Health Care

The Amazon Rain forest  Logging, Farming, and Mining are all affecting the Amazon Rain forest. Trees being destroyed is making it harder to breath. Deforestation is causing the Amazon Rain forest to perish at an alarming rate which is not good for people (and Brazil in general). Logging is bad because it changes forest composition by removing valuable trees during felling, road building and fragments the forest, elevating risks for a fire. Arable farming is also responsible for the loss of tropical rain forest as many farmers are clearing land to grow cash crops, such as soya beans. Mining is bad because to mine, trees and vegetation are cleared and burned and when the ground has cleared the metals and minerals from the soil are being extracted from the ground.These are all the causes of the loss of the trees in the Amazon Rain forest. President Jair Bolsonaro these effects are hurting your environment and is very dangerous to all of Brazil. Human, we breathe air made from the trees, but with the trees dying there's less oxygen for us to breathe which we all know this is bad and it can also affect and harm you too. If you don’t help to stop the raging fires in the Amazon Rain forest. 20% of the oxygen we breathe will decrease. So I'm telling you to take action to protect the Amazon Rain forest. To do this here are some solutions you can do, you can send troops to incarcerate people that are killing Brazil’s environment. Also, you can have a fundraiser to raise money to help build more trees so we can have more oxygen instead of losing them. There are children and their families who live in and near the rain forest. President Jair Bolsonaro, you have to see how they and their families depend on the plants and animals in the rain forest. You also have to see how it would affect you they were not around.    The things that you can do to save the Amazon Rain forest are use to paper and wood consumption, oil consumption and beef consumption. Also, watching where people buy things like your gold jewelry, and who you buy from, can make a difference. "It takes about 250 tons of earth to produce a single wedding ring. You can read about other children who live in and near the rain forest and research what the effect is on them. Finally, you can eat at restaurants that do not use rain forest raised cattle and hold companies responsible for safe practices by writing a letter or boycotting a product. These are the different ways you can save the Amazon Rain forest.

Patients' lives depend on choice. **Since starting the petition, I have realized that there are many issues other than temperatures with forced mail-order pharmacy.  Mail-order pharmacy is very loosely regulated. There are life-threatening delays, lack of face-to-face relationship with pharmacists for people with chronic conditions, and rapid closures of our independent pharmacies; although, a recent study showed people prefer independent pharmacy (2018, Gill).    *************Our Story************* Our son, received a life-saving liver transplant at the age of 2 from a 3-year-old little girl. His life depends on the potency and effectiveness of chemotherapy/immune suppression medications every 12 hours to prevent his body's immune system from fighting off his transplanted liver. In the past mail-order delivered his liquid oral medications in nothing but a plastic envelope on a 102-degree day on a hot enclosed not temperature controlled UPS truck. Shortly after, he went into liver rejection which could have resulted in complete liver failure or death. I speculated that the medication could have been too weak after the delivery of medications in high heat. I vowed to never again risk his life with mail order pharmacy. Recently, we were mandated/forced to only use mail-order pharmacy in order to receive coverage for his life-saving medications.  The package arrived in only a bag on a hot day without an ice pack. The hot non-temperature controlled enclosed delivery truck can reach temperatures up to 170 degrees. His labs elevated again afterward. My son wants to know, "Why would they do that?" I contacted the manufacturer, who performs the testing stated that both of my son's medications should be discarded and considered less potent once stored above 86 degrees as higher temperatures and freezing could both result in lower potency. Liquid medication is the most harmed by the mishandling of medications outside of the manufactures temperature storage guidelines.  I contacted the mail-order pharmacy who refused to replace or take back the medication. They said the law & USP Pharmacopoeia allows them to ship up to 104 degrees, although the manufacturer states it is not proven safe at these temperatures. However, I have received communication from USP Pharmacopoeia who writes guidelines for storage, and they also said that the mail order pharmacy should follow the manufacturer's guidelines of 59-86 degrees for storage. Again, the trucks reach up to 170 degrees which is much hotter than 104.  I contacted the FDA, who states that the mail order pharmacy should be using the manufacturer's guidelines that have been proven safe..However, since the mail-order pharmacies are regulated loosely by the State Board of Pharmacy, not the FDA there was nothing that the FDA could do.  I made over 30 calls to the insurance company begging for them to please let us pick my son's medications up at the local pharmacy at which they are filled. My son's physician wrote a note/appeal as his transplant team has stated that they have tried to voice their concerns about this issue with their pediatric/child patients and no one is listening! The insurance company still denied the doctor's appeal for us to pick up my son's medications in the safest way. It was not until the Media became evolved that the insurance company budged.  I felt helpless and have united with many other pharmacists, physicians, patients, mothers and fathers, and caregivers who feel the same way. Helpless. Mail-order of prescription drugs should be a choice, not the only option of coverage.  Mail-order pharmacies may appear to save money, but when my son ended up in the hospital after taking medications that could have been compromised by having lower potency, the cost of the rejection was thousands of dollars. If his liver would have fully failed, the cost of his liver transplant for just 5 days (he was in the hospital for 5 weeks) was over $1,000,000. The lax regulation and oversight may save money on prescription drug plans but may come at an increased cost to the health plan itself. Also, keep in mind the endless waste of medications that automatically are sent regardless of whether or not patients need them. Also, people with chronic, complex conditions, should always have the option of face to face interaction with a pharmacist who knows their complex needs and medical history. The pharmacist and patient relationship is crucial to the successful outcome of the patient's overall health. Taking this away is harmful to patients and be more costly to our already stressed healthcare system. Another important fact. Mandatory mail-order programs are discriminatory. It is estimated that 40% of the homeless are disabled. How is mandatory mail order fair and working for them as they may not have an address and not even know where they will be from day to day? Only allowing mail-order pharmacy for coverage is unethical and irresponsible. I share stories on my social media sites every day of patients who are suffering from lack of choice.  We need your help to make mandatory mail-order an option, not a mandate.  YOUR URGENT SUPPORT WILL SAVE LIVES! THANK YOU!! WE APPRECIATE ALL OF THE SUPPORTERS, CAREGIVERS, & PATIENTS.  Thank you,  Loretta Boesing, Founder of Unite for Safe Medications You may make a tax-deductible contribution to support our advocacy here Email: loretta@uniteforsafemeds.com Facebook Page: Issues with Mail Order Pharmacy @justamomwholovesherson Twitter: @BoesingLoretta The greatest way that you can help is by sharing this petition & gathering 2-3 people in your community who are having issues and speak to your legislatures.                  Reference: Gill, Lisa L. “Consumers Still Prefer Independent Pharmacies, CR's Ratings Show.” Product Reviews and Ratings - Consumer Reports, 7 Dec. 2018, www.consumerreports.org/pharmacies/consumers-still-prefer-independent-pharmacies-consumer-reports-ratings-show/

Health insurance companies routinely pay for pharmaceutical and surgical treatment for pain patients, the most expensive and risky forms of care. Many who've tried these treatments are still in considerable pain.   At the same time, people in pain are being denied insurance coverage for safer, more effective treatments including physical therapy, massage, chiropractic, biofeedback, acupuncture, marijuana, low level laser therapy, psychotherapy, nutritional and herbal interventions. We need a law that requires health insurance companies to cover all proven effective treatments for pain to the same degree that they cover pharmaceuticals and that requires physicians to be educated about these therapies.   Please support a Pain Treatment Parity Act that requires health insurers to provide coverage for all proven effective pain treatments that is equivalent to coverage of pharmaceuticals with respect to treatment frequency, length of treatment, pre-authorization requirements, co-pays, deductibles, medical necessity reviews and any other requirements that determine access to and affordability of care. In addition, given that non-physician health care providers have not had increases in fees for more than 35 years, the Pain Treatment Parity Act should require that alternative pain treatment provider fees are increased on a par with past physician fee increases to insure continuing availability of these critical services.   Note: More information on the need for this legislation and the evidence for the safety and effectiveness of  nonpharmacological pain treatments can be found at the online Alternative Pain Treatment Directory  

We demand that healthcare facilities honor the decisions of pregnant patients. New York's largest hospital system (Northwell Health) gives their doctors at Staten Island University Hospital the authority to force pregnant patients to have medical procedures without the patient's consent. This violates medical ethics and New York’s Patient Bill of Rights.  In 2011, Northwell’s Staten Island University Hospital (SIUH) forced Rinat Dray to undergo cesarean surgery. Ms. Dray sought to have a vaginal birth for her third child after two previous cesarean surgeries caused her significant pain and grueling postpartum recovery. Despite her repeated refusals to consent to cesarean surgery the hospital and doctors overrode her refusal and subjected her to this major surgery. In response to Ms. Dray’s lawsuit seeking justice for the wrongs she experienced, SIUH has vigorously defended their right to take control of pregnant patients and force them to have medical procedures they don’t want. In fact, since 2008 SIUH had an explicit written policy (“Managing Maternal Refusals”) that let doctors ignore and override the decisions a pregnant woman makes about her body and her life. The New York State Department of Health has already found that this policy violates New York’s Patient Bill of Rights. The actions against Ms. Dray also violate medical ethics, the opinion of leading medical organizations including the American Medical Association and the American College of Obstetricians and Gynecologists, and numerous other laws. As New York’s highest court has ruled: “Every human being of adult years and sound mind has a right to determine what shall be done with his own body; and a surgeon who performs an operation without his patient’s consent commits an assault for which he is liable in damages.” - Schloendorff v. Society of New York Hosp., 105 N.E. 92 (N.Y. 1914) There is no exception to this principle for human beings who are pregnant. To address this, we demand Northwell Health: Immediately rescind all “Managing Maternal Refusal” and similar policies in Northwell’s hospital system and make any new policies addressing “maternal refusal” public. Acknowledge the harms done to Rinat Dray and help her find resolution. Ensure that all Northwell doctors and hospital personnel are trained in their ethical duties to honor the decisions of pregnant patients and to uphold patient rights including a pregnant woman’s right to refuse medical interventions. Establish policies to affirm that women, including pregnant women at all stages of pregnancy, are fully and equally protected in Northwell facilities by the U.S. Constitution, International Human Rights principles, the New York State Patients’ Bill of Rights, and all established common law principles regarding patient consent, privacy and confidentiality. National Advocates for Pregnant Women (NAPW) is a non-profit organization that works to ensure that no one loses their constitutional and human rights (including the right to medical decision-making) as a result of pregnancy.