January 6, 2025: On this episode of NCL’s “We Can Do this” podcast, National Consumers League CEO Sally Greenberg speaks with Amy Hinojosa, President and CEO of Mana, a National Latina Organization, and Dr. Ge Bai, an expert on health care accounting, finance, and policy at Johns Hopkins University, regarding a shocking lack of transparency for a program that has more than doubled in cost reaching more than $120 Billion in 2022.
In terms of the number of people it affects and the serious health problems it creates, obesity is the most significant chronic disease in human history. And yet, it is a disease that is too frequently undiagnosed and untreated, and leads to harsh judgments rather than understanding and care.
As a physician who has devoted my career to addressing the disparities affecting obesity sufferers, I am grateful for the work of the National Consumers League (NCL) in communicating the message that people who have this disease matter and that they have the right to quality healthcare without enduring discrimination or bias.
This argument can’t be made strongly enough. Obesity is a disease that people wear. You can’t look at someone and tell if they have cancer, high blood pressure, or diabetes. Often, you can look at someone and determine that they have obesity, and that leads to negative assumptions about their lifestyle instead of an acknowledgment that they have a chronic disease requiring treatment.
NCL and the National Council on Aging demonstrated essential and invaluable leadership by creating the first-ever Obesity Bill of Rights, defining the core requirements for people with obesity to receive person- centered, quality care. They established, for example, the right to respect from all members of an integrated care team, the right to treatment from qualified health providers, the right to receive care in settings that allow for privacy and the use of size– and weight– accessible equipment and diagnostic scans, and the right to coverage for treatment with access to the full range of treatment options for the patient’s disease.
These organizations put muscle behind their message by creating the Right2ObesityCare, a grassroots movement focused on ensuring that these rights are incorporated into medical practice.
As NCL CEO Sally Greenberg said very well when the Obesity Bill of Rights was announced, “For too long, adults with obesity have encountered a healthcare system that is working against them. They have been stigmatized, discriminated against, not treated with respect by their health providers, and have faced significant hurdles and burdensome requirements to receive obesity care.”
This commitment to health equity remains critical at a time in which 1 billion people worldwide and more than 100 million in the United States are living with obesity. This is a disease for which, too frequently, the economic haves and have-nots in our society have significant differences in care and coverage. There are novel therapies— GLP-1 agonists like Ozempic and Trulicity, for example—that can improve blood sugar control and lead to weight loss. Those in the higher socioeconomic strata have generous health insurance plans that cover these drugs. In contrast, those who struggle financially don’t have access even though they tend to have higher obesity rates.
If we’re to address a disease of this extraordinary magnitude, then these inequities must be addressed.
This is, in fact, a disease so far-reaching that it can’t be solved by just one breakthrough therapy or one effective medicine. This will require a multifaceted approach involving virtually every sector of our society and multiple industries. Most of all, it will take vision and leadership to keep making the point that obesity patients matter and that they require care, not judgment.
NCL is providing that voice, and its actions will continue to be critical in combating this ongoing healthcare crisis.
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Dr. Fatima Cody Stanford is an obesity medicine physician, scientist, educator, and policymaker at Massachusetts General Hospital and Harvard Medical School. She is a sought-after expert in obesity medicine, who bridges the intersection of medicine, public health, policy, and disparities
By Sam Sears, Health Policy Associate, National Consumers League
The National Consumers League (NCL) recently published a new issue brief focused on hospital’s medical debt practices. With over 100 million Americans grappling with medical debt, and 1 in 7 of them reporting to KFF Health News that they’ve been denied care, it is prudent to evaluate these anti-consumer hospital policies.
The analysis, which was completed by Magnolia Market Access, found that 340B hospitals are significantly more aggressive with their medical debt policies – 340B hospitals are twice as likely to deny or defer chare and also significantly more likely to take legal action against a patient. Additionally, our analysis found that for-profit hospitals are significantly less aggressive in their practices against patients with medical debt than nonprofit or government hospitals, and that screening for financial assistance does not resolve medical debt issues.
Medical debt is unpredictable and can have long lasting consequences. Nearly 50% of Americans struggling with medical debt have it reported to their credit report, and over 40 million people owe nearly $88 billion that has been sent to collections. The Biden Administration has taken action to combat and address medical debt, which you can read more about here on our blog. However, there are additional actions that policymakers may take.
NCL has, and continues to fight to protect consumers from excessive troubles due to medical debt, including working with policymakers to combat anti-consumer debt collection policies hospitals continue to practice. The findings from the analysis conducted in this issue brief further highlight the need for 340B Drug Pricing Program reform, to ensure the savings that hospitals receive are reinvested in ways that continue to benefit consumers and patients.
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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 nclnet.org.
For more than a century, the National Consumers League (NCL) has been a vigorous advocate for consumers, playing a pivotal role in protecting health and safety, by providing vital and reliable information on medical and food products so that individuals and families can make informed decisions about matters that affect their well-being.
Since being chartered in 1899, the organization has worked to create and strengthen protections for consumers. These critical protections were led initially by the work of its first general secretary, Florence Kelley, who helped spread the word about the importance of typhoid vaccines to mitigate a disease outbreak at the end of the 19th century and helped lead the League’s efforts to promote the Pure Food and Drug Act of 1906, which laid the foundation for the Food and Drug Administration (FDA).
Indeed, the work and mission of NCL shares much with the FDA, an agency that embraces a basic responsibility to provide the public with accurate, science-based information so that Americans can make well-informed decisions about their health. We’ve seen great success in this area, thanks in part to the work done by NCL. Nevertheless, we still face great challenges, and I am confident that NCL will play a very important role in addressing these as well.
Our nation has enacted important laws to help protect consumers, and we have marshaled extraordinary progress in science and technology in the development of new treatments and cures for diseases. Despite these and other advances that enable us to improve our health, we are today witnessing a troubling new development in, and threat to, public health. Notably, we are experiencing a worrisome decline in our nation’s life expectancy that is in part linked to an increasing prevalence and cumulative impact of a number of chronic diseases — heart, vascular, metabolic (such as obesity and diabetes), and lung and kidney disease, and to troubling rates of overdoses, suicides, and gun violence.
Just as regrettable is the growing problem of misinformation about public health, science, and medicine. A stream of misinformation and often unfounded opinions, most often spread via the Internet and social media, is eroding the public’s trust in science and government agencies, such as the FDA, making it increasingly difficult for the public to verify facts and advice from these trusted sources.
While not a new problem in our nation’s history, the digitization of our culture and the rapid growth of social media have exacerbated the pervasiveness and impact of the problem. This is an area where NCL’s powerful voice and unimpeachable credibility can have an enormous impact. Neither the FDA, nor the entire federal government can combat the spread of misinformation on its own. It is going to require a concerted non-governmental response. Few organizations are better positioned to succeed at this task than the National Consumers League.
It wouldn’t be the first time NCL rose to the occasion. During the COVID-19 public health emergency, NCL was an essential voice – helping Americans better understand the virus, its variants, and how to protect themselves from infection. The organization testified before the FDA and Centers for Disease Control and Prevention panels on vaccine development and safety and advocated for limits on social media misinformation during that crisis.
Similarly, NCL has provided enormous public benefit through its work to help consumers understand food labeling, to hold companies accountable for the claims they make regarding food and health care products, and with programs such as Script Your Future that help raise awareness of the importance of medication adherence among patients, particularly those with chronic health challenges.
There is an old saying that a lie can get halfway around the world before the truth can get out of bed. Given the speed and reach of social media today, that analogy can be applied to misinformation, which is disseminated far too quickly to be adequately countered with trustworthy facts. However, we don’t have the luxury to surrender. The lives and well-being of too many people depend on our ability to provide the public with reliable information grounded in science.
I am confident in our ability to overcome this latest challenge, thanks in large part to allies like the National Consumers League with its long track record of empowering generations of Americans to make well-informed decisions to secure their health and their futures. I look forward to NCL’s continued activism, engagement, and leadership.
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Robert M. Califf, M.D. is Commissioner of the Food and Drug Administration.
The drive to achieve accessible, affordable, high-quality healthcare for every man, woman, and child in the United States has been a long one, and it has been a central pillar of the National Consumers League’s (NCL’s) mission and history. Having served as Secretary of Health and Human Services during the creation and implementation of the Affordable Care Act (ACA), I have a great awareness and appreciation for the role NCL has played in bringing health security to more Americans and preventing those protections from being diminished or taken away by opponents of progress.
As I said, it’s been a long battle and one that is far from complete. You can go back to the Franklin D. Roosevelt Administration to witness NCL’s impact on health reform. Josephine Roche, a former president of NCL, was by President Roosevelt’s side writing the first-ever universal healthcare bill to be introduced in Congress. Components of that legislation became the groundwork for the creation of Medicare and Medicaid.
In building a healthier nation, NCL also played a key role in the passage of the Sheppard– Towner Maternity and Infancy Protection Act, the first venture of the federal government into Social Security legislation and the first major law that came to exist after the full enfranchisement of women. Before its passage, most of the expansion in public health programs occurred at the state and local levels. The act provided support for women and their babies through pregnancy and childbirth and resulted in a decrease in infant mortality rates. It was repealed after lobbying by the American Medical Association, which argued it was “socialized medicine” in 1929, but when the Social Security Act was passed in 1935, it included many of the same provisions.
Since that time, NCL’s name has been there whenever opportunities occur to improve the health and well-being of consumers and working Americans or when efforts to roll back hard-won healthcare benefits need to be fiercely opposed. The Department of Health and Human Services has one of the most far-reaching portfolios of any cabinet department, and, as Secretary, I valued NCL’s ability to weigh in on so many of those issues, be they Medicare reform, prescription drug affordability, or food safety.
What I appreciate about NCL’s work in this space is that its mission involves not just policy advocacy, but also practical guidance for consumers trying to navigate the complexities of our healthcare system. The organization has been an invaluable resource in helping people better understand their healthcare coverage options; protect themselves against fraud; realize the importance of being up-to- date on vaccines; and, through the excellent Script Your Future program, practice better medication adherence.
The need for NCL in today’s healthcare sphere is more important than ever. Healthcare is, and always has been, a politically charged, volatile issue. As we saw during the battles to enact the ACA and prevent its repeal, and again during the COVID-19 pandemic and the effort to get people vaccinated, there is no shortage of misinformation designed to thwart public health initiatives. We need NCL, with its impeccable credibility, to combat the misinformation clutter and to cut through the noise with reliable, evidence-supported messaging that the American people can trust.
NCL’s voice is vital, as well, in the continuing battle to make healthcare more affordable and accessible. While the ACA has been an enormous success in reducing the number of uninsured persons in this country, patients and consumers are still dealing with industry machinations that make it more difficult to get the treatments they need and make out-of- pocket costs higher than they should be. NCL continues to be an effective advocate so that patients and their healthcare providers, rather than insurers, can determine the best course of treatment together.
Yes, the road to universal healthcare is a long one, but we wouldn’t be as far in this journey as we have come without the work of the National Consumers League.
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Kathleen Sebelius is the CEO of Sebelius Resources, LLC, a strategic advisory firm, and was Secretary of Health and Human Services under President Barack Obama, and was a 2023 recipient of the Trumpeter Award.
By Nancy Glick, Director of Food and Nutrition Policy
Today, over 100 million Americans, or 40.3 percent of adults, are living with obesity. This makes obesity the nation’s most widespread chronic condition, impacting many more people than diabetes, heart disease, stroke, certain cancers, chronic lung disease, and chronic kidney disease.
Yet, the sad fact is obesity still gets short shrift from health professionals and policymakers, even though it worsens the outcomes of more than 230 chronic diseases, is responsible for an estimated 400,000 premature deaths annually, and costs society an estimated $1.72 trillion a year. As a consequence, only 10 percent of people with obesity get help from medical professionals, meaning the disease remains largely undiagnosed and undertreated. This is occurring even though leading medical societies, including the American Medical Association (AMA), agree that obesity is a serious disease requiring comprehensive care.
It doesn’t have to be this way, which is why the National Consumers League worked with the National Council on Aging and leading obesity experts to issue the first Obesity Bill of Rights for the nation, which establishes eight essential rights so people with obesity will be screened, diagnosed, counseled, and treated according to medical guidelines. The goal is to put an end to the prejudice, incorrect beliefs about obesity, misinformation about treatment options, and outdated government policies that keep Americans from getting the same standard of care as those with other chronic diseases.
It will take time for the Obesity Bill of Rights to be incorporated into clinical practice, but specific rights already have significance. This is the case with new “blockbuster” injectable medicines called GLP-1 (glucagon-like peptide-1 receptor) agonists that work by mimicking a hormone produced in the small intestine to reduce appetite and slow digestion. Considered a game-changer in chronic obesity treatment, GLP-1s can help people lose up to 20 percent of their weight in 26 months. Thus, The Right to Coverage for Treatment reinforces calls from obesity specialists and medical societies for an end to exclusionary coverage policies by insurers and government agencies, so GLP-1 medications are a treatment option for adults at higher risk for living with weight-related diseases.
The major challenge has been the Medicare program, which excludes coverage for weight loss drugs due to past safety concerns that no longer exist today. But this could change. On November 26, 2024 the Centers for Medicare and Medicaid Services (CMS) published a proposed rule to allow seniors on Medicare and adults with Medicaid to have coverage for GLP-1s, thereby removing one of the biggest obstacles impeding access to quality obesity care in the country. If CMS’s proposal is finalized, the right to coverage for obesity treatment will become a reality for 7.4 million Americans – a good start in ensuring that people with obesity receive individualized quality care.
However, there is a lot of misinformation about GLP-1 medications, so The Right to Accurate, Clear, Trusted, and Accessible Information is also important, especially because disinformation is raising concerns among health professionals and the public. To date, the Food and Drug Administration (FDA) has approved four GLP-1 drugs based on evidence from large-scale clinical trials that these medicines are safe and achieve substantial weight loss. Yet, critics of these drugs assert these compounds cause severe side effects in all users, claim GLP-1 medications cause depression and suicidal thoughts, and allege the European Union (EU) is investigating this matter.
Responding to these allegations, experts in obesity treatment have assembled the facts from scientific journal articles and government reports. In furtherance of the right of the public to have this information, here is a summary of these findings:
The Rand Corporation coined the term “truth decay” to call attention to the blurring of the line between opinion and fact. It is important that “truth decay” not become a new obstacle to Americans receiving quality obesity care.
By Sally Greenberg, Chief Executive Officer
The post-election lame duck session of Congress could be one of the most influential for consumers – if our elected officials are willing to act. As Americans struggle with high prescription drug costs, insurance middlemen pharmacy benefit managers (PBMs) siphon dollars from the drug pricing system into their own pockets. Two bills sitting in Congress aim to change this by increasing transparency, ensuring PBM rebates are passed directly to consumers, and disconnecting PBM profits from the price of medicines.
S. 3973: The Pharmacy Benefit Manager Transparency and Accountability Act, would require PBMs to pass on rebates from drug manufacturers directly to consumers, ensuring they benefit from cost savings at the point of sale. It also delinks PBM profits from drug prices, eliminating the incentive to drive up costs.
S. 3430: The Prescription Drug Price Relief and Consumer Protection Act establishes stronger regulations on PBMs, ensuring transparency in drug pricing and rebate negotiations, and making sure PBMs act in the best interests of consumers.
These bills will create a much fairer system, ensuring that savings reach consumers and medications are made more affordable. Congress must advance these bills this year to protect consumers from PBM exploitation now and lay the groundwork for additional healthcare reforms next session.
Although this session – and year – is coming to a close, meaningful healthcare reforms that directly benefit consumers can start now.
November 26, 2024
Media contact: National Consumers League – Lisa McDonald, lisam@nclnet.org, 202-207-2829
Washington, DC – The National Consumers League (NCL) applauds the action by President Joe Biden to allow millions of Americans on Medicare and Medicaid to have coverage for new and very effective anti-obesity medicines (AOMs), thereby removing one of the biggest obstacles impeding access to quality obesity care in the country.
At a time when obesity has become the nation’s most widespread chronic disease, it worsens the outcomes of more than 230 other chronic diseases, and is responsible for an estimated 400,000 premature deathsannually, the proposed rule issued by the Centers for Medicaid and Medicare Services (CMS) has the potential to save lives and improve the health outcomes of 7.4 million Americans. This includes approximately four million adult Medicaid enrollees who would gain new access to anti-obesity medicines and an estimated 3.4 million Medicare beneficiaries whose treatment with AOMS would be covered, reducing their out-of-pocket costs by as much as 95 percent.
The cost of new anti-obesity medicines is an obvious concern to organizations like NCL, the public health community, and policymakers. However, CMS’s proposed expansion of Medicare and Medicaid coverage for a new class of injectable GPL-1 (glucagon-like peptide-1 receptor) agonists that can achieve a substantial weight loss (up to 20 percent) represents an important investment in the improved health of Americans.
“Today’s proposed action is a major step forward in ensuring that adults with obesity get the same quality care and access to treatments as those with the 230 chronic conditions where obesity is a significant factor,” says Nancy Glick, National Consumers League Director of Food and Nutrition Policy. “Today, only 10 percent of people with obesity get help from medical professionals, meaning the disease remains largely undiagnosed and undertreated. If CMS’s proposed rule is implemented, it will go a long way towards closing this obesity treatment gap, especially since health insurance companies closely align coverage decisions with Medicare policy.”
In January 2024, NCL worked with the National Council on Aging and leading obesity experts to issue the first Obesity Bill of Rights for the nation, which establishes eight essential rights so people with obesity will be screened, diagnosed, counseled, and treated according to medical guidelines. The Right to Coverage for Treatment is one of these essential rights and will become a reality for millions of Americans on Medicare and Medicaid if CMS’s proposal goes into effect.
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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.
Sally Greenberg: Fluoridated Water is Essential for Public Health, Not a Danger
Media contact: National Consumers League – Lisa McDonald, lisam@nclnet.org, 202-207-2829
Washington, DC— In response to recent media coverage about Robert F. Kennedy Jr. and Florida Surgeon General Joseph A. Ladapo campaigning against water fluoridation, Sally Greenberg, CEO of the National Consumers League (NCL), issued the following statement:
“Robert F. Kennedy Jr.’s statements on fluoride could jeopardize a proven public health measure. Consumers are best served by reliable, evidence-based health information, not alarmist misinformation.”
The comments made by Kennedy and Ladapo echo similar claims from the 1960s, when groups like the John Birch Society suggested that fluoridation of drinking water was a “communist plot.” Today’s anti-fluoride activists point to a 2019 Canadian study that found that pregnant mothers exposed to higher fluoride levels during pregnancy, gave birth to baby boys with slightly lower IQ’s, as measured at ages 3-4. In this study, mothers were asked to self-recall beverage consumption per day and did not take into account the children’s fluoride exposure in early childhood.
The Center for Disease Control and Prevention (CDC) calls fluoridated drinking water one of the most successful public health interventions in U.S. history, with its origins dating back to 1945 in Grand Rapids, Michigan. Since then, water fluoridation has been proven to significantly reduce rates of tooth decay, especially in economically disadvantaged and vulnerable populations. The CDC estimates that fluoridated drinking water reduces tooth decay by approximately 25% in children and adults. Health authorities, including the American Dental Association and World Health Organization, affirm that fluoride is safe at the levels currently used in the U.S.
“Fluoridated water is a vital measure to protect public health and reduce health disparities in dental care,” says Greenberg. Recent examples of removing fluoride from water, such as Calgary, Canada (2011) and Juneau, Alaska (2007), resulted in an explosion of dental decay. In both cities, the absence of fluoride in the drinking water corresponded with an increase in cavities and dental surgeries, particularly among children. For more information, visit CDC’s resources on fluoride.
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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.
November 15, 2024
Media contact: National Consumers League – Lisa McDonald, lisam@nclnet.org, 202-207-2829
WASHINGTON, DC – Sally Greenberg, NCL CEO testifies at the FDA about Nonprescription Analgesic/Antipyretic Drug Development in Children 2 to less than 12 Years of Age.
A full video of the U.S. Food and Drug Administration meeting can be found here:
Nonprescription Analgesic/Antipyretic Drug Development in Children 2 to less than 12 Years of Age
Sally Greenberg, CEO of the National Consumers League, testifies at 1:32:24.
The work of the National Consumers League is making a difference in people’s lives across the country. Meet some of the consumers touched by our programs.
Read about NCL’s impact
Paige, 55, a Nashville wife and mother of two, answered an employment ad for secret shoppers. Before sending payment to the scammers, she reached out to NCL.
Read about NCL’s impact
A grease fire flared up in Decklan’s kitchen. As his family scrambled and panicked, fearing that the whole house might erupt in flames, Decklan remained calm. He hurried over to the pantry, grabbed some baking soda, and dumped it on the fire quickly extinguishing the blaze.
Read about NCL’s impact
Cincinnati resident Charles, 45, lost his computer business — and health insurance— during a time of economic downturn. A diabetic, Charles was now unable to afford his medication. He stopped taking it which made him seriously ill and put his life at risk.
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Jeremy is a fast-food worker who has been employed at a number of Chipotle restaurants in New York City. When he was just 20 years old, he took part in an NCL research project that revealed that management practices within the fast food chain were putting workers—and food safety for customers—at risk.
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By Sally Greenberg, NCL Executive Director
While the COVID-19 pandemic has led to hardship for all Americans, it is clear that people of color have been disproportionately burdened. Across the health care continuum, addressing this disparity has become part of the broader conversation about the history of systemic racism and the underlying social determinants of health that negatively affect the mental, physical, and economic health of individuals and entire communities.
The pandemic has underscored persistent health disparities, and there is growing recognition that representation in research and clinical trials can have a profound impact on health outcomes. A lack of representation from racially and ethnically diverse groups in research and clinical trials have typically led to gaps in data, missing the opportunity to assess the full impact of various treatments and drugs across a range of populations. The collection and use of real-world research and data to inform the potential use, risks, and benefits of medical products and treatments can ultimately lead to better health outcomes, particularly for those who have been underrepresented in the past.
Existing efforts to improve inclusion
Efforts to expand diversity and representation in medical research are underway in Congress. Policymakers are encouraging the incorporation of Real World Evidence (RWE) in drug development through the recent Cures 2.0 draft legislation released by Reps. Diana Degette (D-CO-1) and Fred Upton (D-MI-6). While the status quo limits us from effectively reaching underserved populations, the proposed legislation would allow studies that include RWE for some drugs after they have been approved. At the heart of this issue is a growing appreciation that the same therapy can affect different populations in different ways, which is why Cures 2.0 supports collecting data that more accurately reflects the unique experiences and needs of patients across diverse populations.
Recognizing the potential for RWE in maternal health
The lack of representative research in the field of maternal health is undeniable, and its implications are staggering. The dismal state of maternal care in the United States reflects how our health care system has failed women of color, including by not adequately studying treatment options to prevent maternal morbidity and mortality. The need for RWE is clear when you consider the persistent disparities in health outcomes that plague minority communities.
Preterm birth and its disproportionate impact on women of color is a stark illustration of the need to make progress on representative research in maternal health. Preterm birth is the second-largest contributor to infant death in America today. Despite the tremendous physical, emotional, and financial toll that preterm birth continues to take on our country — disproportionately so on women and families of color — not enough therapeutic tools currently exist to prevent it.
Today, “17P,” the only FDA-approved treatment to help reduce the likelihood of spontaneous, recurrent preterm birth in the United States is at-risk of being withdrawn from the market in all its forms, including the branded product and five generic versions. Unfortunately there is conflicting evidence from two different clinical trials, one representative of a diverse U.S. population and another studied in a largely white population in Europe. It’s not a straightforward comparison. If 17P is withdrawn, the women most affected by preterm birth, predominantly women of color, would be left without an FDA-approved treatment option.
The FDA is considering the path forward, including additional data collection through leveraging RWE from past patient use. The success of the first (approval) trial for 17P in the impacted communities signals the importance of RWE. Continued access to 17P is, at its core, a matter of health equity. Black women must not yet again be left vulnerable to a system that historically has overlooked them.
