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MATURE MARKET HEADLINES 11/08/2000

Home Equity Reverse Mortgages Succeed

HUDThe Home Equity Conversion Mortgage (HECM) insurance program, created in 1987 under the National Housing Act, is designed to provide elderly homeowners with a financial vehicle to tap the equity in their homes without selling or moving. The loan became known as a reverse mortgage because the lender makes payments to the homeowner, which is the reverse of the payment pattern of traditional mortgages. Reverse mortgages are intended to help house-rich but cash-poor seniors access additional income to meet expenses and to help elderly, middle-income homeowners convert their home equity into liquid assets.

The Federal Housing Administration (FHA) insures HECM loans originated by FHA-approved lenders to protect the lenders against loss if amounts withdrawn exceed ultimate equity when the property is sold. The FHA insurance also protects borrowers with a guarantee to make any payments lenders fail to make to the borrower.

A new report, "No Place Like Home: A Report to Congress on FHA's Home Equity Conversion Mortgage Program", provides an evaluation of the HECM program. This report is the last in a series of mandatory reports to Congress on the demonstration phase of the HECM program, which became a permanent HUD program in 1998.

The report finds that the demonstration phase of HECM has been a general success, with loan volumes growing, borrowers reporting high levels of satisfaction with the program, premium collections projected to exceed insurance claims by more than $500 per loan, and a trend toward lower average costs paid by borrowers to originate a HECM loan.

Nevertheless, the report indicates that several factors could increase HECM loan volumes. Future HECM volumes could grow if overall loan costs continue to decline, FHA loan limits are increased, and the public's awareness of the program is raised. The combination of lower costs, higher loan limits, and increased awareness might encourage more older homeowners to apply.

"No Place Like Home: A Report to Congress on FHA's Home Equity Conversion Mortgage Program" is available free from HUD USER: 1-800-245-2691. If you are interested in a reverse mortgage, beware of scam artists that charge thousands of dollars for information that is free from HUD. Click here to access HUD's "Top Ten Things To Know About Reverse Mortgages".
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Search for Health Advice Internet Mainstay

American Federation for Aging Research The American Federation for Aging Research (AFA) has launched a new website, www.infoaging.org, which will provide access to current research on aging and age-related diseases and conditions. "The general public, and especially graying baby boomers, are hungry for reliable information on aging, whether for themselves or for their aging parents," says Stephanie Lederman, AFAR executive director.

The impetus for the new website originates from the findings of a poll commissioned for AFAR by Yankelovich Partners. The October 2000 poll revealed that 86% of Internet users have sought-out health and medical information. The majority, 71%, rate the Internet information as good (60%) or excellent (11%). Two out of five Internet users (42%) have used the health or medical information they found online to make changes in their lives.

The main features the "infoaging" website include Disease Centers with information on diabetes, osteoporosis and prostate cancer. Additional centers are "Biology of Aging", which offers information on issues such as oxidative damage and telomeres, and a "Lifestyle Section" with information on nutrition and exercise.

"The number of Americans age 65 and older will double, from 35 million currently to more than 70 million in the next 30 years," says Lederman. "We hope Infoaging.org will become their authoritative alternative to what can otherwise be a maze of confusing and sometimes misleading information."

Additional findings by the Yankelovich survey reports a rather eclectic group of Internet health consumers. The majority of users claim to have searched health information sites (85%) or medical sites (70%). Slightly fewer than one-third of Internet users (31%) have used interactive sites where you input information and receive information back. One-quarter of Internet users (26%) have searched a category of websites commonly called association sites. Fewer than one out of ten Internet users have purchased products (9%), used chat rooms (5%), or purchased information (1%) when looking for health or medical information on the Internet.

The new AFAR website will no doubt be a welcome addition to the galaxy of Internet websites on health and aging. Given the extraordinary use of the Internet as a source of health information and advice, users can expect additional entries into this ever-expanding enterprise. For example, the National Institutes of Health (NIH), consisting of 25 institutes and centers, is just one of eight health agencies administered by the U.S. Department of Health and Human Services. It seems when it comes to health advice, the theme of the day is "the more the merrier".
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Social Noise Results in Sounds of Silence

Hearing HealthGame time. You're at the football stadium having the time of your life. You're rooting for the home team along with 80,000 other fans. Screaming, whooping, yelling, whistling, and banging drums. It's all intended to render the defending team unable to hear the play calls and the snap count. Social noise works against your opponent ... and you, by damaging your hearing.

According to "Hearing Health Today", an educational program offered by hearing aid manufacturer, GN ReSound, the average American's daily noise dose has been steadily escalating. In fact, our repeated exposure to social noise has led to a dramatic, 26%, increase in hearing loss between those aged 35 to 60 years. Recognizing this trend, GN Resound has become a dedicated proponent of hearing health education.

Every day, people are exposed to potentially damaging noise levels and don't even realize it. You may strap on headphones to work out at the gym. Fire up the gas-powered leaf blower to clean your lawn. Vacuum the television room. We all engage in these activities without considering how cumulative exposure to these activities can take their toll over time.

Noise levels are measured in decibels. And, according to the Occupational Safety and Health Administration, the maximum permissible level of noise in an eight-hour workday is 80 decibels. But, for every five-decibel increase in volume, the permissible exposure time is cut in half. Consequently, in a situation where the noise level may reach 110 decibels, as it reaches in football stadiums, you could risk temporary hearing damage in as little as eight minutes.

GN ReSound offers the following chart on noise sources and time frames for safe exposure.

DECIBELS DANGER ZONE ACCEPTABLE EXPOSURE TIME
60
 Normal Conversation No limit
85
 Noisy Traffic / Restaurant 4 hours
112
 Headphones 0 to 15 minutes
117
 Football Stadiums / Theaters less than 4 minutes
120
 Concerts / Close Thunder Instantaneous Risk
140
 Airplane Taking Off Nearby Instantaneous Risk
170
 Shotgun Blast Nearby Instantaneous Risk

How do you know that your hearing is at risk? GN ReSound advises that, when in a noisy situation, wear earplugs. If you are concerned about your hearing, there are a few simple, self-diagnosis techniques that can indicate that the noise may be hurting you. For example, after exposure to loud situations, have you experienced one or more of the following? If your answer is "yes" to any one of these questions, audiologist Dave Smriga, GN ReSound vice president, recommends getting your hearing examined by an audiologist. One of the world's top manufacturers of hearing devices GN ReSound develops, markets, and supports hearing health solutions.
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Wrong Shoes Can Defeat Purpose of Diabetes Care

American Orthopaedic Foot and Ankle SocietyThe American Orthopaedic Foot and Ankle Society continues to highlight the need for therapeutic shoes for diabetic patients as part of its public education efforts on diabetic foot problems. Although diabetes is the leading cause of foot amputations in the United States, few diabetic patients wear protective shoes that could significantly reduce their risk of lower extremity amputation.

Medicare covers protective shoes and custom foot orthoses for diabetic patients who suffer from lost sensation in their feet, impaired circulation, ulcers, calluses or foot deformities or have had all or part of their foot amputated. However, 71% of people with diabetes are younger than 65 and ineligible for Medicare. Not all private and public health insurers provide coverage of therapeutic shoes, which can cost up to $300 per pair.

“Physicians need to understand that use of prophylactic (protective) footwear can substantially improve the quality of patient care,” said Michael S. Pinzur, M.D., lead researcher and chair of the AOFAS Diabetes Committee. “At the same time, we want health insurers to know that providing therapeutic shoes and custom foot orthoses is more cost-effective than treating foot ulcers and infections.”

Earlier this year, the AOFAS and the American Academy of Orthopaedic Surgeons jointly sponsored a resolution urging health insurers to provide coverage of therapeutic shoes for people with diabetes. The resolution was passed by the American Medical Association's House of Delegates at its annual meeting in June 2000.

A recent survey by the AOFAS of diabetes patients showed only 12 percent used protective footwear and only 15 percent used custom foot orthoses. “This represents a substantial opportunity for improvement, ” said Dr. Pinzur, noting that approximately 25 percent of patients with diabetes have evidence of peripheral neuropathy (loss of feeling in the foot) and are at risk for development of foot ulcers or infection.

Less than eight percent of the survey group had their protective footwear or custom orthoses paid for by private health insurance or through the Medicare Therapeutic Shoe Bill, which can cover up to 80 percent of the cost of protective shoes and inserts for diabetic patients participating in a comprehensive treatment plan.

Foot care is a significant component of the $98 billion spent annually on costs associated with diabetic care. The American Diabetes Association estimates the average cost to treat a diabetic foot ulcer is $36,000 per patient. The average cost of a below the knee amputation and rehabilitation is nearly $60,000 per patient. More than half of the 67,000 foot amputations performed each year result from diabetes complications.

In recognition of National Diabetes Month in November, the American Orthopaedic Foot and Ankle Society is sponsoring a series of free diabetic foot screenings during November at locations throughout the country. The program is designed to educate individuals with diabetes about the importance of following a daily foot care regimen, and to identify diabetic patients who are at risk of developing serious foot problems. Visit the AOFAS online for an excellent fact sheet on How to Care for Your Diabetic Feet
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Travel Tips for Mature Travelers Abroad

Here's some of advice for seniors.
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Meds Plus Herbs Is Prescription for Disaster

New Choices - November 2000 America's efforts to stay healthy can sometimes become risky business, according to the November issue of Reader's Digest's New Choices magazine. Mixing herbal or botanical supplements with prescription medications "can sometimes be hazardous or even lethal," says New York internist, Steven Lamm, MD.

"A supplement may reduce the effect of a drug, or it may increase it. Or it may cause a severe reaction. For certain prescription medications, it's critical to maintain precise levels of the drug in the blood. Supplements can, in some cases, interfere with those levels," cautions Dr. Lamm.

Lamm cites St. John's Wort, a supplement millions of people take for depression. "We are seeing new and serious interactions. The herb can interfere with prescription antidepressants, a number of heart medications, and some drugs used to suppress the immune system in people who have had transplants."

How can you tell if a supplement you're taking is reacting adversely with your prescription drug? "Possible signs of trouble include unaccustomed fatigue, constipation or diarrhea, confusion, incontinence, frequent falls, depression, excess drowsiness, hallucinations, anxiety, dizziness, decreased interest in sex, or a rash," notes Lamm. "Call your doctor if you've started taking herbal supplements and develop any of these symptoms."

The chart below illustrates the possible dangers of mixing medications and supplements.

HERB USAGE DANGER
Capsaicin
 arthritis relief may increase risk of dry cough associated with ACE inhibitors
Dong quai
 easing hot flashes may interact with antihistamines and calcium channel blockers
Echinacea
 relieving colds can over stimulate immune system and interact adversely
with drugs for rheumatoid arthritis and lupus
Garlic
 lowering blood pressure may interact with blood thinners, magnifying their effect
Ginseng
 Alleviating stress may diminish effects of drugs taken to lower blood pressure
Ginkgo
 Improving Memory may increase thinning of blood, posing problems for people taking anticoagulants
Valerian
 sleeplessness may interact adversely with alcohol, sedatives, tranquilizers, and antidepressants
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HMOs Drop 1 Million Elders by Year's End

By year-end 2000, nearly 934,000 seniors on Medicare will be dropped from their HMOs, on top of the 700,000 that were dropped in 1998 and 1999. But unlike the experience of previous years, when most seniors could still find alternative HMOs that might accept them, next year they will have few remaining options, according to a study by Weiss Ratings, Inc.

Among the 237 HMOs reviewed by Weiss that opened their doors to Medicare beneficiares in recent years, 147 will have fully or partially abandoned the business by December 31, 2000. This leaves only 90 HMOs that are continuing to maintain their current business, at least for now. To make matters worse, 37 of those 90 HMOs are losing money, $645 million last year.

"Seniors who have been dropped from their HMO should not rejoin another," says Weiss Ratings Inc chairman, Martin D. Weiss. "The latest Medicare withdrawals greatly narrow the viable choices available to seniors down to just a handful of profitable and financially healthy Medicare HMOs, and even many of these may soon be dropping out of the business."

Weiss warns that most seniors will be forced into one of three difficult situations.
  1. sub-standard health care under some form of welfare
  2. burdensome spending out-of-pocket for bills Medicare fails to cover
  3. Medicare supplemental insurance (Medigap), often overpriced
Whether they have been dropped from an HMO or not, Weiss Ratings recommends that seniors seriously consider returning to Medicare while buying a good Medigap policy. Consumers can purchase a "Health Insurance Guide For Seniors" which customizes an individual's health insurance needs. Those needing more information on the financial safety of a specific health insurance company may purchase a rating or analysis from Weiss. For details, call: 1-800-289-9222.
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