Health Care Access

Alternative Treatment Under Scrutiny

Homeopathic Health Care Funding to Stop

In the current economic climate governments are looking to save money and eliminate wasteful expenditure. A recent report from the House of Commons Science and Technology Committee published findings and recommendations that could see the state funding of homeopathic health care treatment axed by the British government. Could this be evidence of good or poor financial management?

Evidence Check on Homeopathic Treatment

The Committee has urged the government to withdraw NHS funding for homeopathic treatment and stop the Medicines and Healthcare Products Regulatory Agency licensing homeopathic treatments. The report states that there is a “mismatch between evidence and policy.”

The committee raised concerns that while the government recognises that there is no evidence that homeopathic treatment works beyond the placebo effect, it continues to fund homeopathic health care treatment through the National Health Service budget. The NSH currently funds four homeopathic hospitals in Scotland and England.

The report follows an evidence check questioning whether the government’s policies on homeopathy were based on sound evidence. Testimony was collected from the director of research at the Royal London Homeopathic Hospital, the chairman of the British Association of Homeopathic Manufacturers and the chief scientific adviser of the Royal Pharmaceutical Society of Great Britain.

Science and Technology Committee Conclusions

The committee concluded that the MHRA should not allow homeopathic product labels to make medical claims without evidence of efficacy. “As they are not medicines, homeopathic products should no longer be licensed by the MHRA,” the committee said.

Other concerns included the introduction of the National Rules Scheme in 2006 that allowed homeopathic treatments to make medical claims that were not based on randomised controlled trials, and the Department of Health’s willingness to spend public money on treatment that was “faith” based, rather than on a foundation of firm evidence.

The committee’s chairman, Liberal Democrat Phil Willis, said in a statement that “this was a challenging inquiry that provoked strong reactions. We were seeking to determine whether the government’s policies are evidence based on current evidence. They are not.”

“It sets an unfortunate precedent for the Department of Health to consider that the existence of a community which believes that homeopathy works is ‘evidence’ enough to continue spending public money on it,” Willis added. “This also sends out a confused message, and has potentially harmful consequences. We await the government’s response to our report with interest.”

It is no secret that the political party that wins the next British general election will implement severe cuts to public expenditure. The recent press reports on the wasteful purchase of unused swine flu vaccines by the British government, underscores the difficulty of doing business with large pharmaceutical corporations and raises questions about the government’s diligence. By comparison, the government’s expenditure on homeopathic health care seems like a drop in the ocean.

While the homeopathic community may seem like a soft target for financial cuts, there are others who may view the situation differently, and see yet more examples of government financial mismanagement on the run in to the next general election.

How to Deduct Medical Expenses on a Tax Return

Claiming Medical Costs Under The Income Tax Act

On a regular income tax return for Canadian citizens, medical expenses are calculated on line 330 and the refundable medical expense supplement is on line 452. There are several medical expenses that many individuals may not realize can be eligible for this deduction and there are other methods to maximize the benefit of claiming this expense.

Save Money By Combining Expenses on Income Tax Return

Combining medical expenses for the entire family and dependents and claiming this amount on the income tax return of the spouse with the higher income may help make this more beneficial. Medical expenses may also be claimed for any 12-month period ending in the year the return is for. If the end of last year and the beginning of this year contained a high amount of medical expenses, it may be more advantageous to wait to claim this amount for this year’s tax return.

What Can Be Claimed Under Medical Expenses?

Canada’s Income Tax Act currently allows prescription medications only to be deducted as a medical expense. Be sure to keep careful records of all prescriptions. Over the counter medications as well as natural and holistic vitamins, supplements and medications are currently not allowed to be deducted as a medical expense in Canada. If a large amount is spent on natural health and holistic products, an extended insurance plan that covers may be financially beneficial. Though the cost of insurance may increase, this amount is deductible on an income tax return and may actually help to save on income tax.

Other medical expenses that can be claimed include premiums paid through employment or university for extended health and dental plans, other extended health insurance plans such as Blue Cross, travel health insurance (even when purchased separately for each trip), and in some cases equipment purchased for home use and renovations done to your home to accommodate an illness or disability, however certain regulations and conditions apply.

Renovation Expenses for Medical Reasons

Renovation or construction expenses that are necessary to allow an individual with severe or prolonged mobility impairment or who suffers from abnormal physical or mental development, are allowable medical expenses under certain conditions. The costs incurred can be deducted minus any other renovation rebates such as for the goods and services tax or home renovation tax. Eligible renovations include those that would not normally be incurred by individuals without illness or impairment such as wheelchair ramps, safety rails, elevators, stair-lifters, lowering counters for easier access, widening doorways and others. For more information see the Revenue Canada site and line 368 in the General Income Tax and Benefit return.

Further Information and List of Allowable Medical Deductions

See your Canada Revenue Agency Site for a complete list of allowable medical expenses. Most equipment , supplies and renovations require medical documentation or a prescription from a physician; be sure that deductions qualify before making purchases or claiming a deduction. Allowable medical expenses that are often overlooked include: laser eye surgery, ambulance costs, medical travel costs (in some cases), surgical hair transplants, allergy specific foods (with a prescription), prescription eyeglasses and contact lenses, dental and orthopedic costs.

Healthcare Costs Rising

The Effect of Exercise on the Healthcare Industry

Many exercise and diet recommendations, articles, and suggestions talk about the benefits of fitness. Some articles will offer tips to build bigger pecs, ways to lose 10 pounds in a week, or how to prepare for a marathon. On television, programming such as Oprah, Dr. Oz., morning talk shows, and infomercials churn out health and exercise related products, services, and information. Whether it is a “wonder pill” to decrease risk of cancer, a machine to get “ripped abs,” or a new exercise routine to “make the pounds melt away” the information is everywhere and endless. So what is the affect from the totality of multibillion dollar businesses, products, and advertising to promote healthy living? A $2.4 trillion price tag on healthcare expenditures in 2009, accounting for almost 16% of the total gross domestic product (GDP). At the current rate, by 2020 healthcare will account 20% of all dollars spent in the US.

Exercise and the Healthcare Economy

How does exercise affect the entire healthcare system? To answer that question it would take hundreds of pages just to scratch the surface. To understand the entire industry, examination of the 300+ million individuals in the United States is necessary. Although exercise, diet, and stress are a small components of the healthcare industry, completely ignoring them can have drastic consequences to the individual and the country. Consider this logical progression of a person diagnosed with type II diabetes:

1. Individual does not maintain healthy lifestyle, including exercise and good diet, resulting in type II diabetes
2. Diagnosis leads to increased visits to doctor, testing supplies, and medications
3. Expenses of healthcare lead to increased pressure on finances
4. Limited financial resources result in decreased vacations, participation in hobbies, and general funds for entertainment
5. Concurrently, process of disease makes walking more difficult, wounds heal slower, and increases susceptibility to other diseases
6. Declining health, having less money, tasty foods being labeled “bad,” and less opportunities to participate in enjoyable activities increases risk for depression
7. Depression sets in motion lack of desire to “get better”
8. Later stages of disease affects circulation and wound healing, resulting in leg amputation
9. Leg amputation further progresses depression
10. Individual continues to get worse, has less and less money, and puts tremendous pressure on the healthcare system

Struggling with Poor Health

In this particular example, the individual suffering this condition has less money, inability to participate in enjoyable activities, and overall declining health. Surrounding family and friends may also bear the burden for the loved one’s health complications. Poor health can make it difficult or impossible to perform some jobs, producing a risk of unemployment in very uncertain times. Hobbies and recreational activities also may suffer because of general poor health, only further progressing overall dissatisfaction with life. By ignoring health prevention measures an individual risks becoming more depressed, dependent, and financially vulnerable. As for healthcare the healthcare industry, the $2.4 trillion continues to rise without end in sight.

Simple Steps to Healthy Living

Diseases such as type II diabetes, heart disease, obesity, and arthrosclerosis often are born and progress from lifestyle choices. Simple interventions such as exercise, diet, and reducing daily stress levels can improve individual health but also benefit the overall economy. With a political climate in constant debate on how to “solve the healthcare problem,” the real resolution starts with millions of individuals. The entire healthcare spectrum may be too abstract to understand but the impact of personal health on individual health, personal satisfaction in life, and financial stability is tremendous. So how can a $2.4 trillion healthcare industry get going in the right direction? It starts with 300+ million people moving in the right direction.

Pandemic or Epidemic – What’s the Difference?

Epidemics

An epidemic is an outbreak of a virus or other illness that spreads easily from human to human but it is more confined to an area, region or even a country. It isn’t a global occurrence. Seasonal flu is an example of an epidemic.

Epidemics usually result from a virus or subtype that is, or has been, circulating among humans. Therefore there is some immunity and the virus will not spread as rapidly. An epidemic can be very deadly, especially to the very young and very old as well as those with chronic illnesses. This is why, for example, flu vaccines are essential to help control the spread of the flu virus and to prevent deaths from complications such as pneumonia.

Pandemics

A pandemic occurs when a novel (or new) virus spreads easily among humans causing serious illness and death. Because it is usually a novel virus, humans have little or no immunity to it and the virus can spread rapidly. It usually causes many more deaths than an epidemic.

After the pandemic spreads, the virus will continue to circulate for several years. With the immunity that humans will have built up from exposure and illness and vaccines that have been developed from the strain, these viruses will not cause further pandemics.

Health care issues with a pandemic include:

• rapid transmission due to a highly mobile society
• antiviral medications and vaccines and antibiotics to treat secondary infections (such as pneumonia) would be used rapidly and supplies could become critically short
• it will take months to develop a vaccine against the novel virus
• medical facilities and personnel could become overwhelmed
• shortages of nurses and physicians could reach critical levels
• vital community services could be affected by a widespread outbreak

Plagues and outbreaks of cholera, small pox, typhus and influenza have caused pandemics throughout history. More recent pandemics include the 1918 Spanish flu which was originally thought to have been a swine flu or H1N1 Influenza A virus, but was not. In 1918, there were over 40 million deaths from the Spanish flu worldwide. What started out as a cough and achy muscles lead to a serious pandemic.

In 1957 the Asian flu pandemic hit and in 1968, the Hong Kong flu also became a pandemic. HIV/AIDS which began in the 1980’s and continues today is also considered a pandemic. The swine flu of 2009 is a pandemic, although with the rapid response worldwide, it is hoped to not be as severe as was originally thought.

Prevention is Key

It is important to understand that viruses can mutate and spread rapidly. Agencies such as WHO and the CDC monitor events and issue warnings as needed. Prevention is key. Handwashing is so low tech, but it can help prevent the spread of illness. Covering a cough or sneeze is not just polite; it is also essential to control the spread of germs. Social isolation as needed is an absolute.

Be Prepared for a Pandemic

Being prepared for any emergency is also an essential fact of life in the 21st century. Keeping a pantry stocked with provisions is vital. Maintaining at least a two week supply of prescription medications as well as a few essential OTC medications for cough, cold, and GI distress is also well advised. Be sure to renew any expired medications and store them according to the manufacturer’s label.

What is Palliative Care?

How is it Different From Hospice?

Many people confuse palliative care with hospice. Hospice uses palliative care to improve the quality of life in terminal illness, but palliative care is not always about end-of-life issues. The goal of palliative care is to improve the quality of life by relieving symptoms no matter what the prognosis.

Symptom Control

In the face of any serious illness, controlling symptoms has been proven to be vital to successful outcomes. Some of the most difficult symptoms include pain, nausea and vomiting, insomnia, anorexia or lack of appetite, and shortness of breath.

Palliative care encompasses the use of Eastern and Western medicine and alternative treatments such as medications, oxygen, herbs, therapeutic massage, energy conservation, meditation, Reiki, acupuncture and acupressure, hypnosis and spiritual care. Some or all of these may be used to achieve the stress and symptom relief and control.

Better Able to Tolerate Curative Measures

When symptoms are well controlled, patients are better able to tolerate treatments necessary for curative measures such as chemotherapy and radiation. As a result, the curative treatments usually have a better chance of working than when the body is under stress and fighting the process. The quality of life is also improved tremendously for patients and their families.

Like hospice care, palliative care is provided by a team of health care professionals including doctors, nurses and social workers who have been trained in palliative care. The team may also include specially trained pharmacists, nutritionists, massage therapists, chaplains or other spiritual care providers all working together with the patient’s personal health care professionals to secure the best possible outcome.

Customized to Meet Patient’s Needs

Palliative care is customized to the needs of the patient and changes as the patient’s needs change. It is not a one-size-fits-all approach. What one patient requires for palliative treatment may be very different from another; even with the same diagnosis and treatments.

While palliative care can be very successful in helping patients achieve a cure or remission of their disease, in the event that the curative treatment is unsuccessful, or the patient wishes to discontinue treatment, the palliative team can help the patient transition to hospice care when the time is right.

Palliative care is most often provided in the hospital setting, but may be available from home health care agencies as well. It is a growing field that offers expanding opportunities to health care professionals and allied services as well.

Unexpected Gifts

February so far has brought a touching outpouring of support for the work our dedicated staff does in the clinic. One of our best and most modest nurse volunteers (thus name withheld) surprised us with a gift of money she collected from her friends and neighbors. She and a few friends organized a neighborhood clothing swap. Participants traded their jackets, sweaters, pants and skirts that they no longer wanted to wear for their neighbors’ cache of gently used clothing. Then, instead of paying one another for the clothes, they took out their check books, dug out their cash and made Health Care Access Clinic the beneficiary of their weekend swap meet. Our volunteer undoubtedly added the extra cash to make it an even $1,000.

When we are presented with a gift like this, we are humbled by the creativity and effort that our supporters employ to find new ways to help our patients. The $1,000 we received will pay for the care of three patients all year long, PLUS, purchase seven lab test cartridges for our new in-house laboratory. We can turn every dollar into $5.44 worth of medical care thanks to the generosity of our community volunteers, LMH donations and plain, old-fashioned frugalness.

As special as that was, we were all moved when a girl came to the clinic with another envelope filled with cash and checks. This extraordinary girl decided she wanted to forgo birthday presents and instead dedicate her birthday celebration to helping those who are uninsured and need medical care. She asked her guests to bring small cash donations instead of presents for herself and then presented the donations to us. The amount was smaller than our first surprise, but the act was huge. It reminded me of a favorite quote from Colin Powell: “Giving back involves a certain amount of giving up.” This exceptional birthday girl understands that better than most. How many of us can say we have done as much?

If you feel moved to make a donation to the Clinic, large or small, or if you have medical items or office supplies you’d like to donate, give in to that feeling and do it! Better yet, if you can find a creative way to engage your friends, co-workers or neighbors in a joint effort to generate a gift to the clinic, we will happily celebrate your generosity and creativity! Names optional.

-Shelly Wakeman

Executive Director

Affordable Care Act

Like other businesses, whether for-profit or non-profit, we have to have money to keep our doors open. When having conversations about funding, I am often asked if Health Care Access Clinic is still needed now that the Affordable Care Act is in place. The answer is a resounding yes. The ACA or ObamaCare” as it’s called provides financial help for moderate income people to buy insurance on the Marketplace. The original law also required states to expand Medicaid for low income adults, but in its present form in Kansas, it does nothing for low income adults who need insurance. The ACA originally required all states to expand their Medicaid program to cover adults living at 138% of the federal poverty level and below ($15,865 for a single person, $30,660 for a family of four). The Supreme Court struck down that provision and told states they didn’t have to expand if they didn’t want to. The federal government offered incentives to states to expand by paying 100% of the cost for the first three years, with a total state share rising to 10% by 2020. Our state has not expanded Medicaid. So, for everyone living below the Marketplace cut off, access to insurance is still far out of reach.

That’s where Health Care Access Clinic comes in. We see the people who desperately need care who are too poor to buy insurance on the Marketplace because they don’t qualify for a subsidy and yet also don’t qualify for Medicaid. In Kansas we call Medicaid “KanCare” and the eligibility requirements are nearly the most restrictive in the nation. The result is there are an estimated 315,000 Kansans age 19-64 with incomes under the new eligibility threshold. Of those, 127,000 are uninsured and at least 9,000 live in Douglas County. (Source: U.S. Census Bureau).

At the end of the week, we will be mailing a letter to past supporters asking for a financial contribution to help us continue to provide life-saving access to care in our clinic. We do not receive any financial support from the federal government and only $220,000 from the state, about a fifth of our cash budget. We receive critical support from Douglas County and the United Way as well, but the bulk of the money that lets us treat the sick and struggling people who live in our communities comes from you. This is a critical time for us, as we strive to rise to the challenge of treating patient with complex medical conditions with nowhere else to go. To donate today, click on our “donate” link and give online. If your civic or church organization can help with a fundraising event, give me a call at 785-841-5760 or email me at director@healthcareaccess.org. We would love to have you as a partner in saving the lives of the most vulnerable citizens of Douglas County.

– Shelly Wakeman

Executive Director