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20/20 Hindsight

You’ll probably read a lot of year end missives talking about how bad 2020 was, probably because it was really, really bad. Think of the babies born in 2020 who will forever be asked about the year they were born as if they could remember their first year on earth. It will be remembered as a year of challenges and heartache and hopefully a year of solutions. I’m not going to dwell on all the bad things that happened in 2020; I want to look forward, using our perfect 20/20 hindsight to guide us as we venture into 2021.

We found out in 2020 that there really are things that can happen that will bring the whole world to its knees. Hopefully, going forward, we will put more effort into studying these viruses so we can be better prepared.

We found out that trusting our scientists makes sense. As Aaron Burr says in the musical Hamilton, we should “talk less, smile more.” Talking less would have helped us listen to what our scientists were saying, and smiling more would have helped everyone’s attitude as we made our way through the pandemic. Keeping our scientists free from political influence should be a priority going forward. The trust in our institutions that exist to keep us safe has been compromised, we need to rebuild that trust and independence.

We reaffirmed the power of our country’s innovation machine. America has built an environment that enables innovation by limiting government regulations while maintaining government oversight. This balance enabled the creation of a COVID-19 vaccine in less than a year, a feat that was deemed impossible in February. I don’t think it was a coincidence that the first vaccine to gain emergency use authorization was created by a partnership of companies that didn’t accept any funds from the government. They feared at the outset that any government interference would slow their progress, and it looks like they were right. As we look to 2021, our government should realize how powerful America’s innovation machine is and find ways to further encourage innovation . . . finding cures saves lives and saves money.

And finally, in 2020 we found how divisiveness stagnates us — how it hinders progress. I hope that the new Administration, coupled with narrow majorities in the House and the Senate will require Washington to cooperate. We might even find that less rhetoric and more discussion will produce progress.

I hope that our perfect 20/20 hindsight gives us a clearer vision of how we can move forward in 2021. I look forward to continuing to speak out for seniors. Have a safe holiday and I’ll see you in January.

Best, Thair

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How Did Your Medicare Open Season Go?

Well, open season for changing Medicare insurance is over (although you can still change your prescription drug insurance, Medicare Part D, until tomorrow). How did it go? Did you keep the insurance you had? If you did you would be in good company, historically over 80% of us don’t change our insurance. Did you take the opportunity to really evaluate your options or did you just take a cursory review, or did you let the opportunity go by and just keep the insurance you had continue for another year? Many people I have talked with didn’t take the time to review their insurance, a dangerous approach given the changes that are going on, to say nothing of the changes to your health that might occur. I warned, cajoled, even begged everyone in earlier blogs to take the time to review their coverage. I hope some of you listened. Let me tell you what steps I went through as I reviewed my insurance and how I made my final decision.

I moved last year and, for the first time, chose a Medicare Advantage (MA) plan. Generally, a MA plan offers more benefits, usually some discounts or free memberships to health clubs, often some hearing benefits, maybe even dental and eye benefits. Surprisingly, these often come with no premiums. For me this was a big change from the premiums I was paying with my old supplementary insurance. As you might imagine these benefits and low or no premiums are offset by some stipulations and rules that need to be considered. Often their network of doctors and hospitals is more restricted, and your copays and other out-of-pocket costs are larger. Many MA plans include prescription drugs, but their formulary may be more tightly controlled. Since MA plans get paid a fixed cost for each member of their plan, they are incentivized to keep you healthy, hence the focus on fitness, healthy living, and preventive care. They are also focused on keeping costs down. Those are the tradeoffs I looked at going into the open season.

I first read my insurance company’s Annual Notice of Changes. I was pleased to find that my copayment for a specialist dropped 20% and for hospital specialists and treatment dropped $110 dollars or 25%. That was big for me since I had paid both of these copays for some tests that I had. The tests turned out fine, but it was pleasing to see that I will pay less in 2021 if I need that sort of healthcare. My drug plan stayed the same except for a big reduction in the cost of insulin in 2021 which was capped due to legislation and rules instigated by Washington. This will have a big impact on many diabetics. Given the healthcare needs of my wife and myself we found that staying with are current MA plan continued to save us money and fit our situation.

I hope that increased competition gave you more choices and more opportunity to save money in 2021. I will be really interested to see what next year’s open season brings. With the hope of vaccines allowing us to return to normal by the second half of 2021, we could see many changes in how healthcare is administered. Telehealth, in-home tests, more sophisticated medical devices to monitor our health, may all lead to changes to how we receive and pay for healthcare.

The new administration will certainly be pressured to control healthcare costs. I hope they see how competition is the quickest and best way to balance access with cost. I’m convinced that the reason my MA plan dropped their copays was not because they had a banner year — many doctors and hospitals saw a big drop in revenue due to the pandemic. What these plans do see in 2021 is a big increase in healthcare demand due to our country’s return to normal as we emerge from the pandemic and an increase in competition to satisfy that demand. A system that is based on cost controls and limited access would not respond as quickly, or at all, to this increased demand.

Keep track of your costs and access to care in 2021. Document the changes in your health. Know where you stand with your prescription drug costs. These are all things that will help you make an informed choice when next year’s open season rolls around. It could have a big impact on your cost and level of care going forward.

Stay Healthy, Thair

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COVID-19 Vaccine – It’s Use or Lose

The great news of how effective the first two vaccine candidates were in the phase three trials gave all of us a burst of hope. Finally, we began to believe that this demoralizing pandemic would finally end. However, there is a hurdle that we need to get over to make this come true, the surprising hesitancy of many in America to take the vaccine. The fact of the matter is, we need somewhere between 60 and 70% of a community to be vaccinated to obtain herd immunity, the point where the virus quits spreading. A poll a few weeks ago showed that less than 50% of the people polled said they were going to get vaccinated as soon as it came available. A more recent poll showed the number increased to above 50%, a step in the right direction but not the participation numbers we need to stop this pandemic. There has been much discussion about why people are hesitant, with many possible reasons put forth. There are two oft sited reasons that deal with the safety of the vaccine that seem to be at the top of the list that I would like to discuss. Hopefully, it will shed some light on why these vaccines are safe.

1. The Vaccine was developed to quickly.

Historically, vaccine development has taken four or more years to be approved for human use. While we have had vaccines for hundreds of years, the science behind vaccines has been slow to progress but in the last few decades it has accelerated at a breathtaking speed. While the approach taken by these first two COVID-19 vaccines is new, it wasn’t discovered this year. Two married scientists, Ugur Sahin and Ozlem Tureci, co-founders of BioNTech, the firm that has teamed with Pfizer, have been working on this vaccine approach since 2001 and have been working on a COVID-19 vaccine since January. With the funding and worldwide logistical support of Pfizer and the commitment of the FDA to cut through the bureaucratic red tape, the new vaccine has gone through all of the required testing in record time. Their phase III testing had over 40,000 participants. They had to jump through all the hoops any new vaccine was required to accomplish. They proved that it works and that it’s safe.

2. The FDA was pressured by politicians to cut corners.

The FDA is recognized worldwide as the gold-standard in the process of approving the safety and efficacy of prescription drugs. The FDA is made up of career scientists who have maintained this reputation for decades and they did it from a commitment to excellence, not through a commitment to any administration or political party. America is the leader in drug development because of the high standards required by the FDA. One of the ways the FDA assures the absence of any political influence is the approval review by an advisory committee made up of external scientists and experts. The committee that will meet on December 10th to review the Pfizer/BioNTech vaccine is the Vaccines and Related Biological Products Advisory Committee (VRBPAC). These committees are thorough and transparent. I have personally testified many times during the public comment portion of various advisory committee meetings and can attest to their attention to detail and their commitment to transparency. The FDA is not about to jeopardize their gold-standard reputation, to say nothing of the health and wellbeing of the whole world, due to the pressure of a lame duck administration.

Three past United States presidents have committed to getting vaccinated as soon as it becomes available. They, more than anyone, understand the workings of the FDA and they trust them to protect us, as we should. The only way we can beat this virus is to take advantage of the great scientific minds and amazing manufacturing capabilities that have made this vaccine a reality. Let’s all get vaccinated as soon as we can, so we don’t lose the chance to once again gather together.

Best, Thair

p.s. I would be remiss if I didn’t recognize the importance of this day of infamy and those who made the ultimate sacrifice at Pearl Harbor. In the space of six months, while serving as a B-52 crew member in the Air Force, I lost fellow aviators and friends in two separate airplane crashes. I am honored to have served with these heroes and I use December 7th as a time recognize and remember all who serve or have served.

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Drug Price Interim Final Rule Order – Two Reasons It Is the Wrong Approach

The President, through the Centers for Medicare and Medicaid Services (CMS), issued an interim final rule after the election that finalizes his prior approach to dealing with the cost of prescription drug prices. It is called the Most Favored Nation approach and amended earlier EO’s, one of which used the term International Price Index. All of these EOs were attempts to lower drug prices by using the prices that foreign countries pay for specific Medicare Part B drugs. You can read some more background on these EOs or rule changes in some of my earlier blogs, here and here.

It only seems fair that we shouldn’t pay more than foreign countries for some prescription drugs, but this new regulation will set the price based on countries with single payer healthcare systems, where the government dictates who gets what medicine. The patients in these countries wait years for new medicines. Of the 74 cancer drugs launched between 2011-2018, 95% are available in the United States, compared with 74% in the UK, 49% in Japan, and 8% in Greece. These facts bring me to the first reason this is the wrong approach.

Foreign countries use many methods to negotiate lower prices, they lower competition by telling the competition that only one class of drug will be available in their country and that one will be the one with the lowest price. There’s no thought to those in their country who may do better on another drug in that class. They may even delay the entry of a particular drug, sometimes for long periods of times, until the manufacturer lowers the price. One of the ways governments dictate the rules and use of healthcare is through rationing, controlling patient access. If we import these foreign countries prices, we are importing their practices of price fixing, rationing, and controlling access. The Executive Order’s own language recognizes this fact. The first notice of this approach to lowering drug prices was released over two years ago with the promise that the new approach would operate “without any restrictions on patient access.” The government’s own advisory group, the Medicare Payment Advisory Commission, expressed doubts this could be accomplished without making some products unavailable to patients. The latest regulation finalized the government’s approach, with the actuary at CMS stating that their estimate is that 19% of the Part B drugs (the drugs that this EO targets) will be unavailable to the patients. The final recognition of denying access comes from the EO itself which states, “a portion of the [Medicare] savings is attributable to beneficiaries not accessing their drugs through the Medicare benefit, along with the associated lost utilization.” This approach saves money by denying access, which is one of the ways foreign countries save money. When we import their prices, we import their ways of doing business.

The second reason this regulation is the wrong approach focuses on a much larger and more troubling scenario, the use of healthcare proposals for political reasons. Why was this approach unveiled two years ago just prior to the med-term elections? Why was this again released in an unfinished state hoping for negotiations, two months before the presidential election and then finalized after the negotiations failed and then released after the election, by a lame duck President. Some have indicated that the release of this EO was solely as retribution for drug manufacturers not releasing the results of the vaccine trials until after the election. Whether these accusations are true or not, just the optics of the releases troubles me. Executive Orders, rule changes and legislation should only be done for the betterment of the American people. The timing of these actions leads one to conjecture that these actions were taken for political reasons. Do we want to give our government more control over our healthcare when we see these types of questionable actions?

There are many ways to make our healthcare more efficient and less costly, it’s my belief that giving more power to the government is not the path to either of these outcomes. I’m a believer in the free market with the umbrella of government oversight accomplished through the checks and balances established in our Constitution. Look how our country responded to the COVID-19 pandemic. I don’t think it’s a coincidence that the first company that completed successful COVID-19 vaccine trials and will most likely get the first emergency authorization, was one of a few, if not the only company, that didn’t take any government funds.

This proposal imports the methods of foreign countries that uses government controls to set prices and limit access. I think we need to rethink how to tackle this problem, because giving more power to the government is not the solution.

Best, Thair   

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Thanksgiving – A Tough Year to Give Thanks

Thanksgiving is usually a time for families to gather together and remember the things we are thankful for. Instead, as the pandemic rages, many states are encouraging their citizens to not gather with anyone that lives outside of their house. What kind of Thanksgiving is this going to be?

I’m not going to tell everyone to soldier on, we’ve done about as much soldiering as we can stand. We’ve been avoiding getting together with our loved ones for almost 9 months and now, on the one day of the year when we all look forward to gathering with our loved ones, we are asked to keep to ourselves. In the vernacular of a younger generation, “this stinks,” or something like that. So . . . what do we do? What can possibly be salvaged from this terrible situation. I’m going to talk about two things that might help us as we strive to get through this tough time.

My first suggestion is, be grateful. We finally have some good news and can finally begin to see a time when this will all be over. The recent great news concerning two vaccines gives us hope that the virus will be contained. We have hope that by next Thanksgiving we will again be able to gather. How grateful we should be that our healthcare system continues to rise to the challenge of this pandemic. How grateful we should be that we will probably have an approval of two vaccines sometime next month and that they could be 95% effective. At the beginning of the pandemic, no one at the CDC had any hope that a vaccine would be developed this fast and would be this effective. In keeping with our healthcare theme, showing gratitude, according to one spiritual leader, “is a fast-acting and long-lasting spiritual prescription.” Showing gratitude is an excellent way to keep us positive.

There is another thing we can do this Thanksgiving that could have a long lasting and lifesaving impact on our families. Thanksgiving Day is National Family Health History Day. This is an ideal day for assessing the health risks for illnesses known to run in your families. Here’s a couple of reasons why we should share and document this family health assessment:  

  1. Some family members may have died young

If you have chronic conditions that run in your family, it’s important to discuss the family’s health history, especially if there were family members who died before the conditions became evident.

  • Many families tend to get these diseases

The most common conditions that occur in families are heart disease, diabetes, and cancer (including colon, stomach, endometrium, lung, bladder, breast, and skin) as well as high blood pressure.

The CDC has a great web page (click here) on how to collect and how to act on your family health history. This information could be invaluable as you and your doctor work to diagnose and effectively treat you or your loved ones. It could guide the doctor to look for specific conditions prior to them becoming a big health problem.

Now, you may ask, how can I do this great thing when our Thanksgiving gatherings are going to be small or non-existent? Well, consider this, use zoom or some other video conferencing software to virtually gather your family together. Tell them what you are planning and why and give them some time to gather information. A big requirement of these health information meetings is to document the results. By recording the session, you can ensure that you (or your assigned recorder) can go back and review the recording to ensure you don’t miss anything of importance.

This Thanksgiving will be different, but if we step back and think of the things that we are grateful for and then share those thoughts with those around us, we can create some positive vibes for us and those around us, and, if we document our family health history we will create a valuable tool that could have life changing impacts on those we love. We really could have some things to be thankful for and, best of all, we could have something positive to say when someone asks us how we spent the COVID Thanksgiving of 2020.

Stay healthy, Thair

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Our Latest Virtual Townhall – A Recap

Last Thursday, November 12th, we held a virtual townhall to share some thoughts on the election and its impact on healthcare in America, and then discuss the importance of America’s caregivers, especially in our current COVID-19 environment, and to offer some resources that are available to caregivers. If you want to see a recording of the townhall click here.

I started out by pointing out that there are three ways to institute changes to our healthcare; legislation, Executive Orders (EO) or rule changes. On the legislative front, the Democrats, rather than increasing their majority in the House, lost seats, with the final tally looking like they will have just a five to ten seat majority. That leaves a lot of room for the Republicans to have influence over legislation in the House.

The Democrats were also hoping to gain a majority in the Senate but now, the best they can do, depending on the outcome of the two Georgia senate runoffs, is a 50/50 tie, which gives them the chance to choose the majority leader and for the Vice President to break any tie votes but the Senate calendar and priorities will have to be done in conjunction with the Republican leaders. Many pollsters are saying that the Republicans are more likely to win the Senate seats in Georgia, but we’re not to keen on pollsters right now so we’ll just have to wait and see. What all this means is it will be tough for the President Elect to pass any large healthcare legislation.

I then reviewed some of the proposed healthcare changes and discussed their chances of being implemented in the near future:

  • Medicare for All – Won’t happen.
  • Biden’s plan, lower age to 60, offer younger people the choice of joining a government healthcare plan – Not this year and probably not for at least two years.
  • Let government negotiate drug prices – Some bi-partisan interest but not by itself, could be part of a “deal” that gets negotiated.
  • Importation of drugs – Already an EO, logistically won’t work, probably will die as an option.
  • IPI (international pricing index) or most favored nation pricing method – Already an EO – Hard to implement, I don’t think it’s a change that the President Elect wants to pursue.
  • Limiting the amount of drug price increases over a year – Has some bipartisan support, might be part of a “deal”
  • The ACA – The President Elect will work hard to expand, may be a place for some of the other changes to get done.
  • Telehealth – Will be have bipartisan support to expand its use.
  • Cap on yearly Medicare Part D out-of-pocket costs – May be something that would gain bipartisan support.
  • Fee-for-service versus value-based care – The migration to value based care will be accelerated.

Covid-19 has put near term changes to healthcare on the back burner, but President Elect Biden promised healthcare changes and he could use budget reconciliation to pass some items. We need to be vigilance to identify those changes that help and those that hurt the patient’s access to, and the cost of, their healthcare.

I then turned the time over to John Schall. He is the CEO of the Caregiver Action Network (CAN) and has over 30 years’ experience both on the Hill and with advocacy organizations.

John started out by pointing out how much the Senate has changed since he worked for Bob Dole and how hard it was to predict what changes would happen going forward.

John reminded us that this month was National Family Caregivers Month and that CAN’s theme this year is caregiving in crisis. He said that every caregiver and their loved one should be involved in reviewing their Medicare coverage during the open enrollment period that we are currently in, not just because Medicare and insurance plans change but that the beneficiary’s health changes. A link to an informative webinar on Medicare that John recommended is here.

John then discussed that the historical profile of the caregiver is a 49 year old women with kids and a job, caring for her mother or mother-in-law. He said that caregiver is still on the job but there has been a huge increase, over a million, in millennials becoming primary caregivers. This has had an impact during the COVID-19 pandemic because many of them have had a reduction in income and their financial burden has increased. They are experiencing the toll that caregiving extracts. The facts are, caregivers have a higher chance of depression, high blood pressure, diabetes and having a stroke. COVID has magnified these problems.

In this environment the caregiver has to weigh the risk of even being around their loved one, taking them to the doctor or helping them in other ways. These are tough decisions that weigh heavily on the caregiver. John spoke as to the financial cost that often accompanies care giving and that it can cost as much as $10,000 a year to give care to a loved one.

John pointed out the huge increase in the use of telehealth but reminded us that it also has its challenges. If that caregiver is not part of the discussion then they don’t get the doctor’s guidance first hand and they also can’t share the knowledge they have of their loved one’s condition.

National Family Caregivers Month has always been a good time to check up on those we love. The Thanksgiving edition of USA Today will have a special insert sponsored by CAN that will offer tips and help to caregivers. John mentioned that there is now a Family Health History day on Thanksgiving Day. This is a day to share and obtain health history from your family and information about your ancestors. Health history is becoming very important as treatments become more and more personalized. This important information has the chance to save a life.

After John’s discussion the meeting was opened up for any questions. I started off by stating how important vaccines were in keeping our loved ones healthy and that the just  announced good news about a COVID-19 vaccine may open the door for older Americans to get their other life improving and even life saving vaccines. I asked John if this is important for caregivers. John stated an emphatical yes, and stated that because of the reduction by the CDC in their recommendation for some vaccines it is very important for the caregiver to do all they can to ensure that their loved ones get the various vaccines that can have such an impact on their life.

A question from a viewer stated that they were struck by the statistics on depression and asked if there were any tips or helps that John had. John stated that the caregiver needed to keep themselves healthy, both physically and mentally, so they can continue to giver care rather than becoming unhealthy and needing their own caregiver. He also pointed out that CAN has a help desk, tasked with professionals, that could be a resource for caregivers. The link to that help desk is here.

Another question was directed to me asking if I thought that a cap on Medicare Part D might be a candidate for bipartisan cooperation and get implemented. I said that President Elect Biden might try to pass and infrastructure bill first, which could have a lot of bipartisan support, and then go to a Part D cap. The cap could be an excellent candidate since it shows Biden accomplishing something in the healthcare arena.

The final question concerned a Biden proposal which allowed support and payments for services that kept patients out of institutional care. John said that CAN enthusiastically supports this approach, and he was especially pleased with the multi-pronged approach this proposal championed.

It was honor to be on this townhall with John. Please look for more of these virtual townhalls as we cover topics that affect older Americans.

Best, Thair

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Veteran’s Day – Ways We Can Honor Our Countries Veterans

November 12th is Veterans Day, a time we reflect on the sacrifice and service of those that served. As a veteran myself, I’ve observed a change over the years in the way the public has honored our veterans. As a B-52 bombardier I spent a few years sitting nuclear alert and had a tour in southeast Asia toward the end of the Vietnam War. I don’t remember anyone thanking me for my service during that time frame, and I know of others who even endured negative reactions toward them for serving in that controversial war. It is different now. I often am thanked for my service, which sometimes makes me a little uncomfortable because I feel the ones that really deserve the honor are those who made the ultimate sacrifice or were injured either physically or mentally during their service. These veterans have earned the best healthcare our country can provide, yet there are many veterans who face barriers in getting the healthcare they need.  Here are just two ways we can honor our veterans.

First, don’t quit thanking veterans for their service. While it might make some uncomfortable, the bottom line is that every veteran took an oath to protect and defend our country, even to the sacrifice of their own life. Whether they were injured or not they were willing to give the ultimate sacrifice and that deserves our thanks. Something that many people do not know is that the oath a veteran takes when they join the service does not expire. They make a lifelong promise to defend our country.

Second, do all you can do to get the veterans the healthcare they deserve. There have been conditions that have come to light of some of the deficiencies in healthcare our veterans have faced. There has been substandard hospital care and a lack of access to convenient healthcare services that have plagued veterans. Here are just three of the areas that need to be improved:

  • The patient’s voice needs to be part of the dialogue as we consider improvements to veteran’s healthcare. Many of the past and present problems could have been avoided if they would have listened to the patient.
  • Better transparency and accountability is needed when it comes to the limitations of the veteran’s prescription drug formulary. The VA has 1,745 prescription drugs listed on its formulary; a common Medicare Part D prescription drug plan has 3,104. You can understand why many veterans choose to pay the extra premiums and join Medicare Part D. Veterans shouldn’t be short changed when it comes to the availability of prescription drugs.
  • Speak out on the need for increased support for veterans mental healthcare. An alarming number of veterans are returning from war with serious mental health conditions. It is sad that these heroes survive the perils of war only to take their own life due to untreated PTSD. They need and deserve the best help available as they fight to overcome the mental impact of their war experiences.

It’s up to us to not only thank them for their service but to also fight for their healthcare like they fought for our freedoms.

I’m thankful to the veterans who fought so that we could vote for the candidates of our choice. It is just one of the freedoms that they have fought to protect for almost 250 years. I will continue to thank them for their service and fight to get them the healthcare they deserve.

Best, Thair

P.S. Don’t forget to join our virtual town hall this Thursday, November 12th at 2:00 pm ET. I’ll talk about some of the changes to healthcare we can expect in the new administration and our special guest speaker, John Schall, CEO of Caregiver Action Network, will talk about caregiving in the COVID-19 environment, the National Family Health History day and the yearly Medicare open enrollment. Please RSVP at the link below:

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November Is National Diabetes Month – This Year We Need to Pay Attention

November is diabetes month, and the COVID-19 pandemic should encourage us to pay attention . . . our lives may depend on it!

In 2019 there were over 48 million Americans 65 or older. Of that population around 28% had diabetes or prediabetes. Just think about it — when you get together with your friends (back when there wasn’t a pandemic and you could get together), almost 3 out of 10 people in the room had diabetes or prediabetes. That’s a lot of your friends, it may even be you. As with most diseases early detection is key to maintaining an active lifestyle and avoiding complications. There are 34 million people in America with diabetes and 1 in 5 of the 34 million are unaware they have it. The bottom line is there are a lot of older Americans with diabetes and the preliminary data indicates that people with diabetes are much more likely to have complications if they catch COVID-19.

So, either you or, most likely, someone you care for or know has diabetes. The question is, what can you do? If we’ve heard it once we’ve heard it a hundred times — wear a mask, social distance, and stay away from large groups indoors. Those are the added steps over and above what we should be doing as diabetics. In fact, some of the COVID-19 restrictions may make it harder for a diabetic to stay healthy. For instance, the CDC highlights the 3 common mistakes diabetics make in controlling their disease.

  1. Not testing enough – Each individual is different. Their testing regime is designed for them and the intervals are important. Testing is critical.
  2. Not moving enough – Here is where the pandemic could cause problems. Self-isolating is a great way to avoid getting the COVID-19 virus. It’s also a great way to turn into couch potatoes. Here’s my catch phrase, find a way to isolate and invigorate. Get up and move, exercise, walking outside is OK and the fresh air will help. Find a way to move every day.
  3. Not checking up – You may think that everything is going well with your diabetes and you don’t need to keep your regular appointment with your doctor, especially with the virus running rampant. Don’t skip your appointment. Follow all of the safety rules but go to the doctor. It’s your best defense against problems.

There’s another important step you can take to keep you healthy, get your flu shot. Now’s the time, if you haven’t had your shot yet, get it this week. This link takes you to a great article on flu and people with diabetes. A couple of important things from the article, for those of us over 50, we should get the shot rather than the nasal spray vaccine. Also, when you go to get your flu shot see if you’re up-to-date on your pneumonia vaccination. Both the flu and pneumonia can be devastating for diabetics or people with prediabetes and is really harmful for those that don’t even know they have diabetes.

This year especially, if you have diabetes, you need to pay attention to the effects the pandemic, flu and pneumonia can have on you. If you are a caregiver to someone with diabetes, or have a friend or loved one with the disease, help them understand how important it is this year to pay attention to your doctor’s directions and observe the recommendations concerning the COVID-19 pandemic. It truly can be a matter of life or death.

Finally, today we will select who will be our President for the next 4 years. I hope you voted. It is the loudest and most effective way seniors can speak out. There are, however, other more frequent ways we can speak out about how we feel on issues that affect us. We only vote for federal offices every two years but we can advocate and speak out as many times as necessary to let those in Washington know how we feel. Just recently, in the diabetes arena, the price of insulin was reduced for many who suffered from diabetes. I feel that our representatives heard loud and clear about how we felt about insulin prices and it had an effect. I urge you to vote and then to stay involved, it’s the only way we can have a say in how our healthcare is administered.

So, pay attention, follow the suggestions on staying healthy with diabetes, including following the guidelines concerning the pandemic and getting your flu and pneumonia vaccinations. And finally, stay involved — you really can make a difference.

Stay healthy, Thair

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Vote – But Be Safe

You’re probably sick of hearing people say – Don’t forget to vote! I’ve joined that chorus in encouraging you to vote in almost all of my recent blogs. It is a fact that a higher percentage of older Americans vote than any other age group. Given that statistic it makes us a powerful voting bloc, even more reason to make our voices heard.

I know many of the reasons that people don’t vote, I’ll list some of them here and include my rebuttal:

  • My state always goes to the Democrats or the Republicans, so my vote doesn’t make a difference.
    1) The percentage of the vote that the dominant party gets makes a difference. You hear all the time about how many percentage points a candidate won by in a previous election. That percentage means something.
    2) What about all those state and local races, amendments, propositions, bonds, etc. that are on your ballot? Those races and changes may have more impact on you personally than the national elections.
  • I don’t feel like I know all I should about the issues to make an educated vote.
    1) There are non-partisan web sites and educational information available that helps you understand where the candidates stand and the estimated impact of the different propositions, etc.
    2) Talk with someone who you trust and who has the same beliefs and political stance as you and ask them how they are voting and why.
  • I’m not sure if I’m registered, or where to vote, or how to vote without going to the actual polls.
    1) have a great link that will answer the questions above. It’s a New York Times link that covers every state, since each state often has different rules. Click here to make sure you’re registered or, if you’re not registered, how you still can register, the different methods you can use to vote and where, depending on your address, the nearest polling and ballot drop boxes are located.

The last reason that people may not vote this year is the COVID-19 pandemic. It is a valid fear, given the spike in the number of people testing positive for the virus. I’ve got some advice on how to stay safe while exercising one of the greatest freedoms we have.

The safest way is to vote without leaving your house. Most states have already mailed ballots out that can be filled out and mailed. Mail them early just to make sure they arrive in time. There’s been a lot of political posturing about the Post Office being overwhelmed or delaying the delivery of your mail. Don’t let it keep you from mailing in your ballot, the Postal Service says it can handle the expected volume.

The next safest approach is to drop your ballot into one of the ballot collection stations. The link above will give the location of those stations. It is easy and reduces the number of hands that your ballot passes through before it gets counted.

If you go to vote on November 3rd there are some steps you can take to keep you safe. First wear a mask . . . not under your chin, not under your nose. Wear a mask that covers your nose and mouth and seals around your face. Multiple layers and N95 materials make the most efficient masks. When you go to the polls:

  • go at off-peak times, like midmorning.
  • monitor the voter line from your car and join when the line is short.
  • fill out any needed registration forms ahead of time.
  • review a sample ballot at home to cut down on time spent at the polling location.
  • take your own black ink pen, or stylus to use on touchscreen voting machines.

Many have said this may be the most important election for decades. I think our founding fathers would say that every election is the most important. It seems like lately there are a lot of things that are out of our control, the pandemic, the negative divisive tone of our politicians, the magnifying of our differences rather than the unity of our common hopes and dreams. Voicing our personal opinions by voting is something we can control, it’s a way we can participate and become involved.

So, for probably not the last time you’ll hear it, be sure and vote. Hopefully, I’ve suggested some tools that will help you to vote efficiently and, most importantly, safely.

Best, Thair

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Bone and Joint Action Week

We all have bones and joints but most of us didn’t pay much attention to them when we were young, we might sprain an ankle or wrench a knee, but it didn’t keep us down too long. Well . . . it’s different now, most of us have joint aches and a lot of us have different degrees of arthritis. As many of you already know these types of aches and pains can have a big effect on our quality of life. Bone and Joint Action week, was last week, October 12th to October 20th. This special week’s goal is to raise the awareness of how bone and joint problems affect a huge number of us and highlights the need for more research and focus on this area of our health.

We’re living longer and that brings these types of bone and joint conditions into play at a steadily increasing rate. Did you know that 54% of Americans over 18 have musculoskeletal (bone and joint) conditions and a 33% went to the doctor or hospital to be treated? There has been an almost 20% increase in the last 10 years in these types of conditions. These bone and joint conditions effect a lot of people and cost our healthcare system a lot (to say nothing about the out-of-pocket costs we pay)  and yet these musculoskeletal conditions make up only 2% of the research budget of the National Institute of Health, and it’s shrinking! This action week is a great way to shine a much-needed light on these conditions that affect so many of us.

There are a number of special days in the Bone and Joint action week, I would like to focus on two of these days, October 12th, World Arthritis Day and October 20th, World Osteoporosis Day.

World Arthritis Day – One of the resources offered during this day is The United States Bone and Joint Initiative (USBJI). They provide Experts in Arthritis, an educational program for people with arthritis. There are sessions by rheumatologist, physical therapists, orthopedic surgeons, nurses, and occupational therapists, offering information and help for both the patient and the caregiver. Another resource is, which offers videos with tips on how patients can control their arthritis.

World Osteoporosis Day – This day, with the theme “That’s Osteoporosis,” will seek to improve the understanding of osteoporosis and its outcome, with the focus on the link between osteoporosis and broken bones and the human and socio-economic costs of fractures. They encourage the public to check their personal risk for osteoporosis through the use of the new IOF Osteoporosis Risk Check. You can learn more at

The other special days in the Bone and Joint Action Week are, October 15th, World Spine Day, October 17th, World Trauma Day and October 19th, World Pediatric Bone and Joint (PB&J) Day.

I have one other piece of advice that I feel is important. I’ve been part of panels, listened to presentations and conferences and moderated panels on numerous healthcare subjects and the pain that results from different diseases. Through all of these different forums I have noticed a common piece of advice that has almost always been offered – – – keep a journal of your symptoms and pain. When we get old our memory isn’t as good as it once was. Write down things like, when did a symptom present itself, in the morning or the evening? Was it after a good night’s sleep or a poor one? When the pain got worse what was I doing, was it better or worse than the last time the pain hit? Etc., Etc. These are the things that we can bring to our doctor, information that can help in our diagnosis. It is a powerful tool we can bring to bear as we seek to be our own best advocate.

I have seen the impact of arthritis on my wife’s mother and grandmother as they were forced to give up their lifelong passion of quilting and needlepoint due to the ravages of arthritis. We’ve all seen the impact of osteoporosis as older people fall and break their hips with often life taking results. When so many of us are impacted by these diseases why is so little research being funded? Let’s be active advocates, both of our own health and the health of our loved ones, by encouraging our government to focus on bone and joint health, something that would help a large number of older Americans.

Stay healthy and safe, Thair