Texas Health Freedom Coalition Update for Texas Legislators

1. Texas Health Freedom Coalition Update for Texas Legislators March, 2010 Prepared by Texas Health Freedom Coalition www.texashealthfreedom.com

2. Overview • Coalition Composition • Challenges Presented By the Current System • Use of complementary and alternative health care (CAM) in the US • How Texas benefits by facilitating wider citizen access to CAM • A potential solution • Call to Action

3. TX Health Freedom Coalition Composition • Total of approx. 50,000 people now directly represented in the Coalition • Network reach of over half a million - Measured by e-mail, phone, fax and letter totals to legislature in 2005/2007/2009 sessions • Lobbyist James Jonas of Holland and Knight joined our Coalition in March 2007

4. THFC Coalition Composition (Cont’d) • Academy of Oriental Medicine in Austin (AOMA) Alumni Association - Several hundred members • Certified Natural Health Professionals (CNHP) - Approx. 5,000 in TX • Certified Nutritionists (CN) - Approx. 350 in TX • Citizens’ Commission on Human Rights (CCHR) Texas • Coalition for Natural Health (CNH, Washington, DC) - Approx. 1,700 in TX • HealthKeepers Alliance • Juice Plus Independent Distributors of Texas - Approx. 400 in TX • International and American Association of Clinical Nutritionists (IAACN) - Approx. 300 in TX

5. THFC Coalition Composition (Cont’d) • National Health Freedom Coalition/Action (Minneapolis, MN) • Organic Consumers’ Association of Texas - Approx. 15,700 in TX • Natural Products Association, Southwest Region (formerly NNFA) - Approx. 2,500 health food stores and over 21,000 total retailers • Nature’s Sunshine TX Distributors - Approx. 16,900 in TX • Standard Process Corp. - Several hundred health professionals • Sunshine Health Freedom Foundation - 501 (c)(3) for Nature’s Sunshine • Texas Health Freedom Steering Committee - Several dozen members; 501(c)(4) and trustee for Coalition • Texans for Medical Freedom • Trinity College of Natural Health (NDs, CNCs, MHs) • World Organization of Natural Medicine Practitioners

6. Challenges Presented by the Current System - Costs • Health care spending is the single greatest threat to our nation’s long term economic well being - Government Accountability Office (GAO), US Comptroller General • Medical bills are now the leading cause of personal bankruptcy in the US- Harvard University study • A couple retiring this year will need about$225,000 in savings to cover medical costs in retirement – Fidelity Investments study

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

8. Complementary and Alternative Health Care in the US • Complementary and alternative health care is the fastest growing segment of the health care industry (Trends in Alternative Medicine Use in the United States, 1990-1997, JAMA, November 11, 1998—Vol. 280, No. 18). • Over 83 million Americans spend over $34 billion on CAM annually (Costs of Complementary and Alternative Medicine (CAM) and Frequency of Visits to CAM Practitioners: United States, 2007, National Health Statistics Reports, No. 18, July 30,2009) • The number of visits to complementary and alternative health care practitioners in 2008 exceeded 354 million(Ibid.)

9. How Texas Benefits • Effect of Selected Dietary Supplements on Health Care Reduction – Study Update (Lewin 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

10. How 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 billion over five years nationally • $1.87 billion savings for Texas over 5 years (est.)

11. How 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.)

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

13. A “Safe Harbor” Bill • Provides an exemption under certain circumstances from charges of being in violation of a professional practice act for “unlicensed practice”. • The broad definitions of the occupations make many unlicensed persons vulnerable to being charged with unlicensed practice even when the 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 public policy, that can be exempt from violations of unlicensed practice. • The bill adds a new exemption to existing professional practice acts for practitioners who practice within certain parameters listed in the safe harbor.

14. Why does the state of Texas need this bill? • The Texas Medical Practice Act defines the practice of medicine so broadly that it includes everything CAM practitioners do. • Examples of Texas CAM practitioners/practitioners in other states who have been harmed or are at risk without this type of legislation. • Under current conditions, selective prosecution of CAM practitioners causes general suppression of CAM practices.

15. How is the safety of the public protected? • It uses existing law to punish bad actors; the enforcement mechanism is the full range of existing legal penalties/remedies. • A standard of care is not required because, as our safety data demonstrates, there is no evidence of injury. • It provides consumer protections via informed consent. By educating the consumer, it gives them a wider range of health care choices. • 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 State Health Services has already been quoted as saying “individual licensure is cost prohibitive.”

16. What happens if Texas doesn’t pass this bill? • The current lack of specificity regarding what CAM practitioners can and can’t do, and its associated risk to the public, will continue. • CAM practitioners will continue to be in jeopardy. • The state of Texas will not receive the full benefit of health care cost savings and wider public access that CAM increasingly demonstrates is available. • By narrowing healthcare to 1 or 2 professions we limit the public access to solutions to their health problems as well as stifle the collection of knowledge that may provide safe, effective, health care solutions.

17. Call to Action • Author/Co-author Bill in Senate/House • Support our positions on other bills • Sign up for Texas Health Freedom Yahoo group to stay abreast of Coalition activities: groups.yahoo.com/group/texashealthfreedom

18. Texas Health Freedom Coalition • Next Luncheon, Thursday, April 8th, Austin Club • E-mail: texascam@earthlink.net • URL: www.texashealthfreedom.com • Phone: 210-372-0557 • Mailing address: POB 1318, Helotes, TX 78023

19. What does this bill accomplish? • It creates a functional definition for complementary and alternative health care services. • It creates a bright line distinction as to what a CAM practitioner can and cannot do, bringing a clearer definition to what constitutes the practice of medicine and what does not. • It codifies what exists now, and creates an institutional recognition of this health care model. • It creates a “safe harbor” for CAM practitioners, which will allow the citizens of Texas to have access to CAM without practitioner fear of being prosecuted or suppressed.

20. What does this bill accomplish? • It is self enforcing. If a practitioner complies with the disclosure and prohibition requirements, they will be protected from prosecution for practicing medicine. • It requires the practitioner to put the required disclosures in writing. • NO NEW TORTS ARE CREATED. • It spells out the rights of a consumer when seeing a CAM practitioner. • It creates a rebuttable presumption to the practice of medicine.

21. Safety Data • (OMNS, January 19, 2010) Zero deaths caused by a dietary supplement in 2008 - U.S. National Poison Data System. • 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 from any other vitamin. • No deaths whatsoever from any amino acid or herbal product. • Zero deaths in 2008 from any dietary mineral supplement. • No man, woman or child died from nutritional supplements. Period.

22. Safety Data • 604 "adverse-event" reports — a list that includes at least five deaths — through the first six months that such accounts have been required by law. - Office of Nutritional Products, Labeling and Dietary Supplements, FDA Center for Food Safety and Applied Nutrition (USA Today, 9/22/08) • "Some of these deaths were likely due to underlying medical conditions." - FDA spokesman Michael Herndon

23. Safety Data

24. Safety Data