Public Health

Canada should follow Trump’s lead and withdraw from the WHO

U.S. President Donald Trump is no friend to Canada, and his tariff threats are a menacing shadow as we approach his Feb. 1 deadline. Yet, while the president seems intent on shattering the foundations of the world’s most symbiotic trade relationship, causing both economic and political turmoil in Canada, some of his policies are worth looking at, particularly his departure from the World Health Organization (WHO).

On his first day in office, Trump signed an executive order withdrawing the United States from the WHO, pointing a spotlight on the organization’s mishandling of the COVID-19 pandemic, along with its broader failures in global health crises, its refusal to undergo necessary reforms and its evident allegiance to the political inclinations of its member states.

And for anyone who thought he was bluffing, he doubled down by ordering the U.S. Centres for Disease Control to stop working with the WHO altogether.

Canada, with its reflexive opposition to anything Trump does — often for good reasons — should take a moment to consider that even a stopped clock is right twice a day. If Canada were to withdraw its hefty contribution to the WHO, $204 million in 2022-23, it might well be closing time for this broken and mismanaged institution.

Trump, in his bombastic fashion, is right when he accuses the WHO of botching its response to COVID-19. From the outset, the WHO has failed in its primary duties. It was late in declaring a Public Health Emergency of International Concern and its own review of the response was nothing short of a condemnation.

In the early stages, WHO officials tweeted that there was no clear evidence of human-to-human transmission. The tweet, which is hilariously still online, was posted on the same day that the WHO’s technical lead on COVID gave a presentation in Geneva saying the exact opposite.

Why would the WHO tweet something its own staff disagreed with? Because it was placating China. The now infamous tweet was posted to provide “balance” based on the data coming from the Chinese Communist Party.

The problem is that the Chinese government already knew about human-to-human transmission, and delayed communicating that fact for another six days. The consequences of the WHO bending to the will of an authoritarian regime cannot be understated.

The WHO’s missteps are undeniably attributable to its suspicious relationship with China. The organization’s allegiance to China became embarrassingly clear when WHO director general Tedros Adhanom Ghebreyesus’ senior advisor, Canadian epidemiologist Bruce Aylward, hung up during an interview rather than discuss Taiwan — a moment that spoke volumes about WHO’s integrity, or lack thereof.

While these tragic mistakes put the organization’s credibility in the crosshairs, it then flip-flopped on key health policies like the utility of masks, the value of travel bans and testing protocols.

In early 2020, the WHO suggested masks should only be worn by health-care workers and those experiencing symptoms. Come June, it flipped, recommending fabric masks for all, leading to confusing, politically charged mask policies around the world.

Anyone who flew during this time remembers the farce of requiring masks on the plane, only to have everyone remove them to eat, rendering the whole exercise useless. Or the miserable experience of entering a restaurant with a mask on, taking it off to eat, but being told to put it back on while heading to the washroom.

The COVID-19 fiasco should have been a wake-up call for the WHO’s reform, yet no such overhaul seems likely. Instead, the WHO marches on with its prohibitionist, anti-scientific stance on matters like alcohol and vaping.

On vaping, the WHO has advocated for draconian restrictions, ignoring the evidence from Public Health England that vaping is 95 per cent less harmfulthan smoking and aids in smoking cessation. Such policies, as Yale University research has shown, ironically serve to increase smoking rates — a contradiction of the WHO’s own mission.

And on alcohol, the WHO has peddled the myth that there’s “no safe” amount, a position that flies in the face of research from the National Academy of Sciences, Engineering and Medicine, whose research found that moderate drinkers live longer than non-drinkers. Similar findings have been detailed innumerous peer-reviewed studies for decades.

Why does the WHO push bad science when good science is available? That’s unclear, but it may have to do with the fact that the researchers the WHO relies on for its work on alcohol have openly declared ties to neo-prohibitionist groups like Movendi.

The WHO’s narrative seems more influenced by neo-prohibitionist agendas than by science, and that should worry anyone who cares about public health. Not to mention that the organization, even prior to the pandemic, was spending upwards of $200 million per year on travel, which is about what we as Canadian taxpayers spend to fund this bloated monstrosity.

Instead of aligning with this compromised organization, Canada might consider spearheading a NATO-like health alliance with democratic nations, focusing on genuine public health, free from the puppet strings of authoritarian regimes like China’s. It’s high time we acknowledge that the WHO has become more a part of the problem than the solution.

Originally published here

Should U.S. Billionaires Dictate Health Policy Overseas?

New York’s former Mayor Michael Bloomberg, known for his obsession with paternalistic policies such as banning Big Gulps, or even just the arrogant statement that sin taxes’ regressive effect on poor people is good because they lack the proper education, has continued being active in the world of public health through Bloomberg Philanthropies. 

The charity arm of Bloomberg, to which he has pledged the majority of his wealth, estimated at over $50 billion, is highly political.

A reasonable assumption would be that a foundation focused on improving public health would support research into curing cancer, investigating rare diseases and orphan drugs, or alleviating the pain and suffering of American patients. After all, if the ambition of giving back to the country in which he amassed his billions were to be the goal, that would appear to be a laudable action.

However, Bloomberg has just continued his nonsensical political battles in the nonprofit world and expanded all around the world. Its latest obsession: (misguided) tobacco control in Vietnam.

In late November, the Socialist Republic of Vietnam passed a law that would ban nicotine alternatives such as vapes and heated tobacco products. Together with the World Health Organization (WHO), Bloomberg Philanthropies “supported” — most likely meaning financially — efforts to ban safer nicotine products. 

Curiously, conventional cigarettes, with all the adverse health effects we have all known about for many decades, remain both legal and sold by Vietnam’s own billion-dollar state-owned tobacco monopoly, Vinataba. With its 12,000+ employees and $8 billion in revenue, which is about 12% of Vietnam’s yearly tax revenue, the Vietnam National Tobacco Company is a not-so-insignificant money collector for the state. 

So, while Bloomberg and the WHO sell this as a victory for public health, officials in Hanoi are more likely to view it as a means of neutralizing competition in its monopoly.

The question is: While the Vietnamese state might have something to gain from a financial decision veiled as a public health boost, why does Bloomberg support a measure that drives people away from devices that help people quit smoking and bring them back to conventional cigarettes?

We need not look for any particular conspiracy here; it’s not money that the New York billionaire needs more of. His charitable foundation is nothing but the elongated arm of his paternalistic and ideological obsession.

Whether it’s sugar, fat, or nicotine, the public health brigade stops at nothing to regulate choices they deem unhealthy.

But at least for sugar and fat, there’s a case to be made that they aren’t healthy choices to begin with. The public utility of a Big Gulp is that as a consumer, I want to have it, not that I need it, and yes, in a free society, that needs to be enough of a reason to keep it. 

Sugar, like any other product, can be consumed in moderation. However, the substitution effect of nicotine alternatives like vapes and heaters goes beyond that because they help people quit harmful cigarettes. E-cigarettes are around 95% less harmfulthan conventional cigarettes, according to Public Health England, and thus serve a public health objective instead of worsening it.

The problem is that while in developed countries, there are institutions and think tanks able to counterbalance the influence of Bloomberg’s vast array of ideological lobbying for the Nanny State, developing nations are much less equipped to do so in the absence of sufficient public debate. This makes them easy targets for the former New York mayor.

As Michelle Minton lays out in a blog post, the American nonprofit Campaign for Tobacco-Free Kids (CTFK), which is funded by Bloomberg, is actively drafting legislation of lobbying for similar types of restrictions on nicotine alternatives in the Philippines, Ukraine, Bosnia, Latin American countries, as well as Africa.

Countries face differing challenges in reducing their smoking rates, which is why they all pursue different policies. Having an American billionaire steamrolling their sometimes legitimate efforts to improve public health with an ideological approach that will backfire, is not just counterproductive, it might very well be the most unhealthy approach of all.

Originally published here

Letter to HHS: Concerns Regarding ICCPUD Alcohol Intake & Health Report 

Today the Consumer Choice Center submitted a formal comment to the Department of Health and Human Services to express our sincere concern about bias in the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD) Alcohol Intake and Health (AIH) report, which could impact the 2025-20230 US Dietary Guidelines. Consumers need the best available information and clearly communicated, in-context summation of risks associated with alcohol, and the ICCPUD failed to do this, as CCC has previously made known.

OR MEDIA QUESTIONS OR INTERVIEWS CONTACT:

Stephen Kent

Media Director, Consumer Choice Center

stephen@consumerchoicecenter.org

###

The Consumer Choice Center is an independent, nonpartisan consumer advocacy group championing the benefits of freedom of choice, innovation, and abundance in everyday life for consumers in over 100 countries. We closely monitor regulatory trends in Washington, Brussels, Ottawa, Brasilia, London, and Geneva. Find out more at www.consumerchoicecenter.org

FDA’s Ban on Red Dye No.3 Defies Scientific Evidence

Today the FDA issued a highly anticipated ban on Red Dye No. 3 as a color additive for food and ingested drugs. In their public statement, the FDA says in the same span of 295 words that Red No. 3 is being banned for representing a threat to public health, while also saying “there is no evidence showing FD&C Red No. 3 causes cancer in humans.

Stephen Kent, an analyst for the Consumer Choice Center (CCC), an international consumer advocacy group, said of the FDA action:

“These color additives are in food and medicines for a reason, and it’s because consumers by-in-large enjoy the products more when they’re aesthetically pleasing. The campaign against Red No. 3 has been a scientific empty vessel from the start. Proponents of this ban will say that it’s not a big deal to have cereal, frozen treats and cupcakes be less colorful when public health is at stake, but they’ve failed to show evidence of harm and have instead relied on misinformation campaigns by social media influencers to frighten the public,” said Stephe Kent.

The FDA is relying on enforcing the Delaney Clause, enacted in 1960 as part of the Color Additives Amendment to the FD&C Act, which prohibits FDA authorization of a food additive or color additive if it has been found to induce cancer in humans or animals.

The ban takes effect in January 2027, offering further evidence of the lack of emergency or public health impact of these common additives on consumers. 

Kent continued, “You could argue the FDA is simply enforcing the law as it is written. When rats were exposed to the dye at extraordinarily high levels, cancer was a result – but it simply isn’t the case in human beings, and they know it. So the law needs to be changed and the public needs better information about the known risks. Red Dye No. 3 isn’t harmful, so we’re just going to have less visually appealing goods because of a law from 1960.” 

Read more about the Red No. 3 debate from the CCC

Washington Examiner

Newsmax Online

Bill Wirtz of the Consumer Choice Center told Newsmax prior to the FDA ban, “Here’s the crucial point to consider: The word “linked” does a lot of heavy lifting here because this particular dye only affected rats that were given unusually high doses in scientific studies. One could write at length about the reliability of animal studies and what they really mean for humans, but the mere fact that the doses were much higher than what even a human would consume shows us that environmental activists do not understand the concept of dosage. Too much of anything will be bad for you — in fact, “too much” describes quite literally the exact quantity that is excessive. For instance, this is equally true for glyphosate residues in beer or aspartame sweetener in Diet Coke. You would need to drink 264 gallons of beer for the glyphosate to adversely affect you or gulp down 36 cans of sugar-free Coke for the aspartame to be bad for you.”

OR MEDIA QUESTIONS OR INTERVIEWS CONTACT:

Stephen Kent

Media Director, Consumer Choice Center

stephen@consumerchoicecenter.org

###

The Consumer Choice Center is an independent, nonpartisan consumer advocacy group championing the benefits of freedom of choice, innovation, and abundance in everyday life for consumers in over 100 countries. We closely monitor regulatory trends in Washington, Brussels, Ottawa, Brasilia, London, and Geneva. Find out more at www.consumerchoicecenter.org

ICCPUD Report on Alcohol Deserves Skepticism

After months of controversy around its development, Health and Human Services (HHS) has published its highly anticipated report on alcohol and health through the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD). The research was slammed in an October letter from 100 US Congressmen who expressed concern over its lack of transparency and known conflicts of interest by researchers involved in the ICCPUD report. 

The Consumer Choice Center’s (CCC) David Clement offered skepticism about the ICCPUD findings, saying “This research was way off target from the ICCPUD’s purpose, which is preventing underage drinking, and has instead focused on promoting abstaining from alcohol across all age groups. You don’t have to dig deep to find the ICCPUD report is co-authored by Tim Naimi, an anti-alcohol activist researcher with declared financial ties to the International Order of Good Templars, also known as Movendi, a temperance group.”

<< Read the CCC in the Washington Examiner on ICCPUD report >>

The ICCPUD report directly conflicts with another government-funded study on alcohol that was published in December by the National Academies of Sciences, Engineering, and Medicine (NASEM), which had a Congressional mandate for their research on alcohol. It found that moderate drinking is associated with a lower risk of cardiovascular disease compared to no alcohol consumption, and a lower risk of “all-cause mortality”. Heavy drinking increases those risks.

Clement continued, “This wave of conflicting information is a problem for consumers because the federal government’s consistent messaging on responsible drinking has made a real positive difference in curbing abuse. A prohibition mindset always backfires by misconstruing risk calculations to the public”

<< Read David Clement in the Financial Post on alcohol studies >>

There has been a steady stream of breaking news on alcohol and consumer health in recent weeks, peaking with the US Surgeon General’s advisory on a “causal link” between alcohol consumption and the risk of contracting cancer. The Consumer Choice Center has also expressed concern over that report and its stretched definition of what constitutes a meaningful “risk” to the consumer. 

“It is no small thing that 100 members of Congress asked for this ICCPUD research to be suspended before the new year. It hasn’t been transparent and did not allow for the proper vetting of researchers. And now we know why,” said David Clement. Experts from the International Scientific Forum on Alcohol Research (ISFAR) have called the work of authors behind the ICCPUD “pseudo-scientific”. “

“With the 2025-2030 Dietary Guidelines coming together, Americans rely on unbiased government guidance for food and beverages like alcohol, and this ICCPUD report is highly counterproductive,” concluded Clement. 

OR MEDIA QUESTIONS OR INTERVIEWS CONTACT:

Stephen Kent

Media Director, Consumer Choice Center

stephen@consumerchoicecenter.org

###

The Consumer Choice Center is an independent, nonpartisan consumer advocacy group championing the benefits of freedom of choice, innovation, and abundance in everyday life for consumers in over 100 countries. We closely monitor regulatory trends in Washington, Brussels, Ottawa, Brasilia, London, and Geneva. Find out more at www.consumerchoicecenter.org

NASEM Findings On Alcohol Safety Are A Win For Science & Consumer Choice

After Congress allocated $1.3 million to the Department of Agriculture and the National Academies of Sciences, Engineering, and Medicine (NASEM) to study alcohol’s impact on consumer health, the findings have been released in time to inform the 2025-2030 U.S. Dietary Guidelines. NASEM’s findings were published today in the Review of Evidence on Alcohol and Health and reported on by POLITICO.

Stephen Kent of the Consumer Choice Center praised the National Academies’ process to research on alcohol, saying,

“There has been intense downward pressure by anti-alcohol activists within the World Health Organization to steer government recommendations against any and all consumption of alcohol, even at responsible levels. Consumers rely on unbiased government research to inform their dietary choices and NASEM delivered on their Congressionally backed mandate to review alcohol’s impact on individual health.”

The Biden Administration’s Health and Human Services (HHS) also launched its own health study on alcohol, not sanctioned by Congress, through the Interagency Coordinating Committee on the Prevention of Underage Drinking. Consumer advocates and 100 Congressmen expressed concern that the HHS report lacked basic transparency and independence from activists seeking to discourage Americans from drinking alcohol. 

** READ MORE FROM STEPHEN KENT: End HHS’ Misadventure on Alcohol Research (WASHINGTON EXAMINER) **

Kent continued, “The appearance of outside influence by the international temperance group, Movendi, is not an insignificant concern with how HHS has approached their research. Imagine a set of federal dietary guidelines featuring input from PETA regarding meat consumption. NASEM had a sufficiently transparent process that involved Congress and should be the only report considered by the USDA as they finalize the next set of US Dietary Guidelines.”

Takeaways from the National Academies report include: 

  • Moderate drinking is associated with a lower risk of cardiovascular disease compared to no alcohol consumption.
  • Moderate drinking is also associated with a lower risk of “all-cause mortality”, though heavy drinking increases such risks.
  • The existing recommendations of limiting drinking to 2 drinks a day for men and 1 for women are reasonable and safe guidelines for consumer enjoyment of alcohol. 

OR MEDIA QUESTIONS OR INTERVIEWS CONTACT:

Stephen Kent

Media Director, Consumer Choice Center

stephen@consumerchoicecenter.org

###

The Consumer Choice Center is an independent, nonpartisan consumer advocacy group championing the benefits of freedom of choice, innovation, and abundance in everyday life for consumers in over 100 countries. We closely monitor regulatory trends in Washington, Brussels, Ottawa, Brasilia, London, and Geneva. Find out more at www.consumerchoicecenter.org

Beyond Insulin: The Rise of GLP-1 Drugs in the Fight Against Diabetes

Diabetes currently affects nearly half a billion people worldwide, and that number is projected to increase dramatically with each generation. According to research from the American Diabetes Association and the CDC, by 2060, over 220,000 young people in the U.S. under age 20 are expected to have Type 2 diabetes, marking a roughly 700 percent increase from recent years. This growth highlights the urgency of addressing one of the most significant challenges facing modern healthcare. The economic impact is staggering, with the condition costing the U.S. $412 billion annually and accounting for about 10 percent of global healthcare spending. In the U.S., one in every four healthcare dollars is spent on treating people with diabetes.

The rising prevalence of diabetes has spurred a race for innovative and affordable solutions to manage weight and combat obesity, with Novo Nordisk leading the way. The company, known for its development of Ozempic and Wegovy, is challenging the usual skepticism surrounding pharmaceutical giants. While insulin manufacturers have often faced criticism for high prices and supply issues, recent progress in diabetes care is shifting the narrative, particularly through the development of glucagon-like peptide-1 receptor agonists (GLP-1), such as Ozempic, Wegovy, and Eli Lilly’s Mounjaro/Zepbound.

These GLP-1 agonists represent a groundbreaking advancement in diabetes and obesity treatment. Unlike traditional weight loss methods, these medications mimic naturally occurring hormones that regulate appetite, leading to enhanced feelings of fullness and satiety. As a result, people taking these drugs often consume less food and may even experience changes in food preferences, showing reduced cravings for salty, high-fat, sweet, and savory foods. This shift helps make healthier eating habits more attainable for patients, promoting sustainable weight loss.

The benefits of GLP-1 agonists go well beyond weight loss. Research has shown that these medications can significantly reduce the risk of serious conditions such as stroke and heart disease. The FDA recently approved Wegovy for treating severe cardiovascular issues, underscoring the drug’s potential to improve heart health. Furthermore, some studies suggest that GLP-1 agonists may play a role in mitigating cognitive decline, possibly helping to prevent conditions like dementia and Parkinson’s disease. The drugs are also reported to curb addictive behaviors, including alcohol use and gambling, providing a range of therapeutic benefits.

While the current cost of GLP-1 agonists remains high, averaging $12,000 annually per patient in the U.S., growing competition is expected to drive prices down, making these life-changing treatments more accessible. In the long term, the widespread adoption of these medications could help reduce healthcare costs by improving overall population health and decreasing the need for expensive diabetes-related treatments. Lower healthcare spending, even by a few percentage points of GDP, would mark a significant shift toward a healthier, more economically sustainable society.

The potential impact extends beyond healthcare. For instance, companies like United Airlines could see substantial cost savings—around $80 million annually on fuel—if the average passenger’s body weight decreased by just five kilograms. The broader economic benefits further underscore the positive ripple effects of embracing innovative treatments for diabetes and obesity.

Novo Nordisk and Eli Lilly are also challenging the longstanding criticism that pharmaceutical companies profit from managing chronic illness rather than curing it. The industry’s recent efforts to develop drugs that not only manage diabetes but also improve overall health represent a significant step forward in addressing complex, widespread conditions. These developments signal a shift toward prioritizing patient outcomes and reflect a broader commitment to transforming the healthcare landscape.

As GLP-1 agonists continue to gain recognition for their versatility and effectiveness, they offer hope for millions of people struggling with diabetes and obesity. This wave of innovation could pave the way for a healthier future, potentially curbing the diabetes epidemic and easing the economic burden it imposes on society.

Originally published here

Reduce wait times by allowing patients to seek care of out of country

The European Union has set an example for how to reduce health-care waitlists. Canada should follow suit

It’s no secret that if you need elective surgery in Canada, you’d better be prepared to wait for a very long time.

Is the problem a shortage of doctors and nurses? Underfunding? Administrative inefficiency? Pretty much everything has been blamed at one point or another. Despite decades of attempts at reform, long wait times continue to be a problem across Canada.

No matter the cause, we know the result: long wait times, lost income, chronic pain and, in some cases, avoidable patient deaths.

Canada is not the only country to be plagued with such issues. Some European nations have had to deal with long wait times, as well. The difference is that they were able to resolve the problem. Part of their solution came from what’s called the “Cross-Border Directive.”

This policy allows European patients to seek treatment in any EU member country and get their medical expenses reimbursed at a level equivalent to what their national health insurance plan would have covered.

Like most policy innovations, this directive emerged out of necessity. In the early 2000s, many British citizens found themselves struggling with long medical waitlists. But through their membership in the European Union, some saw an opportunity to address the delays.

One of these people was Yvonne Watts, who suffered from arthritis in her hips. Unable to get care from Britain’s National Health Service in anything resembling a timely fashion, she requested that it pay for a hip replacement in another EU country. She was declined.

Deciding to take the matter into her own hands, Watts had the procedure done in France at her own expense, paying the equivalent of $10,673 in today’s Canadian dollars. Post-operation, she requested reimbursement from the U.K. government, but again was refused.

Watts never was reimbursed for the cost of her surgery, but she did pave the way for the EU directive on patients’ rights in cross-border health care.

Today, patients in a situation like Watts can decide to receive elective surgery in another country when domestic wait times are too long.

Thanks to the Cross-Border Directive, over 450,000 EU residents sought treatment in another EU country in 2022 alone.

This policy has brought about a significant reduction in wait times, but it has another noteworthy side effect: it helps reduce the overall cost of individual ailments, both to the patients who suffer from them and the states that pay the bills.

This is because the longer a health problem goes untreated, the more the treatment will cost, due to an increased risk of complications. The longer people wait, the more likely it is that their intervention will need to be more invasive (and thus riskier) and will also require more resources to perform.

But the effect on spending is not the only one that needs to be considered. Health issues can have an adverse effect on government revenue, as well.

While elective treatments are not considered urgent, the ailments they hope to treat can still have an effect on our lives. For example, some of the people on waiting lists are workers who are unable to do their jobs, or who are forced to reduce their workloads, due to the pain they’re experiencing. Some are even on worker’s compensation.

Even looking at it solely from a revenue standpoint, it should still be in the state’s best interest to get those workers the treatment they need so they can start paying taxes again. Letting them obtain the required medical attention out of province or out of the country — for the same price the system would pay domestically — should be a no-brainer.

Let’s not forget just how many Canadians can’t get the treatment they need within the recommended timelines.

In 2019, 30 per cent of patients needing a knee implant were unable to receive it within the recommended 26-week period. By 2023, that number had climbed to 41 per cent. Similarly, the proportion of patients needing hip replacements who couldn’t get them within the established time frames rose from 25 per cent to 34 per cent over the same period.

Public coverage of a Canadian cross-border directive would help bring these figures closer to zero and address our substantial surgical backlog. This would allow Canada to better cope with patient needs and improve efficiency across the board.

Originally published here

The Insurance Piggy Bank Delusion

Enforcing medical loss ratio on dental insurers means more competition, more accountability, and more savings for consumers

What critics of the US healthcare system often get wrong is their claim that America’s healthcare system is a free market run amok, with profit-driven hospitals, merciless drug companies, and greedy providers pushing up prices everywhere you look.

The truth is a lot more murky. America’s healthcare system is every bit as bureaucratic or regimented as any other government-managed health system in the world – America just does it a particular way.

American patients rarely end up paying for health services directly (whether government or insurance), prices oscillate wildly depending on the payer, and there are usually dozens of layers of bureaucracy, government mandates, or tax incentives that drive price inflation for health insurance and healthcare.

This is true for dental patients, clients of general practitioners, or anyone who’s unfortunately ended up going to the hospital.

Added to that, specific tax credits and employer mandates force private companies into being arbiters of healthcare for their employees, as well as perpetuating the surplus of insurance coverage that naturally pushes up prices rather than keep them low.

All these factors distort the actual purpose of insurance and create a middleman economy between us and our health practitioners. 

The promise of MLR

What if we have solid policy tools that could help keep that price inflation in check, promote more competition, and keep insurance accountable?

At least one that we’ve championed at the Consumer Choice Center is that of medical loss ratios imposed on insurance companies, specifically for dental care. While the Affordable Care Act imposed an 80% medical-loss ratio on general health insurance firms, no such requirement exists for dental plans.

Our policy primer, entitled The Feasibility of Medical Loss Ratio for Dental Insurance Patients and Consumers, examines the policy in detail, and how these would benefit patients who want more affordable and competitive care.

Seeing this policy put into place across states would have a positive impact toward lowering our costs as individual patients.

And, hopefully, this would also create momentum for large-scale reforms aimed at decoupling insurance plans from employers altogether, providing more direct-to-consumer funding options that eschew insurance, and remove red tape at both the state and federal level to empower consumers within a thriving market for dental care.

The Commonwealth of Massachusetts passed the first enforceable MLR law by popular referendum in 2022, requiring that dental insurance plans spend at least 83% of their premiums directly on patients. It entered into force earlier this year. Other states have MLR reporting requirements, and are actively considering rebates as well.

Considering the law has only been in place for a few months, we do not yet have reliable quantitative data to analyze its effectiveness.

One recent post at American Action Forum believes enforcing medical loss ratios on dental insurers will “disincentive competition, reduce carrier options, and ultimately leave more patients without any dental coverage at all.”

While it’s too early to measure these claims, we can at least tease out the arguments.

To begin, dental insurance is not the same as health insurance.

Dental plans are all capped. Every plan has a maximum they will fork over for your dental procedures and care as a patient. Traditional plans are capped near $1,500, leaving patients meeting the cap responsible for the remaining dental care costs for the year.

In addition, the networks of coverage that exist for dental insurance are complex and not very well unified, consisting of gaps in coverage that make it more difficult for patients to apply their insurance or have to chase after rebates.

We should first consider what the point of any of these reforms is: to lower the costs of dental care. The goal of state-level legislation should not be to artificially prop up one particular insurance product that benefits a handful of companies.

Measuring the success or failure of medical loss ratios on the number of insurance companies who enter or leave or state is faulty, because that’s not the goal. Neither is the overall cost of premiums. It’s about patient prices for care.

Each year, Americans spend $136 billion on dental care. In the last 20 years, dental costs have risen more than 30% per patient. Those without dental insurance are least likely to visit dentists for important check-ups and procedures, worried about costs.

Therefore, all our focus in this debate should be on how patient costs are affected.

We should be most concerned about how legislative fixes will make dental care and overall healthcare more affordable for patients and consumers, and not necessarily how they will impact a specific business model that, as we have argued, is flawed on its face.

When did insurance become a piggy bank?

Insurance, if we recall, is intended to be a product of risk management, protecting consumers from catastrophic financial loss due to unforeseen or unpredictable events that mean you’ll get higher bills. As consumers and patients, we gladly transfer risk to reduce costs while maintaining protection. 

We pay a monthly premium to contribute to a fund held by an insurance company accessed when needed, especially in emergencies. That balancing of financial risk is how insurers make money, hoping to pay out less than they take in from premiums, while consumers benefit by not having to bear the full cost when unexpected expenses occur.

Farmers are happy to pay this premium when their crops run dry for a season. Drivers are delighted they won’t bear the full brunt of the cost if they total their vehicle or someone else’s. These are emergency situations that no one can accurately predict, and thus consumers and companies make worthwhile investments to protect themselves against that risk.

Somewhere along the way, though, especially with health insurance and dental insurance, our insurance plans became piggy banks instead of emergency lines. This, along with many other factors, have led to eye-watering price inflation at hospitals, dental clinics, and every aspect of the healthcare economy.

At the Consumer Choice Center, we’ve long written about the over-reliance on health and dental insurance plans to cover ordinary, routine checkups and visits rather than emergencies. For the sake of consumers, insurance should be simplified, reimagined, and subject to intense competition.

Insurance policies on our cars exist in case we get into severe accidents that cause damage and injury. We do not insure the tires, windshield wipers, or oil changes, which we know we will spend money on.

This is the principal flaw of researchers, insurers, and activists who oppose the imposition of medical loss ratio requirements on insurance products.

One elephant in the room that isn’t often discussed is the role of government plans, subsidies, and tax credits that generally distort the naturally competitive market of dental insurance and dental care.

Government tax credits distort the health and dental insurance market

Apart from the significant role of Medicare and Medicaid in paying for dental services and insurance, 59% of Americans have dental benefits offered by their employer.

Employers negotiate on behalf of their employees for these insurance plans, and agree on premiums to be paid. Employers, in return, are offered significant tax credits by the federal government, sometimes as much as 50% of premiums, according to the IRS, though the Small Business Health Options Program Marketplace.

When government subsidies are handed out for specific products or products, it is only natural that prices will rise. Nonpartisan think tanks such as the Cato Institute have made the argument for getting rid of tax exclusions for employer-sponsored healthcare for this very reason. It has merit.

How this could apply to dental insurance plans, and further to the impact on dental prices overall, would be an appropriate topic for further study. But we have some policy tools available now to provide a fix.

Unlock savings and empower patients

Medical loss ratio is one of our most vital policy tools to hold insurance accountable, unlock benefit spending for patients, and to promote competition among insurers who will provide the most innovative plans.

Similar to general healthcare, the most consumer-friendly option would be to render insurance to its original purpose: as a tool for weighing risk.

Indeed, there are plenty of easy reforms state legislatures could enact that would help improve care: fostering innovation, reducing bureaucracy, giving incentives to patients to use direct-to-consumer options and more. But this has little to do with giving a leg up to insurance providers.

When we use insurance to pay for our care, rather than as an emergency buffer in case the worst happens, there will be natural price inflation. Too many of us are familiar with it.

Medical loss ratios and rebate requirements imposed on dental insurance plans are the quickest short-term fixes to address these issues and unlock savings for patients and consumers. We should eagerly await the results in Massachusetts and beyond.

Read our policy primer on the feasibility of medical loss ratio for dental insurance and patients here.

A Visionary Leader Shaping Consumer Policies

Consumer advocacy is vital in ensuring fair treatment for consumers, promoting product safety, and maintaining transparency in the marketplace. Leaders in this field are essential in deciding which issues to focus on, leading awareness campaigns, and advocating for change through media and lobbying. They also collaborate with stakeholders to increase their influence, educate consumers about their rights, and monitor industry and regulatory changes.

Frederik Cyrus Roeder, Managing Director of the Consumer Choice Center, an independent and non-partisan consumer advocacy group. The organization advocates for freedom of choice and innovation in everyday life. With a background as a Health Economist, Frederik is interested in using innovation to enhance patient healthcare delivery.

From Protest to Advocacy

In the summer of 2014, Frederik Cyrus Roeder lived in Berlin, Germany, where he observed Europe’s taxi drivers protesting against competition from ride-hailing apps. As a consumer who values ride-hailing apps, he was surprised that traditional consumer rights groups did not support choice and competition. With the help of two friends, Frederik organized a small protest highlighting the importance of consumer choice. The absence of representation for consumers who prioritize innovation and choice in these discussions prompted Frederik to recognize the need for a platform for their advocacy. This recognition marked the beginning of the Consumer Choice Center.

Setting the Standard

Under the leadership of Frederik Cyrus Roeder, the Consumer Choice Center is a global advocacy group. It stands out among the numerous nonprofit advocacy groups in the US and European Union focused on policy change. While many groups focus on specific issues or regions, Frederik’s organization prioritizes representing consumers worldwide as a distinct interest group. The Consumer Choice Center adopts a global perspective in advocacy efforts across more than 100 countries. It maintains a presence in capitals such as Washington, Brussels, Ottawa, Brasilia, London, Geneva, and Kuala Lumpur to advocate for consumer rights and interests.

Read the full text here

Farewell, Insulin? The Diabetes ‘Cartel’ Is Disrupting Itself, Proving Cynics Wrong

Diabetes affects nearly half a billion people worldwide, and the numbers are only going up with each generation. Recent research published by the American Diabetes Association and the CDC projects that by 2060 there will be at least 220,000 young people in the U.S. under the age of 20 with Type 2 diabetes. That’s a roughly 700 percent increase from just a few years ago. The disease poses one of the most significant known challenges to modern healthcare systems and has contributed to a new race for innovative, affordable solutions to weight gain and obesity. That race is led by Novo Nordisk, the maker of Ozempic and Wegovy, and it defies much of the usual cynicism about pharmaceutical giants. 

The impact of diabetes extends beyond individual suffering. It’s a condition with huge downstream economic effects – costing the United States a staggering $412 billion annually. Care for the condition accounts for about 10 percent of overall healthcare spending worldwide. As of 2023, people with diagnosed diabetes are responsible for one of every four dollars spent on healthcare in the U.S.

Insulin manufacturers frequently face criticism for escalating prices not making enough of the essential injections. Some U.S. states have even resorted to legal action, accusing insulin makers of maintaining artificial shortages. These companies are often vilified as the embodiment of greed, profiteers of patients’ misery.

U.S. Senator Bernie Sanders knocked Novo Nordisk at the end of March, saying “Novo Nordisk did the right thing by recently reducing the price of its insulin products by some 75% in America – a company that made nearly $15 billion in profits last year, must now do the right thing with respect to Ozempic and Wegovy.”

The world’s largest insulin producers, Eli Lilly and Novo Nordisk, are spearheading the transition to make insulin injections obsolete for millions with developments of drugs classified as glucagon-like peptide-1 receptor agonists (GLP-1) such as Mounjaro/Zepbound and Ozempic/Wegovy. Eli Lilly was the first to commercialize synthetic insulin in 1982 and these companies are now actively betting on disrupting their own business models which made them global leaders in pharmaceuticals. 

These drugs work by essentially mimicking certain hormones produced by the human body, boosting feelings of fullness and satiety.

Patients crave less food and have even shown shifts in their overall food preferences. People taking the drugs were shown pictures of foods and demonstrated “less desire for salty, spicy, high-fat, sweet, and savory foods.” This was also the case with starch and dairy. Eating healthier becomes so much easier on GLP-1 drugs.

Beyond weight loss, GLP-1 agonists reduce the risk of stroke and heart disease. They even might mitigate dementia and Parkinson’s. Recently, the FDA approved Wegovy for treating severe cardiovascular conditions. Some reports even suggest that these drugs moderate alcohol consumption and addictive behaviors like gambling.

Will these myriad benefits help alleviate healthcare inflation? Presently, GLP-1 agonists come at a considerable cost, with an annual treatment cycle averaging $12,000 per patient in the U.S. Growing competition could reduce the sticker shock. More importantly, patients whose long-term health is greatly bettered by the drugs will enjoy lower healthcare costs. 

Thus, GLP-1 agonists have the potential to trim healthcare costs by a few percentage points of GDP. If realized, that’s a very different, more healthy world. Sheila Kahyaoglu of Jefferies Financial told Bloomberg that United Airlines alone stood to save $80 million annually on fuel costs if the average passenger shed 5 kilograms of body weight. Meal delivery services and fast-food chains are rapidly adapting, offering healthier options to accommodate customers embracing healthier lifestyles.

Perhaps the most misguided and longstanding accusation about pharmaceutical companies is that they aim to profit from perpetual illness rather than pursue the creation of curative drugs. The industry disruption we’re witnessing around diabetes management and weight loss should long stand as a reminder of just how wrong that cynical claim is.

Originally published here

Health equity and trial diversity questions still not answered by pharma

While global players are more aware of health equity problems across the world, there are still lingering problems, according to Access to Medicine Foundation CEO Jayasree Iyer.

Speaking at the panel discussion ‘Health Equity – How Can Pharma Make a Difference?’ on the last day of the FT Global Pharma and Biotech Summit in London, UK, Iyer highlighted that commercial and access incentives need to be put together to improve health equity.

Seyda Atadan Memis, general manager of the UK and Ireland at Takeda, noted that while focusing on patients and building trust is crucial, it is also important to address affordability questions in each country.

Memis also said that health equity goes along with ethical considerations inside clinical trials. Takeda has translated its clinical trial guidelines into multiple languages for potential participants and caregivers to improve diversity and representation.

Clinical Trials Arena has previously reported on the importance of including patients from racially diverse backgrounds, improving female representation in early-stage studies, and the inclusion of the pregnant population and patients with cognitive disabilities.

Even though data plays a crucial role in the drug development process, it may also affect diversity. Liz Hampson, executive director of Europe at Deloitte Health Equity Institute, explained that biased data used to pick which products should enter clinical trials will influence what cohorts are enrolled into trials.

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