National Consumers League applauds Congress for surprise billing protections for consumers

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For immediate release: December 22, 2020

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC – The National Consumers League welcomes the inclusion of long-needed surprise billing protections in the COVID Relief Omnibus Spending Bill.

Surprise billing happens when a patient’s insurance doesn’t cover a procedure provided by an out-of-network physician, something patients don’t know or realize when they get a procedure. An estimated one in five emergency visits and one in six inpatient admissions will trigger a surprise bill, which can run into the thousands of dollars.

Medical debt disproportionately drives people into bankruptcy. Bill collectors and hospitals often layer on fees, interest, and penalties, driving the original costs way up. A 2019 study published in the American Journal of Public Health found that 530,000 bankruptcies filed annually are because of debt accrued as a result of treatment for medical illness.

This statement is attributable to NCL Executive Director Sally Greenberg:

“We greatly appreciate the bipartisan leadership of Senators Maggie Hassan (D-NH) and Bill Cassidy (R-LA) in getting the surprise billing language over the finish line. We also thank House Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-NJ), Ranking Member Greg Walden (R-OR), Senate Health Committee Chairman Lamar Alexander (R-TN), and Ranking Member Patty Murray (D-WA) for their early leadership on this issue. This is a shining example of working across the aisle for the betterment of consumers.

Consumers can breathe a huge sigh of relief because under the bill—including the cost of an air ambulance—consumers will be ‘held harmless’ when exposed to out-of-network costs. Once this bill is law, consumers can expect that fees charged will be far more affordable and predictable at in-network rates. We are grateful to Congress for recognizing surprise billing as a predatory practice from which consumers need protection. The committee leadership not only helped to pass a bill but launched an investigation.

After two years of debate and discussion on how health care providers and health plans will negotiate these extra costs, it was agreed that patients should be taken out of the middle of dispute resolution processes. Now, we finally have a workable system for protecting consumers.”

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About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

Jeanette Contreras portrait

2021 rings in new health care protections for consumers

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By NCL Director of Health Policy Jeanette Contreras

Surprise medical bills occur when patients unknowingly receive care from a provider who is not in their health insurance plan’s network. As the first COVID-19 vaccinations are administered, Congress has passed landmark legislation to ensure consumers needn’t worry about surprise medical bills from emergency medical services.

The passage of this legislation couldn’t come soon enough, as more than 476,000 Americans hospitalized with the coronavirus have already incurred exorbitant medical debt from COVID-19 treatment. Now, thankfully, 2020 will come to a close with renewed optimism in the American health care system.

This new law will also protect consumers from surprise billing from out-of-network ambulance and air ambulance trips, which can amount to tens of thousands of dollars in medical bills. Most patients are conscientious consumers, careful to find a doctor that accepts their insurance before making an appointment. However, in the case of an emergency, a patient faces the possibility of receiving care from an out-of-network doctor in an out-of-network hospital.

As Congress debated legislative fixes to surprise billing, the Administration showed political will toward finding a solution with the issuance of Executive Order 13877, Improving Price and Quality Transparency in American Healthcare to Put Patients First, which includes principles on surprise billing. In a July 2020 report addressing surprise billing, the U.S. Department of Health and Human Services (HHS) further urged Congress to act, recognizing that 41 percent of insured adults nationwide were surprised by a medical bill in the past two years.

Following Executive Order 13877, HHS finalized a set of regulations to address price transparency for consumers. The first rule set to take effect on January 1, 2021, requires hospitals to publicly list standard charges for the items and services that they provide. The second rule, set to take effect in 2022, demands similar transparency from most health plans and issuers of health insurance coverage. These regulations offer consumers more control over their health care spending and better information as they shop and compare health coverage options for themselves and their families.

The new HHS regulations, coupled with the surprise billing legislation, amount to the greatest consumer protections in America’s health care system since the Affordable Care Act. Consumers with health insurance should not have to worry about surprise medical bills—especially during a pandemic. The health care system will be a little more consumer-friendly in 2021, which is good news for all of us.

NCL testified before CDC committee on COVID-19 vaccine recommendations

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For immediate release: December 22, 2020

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC – The National Consumers League (NCL) testified before the Centers for Disease Control and Disease Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) this weekend on the equitable distribution of the Moderna vaccine and recommendations for consumer education on vaccine safety. In its testimony, NCL applauds the transparency and access afforded to the public throughout the COVID-19 vaccine approval process.

Equitable distribution:

NCL is encouraged that the Food and Drug Administration (FDA) has approved the Moderna vaccine and that the U.S. government will lead distribution efforts. Due to its ease of transport and storage, the Moderna vaccine stands to readily ship to rural and hard to reach communities. NCL calls on federal health officials at the helm of distribution to facilitate access to the Moderna vaccine to medically underserved areas.

Safety and efficacy:

NCL expressed its trust in the FDA and CDC’s robust inter-agency collaboration to continue ongoing, post-market surveillance of adverse events among recipients of the COVID-19 vaccine and to inform consumers of any additional safety recommendations. NCL urged the CDC to educate consumers about potential reactions and side effects, as this transparency will further encourage the compliance necessary to achieve herd immunity. The vaccine is expected to induce flu-like symptoms after the initial dose and this may deter some patients from getting their second dose if they aren’t warned about what to anticipate.

Vaccine adherence:

NCL encouraged the CDC to conduct culturally competent and inclusive public messaging about vaccine safety to ensure that communities of color and persons with limited English proficiency are informed and feel empowered in their decisions to vaccinate. Adding to the complexity of administering the vaccine, public health officials will need to ensure the completion of two doses in a series. This stands to create additional challenges because evidence has shown that when a vaccine involves multiple doses, nearly 50 percent of patients fail to return for a second dose.

Equitable allocation:

NCL applauds ACIP’s recommendations to prioritize vaccinations for health care workers and long-term care facility residents in Phase 1a. Now that there are two approved vaccines, NCL calls on ACIP to prioritize recommendations to vaccinate the approximately 87 million non-healthcare essential workers unable to work from home—such as bus drivers and grocery workers—who are at higher risk of exposure. Racial and ethnic minorities make up more than 40 percent of the essential workforce and are the backbone of many essential industries. The pandemic has illustrated that low-income minority communities experience more severe COVID-related illness requiring hospitalization and are at higher risk for death.

Persons who recovered from COVID-19:

Lastly, over 18 million individuals in the U.S. have been infected with the coronavirus. It is expected that individuals who recover will acquire some natural immunity to COVID-19. Individuals who recover from the coronavirus want to know if they are protected from reinfection and for how long. We call on the CDC to expedite developing vaccine recommendations for persons who’ve recovered from COVID-19.

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About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

Is your honey real?

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By Nailah John, Linda Golodner Food Safety and Nutrition Fellow

Honey is one of my favorite sweeteners. And I’m not alone. The global demand for honey is extremely high with the market size value in 2020 at 9.79 billion. But are we buying the authentic thing?

This high demand has resulted in market fraud and adulteration. Insider has stated that honey is the third-most-faked food in the world behind milk and olive oil. Assessing the quality of honey can be difficult because of the production process or adulteration with cane sugar or other ingredients.

In the United States, 400 million pounds of honey ends up in our food every year. Most of it is adulterated product from China. Manufacturers either dilute real honey by adding syrups derived from plants or they chemically modify the sugars in those syrups so they look like real honey. Honey consumers in the U.S., and across the globe, are being duped and need to be made more aware of how to tell if the honey they purchased is real or fake.

Here are several ways to spot fakes:

  1. Crystallization – real honey crystallizes over a period of time once kept in a cool dark place. Adulterated honey will always retain the same consistency.
  2. Water test – drop a teaspoon of honey in water. If the honey is pure, it will not easily mix with water but will become slightly thicker in texture.
  3. Microwave test/heat test – place a bowl of honey in the microwave and heat it for a minute. If it caramelizes, then it is real honey. If it bubbles, it is not.
  4. Paper test – put 2 teaspoons of honey on a plate and put paper on it. If the paper soaks the honey, then it is adulterated.

As the demand for honey increases, one would expect that the price of honey would increase. However, the opposite has occurred since the supply of adulterated honey has increased and driven global honey prices down. This has resulted in beekeepers barely being able to sell their honey for a profit.

Another major issue that adulterated honey causes is the threat to pollination and our food systems. Vice highlights that bees help produce 90 commercially-grown crops in the U.S. and have brought in over $24 billion to the economy. Without beekeepers, we would have a failed food system.

Consumers should seek out raw, organic, unadulterated honey that will not have negative impacts on our beekeepers, our crop, and our economy. If you buy a plant-based burger, you would like to know the nutritional value and ingredients of the product and it should be the same for honey or any product that we consume.

I would recommend that each consumer watch the Netflix documentary Rotten. The episode called “Lawyers, Guns and Honey” shows the reasons behind low production of authentic honey and the impact of the dwindling bee population on our environment.

NCL statement on White House pressure to approve COVID-19 vaccine

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For immediate release: December 11, 2020

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC – In just a matter of days, we could potentially have an FDA-approved COVID-19 vaccine ready for rollout. Now more than ever, the public needs to see the evidence of a transparent and deliberate process to ensure the safety of a vaccine. NCL has actively participated in the vaccine approval process, testifying before the Centers for Disease Control and Prevention and the Food and Drug Administration’s (FDA) vaccine advisory committees to ensure that the nation’s most vulnerable consumers are considered at each step of the approval process. The race to a vaccine is a critical one, consumers should not be discouraged by the careful deliberation of the States’ vaccine approval process, but should instead be encouraged that the U.S. is following deliberate, well-established protocol to vet and review the data. 

NCL is amongst the stakeholder groups advocating for increased scrutiny of the data, particularly citing reports from the U.K. about adverse reactions to the Pfizer vaccine among people with severe allergies. We expect that the FDA will be aware of these concerns and call on the agency to perform ongoing post-market surveillance to ensure public safety. Consumers should rely on continuous guidance regarding potential adverse events, as this will be critical to ensuring vaccine confidence. 

NCL has continually recognized the integrity of the career-scientists at the FDA who are entrusted with ensuring the safety of the U.S. drug supply and applaud their demonstrated commitment to fostering public trust throughout the COVID-19 vaccine development, evaluation, and approval process. We have great confidence in the FDA’s rigorous approval methods and trust that the agency will issue an Emergency Use Authorization only after careful consideration of the available safety and efficacy data.

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About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

Child labor’s public perception problem

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Reid Maki is the director of child labor advocacy at the National Consumers League and he coordinates the Child Labor Coalition.

There are a lot of obstacles to ending child labor that the Child Labor Coalition (CLC) and its nearly 40 members confront on a daily basis. Poverty, governmental indifference, educational access, and a lack of awareness of the long-term impact of child labor on children are all big factors, but another is lack of knowledge of the scope or prevalence of the problem. The average American consumer doesn’t understand that child labor is a pervasive problem affecting an estimated 152 million children in the world—and that’s an estimate developed before the pandemic started. We think the number has grown significantly since COVID started throwing hundreds of millions of families into deeper poverty.

We became aware of the gap between the public’s perception of the problem and the reality of the situation seven years ago when the group Child Fund International commissioned a survey of over 1,000 consumers. Only one percent knew that roughly 150 million children were trapped in child labor globally. Even more disturbing: 73 percent of respondents—essentially three out of four—incorrectly guessed that the global total was less the one million. They were off by a factor of 150!

It’s hard to galvanize public and political opinion to confront a pressing social problem when few people realize the massive scope of the problem and instead misperceive it as a tiny, moribund problem. If we want corporations that benefit from child labor to take serious action, we need a better understanding of the problem’s prevalence. Governments are not likely to act or expend financial resources on programs to fix a problem perceived as affecting very few children.

We’ve been wondering if the Internet and Twitter have helped close the perception gap in the several years since Child Fund’s polling. Surveys are expensive and our budget didn’t allow us to conduct a phone-based survey like the 2013 poll. So, we decided to use a Survey Monkey internet poll to see where the public’s perception levels were at. We conducted the poll before COVID struck.

We gave respondents the opportunity to guess how many children were impacted by child labor and offered the following choices:

  • 1 in 10
  • 1 in 100
  • 1 in 500
  • 1 in 1,000
  • 1 in 5,000
  • 1 in 50,000

The most popular answer was the correct one: “1 in 10.” Thirty-five percent guessed correctly that 10 percent of the world’s children toil in child labor. However, that means that roughly two out of three respondents were off by a factor of 10 or more.

We think the answers in our informal internet poll may have skewed toward a better knowledge of the problem because we advertised the survey on our Twitter (@ChildLaborCLC), meaning it was being seen by people who presumably had better knowledge about child labor than the random public. With two-thirds of the public off by a factor of 100 or more, we know we still have a lot of work to do to close the perception gap.

In the last decade, the CLC has posted nearly 11,000 tweets to increase public understanding that child labor is a widespread and pernicious problem. We’re also active on Facebook (@ChildLaborCoalition) and our website (stopchildlabor.org) generates about 100,000 visits a year.

Those efforts don’t seem to be enough and we could use your help in the fight to end child labor. Please follow our posts and share them. Be a warrior in the fight to end child labor!

Remember that Child Fund International poll in 2013 we started with? The good news revealed in that survey was that more than half (55 percent) of the respondents said they would pay more for clothing made without child labor. They said they would pay 34 percent more on average for clothing untainted by child labor! According to cleanclothes.org, labor costs are typically less than 3 percent of clothing costs. Ending child labor would not raise prices significantly.

Garments are just one of 150 products identified by the U.S. Department of Labor “Sweat and Toil” app as being produced with child labor. If consumers are willing to pay more for child labor free clothing, they are likely to pay more for all products without child exploitation. That’s very encouraging.

The Child Labor Coalition is co-chaired by the National Consumers League and the American Federation of Teachers. Consumers who wish to donate to help reduce child labor can do so here.

NCL testified before FDA committee meeting on Pfizer-BioNTech COVID-19 vaccine

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For immediate release: December 11, 2020

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC – The National Consumers League (NCL) testified before the Food and Drug Administration (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC) this week regarding the Pfizer-BioNTech COVID-19 Vaccine.

“As the nation’s oldest consumer advocacy organization, NCL has been encouraged by the honesty, transparency, and access afforded to the public during this critical time.” NCL commended the Food and Drug Administration, Centers for Disease Control and Prevention, and other public health entities for their commitment to fostering public trust throughout the COVID-19 vaccine development and approval process and thanked the committee for the opportunity to speak.

In its testimony, NCL noted that there has never been a more critical time for consumers to have confidence in the FDA.

Emergency Use Authorization (EUA):

The FDA has undergone scrutiny from the scientific community for prematurely issuing EUAs for COVID-19 therapeutics. NCL is aware that developing a vaccine for COVID-19 is a time-sensitive priority and appreciates that the FDA recognizes that an EUA is not intended to replace long-term randomized clinical trials data associated with full FDA approval. We are encouraged by data reporting a consistent vaccine efficacy rate of 95 percent across age, gender, race, and ethnicity demographics and look forward to seeing more guidance around the vaccine, as the trial continues to collect safety and efficacy data.

Safety and Effectiveness:

NCL noted the public’s growing trust in the FDA’s rigorous vaccine approval process and called on the agency to perform ongoing post-market surveillance. Such surveillance performed in the United Kingdom found that the vaccine may be unsafe for individuals with severe allergies. Consumers will rely on ongoing guidance from public health agencies regarding any potential adverse events from the vaccine and expect that the FDA will be aware of these concerns.

Innovative Vaccine Delivery Systems:

Additionally, ensuring innovative vaccine delivery methods, such as including oral or nasal options, could address geographical access issues, diverse health needs, and increase uptake overall.

Diversity in Clinical Trials:

We applaud Pfizer’s efforts to ensure diversity in their COVID-19 vaccine clinical trials. NCL requests that the FDA continue to prioritize vaccine clinical trial data that reflects diversity, as people of color will need to have confidence in the vaccine’s efficacy. This will affect the overall uptake of the vaccine.

The development of a COVID-19 vaccine in such a short time frame is a huge scientific feat, made possible through robust collaboration between private and public entities. NCL will continue to support the FDA and CDC in efforts to release a COVID-19 vaccine safely and expeditiously.

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About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

Throwing COVID-19-related cautions to the wind

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Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy

Over the past nine months, we’ve lived in a state of hypervigilance. The meticulous precautions we’ve observed throughout the pandemic have taken a toll on us. At worse, we’ve lost a loved one, friend, or coworker to this incessant virus. At best, we’ve been forced to recalibrate our routines and our lives. This collective weariness, to which experts have coined “COVID-19 Caution Fatigue“ is a prevailing factor in the current spike in cases.

When we are subjected to high levels of stress (e.g., high alert related to COVID-19), it can activate the stress hormone, cortisol. High levels of this hormone can cause us to become desensitized to the stimuli that triggered the stress hormone in the first place. Meaning, we start to ease up on our vigilance because the threat feels less real. These factors compounded—by feelings of isolation due to limited social contact‑—may have caused us to lose the motivation to maintain safe practices.

We see evidence of this as people are increasingly dining indoors, gathering for weddings, going to rallies, and are boarding flights nationwide. These behaviors are considered responsible for “superspreader events,” where COVID positive people expose multiple others. On average, every person with COVID-19 can potentially transmit the virus to two to three additional people. This has a multiplier effect with people spreading it, in turn, to another two to three people, and, well, you get the picture.

Dr. Fauci has warned that large gatherings during the holiday season could lead to “a surge superimposed upon that surge that we’re already in.” The pandemic demands personal sacrifices—which in turn leads to COVID induced malaise. I’ve personally RSVP’d “No” to a couple of family weddings—because the health and safety of my family matters more than joining them for a round of the “Cha Cha Slide.”

We must listen to public health experts. As I write this, the United States has more than 14.2 million COVID-19 cases and 275,000 deaths. These sad statistics will increase throughout the holiday season. Here are some ways you can combat COVID-19 Caution Fatigue:

  • Build a new routine. Find new and safe ways to move, interact with people, and entertain.
  • Healthy behaviors: focus on nutrient dense food, get adequate sleep, and limit alcohol use.
  • Journal: reflect on all that you’ve endured this year. A lot of us have been pushed to grow, expand, and adjust in unexpected ways. Focus on how far you’ve come, how resilient you are, and keep pushing.
  • Limit sreen time: For those of us working from home, it’s become increasingly tricky to maintain a work-life balance. Try to log off at a set time every day and take a break from screens in general (phone, TV, computer) and find ways to decompress from your day.
  • Personal improvement: Use time that would’ve been spent socializing on cultivating a new hobby. Take a free online course to learn a new concept. I personally like Coursera. Or learn a new language through mobile apps like Duolingo.
  • Prioritize self-care. Practice guided meditations via mobile apps like Headspace, read, or even start virtual therapy to process your emotions, through services like Talkspace.

In recognition of the emotional toll of social distancing, the CDC has issued guidelines on how to cope during the holidays. There’s light at the end of the tunnel. Perhaps several COVID-19 vaccines will be available in the coming months. That said, we have a long way to go, as the demand for the vaccine will far exceed its supply for many months. Remain vigilant and continue to adhere to pandemic-related safety guidelines. Our collective efforts will keep us safe while the vaccines become available across many demographics. Let’s continue to keep ourselves, our loved ones, and our communities safe through care and precautions against COVID-19. Mask up, stay 6 feet apart, wash your hands frequently, and avoid large gatherings. Happy and safe holidays to all!