Topic: HEALTH

(BLOOD) DONORS NEEDED

TYPE “O” BLOOD DONORS NEEDED

WASHINGTON (AFPS) - The Armed Services Blood Program needs eligible Type “O” blood donors to support ongoing military operations worldwide and to replenish the military's frozen blood reserves.

A single battlefield injury victim can require more than 40 units of blood in an emergency. Type “O” donors are especially important to readiness because their blood can be transfused safely for all blood types, especially in remote areas where it is not possible to test for blood type, said officials.

“Type “O” donors are the first line of defense for trauma victims. Until a blood type can be verified, Type “O” blood is used to keep trauma victims alive,” said Lt. Col. Ruth Sylvester, Armed Services Blood Program director. “Once their blood type is determined, type-specific blood is transfused. But without Type “O” blood available, many patients would never make it until the test results came back.”

The Armed Services Blood Program also needs Type “O” blood to maintain its frozen blood reserve. The military maintains a supply of frozen red blood cells to use when fresh blood is not immediately available. Since frozen blood can be safely stored for up to 10 years, it ensures that blood is always readily available to meet the military's needs worldwide, officials said.

Extending the shelf life of blood from 42 days (for liquid red cells) to 10 years in strategic locations enables the blood program to make frozen blood available until the supply of liquid blood begins to flow. But storage requirements and the need for special thawing equipment prevent frozen blood from being used everywhere.

The present need is more acute because military blood donor centers can only collect blood from active-duty service members, government employees, retirees and military family members. Many Operation Iraqi Freedom veterans are deferred from donating for one year because they served in areas where malaria is endemic. This makes regular donations from eligible donors critical, officials said.

“We're always thankful to our donors,” Sylvester said. “We know that blood donations save lives every day. Repeat donors and those who ask that we call them when their blood type is needed help ensure we have a consistent supply of all blood types. They're literally lifesavers when an urgent need arises.”

Blood program officials encourage potential donors or those who could sponsor a group blood drive to contact their local military blood collection facility.



(FIRST AID) OLD BOOZER'S REMEDIES

Along with a bit of skepticism, I send this (unproven by me) set of “old boozer’s tales” remedies - primarily because of its unusual approach to the healing arts.

If true, I wonder if other types of liquor might do likewise? Or, why not just get some pure alcohol in the first place? Is there a chemist in the house?

Anyhow, here it is for whatever it is worth:

  • To remove a bandage painlessly, saturate the bandage with vodka. The solvent dissolves adhesive.
  • To clean the caulking around bathtubs and showers, fill a trigger-spray bottle with vodka, spray the caulking, let set five minutes and wash clean. The alcohol in the vodka kills mold and mildew.
  • To clean your eyeglasses, simply wipe the lenses with a soft, clean cloth dampened with vodka. The alcohol in the vodka cleans the glass and kills germs.
  • Prolong the life of razors by filling a cup with vodka and letting your safety razor blade soak in the alcohol after shaving. The vodka disinfects the blade and prevents rusting.
  • Spray vodka on vomit stains, scrub with a brush, then blot dry.
  • Using a cotton ball, apply vodka to your face as an astringent to cleanse the skin and tighten pores.
  • Add a jigger of vodka to a 12-ounce bottle of shampoo. The alcohol cleanses the scalp, removes toxins from hair, and stimulates the growth of healthy hair.
  • Fill a sixteen-ounce trigger-spray bottle with vodka and spray bees or wasps to kill them. (How’s that for getting dead drunk!)
  • Pour one-half cup vodka and one-half cup water in a Ziploc freezer bag and freeze for a slushy, refreshable ice pack for aches, pain or black eyes.
  • Fill a clean, used mayonnaise jar with freshly packed lavender flowers, fill the jar with vodka, seal the lid tightly and set in the sun for three days. Strain liquid through a coffee filter, then apply the tincture to aches and pains.
  • To relieve a fever, use a washcloth to rub vodka on your chest and back as a liniment.
  • To cure foot odor, wash your feet with vodka.
  • Vodka will disinfect and alleviate a jellyfish sting.
  • Pour vodka over an area affected with poison ivy to remove the oil from your skin.
  • Swish a shot of vodka over an aching tooth. Allow your gums to absorb some of the alcohol to numb the pain.

BUT NEVER DRINK THE STUFF - IT'LL KILL YOU!!



(FIRST AID) TICK REMOVAL

Forwarded by Bill Thompson

A school nurse wrote the following item that will be good news to many:

I had a pediatrician tell me what she believes is the best way to remove a tick. This is great, because it works in those places where it's some times difficult to get to with tweezers: between toes, in the middle of a head full of dark hair, etc.

Apply a glob of liquid soap to a cotton ball. Cover the tick with the soap-soaked cotton ball and swab it for 15 to 20 seconds. It will be stuck to the cotton ball when you lift it away.

This technique has worked every time I've used it (and that was frequently) and it's much less traumatic for the patient and easier for me.

Unless someone is allergic to soap, I can't see that this would be damaging in any way. I even had my doctor's wife call me for advice because she had one stuck to her back and she couldn't reach it with tweezers.

She used this method and immediately called me back to say, “It worked!”



(FOOD) EAT BANANAS

Research shows why this common fruit might replace the apple for a new phrase: “A banana a day keeps the doctor away.”

This is why! [http://www.wnho.net/bananas.htm ]



(HEALTH) ADOLESCENT EATING HABITS

FAMILY MEALS CAN PLAY POSITIVE ROLE

According to an article published in the November 2004 issue of the Journal of Adolescent Health, findings from a recent study on adolescent eating habits suggest that family meals have the potential to play a role in the prevention of unhealthy weight control behaviors among youth.

Unhealthy weight control practices and other disordered eating patterns are prevalent among adolescents, and familial factors clearly contribute to the onset of disordered eating practices in adolescence. Questions remain about the identification of specific familial factors that can have an impact on adolescents and are potentially amenable to change via brief interventions.

The current study examines associations between family meal patterns and disordered eating practices among adolescent girls and boys. The study population included 4,746 ethnically diverse adolescents from urban and suburban school districts in the St. Paul/Minneapolis area of Minnesota. The mean age of the study population was 14.9 years. Data were collected in schools during the 1998-99 school year.

The authors found that:

For girls, after adjusting for Body Mass Index (BMI) and sociodemographic characteristics, more frequent family meals were protective against engaging in all forms of disordered eating (extreme and less extreme unhealthy weight control behaviors, binge eating with loss of control, and chronic dieting). A more structured family meal environment was protective against unhealthy weight-control behaviors and chronic dieting.

For girls, after also adjusting for family connectedness and weight-specific pressures within the home, more frequent family meals and high priority of family meals remained strongly associated with lower levels of unhealthy weight-control behaviors and chronic dieting. Increased structure of family meals was associated with lower levels of unhealthy weight-control behaviors. A positive atmosphere at meals was only protective against extreme unhealthy weight-control behaviors.

For boys, after adjusting for the same characteristics, more frequent family meals, high priority of family meals, and a positive atmosphere at family meals were protective against unhealthy weight-control behaviors but not against binge eating or chronic dieting.

The authors conclude that “health providers working with youth and their parents could take the time to discuss family meal patterns and explore realistic strategies for increasing family meal frequency and improving family meal environment.”

(Source: Neumark-Sztainer D, Wall M, Story M, et al. 2004. Are family meal patterns associated with disordered eating behaviors among adolescents? Journal of Adolescent Health 35(5):350-359)



(HEALTH) HOSPITAL CHART HUMOR

SAY WHAT?
Actual notes from Hospital charts, forwarded by Gary

The patient refused autopsy.

The patient has no previous history of suicides.

Patient has left white blood cells at another hospital.

She has no rigors or shaking chills, but her husband states she was very hot in bed last night.

Patient has chest pain if she lies on her left side for over a year.

On the second day the knee was better, and on the third day it disappeared.

The patient is tearful and crying constantly. She also appears to be depressed.

The patient has been depressed since she began seeing me in 1993.

Discharge status: Alive but without my permission.

Healthy appearing decrepit 69-year-old male, mentally alert but forgetful.

Patient had waffles for breakfast and anorexia for lunch.

She is numb from her toes down.

While in ER, she was examined, x-rated and sent home.

The skin was moist and dry.

Occasional, constant infrequent headaches.

Patient was alert and unresponsive.

She stated that she had been constipated for most of her life, until she got a divorce.

I saw your patient today, who is still under our car for physical therapy.

Skin: somewhat pale but present.

Patient has two teenage children, but no other abnormalities.



(HEALTH) HOW TO LIVE LONGER

A-B-Cs OF HEALTH, HAPPINESS, LONGEVITY
From Keeping Apace 1988

Allot time for rest and recreation
Beware of exposure to sun and cold
Commit to a balanced diet
Drink moderately, if at all
Eliminate use of nicotine and caffeine
Find an enjoyable regular exercise
Get adequate sleep
Have regular check-ups
Initiate new friendships
Judge not your fellow man
Keep involved with family
Lay off fat foods
Maintain a desirable weight
Never drive after drinking
Overlook (their) and eliminate (your) criticism
Practice accident prevention
Quietly refrain from giving advice
Renew old friendships
Stay actively involved
Talk with God
Use seat belts
Volunteer to help others
Work as long as you can
X-cuse your enemies
Yearn for and seek more knowledge
Zestfully enjoy life’s bounties



(HEALTH) MESSAGE FOR THE HEART

Forwarded by BGen Bob Clements, USAF (Ret.)

The American Heart Association says, “Oma-3 fatty acids benefit the heart of healthy people, and those at high risk of - or who have - cardiovascular disease. We recommend eating fish (particularly fatty fish) at least two times a week.

“Fish is a good source of protein and doesn't have the high saturated fat that fatty meat products do.”

Read the full story here [http://www.americanheart.org/presenter.jhtml?identifier=4632].



(HEALTH) OLD HOME REMEDIES REPRISED

From 1stAdmPAO

I can't vouch for the effectiveness of these but it's amazing how some old home remedies seem to work just as well as the expensive fancy bottled elixirsfor some folks.

Achy Muscles. Got achy muscles from a bout of the flu? Mix 1 Tablespoon of horseradish in 1/2 cup of olive oil. Let the mixture sit for 30 minutes, then apply it as a massage oil, for instant relief for aching muscles.

Arthritis Pain. Quaker Oats for fast pain relief. It's not just for breakfast anymore. Mix 2 cups of Quaker Oats and 1 cup of water in a bowl and warm in the microwave for 1 minute, cool slightly, and apply the mixture to your hands for soothing relief from arthritis pain. It's also great for facials and to soften hands.

Blisters. Cleaning and disinfecting the area of a broken blister is difficult sometimes. To disinfect a broken blister, dab on a few drops of Listerine… a powerful antiseptic.

Boils. We all know tomato paste is cooked to a boil… but used “FOR” a boil? Cover the boil with Hunt's tomato paste as a compress. The acids from the tomatoes soothe the pain and bring the boil to a head.

Bruises. White vinegar removes the blues, heals the bruise. Soak a cotton ball in white vinegar and apply it to the bruise for 1 hour. The vinegar reduces the blueness and speeds up the healing process.

Cat Hairballs. Cure for cat hairballs. To prevent troublesome hairballs, apply a dollop of Vaseline petroleum jelly to your cat's nose. The cat will lick off the jelly, lubricating any hair in its stomach so it can pass easily through the digestive system.

Doggy Odor. A rainy day cure for dog odor. Next time your dog comes in from the rain, simply wipe down the animal with Bounce or any dryer sheet, instantly making your dog smell springtime fresh.

Ear Ache. Everyone knows that two aspirin works great for a headache. But did you know that drinking two glasses of Gatorade can relieve earache pain almost immediately without the unpleasant side effects caused by traditional pain relievers?

Ear Mites. Eliminate pets' ear mites. All it takes is a few drops of Wesson corn oil in your cat or dog's ear. Massage it in and then clean with a cotton ball. Repeat daily for 3 days. The oil soothes the pet's skin, smothers the mites, and accelerates healing. Mineral oil or baby oil works well too).

Eyeglass Screws. Have you ever lost a screw from your glasses? It can be frustrating to say the least. But there's an easy way to avoid that. To prevent the screws in your glasses from loosening, apply a small drop of Maybelline Crystal Clear nail polish to the threads of the screws before tightening them.

Fleas. Kill fleas instantly. Dawn dishwashing liquid does the trick. Add a few drops to your dog's bath and shampoo the animal thoroughly. Rinse well to avoid skin irritations. Good-bye, fleas. Seems no other dishwashing liquid works this well.

Skin Blemishes. It's nice to be someone's Honey, but try HONEY as a remedy for skin blemishes. Yep, just cover the blemish with a dab of honey and place a Band-Aid over it. Honey kills the bacteria, keeps the skin sterile, and speeds healing. Works overnight.

Sore Throat. Just mix 1/4 cup of vinegar with 1/4 cup of honey and take 1 Tablespoon six times a day. The vinegar kills the bacteria.

Splinters. Everyone has gotten a smart splinter in their finger from time to time, and have a heck of a time trying to remove it. Just pour a drop of Elmer's Glue-all over the splinter, let dry, and peel the dried glue off the skin. The splinter sticks to the dried glue. No time to let glue dry? Try duct tape. It's strong, and will get the splinter out with one pull.

Stinging Insects. A nasty stinging insect is in the house, and I can't find the RAID! If menacing bees, wasps, hornets, or yellow jackets get in your home and you can't find the insecticide, try a spray of Formula 409. Insects drop to the ground instantly.

Stuffy Nose. Before you go to the drugstore for a high-priced inhaler filled with mysterious chemicals, try chewing on a couple of curiously strong Altoids peppermints. They'll clear up your stuffed nose.

Toenail Fungus. Listerine is a pretty strong mouthwash, but therapy for toenail fungus? Sure enough! Get rid of unsightly toenail fungus by soaking your toes in Listerine mouthwash. The powerful antiseptic leaves your toenails looking healthy again.

Urinary Infection. Cure urinary tract infections with Alka-Seltzer. Just dissolve two tablets in a glass of water and drink it at the onset of the symptoms. Alka-Seltzer begins eliminating urinary tract infections almost instantly even though the product has never been advertised for this use.

READER'S RESPONSE:

“Hello, I enjoyed reading the home remedies you have posted. I noticed one on boils, using tomatoe paste. Thought I'd share one for drawing boils; even splinters. I just used this remedy a couple weeks ago to draw a deep embedded locust thorn from my thigh.

“Cut a piece of bacon to fit over thorn or boil area. Tape down with med. tape or bandaid. I've also used saran wrap if I can actually wrap the spot to hold the bacon in place. It can work in a couple hours to over night, depending on how deep the draw it is working on. My thorn came up in less than an hour and a half. Sincerely, Nancy Williams.”



(HEALTH) SMOKE THAT CIGARETTE

The Rights of Many
From http://www.inkmusings.com [http://www.inkmusings.com]

Pro-smoking's bastion has a new crack. The Government of Ireland has decreed no smoking in workplaces and (gasp) that includes the almost 10,000 pubs that are a home away from home for many Irish. A pint and a cigarette will disappear from the sights to see touring the Emerald Isle (the first one has always been on my list, and the second one only as something to avoid if possible). No doubt pub owners will create outdoor terraces for smoking patrons, so totally avoiding smoke won't go away. You'll still have to run a fog gauntlet for the sweet reward of a smoke-free interior. But it's a step in the right direction. http://www.chron.com/cs/CDA/ssistory.mpl/world/2409640 [http://www.chron.com/cs/CDA/ssistory.mpl/world/2409640]

Does this portend good news from the rest of Europe? It appears so. Anti-smoking laws, already strong in the U.S., continue to gain footholds in areas formerly havens for smokers. Most regulations cite health reasons and the rising health-care cost a country endures treating its aging smokers, and there seems to be a groundswell of grass roots support for cleaner air wherever possible. http://www.greatreporter.com/modules.php?name=News&file=article&sid=215 [http://www.greatreporter.com/modules.php?name=News&file=article&sid=215]

I don't deny smokers their rights to smoke, just advocate isolation so they can all congregate in one place and enjoy the maximum benefit of that nasty habit. To be fair, we should be creating areas in restaurants for overeaters as well, so they can gorge amidst others who indulge in same fashion. And for that matter, let's isolate all the tables with screaming kids…or better yet, create adult-only restaurants. You have to admit that last one would increase the odds of a pleasant evening at your local bistro.

Rights issues are always touchy, since you can't enact legislation of any kind today that doesn't infringe on someone's rights. In a day and age when criminals often are accorded more “rights” than victims, it's little surprise that we have become a blind society in terms of true right and wrong. Last week's news included the airline pilot asking Christians aboard his flight to identify themselves and witness for Christ among the heathens. Whose rights were violated here and whose were protected? Who gave the Christians this sacrosanct right to proselytize? And did the non-Christians have equal time for their beliefs? http://www.newsmax.com/archives/articles/2004/2/9/160946.shtml [http://www.newsmax.com/archives/articles/2004/2/9/160946.shtml]

In a perfect world, everyone has rights and potential to enjoy them. Sorry, but this isn't a perfect world, and not likely to ever rise to that level. In our dog-eat-dog world (apologies to dogs for ignoring “their” rights) it's the loudest and richest that usual prevail. But occasionally, such as in this trend towards control of public smoking, common sense wins.



(HEALTH) THE COMEDY AND THE TRAGEDY

THE POLITICS OF AMERICAN HEALTHCARE
By Dr. Charles L. Armstrong, M.D., in Human Events posted April 28, 2005
Forwarded by BGen Robert Clements USAF (ret)

Within the past few years I have read repeatedly in the opinion sections of newspapers the call for the federal government to provide a “single payer” system for America's medical care. These proposals are classics of left-wing thinking - they work out beautifully in the heads of those doing the proposing.

The comedy occurs when they are subjected to the scrutiny of reality; the tragedy when they become reality.

Government involvement in medicine exacerbates rather than alleviates its ills. HMOs and the government are pre-paid systems that are the cause of the financial crisis facing health care (I mean in addition to the contribution of greedy lawyers and irrational juries).

A caller on a talk show recently commented: “The rest of the world has a one-payer government system, so why don't we?”
The answer: Because then we'll have the same quality of care of the rest of the world.

Socialized medical care is a disaster worldwide for patients who need attention now or tomorrow or by next week, especially if that attention entails a procedure or surgery.

I offer the perspective of a practitioner who has lived through the changes in the system. The cost of health care has increased alarmingly during the decades of my career because of third-party payer systems: HMOs and the government. Health care costs will increase and quality decrease with every increase in government involvement.

READ FULL STORY [http://www.humaneventsonline.com/article.php?id=7284 ]



(HEALTH) WEIGHT LOSS

My son Gary writes about various subjects on his Web site at http://www.inkmusings.com [http://www.inkmusings.com]. I thought you might enjoy this article he posted recently, that relates to most everyone in America - the land of the fast-food addicts:

THE DARK SIDE OF WEIGHT LOSS

Don't get me wrong: I'm thrilled to finally be losing the well-earned fat of the last 30+ years of my decadent American lifestyle. I did my part to fatten the coffers of various fast-food stockholders. But thanks to Atkins (modified, and I hate dropping names but nowadays saying “Atkins” provides a one-word explanation to how one's eating), I've shed 25 pounds and in the process found a new, smaller person inside.

The health benefits of weight loss (and bear in my mind I'm halfway to my target goal) are obvious and lots of problems are going away. But I won't bore my readers with such trivial details, and instead focus on what's really important: fashion.

Yes, the well-won thrills of a shrinking waistline are soon overshadowed by the dark side of weight loss: nothing to wear! I've lost enough weight that nothing in my closet fits, which presents some interesting problems: either I continue to wear these clothes, such as pants that need suspenders to stay up, or I go through and try on everything and toss what doesn't fit.

Since Cappy lovingly informed me that I would never need those sizes again, off they went to a local charity. After the purge, I was qualified to join a nudist colony, since I only had about one day's worth of clothes that fit. Since that wasn't an appealing option, Cappy and I bounced off for her favorite and my least-favorite pursuit: shopping. Like all guys, shopping is one level below trimming toenails on the list of things to do, but it was either shopping or Sunny Cheeks Colony. For those who don't know Cappy, she is the queen of high-style thrifting. No one I've ever known can work the miracles she can with a few hours, a few bucks, and a decent thrift shop.

So how well did we do? I got six shirts, six sweaters, three pants, and a braided leather belt…for $60. Yep, that's not a typo. And brands? Shirts were all Chaps, Hilfiger, Eddie Bauer, J. Crew… sweaters were Polo, Christian Dior, Monsieur, Banana Republic…and so forth. And the irony is that half of them still had store tags on them: translation, new. While this sounds good and it's easy to focus on the results, I should also confess that it took over five hours of trudging through a lot of dreck to find these…but it does show the possibilities.

And so I laughed in the face of the dark side and scoffed at my close call with becoming a nature buff in the buff. And yes, I'll continue to tempt fate and dance to the alluring shrieks of shrinking fat cells and continue on my path, even though I realize I'll have to go through this wardrobe process AGAIN in another 25 pounds. But by then I'll be at my target goal and can wear out my clothes the normal way instead of replacing them the hard way. And that means I won't have to go shopping; definitely a win-win situation.



(HEALTH) ON BEING AN OCTOGENARIAN

Regardless of your politics, you should read Papa Bush's article on being an octogenarian and how he is coping with it. We all get there (or hope to) sooner or later. Nobody escapes Father Time - rank and privilege notwithstanding!

LIFE IS GOOD, BUT YOU CAN’T BE 41 FOREVER
By George H. W. Bush
Forwarded by Charles Spicka, Oceanside CA

Age 80 — What's it like? Let me help you with that one. Maybe other old guys can learn something from this octogenarian. Maybe as they ache and repeat themselves and tilt when they walk and wonder how others cope, they will see they are not alone. That should encourage them to head more confidently toward the finish line.

First of all, there are a lot of changes when you get to be 80. In my case, I still feel like charging ahead and living life to the hilt, but my body lags behind. My mind is out there on the playing field or on the campaign trail or circling the globe, but my skeletal structure cries out suggesting I give it a break.

I can no longer fly fish off the rocks at our house in Kennebunkport. I used to love to go out there and cast chartreuse Clousers at big striped bass or even tiny pollock. Now if I keep my feet in one place as I cast, I find that when I start to turn and move my feet, I am in grave danger of falling into the ocean. It is a balance thing. I now feel closer to the old guys who fall down and break hips. I used to race across the rocks like a surefooted gazelle. Now, no more rock climbing for me.

Down in the Dominican Republic recently I was having a grand hot shower. Suddenly I felt my foot slip. I grabbed the soap dish and stayed upright, but in that scary moment I understood why I get so many calls these days — “Did you hear what happened to old Joe? Yep, he slipped and fell in the bath and broke a hip.” It happens all the time. No question about it, balance at 80 offers great challenges; and, oddly, lack of balance does not get much sympathy from the younger crowd. One little falter and your kids look at you like the town drunk.

Just days ago I climbed out of our Suburban (yes, Arianna Huffington, we have a Suburban), and as I stepped down to the curb I almost fell. It was kind of a stagger at first, then a dive. Had it not been for a great one-handed save by U.S. Secret Service agent Jim Pollard, Barbara would surely have been calling 911.

I love fishing in the rivers of Labrador with my friend Craig Dobbin. But this year the boulders in the Adlatok River that never bothered me a bit became impossible for me to stand on or climb around. My guide, Bill Lynch, held onto me in the river like you'd hold on to a 3-year-old kid. The current threatened me. The slippery rocks did me in. I used to love to wade the rivers and conquer the boulders, but at 80—no way!

I have a fast boat, a very fast 31-foot Fountain. It is rigged for fishing. With its two 225-horsepower Mercury OptiMax outboards, it can fly. I love that boat, and age has not kept me from going out in big seas or from making high-speed entries into our harbor.

There is still a thrill factor there as I speed into our bay then turn sharply. Kids love this. I like watching them scream in a sharp turn; so this boat makes me feel young and very happy. Age has not diminished my love of the sea or the joy of driving my boat across the Atlantic waves.

Barbara does not like the boat because there aren't any really comfortable seats for older people. She can't read at 55 miles per hour either. We used to fish together a lot but now her legs rebel at the boat's pounding. I miss her out there on the open Atlantic.

At 80, body kinds of things matter more. I love a good sauna or a hot tub. Massage therapy is great; make that essential. I hope heaven has these wonders.

My back aches more now. So do my legs. So I have tried stretching. Everyone says, “When you get older, you must stretch.” The problem is stretching is boring. There is no competition in stretching, no winners and losers. But it does help. It is better when someone helps you stretch. I like just lying there and letting someone else tie me into a half granny.

Well, not exactly, because I don't bend that much. I like riding a low-hung exercise bike. I can fast walk but I can no longer jog. I miss the jogging. I miss the adrenaline rush that came on after a good, brisk three- or four-mile jog.

I wish I could still play tennis. I don't play tennis anymore except when I hit at charity events put on each year in Florida by Chrissie Evert or in Texas by Chuck Norris. The Chris Evert event is showbiz at its finest. I am usually Chrissie's partner. We have never lost. Chrissie sees to that. I am not saying the matches are rigged. I am saying the word must be out for the opponents to be kind to this former president.

When playing against some great player like Jim Courier or Tommy Haas, they hold back from hitting hard right at me. To give the crowd a thrill, they occasionally get into a hot rally with Chrissie. I just stand there muttering to myself, “When I was in my 30s, I could have held my own at least for a few crisp volleys.”

Chrissie still goes “Get to the net” or “Bend your knees more” or “Can't you at least cover behind me on a lob?” You might think we were on Centre Court at Wimbledon. Chrissie Evert is a class competitor — was at Forest Hills and Wimbledon, and still is at the stadium at Delray Beach.

My reactions are much slower now. In this year's match, Chris and I were playing against Tommy Haas and Chevy Chase. Chevy is younger than I am and better than I am, but not a heck of a lot better. Anyway, this year he drilled me in the groin with a well-hit forehand.

Several years ago he never would have got me: My reactions would have spared me. But reaction times are down, danger to the groin up. No more real tennis, but I sure miss it.

What was your question? Oh, yes — hearing. My hearing has deteriorated, not dangerously so, however. I can hear selectively. I can tune people out when I want to. One has to be careful with the tuning out, because if the question is shot right at you, you don't want to look dumb. But if the question is shouted from, say, the wife's bathroom, you don't need to respond. Sometimes I can make out the question clearly, at other times it is all just a giant mumble.

I try my hearing aid. Once you get past the part where the device screeches into your ear when you first put it in, it can be helpful. My hearing aid helps when, say, I am watching a rental from Blockbuster. The bad news is it kills when you are at a cocktail party or even in the office. The other day, eating out, I was coasting along hearing pretty well when someone crumpled up some paper a few tables away. It sounded like a low-yield nuke had just gone off.

Barbara used to insist I use my hearing aid: “You have the darn thing, just use it.” She doesn't do that anymore. I have convinced her I only need it at certain times. I have no problem with the cosmetics of hearing aids. I don't care if it is the “tiniest hearing aid ever made.” Hey, if you are 80, people expect you to be deaf as a post.

I tell Barbara and my grandkids to pronounce more clearly. It is a diphthong thing. They don't do it, though. The grandkids are now convinced I am totally deaf. Little do they know that I just tune them out. Life is simpler if I don't have to stop in when summoned to that messy room where they hang out to give my views on Madonna, P. Diddy or Eminem. I have no views on those people. I am happily disconnected from hip-hop, dirty-talking screen performers and science fiction.

I love my grandchildren, all of them. But I no longer want to get their views on Hollywood celebrities or even hear how much they enjoyed the Dave Matthews concert way the hell up near the Canadian border:

“It took us five hours to get to the concert area, and then we had to walk for an hour because there was no parking. We stayed up all night. Pierce slept in the back of a pickup truck.” I listened but I didn't care. Is that selfish? All I could think about was recommending a good psychiatrist to all of them. Who, if totally sane, would rive all day, walk for hours, listen to a rock concert — in the rain yet — then spend the rest of the night camped in the bed of a pickup truck? Give me a break.

At 80, the motto “early to bed and early to rise” makes extraordinary good sense. At 80 you can say at dinner “I am so darned old, I hope you'll forgive me if I excuse myself and go to bed.” No one argues, everyone understands. In fact, I know the younger ones are glad to see the old fogey go. It is wonderful.

Several years ago after dinner, our grandkids used to challenge me. “Let's play peggity” or “I can beat you at backgammon, Gampy.” Every once in a while I'd accept the challenge. Now it's, “I won't even pass go; I'm going to bed.”

There are things kids say that don't exactly disturb me now that I am 80, but things that make me wonder what they are learning. They use the word “like” all the time. My beloved teenagers can't say a sentence without saying “like.” Like “Hi, Gampster, are you like going out in the boat, and if you do will you like take me with you?”

Why do kids do this? Why don't their teachers tell them to cease and desist? They should simply tell the kids “Don't say 'like' all the time.” Maybe it is only us old guys who notice, because we like didn't learn to talk that way and like now everyone under 20 goes “like” all the time. It's a new phenomenon. I hope our grandkids grow out of it before I get to be 85.

At 80, I find I still look forward to things. I still have goals. I look forward to my parachute jump on my 80th birthday. Barbara is okay with it, but she has managed to contain her enthusiasm. “One way or another, George, this will be your final jump.” I asked her to rephrase it. She wouldn't.

I look forward to our oldest grandson, George P. Bush, getting married this summer. I am excited about the big event. I don't dare tell George P. and Mandi, but a remaining goal of mine is for me to get to be a great-grandfather before I turn 82. It could happen.

Another goal is to live until 2008, because I want to attend the commissioning of CVN-77, the newest and most modern aircraft carrier ever to sail the seas. The ship has been named for me, George H. W. Bush. Our daughter, Doro, is the sponsor of the ship. That makes CVN-77 “her ship.” The commissioning of this grand carrier in 2008 is something I really look forward to.

I also look forward to our 60th wedding anniversary less than a year from now. But even in my 80th year, it doesn't seem we have been married that long. It has been a wonderful journey.

Forgetful — that's where my mind is. I can clearly remember some things that happened 40 years ago, and yet now I can't remember where I put my glasses and who's coming to lunch and sometimes I can't instantly recall the names of close friends.

Everyone says, “Well, sir, you have met so many people, how can you possibly remember names? Your mind must be full of names and places and events. How can you begin to remember last week's speech in Orlando or Las Vegas?” The truth is my mind gets a little lazy these days. I am afraid I don't concentrate on names when being introduced to new people.

To understand what's happening to me now, I asked Dr. John Eckstein, my doctor at the Mayo Clinic, about the brain. John tells me that the front of the left temporal lobe is where one stores and then remembers people's names. Okay, so my left temporal lobe is a little lazy. Maybe it is full, maybe a few quarts over the top; but, hey, at 80 I don't worry about this lobe, and I am not going to start eating seaweed, plankton or dried guava. I know I won't be around for many years more so forget it — don't worry about it.

Besides, I can always bluff through it. “Say, how's the wife?” or “How's it going, pal?” “You look great; how's the old lady?” Careful with that last one, though. A lot of old ladies have gone to heaven or been dumped.

At 80, I do find myself reading the obituary pages a lot more. “Hey, Bar, did you see where Andrew died last week?”
“Last week? I thought he died years ago.”
I now understand more clearly what Phyllis Diller meant when she said “All my friends are dying in alphabetical order.”

Here's another very important point about aging at 80. Back when I was a younger man, I could rationally discuss with a friend an ailment I might have. Now, if I start to tell a friend about my hip operation I must brace myself for a lengthy discussion about his operation, his prostate surgery or his wife's gall bladder. It is better not to discuss your body parts with anyone.

How to sum it up. Being 80 is okay, not bad at all. Herewith a few general conclusions:

1) Life is good for Barbara and me. We have many happy memories of being President and First Lady, but at times I literally find it hard to realize that we actually lived in the White House. When we go back there I love to go through the West Wing or browse through the residence. The President and Laura always make us feel so welcome. I am sometimes overcome with emotion when I sit alone in the President's private office on the second floor of the residence. That marvelous White House staff, the men and women who see Presidents come and go and treat them all with respect, always seem to be welcoming us home.

2) It hurts more when the press and political opponents criticize one of my sons than when they used to knock the socks off me. I know that criticism, fair or grossly unfair, goes with the territory; but it still hurts a lot when someone you love is attacked day in and day out.

3) It is true that the older you get, the faster time flies. It's going by lightning fast.

4) Family is everything, and prayers matter a lot.

5) Satchel Paige was right when he said, “Don't look over your shoulder. Something might be gaining on you.” So I look forward. I want to give something back. I want to live life to its fullest. Every night Barbara and I say our prayers and we count our many blessings and we give thanks to God.

At 80, there are a lot of breathtaking sunrises ahead, and many brilliant sunsets, too. In the Navy we young pilots all prayed for CAVU: Ceiling and Visibility Unlimited. But, you see, at 80, that is where my life is now. Thanks to my family and my friends, my life is CAVU.



(HOSPICE) NOT AWARE OF VALUE

By Ed Edelson HealthDay Reporter, Forbes Magazine
Forwarded by LCol Art Krause, USAF (Ret)

Giving straightforward information to elderly people facing death in nursing homes makes them more likely to enter hospices, where they can receive better care in the last days of their life, a new study finds.

One of every five people who got the informational visit entered a hospice within the next 30 days, compared to only one person among those who received usual care. Eventually, 25 percent of those getting hospice information entered hospices, compared to 6 percent of those who did not.

Read complete story HERE [http://www.forbes.com/lifestyle/health/feeds/hscout/2005/07/12/hscout526793.html ].



(INOCULATIONS) JUDGE RULES ON ANTHRAX

DOD RESUMES ANTHRAX SHOTS
By Gerry J. Gilmore, AFPS

WASHINGTON 1/8/04 (AFPN) - A federal judge ruled Jan. 7 that the Defense Department could legally administer anthrax immunizations to service personnel.

The department's anthrax vaccine immunization program had been suspended since Dec. 23, after an injunction granted the previous day by the U.S. District Court for the District of Columbia caused DOD to suspend the program.

Military commanders “should immediately resume the anthrax vaccination program,” wrote Dr. David S.C. Chu, DOD personnel chief, in a department-wide memorandum.

The department “remains convinced that the AVIP complies with all legal requirements, and there is now no judicial restraint on administration of the vaccine,” Dr. Chu stated.

Defense Secretary Donald H. Rumsfeld and Joint Chiefs of Staff Chairman Air Force Gen. Richard B. Myers maintain the anthrax vaccine is a safe and necessary prophylactic for U.S. personnel deployed in the war against terrorism where enemies may employ biological, chemical or nuclear weapons of mass destruction.

Both Rumsfeld and Myers have received the anthrax shots.



(INSURANCE) TRAUMATIC INJURY

By Rick Maze, NavyTimes staff writer, March 10, 2005
Forwarded by YNCS Don Harribine, USN (Ret)

A new insurance program created at the urging of three injured Iraq war veterans has already helped 1,543 people, according to the lawmaker who helped push the plan through Congress.

Sen. Larry Craig, R-Idaho, the Senate Veterans’ Affairs Committee chairman who helped create the new traumatic injury insurance program, said payments ranging from $25,000 to $100,000 have gone to “young men and women with amputations, severe burns, total blindness, total deafness, paralysis and a host of other disabilities sustained in defense of America.”

The payments, he said, “will help close the gap in financial help these heroes need during their convalescence.” Traumatic injury insurance, which Craig calls “wounded warrior insurance,” was first proposed by three Army veterans injured in the Iraq war: Staff Sgts. Health Calhoun and Ryan Kelly and Sgt. Jeremy Feldbusch. “They asked that I author legislation to create a new insurance benefit for traumatic injuries such as theirs. Not for them, mind you.

They were looking ahead on behalf of their comrades still in combat,” Craig said. He was “moved by their passion and motivated by their dedication.”

Under the program passed by Congress, military personnel who received traumatic injuries from Oct. 7, 2001 through Nov. 30, 2005, while serving in Iraq or Afghanistan are eligible for payments, based on the injury. After Dec. 1, 2005, the insurance covers all traumatic injuries, not just those in a combat zone.

SOURCE [http://www.navytimes.com/story.php?f=1-292925-1590831.php ].



(MEDICARE) PRESCRIPTION DRUGS

From BGen R. Clements USAF (Ret)
IMPORTANT CHANGES FOR ENROLLMENT IN PART B
Sent by john.heffernan@littlerock.af.mil [mailto:john.heffernan@littlerock.af.mil]

Although some may not be aware of it, one or more of the provisions in the Medicare Prescriptions Drug, Improvement and Modernization Act of 2003, will affect many members of the retiree community in the near future and in the years to come.

At the top of the list in the Act, signed into law by President Bush on December 8, 2003, are three very important changes relating to enrollment in Medicare Part B. The first two changes affect persons not enrolled or paying surcharges because they enrolled after they were initially eligible for Part B. This includes those individuals who reside overseas where Medicare doesn't pay and those who thought a local medical facility would always be available for their health needs.

Uniformed services beneficiaries who would be eligible for TRICARE for Life, but are not enrolled in Medicare Part B may enroll without penalty during a special enrollment period through December 31, 2004. The special enrollment period will be announced via Medicare on the TRICARE Web site and will be widely publicized.

Second, uniformed services beneficiaries who enrolled in Medicare Part B in 2001, 2002, 2003, and 2004 and are subject to a premium surcharge for late enrollment in Part B, can get those surcharges eliminated by demonstrating that they are covered under TRICARE.

The elimination of surcharges is effective January 1, 2004, but the Department of Health and Human Services must work out procedures to be followed. As of 3 February 2004, I talked with the local Social Security office and the paperwork is still being worked out. You can sign up for Part B now - which will cost you a penalty - but you will get your money back when all the kinks are worked out.

The third change made by the bill affects all seniors, not just uniformed services beneficiaries. The Part B premium will be tied to income beginning in 2007. Premiums for individuals with incomes above $80,000 and couples with incomes above $160,000 will increase.

Prescription drug benefits:

The number one question asked by members of the military retiree community concerning the “Medicare Prescription Drug, Improvement and Modernization Act of 2003,” has been: How does it affect my pharmacy benefits?

The simple answer is that for most uniformed services beneficiaries, it doesn't.

For older Americans, the most significant aspect of the new bill signed into law by President Bush, December 8, 2003 is the fact that it introduces an outpatient prescription drug benefit. However, the TRICARE pharmacy benefits will continue as a separate program.

On the other hand, uniformed services beneficiaries should be aware of the provisions as it could come into play in the future if they lose their TRICARE eligibility. Example: eligibility is lost when a member's widow or widower remarries a person who is NOT entitled to TRICARE benefits.

According to TRICARE officials, the TRICARE pharmacy benefit provides excellent coverage and wide availability of services through military facilities, retail pharmacies, and mail order. Thus, it is likely that the vast majority of uniformed services beneficiaries will not find it advantageous to enroll in the new Medicare pharmacy benefit. Individuals who think it could affect them in the future can obtain more details at: http://www.tricare.osd.mil [http://www.tricare.osd.mil].



(MEDICARE) TRENDS EXPLAINED

FACT SHEETS
Forwarded by BGen Robert Clements, USAF (RET) 5/4/05

The Kaiser Family Foundation today issued four new and updated fact sheets highlighting key facts and the latest statistics about the Medicare program. The fact sheets are designed to provide an overview of the Medicare program, the new Medicare drug benefit, the program's financing and the role of private health plans in the program.

  • MEDICARE AT A GLANCE [http://www.kff.org/medicare/1066-08.cfm ]: This fact sheet provides a basic overview of the Medicare program, including how it is financed, who is eligible, and what benefits are covered under the program.
  • THE MEDICARE SUBSCRIPTION DRUG BENEFIT [http://www.kff.org/medicare/7044-02.cfm ]: This fact sheet describes the new prescription drug benefit added to Medicare by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.
  • MEDICARE SPENDING AND FINANCING [http://www.kff.org/medicare/7305.cfm ]: This fact sheet provides an overview of spending on the Medicare program, how the program is financed, and Medicare's future financial outlook.
  • MEDICARE ADVANTAGE [http://www.kff.org/medicare/2052-08.cfm ]: This fact sheet provides an overview of the Medicare Advantage program, including current data on plan participation, beneficiary enrollment, benefits and premiums, and explains changes made by the 2003 law regarding Medicare
    payments to participating plans.

The fact sheets are part of the Foundation's wide range of background materials and research about the Medicare program and the drug benefit. These resources include reports, analysis, charts and Talking About Medicare, a consumer guide to understand the program. These materials are [http://www.kff.org/medicare ]available online.



(MEDICARE) MDS WHO DONíT ACCEPT IT

CMS is in the process of mailing Medicare and You 2006 to those eligible for Medicare. The following is an excerpt from that publication that everyone on Medicare should understand:

Section 5: Medicare Program Basics - Using Doctors Who Don't Accept Medicare

Some doctors do not accept Medicare payments. If you want to get care from a doctor who doesn't accept Medicare payment, you may be asked to sign a private contract.

A private contract is a written agreement between you and a doctor who has decided not to participate in the Medicare program. The private contract only applies to the services you get from the doctor (such as a physician, dentist, podiatrist, or optometrist) who asked you to sign it.

You can't be asked to sign a private contract in an emergency situation or when you get urgently needed care.

If you sign a private contract with your doctor you will have to pay whatever this doctor or provider charges you for the services you get. Medicare's limiting charge won't apply. No claim should be submitted to Medicare and Medicare won't pay if one is submitted.

Your Medigap policy, if you have one, won't pay anything for this service.

Medicare health plans won't pay any amount for the services you get from this doctor. Your doctor must tell you whether Medicare would pay for the service if you get it from another doctor who participates in Medicare. Your doctor must tell you if he or she has opted out of or has been excluded from the Medicare program.

You may want to talk with someone in your State Health Insurance Assistance Program before signing a private contract (see the inside back cover of your Medicare and You booklet for their telephone number).



(PHARMACY) MANDATORY GENERIC DRUGS

http://tricare.osd.mil [http://tricare.osd.mil ]

The Department of Defense (DOD) and Express Scripts Inc. (ESI), the company selected to manage the TRICARE Retail Pharmacy program (TRRx), are working together to promote a high quality, cost-effective pharmacy benefit. A key factor in making this benefit a success is the mandatory generic drug program, which has been in place for more than 10 years. This program requires that prescriptions be filled with the generic product, if one is available.

When the TRICARE Retail Pharmacy program contract was implemented on June 1, 2004, through ESI, the generic policy was enforced consistently, resulting in denials of prescriptions for brand-name drugs for many beneficiaries accustomed to receiving brand-name products even when generic equivalents were available. In order to allow DOD an opportunity to develop a more permanent solution for these beneficiaries, a 120-day grace period was granted and subsequently extended another 60 days while TRICARE Management Activity finalized options. This waiver was scheduled to expire on Dec. 13, 2004; however, there has been a slight delay due to patient notifications.

DOD as contracted with ESI to mail a letter to all patients who were receiving a brand-name drug on June 1, 2004, for which there was a generic equivalent available, stating that the beneficiaries' current prescription for the brand-name medication will be honored until they have obtained all the refills remaining on their current prescription.

Additionally, the letter will state that when a new prescription is presented at their retail pharmacy for the brand name medication, once the brand refills have expired, the generic equivalent will be dispensed and the brand-name medication will not be covered unless medical necessity for the brand name medication has been established. In order for medical necessity to be established, one or more of the following must occur:

  • Patient must experience, or would be likely to experience, significant adverse effects from the generic medicine;
  • The generic medicine has resulted in, or is likely to result in, therapeutic
    failure; and
  • Patient has previously responded to the brand-name medication, and changing to the generic medication would incur an unacceptable clinical risk.

The letter continues with a description of generic drugs and an explanation of their safety, therapeutic effectiveness and cost effectiveness. The patient is informed that they may switch to the generic by asking their physician to write a prescription for a generic drug or by asking their pharmacist to refill the medications with a generic equivalent when permissible by state pharmacy regulations.

The letter discussed above has been written and DOD is currently compiling the list of addresses for beneficiaries affected by the existing policy. Once all addresses have been compiled, the affected beneficiaries will receive their letter and will be given 30 days before any action is taken with regard to this policy.

We understand that patient treatment decisions are between the patient and the doctor. If the physician feels that it is medically necessary for the patient to continue to receive the brand-name version of the medication instead of the generic, then the physician should be directed to call the TRICARE Retail Pharmacy program Prior Authorization Line at 1-866-684-4488 prior to the patient obtaining the next prescription at the retail pharmacy in order to first obtain the letter of medical necessity. Unless the patient has an approved letter of medical necessity before they fill the new prescription, they will have to pay the full cost of the medication in addition to the cost share.

For additional questions regarding the prescription drug benefit, please contact Express Scripts at 1-866-DoD-TRRx (1-866-363-8779) to speak with a patient care advocate.
http://www.tricare.osd.mil/Status-Drug-Program-final-8-Dec-04.cfm [http://www.tricare.osd.mil/Status-Drug-Program-final-8-Dec-04.cfm]



(PHARMACY) PERSCRIPTION FRAUD

Forwarded by YNCS Don Harribine, USN (Ret)

It has been reported that veterans are receiving calls from a company identifying itself as the “Patient Care Group.” This company is claiming that veteran's prescriptions are now being dispensed through them and if they wanted to continue to receive their meds, they would need to provide a credit card number.

Veterans are to be advised that the VA has not changed the process of receiving and dispensing prescriptions. Veterans are also advised to never give out their personal information including social security numbers and credit card numbers to any organization without first verifying their legitimacy.

If you feel you may be a victim of this scam CLICK HERE [http://www.consumer.gov/idtheft/law_resources.htm ] to contact the appropriate law enforcement agency.

To learn more about how to avoid being taken advantage by this or any other scams YOU SHOULD VISIT [http://www.consumer.gov/idtheft/ ] the Federal Trade Commission's “Identity Theft” website to learn what steps you need to take.



(PHARMACY) PRICE GOUGING

From JiMath via 1stAdmPAO

Recently, Steve Wilson, an investigative reporter for channel 7 News in Detroit, did a story on generic drug price gouging by pharmacies. He found in his investigation that some of these generic drugs were marked-up as much as 3,000 percent or more. That's not a typo - three thousand percent.

So often, we blame the drug companies for the high cost of drugs, and usually rightfully so, but in this case, the fault clearly lies with the pharmacies. For example: If you had to buy a prescription drug and bought the name brand, you might pay $100 for 100 pills. The pharmacist might tell you that if you get the generic equivalent, they would only cost $80, making you think you are “saving” $20. What the pharmacist is not telling you is that those 100 generic pills may have cost him only $10.

At the end of the report, one of the anchors asked Mr. Wilson whether or not there were any pharmacies that did not adhere to this practice, and he said that Costco, for one, consistently charged little over their cost for generic drugs.

I went to the Costco site, where you can look up any drug, and get its online price. It says that the in-store prices are consistent with the online prices.

Just to give you one example from my own experience, I had to use the drug “Compazine,” which helps prevent nausea in chemo patients. I used the generic equivalent, which cost $54.99 for 60 pills at CVS. I checked the price at Costco and I could have bought 100 pills for $19.89. For 145 of my pain pills, I paid $72.57. I could have gotten 150 at Costco for $28.08.

I would like to mention, that although Costco is a membership-type store, you do not have to be a member to buy prescriptions there, as it is a federally regulated substance. You simply tell them at the door that you wish to use the pharmacy, and they let you in.

Editor's Note: Sam's and other such member-type stores allow use of their pharmacies to non-members, too. Might be a good idea to check them to see how their prices compare as well.



(POLICY) CHANGES IN MILITARY MEDICINE

VADM Harold Koenig USN (Ret) wrote:
“On February 16, 2004, I received the following note from an Air Force resident physician. I have omitted his name to preserve his anonymity. I am circulating his email and my reply widely amongst my friends in and retired from the military, as well as key civilians, because I see a huge communication problem here. Perhaps my reply to this young physician may help you help someone you know who's struggling with PBD 712 to better understand the larger process that is continuing:”

Dear Dr. Koenig,

I enjoy reading your articles about the future of military medicine. As an active duty resident physician in the Air Force, I appreciate the few tidbits of information I can get regarding the direction that military medicine is heading in this time of military medicine reshaping.

I have a specific question for you about a policy that I read in the military medicine discussion forum at Studentdoctor.net called “Program Budget Decision 712”. According to an anonymous active duty military physician in the forum, this policy is geared to aggressively replace military physicians with civilian physicians in those fields of medicine that are not directly involved with combat medical care. The policy is supposedly set to be implemented in 2005.

I know that the military has gradually and quietly been downsizing the medical corps for some time now, but this policy, if true, sounds like it will be much more definitive in reshaping the future of military medicine and would have huge implications for GME, dependent care and health care for retirees. Please let me know if you have heard of this policy and where I can get more information about it.

By the way, if you are not familiar with the studentdoctor.net website, there is a good forum that is specifically set up to discuss military medical issues. It is an interesting forum because it gives insight into the thinking of medical students considering a career in the military as well as current perspectives from resident and staff physicians. You may find some of the comments interesting, given your recent article on the declining applicant pool for HPSP and USUHS slots.

Thank you.

_____________________

Here is the reply I sent:

Dear Steven,

Thank you for your email asking about PBD 712 and mentioning my article in the November issue of U.S. Medicine about declining interest in USUHS and HPSP. That was the last column I will write for U.S. Medicine. After five years of writing for them I have decided it is time to pursue other interests.

I am going to try and give you some insight into PBD 712, at least from my perspective. You have my permission to post it to the studentdoctor.net website.

I have only seen the impact PBD 712 will have on the Navy Medical Department, not the Army or Air Force. I suspect the impacts are similar. For the Navy Medical Corps the impact falls disproportionately on the primary care specialties, Pediatrics, Family Practice and Internal Medicine. There are impacts also on the Nurse Corps, Medical Service Corps and Dental Corps.

These cuts are no surprise to me. The U.S. Armed Forces began a drawdown as we saw the Cold War coming to an end. In 1988, two years before the Berlin Wall fell, the United States had its first round of Base Realignment And Closure (BRAC) followed by additional rounds in 1991, 1993 and 1995. The purpose of BRAC was to get rid of infrastructure (bases) that was no longer needed. This was a very controversial political process and the only way it could be accomplished was to “de-politicize” it by setting up an independent commission that would put together a list of bases to close and then submit it to Congress and the President who could only vote yea or nay on it. They could not make changes.

A lot of excess infrastructure was removed from the DOD inventory, communities suffered, but most recovered, got access to the land and are now better off economically than they were before. A few localities have not yet benefited because of local politics. There is another round of BRAC authorized for this year with the final decisions due in May of next year.

Coincident with the BRAC process, there was a need to downsize the force. That means get rid of people, not just in uniform, but civilians as well. That is as tough as getting rid of bases because good people lose their jobs. From the time of the first BRAC until the last, the number of people in uniform dropped from over 2.1 million down to about 1.4 million, a one-third reduction in manpower. Similarly proportional cuts were made in the number of civilian jobs in the Department of Defense.

The medical departments were not spared in this process. Hospitals and clinics that were on bases that closed were also closed. Along with their closure went proportional reductions in medical department end strengths, both uniformed and civilian. All of this caused a lot of anxiety among health care providers and their patients but most of the rest of the nation was pleased with the process because the nation was able to reap a “Peace Dividend.”

The drawdown was not proportional everywhere. Some states saw no bases closed, some saw a lot and suffered economically. But the biggest hits came overseas. Before the drawdown began and in fact up through 1991, we had over 300,000 men and women in uniform in Germany alone. We had eleven hospitals in Germany and a whole lot of clinics. Now we are down to about three hospitals and less than 100,000 uniformed people in Germany. Many of those people rotated back to the USA, but their positions went away. By the way, this process was economically brutal for the German people living in the communities with large U.S. bases that closed.

Now the United States is re-assessing its need for overseas bases again. It looks like we may see a near total pull out of U.S. Forces north of the Alps in Europe. This is not out of pique over recent disagreements over Iraq. This is because after over a half-century of presence we really are not needed there any more. If we aren't needed we shouldn't stay. Imagine how you would feel if there were foreign soldiers based in your community?

Some, but not all of these forces may be moved to other countries in the region that have emerged out of the former Soviet Union. Some of these countries need the protection and stability that the presence of U.S. Forces will provide. Again, we should remain there only as long as we are needed.

We are also looking at possible force reductions or at least relocations in the Far East. This again is because at least some countries in these areas have become more stable and self-sufficient. We should look at all of this as a victory to be celebrated, not a failure to be mourned. Of course, some people will suffer unintended consequences. They may lose their jobs and others may lose convenient access to health care and other services provided on military bases.

While re-assessing our need for overseas bases, we also need to look at our need for bases here at home. That is what the current round of BRAC will do. Along with that will come a need to somewhat proportionally reduce manpower. There is another factor at play here though that needs to be understood. As the force is reduced in size, there is a need to maintain as much of the fighting strength as possible. The military refers to this as “Tooth to Tail ratio.” I am sure you understand the meaning of that.

There are a lot of jobs in the military that can be done by people not in uniform. If those jobs are “civilianized” the “Tooth to Tail ratio” will improve. That is what PBD 712 is all about.

As PBD 712 plays out, keep all of this in mind. This is not about discrimination against certain medical specialties, or nurses, dentists, doctors, patients or any of the other myriad professional areas that can be “civilianized.” It is about maintaining America's military strength in the most efficient and effective way possible.

We are much more fortunate today than we were when all of this drawdown process began back in the late 1980's. Today we have Tricare in place. Then all we had was the old CHAMPUS benefit and Medicare for those over 65 who lost access to military medical facilities. That is an improvement that only those of us who were around then can appreciate.

Tricare just doesn't benefit patients. It also benefits health care providers who prefer to practice in the military environment, even if they have to do so out of uniform. Military medicine will continue to need pediatricians, family practitioners, internists and so on to provide care in its hospitals and clinics. Tricare allows for that with the resource sharing provisions in the contracts.

And finally, don't forget the reserves. There is an on going and perhaps increasing need for health care providers in the reserves, especially the Army Guard and Reserve.

In summary, I see PBD 712 not as bad news but as part of a long on-going effort to “right-size” our military forces and preserve its strength at the lowest cost possible. That is as it should be. There remains an important role for all of you to play in this.



(RECORDS) INDEFINITE ID CARDS

The government has completed a software upgrade at most military identification card issuing facilities, allowing eligible family members and surviving spouses to receive indefinite ID cards at age 75 upon expiration of current IDs. The upgrade should be completed at all bases by Oct. 7, 2005.

Card issuing facilities are authorized to issue the new ID card within 90 days of expiration as there will be no mass issuance, according to ID card management officials. Eligibility rules for ID cards have not changed.

Tricare officials point out that the Military Health System requires all eligible beneficiaries to have a current ID card in order to receive health care. Also, beneficiaries are reminded that their personal information must be current in the Defense Enrollment Eligibility Reporting System (DEERS).

Changes to sponsor's status, home address and family status (marriage, divorce, birth and adoption) are examples of information that needs to be properly maintained in DEERS.

For more information about the permanent retiree ID card or DEERS enrollment, beneficiaries may contact the DEERS Support Office by telephone at 1-800-538-9552 (overseas beneficiaries call 1-888-777-8343) or VISIT ONLINE [http://www.tricare.osd.mil/DEERS ]. .



(RECORDS) MILITARY SYSTEM'S NEW ERA

From DOD Public Affairs
Forwarded by YNCS Don Harribine, USN (Ret)

The Department of Defense achieved a major milestone November 18, 2005, with the launch of AHLTA, its global electronic health record system, at a ceremony hosted by Dr. William Winkenwerder, assistant secretary of defense for health affairs at the National Naval Medical Center in Bethesda.

AHLTA is the largest, most significant electronic health record system of its kind with the potential to serve more than nine million service members, retirees and their families worldwide. When fully implemented, about 60,000 military healthcare professionals at DOD medical facilities in the United States, and 11 other countries will use this electronic health record system.

“Beneficiaries' health records will be available around the clock and around the world, available to healthcare providers, yet protected from loss and unauthorized access,” said Winkenwerder. “Our electronic health record has matured to a point that its size and complexity are unrivaled. Most importantly, this new system was built in partnership with America's leading information technology companies.”

Health and Human Services Secretary Michael O. Leavitt added, “With the roll-out of AHLTA, the Department of Defense has made a great step toward achieving President Bush's goal of making electronic health records available to a majority of Americans within 10 years. The lessons we learn from an initiative of this geographic scope and patient base will prove invaluable for future private and government health systems.”

Today, many thousands of military medical providers are using the system, and nearly 300,000 outpatient visits are captured digitally every week. Full deployment of the system in DOD's 800 clinics and 70 hospitals will be complete by December 2006.

The longer term vision, expected to be achieved in the next two to three years, is a continuously updated digital medical record from the point of injury or care on the battlefield to military clinics and hospitals in the United States, all completely transferable electronically to the Veterans Health Administration.

A massive training program for AHLTA is currently underway in DOD's medical community to ensure all who have access to the system are properly trained in usage and health record security.

For more information CLICK HERE. [http://www.ha.osd.mil/AHLTA ]



(RECORDS) PERMANENT ID CARDS

Family Members, Survivors Over Age 75 Eligible

August 25, 2005 - A permanent United States Uniformed Services Identification (ID) card will be available September 2005 for all eligible Uniformed Services family members and survivors of deceased personnel, who are age 75 and over. Currently, Uniformed Services retirees are the only persons who receive a permanent ID card.

Beneficiaries currently in possession of a valid ID card should obtain the new permanent ID card within 90 days of expiration. If beneficiaries' cards are not due to expire for at least another year, they do not need to apply for the new ID card until their existing card is within 90 days of expiring.

The Military Health System requires all eligible beneficiaries to have an ID card in order to receive health care. Beneficiaries will continue to receive health care benefits and their claims will be processed with their current ID card until they receive the permanent ID card as long as their personal informatioAugust 25, 2005 n is current in the Defense Enrollment Eligibility Reporting System (DEERS).

Even though active duty and retired service members are automatically registered in DEERS, their family members are not. It is the sponsors' responsibility to register their family members into DEERS. Sponsors must also make any necessary updates in DEERS for themselves and their family members to ensure TRICARE benefits and claims processing will continue without interruption. Changes to sponsor's status, home address and family status (marriage, divorce, birth and adoption) are examples of information that needs to be properly maintained in DEERS.

It is important for surviving family members to update their personal information in DEERS when the active duty or retired sponsor dies. The DEERS Support Office can be reached by telephone at 1-800-538-9552, or information can be found online at www.tricare.osd.mil/DEERS.

For more information about the permanent retiree ID card or DEERS enrollment, beneficiaries may visit the Tricare Web HERE [http://www.tricare.osd.mil/deers ] or call the TRICARE Regional Office (TRO) North (1-877-874-2273), the TRO South (1-800-444-5445), or TRO West (1-888-874-9378). Overseas beneficiaries can call 1-888-777-8343. Beneficiaries can also find the nearest ID card issuing facility.



(STUDY) AGENT ORANGE CANCER

Forwarded by Jim Tichacek, RAO Bulletin, raoemo@mozcom.com [mailto:raoemo@mozcom.com]

The February edition of the Journal of Occupational and Environmental Medicine. contains a new analysis of cancer incidence among Air Force veterans of the Vietnam War. It found increased risks of prostate cancer and melanoma in those who sprayed Agent Orange and other herbicide.

The article, written by members of the Air Force Health Study on Operation Ranch Hand, indicates that a statistical adjustment for years served in Southeast Asia (SEA) reveals increased risks of prostate cancer, melanoma and cancer at any anatomical site among those with the highest dioxin exposure. Previous results of the Study's research had found no consistent evidence that Agent Orange is related to cancer.

The National Academy of Sciences will review this study along with many other studies on herbicide and dioxin exposure to make a report to the Secretary of Veterans Affairs to assist decisions related to compensation.

The study included veterans of Operation Ranch Hand, the unit responsible for the aerial spraying of Agent Orange and other herbicides in Vietnam, and comparison Air Force veterans who served in SEA during the war but did not spray herbicides. Since the first health examination in 1982, the Air Force has tried to determine whether long-term health effects exist in the Ranch Hand flyers and ground crew, and if they can be attributed to the herbicides used in Vietnam.

The study included two parts: external contrasts with the national population and internal contrasts with adjustments for years served in the SEA region. In both parts, researchers defined cancer as specified by the Surveillance Epidemiology and End Results (SEER) section of the National Cancer Institute. Contrasts with the national population revealed increased risks of melanoma in Ranch Hand veterans and an increased risk of prostate cancer in Ranch Hand and comparison veterans.

The significantly increased standardized incidence ratios ranged from 1.46 to 2.33. The elevated risks could be partly due to increased case finding as a result of extensive screening at the periodic Air Force Health Study physical examinations.

The study also found a significant decrease in cancer of the digestive system in the Ranch Hand group and a significant decrease in cancer of the urinary and lymphopoietic systems in the comparison group. No significant increase in the risk of death from cancer was found in either the Ranch Hand or the comparison group when compared to national rates.

The second part of the study contrasted Ranch Hands in high, low and background dioxin exposure categories with comparisons. Years in SEA confounded the analysis. Following standard statistical procedures, investigators stratified by this confounding variable. Among those who served no more than two years in SEA, Ranch Hand veterans with the highest dioxin levels were found to exhibit an increased risk of cancer at any anatomical site, prostate and melanoma. The relative risk for “any site cancer” in the high dioxin category was 2.02 with a 95 percent confidence interval of 1.03 to 3.95. Increases in the risk of prostate cancer and melanoma were higher but based on small numbers, and the confidence intervals were wide. Of 65 “any site cancers” in the Ranch Hand group, 21 were of the prostate and 11 were melanoma.

Study methods were derived from discussions with the Ranch Hand Advisory Committee, a non-governmental panel of scientists appointed by the Food and Drug Administration to oversee the study.

Dioxin exposures of members of the Ranch Hand unit were probably greater than those experienced by the average Vietnam veteran. The study is limited by its sample size, preventing detailed analysis of rare cancers, and by uncertainties regarding dioxin exposure. The dioxin determinations were accurate but were measured 15-30 years after service in the Ranch Hand unit.

The study interpretations are limited because other environmental exposures were not measured. Study strengths include record verification of all cancer cases and rigorous quality control. Extrapolation to other Vietnam veterans is not possible with these data.

Associations found in this study do not imply causation. Publication of the Ranch Hand data and findings in the peer-reviewed journal will allow further discussion of the conclusions and implications by the scientific community at large.

For more information, contact the Air Force Surgeon General's Office at (202) 767-4797 or access the Ranch Hand Study website www.brooks.af.mil/AFRL/HED/hedb/afhs/afhs.shtml [http://www.brooks.af.mil/AFRL/HED/hedb/afhs/afhs.shtml].

Source: Secretary of the Air Force, Directorate of Public Affairs, Press Release - No. 0122046, dated 22 January 2004.



(STUDY) DEPLETED URANIUM RISK

By Gerry J. Gilmore, AFPS, 5/3/2004

Washington (AFPN) — Depleted uranium poses very low health risks to U.S. service members, senior Defense Department officials said here April 29.

Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs, said a 10-year, joint DOD-Veterans Affairs study shows “that low levels of depleted uranium that our troops would be exposed to are neither a radiological or chemical health threat to our service members. No evidence exists linking depleted uranium to radiation-induced illnesses like leukemia or cancers.”

Depleted uranium is a dense material produced from uranium processing that is used for armor and armor-piercing weapons. High levels of the substance introduced into the human body could cause kidney damage.

“Service members should know that the potential health risks of depleted uranium are extremely, extremely low,” Dr. Winkenwerder said. “And, we have no evidence that there are health consequences after many years among people who had the highest levels of exposure after the Gulf War.”

However, there is no medical evidence that links low level of exposure to depleted uranium to any medical symptoms among service members. Only three of about 1,000 personnel returning from Operation Iraqi Freedom duty have tested positive for elevated levels of uranium.

Two soldiers and one Airman were involved in combat operations in Iraq and have pieces of depleted-uranium shrapnel in their bodies. It normally can be removed surgically, unless doing so would damage surrounding muscles and other important tissue. Doctors are monitoring the three in a medical follow-up program.

Medical tests performed on Gulf War veterans with depleted uranium shrapnel in their bodies show “their kidneys are perfectly normal,” said DOD spokesman Dr. Kilpatrick. “All people have some uranium in their bodies and bones that causes no ill-health effects. “

Urine testing measures the amount of natural uranium in the system,” Kilpatrick said. “If it's in the normal range, we don't have a concern, but if the level is at all high, then we do a differentiation between natural and depleted uranium. People who inhale dust laced with depleted uranium eventually eliminate the material from their bodies via urination.”



(STUDY) MILITARY WOMEN CAN HACK IT

By Randy Dotinga
Forwarded by Bill Thompson

Female soldiers have long fought off perceptions that their bodies just aren't equipped to handle the rigors of training and warfare. But a decade's worth of research suggests that women are hardly as fragile as critics once thought.

A new study by military researchers found that many assumptions about female bodies are “astoundingly wrong.” Women are just as good as men — in some cases, perhaps even better — at handling intense exercise and decompression sickness.

The findings, reported in the Journal of Women's Health, don't change the fact that women — on the whole — are smaller and less powerful than men. Still, they suggest “that human physiology is more consistent than would be suggested by the social embellishments and exaggerations” that come about when there isn't any actual research, said Col. Karl Friedl, commander of the Army Research Institute of Environmental Medicine and coauthor of the report.

Friedl examined the results of more than 130 studies that followed a 1994 order from Congress to spend $40 million on biomedical research into women in the military.

One of the most surprising findings “was the reversal of the age-old belief that…

Read full story HERE [http://www.wired.com/news/technology/1,70006-0.html ].



(STUDY) WAIST SIZE GAUGES HEALTH

By SSgt Todd Lopez, USAF

Washington, 10/30/03 - According to studies by the American Medical Association and the National Institute of Health, the waist measurement is a gauge for total health.

“The Air Force has adopted this waist measurement concept to determine visceral or intra-abdominal fat,” said Maj. Lisa Schmidt, noting that there is ample evidence linking an increase in visceral fat with an increase in risk for disease.

“When we looked at developing health-based standards, we reviewed a lot of literature of the best ways to predict health risks for members, and abdominal circumference kept surfacing,” Schmidt said. “With more abdominal fat, you have more risk for diabetes, heart disease, stroke and some types of cancer.”

Air Force officials use two tables for measuring waists, one for males and one for females. There are no variations in regards to height or age.

Both male and female can perform the measurement on themselves by using a tape measure wrapped around the abdomen above the right iliac crest, or right above the top of the right hip bone, while ensuring the loop created by the tape remains parallel to the floor.

“The risk for disease is independent of your height,” Schmidt said. “Other things considered, if you are 5 feet 2 inches tall or 6 feet 2 inches tall, your risk for disease is the same if you have a 40-inch waist. This also applies with your age. If you are 20 years old or 50 years old, the risk is the same based on waist measurements.”

Unlike other body parts, the size of the waist does not grow proportionally with height.. “As you get taller, it isn't as if you grow out as well,” Schmidt said. “It is not proportional growth. The area you are measuring does not include any bone.”

While there is no variance allowed for height when it comes to waist measurements, it is important to consider the fitness evaluation as a whole in regards to the total-fitness score.

“When you look at the fitness score, it is a composite,” Schmidt said. “If you have a 20-year-old and a 50-year-old, both with a 39-inch waist, they are going to get the same points for abdominal circumference. However, that 20-year-old is going to have to run faster and do more crunches and more pushups to get the same composite score as the 50-year-old.”

There is hope for airmen who have measured their waists and determined they are not within an acceptable range. Visceral fat is generally the first to go when people begin an exercise program. While it may take several months of running, crunches and weight lifting to knock an inch or two off the waist circumference, that effort pays off in more than just the one or two points gained on the waist-measurement portion of the evaluation.

“A lot of airmen will look at the chart and say it is difficult to lose an inch in abdominal circumference, and that they only get a point for it,” Schmidt said. “But if you are engaged in some kind of program to lose that inch and to gain that point, some aerobic and fitness program, you will improve your performance on the running and strength portions. They are all interrelated. This is about total health.”

Airmen who look at the chart for the first time become fixated on the top numbers for their age group — those numbers needed to score a perfect 100 on the evaluation. They should concentrate instead on getting a “good” or “excellent” fitness score.

According to Schmidt, the expectation is not for most airmen to achieve a perfect score. The expectation is for everyone to participate in a regular fitness program, which results in improvements of overall health and well being.



(SURVEY) TRICARE FEE

Forwarded by p38bob@deepwell.com

Please, if you would, take the time to participate and help Admiral Ryan help military retirees. This is serious business that involves all of us!

CLICK HERE [http://www.military.com/MilitaryReport/0,12914,89880,00.html?ESRC=miltrep.nl ].



(SYSTEMS) DOD-VA DONíT CONNECT

By Rep. Steve Buyer, R-IN, Chairman, House Veterans Affairs Committee
and Army Reserve Col.
From the 31 October 2005 issue of ARMY TIMES

The health care systems of the Defense Department and Department of Veterans Affairs are among the world's best. However, four years after the start of Operation Enduring Freedom, health care officials from both bodies, in testimony provided during hearings before the House Veterans' Affairs Committee, acknowledged that they have yet to forge a truly seamless transition system between the agencies.

We have discovered the lack of even a common understanding of the term ” seamless.” For example, say an active-duty service member who suffers a traumatic brain injury transitions from a military treatment facility to a VA polytrauma center in Minneapolis, one of four such specialty centers in the VA health care system. His journey from the military facility to the VA facility and back to active duty - or from the military facility to a VA hospital to separation - should be seamless.

Congress directed VA and the Defense Department to collaborate on health care in a 1982 law that created a joint committee to improve medical resource sharing. In 2003, responding to inaction between the two departments, Congress mandated that they review all aspects of both agencies to assess potential opportunities to coordinate and share resources.

Despite 20 years of such mandates for resource-sharing, name changes, studies, hearings, and repetitive vows by officials, the two agencies still operate in separate worlds. What little progress exists is inadequate; the jointly conducted Transition Assistance and Disabled Transition Assistance programs help transitioning service members learn about veterans' benefits, but they are only optional.

The two agencies should share a system of electronic medical records and appropriate personal data needed to speed benefits processing. The complete continuum of a service member's health history should be captured from induction to separation and shared with VA, which has an excellent electronic patient record system.

Billions have been spent by both agencies in the past decade, but they still cannot electronically share medical information. Service members leaving active duty must still make hard copies of medical records to give VA. This is unacceptable.

Positive action was taken by the Defense Department and VA when they signed a memorandum agreeing to share patient data after years of wrangling over privacy issues. As we have pressed the departments to collaborate in the past, we will press them to fulfill this agreement.

Seamless transition is much more than an electronic record. It is a discharge physical that meets VA's need to consider claims for disability benefits. It is outreach, counseling, and referral by Defense Department staff to appropriate VA resources and programs. Most of all, it is a commitment by the two agencies to make transition work, and the Defense Department's lack of commitment has been a glaring deficiency over the past 20 years.

I offer compliments to the National Guard, which, in an exceptional example of leadership, has acted: 850 returning New Hampshire Guardsmen recently received a three-day out-processing that includes time with VA health and benefits counselors. As a result, almost 50 percent filed VA claims and 2 percent were found too sick or hurt to be demobilized and were kept temporarily on active duty to receive military health care.

Soldiers, sailors, airmen, Marines and Coast Guardsmen should never be caught in the bureaucracy. After studying this for two decades, we know what must occur to make the transition from service member to veteran a seamless one.

The Defense Department and VA must move decisively ahead.

It is time for joint action.

Rep. Steve Buyer.



(TRICARE) NEW FEE PLAN UNVEILED

By Tom Philpott, Military.com, February 9, 2006

The Bush administration, in its fiscal 2007 defense budget, unveiled its plan to raise TRICARE fees and deductibles for military retirees under age 65 and their dependents.

Co-payments in the TRICARE retail pharmacy network also would climb, but for all beneficiaries except those on active duty.

Marine Corps Gen. Peter Pace, chairman of the Joint Chiefs, immediately endorsed the plan, describing it as a necessary “renorming” of TRICARE fees and deductibles left unchanged since they were set in 1995.

Click HERE [http://www.military.com/features/0,15240,87487,00.html ] for the rest of the story.



(TRICARE) PROPOSED CHANGES

If you haven’t if seen what DOD wants to do commencing in FY07 and FY08, here is a two-page printout from Tricare regarding proposed changes to the system.

It is not what you were promised but it may be what you will get unless Congress derails it, and they’re not likely to do that unless those affected bombard them with the facts.

CLICK HERE [http://www.tricare.osd.mil/STB/downloads/BIFOLD.pdf ].



(WATER) THE BEST THING YOU CAN DRINK

It may appear that any brew,
like beer or tea or coffee, too,
can slake your thirst in nothing flat.
But here’s what experts say ‘bout that:
It’s clear to them you really aughter
consider drinking only water.

Here’s why:

Lack of water is the #1 trigger of daytime fatigue.

One glass of water apiece shut down midnight hunger pangs for almost 100% of the dieters undergoing a university study.

Preliminary research indicates that 8-10 glasses of water a day could significantly ease back and joint pain for up to 80% of sufferers.

Drinking 5 glasses of water daily decreases the risk of colon cancer by 45%, plus it can slash the risk of breast cancer by 79%, and a 50% less likelihood of developing bladder cancer.

A mere 2% drop in body water can trigger fuzzy short-term memory, trouble with basic math, and difficulty focusing on the computer screen.

Are YOU drinking the amount of water YOU should consume every day?



FEDS RECOUP $1.47 BILLION IN HEALTH CARE FRAUD

By Jeffrey Young, The Hill, October 5, 2006

An interdepartmental program designed to curb waste, fraud and abuse in federal healthcare programs will collect $1.47 billion as a result of criminal or civil cases brought in the most recent year reviewed, according to a federal report issued this week.

The Department of Justice and the Office of the Inspector General (OIG) at the Department of Health and Human Services (HHS) also announced that they jointly have deposited $8.85 billion into the Medicare trust fund since their joint program

Lawmakers, such as Sens. Chuck Grassley (R-Iowa) and Tom Coburn (R-Okla.), have repeatedly pressed federal agencies to do more to recover funds due to fraud and abuse.

Read the rest of the story here [http://www.thehill.com/thehill/export/TheHill/News/TheExecutive/100506_fraud.html ].



FOR MILITARY RETIREES

From Floyd Sears

Here is a format for contacting Senators and Representatives to seek support for the Keep Our Promise To America’s Military Retirees Act.

The FAX A REPRESENTATIVE initiative is designed to get the attention of a Representative or Senator by sending a large number of messages to their office on a given day. In order for this to happen it is important that participants adhere to the schedule on this web page which contains the names of Senators that have not cosponsored the “Keep Our Promise To America's Military Retirees Act” (S 407).

For a number of reasons, the FAX is considered the best way to get a message into the office of a Senator or Representative, however, if you do not have a FAX machine then the next best method is to send your message via a Web Form.

CLICK HERE [http://mrgrg-ms.org/fax-it.html ] for the “how to” form.



GENERICS VS. NAME BRAND DRUGS

TRICARE HELP
By James E. Hamby Jr., Navy Times, Oct 30 2006
Forwarded by waspscpo@aol.com

Q: For 27 years, I served my country on active duty and in the reserves. Now I find that same country treats me like a second-class citizen. The health insurance it offers gives me only second-class drugs. Everybody else gets brand-name drugs, but TriCare gives out only generics to our country’s retired troops. Military pharmacies do the same. It’s insulting.

A: It’s not necessary to do a lot of research and quote a bunch of statistics to get agreement from almost everybody that the cost of prescription drugs is very high. If you ask the drug manufacturing industry, you’ll hear about the high cost of research, the number of blind alleys that must be investigated and the occasional lawsuit costing millions. Still, one doesn’t read of drug makers laying off thousands of workers or see pharmacologists and biochemists holding up “homeless” signs at intersections.

To the extent that resolving the problem is possible without paralyzing the industry’s research and development, the most immediate solution to the high prices of drugs is to find cheaper ways to provide them.

Some 75 to 80 years ago, entrepreneurs recognized that the patents were expiring on many drugs whose research and development already had been done. As long as they didn’t use names that had been used previously, they could stir up batches of the same medicines, rename them and sell them much more cheaply than the original developers had been doing for 20 or more years.

The Food and Drug Administration decided it could play, too. With the help of scientists and health care professionals, it devised standards to ensure the purity and effectiveness of those generic drugs.

Today, a generic drug is required by federal law to be an identical copy of the original brand-name drug. It’s the same pill, but with a new shape, color and box. The dosage is the same, as is the strength and quality. The FDA requires them to be the bio and therapeutic equivalent of the brand-name original. It must be possible to use the brand-name drugs and the generic equivalent drugs interchangeably, with no detectable difference except in your pocketbook.

All generic equivalent drugs must be approved by the FDA as safe and effective for their on-label use. There are no second-class drugs. Unlike generic green beans or hand lotion, FDA-approved drugs are as safe and effective, and have the same production standards, as their brand-name ancestors.

So, are generic drugs the solution to prescription drug prices? Of course not. Expensive drug research still has to be conducted and paid for, and the product must be advertised and sold at a profit to pay for the next round of research for new drugs.

Many, if not most, health insurance policies now prefer dispensing generic equivalent drugs, often from a select formulary (its list of covered drugs) for full coverage. The reason is very simple: cost.

The uniformed services now require their pharmacies to stock and dispense generic drugs from a limited formulary when they are available. TriCare has the same rules for both its local retail network of pharmacies and its mail-order prescription plan.

Some physicians still do not trust generic drugs, and some patients experience real, or perceived, differences when they use a generic equivalent drug versus the brand-name form.

TriCare now has three tiers of drugs: generic, brand-name formulary and nonformulary drugs. The patient’s cost share breaks, accordingly, into $3, $9 and $22 categories. If the physician deems it medically necessary for a specific patient to take only a particular brand-name or nonformulary drug, and if the physician can adequately document the medical necessity to take only that drug, TriCare will make it available for $9.

Generic drugs are not “second-class” drugs, and a health benefits plan that gives them preference is not treating you like a second-class citizen. Great care in manufacturing and dispensing generic drugs has been written into federal law to ensure their safety and effectiveness.

See also: TriCare Formulary Update [http://www.tricare.osd.mil/news/news.aspx?fid=236 ].

For more information about generic drugs, you can go to the Food and Drug Administration Web site at www.fda.gov. You can write the FDA at U.S. Food and Drug Administration, 5600 Fishers Lane, Rockville, MD 208570001 or call 1-888-INFO FDA (463-6332).

__________

Write to James E. Hamby Jr. at TriCare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or by sending e-mail to tricarehelp@atpco.com. In e-mail, please include the word TriCare in the subject line and do not attach files. If using regular mail, please include an e-mail address if possible to prompt a faster response.



HOW TO STAY YOUNG

Forwarded by FlyBurd. Original author not given.

Sometimes life seems complicated. Maybe these simply recommendations will help:

  • Throw out nonessential numbers. This includes age, weight and height. Let the doctors worry about them. That is why you pay them.
  • Keep only cheerful friends. The grouches pull you down. Keep this In mind if you are one of those grouches.
  • Keep learning. Learn more about the computer, crafts, gardening, whatever. Never let the brain get idle. “An idle mind is the devil's workshop.” And the devil's name is Alzheimer's!
  • Enjoy the simple things.
  • Laugh often, long and loud. Laugh until you gasp for breath. And if you have a friend who makes you laugh, spend lots and Lots of time with him or her.
  • Tears happen. Endure, grieve, and move on. The only person who is with you your entire life, is yourself. Live while you are alive.
  • Surround yourself with what you love, whether it's family, pets, keepsakes, music, plants, hobbies, whatever.
    Your home is your refuge.
  • Cherish your health. If it is good, preserve it. If it is unstable, improve it. If it is beyond what you can improve, get help.
  • Don't take guilt trips. Take a trip to the mall, even to the next county, to a foreign country, but not to where the guilt is.
  • Tell the people you love that you love them, at every opportunity.

And if you don't send this to at least four people - who cares? But do share it with someone.



LETTER TO THE PRESIDENT

From Captain Charles W. Northington, USPHS (Ret)
Forwarded by BGen Robert Clements USAF (Ret)

27 April 2005

George W. Bush
President of the United States
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500

Reference: Funding for TFL taking DOD funds from active duty needs.

Dear Mr. President:

Two of your DOD appointees, Mr. David Chu and Dr. Winkenworder, have been quoted by several reporters, who are usually very reliable, as stating that funding for TFL is taking funds from the DOD budget that are needed for active duty benefits and needs.

I am having great difficulty in understanding how this situation can exist. Especially when current legislation provides for TFL funding to come directly from the Federal Treasury, not the DOD budget.

When TFL was first authorized, the legislation provided for TFL funding for existing beneficiaries be supplied directly from the Federal Treasury, not the DOD budget. That original legislation did leave DOD with the responsibility for the accrual payments for funding TFL benefits to future beneficiaries.

But, NDAA-2005 provided for the funding for future TFL beneficiaries be supplied directly from the Federal Treasury instead of continuing to come from the DOD budget.

Mr. President, if all TFL funding is supplied directly from the Federal Treasury. Why and how is that causing a reduction of funds budgeted for active duty benefits and needs?

Are your appointees, Mr. Chu and Dr. Winkenworder, lying? Or being misquoted? Or is something diabolical going on with TFL funding?

Will you please cause a public clarification of this mess, which is being put on your door step, and with the public blame being placed on military retirees and beneficiaries?

Respectfully,

Charles W. Northington
Captain, USPHS (Ret)



MY OPINION

Robert S. Dudney, editor in chief, Air Force Magazine 3/22/06

WASHINGTON, DC - In 1995, various federal budgeteers advanced the idea that government-sponsored health care for military retirees was nothing more than a “contingent benefit” - in other words, it was a privilege and not a right.

We remember their words today as an example of shocking ignorance. Ninety percent of military retirees insisted they had been promised these benefits, and they papered Capitol Hill with their complaints. Chastened officials repudiated the budgeteers and accepted “the promise” as valid. Elderly retirees were by law given access to the Pentagon's Tricare medical system and related benefits.

The system itself was expanded. Yet questions persisted. Was this care supposed to be “free,” “low-cost” or
what? Should the country's liability be limited? Eleven years on, some officials still argue about this. In a Feb. 6 statement, William Winkenwerder Jr., the assistant secretary of defense for health affairs, raised alarms about rising costs. In 1995, health care consumed 5 percent of DOD's budget; now, it's 8 percent, and unless
something is done, the figure in 2015 could top 12 percent. Winkenwerder called this “unsustainable growth.”

David S.C. Chu, the undersecretary of defense for personnel and readiness, famously declared of retiree and veteran benefits, “They are taking away from the nation's ability to defend itself.”

Pentagon chief Donald H. Rumsfeld told Congress that retiree care must change “because it's an enormous amount of money.” That prompted a riposte from Stephen P. Condon, chairman of the Air Force Association.

“We appreciate that the administration is attempting to make the best out of a tough fiscal situation,” he said on Feb. 22, “but the budget must not be balanced on the backs of veterans.”

That shouldn't happen - but it might. The Bush administration's approach, as laid out in the fiscal 2007 budget, would sharply raise Tricare enrollment fees - doubling or tripling some - for retirees under age 65. This is supposed to yield savings of $32 billion over 10 years, but it could anger affected retirees and dependents.

“You're about to take your best recruiters and turn them into your worst nightmare,” Rep. Gene Taylor, D-Miss., warned senior defense officials at a recent House Armed Services Committee session.

There are some 2.1 million military retirees and survivor-benefit recipients and 6 million to 8 million dependents. If the fee increases are imposed and many retirees revolt, it will be because Washington lost sight of some important truths:

  • Paying for retiree care is not a favor, but an obligation. It is unfortunate that costs have turned out to be so high, but that is not the fault of retirees.
  • It is unseemly to declare (as many in the Pentagon do) that spending on retiree care drains money away from vital weapons and threatens national defense. That would be true only if the Bush administration accepted an arbitrary ceiling on DOD spending. The remedy for a shortage of money for validated needs is to obtain more money, which the U.S. could easily do. As Condon pointed out, current defense spending consumes only 4 percent of the nation's GDP, a burden
    that is low by historic U.S. standards.
  • Brig. Gen. Elder Granger, a top DOD medical official, makes much of the fact that retirees in 1995 paid 27 percent of their own medical costs and today pay only 12 percent, largely because benefits have grown while fees have not changed. Yet the promise was for “free” treatment. The problem is not that retirees pay too little for care, but that they pay as much as they do.
  • Much of DOD's expenditure increase stems from Tricare For Life, the program for 65-and-over retirees, but all of the new Tricare fee increases apply only to younger beneficiaries, mostly in their 40s and 50s. Congress knew Tricare For Life would be a high-cost program. It is not fair and equitable to finance the program with fees extracted from under-65 retirees.

Let us stipulate that Rumsfeld has a very tough job to do. However, it does no one any good to pit retired military personnel who served honorably against those who now wear the uniform.

In the past, lawmakers have rejected similar efforts. They should do so again.

E-mail Robert S. Dudney, editor in chief of Air Force Magazine, at RDudney@AFA.org.