify for a new Medicare Supplement plan?

To qualify for a new Medsupp plan, in general you will need “No” answers to the following health questions. The language on each companies’ application may vary somewhat, but they are similar.

1) In the last two years have you had or been treated for circulatory or heart disease including a heart attack, heart bypass surgery, stent placement, atrial-fib, or pacemaker implantation?

2) Have you been treated for internal cancer, melanoma, or lymphoma in the last two years? (Does not include most skin cancers.)

3) Have you had a stroke or TIAs in the past two years?

4) Have you been diagnosed or treated for COPD, emphysema, or chronic bronchitis in the past two years?

5) Have you been hospitalized more than two times in the last two years?

6) Have you been diagnosed with any type of dementia, Alzheimer’s, or Parkinson’s disease? Note: One of our companies will take people with these conditions if there are no other major issues.

7) Do you have any auto-immune disease such as AIDs, HIV, multiple sclerosis, rheumatoid arthritis etc? (Other diseases may be included depending on the company.)

8) Do you have any planned procedures like physical therapy or surgeries such as a joint replacement or a cataract surgery recommended to be completed in the next twelve months?

These are the major categories. A company may request additional information.

Routine prescriptions such as blood pressure, cholesterol, and type 2 diabetes meds are usually okay. Most companies have a drug decline list. Examples are opioids and many cancer related drugs. The companies generally require that you list all prescriptions on your application. Certain combinations of drugs such as ones used to treat diabetes (particularly insulin) and hypertension may cause a decline with one or two companies.

Why do we pre-qualify you before applying?

If you have a medical condition that is iffy, we can shop for the company that is most likely to accept your application. One company may be more picky about one particular health issue compared to another. Through the years, we have learned that a certain health issue that may not fly with one company can go through with another. Many companies will decline hydrocodone use, but one or two companies will consider your application.

Why are some people reluctant to change if they can quality for substantially lower rates?

The biggest reason that we have seen is fear. They are afraid that the new company won’t pay its claims. However, this fear is completely unfounded. The plans are standardized, and all companies pay their claims. We have encountered folks who could save $80 per month or more by changing out of an old, expensive plan. Unfortunately, a few of them wouldn’t budge because they were deathly afraid that their new company won’t pay its claims.

Do we ALWAYS shop for the lowest rate available?

Not necessarily. In fact, there are a couple of companies that we avoid. One of them was owned by one hedge fund that pawned it off to another hedge fund. The game they play is to come out with absurdly low rates. People will chase those rates only to discover that within two years or so the rates are going through the roof.

This game is called “buying the business.” A company is willing to break even or even lose money to get a bunch of people signed up. They also entice agents to peddle their product with high commissions and lucrative production bonuses. Within two years or so they go to the state insurance department, show their losses, and file for big rate increases. Meanwhile, If a person has developed an uninsurable condition, he/she is stuck with that company. Sorry, that’s not a game we’re going to play. We prefer to work with reputable companies.

What if I have a health issue that no new company will accept?

The solution for the people in this situation may be switching to a Medicare advantage (MA) plan during the fall October 15 through December 7th Annual Election Period (AEP), also known as Medicare open enrollment.

There are pros and cons involved in switching to an MA plan. Please contact us for details. On the other hand, many people are happy enough with their current plan. Nothing says that you have to change.

Why is it much easier to switch to a Medicare advantage (MA) plan?

The only health question on an MA application is kidney failure. You could have had a recent stroke, been treated for cancer in the past two years, or have multiple sclerosis, and you still can qualify for an MA plan. Those conditions will likely cause a decline on most any Medsupp company’s application.

However, switching to an MA plan is not feasible for some people if they live in a county that has no available MA plan.

How do I find out if I’m eligible for lower rates? Please call us at (208) 746-6283 or (888) 746-6285, or email us at lance@nwsimail.com. If you have a health situation that you believe may be an issue, contact us anyway, and we’ll see what we can do. End

Fat Heals—Sugar Kills: Chapter 1

by Dr. Bruce Fife

Chapter 1: A Big Fat Mistake

Dr. Fife by profession is a certified nutritionist and naturopathic physician, and he authored over 20 books dealing with health and healing. He also is a very strong advocate of using coconut oil in place of vegetable or seed-derived oils.

If I could sum up this chapter with a one-word acronym it would be this:

LCHF, meaning a Low Carbohydrate, High Fat diet. In essence, that’s the gist of Dr. Fife’s book.

Dr. Fife starts the chapter by discussing a patient named Reyn. At 370 pounds, Reyn was a disaster waiting to happen. His cardiologist had him on the usual trifecta of prescription drugs including blood pressure meds, statin drugs, metformin for blood sugar, and Victoza to lose weight.

Reyn followed his doctor’s usual nutritional advice of eating a low-fat diet along with lean protein. This included, of course, avoiding saturated fats. His meals were centered around grains, fruit, and low-fat dairy. Because he took his meds, Reyn felt free to occasionally indulge in sweets, especially if they were sweetened with artificial sweeteners.

Despite taking his meds and following his doctor’s dietary advice, Reyn’s health continued to decline. He was hospitalized due to heart problems and blamed it on bad genetics.

Reyn attended a health conference where he heard about Low Carbohydrate, High Fat (LCHF) diets for the first time. Afterwards, he listened to several speakers extolling the virtues of the LCHF diet. One of them was Jason Fund, MD, a featured speaker at the conference.

The concept of the LCHF diet was new to Reyn, and it was contrary to his pre-conceived beliefs about diets. The following are some attributes of the LCHF diet:

  • High carb foods such as grains, starchy vegetables, and most fruits are limited.
  • Fat consumption is significantly increased. Non-fat milk is replaced with full-fat milk. Low fat cheese is replaced with full-fat cheese.
  • Most of the fats are saturated
  • The use of poly-unsaturated vegetable (seed oils) from soybeans, canola, corn safflower, etc. is limited.
  • Fatty cuts of meat are fine and preferred over lean meats

Dr. Fife points out the we [as a society] have been eating low fat for over 40 years, and what has it gotten us? Obesity is at an all-time high, and degenerative diseases such as type 2 diabetes, Alzheimer’s, arthritis, fibromyalgia, etc. are at epidemic proportions.

He points out that a growing body of research is showing that LCHF diets….

  • Can balance blood sugar
  • Improve blood cholesterol levels
  • Lower elevated blood pressure
  • Melt off excess body fat
  • Boost energy levels
  • Balance hormones
  • Strengthen the heart and much more

Dr. Fife makes this key point:

While medications may help relieve symptoms associated with the above conditions, the LCHF diet can accomplish the same thing and allow their patients to get off their drugs and lead healthier lives.

My Comment: Who wouldn’t that for his/her life?

Continuing: Here’s what Reyn did. He embraced the LCHF diet to the point where 75% of his calories were from fat, 15-20% from protein, and 5% were from carbs.

Here’s what happened. He was able to wean himself off his insulin and cholesterol meds until he stopped them entirely. When Reyn told his cardiologist that he didn’t want to renew his meds, his doctor scoffed at him.

After a year, he lost 117 pounds and ate full meals until he was satisfied. He had more energy than ever, and he discovered weight loss was never so easy. His A1C levels normalized, and his peripheral neuropathy caused by his diabetes vanished completely. A year ago, Reyn left the hospital with one foot in the grave, and now he’s a new man.

Low-Fat Diets Are Killing Us Fife next delves into the problem with the government food recommendations. He specifically takes to task the recommendations to eat more grain of “6-11 servings per day” which could include white bread rolls, muffins, and packaged dry cereals. Fried potatoes, catsup, and pizza sauce could fulfill the vegetable requirements. Sugary fruit juices, cherry pie filling and sugar soaked canned fruits all can satisfy the fruit requirements. Non-fat milk and cheese are to be preferred over the full-fat versions. Lean meats and egg white are preferred, and fats and sugars are to be used sparingly.

Key point: This reduction in fat has led to an increase in carbohydrate consumption because removing fat from meals generally leads to eating more carbohydrate-rich foods to make up for the loss of calories from fat.

My comments: You can bet your last dollar that to make matters even worse, these carb calories are primarily from refined carbohydrates. This list includes pizza crust, white rice, bagels, rolls, and bread. Even most so-called whole wheat breads are mostly made from “enriched” white flour.

All of this contributes to the spiking of your blood sugar level which then can lead to insulin resistance. It is this insulin resistance that opens to door to metabolic syndrome, which consists of obesity, type 2 diabetes, heart disease, and a long list of other maladies.

Continuing: Fife makes another key point:

Although the guidelines suggest limiting sugar intake, this advice is not stressed and has generally been ignored, with more emphasis placed on reducing total fat intake and cutting out saturated fat and cholesterol as much as possible.

Even worse, since saturated fats have been demonized, they have been largely replaced with polyunsaturated vegetable* oils. Included in this group of unhealthy fats are hydrogenated vegetable oils. shortening, and margarine. *Calling these oils vegetable oils is a bad misnomer. With mainly the exception of olives, you don’t get oil from vegetables. Rather, you get the oil by squeezing soybeans, canola (rapeseed) seeds, corn, etc. at very high pressure.

In 1961, the American Heart Association (AHA) recommended a low-fat and low cholesterol diet. In spite of this, as Fife points out, 60 years later heart disease is still the number killer in the USA.

He continues by saying that one of the rationales for the low-fat diet was to help people lose weight. The statistics, unfortunately, say that just the opposite has happened. In 1975 45% of adults were overweight. Now it’s 75%.

Likewise, there has been an accompanying rise is type 2 diabetes rates. He points out that Alzheimer’s disease is now referred to as type 3 diabetes or diabetes of the brain. He comments that the rates of other degenerative diseases are also on the rise and suggests that since those rates continue to climb, the cause is not genetic. He points out that we are now seeing Alzheimer’s occurring at younger and younger ages.

Fife explains that the cause for these increased disease rates is primarily due to the faulty dietary advice.

Key takeaway point:

If you want to lose excess weight as well as reduce your risk of stroke, heart disease, atherosclerosis, cancer, and many other degenerative diseases, you should eat more fat and less sugar and refined carbohydrates…

Dr. Fife points out that fat has been savored by people eating ancestral diets. Fat on game meat was relished. People enjoyed excellent health on high fat diets.

My comment: The Eskimos relish the fat from their game meat and throw the lean meat to the dogs. Maybe there is more to it than just needing the fat to help keep themselves warm in cold climates.

What an LCHF Diet Can Do for You

Fife lists 40 degenerative diseases where the conditions can be stopped or reversed with an LCHF diet. Here are twelve of them.

  • Alzheimer’s disease
  • Cancer
  • Cataracts
  • Coronary heart disease
  • Diabetes
  • Glaucoma
  • Hypertension
  • Kidney disease and kidney stones
  • Macular degeneration
  • Parkinson’s disease
  • Sleep apnea
  • Ulcerative colitis

In addition to improvements in the above conditions, he continues by enumerating the changes that an LCHF diet may bring to your life:

  • Get off most, if not all of your medications
  • Have more energy
  • Be more resistant to infections
  • Feel better, sleep better, and have a clearer mind and a better memory
  • Experience an overall enhanced feeling of well-being

Dr. fife makes this concluding comment about the LSCH diet:

Not all fats are of equal value, and some can be harmful, or harmful if eaten to excess…This book will be a guide.

While it may look that an LCHF diet can correct just about anything, it is not a cure-all, nor do I claim it to be such. The diet itself doesn’t cure anything. It simply provides the body with the nutrients it needs to correct imbalances caused by poor dietary and lifestyle choice. If you have been eating the standard low-fat diet, this new way of eating has the potential to significantly improve your health. It may just be the solution you are looking for. Give it a try—you have nothing to lose except your poor health.

End

Tips for using PDPHelper

This 2019 AEP is our fourth year of using PDPHelper.com. The following are some tips to help us do an accurate search on your behalf for your 2020 Prescription Drug Plan (PDP). Our goal is to recommend the PDP that will be most suitable for you. This is especially important with the WellCare takeover of the Aetna PDPs and Humana revamping their plans.

Step 1

Please enter your name, phone, email address, your zip code, and your county of residence. Some zip codes span multiple counties, and that’s why we request your county of residence. This means where your residence sits.

Next, please list your top pharmacy choices. We also ask you if you would be willing to use Walmart, Walgreens, or a mail order pharmacy if that will save you money.

Step 2

In this section, only enter your pills, capsules, or tablets. Liquids, gels, creams, insulin, eye drops, patches, etc. are in the next steps.

Enter the name of your prescription, the dose, and the quantity you buy. Important, is the quantity you buy per one month, per every two months, per every three months, or per every twelve months? If you take something as needed, estimate how many pills you buy and how often you buy it. Your estimate does need to be exact. Just get it as reasonably close as you can.

Example #1—Betty take two, 500mg metformin tablets every day. She buys 60 every month.

Name of Prescription: Metformin
Dosage: Enter 500mg
Quantity: Enter 60
Frequency: Enter month

Example #2—John take hydrocodone/apap, 325/10mg, as needed for back pain. Some days he takes none but other days he takes two or three. He estimates he takes around 45 per month

Name of Prescription: Hydrocodone/apap
Dosage: Enter 325/10mg
Quantity: Enter 45
Frequency: Enter month

Step 3

The section is for Insulin, Inhalers and Nebulizers

Example #3—Alice uses insulin. She checks “yes”. She enters her information as follows:

Name of insulin: Lantus Solostar pens
Size: 3 mL
Quantity: 5 pack or just 5
Frequency: per 2 months

Example #4—Shirley uses Advair. She checks “yes” for the category: “Do you use any inhalers or nebulizers?” She enters her information as follows:

Name of inhaler: Advair
Size: 250/50
Quantity: 1
Frequency: 1 month

Step 4

This final step is for Eye Drops. Gels, Creams, Lotions or Salves, and Other Prescriptions.

Example #5—Mary uses eye drops. She checks “yes” for this category and fills in her information. Please do NOT attempt to say “2 drops per eye each day.” We need to know the size of the bottle, usually 2.5 mL, 5 mL, or 10 mL and how often you fill your prescription.

Name of eye drops: Latanoprost SOL 0.005%
Size: 2.5 mL
Quantity: 1
Frequency: 1 month

When finished, please hit the submit button. Thank you in advance for using PDPhelper.com. End

Prescription Drug Plans—Big Changes for 2020

It seems like not a year goes by without some major shakeup regarding either Medicare advantage or Medicare Part D Prescription (PDP) plans. This year we have changes on steroids.

The first headache agents and other senior volunteers will be facing this fall is that the Center for Medicare and Medicaid Services (CMS) is changing its Prescription Drug finder (PDF) on Medicare.gov. For years we have had the ability to create a “Drug List ID.” This gave us a unique ten-digit ID number and the date of our search and the option to save our list. It has been an invaluable tool for us.

Let’s say Betty Rubble takes ten meds. Also, let’s say that last fall during the Annual Election Period (AEP from Oct. 15 through Dec. 7) I pulled up her previous list. Betty told me that she dropped one of her meds and added a new one. I would not have to reenter all of her ten meds. I’d simply recall the saved list by populating the fields for the drug list ID and the date of our original search.

Voila, the list of her ten meds pulls up. we delete the one med she has discontinued and add her new one. We enter her preferred pharmacy and hit “Continue to Plan Results.” The website sorts the PDPs in order of the best buys. By best buy we mean the estimated annual cost.

This estimated annual cost includes and is the sum of the following:

  • The monthly premium times 12.
  • The deductible if there is one.
  • The copay for her meds before and after the deductible.
  • Her costs when she is in the coverage gap (if applicable).
  • Her catastrophic costs once she has moved out of the coverage gap (if applicable).

There have been a few minor traps that a new user could fall into when using the PDF, but a knowledgeable person knew what they were. In short order we advised our clients which PDP that would be their best buy for the upcoming year. One exception for not chasing the lowest cost plan was a PDP with a sub-standard rating. Another exception has been a company known for poor customer service. Other than that, we’d recommend the plan that was the best buy.

Some plans compensate the agents and others don’t. We’d have recommended to you to the most cost-effective PDP irrespective of whether or not the plan compensates agents. Also, there is no incentive for an agent to “churn” people from one plan to another. CMS does not allow any additional compensation for doing this.

We’re happy to provide this service for our clients and we will continue to do so. However, we’re entering uncharted territory this year because of the changes that CMS has made to the prescription drug finder (PDF) on Medicare.gov.

First, our saved drug list will not carry over to the new PDF. That means the hundreds of saved lists are going POOF! Gone!

Medicare wants you to set up a My Medicare account. You enter your date of birth, your Medicare number and create a username and password. So far, the PDF does not give a simple list of the best to the worst buys. It uses a different format for comparing plans. Our experience is that it sorts by premium or copays. Thus, the user has to enter different sort criteria.

The new PDF may be easier for you the consumer to navigate, but it appears to be far less friendly to agents and senior volunteers that do multiple searches per day. You can spend an evening to get set up for yourself, but we’re simply not going to have the time to help everyone set up his/her My Medicare.

Complaints about the new revised PDF have been flooding into CMS, so we don’t know exactly how their new revised PDF is going to play out. There may be more revisions by October 1st.

What’s really irritating about this is CMS’s timing. They wait until the busiest time of the year to foist their new change onto the public. If they would have chosen April, for example, we’d have six months to learn and understand their new website prior to the October AEP. They would have had six months to work out the bugs.

There is some good news here. There is a private prescription drug plan finder that will be available for agents but not for the public. We’ll still have to input your meds, but at least we’ll have a program that will assist us in making the most suitable recommendation for you. We’ll know more as we use this new PDF.

Big Prescription Plan Changes

CMS puts a gag on revealing specific plan information prior to October 1st. By this we mean premiums and specific benefits. However, we can provide you some generalities prior to October 1st.

Humana PDPs

For several years Humana has sponsored three PDPs. They have been as follows:

  • Humana Enhanced PDP
  • Humana Preferred PDP
  • Humana Walmart PDP

Humana is scrapping those three plans and creating three NEW plans. They are as follows:

  • Humana Premier PDP
  • Humana Basic PDP
  • Walmart Value PDP

The Premier plan will have the highest premium. The Humana Basic plan is intended for those on Extra Help from Medicare. (Extra Help is a federal program that subsidizes some or all of a beneficiary’s PDP premium and provides for lower cost copays. Qualification is based in income and assets or resources.)

The new Walmart Value plan will be the budget plan and will compete in the arena of lowest premium plans.

If you do nothing, here is what will happen in 2020. The people in the current Enhanced plan will be moved to the Premier Plan. Those with the Humana Preferred plan will be moved to the new Humana Basic plan. So far, so good.

Attention for those that have the current Humana Walmart plan.

The Humana Walmart members: If you do nothing, will be moved to the Humana Premier plan. You will NOT be automatically be moved to the new Walmart Value plan. Humana will be announcing this in your Annual Notice of Change (ANOC) letter that you’ll be receiving (if not already) from Humana. You may even receive a phone call from a Humana representative regarding this situation.

We will be contacting you as fast as possible to guide you into the most cost-effective plan for 2020. Please be patient, as we cannot service hundreds of people the first day, but we will get to you during the AEP. Also, please feel free to contact us, and we’ll put you on our list.

Aetna and WellCare

CVS bought Aetna, and the merger is complete. One of the obstacles prior to this merger was the concern by the regulators that CVS would have too strong of an influence regarding PDPs. CVS sponsors the Silver Script PDPs. So, to keep the regulators satisfied, Aetna sold off its PDP unit to WellCare. A few of you have already contacted us about the somewhat vague letter from WellCare explaining this situation.

Be sure to read the ANOC that you’ll be receiving from WellCare. Please contact us with any questions.

PDPHelper.com

We really appreciate the large numbers of you that have previously used PDPHelper.com as a method of submitting to us a list of your meds. Please continue to do so for this coming AEP. Our website is not affected by the changes on Medicare.gov.

Lastly, thank you for your continued business. It is your patronage that keeps us operating.

The Statin Prescription Number That Makes My Blood Boil

by Dr. David Eifrig

221 million prescriptions…

That’s the latest number available for the number of prescriptions written in a single year (2012-2013) for statins.

In a little more than a decade, from 2002 to 2013, use of this cholesterol medicine increased 80%. The reason? The American Heart Association lowered the guidelines for “normal” cholesterol numbers. Overnight, millions of Americans suddenly had high cholesterol… and doctors turned to Big Pharma to “fix” the problem.

Today, one in four Americans over the age of 40 takes statins. That number makes my blood boil. Particularly when friends of mine resign themselves to taking the drug for the rest of their lives.

I’ve written before about the big myth behind cholesterol. Solely treating a set of numbers with an overprescribed drug class like statins is an irresponsible – and dangerous – practice.

That’s largely due to the fact that inflammation – not cholesterol – is the root cause of heart disease. That’s why simply treating cholesterol numbers doesn’t work. Doctors need to focus on the whole patient – including lifestyle elements like diet and exercise.

But given how many folks still write to me asking about statins, I wanted to address my views on them in today’s issue. Let’s get started…

Please click here to keep reading.

The following are my comments.
by Lance Reedy

My comments: What are these processed foods that Dr. Eifrig refers to? For several years I have used the acronym SORF to describe these unhealthy foods that Dr. Eifrig and others refer to. If you avoid processed foods with one, two, or all three components of SORF you will go a long way to avoid inflammation-causing foods. Sadly, there are hundreds of these dressed up packages sitting on grocery store shelves that unsuspecting shoppers unwittingly purchase.

S = Sugar   This includes sugar, high fructose corn syrup (HFCS), and sugar alcohols. Even though artificial sweeteners such as aspartame, Splenda, etc. aren’t sugar, they are toxic chemicals that you don’t want in your body. Don’t forget the Agave scam. Agave is high in fructose. The over-consumption of these sugars can lead to insulin resistance and metabolic syndrome.

O = Oils   This refers to oils that require a factory to produce. Included in this list are soybean oil, canola oil, safflower oil, corn oil, etc. The industrial processing causes these unstable Omega 6 oils to become rancid. This causes harmless, low-density lipoproteins to become oxidized and transformed into small, B-B-like particles. These particles, in turn, cause inflammation to the lining of your coronary arteries. Please refer to Dr. Stephen Sinatra’s The Great Cholesterol Myth.

What about the advertising the suggests that these oils are heart-healthy? At best they are bogus, and at worst they are fraudulent propaganda.

RF = Refined Flours   This list includes white flour or “enriched” white flour, white rice, or any product made by milling off the bran and germ of any grain. The refining process robs the grains of valuable B vitamins and fiber. Worse, it concentrates the starch, causing your blood sugar to spike as if you had eaten sugar. Again, this contributes to insulin resistance and metabolic syndrome.

Want to stay in optimal health and avoid as much inflammation as possible? Avoid SORF!

Disclaimer

The articles in Northwest Senior News are for your education and general health information only, and the opinions of various writers do not necessarily reflect those of Northwest Senior News. The ideas, opinions and suggestions contained in Northwest Senior News are NOT to be used as a substitute for medical advice, diagnosis or treatment from your doctor for any health condition or related issues. Readers of Northwest Senior News should not rely on information provided in these articles for their own healthcare. Any questions regarding your own healthcare should be addressed to your own physician. Please do NOT start or stop any medications or any other medical protocol without consulting your doctor or other licensed healthcare practitioners.