Texas Health Freedom Coalition Texas Health Freedom Coalition Update for Texas LegislatorsUpdate for Texas Legislators

March, 2010March, 2010Prepared byPrepared by

Texas Health Freedom Coalition Texas Health Freedom Coalition www.texashealthfreedom.comwww.texashealthfreedom.com

OverviewOverview

Coalition CompositionCoalition Composition

Challenges Presented By the Current SystemChallenges Presented By the Current System

Use of complementary and alternative health care Use of complementary and alternative health care (CAM) in the US(CAM) in the US

How Texas benefits by facilitating wider citizen How Texas benefits by facilitating wider citizen access to CAMaccess to CAM

A potential solutionA potential solution

Call to ActionCall to Action

TX Health Freedom Coalition TX Health Freedom Coalition CompositionComposition

Total of approx. 50,000 people now directly Total of approx. 50,000 people now directly represented in the Coalitionrepresented in the Coalition

Network reach of over half a millionNetwork reach of over half a million

- Measured by e-mail, phone, fax and letter totals - Measured by e-mail, phone, fax and letter totals to legislature in 2005/2007/2009 sessionsto legislature in 2005/2007/2009 sessions

Lobbyist James Jonas of Holland and Knight Lobbyist James Jonas of Holland and Knight joined our Coalition in March 2007joined our Coalition in March 2007

THFC Coalition Composition THFC Coalition Composition (Cont’d)(Cont’d)

Academy of Oriental Medicine in Austin (AOMA) Alumni Association Academy of Oriental Medicine in Austin (AOMA) Alumni Association - Several hundred members- Several hundred membersCertified Natural Health Professionals (CNHP)Certified Natural Health Professionals (CNHP)

- Approx. 5,000 in TX- Approx. 5,000 in TXCertified Nutritionists (CN)Certified Nutritionists (CN)

- Approx. 350 in TX- Approx. 350 in TXCitizens’ Commission on Human Rights (CCHR) Texas Citizens’ Commission on Human Rights (CCHR) Texas Coalition for Natural Health (CNH, Washington, DC)Coalition for Natural Health (CNH, Washington, DC)

- Approx. 1,700 in TX- Approx. 1,700 in TXHealthKeepers AllianceHealthKeepers AllianceJuice Plus Independent Distributors of TexasJuice Plus Independent Distributors of Texas

- Approx. 400 in TX- Approx. 400 in TXInternational and American Association of Clinical Nutritionists International and American Association of Clinical Nutritionists (IAACN)(IAACN)

- Approx. 300 in TX- Approx. 300 in TX

THFC Coalition Composition THFC Coalition Composition (Cont’d)(Cont’d)

National Health Freedom Coalition/Action (Minneapolis, MN)National Health Freedom Coalition/Action (Minneapolis, MN)Organic Consumers’ Association of Texas Organic Consumers’ Association of Texas

- Approx. 15,700 in TX- Approx. 15,700 in TXNatural Products Association, Southwest Region (formerly NNFA)Natural Products Association, Southwest Region (formerly NNFA)

- Approx. 2,500 health food stores and over 21,000 total retailers- Approx. 2,500 health food stores and over 21,000 total retailersNature’s Sunshine TX Distributors Nature’s Sunshine TX Distributors

- Approx. 16,900 in TX- Approx. 16,900 in TXStandard Process Corp.Standard Process Corp.

- Several hundred health professionals- Several hundred health professionalsSunshine Health Freedom FoundationSunshine Health Freedom Foundation

- 501 (c)(3) for Nature’s Sunshine- 501 (c)(3) for Nature’s SunshineTexas Health Freedom Steering CommitteeTexas Health Freedom Steering Committee

- Several dozen members; 501(c)(4) and trustee for Coalition- Several dozen members; 501(c)(4) and trustee for CoalitionTexans for Medical FreedomTexans for Medical FreedomTrinity College of Natural Health (NDs, CNCs, MHs)Trinity College of Natural Health (NDs, CNCs, MHs)World Organization of Natural Medicine PractitionersWorld Organization of Natural Medicine Practitioners

Challenges Presented by the Challenges Presented by the Current System - CostsCurrent System - Costs

Health care spending is the Health care spending is the single greatest threat to single greatest threat to our nation’s long term economic well beingour nation’s long term economic well being - - Government Accountability Office (GAO), US Government Accountability Office (GAO), US Comptroller General Comptroller General

Medical bills are now the leading cause of personal Medical bills are now the leading cause of personal bankruptcy in the USbankruptcy in the US - Harvard University study

A couple retiring this year will need aboutA couple retiring this year will need about $225,000 in $225,000 in savings to cover medical costs in retirementsavings to cover medical costs in retirement – – Fidelity Investments study

Challenges Presented by the Challenges Presented by the Current System - OutcomesCurrent System - Outcomes

"Increasingly, "Increasingly, there is clear evidence thatthere is clear evidence that the major chronic conditions the major chronic conditions that account for so much of the morbidity and mortality in the United that account for so much of the morbidity and mortality in the United States, States, and the enormous direct and indirect costs associated with and the enormous direct and indirect costs associated with them, in large part are preventable - and that to a considerable degree them, in large part are preventable - and that to a considerable degree theythey stem from, and are exacerbated by, individual behaviors stem from, and are exacerbated by, individual behaviors ... As ... As Americans see healthcare expenditures continue to increase, Americans see healthcare expenditures continue to increase, it is it is important to focus on strategies that reduce the prevalence and cost important to focus on strategies that reduce the prevalence and cost of preventable diseaseof preventable disease." - U.S. Dept. of Health and Human Services - ." - U.S. Dept. of Health and Human Services - Prevention Makes Common CentsPrevention Makes Common Cents

““We're not focusing on keeping people healthy - we're focusing on getting people well when they show up at the hospitals. . . We're going to have to change how we practice medicine. I'm totally convinced that our model is unsustainable. . . I want to look at a transformational solution to get us into the end zone. . . We don't have health care in America. We have sick care.” – TX Lt Gov David Dewhurst, Austin American-Statesman, Jan. 23, 2009

Complementary and Alternative Complementary and Alternative Health Care in the USHealth Care in the US

Complementary and alternative health care is the Complementary and alternative health care is the fastest growing segment of the health care industry fastest growing segment of the health care industry ((Trends in Alternative Medicine Use in the United Trends in Alternative Medicine Use in the United States, 1990-1997, States, 1990-1997, JAMA, November 11, 1998—Vol. JAMA, November 11, 1998—Vol. 280, No. 18).280, No. 18).

Over 83 million Americans spend over $34 billion on Over 83 million Americans spend over $34 billion on CAM annuallyCAM annually ( (Costs of Complementary and Alternative Costs of Complementary and Alternative Medicine (CAM) and Frequency of Visits to CAM Medicine (CAM) and Frequency of Visits to CAM Practitioners: United States, 2007, Practitioners: United States, 2007, National Health National Health Statistics Reports, No. 18, July 30,2009)Statistics Reports, No. 18, July 30,2009)

The number of visits to complementary and alternative The number of visits to complementary and alternative health care practitioners in 2008 exceeded 354 millionhealth care practitioners in 2008 exceeded 354 million (Ibid.)(Ibid.)

How Texas BenefitsHow Texas Benefits

Effect of Selected Dietary Supplements on Health Care Reduction – Study Update (Lewin (Lewin Group, June 5, 2007)Group, June 5, 2007)

Congressional Budget Office cost accounting methodology to determine the economic impact on Medicare and others that could result from daily supplement use.

Four supplement/disease combinations were examined and earlier estimates of cost effects were updated

How Texas BenefitsHow Texas Benefits

Selected because the rigor and validity of the available scientific literature met critical evidentiary thresholds.

The supplements are: Calcium with Vitamin D; Folic Acid; Omega-3 Fatty Acids; Lutein with Zeaxanthin

Widespread use of just four supplements saves $24 Widespread use of just four supplements saves $24 billion over five years nationallybillion over five years nationally

$1.87 billion savings for Texas over 5 years (est.)$1.87 billion savings for Texas over 5 years (est.)

How Texas BenefitsHow Texas Benefits

A recent pilot study, conducted by a major state level health care insurance carrier, employed complementary and alternative practitioners (chiropractors) as primary care providers for a large test group.

Medical insurance claims from the group dropped by 50% over two years, and in excess of 70% over the remainder of the study. (Clinical Utilization and Cost Outcomes From an Integrative Medicine Independent Physician Association: An Additional 3-Year Update, Journal of Manipulative and Physiological Therapeutics, May 2007, pgs. 263-269.)

How Texas BenefitsHow Texas Benefits“Clinical and cost utilization based on 70,274 member-months over a 7-year period demonstrated decreases of:

- 60.2% in-hospital admissions - 59.0% hospital days - 62.0% outpatient surgeries and procedures - 85% pharmaceutical costs

When compared with conventional medicine IPA performance for the same health maintenance organization product in the same geography and time frame” (Ibid.)(Ibid.)

Apply these reductions to the >$53 billion TX health care budget. Cost savings?

A “Safe Harbor” BillA “Safe Harbor” BillProvides an exemption under certain circumstances from charges of being Provides an exemption under certain circumstances from charges of being in violation of a professional practice act for “unlicensed practice”. in violation of a professional practice act for “unlicensed practice”.

    The broad definitions of the occupations make many unlicensed persons The broad definitions of the occupations make many unlicensed persons vulnerable to being charged with unlicensed practice even when the vulnerable to being charged with unlicensed practice even when the practitioner is not causing any harm to the public or using protected titles. practitioner is not causing any harm to the public or using protected titles.

Most practice acts create an exemption list, and it lists persons, based on Most practice acts create an exemption list, and it lists persons, based on public policy, that can be exempt from violations of unlicensed practice. public policy, that can be exempt from violations of unlicensed practice.

The bill adds a new exemption to existing professional practice acts for The bill adds a new exemption to existing professional practice acts for practitioners who practice within certain parameters listed in the safe harbor. practitioners who practice within certain parameters listed in the safe harbor.

Why does the state of Texas Why does the state of Texas need this bill?need this bill?

The Texas Medical Practice Act defines the practice The Texas Medical Practice Act defines the practice of medicine so broadly that it includes everything of medicine so broadly that it includes everything CAM practitioners do.CAM practitioners do.

Examples of Texas CAM practitioners/practitioners Examples of Texas CAM practitioners/practitioners in other states who have been harmed or are at risk in other states who have been harmed or are at risk without this type of legislationwithout this type of legislation..

Under current conditions, selective prosecution of Under current conditions, selective prosecution of CAM practitioners causes general suppression of CAM practitioners causes general suppression of CAM practices.CAM practices.

How is the safety of the public How is the safety of the public protected?protected?

It uses existing law to punish bad actors; the enforcement It uses existing law to punish bad actors; the enforcement mechanism is the full range of existing legal penalties/remedies. mechanism is the full range of existing legal penalties/remedies.

A standard of care is not required because, as our safety data A standard of care is not required because, as our safety data demonstrates, there is no evidence of injury.demonstrates, there is no evidence of injury.

It provides consumer protections via informed consent. By It provides consumer protections via informed consent. By educating the consumer, it gives them a wider range of health care educating the consumer, it gives them a wider range of health care choices. choices.

There are an estimated 1,200 different CAM modalities in the US There are an estimated 1,200 different CAM modalities in the US and hundreds in the State of Texas. Dr. Lakey of the Department of and hundreds in the State of Texas. Dr. Lakey of the Department of State Health Services has already been quoted as saying “individual State Health Services has already been quoted as saying “individual licensure is cost prohibitive.” licensure is cost prohibitive.”

What happens if Texas doesn’t What happens if Texas doesn’t pass this bill?pass this bill?

The current lack of specificity regarding what CAM practitioners can The current lack of specificity regarding what CAM practitioners can and can’t do, and its associated risk to the public, will continue.and can’t do, and its associated risk to the public, will continue.

CAM practitioners will continue to be in jeopardy.CAM practitioners will continue to be in jeopardy.

The state of Texas will not receive the full benefit of health care cost The state of Texas will not receive the full benefit of health care cost savings and wider public access that CAM increasingly savings and wider public access that CAM increasingly demonstrates is available.demonstrates is available.

By narrowing healthcare to 1 or 2 professions we limit the public By narrowing healthcare to 1 or 2 professions we limit the public access to solutions to their health problems as well as stifle the access to solutions to their health problems as well as stifle the collection of knowledge that may provide safe, effective, health care collection of knowledge that may provide safe, effective, health care solutions.solutions.

Call to ActionCall to Action

Author/Co-author Bill in Senate/HouseAuthor/Co-author Bill in Senate/House

Support our positions on other billsSupport our positions on other bills

Sign up for Texas Health Freedom Yahoo group Sign up for Texas Health Freedom Yahoo group to stay abreast of Coalition activities:to stay abreast of Coalition activities:

groupsgroups.yahoo.com.yahoo.com/group/texashealthfreedom/group/texashealthfreedom

Texas Health Freedom CoalitionTexas Health Freedom Coalition

Next Luncheon, Thursday, April 8Next Luncheon, Thursday, April 8thth, Austin Club, Austin ClubE-mail: E-mail: texascam@earthlink.nettexascam@earthlink.netURL: URL: www.texashealthfreedom.comwww.texashealthfreedom.comPhone: 210-372-0557Phone: 210-372-0557Mailing address: POB 1318, Helotes, TX 78023Mailing address: POB 1318, Helotes, TX 78023

What does this bill accomplish?What does this bill accomplish?

It creates a functional definition for complementary and alternative It creates a functional definition for complementary and alternative health care services.health care services.

It creates a bright line distinction as to what a CAM practitioner can It creates a bright line distinction as to what a CAM practitioner can and cannot do, bringing a clearer definition to what constitutes the and cannot do, bringing a clearer definition to what constitutes the practice of medicine and what does not.practice of medicine and what does not.

It codifies what exists now, and creates an institutional recognition It codifies what exists now, and creates an institutional recognition of this health care model.of this health care model.

It creates a “safe harbor” for CAM practitioners, which will allow the It creates a “safe harbor” for CAM practitioners, which will allow the citizens of Texas to have access to CAM without practitioner fear of citizens of Texas to have access to CAM without practitioner fear of being prosecuted or suppressed.being prosecuted or suppressed.

What does this bill accomplish?What does this bill accomplish?

It is self enforcing. If a practitioner complies with the disclosure and It is self enforcing. If a practitioner complies with the disclosure and prohibition requirements, they will be protected from prosecution for prohibition requirements, they will be protected from prosecution for practicing medicine.practicing medicine.

It requires the practitioner to put the required disclosures in writing.It requires the practitioner to put the required disclosures in writing.

NO NEW TORTS ARE CREATED. NO NEW TORTS ARE CREATED.

It spells out the rights of a consumer when seeing a CAM It spells out the rights of a consumer when seeing a CAM practitioner.practitioner.

It creates a rebuttable presumption to the practice of medicine.It creates a rebuttable presumption to the practice of medicine.

Safety DataSafety Data

(OMNS, January 19, 2010) Zero deaths caused by a dietary (OMNS, January 19, 2010) Zero deaths caused by a dietary supplement in 2008 - U.S. National Poison Data System.supplement in 2008 - U.S. National Poison Data System.

Zero deaths from multiple vitamins; zero deaths from any of the B Zero deaths from multiple vitamins; zero deaths from any of the B vitamins; zero deaths from vitamins A, C, D, or E; and zero deaths vitamins; zero deaths from vitamins A, C, D, or E; and zero deaths from any other vitamin.from any other vitamin.

No deaths whatsoever from any amino acid or herbal product. No deaths whatsoever from any amino acid or herbal product.

Zero deaths in 2008 from any dietary mineral supplement. Zero deaths in 2008 from any dietary mineral supplement.

No man, woman or child died from nutritional supplements. Period.No man, woman or child died from nutritional supplements. Period.

Safety DataSafety Data

604 "adverse-event" reports — a list that 604 "adverse-event" reports — a list that includes at least five deaths — through the first includes at least five deaths — through the first six months that such accounts have been six months that such accounts have been required by law. required by law.

- Office of Nutritional Products, Labeling and - Office of Nutritional Products, Labeling and Dietary Supplements, FDA Center for Food Dietary Supplements, FDA Center for Food Safety and Applied Nutrition (USA Today, Safety and Applied Nutrition (USA Today, 9/22/08) 9/22/08)

"Some of these deaths were likely due to "Some of these deaths were likely due to underlying medical conditions." underlying medical conditions."

- FDA spokesman Michael Herndon - FDA spokesman Michael Herndon

Safety DataSafety Data

Safety DataSafety Data