Fee-for-service health care system deserves scrutiny – National Consumers League

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By Sally Greenberg, NCL Executive Director

A new study reveals that doctors’ fees and salaries – especially those of medical specialists – in the United States are much higher than they are in other western countries. That actually shouldn’t come as a surprise. As Atul Gawende has written in a New Yorker magazine piece entitled “The Cost Conundrum,” a fee-for-service system of health care means that doctors get paid per procedure, so the more procedures they do, the more they get paid. There’s every incentive, then, for them to recommend medical procedures even when they may not be needed.

What surprised me about this study, done by Columbia University professor Sherry A. Glied (who now works for HHS), and one of her Columbia colleagues, was that the average orthopedic surgeon in the United States earns an average of $442,450! That means figuring in all of the doctors across the country, in expensive and less expensive communities, that’s the average. That’s a lot of money to earn in one year. In other countries, the average for orthopedic surgeons is more like $210,000.

Even American primary care doctors earn 1/3 more than their counterparts in places like Australia, Canada, France, Germany, and the UK. The study concludes that the inflated cost of physician salaries in the United States is driving up the cost of health care without corresponding benefits to patients overall health.

I respect and admire doctors, and I understand that they are highly trained professionals who save lives and that most are deeply committed to their patients. But the payment model of fee-for-service for doctors must not be exempt from scrutiny as we seek to reduce the cost of health care in the United States.

NCL Fact Sheet on Saw Safety – National Consumers League

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Table saws cause tens of thousands of serious injuries every year, costing billions of dollars.

Approximately 40,000 Americans go to hospital emergency rooms every year with injuries sustained while operating table saws.  About 4,000 of those injuries – or more than 10 every day – are amputations.

Table saw injuries cost the United States approximately $2 billion every year. 

Current table saw safety standards have proven ineffective in protecting consumers.

The primary technology used by the majority of table saw manufacturers to prevent table saw injuries is a plastic blade guard.  This technology has remained essentially the same for over 50 years.  Yet, blade guards have proved to be ineffective in reducing the 40,000 serious table saw injuries that occur every year.

Guards must be removed in order to perform many tasks on a table saw, such as cutting a notch in a board.  Users find them cumbersome and many simply remove the guards from their saws.  According to the most recent CPSC injury report, in approximately two-thirds of table saw injuries, the guard had been removed. And even when guards are in place, blade contact injuries can occur.  The CPSC report found that almost one-third of table saw injuries occur with the blade guard in place.

Technologies exist that prevent serious injuries if a person comes in contact with the blade.

One of these technologies, called SawStop, stops the blade within milliseconds of contact to minimize injury.  It is on the market already and has demonstrated its effectiveness with over 1000 finger saves.  Another technology was developed by a consortium of table saw manufacturers.  It retracts the blade within milliseconds of contact to minimize injury.  It has not yet been brought to market.

The benefits of improving table saw safety clearly outweigh the costs. 

It would cost approximately $100 per saw to put automatic safety technology on every table saw sold in the United States. According to Dr. John D. Graham, head of the Office of Information and Regulatory Affairs for President George W. Bush, an average table saw equipped with an automatic safety system will deliver $753 in benefits due to reduced injuries. The $753 benefit per table saw is many times greater than the $100 cost per saw to equip table saws with automatic safety technology, which means this safety requirement would be very cost-effective.  And those monetary benefits don’t even take into account the benefits of eliminating pain, suffering and emotional trauma that serious injuries impose on victims and their families.

The table saw industry is using many of the same arguments that auto manufacturers used to delay airbag requirements for 20 years.  In that time, an estimated 162,000 people died unnecessarily.

In the eight years that the Power Tool Industry (PTI) has been opposing automatic safety technology for table saws, an estimated 320,000 serious table saw injuries have occurred, including 32,000 amputations.

The PTI argues:

  • The requirement would be too costly.

But statistics show that it is cost-beneficial to prevent 40,000 serious injuries every year with this proven technology.  Auto manufacturers also argued that airbags would be too expensive for many cars and that consumers would not want to spend more money for the additional safety.

  • Blade guards work if people will use them.

Blade guards must be removed for many kinds of cuts made on a table saw, so they cannot be used all the time.  Automatic safety devices on table saws, in contrast, can be used for virtually every cut of wood and other non-conductive material. Also, people don’t use blade guards because they are cumbersome and often interfere with the work. Automatic safety devices, in contrast, are invisible to the user and they don’t interfere with the work.

Automobile manufacturers argued that seat belts were sufficient to protect drivers and passengers. Airbags and seat belts are similar to automatic safety devices and blade guards.  Many people don’t use seat belts.  And unlike seat belts, airbags are automatic devices that are invisible to the user and they don’t interfere with the operation of the car.

And just like airbags and seat belts, the safest way to operate a table saw is to have both an automatic safety device AND a blade guard.

  • If consumers want to pay extra for safety, they can buy the safe table saw that is now on the market.

It is wrong to say that consumers will pay more if safer saws are required because society is already paying $2 billion per year due to preventable table saw injuries.  Society will save money if safer saws are required.  In addition, safety should not be available to only those who can afford it.  What if we sold cars with seat belts and airbags only to those who could afford them?  Or only made safe food and water available for those who could pay for it?  Safety shouldn’t only be for the affluent.  All members of society have a right to expect that the products they use will be safe.

It is time for the Consumer Product Safety Commission to act quickly to enact a performance standard that would require table saws to mitigate injuries when blade contact occurs or is about to occur.   Table saws that would meet such a performance standard are already operating successfully in the marketplace; the benefits far outweigh the costs; and injuries have not been reduced under the current voluntary safety standard.   Every day of delay means another 100 serious injuries – that is too high a price to pay.

Advocates force ouster of Uzbek official from Fashion Week over child labor issues – National Consumers League

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By Reid Maki, Child Labor Coalition Coordinator and NCL Director of Social Responsibility and Fair Labor Standards

It’s not every day that you get your message through to one of the world’s most notorious dictators, but some of us in the child labor advocacy community think we may have just done that last week during New York City’s Fashion Week.

For several years, the Child Labor Coalition, 28 organizations working to end the labor exploitation of children around the world, has been deeply concerned about the forced use of child labor in Uzbekistan, where Islam Karimov has ruled with an iron fist for 21 years. Each fall, Uzbek school children and their teachers are forced to leave their classrooms and perform arduous hand-harvesting of cotton for up to two months. The children—estimates of their numbers range from several hundred thousand to almost two million—receive little or no pay and often perform this back-breaking work from young childhood and through college. The workers are charged for shelter and food and by the time those expenses are deducted their compensation is so small it would be fair to say they worked for little or no pay or “slave wages.” The profits of this labor tend to flow to Uzbekistan’s ruling elite. Unlike child labor in most countries, Uzbekistan’s occurs as a result of national policy filtered down to local government authorities.

Recently, members of the Cotton Advocacy Network and the Child Labor Coalition, led by the International Labor Rights Forum and other CLC members like the American Federation of Teachers and the Human Rights Watch highlighted this issue by targeting advocacy at Karimov’s daughter Gulnara, who in addition to being Uzbekistan’s ambassador to Spain is a fashion designer who was participating in Fashion Week, where designers from around the world hold shows to reveal their new clothing lines.

Since Gulnara Karimov has bragged about the use of “high quality” Uzbek cotton and is a member of Karimov government, the advocacy community felt that she could fairly be used as an advocacy target.

As ILRF and the Cotton Advocacy Network planned its protest, IMG, Fashion Week’s organizer, washed its hands of Gulnara’s controversial show by cancelling it. Gulnara then moved her fashion show to the stylish Manhattan restaurant Cipriani on 42nd Street for a private show on September 15th. About two dozen of us followed the show to let attendees know about Uzbekistan’s child labor problem. It appears that our efforts scared away Gulnara, who according to media reports, was nowhere to be found.

We shouted things like “Hey, hey, ho, ho—Child Labor’s got to go” and “Uzbek cotton is mighty rotten.” We were joined by several Uzbek nationals, including one who had been forced to work in the fields himself as a child. Another Uzbek man said his daughter is a college student in Uzbekistan and that she is forced to harvest cotton every afternoon. He told a reporter from the Guardian that “it is back-breaking work, very, very hard, and most children have to work from sunrise to sunset every day until the harvest is finished. No weekends, nothing, for two or three months.” One protestor, an American woman from Connecticut, carried a sign that said, “Free Abdul,” who she explained was an Uzbek exchange student that she hosted who has subsequently been jailed by the Karimov regime as a political prisoner. Photos of the rally can be found here.

[youtube=https://www.youtube.com/watch?v=VVHNYRzCg7c&feature=related]

We handed out hundreds of leaflets and our protest received wide coverage about a dozen journalistic organizations including the New York Post, and Britain’s Guardian newspaper.

Members of the CLC conducted a similar protest outside the Embassy of Uzbekistan in 2009. At that time, some of us wondered if word of the protest would filter up to Karimov. With the ouster of his daughter from Fashion Week, we’re pretty sure Islam Karimov got the news this time.

If you would like clothing retailers to know about your concerns regarding Uzbek cotton, please consider adding your name to this Change.org petition (one of several targeting specific retail chains).

Airline industry disappoints consumers. Again. – National Consumers League

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$25 for one checked bag? Another $20 to choose your seat? Is it any wonder that the airline industry consistently scores the lowest in consumer satisfaction surveys? Earlier this summer, the American Customer Satisfaction index reported that, out of the 47 industries evaluated, airlines tied newspapers for the lowest-satisfaction rating, and airline satisfaction only continues to spiral downward.

The airline industry’s actions over the past few months will do nothing to improve consumer confidence. When the government failed to reauthorize the FAA in July, several federal taxes were discontinued, which could have meant a 15-percent break on airfare for passengers. Instead of passing the money saved from the tax holiday on to consumers, most airlines actually raised prices–allowing them to collect nearly $70 million a day, almost $500 million in total, before the FAA’s taxing authority was reinstated.

NCL, along with a coalition of consumer interest groups, condemned airline executives in a letter to the CEO of the Air Transport Association for their greed and lack of transparency in ticketing fees.

If airlines continue to exhibit this type of anti-consumer behavior, it’s a fair bet that the industry can expect a permanent spot on the bottom of the consumer satisfaction scale.

Consumer groups spotlight airline greed and hidden fees – National Consumers League

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September 14, 2011

Contact: NCL Communications, (202) 835-3323, media@nclnet.org

WASHINGTON, D.C. – In a letter to the CEO of the Air Transport Association, a coalition of consumer interest groups today condemned airline executives for two major anti-consumer moves over the last few months — pocketing tax monies that should have gone to consumers and continuing to obscure their proliferating airline fees.

First, many airlines chose to pocket nearly $500 million during the temporary shutdown of the U.S. Federal Aviation Administration (FAA) rather than refund the discontinued excise tax charges and other government fees. The Consumer Travel Alliance, Consumers Union, National Consumers League, Consumer Action, US PIRG, AirlinePassengers.org, Association of Airline Passenger Rights and Consumer Federation of America noted in the letter that the majority of airlines actually raised their airfares rather than pass this money onto consumers as savings.

The FAA’s taxing authority expired on July 23 when Congress failed to extend the reauthorization of the agency. At the same time, the Air Transport Association was delivering newspaper advertisements to Senate and House offices, calling for tax reductions in order to provide consumers more bang for their dollar.

The airlines that increased their airfares were able to collect nearly $70 million a day, almost $500 million in total, before the FAA’s taxing authority was reinstated on Aug. 8th.

“This could have been a profound teaching moment,” the consumer interest groups wrote, “regarding the benefits of lower aviation taxes and fees. Instead, we are chagrined that some airlines chose to pocket the substantial windfall created by the expiration of taxing authority. Rather than doing right by their customers, most airline CEOs decided to line their corporate pockets.”

The letter also urged the ATA to insist the airlines adopt greater transparency with respect to airline fees that can add substantial amounts to ticket prices. When the Department of Transportation’s (DOT) latest rules came into effect requiring airlines to inform consumers of the variety of optional fees related to the cost of an airline ticket, many of ATA airline members chose to present the information in ways that do not meet the test for a “prominent” link on the home page. This is despite the DOT’s clear intent to provide transparency for consumers with respect to airline fees that can add substantial amounts to ticket prices.

“Actions speak louder than words,” the groups wrote. “Airlines, like all businesses, should be driven by customer service, price transparency and honest disclosures. Suffice it to say, we are disappointed in most of the airline industry’s response to the new DOT rules.”

The consumer groups are calling for a meeting with ATA and making sure that the Secretary of Transportation and the appropriate congressional committee chairmen and ranking members are aware of these anti-consumer airline actions.

To learn more about these consumer interest groups visit their websites:

AirlinePassengers.org, www.airlinepassengers.org

Association of Airline Passenger Rights, www.flyfriendlyskies.com

Consumer Action, www.consumer-action.org

Consumer Federation of America, www.consumerfed.org

Consumer Travel Alliance, www.consumertravelalliance.org

Consumers Union, www.consumer.org

National Consumer League, www.nclnet.org

U.S. PIRG, Website: www.uspirg.org

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About the National Consumers League

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.

‘But Moooooommm!’ – help for parents shopping for tweens’ cell phones – National Consumers League

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By John Breyault, NCL Vice President of Public Policy, Telecommunications and Fraud

As kids head back to school this time of year, parents will undoubtedly soon be deluged with requests to buy cell phones for their children. Research shows that children are having these wishes fulfilled at progressively earlier ages, as well.

For example, a 2009 Pew Internet and American Life Project survey found that 5 percent of 16-year-olds say they received their first cell phone at age 11 or before. Conversely, 57 percent of 12-year-olds say they received their first cell phone at age 11 or before.

The complaints of family blogger Carol Brooks Ball mentioned recently are typical when it comes to parents’ headaches surrounding their tweens’ first phones:

“Both of my children have cell phones. And both phones, in my mind, were purchased for the sole purpose of keeping in touch. With me.

Them, not so much. To them, their cell phones serve the purpose of allowing virtually-constant contact with friends.

…

When I first got the kids their cell phones – when they were both ‘tweens’ – I learned the hard way about the cost of going over the wireless plan’s small monthly allotment for text messaging. My daughter quickly burned through the texting limit (my son wasn’t, and still isn’t, much of a texter; if I send him a text message, he calls me back).

While I soon set limits for my daughter due to her texting proclivities, I also quietly signed up for unlimited texting through my wireless carrier. But, how great it would have been to have had some objective guidance on the subject at the time.”

It’s for parents like Carol that NCL, through an educational grant from TracFone Wireless, has produced a new consumer guide for parents of tweens getting their child’s first cell phones.

When considering a tween’s first cell phone, parents have a number of important considerations to keep I mind. For example, an older teenager is likely to be using their phone to stay in touch while at an after-school job. On the other hand, a tween is less likely to be roaming far from home on their own, needing a phone only to call Mom for a ride home from soccer practice.

Older teens are more likely to be riding in cars with other teens, so a serious discussion about texting-while-driving will likely be in the cards. Pre-teens probably won’t find themselves without an adult in a car, but they do take their phones with them while on two wheels, so texting-while-biking should be a topic of discussion. Tweens also may not have had as much practice in taking care of their own personal (and expensive!) electronics as older teens.

To help parents with these and other issues, NCL’s new guide contains a wealth of tips for parents for figuring out why (or even if) your tween needs a cell phone, sorting through the vast universe of handsets and service plans and setting “rules of the road” for responsible use.

NCL statement on USDA’s announcement to regulate six additional strains of E. coli – National Consumers League

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September 13, 2011

Contact: NCL Communications, (202) 835-3323, media@nclnet.org

Washington—The National Consumers League has issued the following statement regarding today’s U.S. Department of Agriculture (USDA) announcement:

“The National Consumers League applauds USDA’s announcement that the agency will add six strains of non-0157 shiga toxin-producing E. coli (STEC), known as “the Big Six” to its list of adulterants.

Foodborne illness impacts 1 in 6 Americans annually, leading to over 120,000 hospitalizations and 3,000 deaths annually. According to the Centers for Disease Control and Prevention (CDC), E. coli is a major source of illness and non-0157 STECs account for nearly two-thirds of E. coli infections.

USDA’s announcement means that American consumers will now be protected from “the Big Six” for the first time. These measures will ensure that the U.S. food supply is even safer in coming years. The National Consumers League, which has worked in concert with other consumer groups in support of this measure, commends the USDA on its decision to regulate these dangerous strains of E. coli.”

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About the National Consumers League

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.

NCL statement on the 10th anniversary of 9/11 terrorist attacks – National Consumers League

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September 11, 2011

Contact: NCL Communications, (202) 835-3323, media@nclnet.org

Washington, DC—The National Consumers League posted this statement on the 10th Anniversary of the 9/11 terrorist attack on the United States.

“The National Consumers League pays tribute to the nearly 3,000 people who were killed in the 9/11 attacks on the United States. On this solemn 10 year anniversary of the unspeakable series of terrorist attacks on the United States, the NCL joins with our fellow Americans in mourning the loss of so many innocent men, women and children.

The forces of evil who orchestrated this despicable attack were motivated by a contempt for the democracy we hold so dear in the United States, and for a way of life that respects and protects the rights of all people. We also acknowledge the many first responders – police officers, fire fighters and emergency medical teams – many of whom were public employees – who lost their lives rushing into burning buildings trying to save the victims of the 9/11 attacks.

We join with President Obama – who spoke at Washington’s Kennedy Center tribute this evening- in redoubling our commitment to democratic ideals, and in paying tribute to the thousands of Americans, and their surviving families, who died 10 years ago in the terrorist attacks on the United States. “

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About the National Consumers League

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.

Welcome to the 2011-2012 LifeSmarts program year! – National Consumers League

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By Lisa Hertzberg, LifeSmarts Program Director

The pencils are sharpened, the new tennis shoes are squeezing the toes, and students across the country are primed to learn about consumer issues and tackle NCL’s competition about real-life: LifeSmarts.

LifeSmarts introduces middle school and high school students to real-world knowledge they can use now. We quiz them about workers’ rights, managing money, eating well, using technology, and much more.

Students may begin competing today!  Students can practice using the vast array of consumer resources available at lifesmarts.org, including practice quizzes.

Highlights at lifesmarts.org include:

  • TeamSmarts: Monthly 100-question quizzes focus on one topic area. Teams of students can work together and test their smarts against other teams from across the country. Prizes go to the top LifeSmarts and FCCLA teams each month. To warm up, try the practice quiz first (password: practice)

We are excited to kick-off the new LifeSmarts program year today! We expect it will be our best year yet. Join us!

LifeSmarts launches 2011-2012 program year at lifesmarts.org – National Consumers League

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September 12, 2011

Contact: NCL Communications, (202) 835-3323, media@nclnet.org

Washington, DC—The 2011-2012 LifeSmarts season is officially underway this week, with a new competition year going live at the program’s online home, www.lifesmarts.org, along with a variety of new resources for adult and youth participants. LifeSmarts is an educational competition run by the National Consumers League that tests middle school and high school students nationwide on real-life consumer issues through online quizzes and live contests. It culminates in the annual national LifeSmarts championship, where winning teams and individuals are awarded academic scholarships and prizes.

“We’re thrilled to be launching the 18th year of LifeSmarts,” said Program Director Lisa Hertzberg. “LifeSmarts delivers real-world knowledge to students and allows them to shine in competitions where they demonstrate all that they have learned,” said Hertzberg. “It also provides thousands of teachers across the country access to much-needed consumer curriculum, which they unfortunately often aren’t getting elsewhere.”

Over the years, LifeSmarts has steadily grown in numbers of student and adult participants, state partnerships, and corporate sponsorships. In the most recent season, an estimated 100,000 students and teachers across the country answered more than 3.5 million LifeSmarts questions.

“As the consumer marketplace has become more challenging to navigate, LifeSmarts content is keeping up, preparing our teens and tweens to become the next generation of smart consumers and workers,” Hertzberg said.

LifeSmarts provides participants with practical advice and information on consumer issues ranging from personal finance and health and safety to the environment, technology, and consumer rights and responsibilities. Starting online each fall, the competition progresses to live state play-offs, and then builds to a high-spirited National Championship, which will be held in 2012 in Philadelphia, Pennsylvania. At last year’s national competition held in Hollywood, California, students on teams from 32 states competed over the course of four days. In the final match, the state champion team from Nickerson High School, Kansas, was crowned the 2011 national champs, beating out the team from New Hampshire.

NCL partners with coordinators in more than 30 states, including Better Business Bureaus, credit unions, state attorneys general and consumer protection agencies, State FCCLA organizations, Jump$tart Coalitions, and others, to staff and promote the program. Interested students and adults can visit the LifeSmarts Web site to connect with the program in their state.

“The National Consumers League’s mission is to inspire confidence and safety in the marketplace,” said Sally Greenberg, NCL Executive Director. “The LifeSmarts program, our consumer education initiative for youth, fosters students’ understanding of consumer issues and provides them with real-world knowledge they will need to take charge of their lives.”

New this fall at www.lifesmarts.org are dozens of up-to-the-minute teaching resources for coaches, including innovative lessons housed within the LifeSmarts U virtual campus, daily practice quizzes, question-of-the-day calendars, and more, all utilizing thousands of new competition questions.

Major LifeSmarts contributors include Visa, Experian, Toyota Financial Services, Western Union, American Express, American Century Investments Foundation, Bridgestone Retail Operations, LLC, McNeil Consumer Healthcare, TracFone Wireless, Inc., and others. To see a full list of current LifeSmarts contributors, visit www.lifesmarts.org.

To test your LifeSmarts, take a sample quiz at https://start.lifesmarts.org/. From there, click on “Daily Quiz” to get started.

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About the National Consumers League and LifeSmarts

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.

LifeSmarts is a program of the National Consumers League. State coordinators run the programs on a volunteer basis. For more information, visit: www.lifesmarts.org, email  lifesmarts@nclnet.org , or call the National Consumers League’s communications department at 202-835-3323.