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Page 6 -T h e Portland Observer—July 31, 1991
HEALTH CARE 1991
View From Health and Human Services
BY LOUIS W. SULLIVAN, M.O.
Ten years after we learned about
AIDS, for which there still is no cure
and no preventive vaccine, the disease
poses a major health threat to black and
other minority communities.
Consider this sobering outlook: By
the end o f 1993, more than 125,000
black Americans, about one in every
250, will have been diagnosed with
AIDS. Then most of us will have some
one with AIDS in ourcircle of family 01
acquaintances.
That alarming but conservative es
timate assumes that blacks, just 12 per
cent of the U.S. population but a dis
proportionate 28 percent of the nation’s
reported AIDS cases (51,190 of 179,136
in May), will start reducing this epi
demic in black communities. But to
day, the problem is growing-particu-
larly among black women, children
and teen-age m ales-and blacks repre
sent a staggering 35.2 percent of all
newly diagnosed AIDS cases. Nearly
40 percent of AIDS cases in the black
community have resulted in one way or
another from abuse of illegal drugs.
Cold numbers don’t reflect the true
impact AIDS is having on the black
family and our com m unity-the ter
rible loss of contribution from talented
individuals, the orphaned children and
the strain on an already overburdened
health care system.
The federal government must help
turn the tide in this battle. Toward that
end, under my leadership the Public
Health Service is increasing participa
tion of blacks and other minorities in
the 1991 AIDS research effort, budg
eted at $1.3 billion, and targeting more
of the $524 million AIDS education
campaign directly to these groups.
In FY ’92, Medicaid (federal share)
and Medicare coverage plus Social
Security assistance payments to people
with AIDS will run about $1.79 billion.
Govemment-wide.FY ’92 spending on
AIDS-related activities will hit $4.3
billion.
At the community level, we must
recongize that AIDS is not someone
else’s problem, it is our problem. We
have to talk more about it in our fami
lies, our neighborhoods, our schools
and our churches.
We must translate the AIDS mcs-
sages about the dangers of drugs and
needle-sharing and unprotected sex into
language that will be clear, direct and
convincing to our people. No one should
be misled: At this point, preventing
AIDS is the only way to survive the
disease.
We need to motivate all those who
have engaged in high-risk behavior such
as substance abuse and unprotected sex,
to seek counseling and get tested. Fac
ing up to being infected with the AIDS
virus is a crucial step in taking care of
one’s self and preventing further spread
of the virus. Drugs such as AZT can
prolong life and enhance its quality.
AIDS does no discriminate. This is
no time to point fingers and cast stones.
It’s lime to join together to v>age a
battle we must win, a time for compas
sion for those who are sick and dying-
including those young and old who are
homeless or have been abandoned by
family and friends.
I urge you to learn more from your
local AIDS organization, or call our
federal hotline: 1-800-342-AIDS.
(Dr. Sullivan is U.S. secretary of
health and human services.)
Measles: Time To Check Immunization Status
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The Multnomah County Health
Division is issuing a reminder for county
residents to review their own and their
family’s immunization records. Rec
ords of children’s immunization are es
pecially important to review.
Vaccine-preventable diseases still
occur regularly in our community.
Multnomah County has had a total of
20 cases o f measles reported so far this
year. This is three times the number of
cases reported for all of 1990. Four of
these cases occurred in March and April
and 16 cases have occurred in May and
June. The latest reported case began
June 24,1991.
Measles usually begins with non
specific symptoms including fever,
cough, runny nose and red, watery eyes.
A red, blotchy rash typically appears
between the 3rd and 7th day of illness.
The rash usually begins on the face and
then spreads to the rest of the body. The
rash usually lasts 4 to 7 days. The
illness usally begins about 10 days after
exposure, but may begin anywhere from
7 to 18 days following exposure.
Measles is a highly contagious
serious communicable disease. Perma
nent brain damage occurs in approxi
mately 1 out of every 1,000 cases and
death occurs in approximately 1 out of
every 1,000 cases. Other complications
include ear infections and pneumonia.
Children less than 1 year old and
adults are likely to have serious com
plications.
Many people are immune to
measles. Most people bom before Janu
ary 1, 1957 have had measles and are
immune as a result of this past infec
tion. Most children bom after 1969
have been vaccinated against measles.
However, measles vaccination was not
required for school entry in Oregon
until 1982. Further, there is a signifi
cant proportion of individuals who were
vaccinated in the late 1960s and early
1970s who are not immune. Therefore,
there is a substantial number of people
in our community who are at risk of
catching measles.
It is important to immunize chil
dren at 15 months of age. although
most of our recent measles cases have
been between the ages of 15-25 years.
Other communities around the country
(e.g., Los Angles and New York City)
are experiencing epidemics of measles
among young children, especially chil
dren under two years of age. Deaths
due to measles in young children, espe
cially children under two years of age.
Deaths due to measles in young chil
dren have been reported in these com
munities.
The Multnomah County Health
Division recommends:
* Immunization of all children age
15 months and over with MMR (measles,
mumps, and rubella) vaccine.
* Reimmunization of all children
12 years of age with MMR.
* Reimmunization of college en
trants prior to college admission this
fall.
* reimmunization of individuals
planning international travel; this should
be done prior to travel.
People bom prior to January 1,
1957, are generally considered immune;
immunization of these individuals is
not necessary, except in special cir
cumstances.
When reviewing their own and their
family’s immunization records for
measles, it would be wise for county
residents to review other immuniza
tions as well. Adults need to be current
on their tetanus-diphtheria (Td) immu
nization. Routine immunization every
10 years is recommended; a prompt Td
booster shot is also recommended when
someone sustains a puncture wound,
significant bum, or a dirty wound.
Children should receive a series of
each of the following immunizations:
* DTP (diphtheria, tetanus and
pertussis vaccine)
* OPV (oral polio vaccine)
* Haemophilis influenza type b
vaccine
A families usual doctor or clinic
can assist in determining if anyone in
the family needs to be updated on im
munizations. The Multnomah County
Health Division’s Information and
Referral service at 248-3816 can pro
vide information and make referrals to
county clinics and other medical re
sources in the community.
For questions regarding comm uni-
cable diseases in Multnomah County
please call the county Disease Control
Office at 248-3406.
Additional contacts:
Jan Poujade, RN Manager for
Disease Control 248-3406
Gary L. Oxman, MD MPH, Health
Officer of Multnomah County 248-3674
Medigap Hearings
The Insurance Division recently
held hearings in three cities on pro
posed increases in Medicare supple
ment premiums. The hearings were an
opportunity to evaluate the merits of
each company’s request and to hear
from everyone who will be affected by
the proposed increases.
The hearings focused on increase
requests exceeding 15 percent. Approxi
mately 70,000 senior Oregonians may
be affected by these premium increases.
This was also a chance for consumers
to become educated in all factors con
tributing to health insurance premium
increases.
Consumer advocates pointed out
that many seniors cannot absorb in
creases of more than eight percent-
especially those seniors who rely on
Social Security checks as the sole source
of income.
More than 110,000 senior Orego
nians live on an annual income of less
than 12,500, according to Dr. Jim Davis
of the Oregon State Council of Senior
Citizens. Such people have to chose
between paying increased Medicare
supplement premiums or for the basic
necessities of life. He asked the hear
ings officers to closely examine the
necessity of the increases, the adminis
trative costs associated with the plans,
the effect of inflation, and the magni
tude and frequency of Medicare sup
plement premium increases.
Dr. Davis also argued for increased
consumer involvement in health insur
ance premium increase requests. He
recommended automatic hearings on
increases greater than ten percent. He
acknowledged that increases must be
made in some cases and was prepared
to accept some of them, “ As long as
we know consumers are a part of the
process.”
Robert Reilly, president of a 2,000-
member Chapter of the American As
sociation of Retired Person echoed these
concerns, “ W e’re getting priced out of
the market and we can no longer afford
these increases,’ ’ he said. According to
Mr. Reilly, premiums “ come out of
food and other choices,” when they
exceed the four to five percent annual
increase in Social Security.
Mr. Reilly also urged more uni
formity in Medicare supplement pre
mium increases, asking that decisions
be made in September or October of
each year with January 1 effective dales.
Such a change would make it possible
for organizations to compare policy
costs for their members, he said.
Oregon Insurance Consumer Ad
vocate Thomas Erwin wrapped up the
consumer testimony by asking the
hearings officers to examine company
complaint performance. He pointed out
that many Medicare supplement carri
ers have fairly high complaint indices
and rank near the bottom of Oregon In
surance Complaints: Part One. He urged
the division to give these companies
extra attention.
Erwin also asked that Weeks “ do
whatever possible to encourage com
panies to combine blocks of business,”
and end the practice o f blocking.
Testimony from insurance com
panies was then heard. Missy Bartlett
of Physicians Association o f Clacka
mas County (PACC) pointed out that
the company’s rates had not increased
in over two years.
PACC lost six dollars per member
per month in 1990 on its Medicare
supplement business. Ms. Barlett also
pointed out that the company has insti
tuted a number of cost containment ef
forts including a full-time medical di
rector.
Eugene Volk, a representative of
Bankers Life and Casualty, Certified
Life and Union Bankers, pointed to
cost-shifting as a major contributor to
premium increases.
Blue Cross and Blue Shield
(BCBS), Oregon’s largest health in
surance company, reported it was los
ing money on its medicare supplement
coverage. The company stated that
increases against seniors’ ability to
pay. “ We are very much aware that we
are dealing here with retired people on
fixed incomes. The strategy we are an
nouncing today is designed to bring
the rates up in smaller steps, giving
Blue Cross the income it needs to fi
nance this coverage, but avoiding a
single massive jump in premium,” said
Roderick Bunnell, attorney for BCBS.
These hearings were a successful
beginning of an ongoing process by
which the interests of consumers and
companies can find common ground.
As one senior advocate at the hearing
said, “ I’m prepared to listen and
learn...but we all need to be united if
we’re going to achieve cost-contain
m ent.”
Future forums will bring consum
ers and companies together to under
stand their mutual concerns and to
jointly address escalating health care
costs which in turn lead to higher pre
miums.
Medicare supplement insurers will
increase premiums by a smaller amount
than they originally requested under a
recent decision by Gary Weeks, Ore
gon Insurance Commissioner.
Weeks held hearings to examine
requested rate increases for Medicare
supplement insurance which ranged
from 15 to 63 percent. After hearing
testimony from consumer groups and
company representatives, Weeks re
duced the requested average increase
of 23.3 percent to an average increase
of 16.7 percent. “ Seniors simply can
not absorb increases o f the magnitude
requested by some companies,” Weeks
said. “ This decision will benefit con
sumers and will not jeopardize the fi
nancial solvency of any company. The
decision should also encourage com
panies to take another look at ways to
control costs.”
The Commissioner pointed out that
some increases are inevitable. “ Changes
in M edicare’s benefits, cost-shifting
by the federal government, excessive
loses, increased utilization, and, most
importantly, inflation in health care
costs all mean that companies need
some increases to stay in business,”
Weeks said.
Weeks has also asked companies
to maintain a higher loss ratio than
required by Oregon law. Currently,
companies are required to pay 60 cents
of every premium dollar in the form of
benefits. Weeks has asked companies
to increase that ratio to 65 cents of
every dollar. “ Iam committed to see
ing seniors get reasonable benefits for
their premium dollars,” he stated.
P ortland M attress C ompany
1868 N. Lombard, Portland, Oregon 97217
(503) 286-7578
Helpful Hints Offered To Avoid Weight Loss Frauds
BY PATRICK M. O'NEIL
Taken from a Special to the Post-Courier
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Last week we profiled a very few
of the weight loss scams waiting to
pounce on your wallet and prey on your
pound-shedding desires. Here are some
tips you can use to protect yourself.
1) If it sounds to good to be true, it
is.
Y oucan’tfool Mother Nature. You
MUST bum more calories than you
takein if you wish to lose fat. Some
outlandishly priced mail - and phone-
order books, products and “ systems”
actually may include some sensible sug
gestions, tucked behind the hype about
the “ gimmick.” Watch, though, for
pseudo-scientific jargon and prices line
with their unsubstantiated claims. If
they’re selling the product more than
the food plan or behavioral tips, forget
it.
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2) Watch for testimonials.
Legitimate programs obviously
enjoy satisfied patients or customers
who are gratified to tell their stories.
But is there more? How does it work on
the average? Effective weight loss tech
niques should have controlled studies
behind them. What about people who
follow the food plan (which all gim
micks have) but don’t take the pill or
drops or listen to the tape? If the only
data came from “ S.K. of Tarpaper,
Mississippi,” forget i t
3) Watch for motivations that are
unrealistic.
Is the ad pitched toward your de
sire to get back into your 1969 swim
suit, or vengeance to make your ex
spouse jealous? These and other de
sires are all understandable parts of
human nature, but be realistic. No pill,
diet, patch, plan, or “motivational tape’’
has yet been devised that will reverse
20 years of life or give a former spouse
what you believe he or she deserves. If
the ad plays to these types of motiva
tions, enjoy the fantasy, but keep the
checkbook out of reach.
4) “ Subliminal perception” doesn’t
work.
If it did, w e’d be doing this column
in those little black spaces between TV
or radio ads.
5) W hat’s up with the doc?
Sponsorship by a doctor often lends
an aura o f credibility that may or may
not be deserved. Most physicians and
psychologists are capable and ethical,
but a bunch of letters after a name isn’t
in and of itself sufficient. Is the “ doc
tor” even named. A “ doctor” of what?
A Ph.D. in comparative religions is a
very legitimate, difficult degree, but it
doesn’t equip one to prescribe diets.
And don’t expect less of foreign
doctors than you would of your home
town family doctor. A recently popu
lar, potentially dangerous mail-order
diet pill was attributed to a French
doctor. Just because he spoke fluently
at age eight what you struggled to learn
at age eighteen, does that mean he has
the magic answer to your weight prob
lem?
6) Never order a pill from a post
office box.
7) Watch for anti-establishment
bias and conspiracy theories.
If the ad tries to convince you that
reputable pharmaceutical companies and
health-care specialists are afraid of the
seller’s “ breakthrough” product, hang
onto your wallet. If you don’t trust the
concern and compassion of people in
health care, trust their greed. Pharma
ceutical companies spend billions of
dollars annually on research and mar
keting costs for the drugs your physi
cian can prescribe. Usually, the more
promising the drug, the more it costs
you, as you may have noted. If these
people were aware of a sure way to
produce weight loss, don’t you think
they’d latch onto it and charg the
dickens out of you?
8) Iron is attracted by magnet Fat
isn’t
9) What does the guarantee guar
antee?
If there’s a money-back guarantee,
ask about the fine print before you send
your money away. Otherwise you may
never get it back. Many ads of dubious
pills, tapes, and devices and “ systems”
give up all the space to promoting the
gim m ick, assuring you that your money
will be swiftly returned if you don’t
lose weight. When your purchase ar
rives though, you may find that you’ll
get you money back if you use the
gimmick and follow the enclosed -
surprise - DIET. So much for miracles.
What about offers to accept post
dated checks? You won’t see this on
big-ticket items, of course. (Ever try
driving a car off the dealer’s lot after
handing over a post-dated check?) On
lower-priced items offering this form
of “ free examination,” call your bank
and ask them what you have to pay and
do to stop a check. By the time your
new purchase arrives, you may not have
time to write to request your check
back.
10) There are no magic combina
tions of food that melt away fat.
There are "m agic foods, however,
that will help you lose fat - if you
reduce them. Examples are butter,
margarine, cream, and other fats.
90 DAYS SAME AS CASH
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