The Hacking of the American Mind—Report #1

The Introduction

My Beginning Comments: I became familiar with Dr. Robert Lustig from his Youtube video titled, Sugar, The Bitter Truth. In the video, Lustig discussed the myriad of health problems that have resulted from the introduction in the 1970s of High Fructose Corn Syrup (HFCS) in Western diets. Among these ill-effects are an explosion of type two diabetes and obesity. An acquaintance referred me to his newest book, The Hacking of the American Mind. For future reference I’ll shorten the title to Hacking.

I looked at Lustig’s Youtube video titled The Hacking of the American Mind with Dr. Robert Lustig and decided that Hacking has merit for anyone wanting to better understand how we got to where we are as far as the American diet goes. Lustig poses an interesting question, “Have our minds been hacked by corporate and governmental interests?” He suggests that they have.

Lustig deals with philosophical, political, economic, and theological elements as he discusses one of the central themes of his book. This is the conflating, or mixing up of the concepts of pleasure and happiness.

In college I was never thrilled when I had to deal with abstract subjects; it just wasn’t my cup of tea. So, here I go; I’m dealing with more abstract topics. I feel like I’m struggling with my college classes all over again.

I’m totally sympathetic with those of you who aren’t too thrilled about having to deal with abstract topics and concepts. With that in mind, I promise that I will do my best to explain Lustig’s concepts in a simple and understandable way.

Lustig uses an English word that was new to me, and that is conflate or conflating. Merriam-Webster defines “conflate” as to bring together, fuse. A second definition is to confuse. Google defines conflate as follows: combine (two or more texts, ideas, etc.) into one. Specifically, Lustig demonstrates how corporations have conflated the concepts of pleasure and happiness for their profitable gain.

If you would like to delve into more detail than I can realistically present in these reviews and digests, I encourage you to acquire your own copy of The Hacking of the American Mind: The Science Behind the Corporate Takeover of Our Bodies and Brains.


Lustig’s Introduction

Lustig begins by explaining that childhood is a time when the balloon of happiness soars high above the mundane. He says that he became a pediatrician in part, to relive and help channel the wonder and delight involved in growth.

He sadly explains that four decades later something has happened as he now sees children taking adult prescriptions such as metformin for type 2 diabetes and benazepril for hypertension. Lustig says that the balloon of happiness has been deflated and now children have the pleasures of Capri Sun, Netflix, and Snapchat.

Lustig poses these questions: What if those pleasures, ostensibly developed and marketed in the name of increasing your happiness, actually did the opposite? What if they actually made you unhappy? What if they changed your brain so that happiness was sapped from you? What if today’s kids are actually canaries in the coal mine?

He spends some time discussing the ancient philosophical differences between pleasure and happiness. As Lustig reflects back over a four-decade time span, he makes this telling comment:

These past forty years have witnessed the twin epidemic of the negative extremes of both of these emotions: addiction (from too much pleasure) and depression (from not enough happiness).

He asks more rhetorical questions:

Did this uptick in addiction and depression occur naturally? Separately? In a vacuum? Or under what form of outside pressure? What if all of Western society has been hacked, to profit a few at the expense of the many? And what if you didn’t even know you’d been hacked?

Lustig then proceeds to define what he means by “hack.” Initially “hack” meant a prank. Then Silicon Valley types stole the word to denote clever solutions to difficult problems. That was “white hat” hacking. “Black hat” hacking is breaking into computers and infecting them with viruses and stealing data.

Lustig emphatically points out that he is not a conspiracy theorist by saying I’m not going to stick my neck so far out as to say that there has been a conspiracy between different industries and the government to purposely inflict malice on the public. However, he states that there has been a plot by some industries to obfuscate the link between their products and disease, and to willfully confuse the concepts of pleasure and happiness with the sole motive being profit.

My comments: All one has to do is to look at the food and beverage industry’s peddling high profit snacks and beverages that promote type 2 diabetes, obesity, and hypertension.

Continuing: Lustig refers to “sugar” as the other white powder [the first being cocaine]. He references his earlier book, Fat Chance where he posed these two rhetorical questions. Why are we all so fat and sick? And in just thirty years? He points out that there is a wealth of information on the role of nutrition on outcomes related to behavioral health. He says that this information is virtually unknown to most doctors and patients. He continues by saying that industries and governments have pushed their reward-generating substances onto their unsuspecting populations which has caused further unhappiness. Lustig concludes this section by stating that some of the basic tenets [beliefs] of modern medicine are rubbish.

Lustig next defines pleasure and happiness and how they are different.

Pleasure: Enjoyment or satisfaction derived from what is to one’s liking; gratification. While pleasure has a multitude of synonyms, it has a specific, well understood “reward pathway” in our brain.

Happiness: The quality of being happy or contentment. I’ll skip over the philosophy of Aristotle that he cites to further explain happiness. Contentment says that I’m satisfied; it’s not necessary to seek more.

My comments: To help myself better understand the difference between the emotions of pleasure and happiness, I have recounted these memories. I knew a young woman who was somewhat overweight. One evening she binged on chocolates and had immense pleasure as she was scarfing them down. The next day she was bummed and depressed about what she had done. What gave her fleeting pleasures devolved into unhappiness and depression. I, too, well understand this as sadly, in my previous life of being a sugar addict, I have experienced the same emotions.

Fast forward to today. When offered addictive sweets and treats, I do everything possible to politely pass on the offerings. I willfully forgo indulging in the goodies as I derive much more happiness that I have mastery over a temporary pleasure. I cannot agree enough with Lustig when he states that too much pleasure leads to addiction, and not enough happiness leads to depression. It’s so true!

Continuing: Lustig states that scientists know that pleasure (reward) is the emotional state where your brain says, this feels good—I want more. Contentment says I’m okay, I don’t need any more.

My Comments: Here is what is swirling in my mind as I sit here and press keys on my keyboard. If I’m contented with my station in life, my house, my car, my clothes, and my wholesome food diet, I don’t feel the need to be out there spending money to buy stuff to make me happy.

Continuing: Lustig uses pages 9-10 to further discuss the connection between reward and pleasure. He points out that pleasure and happiness are not mutually exclusive [meaning they can both exist at the same time]. The example he cites is having dinner at a fine restaurant where it’s a shared experience with family and friends.  You can simultaneously have the pleasure of eating fine food and happiness derived from your social gathering.

He continues with this revealing comment about reward:

Reward when unchecked can lead us into misery, like addiction. Too much substance use (food, drugs, nicotine, alcohol) or compulsive behavior (gambling, shopping, surfing the internet, sex) will overload the reward pathway, and lead not to just depression, destitution and disease, but not uncommonly death as well.

He points out that pleasure is usually driven by taking something such as taking a drug (legal or illegal), taking in sugary foods, and going to casinos to get the thrill of rolling the dice and winning the big one.

Happiness or contentment is derived from giving. This can include spending time with your grandchild or giving to a charity.

Lustig’s final point about reward is this:

Reward is driven by dopamine and contentment by serotonin. Each is a neurotransmitter—a biochemical manufactured in the brain that derives feelings and emotions—but the two couldn’t be more different. Although dopamine and serotonin drive separate brain processes, it is where they overlap and how they influence each other that generates the action in this story.

This concludes his discussion of reward. He continues with a caution saying that the science about dopamine and serotonin is largely based on animal studies. He says that human studies are correlational at best. Correlational means that two things are related, but that doesn’t mean that one thing proves another. He offers more details on page 12 concerning some of the problems with human studies.

Lustig concludes his introduction by briefly outlining what he will cover in each part of his book.

Part 1: He discusses the differences between reward and contentment.

Part 2: He will elaborate on the biology of reward and science of dopamine.

Part 3: He discusses the biology of contentment and the science of serotonin. Anyone taking an anti-depressant may find this chapter to be very informative.

Part 4: Lustig will show how the perpetration of this “plot” [the conflating of pleasure and happiness for profit] has brought us to this place from a personal, cultural, and economic standpoint. He makes this sobering statement:

In the last half century, America and most of the Western world have become more and more unhappy, sicker, and broke as well.

Part 5: He will offer solutions as to how you can defend yourself against the “peddlers of pleasure.”

To be Continued

Gary Taubes ‘The Case Against Sugar’, a YouTube video Part 3

transcribed by Liz Reedy

To view Gary Taubes’ 1 hour and 22-minute YouTube video, please click here.

Please click here for our Part 1 transcription.

Please click here for our Part 2 transcription.

Part 3 continues beginning at 28:03

Think about it this way. If I was giving a talk on wealth, I might get a pretty good audience. And afterward in the Q&A, someone would ask me, “Why are Bill Gates and Jeff Bezos so rich?” And I would say, “Because they make more money than they spend.” You guys would leave, right?

If I was giving a talk on climate change, that would probably get a pretty full house. And at the end somebody would ask, “Well Gary, why is the atmosphere heating up?” And I would reply, “Because it’s taking in more energy than it expends.” And if I looked at you like it was a serious answer you would think I was joking.

But in obesity research, if somebody asks why some people get fat and others don’t, the answer is that they take in more calories than they expend. And it’s almost incomprehensively naïve. It has become conventional wisdom. You show me a paper on obesity, and I’ll show you where that belief system is interwoven into that research or that paper.

My geneticist friend at Cambridge University, the BBC host, is not studying the genetics of why people get fat; he’s studying the genetics of why he thinks people eat too much or exercise too little. Part of this goal is to get people to get rid of that energy/balance idea. And the stakes are enormous. I am trying to do a fundamental thing with this book.

Claude Benard, the great French physiologist, said in 1865, “Science is about explaining what we observe.” Fundamentally that’s what you’re always doing in science, whether what you observe is a supernova or a gamma ray burst or something else in the night sky. It could be how a frog behaves or how swallows mate or anything you can name.

Why we get heart disease, why we have obesity, it’s about explaining what we observe. The observation today that is so frightening is these obesity and diabetic epidemics are worldwide. It happens in every population in the world in which they transition to a Western diet from whatever they were eating baseline.

It doesn’t matter if they were Inuits living on caribou and seal meat, or Maasain Africans living on the meat and milk and urine from the cattle they herd, or the agrarian population in the Himalayas, or Native Americans or any population that started eating western diets. They experience these tremendous increases in obesity and diabetes.

In October, the director general of the World Health Organization, Margaret Chan, gave a key note address to the annual meeting of the National Academy of Sciences. She said that these epidemics of obesity and diabetes represent a slow-motion disaster world-wide.

They are overwhelming health-care systems. The estimated cost of obesity and diabetes in direct health-care costs in the U.S. is a billion dollars a day. If you look at indirect societal costs and you believe these estimates, it’s a trillion dollars a year.

Margaret Chan said the chances of the public health organizations like the W.H.O. to reign in these epidemics in order to prevent a “bad situation” from getting much worse is effectively zero. Think about that. The director general of the World Health Organization is talking about these slow-motion disaster epidemics, and not only acknowledging that organizations like hers have completely failed to curb them, but predicting complete failure in the future.

One of the things I would do if I were a journalist or in newspapers, I would imagine if this was HIV. In 1985 we understood that the HIV virus causes AIDS. But imagine after coming to that conclusion, thirty years later, AIDS prevalence and AIDS incidents had continued to go up and mortality from this disease had continued to go up.

We would have a task force, committees, think tanks and a team of researchers. We would be spending billions, if not trillions of dollars, trying to understand what we don’t understand about this disease. But in obesity and diabetes we’ve had this same phenomenon.

In the 1890s, on the Eastern coast the estimate was that one out of every three thousand patients in the hospital suffered from diabetes. Today, if you go to a VA hospital, one out of four patients suffers from diabetes. One out of every eleven Americans in or out of hospitals has diabetes today. There’s been this tremendous explosion, and we have to understand what’s causing it.

You cannot stop an epidemic unless you understand the cause. You have to know what to remove, what to get out of the population, whether it’s the HIV virus, or you recommend safe sex and contraceptives and you design drugs that go after the virus. If it’s a lung cancer epidemic you have to know that smoking is causing it, right? So you can tell people to stop smoking.

In this country with obesity and diabetes we have the director general of the W.H.O basically shrugging her shoulders and saying, “Yes, we’ve seen 900% increases of diabetes in the United States in 50 years. And it’s going to go up. But we don’t know what to do about it.” Well, how about you examine your assumptions.

What I’m trying to do in this book is ask the question, “Are we wrong about what the cause is?” If this was a legal case and we have a similar crime being committed in a very similar way in every country in the world, who is the prime suspect? Who should we be targeting? Why should we be targeting? And the answer is sugar.

So, with that long introduction I’m going to do a little bit of reading, and I’m going to hope for the best. I have to borrow a book. The first chapter of this book discusses obesity and diabetes epidemics and why I’m focusing on sugar and why I think it’s the prime suspect. As I say in this book, if this were a legal case this book would be the prosecution’s strategy.

I had trouble writing it. I don’t like writing. One of the reasons I’m such a good reporter, if I am a good reporter, is because reporting is a way to procrastinate on writing. As long as you keep doing the research you don’t have to write…until you run out of money as I said earlier, and then you have to write.

I finally wrote the first chapter, and then I wrote the second chapter, Drug or Food, which I’m going to read from. And I finally had the sense of profound relief that this is a good chapter, that I’m on my way, that I’m going to be able to get this book done. So, I have four thousand words written discussing whether sugar is a drug or a food, and is it addictive?

Then I read a book called 1493, [1493: Uncovering the New World Columbus Created] written by a friend of mine, Charles Mann. It’s about the history of what’s called the Columbus exchange, which is about the spread of foods and plants around the world after Columbus discovered America. Charles (Cam) is such a beautiful writer that I can’t even read his writing, as it depresses me so much.

But I realized he had a chapter on the history of sugar and knew I should read it. He’s a great reporter and a great writer. I read it and in this chapter, he has a single line made up of seventeen words. He says, “Scientists today debate amongst themselves whether sugar is an addictive substance, and people just act like it is.”

And I think, “Great. I’ve just written four thousand words about this, and here Cam wrapped it up in seventeen.” I could throw away my first chapter and then I’m back to the state of frozen writer’s block that I was in, or I could keep the first chapter and quote Cam, which is what I decided to do. So, you can find Cam’s quote in here.

It begins with two other quotes, two epigraphs. The first is from Roald Dahl, from his memoir, Boy: Tales of Childhood, which was written in 1984. Dahl said, “The sweet shop in Llandaff [UK] from 1923 was the very center of our lives. Thus, it was what a bar is to a drunk or a church is to a bishop. Without it, there would have been little to live for. Sweets were our life-blood.”

The second quote is from Michael Pollan’s, Botany of Desire in 2001, one of the great books Michael wrote before Omnivore Dilemma. He said, “Imagine a moment when the sensation of honey or sugar on the tongue was an astonishment, a kind of intoxication. The closest I’ve ever come to recovering such a sense of sweetness was secondhand, though it left a powerful impression on me even so. I’m thinking of my son’s first experience of sugar, the icing on the cake at his first birthday.”

“I have only the testimony of Isaac’s face to go by, that and his fierceness to repeat the experience. It was plain that his first encounter with sugar had intoxicated him. It was, in fact, an ecstasy in the literal sense of that word. That is, he was beside himself with the pleasure of it. No longer here with me in space and time in quite the same way he had been just a moment before. Between bites, Isaac gazed up at me in amazement (he was on my lap as I delivered the ambrosial forkfuls to his gaping mouth), as if to exclaim ‘Your world contains this? From this day forward, I shall dedicate my life to it.’”

By the way, you should argue the wisdom of starting a book with quotes from two authors who can write better than you can. Your readers are likely to put your book down and say, “I’m going to go get Botany of Desire.”

What if Roald Dahl and Michael Pollan are right that the taste of sugar on the tongue can be a kind of intoxication? Doesn’t it suggest that the possibility that sugar itself is an intoxicant, a drug? Imagine a drug that can do this to us, that can infuse us with energy and can do so when taken by mouth. It doesn’t have to be injected, smoked or snorted for us to experience its sublime and soothing effect.  END at 39:08

Medicare Updates and News

by Ron Iverson, President of the National Association of Medicare Supplement and Medicare Advantage Producers. Inc. and Lance D. Reedy

New Medicare Numbers

Background from Lance: I’m sure that everyone is aware that the Social Security Administration (SSA) has used your Social Security numbers for your Medicare numbers [Health Insurance Claim Number or HICN] since the beginning of Medicare. For most people that have worked at least ten years and paid into the SS system, their Medicare number is their SS# followed by the letter “A”.

In some cases, for those that have not paid into the SS system for ten years, their Medicare number is typically their husband’s SS# following by the letter “B”. The letter “T” has been used for those on Medicare but not yet drawing SS. There are various “D” codes for typically a widow who is drawing off her deceased husband’s SS. The Railroad Retirement Board uses letter(s) in front of one’s SS#.

The problem, of course, is that we are sadly in the age of identity and medical theft. If your wallet or pocketbook containing your Medicare card is lost or stolen, now your or your spouse’s SS# is floating around ready to be co-opted by an identity thief.

People have griped at the SSA for years about this problem, but the wheels of government bureaucracies turn slowly. Finally, Congress passed the “Doc Fix” legislation in 2015. One of its amendments was to direct the SSA to begin issuing new, non-Social Security, Medicare numbers beginning in 2018.

From Ron Iverson: CMS [Centers for Medicare and Medicaid Services] recently released a bulletin answering questions about the rollout of the new non-Social Security Medicare numbers. The first wave [of new Medicare numbers] from April to June will be sent to Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia.

I have provided the following links to CMS’ website to answer questions you may have about this new rollout.

Number 1: Medicare Card Messaging Guidelines

This link answers general questions and provides instructions about the new Medicare card that you will be receiving in the coming year.

Number 2: New Medicare Cards and Why They are Important

This link provides more details about the new Medicare Beneficiary Identifier (MBI). Yes, you have a new acronym to keep straight. The new MBI replaces the SS# based Health Insurance Claim Number (HICN) that is on your existing Medicare cards.

Number 3: New Medicare Card Mailing Strategy

Oregon will be in Wave #2. Idaho, Montana, Wyoming, and Washington will be in Wave #6


Speech, Physical, and Occupational Therapy Limits

from Ron Iverson

One of our members, Paula Smith, sent me an article from AARP dated January 24th, which indicates some rather unsettling news regarding the Part B benefit of speech, physical, and occupational therapies. We all have been aware that there are limitations on those benefits, but you may not have known that, according to the article, “Congress has previously passed an automatic exception that allows Medicare to pay for care beyond the caps when the treatments are deemed medically necessary.”

Paula was rightfully concerned because her accountant had forwarded the article to her, and she contacted her Congressman who knew nothing about it.  She also was told that people should be contacting their legislators to keep this benefit going.  So, what is the change in the benefit?

Well, the change is pretty serious, because the automatic exception expired December 31st. According to the article, “which then means that the caps of $2,010 for physical and speech language therapy and the $2,010 cap for occupational therapy are being enforced.  When the exceptions were in place, Medicare beneficiaries paid only the 20 percent coinsurance* that Part B requires.”  (The $2,010 figures are for 2018.)  *Some or all of this amount would be picked up by your Medicare supplement plan.

“Without the exceptions, Medicare beneficiaries must pay the entire therapy bill once they exceed the threshold.“ According to AARP, some beneficiaries with high-cost conditions could reach the annual cap in the coming weeks.  According to a recent analysis commissioned by the American Occupational Therapy Association, nearly 6 million Medicare beneficiaries accessed outpatient therapy services in 2015.  Of those, nearly 1 million cases required care that exceeded the combined cap on physical and speech therapy, while nearly 250,000 surpassed the occupational therapy threshold.”

Comments from Ron Iverson:  This is a serious matter, and one which very few Medicare Part B enrollees would know about until they go to their therapist and get the bad news.  I know of people who suffer a stroke, and the $2,010 limit does not begin to cover what can become a six-month, or longer, need for speech rehab, let alone physical therapy.  This situation is going to impact the providers, who now cannot use the exceptions, and risk placing themselves in a bad standing with CMS.  Good ol’ RACs [Recovery Audit Contractors] come into play here.  We, and Congress, have known for years that something must be done in relation to these limits on therapy.

Since Paula’s Congressman didn’t know about this problem, it’s likely that there are many others in the same situation. It’s time for CMS to take action and forward solutions to Congress for some type of revival of the “automatic exception” rule. I understand the fact that CMS is trying to save money and lower costs to the program, but this is not a way to do it.

Comments from Lance: For an even better understanding of this situation, please read this article on the American Physical Therapies Association’s website. Here is a key paragraph.

Wasn’t Congress ready to permanently end the hard cap? What happened?

It’s true: over the fall, a bipartisan, bicameral deal was reached that would have permanently eliminated the hard cap on therapy services. That deal was part of a larger piece of legislation that included other changes to Medicare, such as payments for ground ambulances and reauthorization of special needs plans. This package of so-called “Medicare extenders” was supposed to be adopted in early December. Unfortunately, the debate over the tax reform legislation dominated Congress in the final weeks of session, pushing nearly all other issues to 2018.

Let’s hope the Congress can fix this problem sooner than later.  End

Always Call Your Agent First

By Lance D. Reedy

For several years I have pounded the table with this central message: If you have any questions, thoughts, ideas, or concerns about anything connected with your Medicare plans, please call your agent first. Doing so can save you much grief and acid indigestion.

Before I get into the details about this topic, I want to describe an incident that happened with one of my daughters. For this discussion, I’ll give her the fictitious name of Susan. In March of 2016 Sue was hit as a pedestrian in a crosswalk while walking to class at the University of Idaho in Moscow. She ended up with a cracked vertebra and a broken scapula. She was initially transported by ambulance to Gritman Medical Center in Moscow and then to St. Joseph Regional Medical Center in Lewiston.

Fortunately, the woman driving the Ram pickup that hit Sue had liability insurance in force. I told my wife and daughter that it was imperative that we quickly secure the services of a top-notch personal injury (PI) attorney. Through a referral, we met with Ted Harris (also fictitious), Attorney at Law in Moscow.

I might add here, that if you ever need the services of a PI attorney, make sure that he is a TRIAL lawyer. Insurance companies know that they can’t play foolery games with an experienced trial attorney. I’ll also comment that even though our PI attorney charged the typical 33 1/3% of the settlement, he was worth every penny!

All the phone calls, hassling with the insurance company, and dealing with bill collectors was lifted from us.  Not only was Mr. Harris worth his fees, he was able to put in a claim for under-insured motorists with our own insurance company as the offending party was under-insured. Sue ended up with a better settlement than she could possibly have imagined if we had done this on our own.

Additionally, Mr. Harris negotiated with the hospitals to re-price some of the billings. We were being billed the full-blown rate, and he used his influence to have those bills repriced to what the providers would have billed a health insurance company. That left a larger nest egg for Sue’s future physical therapy costs and who knows what else that might happen as a result of her accident.

About a year and nine months after the accident, attorney Harris had everything wrapped up and finalized, or so we thought. In December 2017 Sue received a letter from a local collection agency demanding payment of $850 for some past due medical bills. Her attorney said everything was wrapped up and finalized, and all bills had been paid out of the settlement. What happened?

I told my daughter that we’re not going to lose one second of sleep about this newest problem. I emailed Mr. Harris and attached a scanned copy of the collection letter. The $850 was for $675 of past due hospital bills and $175 in interest. I made NO phone calls to the hospital or collection agency. I just dropped the matter in Harris’ lap and said, “Please fix it.”

A week later he emailed me back that we could disregard the collection letter. When the hospital submitted their final bill to our attorney, they were legally, in fact, saying “Case closed, we have been paid in full.” Evidently, they had missed some bills for the final tally, or so they claimed, and since the bills were more than a year out, they turned it over to a local collection agency.

I will interject here that during my 18 years of being in the Medicare business, I have dealt with several billing mistakes. When there is some sort of a billing or claims issue, the chances are 90% or better that the billing office has made a mistake.

In Sue’s case, the hospital declared to our attorney that all bills were settled. It was legal finality; they agreed that that was it. Whether or not the billing office overlooked some charges is a moot point. They made a mistake by trying to charge Sue more after they had agreed that all charges had been settled.

In the end they agreed to “write off” the $650 and instructed the collection agency to drop that demand. Mr. Harris asked us if this was agreeable to us. “YES, of course!” I emailed back to him.

We called our attorney

We hired a pro attorney, and by doing so, that lifted the legal burden from us. After all, my wife was almost full-time for four weeks caring for our daughter. We turned it all over to attorney Ted, and he guided us through the entire process. The last thing we wanted to do was to hassle with an insurance company, and we didn’t! Oh yes, there were email consultations during the process, but we were relieved from the legal hassles. The entire saga went remarkably well.

Joe Called His Agent First

To protect the individuals’ privacy in the following events, I have changed their names and city of residence. Those are fictitious, but the events are real. Joe Jensen lives in Pinetree, Montana. In the summer of 2014 he was in a serious auto accident, and very well could have died from his perilous injuries. But in his 80s, Joe is one tough ol’ dude. He is like The Cat Came Back, he Just Wouldn’t Go Away. Remember the old camp song?

Joe was on a Medicare advantage (MA) plan when this near fatal accident happened, and he stayed on Medicare advantage through the end of 2017. When his plan provider terminated his plan effective December 31, 2017, Joe elected to return to original Medicare and go with a Medicare supplement plan instead of signing up for another MA plan.

Please keep in mind that during Joe’s recovery, Medicare was never billed as he was on a Medicare advantage plan. In mid-January 2018 Joe went to his medical supply store in Pinetree to pick up some home-health medical supplies. When Joe presented his Medicare card and Medicare supplement card, he received some unsettling news.

The proprietor told Joe that Always Safe (fictitious) was his primary insurer and that Medicare was his secondary insurer. Highly puzzled, Joe called me FIRST.

Here’s what happened. Joe’s auto-insurance company, Always Safe, became the primary insurer for some of Joe’s accident claims. Joe’s MA plan was the secondary in some cases. MEDICARE WAS NEVER BILLED because he was on an MA plan. For the remainder of 2014 all the way to the end of 2017, Joe was on Medicare advantage. After his recovery from his injuries, his Medicare advantage plan was his PRIMARY insurer, and the thing with Always Safe was in the past and long forgotten.

Even though there was a lingering old record of Always Safe paying some bills from Joe’s accident, it was a non-issue. It never came up. However, starting January 1, 2018, Joe was now on original Medicare, and his Part B providers would now be billing original Medicare and his Medicare supplement plan as his secondary.

Once the proprietor at Pinetree (Mac) checked his Medicare data base on his computer to verify Joe’s Medicare status, this thing with Always Safe popped up now that Joe was on original Medicare for the first time in four years. Also, Mac likely misinterpreted what he was reading on his screen, which added more confusion to the issue. He said to Joe, “Always Safe is your primary and Medicare is your secondary insurer.”

In a state of bewilderment, Joe did the right thing and called me. I told him that we needed to initiate a three-way phone conversation with Medicare. With the privacy rules and regulations, I cannot take care of this on my own. Joe must be on the phone to give his permission to the Medicare representative for me to speak on his behalf.

The Medicare rep, Chris, after hearing the story, directed us to contact the Benefits Coordination Recovery Center (BCRC) at 855-798-2627. We thanked Chris, called BCRC the next day, and quickly and successfully resolved the problem.

If Joe had been on his own, he likely would have started making phone calls with his Medicare supplement plan. That would have been useless. In this case, since he contacted me first, I was able to work with him on a step by step process to correct the problem.

She Called Me Last

I have run into similar situations where people have spent stress-filled hours on the phone trying to resolve a similar situation. In one case, Joan went to her pharmacist for a recommendation for a Part D prescription plan (PDP) for her husband, Scott.

In January 2018 Scott went to his pharmacist to fill his prescriptions, but the pharmacist told him that the charge to his PDP provider wasn’t going through. The result was that Scott had to pay full price. Joan went to work on behalf of her husband in an attempt to resolve the problem. She spent hours on the phone with both Scott’s pharmacist and his PDP plan provider in an attempt to fix the problem. Getting nowhere, she called me.

I explained to her that this was a Medicare issue and that sometime in the past Scott must have had prescription coverage through a former employer. I explained to her that she needed to call Medicare to fix this problem. Joan called me back a day later to explain that she was successful. Unfortunately, before calling me, she spent many frustrating hours on the phone getting nowhere.


Some people have voiced to me that they didn’t want to “bother” us with what seemed to be a trivial issue. The insurance companies compensate us agents for your business. As part of that picture, you are entitled to customer service from your agent.

Our daughter Sue needed help after she was hit by a truck. Sue hired a professional attorney to handle her legal needs and to reach a fair settlement. She didn’t have to deal with legal complexities or hassling with an insurance company!

Joe called me first when he ran into a problem, and as a result, he didn’t have to stumble around trying to fix it on his own. The burden was lifted from him.

Once Joan finally called us, we were able to quickly direct her to the solution for her husband’s problem. End

The Closing of the Coverage Gap

Note: This is a reprint of an article we originally published in October 2015.

One of the provisions of the 2010 Affordable Care Act (ACA) is to close the coverage gap in Part D Prescription Plans (PDPs). By 2020, PDP members (that’s you) will only pay 25% of the cost of both generics and name brand drugs while in the coverage gap.  The key questions are what is the schedule for this reduction and how will that affect the premiums for the PDPs?

Name Brand Drugs

Starting in 2011, pharmaceutical companies were required to give members a 50% discount off the retail cost of brand name drugs when the member entered the coverage gap.  The member paid the other 50%. In 2013 and 2014 the PDP paid 2.5% of the cost of brand name drugs reducing the members’ share to 47.5%.  The manufacturers still contribute with their 50% discount.  In 2015 and 2016 the PDP now pays 5% of the cost of brands while the member is in the coverage gap.  The member’s share is reduced to 45%. (See chart #1 below)

The manufacturers’ discount remains at 50% as represented by the light blue.  The dark blue represents the declining amount that the member pays.  The medium blue represents the increasing share that the PDP pays.  Thus, from 2017 to 2020 the PDP pays 5% more every year. Unless the plan receives an increased subsidy from Medicare, it has no other alternative then to raise the premium for the plan in order to raise more revenue to pay for their increasing share of the costs while a member is in the coverage gap.


As far as the PDP having to pay more for generics, the situation is very similar to what they will be required to do while their members are in the coverage gap.  The only difference is that there is no manufacturers’ discount. We can assume that the margins for generics are much thinner, so there is little or no room for discounts.

Starting in 2011, the plan paid 7% of the costs of generics when the member entered the gap.  The member’s cost was reduced from 100% in 2011 to 93% in 2012.  Every year until 2019 the PDP will pay an additional 7% and the member pays 7% less.  In 2020 the member receives another 12% discount, reducing his/her share to just 25% of the cost of the generic drug.  (See chart #2 below.)

The member’s share is represented by the dark blue, and the PDPs’ increasing share is represented by the medium blue.  The declining share of the costs for the member certainly is advantageous for him/her, however, the PDP is being required to shoulder more of the costs.

Similar to paying more for brand name drugs, the increasing percent of the coverage for generics for the PDPs will add to their costs.  This all puts pressure on premiums, pressure that pushes them higher.

Another factor that adds to premium increases is the increased costs for drugs. The PDP passes this cost along in higher copays or moving a drug from a “preferred” brand to a “non-preferred” brand.  This change approximately doubles the copay for the member.

There is another strategy that the PDP uses to mitigate its increased costs. The PDP can drop a more expensive brand, or generic, as long as it has two drugs covering each therapeutic category. For example, most of the cholesterol drugs have gone generic.  Many plans no longer cover Crestor, the only remaining name-brand statin drug, in their formulary.  Since they cover lovastatin, pravastatin, simvastatin, and atorvastatin (Lipitor), they have the therapeutic category of cholesterol drugs covered.  They do not have to cover the expensive brand, Crestor.  Editor’s Note: This article was originally published in October of 2015.  Since then, Crestor (Rosuvastatin) has gone generic.

In regards to premium increases, there is some good news. There is competition among the various insurance companies’ PDPs. We can assume that most of them would like to gain more market share.  The competition has caused the copays for many inexpensive generics to go down.  A couple of companies’ plans have either no copays or very small copays when the member orders his/her prescriptions through the companies’ mail order pharmacy.

Understanding the Estimated Annual Spend for PDPs

What is meant by the annual cost, annual spend, or estimated annual cost when we do a prescription drug plan (PDP) search on your behalf on

Put simply, the estimated annual spend is how much will you spend for your entire prescription drug plan package for the entire year (or remainder of the current year). This number includes the PDP plan premium, your copays and, if applicable, the deductible.

Example: After doing a search on, the plan that shows up as the best buy for Sam Fuller (fictitious), using his preferred pharmacy has an annual cost of $444. The name of the plan is Good Health Rx (fictitious), and Sam’s annual spend will be $444.

The plan premium is $25 per month. $25 per month x 12 months = $300 for the year.

Let’s say Sam has all tier 1 and 2 generics with low copays. Good Health Rx also has no deductible for tier 1 and 2 generics.

Here’s the list of his prescriptions.

Name of Drug Dose Frequency Tier Copay
Atorvastatin 40 mg 30/month Tier 2 $4
Metformin 500mg 60/month Tier 1 $1
Lisinopril 20 mg 30/month Tier 1 $1
Amlodipine 5 mg 30/month Tier 2 $4
Citalopram 10mg 30/month Tier 1 $1
Meloxicam 15mg 30/month Tier 1 $1
Total monthly copays $12


Sam’s prescription copays are $12 per month. $12/month x 12 months = $144.

Plan premium = $300 for the year.

Drug copays = $144 for the year.

Sam’s annual cost = $444    ($300 + $144 = $444)

Note: If your plan effective date is mid-year, the annual spend refers to your estimated cost for the remaining portion of the year. Let’s say your Medicare A and B are effective July 1, 2018. You sign up for a PDP in May with a July 1 effective date. Using the above example, your annual cost will be half of the $444 annual or just $222. End

Important Notes for December 2017

Annual Election Period (AEP)

The AEP, also known as Medicare open enrollment, ends December 7th. This is the deadline for changing your Part D Prescription plan (PDP) or changing or adding a Medicare advantage with prescription drugs (MA-PD) plan.

We have republished some excerpts from a previous article detailing the kinds of changes you can make during the AEP.

  1. Change from one PDP to another PDP.
  2. Adding a new PDP. Please keep in mind that you may be subject to a late enrollment penalty (LEP) if you never have had a PDP.
  3. Change from one MA-PD to another MA-PD.
  4. Disenroll from your MA-PD and switch to original Medicare (OM) only.
  5. You want to switch from a Medicare supplement plan to an MA-PD. Be sure to cancel your Medsupp plan the end of December.
  6. You currently have an MA-PD and want to go to a Medicare supplement.
    1. This one is a little tricky. If you are voluntarily leaving your MA or MA-PD plan, you have to apply and medically qualify for a Medicare supplement. This is NOT a guarantee issue! Then, if you do qualify, you will need to notify your MA or MA-PD plan that you want to disenroll and return to original Medicare effective Jan. 1, 2018.
    2. If you received a disenrollment letter from your MA-PD plan, you do NOT need to notify your MA-PD provider.

For a smooth transition, be sure to work with us on this one.

The Special Enrollment Period (SEP) begins December 8th

The those who have received a disenrollment notice from your Medicare advantage plan provider, you have a Special Enrollment Period that runs from December 8 through the end of February 2018.

Some people have frantically contacted us thinking that they have a December 7 deadline. While that is true for people switching plans, it is NOT the case for those that have received a disenrollment notice from their Medicare advantage company. Medicare wants you to have plenty of time to choose a new plan! Please contact us if you have yet to decide which way you want to go.


Changing a Medicare Supplement (Medsupp) plan

A question that comes up every year is when can I change my Medsupp plan. The answer is that you can change your Medsupp plan any month of the year subject to medical qualification. Please refer to the more detailed article in our September issue of Northwest Senior News.

A common misunderstanding among some people is thinking that the AEP is open enrollment for a Medsupp plan. Yes, it can be confusing. Remember, for most people, once you are past 65 ½, you can change your Medsupp plan any month of the year, again, subject to medical qualification.


Prescription Drug Plans

After running hundreds of people’s combinations of prescriptions on’s website, we have noticed another interesting trend. Four or five years ago we signed up people for two low cost PDPs that offered the lowest estimated annual cost for many people. (Please refer to our companion article in this issue discussing what is meant by the annual cost.)

Times have changed. For the most part, these plans have become also-rans. In many cases they are substantially more expensive compared to newer designed plans. This is why we pound the table with a strong recommendation that you have us shop your PDP every year.

In many cases, your current PDP may still be the most competitive one for 2018. If that is the case, we will notify you to stay the course.

However, in one case here is what we discovered. Alice Rankton (fictitious) signed up for the Super Health Medicare Saver PDP plan (a real example with a fictitious name) a few years ago. We re-ran her meds on Using her preferred pharmacy of Shopko her annual spend for Super Health would have been $1,369. This plan wasn’t even close to being her best buy.

Again, using Shopko the Bargain Scripts Value Plus (another fictitious name) came in with an annual spend of $709. Wow, her also-ran Super Health would have cost her almost double compared to the Bargain Value plan.

We might add that in this case Bargain Value does not work with agents, so we gave Alice their phone number to sign herself up for this new plan. We are not compensated when we do this.


The Key Takeaway

Understandably, we don’t like change. Personally, I (Lance) am annoyed when a website revamps their format forcing me to learn it all over again. Fortunately, Isaac comes to my rescue.

Regarding PDP’s, I’ve heard too many people say: I don’t want to change!

I well understand how those people feel. However, the plans are changing on you, and if you don’t stay current with the most competitive plans, it can financially cost you dearly. End

Agent Violations and Unethical Behavior

Just yesterday (as I write) I returned a call to one of my Blue Cross Blue Shield (BCBS) of Montana clients in Kalispell. I’ll assign him a fictitious name of Roger Jones. He told me that another agent from Acme Health Insurance called him to interest him in a Medicare advantage plan sponsored by Acme Health & Life. Acme is a large national insurance company that is spending a fortune in TV and direct mail advertising.

Roger continued by explaining that this agent called him multiple times. I asked Roger if he had called Acme or responded to any of their mailings. His response was negative. I queried Roger as to how this agent knew that he was one of the people receiving a non-renewal letter from BCBS. He had no idea.

At this point I explained to Roger some of the marketing rules that are explicitly covered in our annual agent recertification. Regarding marketing practices, The Center for Medicare and Medicaid Services (CMS) has made it abundantly clear that agents are prohibited from doing the following marketing practices for Medicare advantage (MA) plans and Part D prescription (PDP) plans:

  • Cold calling on the phone
  • Door to door canvasing
  • Sending communications via blind email lists
  • Approaching strangers in a health care setting such as a hospital cafeteria or at a pharmacy

During the conversation Roger also explained to me that a second agent had also called and said that he represented BCBS of Oklahoma and could put Roger in one of their Medicare Advantage plans. I explained to Roger that the only Medicare advantage plans he can sign up for are ones that are offered in Flathead county, period. An Oklahoma plan is out of the picture.

The parent company of BCBS of Montana is Health Care Service Corporation (HCSC) which is headquartered in Chicago. HCSC owns Blues in Illinois, Texas, New Mexico, Oklahoma, and Montana. This second agent could have purloined a list of Montana Medicare advantage members, maybe. Another possibility is that this whole Oklahoma thing was a ruse. It’s hard to say.

The Acme agent may have been fishing (cold calling) knowing that sooner or later he would reach someone with a non-renewed BCBS Medicare advantage plan. It’s possible that he somehow acquired an illegal list. We don’t know for sure.

These miscreant agents are like poachers. The poachers know the fish and game rules, but they ignore them and do illegal harvesting anyway for their own personal gain. These scumbag agents know the rules, but they flagrantly violate them in attempt to chase more commissions. Yes, they are commission chasers.

Just as state fish and game departments have established rules for orderly hunting and fishing, CMS has established rules for orderly marketing practices for MA and PDP plans. If you see someone suspected of poaching, the way to stop it is to capture a license plate number and a vehicle description and report it to the local authorities.

Here’s how you can put the brakes on these rule-violating agents. Ask for their name, phone number, and name of their agency. Then report it to the consumer affairs division of your state department of insurance.

Situation #2

I recently met with two related couples in Sanders County, Montana. I’ll call them the Smith’s and the Jones’. One spouse of each of the two couples has a non-renewed BCBS Medicare advantage plan. BCBS has exited many rural counties in Montana including Sanders. For those unfamiliar with Montana geography, Sanders County borders Bonner County (think Sandpoint) in northern Idaho.

The people initially reported to me when we set up the meeting in their home, that they had invited a third couple, their friends, John and Jane, to join us. John also has a non-renewed BCBS Medicare advantage plan.

Upon my arrival to the Smith’s residence, the Smith’s reported to me that John and Jane would not be coming. Here is what the Smith’s said.

John and Jane went to a seminar in Thompson Falls (put on by an Acme agent). John wanted to “get it over with”, so he signed up for an Acme Medicare advantage plan. They told us that the agent was giving away $25 Walmart gift cards.

I queried back, “You’re kidding!”

That’s what they said,” the Smith’s said.

I asked, “Was the agent giving the $25 gift cards out to everyone or only to those who signed up for Acme’s Medicare advantage plan?” The Smith’s answered back, “We’re not sure.”

Explanation and a huge violation

It doesn’t make any difference if the gift cards were given to all attendees or just those that signed on the dotted line. The entire episode is another poaching violation.  CMS has established explicit rules regarding gifts offered in a public seminar or meeting. Again, these rules are hammered into agents in our annual recertification.

  1. The gifts can have a nominal retail value of no more than $15.
  2. If multiple gifts are given, they can have a combined retail value of no more than $15.
  3. Cash or cash equivalents (gift cards) are strictly prohibited.
  4. The gifts are to be offered to all attendees, not just those that sign up for a Medicare advantage plan.
  5. Meals are prohibited, but light snacks are permissible.

The reason for CMS’ rules are quite obvious. They want to prevent gift-giving to be used as an inducement to get people to sign up for the agent’s Medicare advantage plan. Just like poachers, there are agents that choose to ignore the rules.

What to do about it? Just as in the first situation, these agents should be reported to the Consumer Affairs division of your state insurance department. In Montana, their phone number is (406) 444-2040.

It’s best to avoid these agents as they clearly demonstrate that the rules don’t apply to them. The real tragedy of the situation is that these miscreant agents are taking advantage of many vulnerable seniors who are confused by the entire Medicare maze.

More Agent Malpractice

Can you imagine going to a doctor, and without doing any examination, he/she writes you a prescription, charges you $225 and sends you on your way? I have now run across several situations where the plans being offered by these Acme agents would cost you hundreds of dollars more per year in drug copays compared to other more cost-effective options.

As just one example, a client of mine, Bonnie (fictitious), got conned into signing up for an Acme Medicare advantage plan sold by another agent. Bonnie has been with me for several years, and I knew that she takes several prescriptions. I asked her if the Acme agent ran her meds on She said no.

After checking on, I found the dismaying results. The Acme plan will cost Bonnie around $500 to $550 more per year in prescription copays compared to two other alternatives. $500 per year is around $42 per month. This is the last thing Bonnie needs for her already tight fixed-income budget.

Sticking Bonnie with an extra $500 in bills for the sake of a $225 commission is an all too common example of agent malpractice. As mentioned above, these types of agents are nothing more than commission chasers.

Every profession has its bad apples, Unfortunately, the three situations I described above are examples of our bad apples. One of the easiest ways to determine if said agent is a bad actor is to ask the following question: What companies do you represent? If that agent says only Acme Health, or only Best Buy Health, or only XYZ Health & Life, it’s time to move on.

Representing only one company doesn’t mean that all such agents are bad actors, but it’s a warning sign. This is where they tend to reside. Find an agent that represents multiple companies. End

Misleading and Deceptive Advertising

TV advertising

Every year goes by and I receive phone calls from clients that ask about an ad they saw on TV. Here are some examples.

#1 Brenda from Moscow Idaho: “I saw on tv where you could get this $24 a month plan.”

Explanation: The ad is for an HMO Medicare advantage plan offered by Purple Cross (fictitious) of Washington that is available in Spokane County. It’s not available for Idaho residents or in surrounding rural Washington counties. The ad does not make that clear.

#2 John from Eureka, Montana: “What about this plan where you don’t pay anything and you get vision and dental.”

Explanation: This is in all likelihood an ad from a national health insurance company that offers a zero premium Medicare advantage plan in some of the larger markets such as Seattle, Spokane, Boise, or Salt Lake City. It’s not available in most rural areas.

There usually is some unreadable fine print at the bottom of the ad or the voice over quickly says at the end of the ad, “Not available in all area” or something to that effect.

What is boldly promoted in these TV ads? Yes, it’s the huge toll-free number held on the screen for eons to allow the viewer enough time to write it down.

These ads are similar to pharmaceutical ads. They extoll the virtues of their product while ignoring or glossing over the downsides. The drug ads portray how wonderful your life will be if you “ask your doctor for this drug”, oops, “ask your doctor about……” Meanwhile, the voice over quickly rolls past the myriad of potential side effects in an almost non-understandable monotone.

Print advertising

A couple in Bigfork, Montana showed me a mailer they received from Acme Health and Life, again, a fictitious name. The paper flier leads off with a bright red “0 or affordable premium….” The zero is in bolded bright red and the text reverted back to black.

I explained to them that there are no zero premium Medicare advantage (MA) plans in Montana that include prescription coverage. I also said that in some counties Acme has available a zero premium MA only plan, but this plan has no prescription coverage. If you enroll in stand-alone prescription drug plan, then you will then disenroll yourself from this MA only plan.

The couple said, “Isn’t that deceptive?” “Yes it is” was my response. In fact, I’d say it’s really close to bait and switch. You’re baited with the bright red zero only to find out that the zero-premium MA only plan won’t work for you.

After you call the prominent toll-free number displayed on the flier and have an ACME agent visit you, the agent will discuss a plan with premium. You are baited with the bright red “0” and then switched to a plan with a premium.

Acme skates free because the language says, “$0 or affordable premium…” It’s technically true, but it’s also unfeasible for most all consumers. This is classic bait and switch.

The Whole Point
Is the purpose of most Medicare related TV and print advertising to properly inform you about the products being advertised? Of course not. Instead the purpose is to use whatever manipulative trick it takes to get you to call the sponsor’s toll-free number.

If the company would send you a professional agent that put your interests ahead of the company’s bottom line, then it wouldn’t be so bad. Unfortunately, you typically get the used car salesman type that overlooks and/or hides the defects of the product he is selling. End

Miscellaneous Notes for November 2017

Annual Election Period (AEP)

The AEP, also known as Medicare open enrollment, runs from October 15 through December 7th. We are working hard to serve everyone. If you have contacted us via a paper response form or through, we appreciate your patience. We are making headway.

The AEP is the time when you can change your Medicare advantage (MA) or Part D prescription drug plan (PDP). If you have a Medicare supplement plan, you have the option to switch to an MA plan.


Special Election Period beginning December 8th

For those who have been disenrolled from an MA plan, you have lots of time to elect your new choice. Medicare has established a special enrollment period (SEP) that begins December 8th and runs through the end of February. For those affected, you can choose a new MA plan, or you can take advantage of the guarantee issue rules and enroll in Medicare supplement plans A, B, C, F, K, and L with no health qualifications. For more details, please refer to our article I Received a Disenrollment Letter: What Now?.


Changing a Medicare Supplement (Medsupp) plan

A question that comes up every year is when can I change my Medsupp plan. The answer is that you can change your Medsupp plan any month of the year subject to medical qualification. Please refer to the more detailed article, Have Your Medicare Supplement’s Rates Gone Up?.

A common misunderstanding among some people is thinking that the AEP is open enrollment for a Medsupp plan. Yes, it can be confusing. Remember, for most people, once you are past 65 ½, you can change your Medsupp plan any month of the year, again, subject to medical qualification.


News on the PDP front and hidden rate Increases

We have seen some minor changes regarding the Part D prescription plans. Some premiums have increased a few dollars here and there. One plan has a new lower premium and is quite competitive.

One of the ways that a plan makes a hidden rate increase is by moving a drug to a higher numbered tier.  For example, one plan from Best Buy Health (fictitious) has moved fenofibrate from a tier 2 generic to a tier 3 preferred brand. When fenofibrate was in the tier 2 category, it had a $4.00 copay and was excluded from the deductible.

Now that it’s a tier 3 drug, it’s subject to the $405 deductible. Let’s say that fenofibrate has a retail price of $10.00.  Last year you paid a $4.00 copay. If fenofibrate is your only tier 3 drug and all others are tier 1 and 2, then you pay $10.00 instead of $4.00 through the entire year. At $10.00 per month, you never meet the $405 deductible. Instead of paying $4.00, you now pay $10.00. A higher copay is a form of a rate increase.


Beating Advertising Anxiety

The large health insurance companies flood the air waves and your mailboxes this time of the year with their advertising. I have fielded several calls from clients that have expressed their anxiety that is caused by listening to or seeing print Medicare-related advertising. I just visited a home, and in the space of twenty minutes, I heard two Medicare related advertisements from a television in an adjoining room.

The fact that the advertising creates anxiety, shows its effectiveness, as that is exactly its intended purpose. To relieve your anxiety that they created, you dial the toll-free number prominently displayed on your screen. Help is now on the way…uh, well, not quite.

The best way to deal with it is to do whatever you can to limit your exposure to the psychological bombardment of your well-being from the ads. Throw the print stuff away, and mute your tv when the ads come. Please refer to our companion article in this issue titled Misleading and Deceptive Advertising.

If exposure to paint fumes, for example, makes you feel ill, what’s the obvious solution? You limit your exposure or avoid it altogether. If you know someone who you realize is a toxic person, you can limit or even cut-off your contact with that person.

I have a relative that has her tv on constantly. When I’m exposed to the tv when I visit her, I get a dose of just how manipulative the tv advertising can be. They’re playing with our minds all day long. I feel like I’m being exposed to a mental electric shock. And again, that’s why the advertisers spend billions every year hawking their products. End