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

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

Beware cataract surgical procedure price-gouging: Non-public fairness teams are scooping up eye care doctor practices nationwide as money-making alternatives develop in medical eye care. By @LaurenWeberHP #healthcare @FortuneMagazine by way of @khnews

— Catherine Arnst (@cathyarnst) September 19, 2022

— Catherine Arnst, New York Metropolis

Seeing Eye Look after What It Is

Thanks for telling the story of EyeCare Companions and others (Sufferers for Revenue: “Non-public Fairness Sees the Billions in Eye Care as Companies Goal Excessive-Revenue 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, docs themselves are ruining their career’s fame. Please proceed your tales to assist us get a minimum of halfway-decent care. I’ve no hope of it ever returning to excellent care.

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

— Hazel M. White, St. Louis

One more reminder that pure does not imply secure.

— Julie Doll (@JulieDoll_Ks) August 25, 2022

— 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 sturdy 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 Spouse Died After Taking Natural Treatment 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 be used as a meals ingredient. The 2 most complete and authoritative English language compendia of conventional Chinese language medication — “Chinese language Natural Medication” and “Chinese language Medical Herbology and Pharmacology” — don’t record any vital cautions or contraindications related to mulberry leaf use.

Most medical trials finding out white mulberry leaf report no opposed 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 opposed occasions between individuals receiving mulberry leaf and a placebo.

The scientific consensus on the protection of white mulberry leaf can be mirrored within the “Botanical Security Handbook,” maintained by the American Natural Merchandise Affiliation and topic to strict requirements of professional evaluation. The contributing consultants positioned white mulberry leaf within the reference’s most secure classification based mostly on an in depth evaluation of the scientific literature. This classification course of included a scientific literature evaluation 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 by which 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 opposed 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 acknowledged, “White mulberry isn’t poisonous.”

Whereas the loss of life certificates declares “an post-mortem with toxicology testing confirmed the reason for loss of life,” there is no such thing as 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 in the end 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 sturdy 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 instances of individuals “sickened by mulberry dietary supplements” have been reported to the FDA since 2004 and that “[a]t least a kind of instances led to hospitalization.” AHPA has reviewed the publicly obtainable data of those two instances and notes the next vital particulars omitted from the article:

  • A 77-year-old lady was hospitalized in July 2008 with circumstances described as together with diabetes mellitus, gallbladder dysfunction, hypotension, myocardial infarction, renal dysfunction, and thrombosis; whether or not these circumstances had been preexisting isn’t clear within the presently obtainable public file. This file 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 identified with hypoesthesia (numbness) and was hospitalized in December 2009.

AHPA has obtained these two opposed occasion stories by means of a Freedom of Info 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 explanation for Lori McClintock’s loss of life, the Sacramento County Coroner’s Workplace ought to significantly think about conducting further investigations and, as applicable, revising the loss of life certificates.

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

It’s attention-grabbing to me what number of authorities companies refuse to speak about any of this. All of them have insurance policies towards transparency and everybody simply accepts it. “Yep, that’s the way it needs to be.” It’s not the way it needs to be. A girl is lifeless.

— Montel Courvoisier III (@REvolt3d) August 26, 2022

— Keith Vance, Gaithersburg, Maryland

Solely in #America the place even doing the precise factor isn’t sufficient! 😡 That is improper and undoubtedly not #ProLife! #MedicareForAll #Universal #healthcare

— Lee Moss, FAANP, FAAN (@LeeMossNP) July 9, 2022

— 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 Incapacity Program Promised to Carry Folks From Poverty. As an alternative, It Left Many Homeless,” Sept. 16). I lived in homeless shelters in St. Louis and Cellular, Alabama, and there’s something you overlooked of your article: For those who stay in a homeless shelter, the Social Safety Administration could decrease your SSI profit much more as a result of they determine you’re not paying lease so that you’re not entitled to full advantages. It did that to me once I was in Cellular. It additionally occurred to a good friend of mine in St. Louis. The company diminished hers by $200. That’s precisely the time we want our whole advantages, so we will discover a place.

— Lauralee Wiltsie, Bay Minette, Alabama

Critically essential concern to homelessness. Most unhoused individuals are outdated aged or disabled. This security is damaged and Congress wants to repair it. Excessive rents outpace federal incapacity funds, leaving many homeless

— Dennis Culhane (@DennisCulhane) September 22, 2022

— Dennis Culhane, Philadelphia

Seniors in Want of a Lifeline

I’m a senior dwelling in reasonably priced housing and am so unhappy. Not simply because I can’t afford to care for my private wants the best way 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 Getting older: “‘It’s Changing into Too Costly to Dwell’: Anxious Older Adults Attempt to Cope With Restricted Budgets,” Sept. 7). Throughout the peak of the pandemic, individuals had been so form and I did have sufficient meals to eat. Now that issues are virtually again to regular, individuals have began performing imply once more. They simply don’t care about us seniors. Assist us.

— Barbara Little, Atlanta

A quote that ought to hang-out us all, “It’s changing into too costly to be alive…” On this new piece by ⁦@judith_graham⁩ w/ ⁦@KHNews⁩ the numbers simply don’t add up, illustrating why many older ladies stay one disaster away daily.

— Ramsey Alwin 🦞 (@Ramsey_Alwin) September 8, 2022

— Ramsey Alwin, Washington, D.C.

Solely One Aspect of the Story?

I listened to Dr. Elisabeth Rosenthal’s feedback on CBS Information this morning (Invoice of the Month: “Watch: Crashing Into Shock Ambulance Payments,” 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 turbines for a lot of native hearth departments.” Whereas that could be true in uncommon instances, most emergency medical companies which are nonprofit barely get by. Why? As a result of insurance coverage corporations don’t pay ambulances appropriately.

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

Let me put it one other approach: You personal a restaurant. You provide a dinner for 2 for $100. You invoice the individual’s dinner insurance coverage. It pays $40. It prices the restaurant $60 to place the meal collectively, together with employees 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 companies don’t be a part of insurance coverage corporations’ 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 approach: The hearth 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.

For those who’re going to deal with this story pretty, perhaps have all of the details about EMS — not only one aspect of it.

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

— Anthony Tucci, West Garden, Pennsylvania

The Ambulance Chased One Affected person Into Collections by way of @khnews Message: Strive to not get into accidents, assaults, shootings, and different body-damaging occasions!

— JonWallner (@JonWallner) July 27, 2022

— Jon Wallner, Montgomery County, Pennsylvania

This text was very one-sided. Nonprofit ambulance companies 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 corporations sticking the affected person with a larger duty for the price of emergency companies than earlier than the No Surprises Act and but the insurance coverage corporations themselves now reimburse at solely round 67%, after they used to pay almost 100% of claimed expenses.

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

— Jennifer Costello, Columbus, Ohio

Story illustrates 2 key issues: lack of ability of sufferers to get correct worth information earlier than procedures, and better prices paid by these with excessive deductible plans vs if no insurance

— Kathryn A Phillips PhD (@KathrynP_phd) September 6, 2022

— Kathryn A. Phillips, San Francisco

If It’s Damaged, Repair It

I’m a household follow doctor. Spinning off of your Invoice of the Month sequence, I believe it could 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 most of the mainstays on the Fortune 500 record are insurance coverage corporations. I believe individuals (i.e., voters) want to listen to extra about what well being care would appear like if Medicare and Medicaid had been the one payers. The damaged system exists, and other people must know work by means of 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

This story is about a normal medical process carried out at a hospital right here in SC.Had she paid in money, she would’ve owed ~$1400. As a result of she had insurance coverage, “negotiated” charges had her paying over $5,000 out of pocket. One thing’s significantly damaged right here.

— Invoice Kimler for SC State Home 13 🇺🇸 (@Kimler4SanitySC) September 2, 2022

— Invoice Kimler, Greenwood, South Carolina

An ‘Inherently Abusive and Ineffective’ Therapy for Autism

As a member of the autistic group (and a skilled journalist myself), I’m deeply disturbed by the current article “‘So Rudderless’: A Couple’s Quest for Autism Therapy 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 revealed on March 30. Each articles uncritically promote utilized conduct 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 fundamental journalistic requirements.

ABA is an inherently abusive and ineffective pseudoscience designed to not improve the lives of autistic individuals, however somewhat 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 Girls & Nonbinary Community being two outstanding examples). Additional, for the previous a number of years, the Division of Protection Workplace of Inspector Common 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 youngsters with electrical shocks and corporal punishment. Additionally they didn’t point out critics’ particular issues about presently 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 carried out by autistic researcher Henny Kupferstein, which discovered that autistic people uncovered to ABA had 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. Nonetheless, your reporters selected to not attain out to any outstanding critics of ABA for a quote or to quote any of their particular issues.

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 varied outstanding “charities,” like Autism Speaks, our group as an entire is absolutely able to stating our opinions and fascinating in self-determination.

I might recognize a response to this letter. Hopefully, you notice the seriousness of this matter and intend to publish a follow-up article inspecting ABA’s rampant abuses.

— Matthew Zeidman, New Hyde Park, New York

An anecdotal instance of the challenges encountered by mother and father/caregivers of youngsters with Autism Spectrum Dysfunction as they search efficient companies for his or her youngsters.

— CYSHCNetwork (@CyshcNetwork) August 15, 2022

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


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