Breastfeeding denied coverage by IRS – National Consumers League

By Sally Greenberg, NCL Executive Director

Since our founding in 1899, the National Consumers League has worked hard to advocate for the better health of women and children. Florence Kelley, the League’s first leader, grew up in a family in which five of her mother’s eight children died from infection or disease. Babies during that time – the period right after the Civil War – were relatively safe while breastfeeding. Once weaned, they were exposed to illness from unsanitary food, water, and milk. Today, though we pasteurize milk and have access to safe drinking water, breastfeeding remains the best option for babies and their mothers, at least for the first 6 months of a child’s life.

That is why NCL was disturbed to read about an Internal Revenue Service decision that denies nursing mothers the ability to use their tax-sheltered health care accounts to pay for breast pumps and other breastfeeding supplies. NCL has written to the IRS to ask that the agency reverse its decision.

According to IRS Publication 502, reimbursable items include those that aid in the “prevention of disease.” The IRS apparently has determined that breast-feeding does not help in the prevention of disease. NCL could not disagree more. Medical evidence that far more widespread breastfeeding would not only “prevent disease” in the United States, but would save our health care system billions of dollars is overwhelming.

Consider the following evidence about the myriad health benefits to both breastfeeding mother and child:

  • According to a Harvard study published in April of this year, if 90 percent of American families would comply with medical recommendationsto breastfeed exclusively for 6 months, the United States wouldsave $13 billion per year and prevent an excess 911 deaths,nearly all of which would be among infants ($10.5 billion and 741deaths at 80 percent compliance).

  • The U.S. Department of Health and Human Services has found that breastfed infants have a lower risk of contracting ear infections, stomach viruses, atopic dermatitis, type 1 and 2 diabetes, childhood leukemia, and other health problems.

  • Mothers also benefit from breastfeeding because of lower risk of contracting type 2 diabetes, breast cancer, ovarian cancer, and postpartum depression (PPD).
  • Breastfed infants typically need fewer sick care visits; Congress recently acknowledged the importance of breastfeeding in landmark health care reform legislation by requiring that workplaces provide women with a private place to nurse or use a breast pump.

As Dr. Robert W. Block, president-elect of the American Academy of Pediatrics (AAP) noted in the New York Times this week, “The old adage that breast-feeding is a child’s first immunization really is true … So we need to do everything we can to remove the barriers that make it difficult.”

We agree with Dr. Block. And NCL reached out to our friends at AAP to share our letter and join forces with those who work to protect and improve the health of babies.

NCL strongly believes we need to encourage, not discourage, barriers to widespread breastfeeding. As in Florence Kelley’s day and ours, breast-fed babies get the best of all protections. Unfortunately, the IRS determination NOT to allow parents to use their tax-sheltered flex accounts to cover the cost of breast pumps has the impact of further discouraging women from breastfeeding and directly undermines what is by every measure a critical practice for improved public health. We believe the cost of breast pumps should and must be covered cost in these flex plans. We hope that NCL’s voice, along with the voices of AAP and so many others, will help to press the IRS Commissioner to reverse his decision.

An Election Day primer – National Consumers League

By Jacob Markey, LifeSmarts Summer 2010 Intern

November is finally here, and LifeSmarts is, appropriately, focusing on topics in Consumer Rights and Responsibilities! As a political science major at the University of Wisconsin-Madison, very few moments get me as excited as election night — watching the polls come in and finding out the winners (especially if the people I vote for win).

Tuesday, November 7 is Election Day, one of the most important days of the year for both the short and long-term state of the country. Voting is one of the most important actions a citizen can take in a democracy. By voting, you can have your say in who is elected, the direction of the local, state or national government, and what could potentially be accomplished in the future. In honor of Election Day, I think a blog post about elections and voting rights will be fun.

The upcoming election is what is known as a midterm election, meaning the President is not up for re-election (his election will be in 2012). Even with the President’s office absent from the ballot, there are still many important races happening across the country. If you are a member of the House of Representatives, you certainly are up for re-election next month, as all House members have terms of two years. The terms for members of the Senate are for six years, but they are staggered so that, on average, one-third of the members are up for re-election during each election cycle. This helps to prevent the likelihood of the same amount of turnover as in the House.

Additionally, in most states there are gubernatorial elections and countless races for senators and representatives. There are numerous local races and many other issues up for referendum in various states.

Not just anyone can vote. Knowledgeable LifeSmarts participants know that there are some important criteria you must meet in order to vote, including:

  • Thanks to the 26th Amendment to the Constitution, if you are at least 18 years old and a U.S. citizen, you are eligible to vote.
  • There is no uniform method of voting. Each state runs elections slightly differently and has their own rules. These include hours the polls are open, how you can register, and locations where you may vote.
  • You don’t necessarily have to be in your home state on Election Day to vote. Through absentee voting, you can send in your choices ahead of time. So, if you are out of town on vacation, for work, school, or some other reason, you can use this method to still ensure your vote is counted.

There is so much information about the electoral system. If you are interested in more information about both the upcoming election the electoral process, I recommend you check out any major news site and/or your local paper. They have detailed information that will help to explain much more about American politics and our country’s political system.

I hope you are all as excited as I am about Election Day. If you are eligible to vote on November 7, go out and vote!

Collaborating for better (global) consumer protections – National Consumers League

By Terry Kush, NCL Senior Director of Operations and Finance

Two weeks ago today, I stood waiting in the Cairo airport anxious to return to Washington, DC. While in Egypt, I participated in two workshops (one in Luxor and another in Cairo) on behalf of the National Consumers League. The workshops, titled “Regional NGO Capacity Building Workshops,” was sponsored and coordinated by the United States Department of Commerce’s Commercial Law Development Program (CLDP) in cooperation with the Egyptian Consumer Protection Agency (ECPA), and funded by United States Agency for International Development (USAID). I was joined by our colleagues from Consumers Union, Consumers Federation of America, and Consumers International.

According to CLDP, the purpose of the workshops was to “strengthen management skills, build confidence of NGOs’ staff to use management tools operationally in implementing their activities, and promote public awareness and spread the culture of consumer protection.” However, I believe it is the exchange of “best practices” and shared experiences along with the various strategic planning, market surveillance and capacity building tools that made these workshops very participatory in nature, and; therefore, beneficial to everyone. In Luxor, we hosted roughly 20-25 NGOs from 7 surrounding districts. These organizations represented those new to the consumer movement and those in operation for 1 – 2+ years. In Cairo, an even bigger turn out, we had close to 30-35 NGOs representing 7-8 outposts.

In 2006, the Egyptian government instituted a consumer protection law, which resulted in the creation of the Consumer Protection Agency. Their role is “to protect consumers by implementing the consumer protection law in coordination with other governmental entities concerned with its implementation.” Sounds familiar?! Well, of course it does. They used the framework established in the 1960’s by a speech given by President Kennedy, in front of Congress (March 15, 1962), pointing out “Consumers, by definition, include us all,” and outlined his vision for consumer rights. These governing principals include eight consumer rights:

  • The right to satisfaction of basic needs
  • The right to safety
  • The right to be informed
  • The right to choose
  • The right to be heard
  • The right to redress
  • The right to consumer education
  • The right to a healthy environment

What I found astonishing is that Egypt has a consumer protection agency at all; and, while the United States works through — maybe — the kinks of re-establishing the consumer protection agency in the White House, consumers remain, as President Kennedy noted, “… the only important group… whose views are often not heard.”

What I also found interesting is some of the similarities that my own organization shares with the umbrella organization ECPA. Like ECPA, the National Consumers League houses a fraud center that consumers can use to file complaints. ECPA, as do we, receives complaints electronically, via fax and in writing. They track unfair practices in the marketplace such as durable goods, car safety and Internet fraud. Many of the smaller NGOs work to educate the consumer about his/her rights as a consumer. Like America, product safety is a never-ending battle. Egyptians would argue that their cases of unsafe products are much higher and a bigger problem than in the United States, since many of the products that come into the country do not have restrictions or guidelines that must be adhered to. At the end of the day, there was a common theme among consumer organizations, “How do we deal with inappropriate and false advertising?” to “How do we create consumer awareness and corporate social responsibility?”

These workshops speak to the ever-growing need for collaboration among consumer NGOs, as the issues increase due to the global marketplace and access to services and goods via the Internet. What we will find is that if consumer awareness is a part of both institutional agendas and government mandate we, as consumer organizations, can have a bigger impact on product safety, corporate social responsibility, fair prices in the global marketplace and fair treatment of not only consumers but workers’ rights around the world.

It is my hope that we take this message around the world as we look to create and expand consumer NGOs nationally and abroad.

Understanding ‘risk’ – National Consumers League

By Rebecca Burkholder, NCL Vice President for Health Policy

When we read a headline about a new study that shows a drug or procedure will reduce the risk of cancer by 10 percent, what does that really mean? It can definitely be challenging for consumers to interpret the evidence for themselves.

At the 10th Annual Cochrane Collaboration Meeting I attended last week in Colorado, how we look at evidence and interpret it was the subject of several sessions and workshops. For consumers to be able to interpret evidence, one of the basic concepts to understand is how study results are reported.

Steve Goodman, with Johns Hopkins Medical Institutions, explained at one session about the difference between relative and absolute risk and that most study results are reported in terms of relative risk. So why does that matter? There are two ways to report risk:

  • Absolute risk: your own risk
  • Relative risk: used to compare the risks in two different groups of people

Here is an example when talking about how a treatment may reduce the risk of a disease. Say women have a 4 in 100 risk of developing a certain cancer. Then, research shows that a new drug reduces the relative risk of getting the cancer by 50 percent. Sounds pretty good, right? It means that the “4” in 100 is reduced by 50 percent to”2” in 100. So, the absolute risk of getting the cancer only dropped by 2 percent (4 percent minus 2 percent equals 2 percent ).

Which headline sounds better?

“New drug reduces risk of cancer by 50 percent !”

OR

“New drug results in 2 percent drop of cancer risk!”

Both of these are reporting on the same study results.

Absolute risk is generally better understood by the public, but relative risk is more often used to report results since is it usually a bigger number and looks a lot better than absolute risk.

Next time you are looking at a study on the Internet or hear about one on the news, make sure you are taking a critical look at how the results are reported, especially the risk that is reportedly being lowered. What does it really mean for you?

Advocates taking sides on food stamps for sugary beverages controversy – National Consumers League

By Sally Greenberg, NCL Executive Director

Should it be possible to use food stamps to buy sugar-sweetened beverages? This very issue is causing people and groups that are often allies to line up on opposing sides.

In recent weeks, New York City Mayor Michael Bloomberg has asked the United States Department of Agriculture for permission to temporarily bar New York City’s Supplemental Nutrition Assistance Program (SNAP) recipients from buying sugary drinks with their benefits, commonly known as food stamps. The proposed two-year change to the program would allow researchers to study the potential impact of such a ban on public health. But a number of anti-hunger advocates – including Ellen Vollinger, the legal director of the Food Research and Action Center (FRAC), and Joel Berg, executive director of the New York City Coalition Against Hunger – are opposing the Mayor’s request.

These individuals and organizations dedicated to fighting hunger in America, especially among children, think Bloomberg’s action would perpetuate the myth that people who need government assistance make bad choices at the supermarket. The food stamp program serves 41.8 million individuals, about half of them children.

Though I strongly support the work of FRAC and other anti-hunger organizations – in fact, NCL directed funds to FRAC from a legal settlement we reached recently – and, of course, believe that we should be respectful of those who rely on food stamps to eat each month, I think I come down on the side of Mayor Bloomberg on this one. He’s not saying that people on food stamps can’t buy sugary drinks – they just can’t use these benefits meant as “supplemental nutrition assistance” dollars for products that have no nutritional value, and sugary drinks give new meaning to the term “no nutritional value.” Check the label sometime to try to find anything that is good for you and you’ll come up short.

As the name implies, the food stamp program is intended to supplement the nutritional needs of struggling Americans. You can’t use them to buy alcohol or cigarettes; I would put sugary drinks in the same category.

Another argument in the Mayor’s favor is the alarming number of Americans who are now considered overweight – 2/3 of all of us fall into that category. Sugary drinks contribute mightily to that problem, adding nutritionally bereft calories to the diets of far too many Americans, especially kids. The findings from numerous studies demonstrate a link between sugar-sweetened beverage consumption and weight gain, overweight, and obesity.

Noting one of anti-hunger advocates’ central arguments against the proposal, Joel Berg stated, “It’s sending the message to low-income people that they are uniquely the only people in America who don’t know how to take care of their family.” I get that, but in this case, I think Mayor Bloomberg has the stronger argument.

Caveat: we have active dissent from my position among our staff – and they make some compelling arguments. So, in this case I’m stating my opinion and not all of NCL’s. I’d welcome others’ thoughts and ideas.

Consumers deserve better than blocking – National Consumers League

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

According to today’s Wall Street Journal, several networks, including CBS, NBC, and ABC are blocking their online content from being viewed on the new Google TV devices that are being sold by Logitech and Sony.

The networks justify this in part because of a fear that video listings delivered via the Google TV devices will not adequately filter for pirated video content. The more cynical suspicion (which the WSJ article explicitly states) is that the networks have not yet figured out how to monetize this new viewing platform and are holding back their most popular content until they do.

What should not be debatable is that consumers expect to be able to connect any device of their choosing to a home broadband or cable TV connection and use it to access the same content they would if they were looking for it on their home computers or surfing their DVR content.

From a consumer’s point of view, watching video on a Google TV-enabled television should be little different from watching video on a laptop computer. In both cases, a browser is being used to surf online content and make it accessible. Many consumers will undoubtedly be angry if they spend thousands of dollars on one of the new Google TV-enabled televisions only to find that many of their favorite shows are unavailable.

Network using heavy-handed blocking techniques rather than finding new ways to adapt to disruptive business models is not new. Content providers fought against the VCR because it enabled consumers to record live television and play it back later and (more importantly to the networks) fast forward through commercials. It was not until later that they realized the goldmine the VCR represented in terms of the sale of content on video cassettes.

Today, content providers seem to be taking the same “fire, ready, aim” approach to Google TV and the raft of similar devices that will make their way to market in the future. Rather than realizing the potential of the new technology to both enrich consumers’ viewing experiences and the networks’ bottom lines, they are seeking to kill the new technology in its infancy.

As the ongoing Fox-Cablevision dispute illustrates, consumers are the ultimate losers in these fights between content companies on one hand and platform and technology providers on the other.  Consumers inevitably end up paying more for content (in the form of higher cable bills and pay walls) or not getting access to content at all.  Neither scenario benefits the public interest and we would urge the companies to come together to ensure that consumers are allowed to access the content of their choice without restrictions.

LifeSmarts alum a good reminder of need for financial literacy – National Consumers League

By Brandi Williams, LifeSmarts Program Assistant

On October 7, the National Consumers League held our 2010 Trumpeter Awards in Washington, DC, honoring Surgeon General Regina Benjamin, Kenneth Feinberg and Jean Ann Fox. Amongst these notables was LifeSmarts alum Tony Aronica of Washington state, who was invited by NCL to speak to the audience about how his experience in LifeSmarts helped prepare him for life after high school. Check out the LifeSmarts Facebook page for photos.

Tony’s remarks served as yet another reminder to me of the importance of consumer education and personal financial literacy for young adults. Personal finance is one of the core topics we cover in LifeSmarts, and it was exciting to hear from a past participant that those lessons had an impact on his future decisions. While policymakers and religious leaders debate topics like sex education and school prayer in the public arena, more and more young people are entering the realm of adulthood ill-equipped to deal with realities like understanding financial terms, choosing credit cards, workplace safety, and setting financial goals, because these topics aren’t flashy enough for public debate. In the meantime, parents making poor financial decisions continue to pass on bad habits to their children.

“Learning to be a steward of one’s personal finances, setting personal goals and preparing steps to achieve established goals is not intuitive, but a collection of learned skills,” Tony said passionately, receiving nods and murmurs of agreement from the audience as he summed up the necessity for programs like LifeSmarts that teach kids to be smart consumers able to advocate for themselves in the marketplace.

And he’s right.  Personal financial literacy is important for people of all ages, especially the 13 to 19-year-olds who are estimated to spend $200 billion annually. According to the National Council on Economic Education, in 2009 only 13 states required students to take a personal finance course in order to graduate.

This is why programs like LifeSmarts are so important to young people in helping to bridge the gap between economics lessons in class and making personal financial choices outside of the classroom. “Combining consumer awareness tips, household budgeting, personal fitness and nutritional information within a competitive team format meant that we were receiving knowledge that was largely unavailable in a standard academic experience,” Tony told the Trumpeter audience, adding “we were absorbing it in a way that was extremely helpful.”

It is so exciting to have the opportunity to interact with the young people who have benefitted from LifeSmarts.  And when I do, it is truly a pleasure. These young people are so enthusiastic, excited, and eager to soak up what LifeSmarts is teaching them, to master the skills to think independently and interact with the marketplace as informed consumers able to advocate for themselves and others.

When I have the chance to visit state LifeSmarts competitions in the winter, the comment I hear most often from adults is: “I wish this program was around when I was a kid.”

Well, it’s here now for our kids.

 

Medicine based on the evidence, right? Not necessarily – National Consumers League

By Rebecca Burkholder, NCL VP Public Policy, Health

The practice of medicine is based on the best evidence, right? Not necessarily, as I am learning at the International Cochrane Colloquium in Colorado this week. Many health care treatment decisions are still made without up-to-date, reliable evidence on their benefits and possible harms. There have been many individual studies on a specific drug or treatment, but, surprisingly, often no one has looked at all the studies together and what they tell us.

The Cochrane Collaboration is an international organization, with more than 11,000 contributors from around the world, that reviews existing research on health care interventions so that health care practitioners, consumers, and policymakers can make well–informed decisions about health care. So what does that mean? Basically, after carefully looking at all the studies done on a drug or procedure, Cochrane puts out a review on whether the treatment works or not (or if there is not enough evidence). The goal for Cochrane is that with evidence health care practitioners and patients can make good choices about health care.

Here’s an example of what Cochrane reviews found: Giving women at risk of preterm birth a single course of corticosteroids speeds up fetal lung development and should be considered routine for preterm delivery to reduce the number of babies who die or suffer breathing problems at birth. Other reviews have found that remaining upright during the first stage of labor can reduce labor by an hour, that weight-loss surgery is more effective than other strategies for shedding pounds but may not be safe, that statins given to the elderly do not reduce the risk of Alzheimer’s or other dementias, and that Echinacea doesn’t get rid of a cold any faster than doing nothing. Cochrane has reviewed the evidence to answer such questions as – Will taking the dietary supplement glucosamine help relieve the arthritis in my knee? Should I treat my asthma with allergy shots? Is there a cure for morning sickness?

Unless consumers (as well as health care practitioners) have good evidence on whether a drug or procedure works and the benefits and risks, we are in the dark. Armed with evidence, we can, in consultation with our doctor, make informed decisions about our health care and figure out what is best for us

Check out the Cochrane reviews, and those that have been translated for consumers, at the Cochrane site. And the next time your doctor recommends a drug or treatment, don’t be afraid to talk to your doctor about the evidence.

Gap between the richest and the rest a widening problem – National Consumers League

By Sally Greenberg, NCL Executive Director

With the economy stagnant, unemployment continuing to hover near 10 percent, a depressing mid-term election a few weeks away, Americans are angry, frustrated, frightened about their economic future and looking for someone to blame.

In terms of cause and effect, I think it’s impossible for economists – and the rest of us – to ignore any longer the staggering gap between the richest Americans and the rest of us.

Columnist Robert Frank in the New York Times cites some sobering statistics. During the three decades after WWII, incomes rose in the United States at almost 3 percent a year for people at all income levels. America, Frank says, had an economically vibrant middle class. Roads and bridges were well maintained and people were optimistic. The contrast between today and 1976 is stark. The share of total income going to the top 1 percent of earners, which was 8.9 percent in 1976, rose to 23.5 percent by 2007, but during the same period, the average hourly wage declined by more than 7 percent.

Frank says economists are reluctant to confront rising income inequality and they by and large refuse to take a position on whether the growing income inequality is a good or bad trend.

Worker productivity has grown over the past two decades. Workers are now earning only 83 cents of every dollar they earned more than 35 years ago, while their productivity has increased a dramatic 80 percent. This is the central explanation for the *explosion in corporate profits and the growing income gap in America.

But the gains from that increased productivity have not gone to workers; they have been scooped up by management — good manufacturing jobs, including union jobs with good benefits that provided a solid middle class income to working Americans, have disappeared. The percentage of private sector union jobs has shrunk to 7 percent.

But, for reasons I don’t understand, outsize pay packages – including probably the most outrageous case – $1 billion in total compensation claimed by the former head of United Health Care – (who felt he was entitled to take those kind of profits from the health care system when we have 50 million Americans with no health insurance) haven’t generated all that much anger and outrage.

The widening gap between the super rich in America and the amount of income they have taken out of the economy – at the expense of the vast majority of hard working Americans who struggle to make ends meet every day– may just be far more destructive than any of us understand.

*Links are no longer active as the original sources have removed the content, sometimes due to federal website changes or restructurings.

Companies amassing cash instead of investing in workers – National Consumers League

By Sally Greenberg, NCL Executive Director

While visiting family in Minneapolis, I read an article in the Star Tribune about Minnesota companies piling up the cash and not spending it on hiring new workers or buying new equipment. This is written as the United States faces 10 percent unemployment. The piece was written with a cool remove – just reporting the facts. But there were numerous references to the impact of these policies – with an emphasis on how much the companies care about investors and paying dividends and such – with little or no concern about workers. On the list were Hormel ($288+million), Medtronic (nearly $4 billion), 3M (nearly $5 billion), and United Health Group ($11 billion)

And how did these companies amass the cash? In 3M’s case, it slashed 4,000 jobs, got rid of free lunches for employees, and banned merit increases. What did they do with all the money they saved? They’ve acquired three new companies for $2 billion. The biggest concern in making these investments is expanding the company – and ensuring rewards to investors. The article notes that “cash-rich United Health Group upped its annual dividend this year to 50 cents a share,” and “Target hiked its quarterly dividend to 25 cents a share.”

Yes, that’s important. But equally important is making sure that the workers in these companies aren’t summarily laid off or deprived of basic benefits like health care or decent 401k contributions, and that these companies realize that those who go to work each day for them, their loyal employees, are the capital that allows the company to amass its billions in reserves. And yet you don’t hear about the things the company is doing to shore up its workforce, boost morale, or reward performance that has lead to greater productivity. There’s something wrong with this picture, in my view, when investors become more important than the folks that keep the company going day to day. But I guess I’m naïve – clearly the authors of this article think the emphasis on paying bigger dividends and acquiring more companies is more important.