Samuel D. Benjamin, M.D. received his Medical Degree from the Universidad De Guadalajara Facultad De Medicina in Mexico and was awarded another M.D. from the State University of New York. He trained in a Fifth Pathway program at New York University Medical Center and then did his residency in Pediatrics and Social Medicine at Montefiore Medical Center Hospital, the University Hospital and Academic Medical Center of the Albert Einstein College of Medicine in New York and served as a Chief Resident during his last year.
Later, Benjamin served as a Medical Director of a model primary care program for urban inner cities that was funded jointly by the federal government and the Robert Wood Johnson Foundation. He later became the Medical Director for the Western Hemisphere Region of the International Planned Parenthood Federation where he focused on maternal/child health.
In 1982 Dr. Benjamin moved to Phoenix and helped establish a pediatric and family practice medical group. He served as Medical Director of the then nation’s largest PPO and joined the advisory board of Humana’s local HMO. He trained in Medical Acupuncture at the UCLA Medical School of Medicine and then formed the Arizona Center for Health and Medicine for Catholic Healthcare West which was the nation’s first mainstream, hospital system affiliated large scale integrative medical facility. The center and his activities were featured in Life magazine.
He returned to New York for several years as a professor and Director of the Center for Complementary and Alternative Medicine at the State University of New York at Stony Brook School of Medicine.Leaving academics, he served as Corporate Medical Director of Integrative Health Strategies for Humana Inc. and as radio talk show host of the Dr. Sam Show for six years.
Dr. Benjamin is a licensed allopathic (Western) physician, a licensed homeopathic physician or MD (H) and a certified acupuncturist. He hosts ‘Primary Care‘ on News/Talk KTAR 92.3 FM Saturdays at 2 PM MST.
Compact fluorescent light (CFL) bulbs according to the industry and U.S. government’s Energy Star program, which promotes CFL bulbs and other substitutes for energy-hogging incandescent, a CFL uses 75 percent less energy than its incandescent counterpart, lasts up to 10 times longer and prevents more than 450 pounds of greenhouse gas emissions from entering the atmosphere. Over its lifetime, a single CFL can save the consumer $80 or more, depending on local electric rates and the climate according to the Environmental Working Group ( a not for profit organization that I used as the source for this entry and a group that I trust for their accuracy). If most of your home uses CFL’s the cost of air conditioning (a BIG issue in Arizona) would also decrease because incandescent bulbs HEAT your home and CFL’s do not!
But all CFL bulbs aren’t equal. Some have lower mercury content than others, and some last much longer. Unfortunately, you can’t tell the best of the best by their labels - or the U.S. government Energy Star logo. Some Energy Star labeled bulbs could not be legally sold in Europe due to excessive mercury content.
An Environmental Working Group investigation has identified 7 bulb lines made by Earthmate, Litetronics, Sylvania, Feit, MaxLite and Philips that trump the rest. These bulbs, listed in our Green Lighting Guide contain a fraction of the toxic mercury allowed by Energy Star, reducing the mercury contamination from a broken bulb. All last 8-15,000 hours, dramatically longer than the Energy Star standard of 6,000 hours, and also offer high efficiency.
The Department of Energy (DOE) and Environmental Protection Agency (EPA)– have not adequately addressed the risks of mercury in CFL bulbs.
PLEASE read the two texts I have hyperlinked BEFORE you buy CFL’s! :
http://www.ewg.org/reports/compact-fluorescent-light-bulbs (A good general discussion about CFL’s which I have used as my primary source of information about these products.)
http://www.ewg.org/greenlightbulbs (The EWG Green Lighting Guide)
http://www.ewg.org/node/27222 (What to do when a CFL breaks. It COULD be a BIG health problem for you and your family if you do not handle this correctly!!!!!)
Adult primary care providers (PCP’s-Family Doctors and Internists) are paid 55% of what reimbursement is typically for specialists Yet, specialists (cardiologists, radiologists, surgeons, etc.) increase the cost of care, increase the number of hospitalizations, and utilize pharmaceuticals in greater numbers, DECREASE lifespan and quality of life. PCP’s, on the other hand, INCREASE length of life, DECREASE mortality and decrease all the other parameters I just mentioned like hospitalizations, unnecessary X-ray studies, etc. PCP’s are by consequence not as profitable for pharmaceutical companies, radiology testing facilities, laboratories, medical device manufacturers, etc. because they use less of these modalities. In the Bush administration, there was no encouragement professionally and/or financially for the lowly PCP to do his/her work. As a result, fewer and fewer PCP’s remain as medical students shy away from the underpaid and poorly respected primary care roles in training institutions. Existing PCP’s are retiring early, changing professions and leaving a vacuum that is endangering communities- urban and rural alike. PCP’s that remain and struggling to survive financially are seeing fewer poor, seniors and middle class patients by dropping participation in Medicaid, Medicare and commercial insurances to become “concierge” or cash doctors- catering to the rich only.
Sadly, the Bush administration and the Republican Party were deaf to the changes needed to protect PCP’s and halt their extinction. Now, great news! It looks like Medicare will be raising reimbursement for PCP’s while it begins to trim reimbursement for overpaid radiology, surgery and other specialties starting in 2009. In addition, funds will be increasing the training and retention of PCP’s. This will have a dramatic ripple effect within all insurance programs nationally that use Medicare as their guidepost for establishing their rates. Starting this year and looking forward the Obama administration has set in motion a striking and much needed shift in health care- bringing the status and the pay of the PCP in line with what should be. Congratulations!
ATTORNEY GENERAL CUOMO ANNOUNCES HISTORIC NATIONWIDE HEALTH INSURANCE REFORM; ENDS PRACTICE OF MANIPULATING RATES TO OVERCHARGE PATIENTS BY HUNDREDS OF MILLIONS OF DOLLARS
Industry-Wide Reform of Reimbursement System Will End Conflicts of Interest and Create Fair Rates for Consumers Nationwide
NEW YORK, NY (January 13, 2009) – Attorney General Andrew M. Cuomo today announced historic reform of the nationwide health care reimbursement system that will end conflicts of interest and generate fair reimbursement rates for working families nationwide. Cuomo has reached an agreement with UnitedHealth Group Inc. (NYSE: UNH) (”United”), the nation’s second largest health insurer, after conducting an industry-wide investigation into a scheme to defraud consumers by manipulating reimbursement rates.
At the center of the scheme is Ingenix, Inc. (”Ingenix”), a wholly-owned subsidiary of United, which is the nation’s largest provider of health care billing information. Under the agreement with United, the database of billing information operated by Ingenix will close. United will pay $50 million to a qualified nonprofit organization that will establish a new, independent database to help determine fair out-of-network reimbursement rates for consumers throughout the United States.
“For the past ten years, American patients have suffered from unfair reimbursements for critical medical services due to a conflict-ridden system that has been owned, operated, and manipulated by the health insurance industry. This agreement marks the end of that flawed system,” said Attorney General Cuomo. “As working families throughout our nation struggle with the burden of health care costs, we will make sure that health insurers keep their promise to pay their fair share. The industry reforms that we announce today will bring crucial accuracy, transparency, and independence to a broken system. During these tough economic times, this agreement will keep hundreds of millions of dollars in the pockets of over one hundred million Americans.”
In February 2008, the Attorney General announced an industry-wide investigation into allegations that health insurers unfairly saddle consumers with too much of the cost of out-of-network health care. Seventy percent of insured working Americans pay higher premiums for insurance plans that allow them to use out-of-network doctors. In exchange, insurers often promise to cover up to eighty percent of the “usual and customary” rate of the out-of-network expenses, and consumers are responsible for paying the balance of the bill.
United and the largest health insurers in the country rely on the United-owned Ingenix database to determine their “usual and customary” rates. The Ingenix database uses the insurers’ billing information to calculate “usual and customary” rates for individual claims by assessing how much the same, or similar, medical services would typically cost, generally taking into account the type of service and geographical location. Under this system, insurers control reimbursement rates that are supposed to fairly reflect the market.
Attorney General Cuomo’s investigation concerned allegations that the Ingenix database intentionally skewed “usual and customary” rates downward through faulty data collection, poor pooling procedures, and the lack of audits. That means many consumers were forced to pay more than they should have. The investigation found the rate of underpayment by insurers ranged from ten to twenty-eight percent for various medical services across the state. The Attorney General found that having a health insurer determine the “usual and customary” rate – a large portion of which the insurer then reimburses – creates an incentive for the insurer to manipulate the rate downward. The creation of a new database, independently maintained by a nonprofit organization, is designed to remove this conflict of interest.
Under Attorney General Cuomo’s agreement with United:
United will pay $50 million to establish a new, independent database run by a qualified nonprofit organization;
The nonprofit will own and operate the new database, and will be the sole arbiter and decision-maker with respect to all data contribution protocols and all other methodologies used in connection with the database;
The nonprofit will develop a website where, for the first time, consumers around the country can find out in advance how much they may be reimbursed for common out-of-network medical services in their area;
The nonprofit will make rate information from the database available to health insurers;
The nonprofit will use the new database to conduct academic research to help improve the health care system;
The nonprofit will be selected and announced at a future date.
In February 2008, Cuomo also announced that he had issued subpoenas to the nation’s largest health insurance companies that use the Ingenix database, including Aetna (NYSE: AET), CIGNA (NYSE: CI), and WellPoint/Empire BlueCross BlueShield (NYSE: WLP). The Attorney General’s industry-wide investigation is ongoing.
Cuomo continued, “Our agreement with United removes the conflicts of interest that have been inherent in the consumer reimbursement system. This has been an industry-wide problem, and it demands an industry-wide reform. We commend United for leading the industry on this issue, and we encourage other insurers to follow suit.”
Cuomo was joined by representatives from United and from leading medical and consumer organizations in making today’s announcement at the Saint Vincent Catholic Medical Center in Manhattan.
“We are committed to increasing the amount of useful information available in the health care marketplace so that people can make informed decisions, and this agreement is consistent with that approach and philosophy,” said Thomas L. Strickland, Executive Vice President and Chief Legal Officer of UnitedHealth Group. “We are pleased that a not-for-profit entity will play this important role for the marketplace.”
President of the American Medical Association (AMA), Nancy Nielsen, M.D., said, “Today, patients and physicians prevailed over health insurance giant UnitedHealth Group when New York Attorney General Cuomo stopped the insurer from using a rigged Ingenix database that increased insurer profits at the expense of patients and physicians. The AMA appreciates the leadership of Attorney General Cuomo in initiating his investigation into the Ingenix database, and fully supports the Attorney General’s actions to have a nonprofit entity create a new, reliable database that is fair to patients and physicians.”
President of the Medical Society of the State of New York (MSSNY) Michael H. Rosenberg, M.D., said, “We thank Attorney General Cuomo for taking decisive action to finally achieve one of the major goals of a lawsuit that the Medical Society of the State of New York initiated with two other medical societies over eight years ago. Because of the thorough research and diligent negotiation of Mr. Cuomo and his expert staff, patients and their physicians will no longer be subject to inadequate out-of-network payments determined by the flawed Ingenix database.”
Consumers Union Programs Director Chuck Bell said, “Consumers Union greatly appreciates the care that Attorney General Cuomo and his staff have taken in investigating these issues, and creating the careful architecture in this settlement. This is an extremely sensible, fair solution, which will be of great benefit for consumers nationwide. We appreciate the fact that United Healthcare has come to the table to resolve these issues in a comprehensive way, and we hope that other insurance companies will quickly get on board, and strongly support this excellent plan to improve transparency for out-of-network charges.” Consumers Union is the nonprofit publisher of Consumer Reports.
Today, Cuomo also issued a report on his investigation, “Health Care Report: The Consumer Reimbursement System is Code Blue.” The report highlights the conflicts of interest and other defects in the current system and calls for the reforms announced today. It can be accessed at http://www.oag.state.ny.us/bureaus/health_care/HIT/reimbursement_rates.html.
The agreement announced today is the result of an investigation by Deputy Chief of the Health Care Bureau James E. Dering, Senior Trial Counsel Kathryn E. Diaz, and Assistant Attorneys General Brant Campbell and Sandra Rodriguez, under the direction of Linda A. Lacewell, the head of the Attorney General’s Healthcare Industry Taskforce. The Attorney General expressed his appreciation to Steven E. Fineman, Esq., of Lieff Cabraser Heimann & Bernstein, LLP, for his pro bono services in this matter.
For more information, including consumer tips for out-of-network care, or to file a complaint, please visit http://www.oag.state.ny.us/bureaus/health_care/HIT/reimbursement_rates.html
Neither Congress nor the President (as demonstrated time and time again in the last few months), AIG (which WE own and yet they spit in our faces awarding millions to their employees and partying in England and in Arizona) nor managed care companies (who have their PRIMARY loyalty to their stock holders and employers) have any real ACCOUNTABILITY to you - the rank and file of America - the shareholders in AIG and the health care consumer.
All of these failed parties have good reason to forget about you. Congress and the President (except at times of election) are in bed with special interest groups that hold the cash. Why should AIG be concerned with you OR a pathetic Congress and Executive Branch? They can conduct business as usual and answer essentially to no one. Managed care companies continue to thrive by creating the appearance of efficiency when, in fact, they have failed- health care costs soar annually and the government run Medicare program (hardly a model of efficiency) is cheaper and more efficient! Yipes!
You are a complication, but not the real customer. Managed care administrators figure out how to squeeze YOU, the health care consumer, not with efficiencies, but with cost cutting in the wrong places (like shafting primary care doctors who could actually save money or nickel and diming docs on immunizations so that many lose money) and increasing deductibles and co-pays so that you will be less inclined (let alone in these economic times even able) to buy the life saving services that you and your family might need..
Is it any wonder then that you are treated so poorly as a managed care insured? Are you really surprised that your already disenfranchised doctor feels less accountable to you and more a shackled servant to the myriad of rules, paperwork and bureaucracy that managed care insurance companies have sewn into a noose and slipped around his/her neck?
They are all accountable to more powerful forces than just you alone - your life, family and soul. They answer to cash. And you??? You are a nuisance, a vehicle to facilitate greed and incompetence - not the master as you should be. You are to be herded through the health care system and managed care- totally ineffective to begin with- is using the cattle prod. This is why UNLESS health reform addresses the imbalance, it WILL fail America and fail you. Whether you are to the left or right, whether you believe in a national health care system or purely a private enterprise model, you must fight to gain control of your own body, your mind and your health. This could be THE epic struggle.
Of course he is accountable to you on healthcare. He takes this responsabiwity VEWY seriously!
An estimated 38 percent of U.S. adults and 12 percent of children use some type of complementary and alternative medicine, a new U.S. government survey finds.
Complementary and alternative medicine (CAM) — is an umbrella term for a collection of wide-ranging medical and health care systems, practices and products that aren’t generally considered conventional medicine. It includes herbal supplements, homeopathy, herbal treatments, meditation (mind-body interventions), chiropractic treatment and acupuncture.
“If you are going to use CAM, you should always let your conventional [health care] provider know about it,” said survey co-author Richard L. Nahin, acting director of the U.S. National Center for Complementary and Alternative Medicine’s division of extramural research.
This is a great pie in the sky notion but the truth is that most conventional doctors are sooooo brainwashed by pharmaceutical companies and often arrogant professors at medical schools who may be on the payroll of the pharmaceutical and medical device companies that if you tell them, they either know nothing about CAM, care nothing about CAM or are so prejudiced against CAM that it is impossible for a patient to talk intelligently with these providers and actually get useful information and guidance about CAM.
There are a small but increasing number of physicians who are integrating conventional and CAM medical care. Seek them out because it shows that they care enough to implement whatever will help you and that they still have independent minds - not white washed by the “mainstream” that has bankrupted health care in this country.
The survey found that the most popular alternative techniques are deep breathing exercises, meditation, chiropractic or osteopathic manipulation, massage and yoga. However, the survey is absurdly flawed because functional foods (e.g. eggs that have omega-3 fatty acids in them), organic and preservative free cosmetics, cleansers and the like need to be included as part of CAM because people use this as health tools.
In addition, the study did not include those who use vitamins routinely. If it had, the percentage of Americans using CAM would be much greater and the list of popular CAM therapies and products would have been much larger.
In the study, adults use CAM most often to treat pain, including back pain, neck pain or problems, joint pain, arthritis, and other musculoskeletal conditions. I think that again the study missed an important area - disease prevention, looking better and maintaining an acceptable quality of life.
Everywhere I go folks are asking me about the cold and flu kit that I suggest in my office and on radio so that you will be prepared. It WAS on the blog in the past, but nooooooooooo………………………… you guys didn’t read or take it seriously until now that there are lots of kids and adults coming down with the cold, flu and other assorted viruses. (A little Bronx guilt!!!) So, here it is again - listen up!
Do Not
• Do not use “cold” medicines as they have no discernable effects and can actually make things worse as well as be life threatening in the case of children.
• Do not use acetaminophen (Tylenol, other brands) as it may prolong the cold or flu - unless the pain, fever and aches are simply too much to bear. The same may be true for Aleve, Motrin, etc., although this class of medication (nonsteroidal anti-inflammatory drugs) does control fever and pain better.
• Do not demand antibiotics from your doctor as they are near useless most of the time and can cause resistant germs to develop.
Do
• Drink lots of fluids.
• Call your doctor with questions or if fever and malaise persist.
• Get the flu vaccine! (No, it does not always work and yes, you could get a reaction which is RARE but for the 30- 40% that it helps, it can really relieve your symptoms.)
• Use salt water drops like Ocean to clear your nose.
• Get lots of rest/ sleep.
Keep these at home (they can be bought over the counter):
1. Cold Eze Homeopathic Lozenges - Take AT THE VERY FIRST SIGNS OF A COLD.
2. Sinusin by Heel - is great for nasal congestion due to colds.
3. Umcka by Nature’s Way – take for chest congestion/bronchitis.
4. Bronchalis Homeopathic by Heel - take with Umcka for Bronchitis.
5. American ginseng by Native Essence - take at the first sign of a cold. (This brand is Wisconsin grown and processed in New Mexico - not China! If you can’t find it, we can send it to you from my office. Call (480) 661- 1880.
6. Sambucol by Nature’s Way- If you DO get the flu, this Black Elderberry extract can relieve symptoms and shorten the course of your illness.
7. Oscillococcinum (homeopathic remedy) - At the very first sign of the flu, this remedy might just thwart it. A MUST when traveling as each compact tube can be packed conveniently, does not require cooling and can be taken on the plane with you.
Below is a copy of an e-mail alert sent to my patients with hypertension. It might apply to you! Check with your doctor.
If you have hypertension (HTN, high blood pressure), diabetes (IDDM, NIDDM) or congestive heart failure (CHF) with or without coronary artery disease (atherosclerosis) and with or without elevated cholesterol or triglycerides - LISTEN UP!!!!!!!!!
After careful consideration, I am NO LONGER recommending ARBs (angiotensin- renin blockers), EXCEPT in certain instances and these must be considered on a case-by-case basis.
This class of drugs, while helpful for some and even though it lowers blood pressure, may NOT actually prevent one of the major complications of high blood pressure - cardiovascular disease (heart attacks) and in fact may INCREASE the risk of having a heart attack! Here are the most common brands of this class of pharmaceuticals - none of which are generic and all of which are quite costly even with the co-pays of most insurance coverage:
candesartan (ATACAND), eprosartan (TEVETAN), irbesartan (AVAPRO), telmisartan (MYCARDIS), valsartan (DIOVAN), and losartan (COZAAR)
PLEASE remember some of you now using these drugs may STILL need to remain on them because of renal (kidney) disease associated with diabetes, congestive heart failure therapy or adverse reactions like an intractable cough, headache and allergies associated with another class of drugs (ACE inhibitors) typically used instead of ARBs.
ACE inhibitors (angiotensin converting enzyme inhibitors) are an older class of prescription medication that have been used worldwide for close to 30 years. Most of the brands can be purchased as generics and some are available at Wal-Mart. Costco, Safeway and Fry’s pharmacies for $4 a month or $10 for a three month supply which is most often better than your insurance copay. They treat hypertension, slow progression of renal (kidney) failure in diabetics, are used in congestive heart failure (CHF) and are associated with a DECREASE in the occurrence of heart attacks and strokes. Here are the brands and their generic names in the U.S.:
benazepril (LOTENSIN), captopril (CAPOTEN), enalapril(VASOTEC), fosinopril (MONOPRIL), lisinopril (PRINIVIL, ZESTRIL), moexipril(UNIVASC), perindopril(ACEON), quinapril (ACCUPRIL), ramipril (ALTACE), trandolapril (MAVIK).
Because these drugs (ACE inhibitors) are now off patent protection and available as generics, drug companies have been pushing ARB’s (much more profitable) and combinations of ARB’s with other meds that are already generic- sporting new names so that your doctor and you think one is really different from another and worth the high price which they are not.
WHAT TO DO IF YOU ARE ON AN ARB? CALL MY OFFICE. MAKE AN APPOINTMENT. LET’S REVIEW YOUR NEEDS AND MAKE A CHANGE IN DRUGS IF APPROPRIATE. DO NOT FREAK OUT!!!!!!!!!!! I HAVE BEEN ON AN ARB FOR A DECADE. I AM STILL BREATHING, BUT, BECAUSE I AM AT RISK JUST AS YOU ARE, I AM CHANGING TO AN ACE INHIBITOR JUST AS YOU MAY.
DO NOT STOP YOUR ARB UNTIL WE HAVE SWITCHED YOU BECAUSE THIS COULD BE VERY DANGEROUS!!!
I am NOT about to enter into the philosophical/scientific/religious fray about whether there is or is not a God - no way! I know that research until present has not shown us clear evidence that there is a creator who gives order to the universe and summons chaos theory for more sophisticated phenomena of the universe. I believe in science. I believe that there are other dimensions and I sort of understand string theory, Heisenberg’s uncertainty theory and how light could be bent in space and time. I fantasize how we could one day travel through time and dimensions and I wonder if there is another me, say, some 300 meters from where I write this at this very moment.
But there is something about being a human that is very special - something IRRATIONAL and inexplicable about our very substance that is so admirable and marvelous and that is admittedly IRRATIONAL (even chaotic) behavior!
Just last week, a heroic Indian woman in the Chabad House under terrorist siege in Mumbai escaped with a two-year-old Jewish child, saving his life no doubt before he would have been executed, as were his parents. The act was at once impetuous, heroic and IRRATIONAL. Why did she risk her life to save the life of another? Because she is a human and we are a noble species! We fall helplessly in love, dance in the streets after last year’s Super Bowl win of the Giants, sing our hearts out in churches and talk awfully silly to babies who may not have a clue about what the heck we are saying. Yet, there is meaning in these acts - sometimes inexplicable. They help define who we are as humans - often IRRATIONAL- NO rhyme or reason - just human! So is it with me and God. I can’t swear there is a God, but I talk to him (her?) everyday. I pray at home. I pray with my patients. I pray with my children and sometimes in public places. When I am around those who pray I feel good inside - secure. I love prayer when accompanied by music, whether it’s a Baptist choir, a Jewish cantor chanting or the haunting drumming and prayers of Native Americans. I am not a fanatic! I can’t say that I am a terribly religious man. I just believe and I just pray.
This might be IRRATIONAL, but it works for me and apparently for others because it seems that those who pray and participate in some form of religion live nearly 20% longer than those who do neither - at least according to one study.
It appears that rational scientific thought allows little or no place for religion, prayer and belief in God. I do not reject science but what’s RATIONAL got to do with it? Thank God that I was born IRRATIONAL! God bless!
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