Guest blog: Kids and car safety

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By Sydney Greenberger, NCL Summer Intern

On June 20, the first day of Summer 2024, 1,086 baby onesies were placed in a display across from the U.S. Department of Transportation headquarters in Washington, DC, representing the number of young lives lost to hot cars since 1990 in the United States. Kids and Car Safety predicts that over 7,500 more children have survived being left in hot cars, with various injuries. Already in 2024, three young children have lost their lives; the situation is exacerbated because the National Highway Traffic Safety Administration (NHTSA) has failed to issue a regulation requiring technology to be placed in new cars to stop hot car deaths despite a mandate from Congress to do so.

In 2022, Congress directed the NHSTA to issue a federal safety standard requiring new vehicles to be equipped with technology to prevent hot car deaths by November 2023. The NHTSA has delayed action until November 2024. The technology is there, and it isn’t expensive, but the NHTSA has priorities other than protecting the lives of innocent children and companion animals at risk of being forgotten in hot cars this summer.

A common misconception among parents in the U.S. is ‘this would never happen to my family; how could you ever leave your child in a car?’ However, history proves that these tragedies can happen to anyone. More than half of these accidents occur because a parent unknowingly left their child in their vehicle. It happens to parents who are absent-minded. But it also happens to the most attentive parents. Parents who are well-educated and well-off. Over the past decade, it has happened to a dentist, a social worker, a police officer, a nurse, an assistant principal, a pediatrician, and many more. Preventable hot car tragedies can happen to anyone.

On average, 38 American children die yearly from these tragedies. 88% of these victims are under three years of age. 43% of children who were unknowingly left in cars were supposed to be dropped off at their daycare. Rear-facing car seats look the same to parents whether there is a child in them or not, and if a child is asleep, it can be easy to forget they are there.

Once a child has been left in a hot vehicle, saving them from these preventable tragedies is a race against the clock. A child’s body temperature rises 3-5 times faster than an adult’s. Cracking the windows and parking in the shade do little to slow the heating process or decrease the maximum temperatures in a vehicle, and temperatures in cars rise fastest within the first 10 minutes of being parked. Hot car deaths have occurred on sunny days with temperatures as low as 60 degrees. Heatstroke starts when the body reaches a core temperature of 104 degrees, and death can occur at just 107 degrees. By the time parents realize what has happened, it is almost always too late.

Technology could have prevented most of these accidents from occurring. Most car manufacturers support rear-seat reminder systems, which are audio and visual systems that remind drivers to check the backseat after shutting off the engine and exiting the vehicle. The hot car provision passed by Congress calls for these audio and visual reminders, but advocates believe that occupant detection systems are needed to prevent hot car deaths and injuries. Occupant detection systems use motion, radar, lidar, and carbon dioxide to detect a living being inside a vehicle. These systems can distinguish between living things and inanimate objects in the back seat. The system cannot be overridden or disabled, and minimizes false alarms.

Rather than require occupant detection and alert technology that costs less than $20 per vehicle, the NHTSA has decided that a “Stop. Look. Lock.” campaign is more effective than inexpensive life-saving technology.

Until the NHTSA passes these required regulations to ensure child safety in hot cars this summer, it’s up to parents to ensure the safety of their children and pets. If you see a child left unattended in a vehicle, immediately call 911. Teach children that vehicles are not a play area, and store car keys out of reach. Have a plan that your childcare provider will call you if your child fails to show up for school. Create a “look before leaving” routine whenever you get out of the car. Many parents leave their briefcase or ID badge in the back seat, so they must check before going into the office. Others always keep a large stuffed animal in the car seat. If their child is in the car, the stuffed animal moves to the front seat, reminding parents that the child is in the back.

The most effective way to prevent hot car deaths of children and pets is through the life-saving technology that the NHTSA has failed to regulate and require. The NHTSA has left it solely to parents to ensure child and animal car safety. We should all be calling our members of Congress and urging government officials to prioritize and regulate the safety of children and pets.

Sources

Safety recommendations from noheatstroke.org

Kids and Car Safety

Kids and Car Safety Occupant Detection vs. End of Trip Reminder

From the NHTSA

32304B. Child Safety

Advocates for Highway and Auto Safety

Press Release

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NCL staff attends consumer protection brownbag

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By Sally Greenberg, Chief Executive Officer, NCL

On June 25, 2024, the National Consumers League (NCL) joined the Consumer Protection Brownbag event, moderated by Adam Teitelbaum, the Director of the Office of Consumer Protection at the DC Attorney General’s Office.

I shared the history and mission of NCL and discussed our more recent successes, including NCL’s advocacy role for workers in DC receiving minimum wage through the “One Fair Wage” initiative and the Federal Aviation Administration Reauthorization Act of 2024, which now includes automatic refunds for flight cancellations and excessive delays and the elimination of fees for parents to sit with their children. We also discussed anti-trust concerns with the Ticketmaster-Live Nation merger and the ongoing lawsuit involving the DOJ and DC OAG. Moreover, I spoke about our case against Starbucks for false claims regarding ethically sourced products. Finally, I covered a range of consumer protection efforts, from fraud prevention and unit pricing enforcement to proposed alcohol labeling reforms.

Erin Witte, Director of Consumer Protection at the Consumer Federation of America (CFA), spoke about the mission of CFA and her personal journey from criminal lawyer to consumer protections advocate. She outlined CFA’s current focus areas, including tackling junk fees, combating forced arbitration clauses that limit consumers’ legal recourse, and advocating for product safety, food and alcohol regulations, investor protection, and insurance reforms. She also discussed the link between credit scores and car insurance, and how this association is one of the primary drivers of rising insurance costs. Witte highlighted CFA’s collaboration with regulatory agencies to address these pressing consumer issues.

Witte, Teitelbaum, and I responded to questions during the question and answer session about the obstacles faced by attorneys and advocates pursuing consumer protections and how the possible changes in administrative deference could affect the future of consumer protection.

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Patients can’t afford Congress delaying PBM reform another year

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By Robin Strongin, Senior Director of Health Policy

As the 2024 political campaigns intensify, we’re going to be hearing a lot from candidates about what they’re going to do to make healthcare more affordable. The problem is, we’re dealing with high out-of-pocket costs right now and we shouldn’t have to wait until after another election for something to be done about them, especially when the current Congress has solutions today.

As I navigate my husband’s care through his battle with Lewy body dementia and speak to other patients and their loved ones, I have become all too familiar with the practices certain players in our healthcare system use to boost their already extraordinary profits at our expense. Pharmacy benefit managers, or PBMs, are a prime example of this and we urgently need legislation to rein in their actions that are affecting both the costs we pay for care and access to the medicines our families need.

Several committees in both the U.S. House and Senate have been working on PBM reform legislation for months and there are multiple bills that could be passed now and sent to President Biden for his signature. With the time they will be taking off for campaigning, lawmakers have very few days left that they will be in Washington, D.C. this year. It would be all too easy for them to kick this can down the road and let the next Congress deal with it.

We need to raise our voices to demand that they don’t pass on this opportunity to make a difference.

There are two elements of PBM reform that could have an immediate impact on costs and prescription drug accessibility that Congress should pass without hesitation:

  • Disconnect PBM profits from drug prices. Right now, PBMs generate revenues from the rebates they demand from drug manufacturers. The higher the drug costs, the more they make in rebates and, consequently, they steer patients to medicines that cost more and block access to lower-priced generics and biosimilars. Enough is enough. Pass legislation that will have PBMs paid a flat fee for their services and remove the perverse incentives that are forcing patients to pay more and that place financial interests between patients and their healthcare providers.
  • Mandate that the PBMs pass along those negotiated rebates and discounts to consumers. Currently, these middlemen are moving those dollars into their own pockets. These savings should be going to patients at the pharmacy counter. It’s just common sense.

These are urgent issues that affect the lives and pocketbooks of millions of Americans. Yes, it’s great that politicians are making promises about how they will fix healthcare costs next year, but we need action now. Congress must pass PBM reform legislation before they adjourn this year.

The Pain Project: Pain management doesn’t just mean opioids*

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By Sam Sears, Health Policy Associate, National Consumers League

Earlier this year, the National Consumers League (NCL) produced, as part of its health series, an episode of the “We Can Do This!” podcast focused on alternatives to opioids for pain control. In this podcast, listeners were able to hear directly from those with lived experience with opioid use disorder, both personally and as the loved one of someone with the disorder. You can listen to the podcast here. Each of the speakers on this episode was brought together, through the creation and launch of “The Painful Truth” campaign.

The campaign features a three-minute film, which features real individuals looking for pain control, discussing their options and the complications that can come with opioids. Matt Robinson, who is featured in the film and one of the speakers on our podcast, discusses his experience with opioid use disorder, and shares with NCL that his first experience with opioids for pain control was when he was 12; the result of a sports injury. Former Congresswoman Mary Bono discusses the founding of Mothers Against Prescription Drug Abuse, and her experience with a loved one who experienced opioid use disorder. Our final guest, Charlene Ng, Vice President of US Medical Affairs at Bayer, shares how recently her teenage son was offered a prescription for opioids for pain management after wisdom teeth removal.

I think it’s really important to highlight how in two of the stories the speakers shared on this episode how they or their loved one were first offered a prescription for opioids as young adults and as teens. We know we’re in a mental health, and, specifically a substance use disorder, crisis within the States, and while the overall national dispensing rate for opioids has declined between 2019 and 2022, our nation still consumes over four-fifths of the world’s opioids. Given that the US makes up less than 5% of the world’s population, that’s a truly staggering number.

Generally, we trust doctors. They’re highly educated, specialize in their field, and pledge an ethical code of conduct to ‘do no harm’. It’s understandable that when a doctor recommends something, especially a medication for pain management, there isn’t a whole lot of questioning or concern. However, opioids are not the only option for pain management that is out there and available for consumers – especially considering the significant side effects that come with such an addictive substance.

Not too long ago, in 2022, the CDC issued new and updated clinical guidelines for prescribing opioids for pain. There are 12 total recommendations for these guidelines, grouped into four categories, and I think the most important recommendations happen to be the first two related to determining whether or not to initiate opioids for pain. Regardless of the type of pain, be it chronic or acute, the CDC states that nonopioid options, both nonpharmacological and other medications that aren’t opioids, are preferred to opioid use for pain management. What really resonated with me in these is that nonopioid therapies can be as effective, if not more so, for common types of acute pain (which includes wisdom teeth removal and acute musculoskeletal injuries like common sports-related sprains and breaks). These therapies include non-pharmacological options such as heat therapy, massage, acupuncture, chiropractic care, and more, and pharmacological non-opioid options such as NSAIDs, acetaminophen, and more, depending on the cause of the pain.

In general, the most important thing for consumers to know is to talk to their doctor or health professional. Doctors work for and with us. Substance use disorder and addiction are a huge problem within the US currently, and it can be very scary to have to take a medication that can lead to that. But opioids aren’t our only option. If you are getting an opioid prescription, ask why, or ask about nonaddictive options! Make sure your health team talks to you about all the possible side effects and consequences that may develop, and if moving forward with an opioid is the right step for you.

If you or someone you know is struggling, options for treatment and help can be found on SAMHSA’s website.

*Medical Disclaimer: All information in this blog post is strictly for informational and educational purposes only.  Nothing in this post is a substitute for medical advice, diagnosis, or treatment.

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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.

Consumers and music lovers beware: My piano-moving scams saga

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By Sally Greenberg, Chief Executive Officer, National Consumers League

The National Consumers League fights scams. We manage Fraud.org and James Perry on our staff is a world expert on scams.

I often tell the staff that the only recent scam I almost fell for was the piano moving scam.

Here’s how the scam works. Someone posts that their uncle, friend, brother, or parent has a beloved, very expensive, and fancy piano that needs a good home. It’s always a grand piano or baby grand piano, always “in excellent condition,” often “just tuned,” a valuable instrument, and in demand. It needs “a good home, someone who will love it like my relative/friend always has.” That person is “giving away the piano for free, all that is required to pay to have it moved.” A picture of the piano is often posted, and it is indeed a baby grand piano. A very authentic photo will often be included. The payment options are nonrefundable options. Another red flag.

Here’s a classic scam email:

Hope your day is going great. The ” Wurlitzer 200A Electric Piano” used to be owned and played by my husband who is now deceased and it was last tuned in November last year before he passed, I’m almost done moving my properties and I don’t think my husband will be happy if I was to sell his piano, at the same time I’m not happy seeing it around because of less storage I have in my new house, so I’m hoping to give it out to someone who is a passionate lover of the instrument.

The first lady I thought would get it didn’t show up as she promised, and I wasn’t going to leave it alone in an empty house. It’s currently going to be with the movers I employed to move my properties from my place, which they’ve moved for onward delivery, if you really don’t mind making new arrangements with the movers, I can attempt to get in touch with them to reroute it, this should not attract many charges. I’m sorry for the inconvenience but do let me know if you wish that I get through to the movers. Just so you know I’m not giving out a scrap or a waste. It’s in good shape and condition.

Regards,

John Doe

Family Piano has some great tips for recognizing the scam, including that no one gives a valuable piano away to strangers.

A few years ago, I got such an email and thought, “Oh boy, finally a great piano I can play and for free as long as I pay to have it moved!” So I called and was told that the owner would put me in touch with the movers. However, the piano was in Oklahoma. Hmmm, I thought this email came from someone in my synagogue, just down the street. I smelled something fishy, so I googled “piano scams,” and up popped hundreds of stories about people attempting to take advantage of a wonderful piano given away for free, paying moving costs to get it, and finding out the cost of moving the piano is the scam.

The Better Business Bureau has a whole site devoted to piano-moving scams here.

Here’s one example from the BBB site:

One consumer reported this experience after contacting the so-called moving company: “The customer service rep sent me a picture of packaged piano and asked me to pay the moving fee. They sent me an invoice for $843 and instructions on how to send the money through PayPal. They asked me to send them the receipt via email so they could prepare for the shipment. Three days later, they gave me a ‘trucking number.’ But on the morning the item should’ve been delivered, they sent me an email saying there was an unexpected payment owed on the piano and I would need to pay an additional $1,424… If not, they said they would return it to their warehouse.”

So, of course, that was the end of that. In fact, the offer I received exactly replicated many other consumers had received. I didn’t go through with the transaction, thankfully.

Then, just last week, someone named “George Hooper,” from “East Chevy Chase” posted this note on Nextdoor app:

“A friend of mine, who lives in McLean, VA, can’t take her piano with her. (George Steck – Paris, London, New York – baby grand piano. It was a practice piano at the Kennedy Center. In excellent condition.) She’s willing to give it away for free providing the recipient pays for moving the piano. Let me know if you want a pic of the instrument and the owner’s contact info, but please don’t respond to this extraordinarily good deal unless you are very serious about acquiring it.”

I hadn’t realized, though in my line of work I should have, that Nextdoor has become rife with scams and people are more trusting because they think everyone is a bona fide neighbor. Repair scams are especially prevalent on Nextdoor, such as described here on BuzzFeed.

And Nextdoor itself is posting this warning to users.

My immediate response to the offering was to warn users that this is a piano moving scam and not to fall for it. This George Hooper, whoever he is, became irate and said I had “poisoned” his benign email. He then listed the name of the woman with the piano and phone her number was a Northern Virginia area code. I called her and she confirmed she had the piano and I could come and look at it, but she would have to get me through security. Then I asked whether I could get my own movers and her response was, “Yes, well I have to get it tuned and I have a moving company that has moved it twice and it has legs so it’s complicated.”

It all sounded so believable, but I was still suspicious.

It occurred to me that if you’re giving away a piano for free and it is going to be moved, why would you get it tuned?

A few people said they wanted the piano and George said, “It’s gone. I’ll send a photo of the person who bought it who can play a concert for you once it has been delivered.” That’s the last we heard.

So I went online and read the thousands of piano moving scams, such as this story. The lengths they will go to!

This article points out all the red flags for piano moving scams. Be wary of them and be wary of people like “George Hooper”!

Stopping the epidemic of catalytic converter theft

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By Sally Greenberg, Chief Executive Officer, National Consumers League

For many years, I drove a 2007 Toyota Prius. I loved my little fuel-efficient and quiet machine, getting 45 mph and putting almost 189,000+ miles on it. All went well until one night a few years ago when—being an insomniac, I was up reading at 3 am—outside my window I heard what sounded like someone taking bolts off a tire, a loud buzzing or whirring sound. It lasted about 5 minutes. I thought some kindly father or uncle was putting air in a kid’s tire or changing a flat.

The next morning when I headed out for work, I started up my Prius, and to my shock, it sounded like a jet engine driving down the street! It dawned on me that the sound I heard last night was guys cutting the catalytic converter (CC) off my Prius! To borrow a phrase my mother used to say, I was mad as a wet hen!

 So I called my insurance company.

And, sure enough, they confirmed that 2005-2009 Priuses are a prime target because their CCs have precious metals that can be melted down and sold by unscrupulous actors. The CC is used to filter out harmful byproducts from the car’s exhaust, using precious metals like platinum, palladium, and rhodium to accomplish this. These metals can sell for hundreds to thousands of dollars per ounce.

While my auto insurer, State Farm, thankfully covered most of the replacement cost, I had to cancel going to work. I couldn’t drive the car so I had to have it towed to my garage seven miles away. I ended up paying for a shield to be placed on the CC to prevent it from happening in the future. In total, I was out of pocket $1,000 while the repair cost more than $3,500.

According to State Farm, the average cost of a repair comes in at around $2,900. As of October 2023, $41.7 million had been paid out to State Farm customers to repair and replace the part. In addition to the cost of replacement, customers report that repairs can take weeks to months, depending on the vehicle and due to a shortage of available replacement parts. Used vehicle lots are bearing a large brunt of this wholescale theft and insurance companies are also paying needless costs.

Ever since my catalytic converter incident, I’ve taken a closer look at this issue and learned that there is no legitimate use for a sawed-off CC because it cannot be used in another vehicle. The only thing it’s good for is its melted-down metals. Thus, the business model is illegal. In other words, there are bad guys on both sides—the theft rings and those who accept and pay for the scrap metal for melting down.

The good news is that in the first half of 2023, claims are down. There were around 14,500 claims filed then, compared to the 23,000 claims made during the same timeframe in 2022.

Carfax, however, issued a warning that the nation might be underestimating how widespread the problem is because many car owners don’t file insurance claims. Some drivers don’t have full coverage on older vehicles and some don’t have insurance at all.

That is why we welcome efforts by Congress to pass laws to deter catalytic converter theft. The bills introduced so far in the House and Senate include marking the part with a unique number and requiring the identity of those selling and buying the CC. NCL supports both!

H.R. 621, the PART Act,  was introduced by Reps. Jim Baird (R-Ind.), Betty McCollum (D-Minn.), Angie Craig (D-Minn.), Randy Feenstra (R-Iowa), and Michael Guest (R-Miss.). S. 154 was introduced by Sens. Amy Klobuchar (D-Minn.), Mike Braun (R-Ind.), Ron Wyden (D-Ore.), and J.D. Vance (R-Ohio).

We are working with the National Auto Dealers Association and 20 other organizations who all sent a letter to the leadership of the House and Senate Commerce Committees in support of the PART Act in May. NCL urges members to cosponsor H.R. 621/S. 154.

As for me, I replaced my 2007 Prius last summer with a new Prius Prime, whose CC is relatively worthless in terms of precious metals. I love my new car and am so relieved to know it won’t be a target for thieves in the night.

NCL looks forward to working with Congress to pass the PART Act, which will protect consumers and insurance companies from the hassle and expense of catalytic converter theft.

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Resources:

Issue Brief

Request to Cosponsor

Current Cosponsors

Coalition Letter to Commerce Committees

 

 

Not so fast, PBMs: You aren’t fooling consumers

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By Robin Strongin, Senior Director of Health Policy

A recent op-ed, “It’s Time for Facts in the PBM Debate” by the president of one of the nation’s largest pharmacy benefit managers (PBMs), is at odds with the reality of what consumers are facing when we go to the pharmacy.

In his commentary, David Joyner paints a rosy picture of how the largest PBMs lower drug prices. Meanwhile, consumers across the country are being hit with higher out-of-pocket costs and a lack of understanding about what goes into the costs for their medicines. This opaque system results in consumers running into several issues trying to access more affordable drug options.

The PBMs aren’t fooling anyone.

In Joyner’s own company, a whistleblower brought suit over the PBM’s scheme to keep lower-cost generics off its formularies for Medicare beneficiaries, pushing seniors to more expensive drugs (for which the PBM had negotiated higher profits for itself). The whistleblower said she was told by company executives that the financial benefits of this manipulation outweighed the possibility of getting caught.

More recently, community pharmacies in Iowa filed a lawsuit against CVS Health and its Caremark PBM claiming that they violated antitrust laws and illegally collected fees from pharmacies filling Medicare prescriptions. We’ve seen this behavior often force trusted, and long-established local pharmacies out of business.

What’s most concerning is that such questionable PBM behavior can have tragic results beyond pharmacy closures. In Wisconsin earlier this year, a young man with severe asthma died after he was informed at the pharmacy that his inhaler was no longer covered by insurance and he couldn’t afford the hefty out-of-pocket cost.

We can’t let this happen to another person. Consumers deserve more transparency. They deserve accountability in this middlemen PBM system. Most of all, we all deserve better than to be inundated with large PBM falsehoods.

Even as these mega-PBMs assure us that they are patient advocates, they are fighting tooth and nail in Congress and state legislatures to block measures that would take the necessary steps to ensure that consumers – and not the PBMs themselves – actually benefit.

Those are the facts in the big PBM debate.

Honoring the legacy of Cesar Chavez

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By David G. Oddo, retired teacher and a former volunteer with the Child Labor Coalition

I have been an enthusiastic supporter of Cesar Chavez and the farm worker movement since 1968. In September of that year, I was a freshman at the University of San Diego High School and the United Farm Workers-led grape boycott was in full swing. One day, my father handed me a “Boycott Grapes” button and he told me I should wear it to school. When I asked my father how I should respond to questions regarding the boycott, he calmly told me: “Tell your fellow students that you like to eat grapes, however, you do not like the way in which farm workers are being treated.”

Eight years after surviving my first “baptism under fire,” I became an active participant in the farm workers’ nonviolent struggle for social justice. During the period of 1976-1991, I marched with Cesar Chavez, walked dozens of picket lines, and spent two weeks in Ohio as a volunteer with the Farm Labor Organizing Committee. I also had the privilege of meeting Cesar on two occasions. In September 1991, however, disaster struck.

While vacationing in Puerto Vallarta, I became seriously ill with a neurological condition known as Guillain-Barre Syndrome. Within a week, I had become completely paralyzed and was in danger of losing the ability to breathe. I was immediately airlifted to the intensive care unit of Scripps Mercy Hospital, where I nearly died due to complications from my illness.

Fortunately, my condition gradually improved. After a seven-month stint at Mercy and Sharp Rehabilitation hospitals, I was able to return to my home in San Diego. However, the next several years were spent confined to a wheelchair. As well, I faced the daunting task of relearning to walk.

To be completely honest, I don’t know how I survived those difficult times. I am certain that my faith in God was essential to my recovery. The love and support of my family and friends were equally important. Perhaps I was just plain stubborn, especially after being told by my doctors that I would never again be able to walk.

During those difficult days, I would often think of the accomplishments of Cesar Chavez and the farm worker movement. For example, the banning of dangerous agricultural pesticides such as DDT, the elimination of the infamous short-handled hoe, and the enactment of a collective bargaining law for California farm workers. Perhaps the most enduring legacy, from a personal perspective, was the “Si Se Puede” (Yes, it can be done) attitude of the farm worker movement. This was a source of inspiration as I was recovering from my illness.

It has been nearly 18 years since I became seriously ill. However, I am vastly improved. Despite daily challenges and numerous setbacks, I am currently able to walk with the aid of a walker and a quad cane. And the wheelchair? It is collecting dust in my condo’s storage area. More important, I am now physically able to rejoin the struggle for farm worker justice. I realize that I have a difficult journey on the road to recovery. And there is much work to be done with regard to our nation’s agricultural workers. Indeed, the vast majority still labor under hazardous conditions, earn poverty-level wages, and are excluded from the benefits of collective bargaining agreements. Child labor is widespread.

As I move forward with these challenges, it is my hope that the spirit of Cesar Chavez will guide me on my journey.

Nancy Glick

It’s time to care about obesity care

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Nancy GlickBy Nancy Glick, Director of Food and Nutrition Policy

Every year, the calendar is full of national health observances – special months, weeks and days that raise awareness of serious diseases and health issues. While all are valuable to advance the health of the Americans, Obesity Care Week taking place March 4-8 is especially significant.

Why?  Because even though the adult obesity rate now exceeds 42 percent – the highest level ever recorded – obesity is still viewed as a problem of lack of willpower, too many health professionals act in discriminatory ways based on people’s size, and those seeking obesity care often face exclusions in insurance plans or restrictive practices that delay or deny treatment.

The consequence is that that only 10 percent of people with obesity get help from medical professionals, meaning the disease remains largely undiagnosed and undertreated.

It doesn’t have to be this way. There are a variety of safe and effective treatment options. And medical societies, including the American Medical Association (AMA), agree that obesity is a complex disease requiring ongoing quality care. The key is for society – including health professionals, insurers and policymakers – to care about obesity and agree that treatment matters. Here are the reasons why.

It is long past time for health professionals, employers, insurers, policymakers and the American public to care about obesity and work collectively to break down the barriers that prevent people from accessing proper care and treatment. This is the purpose of Obesity Care Week – to shine a light on a disease that no one has wanted to talk or think about and shift the way society views obesity and treats the disease.

Obesity Care Week is also an opportunity to call attention to the first Obesity Bill of Rights for the nation, developed by NCL and the National Council on Aging in consultation with leading obesity specialists and issued in January 2024. Starting with the recognition that obesity is a treatable disease, the Obesity Bill of Rights establishes eight essential rights so adults will receive the same level of attention and care as those with other chronic conditions and have access to all treatments deemed appropriate by their health providers. Now is the time to advance changes in federal, state, and employer policies that will ensure these rights are incorporated into medical practice.

More information about the Obesity Bill of Rights is available at: www.right2obesitycare.org.

The 340B drug discount program should be helping patients in need, not boosting pharmacy chain profits

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By Sally Greenberg, Chief Executive Officer, National Consumers League

The federal 340B drug discount program is a worthy and critical program. Created by Congress in 1992, it mandates that pharmaceutical manufacturers participating in the Medicaid program must offer prescription medicines at discounted rates to community health centers and safety-net hospitals serving low-income and uninsured patients. Over the years, this program has given vulnerable patients access to the drugs they need and freed up resources for the qualified facilities to offer more health care services to indigent communities.

Over the past decade or so, however, this valuable program has been increasingly corporatized by for profit entities known to increase costs for consumers including middlemen like pharmacy benefit managers and pharmacy chains. Too many of the dollars circulating through the 340B program are benefiting the well-off and for-profit corporations, instead of consumers with significant health and financial needs. News stories have shined a spotlight on big health systems using the program to bolster profits, while hallowing out critical resources in underserved areas. However, more attention needs to be given to the billions of 340B dollars going to major pharmacy chains like CVS, Walgreens, Walmart and Rite-Aid that are not benefiting the patients this program is intended to serve. Increasingly, however, policymakers at the federal and state level are suggesting bailing out these for-profit entities under the guides of “contract pharmacy” legislation.

Here’s the problem: In 2010, the federal government issued guidelines allowing 340B-eligible health providers to contract with for-profit retail pharmacies to dispense medications, with virtually no rules or safeguards. Since that time, the number of pharmacies participating in the 340B program has grown from 789 in 2009 to over 25,000 today. If this meant more access to affordable drugs for consumer, that would be one thing, but this has not been the case. As contract pharmacies have increased, so too has consumer challenges affording their medicines, nearly in parallel. For example:

  • Even though 340B contract pharmacies are receiving drugs at discounted prices, there is no evidence they are passing those savings onto consumers. One analysis from the respected IQVIA firm found that 340B discounts were shared with consumers in only 1.5 percent of eligible pharmacy claims.
  • Although the 340B program is intended to benefit underserved, vulnerable communities with high proportions of poor and uninsured patients, hospitals in the program are contracting with pharmacies that are not, in fact, in areas afflicted with poverty and a scarcity of health care services.
  • The vast majority of 340B contract pharmacy arrangements are with the aforementioned big national chains like CVS and Walgreens, which are enjoying enormous profits as a result of their participation in the drug discount program. Contract pharmacies collected an estimated $13 billion in gross profits in 2018, with a 72% profit margin on 340B drugs (because they are getting those drugs at a steep discount, which they don’t share with consumers). Needless to say, fattening corporate pharmacy profits should not be this program’s mission.

Contract pharmacy abuse of the 340B program has not gone unnoticed by policymakers in Washington. In January 2024, leaders in the U.S. Senate questioned CVS Health and Walgreens as part of as part of an ongoing investigation into how health care entities use and generate revenue from the 340B Drug Pricing Program. The Government Accountability Office (GAO) and the Department of Health and Human Service Office of the Inspector General (OIG), also highlighted issues with the program’s integrity as it relates to contract pharmacy use. 340B is in desperate need of transparency and oversight, not unfettered expansion.

Yet that is exactly what is happening in some U.S. states. This matter is taking on a greater urgency now as several states are contemplating legislation that doubles down on the problem instead of fixing it. Consumers would be shocked to learn their state representatives are ushering through changes that would further solidify the profitable role these large corporate contract pharmacies are playing in the abused 340B program. Policymakers at the state and federal level need to address a fundamental question – where do 340B savings go? And when the answer is to corporate pharmacy giants – not patients – it’s time to reconsider ill-conceived policies giving contract pharmacies even more access to 340B drug discounts.

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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.