2017 Greetings! It’s been much longer than I anticipated to be able to get back to writing this blog, so return now to fulfill one of my New Year’s resolutions. Health justice work is more important than ever and I created this blog to share information and perspectives on topics that may not get much attention elsewhere. My goal is to post once a month at minimum, and to keep a focus on my Washington as well as local developments and the bigger picture. I will start with a story on a positive development for healthcare consumers in our state.
Archive for the ‘Health Care Marketing’ Category
Back to blogging
Posted in Health Care Marketing on 7 January 2017| Leave a Comment »
News Roundup
Posted in Health Care Marketing on 21 January 2015| 1 Comment »
From the hyper-local to the global, news of note:
American Red Cross Under Pressure to Stop Accepting Tobacco Money
Questions arise over hospital ‘reality’ TV shows
Unlike ZoomCare, Legacy will accept Medicare and Medicaid at new Portland clinics
Tax Preparers Get Ready To Be Bearers Of Bad News About Health Law
The Nasty Patent Games Drug Companies Play To Stop You From Getting Cheaper Drugs
Chinese Man with Leukemia Prosecuted for Buying Medicine from India
Posted in Access to Medicines, Advocacy, Assistance, Cancer, Economics of Health Care, Generics, Glivec, Global Health, Health Care Marketing, Health Insurance, Leukemia, Patient groups, Prescription drugs on 29 December 2014| Leave a Comment »
News from China gives us even more pause to reflect on the access to medicines scenario. The situation in the US where there are no good excuses for unaffordable medicines, pales in comparison to this chilling tale of a patient whose actions to secure the life-saving drug imatinib mesylate at an affordable price, has resulted in his criminal prosecution.
To prosecutors, a leukemia patient named Lu Yong is a criminal involved in credit card fraud and a counterfeit drug scam. But to 1,000 fellow leukemia patients in China, Lu is an unsung hero for helping them get access to cheap, life-saving generic medicines from India.
His crime? Selling fake drugs and breaking a law about purchase of international credit cards. What Lu did was considered criminal because any drug produced in or imported into China without the government’s approval is classified as a “fake drug,” and Lu purchased international credit cards online to facilitate the transactions. China.org.cn reported that:
The defendant, Lu Yong, was diagnosed with chronic myelocytic leukemia in 2002. He was prescribed Gleevec, a drug produced by Swiss drug-maker Novartis, which cost 23,500 yuan (US$ 3,775) per month, far too expensive for average Chinese families. Lu was even more depressed since the expenses of treating leukemia are not covered by China’s medical insurance system.
Lu later found out that India produced a generic drug which was comparable to Gleevec but which cost only 4,000 yuan, about 17 percent of the cost of Gleevec. He took the medicine himself and found it effective. Later, Lu began helping several thousand fellow patients buy the drug, since the purchasing process was difficult and some patients were not able to fill out the English purchase forms.
Meanwhile, Lu’s trial has been postponed due to his health problems, and some 300 fellow patients with CML have signed an online petition asking for his release.
Also of significance is the astronomical price of Gleevec in China, said to be the highest in the world, which led Lu to seek an alternative. As a point of comparison, Costco’s US online pharmacy is now selling a 30-day supply of the standard 400mg dose of Gleevec for $9022.05.
WA Health Benefit Exchange in the Headlines
Posted in Health Care Marketing on 29 December 2013| Leave a Comment »
Media reports from around the state:
People behind Washington state’s health exchange: Teresa Mosqueda
13% pay raise for CEO of WA HBE exceeded what was planned
Immigrant service providers frustrated with Healthplanfinder site
Many Wash. Health-Exchange Plans Exclude Top Hospitals From Coverage
Fired worker, WA Health Benefit Exchange at odds over progress
Release: Healthplanfinder Enrollment Spikes by Dec. 23 Deadline
WA Healthplanfinder Updates
Posted in Advocacy, Assistance, Discrimination, Ethics, Global Health, Health Care Marketing, Health Care Reform, Health Disparities, Health Insurance, Health Literacy, Healthcare Inequalities, Hispanic/Latino, Immigrants, Language Access, Language Services, Limited English Proficiency, Medicaid, Promotions, State of Washington, Translation on 20 December 2013| Leave a Comment »

Translations for WA Health Benefit Exchange Still a Struggle
Posted in Advocacy, Discrimination, Global Health, Health Care Marketing, Health Care Reform, Health Disparities, Health Insurance, Health Literacy, Healthcare Inequalities, Hispanic/Latino, Immigrants, Language Access, Language Services, Limited English Proficiency, Medicaid, State of Washington, Translation, tagged language translations, quality translations, translations, Washington Healthplanfinder, Washington State on 10 December 2013| Leave a Comment »
The irony was not lost for me that while writing on the positive results of the FDA’s use of translation services, that here in my state, once known as a national leader in language services, we are still struggling to get quality translations for our Health Benefits Exchange (HBE). The efforts to achieve this goal have been a major focus for the Washington State Coalition for Language Access, and its been a year now since we co-authored with Northwest Health Law Advocates the report Language Access in Washington under the Patient Protection & Affordable Care Act expressly for the HBE efforts. Now with 175,000 enrollees, Washington State deserves the praise it’s getting for the record-breaking enrollment figures in the new health insurance marketplace Washington Healthplanfinder, especially compared to the situation in neighboring Oregon and to the federal Healthcare.gov platform. But the picture is much less rosy regarding providing equal access for Washingtonians with limited English proficiency (LEP), who now number some 8% of state population or half-million residents, representing an increase of 210 % in the past decade . Demographic data on enrollees is said not to be available.
We are now less than 2 weeks away from the enrollment deadline for coverage to start Jan. 1, 2014, and the consumer fact sheets that were intended to inform the public of the options under the ACA have not yet been made available to Washington’s LEP population. Even though work began in July to replace the problematic original translations – errors brought to HBE’s attention by advocates- there are still no consumer fact sheets available in Washington’s threshold languages ( in written form these are: Chinese, Lao, Khmer, Korean, Russian, Spanish, Somali, and Vietnamese).
In addition, the Spanish versions of the paper application for Healthplanfinder, while continuing to be publicly available, have contained horrific translation errors. In the section which inquires about the applicant’s citizenship status, the phrase ” Non-citizen legally present in the US” was translated into Spanish to mean just the opposite, i.e., the translation says “ non-citizen not legally present….” , complete with the I-word in Spanish in version #1. After the mistake was identified on Oct. 15 , again by advocates, staff said they took immediate action to have the vendor correct it. The screenshots included here show the sections containing the mistranslations.
Spanish version #1
And yet, advocates identified that the new translation contained the same error, just written with different wording. Here is Spanish version #2, as it appeared on Nov. 14:
This one particular error may now have been recently corrected for a 3rd iteration, through volunteer efforts of local language access advocates trying to beat the clock to help consumers. However, we hear anecdotally that more translation concerns persist and can’t be confident that there are not similar errors in the translations in the other languages.
What remains a mystery is how this sorry state of affairs has come about, and if there were ever robust quality assurance measures in the procurement chain for the translations. It is beyond comprehension how such blatant errors could be made given that the work was done by vendors holding official State contracts who must affirm that they use qualified translators and proper translation procedures. And if this is happening in Spanish, the 2nd most used language in both our State and nationally, and thus one for which there is an ample number of nationally-certified translators available to do the work, there is a real reason to fear that similar egregious errors may exist in other language translations.
Shortly before Thanksgiving, HBE staffers announced at a meeting of its Health Equity Technical Advisory Committee, that work halted back in June to create a Language Access Plan (LAP) for the HBE requested by the TAC , will resume in the new year. LAPs are meant to serve as blueprints to guide the work of agencies and programs to comply with the laws requiring they provide language services, and to help prevent the kind of problems that we’ve being seeing here in the other Washington. I’ll continue to report on the work in progress.
A Honey of a Translation
Posted in Consumer Protection, Environmental Health, Ethics, FDA, Global Health, Health Care Marketing, Hispanic/Latino, Language Services, Paitent safety, Patient Safety, Promotions, Translation on 9 December 2013| 3 Comments »
Two recent news stories about honey, illustrate yet again the vital importance of communications to health. In these completely unrelated cases, it was all about translations, the rendering of messages from one written language to another. The fraudsters seemed to have assumed they could get away with selling their products to unsuspecting consumers due to a lack of language skills on the part of regulatory authorities.
In September, Bloomberg Businessweek broke the story on a honey scandal at the global level with an article entitled The Honey Launderers: Uncovering the Largest Food Fraud in U.S. History , describing a convoluted plot by German company ALW to sell millions of pounds of Chinese honey in the US, by disguising its origins. Over the course of several years, ALW arranged with the Chinese brokers to channel their product through other countries, where it was filtered, doused with additives to disguise its unpleasant flavor, and re-labeled to make it seem to have come from nations authorized to export honey to the US. Some of the adulterated honey was also found to contain residues of the antibiotic chloramphenicol, long banned in the US. The impetus for the fraud was purely financial , as honey fetches top dollar in this country, the major world consumer. Over a decade ago when domestic beekeepers complained that honey imports from China were seriously undercutting their business, the US imposed such stiff tariffs on Chinese honey imports that little enters the country legally any more. But the super-cheap price of honey in China has remained a lure for international exporters. Some Chinese producers seize this opportunity to increase their own profits by artificially increasing the quantity of honey available to be sold. According to the FDA investigation of this case, a number of techniques like harvesting the honey early and not letting the bees complete the process naturally were routinely used in China, along with machine-drying the honey to speed things along. ALW abetted the process and instructed its 2nd-country middlemen to add sweeteners to disguise the sour taste caused by the premature harvesting.
In order to keep the doings secret, ALW officials exhorted the young German employees sent to run the firm’s US operations to use the phone, not emails, to discuss business and to conduct all communications in their native language. While the staff did restrict their discussions to the German language, they continued to use emails for correspondence. Their missives were later translated into English during the course of the FDA investigation. The federal prosecutor who worked on the case commented:
Earlier in the year in a less notorious case, the honey firm Nature Nate’s in Texas garnered FDA censure because it violated the instructions issued by the FDA following a 2012 audit, when the company was ordered to stop advertising its honey in ways that characterized it as a drug, i.e. by making various health claims for its products. While Nate’s had promised to stop the spurious marketing by Fall of 2012, an FDA follow-up in mid-2013 found that the firm continued to make these claims on its Spanish-language website, under the banner ” Remedios Caseros con Miel or Honey Home Remedies “, describing such benefits (in English translation) as:
• “Food Poisoning. Blend 1 Tablespoon Apple Cider Vinegar and 1 Tablespoon of North Dallas Honey dissolved in a glass of chilled water.”
• “‘[O]rganic honey’. A client of mine that is a doctor told me to try yours for allergy relief. It has COMPLETELY eliminated allergies for the entire household … it is our daily dose … “
A cached copy of the Spanish information on how to use Nate’s honey as an arthritis remedy said:
Para la artritis – 100% Pure Raw & Unfiltered Honey naturenates.com/espanol/para-la-artritis
“Receta 1. Tome una taza de agua caliente con dos cucharadas de miel y una cucharadita de canela en polvo por la mañana y la noche. …
The FDA issued the new warning letter in June 2013, and Spanish version of Nature Nate’s website appears to have now been taken down.
And the phenomenon of the FDA using translation as an investigative tool is hopefully now a regular practice, as a evidenced by yet another recent case, this time involving the Sundial herbal supplement company which got an FDA Warning Letter based on claims made solely in Spanish which characterized its products as drugs. As a commentator for Regulatory Affairs so aptly explained
…just because a product’s unapproved claims aren’t in English, that doesn’t mean FDA isn’t paying attention.
National Library of Medicine sets up People Locator for Boston Marathon Explosions
Posted in Health Care Marketing on 15 April 2013| Leave a Comment »