Consumer Health Digest is a free weekly e-mail newsletter edited by William M. London, Ed.D., M.P.H., with help from Stephen Barrett, M.D., It summarizes scientific reports; legislative developments; enforcement actions; other news items; Web site evaluations; recommended and nonrecommended books; research tips; and other information relevant to consumer protection and consumer decision-making. The Digest’s primary focus is on health, but occasionally it includes non-health scams and practical tips. Items posted to this archive may be updated when relevant information becomes available. To subscribe, click here.
Consumers warned about misleading claims by “health-care-sharing ministry” plans. Health-care-sharing ministries share health-care costs among members in a risk-pooling framework. California’s attorney general has issued a warning that some of these ministries mislead consumers into enrolling under the guise of offering an affordable alternative to health insurance from the Covered California marketplace. Their plans use language that mimics traditional health insurance. The plans also enable the ministries to choose to not cover your care based on pre-existing conditions. The premiums to enroll are generally cheaper than traditional health insurance because they are not obligated to pay for your medical costs even though you have made all your monthly payments. In 2020, the California Department of Insurance issued a cease and desist order to Aliera Healthcare, Inc., and Trinity Healthshares, Inc., for misleading California consumers into purchasing their products. [Attorney General Bonta issues consumer alert warning [to] Californians about misleading claims made by healthcare sharing ministry plans. State of California Department of Justice press release, April 30, 2021]
John Oliver lambastes health-care-sharing ministries. In a 23-minute video, comedian John Oliver has exposed how health-care-sharing ministries (HCSMs) are deceptively advertised as a more affordable, faith-based alternative to health insurance in the U.S. Oliver notes:
- The 2010 Affordable Care Act (ACA) exempted people from paying a tax penalty for not getting insurance if they became members of an HCSM.
- An estimated one million people are now members of an HCSM.
- HCSMs are sold by insurance brokers even though they aren’t insurance.
- HCSMs don’t have to abide by laws regulating insurance products so they can and do exclude coverage for people with pre-existing conditions, and many don’t cover treatment for substance abuse, mental health conditions, obesity, or autism.
- HCSMs may not cover routine care, maintenance care, preventive care, or wellness care.
- The most that can be shared for a given need is $250,000.
- HCSMs can deny coverage based on “morality” issues, such as homosexuality, cigarette smoking, alcohol-related illnesses, abortion, and other “lifestyle-related choices.”
- Liberty HealthShare insists that “an applicant must comply with…a Christian lifestyle.”
- Samaritan Ministries will not pay for treatment of sexually transmitted diseases if “contracted by consensual sex outside of marriage.”
- Members are responsible to bargain down bills they receive as much as they can, pay the bills, and then submit the bills to their HCSM for reimbursement.
- As members depend on other members to voluntarily share finances to pay for services, there is no guarantee that a particular bill will be paid.
- HCSMs have lobbied for safe harbor laws in 30 states to ensure that they can operate outside of insurance regulations.
- While the ACA requires that no more that 20% of a health insurer’s costs can be for administration, overhead, and marketing, there is no such requirement for HCSMs.
- A 2019 Oregon Department of Consumer and Business Services investigation found that out of every $100 a Trinity HealthShare member paid in premiums, only $16.03 went toward paying medical expenses.
In Florida, where HCSM regulations were recently loosened, Oliver founded a phony church called “Our Lady of Perpetual Health” and easily set up JohnnyCare as the church’s HCSM. JohnnyCare’s website, freedomfromhealthcare.org, even declares that HCSMs are not required to be accountable to consumers.
Evidence lacking for “alternative” weight-loss therapies. A systematic review of published research evaluating the efficacy of dietary supplements and “alternative therapies” for weight loss among people at least 18 years of age has found that supportive evidence is weak. Many clinical trials were also hampered by a significant risk of bias due to inconsistent testing methods. Problems with studies include small sample sizes, short follow-up periods, and poor study designs. [Batsis JA. A systematic review of dietary supplements and alternative therapies for weight loss. Obesity, June 23, 2021] Key findings included:
- Out of 315 randomized controlled trials included in the review, 52 were classified as having a low risk of bias, of which 16 demonstrated significant weight changes for tested therapies compared to placebo.
- No high-quality evidence supported acupuncture, calcium-vitamin D supplementation, chocolate/cocoa, phenylpropanolamine, guar gum, Phaseolus vulgaris, pyruvate, and mind-body interventions as weight-loss therapies.
- At least half of the low-risk-of-bias studies of chromium, ephedra and caffeine, garcinia and/or hydroxycitrate, green tea, and conjugated linoleic acid showed no difference between treatment and placebo groups.
- The only study of chitosan for weight loss with a low risk of bias found an average loss of 5 lbs. in a six-week follow-up period.
- Out of 66 randomized controlled trials testing therapies in 39 miscellaneous categories, only 16 had a low risk of bias, but 10 of these provided no supportive evidence and six noted an average weight loss of only 1.5 to 6.6 pounds.
Drugs approved by the U.S. Food and Drug Administration (FDA) since 2015 have enabled obese children, adolescents, and adults to lose substantial weight though not as much weight loss as can be achieved through bariatric surgery. [Yanovski SZ. Yanovski JA. Progress in pharmacotherapy for obesity. JAMA, June 23, 2021; Abbasi J. Semaglutide’s success could usher in a “new dawn” for obesity treatment. JAMA, June 23, 2021] Many insurers do not cover anti-obesity medications or require prior authorization.
Companies warned about misleading “FDA registration certificates.” The FDA has ordered 25 companies to stop issuing documents that state that a medical device has been registered with the FDA. The certificates often look like official government documents, and many display the FDA logo. The agency believes that the certificates falsely imply that a device has been evaluated, cleared, or approved as effective for its intended purposes. The FDA does not issue any type of device registration certificate, and registration does not denote approval or clearance of a manufacturer or its devices. It merely means that certain information has been provided to the FDA. [Barrett S. FDA orders 25 companies to stop issuing misleading “FDA registration certificates.” Device Watch, July 4, 2021] The marketers of Healy bioresonance devices are using a certificate which states that their device has been cleared. Although the recent FDA action concerned registration certificates, the same principles appear applicable to “clearance certificates.” [Barrett S. A skeptical look at the Healy “bioresonance” device. Device Watch, July 4, 2021]
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