Readers and Tweeters Take a Close Look at Eye Care and White Mulberry Leaf

Letters to the Editor is a periodic function. We welcome all comments and can publish a variety. We edit for size and readability and require full names.

— Catherine Arnst, New York Metropolis

Seeing Eye Look after What It Is

Thanks for telling the story of EyeCare Companions and others (Patients for Profit: “Private Equity Sees the Billions in Eye Care as Firms Target High-Profit Procedures,” Sept. 19). I went to EyeCare as soon as. All I’ll say is I’ll by no means return. I additionally went to a private-practice ophthalmologist. He ought to be ashamed of himself.

Sadly, medical doctors themselves are ruining their occupation’s fame. Please proceed your tales to assist us get not less than halfway-decent care. I’ve no hope of it ever returning to excellent care.

Your story brings out one old-time truth: Sufferers have to know that an excessively busy physician doesn’t essentially imply a “good” physician. Thanks once more.

— Hazel M. White, St. Louis

— Julie Doll, Backyard Metropolis, Kansas

American Natural Merchandise Affiliation Weighs In on White Mulberry Leaf

The article written by Samantha Younger on the premature loss of life of Lori McClintock, the spouse of California congressman Tom McClintock, used this tragic occasion to problem the strong regulation of dietary dietary supplements by the federal authorities, regardless of there being no info within the report displaying that Lori McClintock consumed white mulberry leaf as a dietary complement (“Congressman’s Wife Died After Taking Herbal Remedy Marketed for Diabetes and Weight Loss,” Aug. 24).

White mulberry leaf is generally administered for therapeutic use within the type of a tea or powdered extract, and the leaf can also be used as a meals ingredient. The 2 most complete and authoritative English language compendia of conventional Chinese language medication — “Chinese language Natural Drugs” and “Chinese language Medical Herbology and Pharmacology” — don’t listing any vital cautions or contraindications related to mulberry leaf use.

Most medical trials learning white mulberry leaf report no hostile occasions, though some placebo-controlled research have reported minor gastrointestinal points — akin to an upset abdomen. A pooled evaluation of those research discovered no statistically vital distinction in hostile occasions between contributors receiving mulberry leaf and a placebo.

The scientific consensus on the security of white mulberry leaf can also be mirrored within the “Botanical Security Handbook,” maintained by the American Herbal Products Association and topic to strict requirements of knowledgeable evaluate. The contributing consultants positioned white mulberry leaf within the reference’s most secure classification based mostly on an intensive evaluate of the scientific literature. This classification course of included a scientific literature evaluate masking acute, short-term, and sub-chronic toxicity research in addition to in vitro, human, and animal analysis. The reviewers additionally looked for, and didn’t establish, any case stories wherein white mulberry leaf produced a suspected drug or dietary complement interplay.

Lori McClintock’s loss of life certificates and the accompanying coroner’s report establish the reason for loss of life to be dehydration resulting from gastroenteritis resulting from hostile results of white mulberry leaf ingestion. The coroner’s report states that “a partial plant leaf” was current within the abdomen and that “parts of tablets and capsules [were not] discerned within the abdomen.” A College of California-Davis botanist recognized the fabric as white mulberry leaf and said, “White mulberry just isn’t poisonous.”

Whereas the loss of life certificates declares “an post-mortem with toxicology testing confirmed the reason for loss of life,” there isn’t a toxicology take a look at for white mulberry, and not one of the toxicology testing carried out for different unrelated medication or frequent toxins revealed something linking the loss of life to white mulberry.

The coroner’s report didn’t clarify whether or not or not there was proof of any particular product(s) the deceased might need been taking, and finally how a conclusion was drawn to implicate white mulberry. With out this info, it’s not doable to corroborate the coroner’s findings and conclusions.

Furthermore, almost half of the article is offered as a criticism of the strong federal regulation of dietary dietary supplements, claiming that “McClintock’s loss of life underscores the dangers of the huge, booming market of dietary dietary supplements and natural cures.” The article stories that two circumstances of individuals “sickened by mulberry dietary supplements” have been reported to the FDA since 2004 and that “[a]t least a type of circumstances led to hospitalization.” AHPA has reviewed the publicly out there information of those two circumstances and notes the next vital particulars omitted from the article:

  • A 77-year-old lady was hospitalized in July 2008 with situations described as together with diabetes mellitus, gallbladder dysfunction, hypotension, myocardial infarction, renal dysfunction, and thrombosis; whether or not these situations have been preexisting just isn’t clear within the at present out there public report. This report identifies 31 dietary dietary supplements (together with a mulberry leaf product) related to this case.
  • Within the different case, a 63-year-old lady was reported as taking 4 merchandise — goji berry; a mix of cinnamon extract, Gymnema sylvestre leaf, and mulberry leaf; a multivitamin; and fish oil. She was recognized with hypoesthesia (numbness) and was hospitalized in December 2009.

AHPA has obtained these two hostile occasion stories via a Freedom of Data Act request. The conclusion drawn by the KHN article that both of those stories represents a person who was “sickened by mulberry dietary supplements” is solely not substantiated by the FDA’s database.

On condition that consumption of white mulberry leaf was unlikely to have been a direct or oblique reason for Lori McClintock’s loss of life, the Sacramento County Coroner’s Workplace ought to critically take into account conducting extra investigations and, as acceptable, revising the loss of life certificates.

— Michael McGuffin, president, American Natural Merchandise Affiliation, Silver Spring, Maryland

— Keith Vance, Gaithersburg, Maryland

Two Methods to Reduce Medical Debt

Your latest article “Upended: How Medical Debt Changed Their Lives” (Aug. 18) was very highly effective and informative. Thanks very a lot on your efforts.

There are two reforms that may enormously relieve the monetary struggling of your topics:

1. We want a legislation stating that if a medical health insurance declare is denied, and if the affected person was not conscious this might occur, then the affected person just isn’t accountable for the costs. Medicare has had this rule for many years. With such a rule, the suppliers and insurers can struggle out their disputes and the affected person won’t be harmed.

2. Sufferers with giant medical money owed ought to have entry to a low-cost, federally funded chapter legal professional. A few of your topics appear to not have been conscious of the chapter possibility. Others made tragic errors like cashing in retirement accounts, when that’s pointless in chapter. Most hospitals are prepared to barter and cut back giant payments, if a halfway-aggressive legal professional or advisor approaches them on a well timed foundation. Your topics have been, sadly, remoted and unadvised.

Thanks once more on your work.

— Bob Hertz, St. Paul, Minnesota

— Lee Moss, Salt Lake Metropolis

Homelessness and Social ‘In’-Safety

I learn your story on the Supplemental Safety Revenue program and the lady within the homeless shelter (“A Disability Program Promised to Lift People From Poverty. Instead, It Left Many Homeless,” Sept. 16). I lived in homeless shelters in St. Louis and Cellular, Alabama, and there’s something you unnoticed of your article: In case you dwell in a homeless shelter, the Social Security Administration may lower your SSI benefit much more as a result of they determine you’re not paying hire so that you’re not entitled to full advantages. It did that to me after I was in Cellular. It additionally occurred to a good friend of mine in St. Louis. The company lowered hers by $200. That’s precisely the time we want our whole advantages, so we will discover a place.

— Lauralee Wiltsie, Bay Minette, Alabama

— Dennis Culhane, Philadelphia

Seniors in Want of a Lifeline

I’m a senior residing in inexpensive housing and am so unhappy. Not simply because I can’t afford to deal with my private wants the way in which I used to, however as a result of I really feel as if nobody cares about seniors anymore. I learn in one in all your tales it’s too costly to remain alive (Navigating Aging: “‘It’s Becoming Too Expensive to Live’: Anxious Older Adults Try to Cope With Limited Budgets,” Sept. 7). Throughout the top of the pandemic, individuals have been so form and I did have sufficient meals to eat. Now that issues are nearly again to regular, individuals have began performing imply once more. They only don’t care about us seniors. Assist us.

— Barbara Little, Atlanta

— Ramsey Alwin, Washington, D.C.

Solely One Facet of the Story?

I listened to Dr. Elisabeth Rosenthal’s feedback on CBS Information this morning (Bill of the Month: “Watch: Crashing Into Surprise Ambulance Bills,” Aug. 24).

First, her feedback about protection for floor ambulances being excluded from the federal No Surprises Act, which purportedly guards towards shock medical payments. She stated: “There’s some hypothesis that floor ambulances are income mills for a lot of native hearth departments.” Whereas which may be true in uncommon circumstances, most emergency medical providers which can be nonprofit barely get by. Why? As a result of insurance coverage firms don’t pay ambulances accurately.

Have a coronary heart assault and EMS may invoice you $1,100. Insurance coverage firms pay $400. Medicare pays round $300 for a similar name. Medicaid pays $200 for a similar name.

Let me put it one other method: You personal a restaurant. You provide a dinner for 2 for $100. You invoice the particular person’s dinner insurance coverage. It pays $40. It prices the restaurant $60 to place the meal collectively, together with workers pay and utilities. You simply misplaced $20 and made nothing to place again into the enterprise. How lengthy are you going to remain in enterprise?

Ambulance businesses don’t be a part of insurance coverage firms’ networks as a result of they’re provided a decrease pay price to be in-network — so why ought to we be a part of?

Let me put it one other method: The fireplace division is run by the municipality and the taxpayer pays for it. You pay roughly $600 per family in taxes for hearth safety annually. So over 10 years, many taxpayers have paid $6,000 for hearth safety they by no means used. However most municipalities don’t fund EMS.

In case you’re going to deal with this story pretty, possibly have all of the details about EMS — not only one facet of it.

And as for shock billing, you referred to as 911 to get a floor ambulance to come back. How is the invoice a shock?

— Anthony Tucci, West Garden, Pennsylvania

— Jon Wallner, Montgomery County, Pennsylvania

This text was very one-sided. Nonprofit ambulance providers are being lumped into this combine unfairly. As well as, some states have enacted their very own floor portion of the federal No Surprises Act. I’ve seen business insurance coverage firms sticking the affected person with a larger duty for the price of emergency providers than earlier than the No Surprises Act and but the insurance coverage firms themselves now reimburse at solely round 67%, once they used to pay almost 100% of claimed fees.

As well as, extra ambulance firms would be a part of business insurance coverage firms’ networks in the event that they acquired truthful, well timed reimbursement. There are such a lot of floor ambulance firms going out of enterprise resulting from insurance coverage firm video games, inappropriate denials, and lack of cost.

— Jennifer Costello, Columbus, Ohio

— Kathryn A. Phillips, San Francisco

If It’s Damaged, Repair It

I’m a household follow doctor. Spinning off of your Bill of the Month sequence, I believe it will be very helpful to publish extra tales on what well being care and prices appear like overseas. Hospitals and suppliers are merely functioning inside a damaged system. After all, prices are astronomical when lots of the mainstays on the Fortune 500 listing are insurance coverage firms. I believe individuals (i.e., voters) want to listen to extra about what well being care would appear like if Medicare and Medicaid have been the one payers. The damaged system exists, and folks have to know easy methods to work via that, however individuals additionally want to listen to that there are different equally efficient methods of delivering well being care.

— Dr. Justin Riederer, Asheville, North Carolina

— Invoice Kimler, Greenwood, South Carolina

An ‘Inherently Abusive and Ineffective’ Remedy for Autism

As a member of the autistic group (and a educated journalist myself), I’m deeply disturbed by the latest article “‘So Rudderless’: A Couple’s Quest for Autism Treatment for Their Son Hits Repeated Obstacles” (July 21), by Michelle Andrews.

This text seems to be a follow-up to an article written by Andy Miller and Jenny Gold and printed on March 30. Each articles uncritically promote utilized habits evaluation (ABA) and falsely painting households unable to entry ABA as victims of the pandemic and/or well being care paperwork.

You have to be conscious that each articles taint KHN’s fame as a dependable supply for medical/well being care information and data and don’t meet even primary journalistic requirements.

ABA is an inherently abusive and ineffective pseudoscience designed to not improve the lives of autistic individuals, however quite to power us to suppress our autistic traits and carry out neurotypical ones. Among the many critics are survivors of ABA (Julia Bascom of the Autistic Self Advocacy Community and Amy Sequenzia of the Autistic Ladies & Nonbinary Community being two distinguished examples). Additional, for the previous a number of years, the Division of Protection Workplace of Inspector Basic has discovered that ABA is basically ineffective, even by its personal requirements. None of this was talked about in both article.

Your articles additionally didn’t point out the origins of ABA, together with the truth that the follow was pioneered by O. Ivar Lovaas, the identical man who helped pioneer homosexual/trans conversion remedy and was notorious for “treating” autistic kids with electrical shocks and corporal punishment. In addition they didn’t point out critics’ particular considerations about at present practiced ABA, together with that it teaches autistic people that they haven’t any proper to say no and that, in the event that they do say no, they’ll be bodily and verbally bulldozed into compliance.

I additionally didn’t see any reference in your articles to the 2018 survey performed by autistic researcher Henny Kupferstein, which discovered that autistic people uncovered to ABA have been 86% extra more likely to exhibit signs in line with post-traumatic stress dysfunction.

The few factors I’ve talked about above barely scratch the floor concerning the controversy surrounding ABA. Nevertheless, your reporters selected to not attain out to any distinguished critics of ABA for a quote or to quote any of their particular considerations.

Additional, your reporters didn’t attain out to a single autistic supply, regardless of each articles being concerning the autistic group. Regardless of how the autistic group is infantilized and portrayed as incompetent by numerous distinguished “charities,” like Autism Speaks, our group as a complete is totally able to stating our opinions and interesting in self-determination.

I’d admire a response to this letter. Hopefully, you understand the seriousness of this matter and intend to publish a follow-up article analyzing ABA’s rampant abuses.

— Matthew Zeidman, New Hyde Park, New York

— The Kids and Youth With Particular Well being Care Wants Nationwide Analysis Community, Denver


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