Thursday, May 24, 2012

Vermont Bill S.209 - Introduction

On April 11, 2012 the Vermont House Health Care Committed held a hearing on Bill S.209, which would “require health insurers to include naturopathic physicians as primary care providers, include naturopathic physicians as medical homes under the Blueprint for Health, specify that naturopathic physicians may practice independently and without supervision, and allow naturopathic physicians to apply for loans and grants from the state’s health information technology fund to enable them to purchase electronic health record programs.”

The primary purpose of the bill was to make sure that NDs would be included along with MDs and DOs who can practice independently as primary care physicians and be reimbursed for their services. 

Because of another bill that would have eliminated the philosophical exemption as a reason for letting parents opt out of vaccinating their children while still permitting them to attend school the legislators, and especially those on this committee, had been extremely busy. That bill brought out strong emotions pro and con with many people speaking out and lobbying for and against its passage making the 2012 legislative session pretty hectic for all while Bill S.209 and H.524 went unnoticed. I myself only stumbled upon them accidentally when it was already late in the game. 

These were the 2012 committee members on the House Health Care Committee considering Bill S.209:

Rep. Michael Fisher, Chair
Rep. Sarah Copeland-Hanzas, Vice Chair
Rep. Paul N. Poirier, Ranking Member
Rep. Leigh Dakin, Clerk
Rep. Jim Eckhardt
Rep. Patti Komline
Rep. Mary A. Morrissey
Rep. Christopher Pearson
Rep. Kristy Spengler
Rep. George W. Till
Rep. Mark Woodward

I submitted the following written testimony to the committee:

Testimony Before Vermont House Health Committee on Bill S.209
April 11, 2012
Rosemary Jacobs
Derby, VT 05829

I oppose Bill S.209.
I believe that naturopaths, NDs, acting as primary care physicians pose an unreasonable risk to Vermonters, offer substandard care and greatly increase health care costs for everyone, even those who do not make use of their services.
Unreasonable Risk - Substandard Care
NDs have a state sanctioned formulary Physician Formulary 20091211.pdf that includes “silver” for IV use (p.5) and “colloidal silver” for use in the eyes (p.1). When I told them of the danger and illegality of this, they ignored me.
When I asked the source of their IV drugs and colloidal silver, they refused to tell me which makes me believe that they have illegally been using “dietary supplements” as drugs.
Until I spoke with the Director of the Office of Professional Regulation and the Health Commissioner who I was only able to reach through the efforts of Rep. Michael Marcotte who serves with me on the Board of Directors of the Orleans/Essex VNA, I don’t think that the NDs or their regulators knew that the FDA had posted a rule in the Federal Register in 1999 stating that silver cannot be used as a drug because there is no evidence that it offers any benefits and that there is a lot of evidence that it causes harm.  (Click on PDF)
Silver can discolor the skin. The condition is called argyria. I have had argyria for over 50 years.
Silver was used by desperate doctors and patients before the advent of antibiotics. It didn’t work and caused many cases of argyria. While there are many uses for silver in medicine, including approved topical drugs, medical doctors who practice evidence-based medicine have not used silver internally for over 50 years.
I think that NDs either didn’t know or didn’t care that while it is legal to sell silver as a “dietary supplement” which is often called “colloidal silver” or “CS”, that it is illegal to make drug claims for supplements and that supplements have to be taken by mouth, not put in the eye or administered IV.
“Dietary supplements” are legally classified as “food” under present law and unlike drugs their safety and efficacy is not evaluated by the FDA or anyone else before they are sold.
While legally anyone who follows good manufacturing practices can make a supplement, I think the NDs either didn’t know or didn’t care that only a licensed drug manufacturer or compounding pharmacist can manufacture a drug and that even they are limited as to which substances they can use and which drugs they can make.
Until I brought it up, I don’t think that NDs realized the reasons why, unlike with supplements, only authorized people can manufacture drugs, or the necessity for IV drugs to be sterile. Here is a tragic example of the danger of injecting a unsterile substance into a person - a Canadian ND charged with manslaughter after her patient died subsequent to her injecting him with a contaminated substance.
According to the article, the substance was magnesium, one of the “minerals” listed on p. 5 along with silver in the VT ND formulary that VT NDs may use intravenously.
As specific dietary supplements have become popular, scientists have started to study them. They are finding that many, even those which initially had looked promising and were previously assumed to be safe, may in fact be harmful.                                                                
My greatest fear is that there is something totally useless out there that is as lethal as cigarettes and that by the time that is discovered it will be too late to save many from premature deaths.
Useless Therapies
NDs have traditionally called themselves “drugless healers” who avoided pharmaceuticals using and promoting “natural remedies” instead. In 1994 with the passage of the Dietary Supplement Health and Education Act, DSHEA, pronounced duh shay, natural remedies were classified as “dietary supplements”. NDs, even those in states which have recently granted them prescription privileges, still make extensive use of supplements, products which are not evaluated for safety or efficacy before they are sold. Yet most if not all NDs believe in, promote and sell supplements directly to the patients they treat in spite of the fact that there is no objective, much less scientific, evidence of their value.
Naturopaths believe in, study and use classical homeopathy, the biggest scam to ever come down the pike.
Classical homeopathic products are almost always devoid of active ingredients. They are just inert substances like sugar and water which NDs believe have healing powers.
The James Randi Foundation offered a $1 million prize quite some time ago to anyone who could demonstrate that a homeopathic remedy works. No one has won it yet. He repeats the offer here where he also shows how pharmacies are using a belief-based system of medicine espoused and promoted by NDs to rip off customers and rob them of their health care dollars:
A Philosophy-Based System of Medicine
NDs also practice anthroposophical medicine, Physician Formulary 20091211.pdf  p.4 The only listing for that on the NCCAM, National Center for Complementary and Alternative Medicine, site simple states that a MD on their staff studied the modality in Germany. This is what wiki says about that obscure practice NDs call “medicine”,
Utter nonsense
IV Tin for baldness, a treatment that would be so easy to test especially on some of the bald NDs I’ve seen:
Scroll down to # 12

The Warming Sock Treatment from a VT licensed ND who practices in VT & MA, where NDs are not licensed. VT residents can be reimbursed for some of her services by insurance, but not MA residents:                             

Unnecessary Costs
When NDs, their treatments and the products they promote harm people, the cures or attempted cures can be costly. Most people who have gotten argyria recently from sliver supplements are being treated with laser therapy by dermatologists. Both the patients and doctors have so far been very pleased with the results. The cost of treating an entire face is about $7,000, but no one is satisfied with just a face. They move on to ears, throats, hands, etc. The estimated cost of treating an entire body is $100,000. The treatment isn’t permanent and has to be repeated and no one knows if there will be side effects later on. Insurance has been picking up the tab and I can’t believe that the insurance companies aren’t passing the costs on to all their customers. Actually, I don’t know how they could stay in business if they didn’t.
Preventive Medicine
Without presenting any evidence to substantiate the claim, NDs say that they save us all money by keeping patients well and preventing disease. They say that they get their patients to eat healthy diets and follow healthy lifestyles often erroneously stating that no one else, especially MDs, addresses those things or succeeds like they do.
If NDs have found techniques that get the majority of people to eat balanced diets, maintain a normal weight, refrain from smoking and excessive alcohol and to exercise in moderation, they should share it with the rest of us. However, I suspect that they haven’t found any such techniques. If in fact it is true that their patients follow healthier lifestyles than the majority of the population, I suspect that is because the people presently attracted to NDs are obsessed with health and would do the same without ever speaking to an ND.
NDs practice a belief-based system of medicine that holds that nature and natural products heal even when, as with silver, there is overwhelming evidence showing that the opposite is true. NDs use dangerous and useless therapies that didn’t work for our grandparents and were for that reason discarded by those who practice scientific or evidence-based medicine decades ago.
While I believe that people who want to should be able to use their services as they can now, I don’t believe that third party payers should be forced to pick up the tab. Forcing them to will waste health care money and erroneously give the general public, the ones who are not true believers in alternative medicine, the impression that NDs are the same as MDs and that their drugs and therapies are supported by objective evidence of safety and efficacy when that isn’t true.
While I believe that adults should be able to do whatever they want as long as they don’t hurt anyone else, even ingest silver, I don’t believe they should be able to force anyone else to pay if they decide to use remedies or therapies for which there is no good evidence of safety and efficacy or to force others to pay for cures if they injure themselves with such things.
I also believe that naturopaths should be honest with themselves and everyone else and admit that their system of medicine is a belief-based one, not an evidence-based one, so that people can make informed decisions about whether or not they want to use their services.
naturopaths, vermont, Blueprint for Health, Michael Fisher, Sarah Copeland-Hanzas, Paul N. Poirier, Leigh Dakin, Jim Eckhardt, Patti Komline, Mary A. Morrissey, Christopher Pearson, Kristy Spengler, George W. Till, Mark Woodward, Vermont House Health Care Committee

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