The human body exists in a sea of energy and is itself surrounded by a globe of energy, the “aura,” says former NASA physicist Barbara Ann Brennan. Now a healer, teacher, and author, Brennan, fifty-one, says that she has been healing illness through the aura, or “human energy field,” for more than fifteen years.

In her first book, Hands of Light, she describes her vision of the auric field and explains how to work with it. Apparently, people are getting the message. Hands of Light, at first self-published, is now a Bantam book. Approximately 135,000 copies have been distributed in English alone, and the book is published in seven other languages. Brennan’s healing message has found voice in much of the mainstream press, including the San Francisco Chronicle and Self magazine. The Chronicle called Hands of Light “the definitive work on psychic healing. “Her next book, Light Emerging, will further detail her healing work and ongoing discoveries.

Brennan hopes to influence the conventional medical community, which has a long way to go before accepting the existence of energy fields. “I know about the aura field,” says William Jarvis, Ph.D., a professor at the Loma Linda School of Medicine in California and a volunteer on the National Council Against Health Fraud. “It doesn’t exist.”

Jarvis contends that people who claim to see auras are being fooled by retina fatigue: a viewer stares at a subject; the subject then moves away but the image is retained on the retina for a few moments. But how can I develop my psychic powers? Brennan counters that she easily distinguishes aura reading from retina fatigue. She instructs students to look away at a blank wall after staring at the subject. If they still see a haze, they are experiencing retina fatigue. With her method of “seeing” she can detect physical and emotional problems, she says.

Critics and skeptics abound, but Brennan has convinced some medical practitioners, such as Marty Minniti Hill, a critical care nurse from Philadelphia and president of Skilled Nursing, Inc., a Flourtown, Pennsylvania, company that brokers nurses services to hospitals and intensive care units. At a healing workshop several years ago Hill volunteered to let Brennan work on her. Brennan’s healing technique, which looks like a laying on of hands, triggered a rush of energy, says Hill: “I thought about the world and world peace, and the origins of disease.”

Later, in private conversation, Brennan told Hill that she had seen something to check. She drew a sketch of Hill’s cervix, indicating trouble spots at “12 o’clock and 3 o’clock,” Hill recalls, using the jargon of the medical community. Hill had had a Pap test-a few months earlier, but she went back to her doctor after Brennan’s examination. This time the test revealed dysplasia, the presence of precancerous cells. A biopsy confirmed unusual cell growth at 12 o’clock and 3 o’clock. Hill’s doctor recommended laser surgery, among other procedures, but Hill opted for treatment with Brennan, which involved physical hands-on work that “balanced and cleansed the aura.” Six weeks later another biopsy was done. This time there was no abnormality, and Pap test results were negative.

“The physicians asked themselves, Did we have the right tissue samples? They did anything they could to say, ‘This can’t be real,’” says Hill. Through more work with Brennan and through therapy, Hill came to believe that her problem originated in guilt feelings about a terminated pregnancy and detachment from her femininity and sensual feelings.

During a healing session for George Sarant, M.D., formerly with the department of emergency medical care at Doctors’ Hospital, New York City, and currently resident in psychiatry at Bronx Municipal Hospital, Brennan saw discoloration in the heart area. Sarant informed her of past heart surgery. “Part of my heart tissue had died. I believe that she was seeing this abnormality,” says Sarant.

Brennan says that she has seen tumors, heart disease, acute hepatitis, and a host of other problems by reading the human energy field. She sees at least seven layers to the aura, which correspond to the seven main “chakras,” or energy centers, located in the body. Illness, she says, begins in the auric field at the level where people carry their belief systems and can, if not treated there, manifest in the body.

Having put aside her one-on-one healing practice, Brennan is dedicated to teaching at the Barbara Brennan School of Healing in East Hampton, New York. During the winter months as many as two hundred students come from throughout the world to learn her techniques, which including seeing and feeling the aura and the hands-on practice of chelation (“charging” and “clearing” the aura of psychic debris by the laying on of hands). She teaches “high sense perception” healing, which shows the student how to visualize the subject’s energy field that surrounds the body. The past year’s freshman class was made up of 105 students, five of whom were M.D.’s.

Brennan began to see auras as a child on the Wisconsin farm where she grew up. “I saw energy around trees and animals. It was a kind of haze around things,” she recalls. “When I sat still in the woods, the animals would walk on my feet,” says the slightly built, blond-haired Brennan. It never occurred her to describe those experiences to others–she believed that everyone could “see.” The family was more concerned with survival than esoteric matters.

Although they belonged to a branch of the Evangelical church, Brennan’s family was not particularly religious. She does recall making a spiritual commitment while spending a week at a church camp: “They asked, ‘Who will give their life to Christ?’ I went up to the front of the room. I took it very seriously.”

During high school, Brennan’s experience of seeing energy faded as she became interested in schoolwork. She excelled in art and physics, and chose to commit herself to the latter “because it was harder.” She earned her undergraduate and graduate degrees in upper atmospheric physics, then went on to NASA. She was with the organization during its heyday in the 1960s.

As part of her work for the space agency, Brennan studied the reflection of sunlight from various surfaces: cloud cover, the Amazon jungle, the Pacific Ocean, and the Arctic. To test instrumentation, pilots often had to fly at angles. She recalls, “I was once in a plane that was flying on its side, and my feet straddled a window that looked down on the North Sea. I thought to myself, perhaps this is a dangerous job.”

Until the late 1960s, Brennan lived in the quantitative world of scientific theorems. As the social climate began to change, she became interested in the issues of the day. Says Brennan, “In Wisconsin, there were no blacks, there were no Jews. Then, I was only aware of being poor.”

It was a different world in her new home, Washington, D.C., a predominantly black city. Women in the consciousness-raising support groups she sought out didn’t wholly endorse Brennan’s NASA connections. “People asked me, ‘How can you work for this evil organization?’” she laughs. “I thought I had done well for myself, being from the farm and coming as far as I had.” But in 1971 she cut her ties with NASA. She was tired of the relentless circle of doing research that would get money so that more research could be done. “I became disillusioned,” she says.

Brennan and her husband at the time planned a long sailing trip. They ended up going to Yucatan in Mexico, in a Volkswagen bus. During their year there, Brennan had a baby daughter and suffered through a change in lifestyle. “i went from NASA to being pregnant in a country where I didn’t speak the language,” she says. “It was rough.” Meditation kept her moving forward, she remembers. “It was in Mexico that I made a spiritual link. I would climb out on the roof and meditate every day without fail.”

The family moved back to Washington, where Brennan studied then began to practice and teach bioenergetics and core energetics, bodywork therapies that release emotion through movement. She became a counselor and continued to meditate. She says that visions eventually accompanied her meditations–”incredible, beautiful visions”–and that those experiences answered a deep longing. “I’ve always been interested in how the world works and in trying to find the answer to ‘Why?’ I looked to science, but it taught me ‘how’. I looked to philosophy, but it taught me ‘what’. Meditation finally answered the ‘why’. It was a time for exploring inner space.”

As her counseling work continued, she says, she began to have spontaneous visions of her patients’ energy fields. She remembered her childhood experiences of seeing a haze around the trees and animals on her parents’ farm. She also began to see clients’ “past lives.”

The experiences were both fascinating and frightening, she says. “I had come to something very powerful, and I knew I needed help with it. I started praying for help.” Help came in the form of a spiritual experience one night while camping in Maryland: someone called her name and she awoke, but no one was there. She says that the voice called twice more, and that she then had a deeper experience as she looked at the stars. Not long after, she went to the Pathwork, a spiritual community in Phoenicia, New York, where the writings channeled by resident spiritualist Eva Pierrakos are studied. Brennan says she was comforted that John Pierrakos, Eva’s husband, also saw aurus. She had someone she could talk to after being “isolated with this for years.”

Brennan, newly divorced, lived in the spiritual community for nine years, initially assuming such duties as assistant kitchen manager. She says that the change was a challenge: “I went from scientist to therapist to pot washer.” She had given up her outside practices to concentrate on her spiritual work. She eventually became a “senior helper” at the community, teaching core energetics and other healing practices.

Today Brennan, who has remarried, says that she communicates with spirit guides and consults often with one named Heyoan. She also works with a technique called “internal viewing,” which, she says, allows her to see inside the body. In Hands of Light she writes about sightings of tumors, blood cell abnormalities such as leukemia, and bone problems.

Science cannot yet explain many of the concepts that Brennan teaches, but she says she is working toward the day when her ideas can be validated scientifically. She encourages people to be open-minded until then. “As a scientist, I can’t deny the phenomenon just because it doesn’t fit rational thinking,” says Brennan. “I see science as making observations to test theory that then becomes accpeted as physical law. But laws are limited by equipment that a scientist can build; they are limited by the five senses. A true scientist would not deny the phenomenon, but rather would acknowledge that we can’t explain it yet.” Brennan envisions equipment being built to analyze the aura the same way machines currently test the physical state of the body.

Brennan has already participated in several experiments. In the late 1970s she worked with a group of scientists at Drexel University in Philedelphia to try to effect a change in a small, 2-milliwatt laser beam without touching it or using heat or wind. She says that she and another psychic were able to make a measured amount of light from the beam decreased in brightness. The goal was to be able to repeat it at will, which Brennan was able to do. Another piece of equipment was needed,
however, for the next stage, and at that point the experiment was canceled for lack of funds.

Arguing about what phenomena are valid is an empty exercise, asserts Brennan. She doesn’t ask whether something is real as much as whether it is useful. “We can take responsibility and learn how to heal,” she says. “There is a problem in this culture–we dissociate from the earth and the body and then depend on someone else to tell us what to do.” She goes on to explain that healing is remebering who we are, remembering that we are one with and part of God, the “life force” or any other term we want to use for spiritual energy and power. Conversely, illness comes from “forgetting,” and is rooted in fear. Love, Brennan says, is the basis of healing.

Brennan contends that all illness begins when the “creative force” is blocked. This entity, she says, is in the present, “the unfolding moment.” She adds, “The creative act is expressing the self through every part of life in the now. Illness is a blocking of this creative force.” The blockages begin in our belief system and may eventually manifest in all levels of the auric body.

Brennan is specific about what she sees in the auric field. She says that the lower levels are dense, and the first, third, fifth, and seventh layers have definite structure. The ones between are composed of fluid-like substances. The first layer of the auric field, which is closest to the body, is the layer that revels our physical sensations, our connection to the earth, and our will to live. To Brennan, this layer looks like a web of tiny blue lines. The second layer is related to our emotions and to our sensuality. It is in this layer that Brennan sees the colors that are frequently associated with auric readings: red (first chakra); orange (second chakra); yellow (third chakra); green (fourth chakra); sky blue (fifth chakra); indigo (sixth chakra); and violet-white (seventh chakra). The third layer of the aura is associated with our thoughts and mental processes. To Brennan, this layer is mostly yellow and reveals thought forms as blobs of varying brightness and form. The fourth layer is related to love of others and the world, and carries colors similar to the second layer, except that it has a rose tint. People in love, she says, send each other arcs of rose-colored energy. The fifth layer has to do with giving and receiving, “speaking your truth,” and “connection to divine will.” This layer looks to Brennan like a photographic negative. It is a blueprint of the physical body. The sixth layer is the level at which we experience spiritual ecstasy. This level, to Brennan, looks like shimmering light composed of pastel colors. The seventh layer is an integration of spirituality and personality, the connection to God or to a creative life force. The outer form of this layer is an egg shape around the body that contains all the other layers. It is composed of tiny threads of golden-silver and also contains a grid structure of the body. Within these seven layers, Brennan sees current traumas and belief systems, as well as past-life events.

Brennan says she also sees the seven main chakras, located at the front and back of the body. Each chakra center has a spinning vortex that relates to one’s physical and emotional characteristics.

The ability to perceive the body this way could dramatically change conventional medical thinking. “With high sense perception, the healer can see the disease in the auric field before it happens in the body,” says Brennan, “and can then set the field the way a physician would set a bone.” Her goal is to add another dimension to medical science so that it can truly become preventive.

Everyone like a good show. Brennan, like other healers, has been invited by professional skeptic and magician The Amazing Randi, as well as others in the entertainment world, to do healing demonstrations. She was a guest on the television show “Geraldo” because she hoped to take her message to a national audience, but she says she was given little time to explain her philisophy. She adds that Geraldo Rivera was highly skeptical, almost contentious. He asked her to touch his shoulder, after which he told the audience that nothing happened. “What does that prove?” Brennan asks, “That there was no healing energy or that he can’t feel?”

When Brennan reads an auric field, she appears to be looking at the body but actually sees much more than the physical. At times her gaze focuses on points that surround the body. Her healing modality is the laying on of hands, and she actually touches the body and, she claims, the auric layers that surrounds it. Because each layer holds unique information, Brennan teaches students to work on each one.

Out of curiosity, I asked Brennan to read my aura. She agreed, and began by telling me that my left ovary needed energy. This disconcerting information verified the sensitivity I had been feeling in that area, although my gynecologist found nothing unusual during my annual examination. “These are things in the energy field,” Brennan explained. “A doctor would not yet see it.”

She told me that an energy block in the second chakra was related to my relationship with my father. She said she could “feel” my father in my energy field and she described our relationship. He was not overtly cruel to me, but he did not acknowledge me, especially when I was growing up and becoming a sensual female. There were blocks and emotional distance in our relationship. Brennan advised me to “get in touch with the fecund eart” and to “move that area”–to dance, to exercise, to “send warm thoughts” to the area. She also talked about the deep-rooted anger that can accompany such a parent-child relationship. She cautioned me against working to achieve just for my father and straining for his attention.

She did not feel my mother in my energy field and asked if I was an orphan. “No,” I replied. “But my mother was.”

Next she focused on my solar plexus–the third chakra. She saw some digestive problems of which I was more concretely aware. Indeed, I had been seeing a holistic physician since the fall of 1988 for what was diagnosed as hypoglycemia and a yeast problem, which we began to heal through supplements and diet. The digestive problems cleared up.

As Brennan explains it, what was happening in me was that energy related to sensuality and emotions was being blocked in the second chakra, creating an imbalance. The third chakra was then being called on to compensate. It was overworked and weak. She warned me that the imbalance, if left untreated, could eventually create an ulcer.

She went on to read my “purpose in this incaranation” and saw me surrounded by children “who didn’t get what they needed.” Interestingly, for the past three and a half years I had done volunteer work with a youth organization that ran support groups for teenagers coping with alcoholism and other issues.

Self-treatment in America has remained a surprisingly uncharted area. This despite the fact that OTCs are a multibillion-dollar industry here and studies in countries such as Great Britain and Australia show that three out of four of all health problems are handled without professional help.

In the first major attempt to illuminate this segment of the U.S. healthcare system, the Proprietary Association this month released the results of a nationwide, yearlong survey of actual patterns of self-treatment reported by a representative sample of more than 2,000 people. PA provided Drug Topics with an advance copy of this unique study, which contains some surprising findings as well as the first “objective measurement” of what had been mostly educated guesses.

The study was conducted by Harry Heller Research Corp. between August 1982 and July 198o–”to get a better picture of seasonal variations in illness.” About 150 respondents were interviewed each month, and, “in order to reduce inaccuracies caused by faulty memory, answers from all respondents were largely based on problems experienced and on actions taken during the two weeks before the interview,” PA explained. Quota groups were established to ensure that certain age segments

The goal of the study, according to PA, “was to help substantiate with good data the kinds of health problems that consumers report as well as their behavior in response to these findings.” Some of the information, the association acknowledged, simply confirmed conventional wisdom– such as the fact that children have more cuts and scratches, teen- agers more acne, and the elderly more arthritis. “This may not be ‘gee whiz’ information, but prior to this study much of it could only be supposed,” PA noted.

The study also confirmed the importance of the pharmacist’s role in self-medication. Pharmacists ranked high (mentioned by 79% of the respondents) as a “good source of information” on OTC products. In this regard, 86% of the respondents said that reading package labels is “one way they use to decide with OTC to take,” while 72% find that advertising helps them learn about the availability of products they can use for their problems.

The respondents reported 4.5 self- treatable health problems per person per two-week period. These complaints fell into seven broad categories, ranging from skin problems, reported by 67%, to feminine-related ailments, listed by 27%.

The categories were further divided into 68 specific problems, with the eight most commonly reported complaints accounting for “nearly half of all reports of problems affecting adults.”

Overall, men and women experienced most health problems about equally. Two exceptions: “Women more often reported overweight and men more often reported minor cuts and scratches,” PA pointed out. Females also showed a higher incidence of arthritis/rheumatism, but the researchers noted that because women outnumbered men in the elderly sample group, the increase in arthritis “may be age-related rather than gender-related.”

Unexpectedly, the elderly reported “somewhat fewer episodes of the problems most commonly reported by other adults,” the survey concluded. But PA commented: “This is not to say the elderly are healthier, only that they report fewer self-treatable ailments.”

Differences in income “produced only slight variations in the incidence of health problems,” with those making below $10,000 reporting more arthritis/rheumatism, while the affluent cited more minor anxiety and tooth problems. Again, the researchers noted that the preponderance of low-income older Americans may suggest that age is more responsible for these differences in reported problems than income.

Health problems also did not vary much by time of year–but the few exceptions “can be striking,” PA said. The incidence of colds rose to 30% for adults during the winter, compared with 10% in the summer. The converse was true for allergies, with the 5% winter incidence more than tripling to 18% in the warm months.

In responding to the plethora of aches and pains, upset stomachs and sniffles, and similar problems, a large number of respondents were likely to “tolerate” them–i.e., do nothing. “Of all health problems experienced, 37% were not treated,” while 14% of respondents used “home remedies” such as baking soda for indigestion, the survey found. %OTC drugs were looked to for relief by 35%, and only 9% called or made a visit to their physician or dentist. “In other words, 91% of all problems were handled without M.D. contact of any kind,” PA said.

Different patterns of response were seen mainly in “children, teens, and the elderly” and in pregnant women, the survey noted. For example, for OTC use “there is a distinct blip in the child group,” with almost half of all children’s complaints treated by a nonprescription drug, compared with a rate of 33% for the population as a whole.

“One strong finding consistent throughout the study was that parents treated their children’s health problems more frequently than they did their own,” PA commented.

Pregnant women also showed a “striking variation” in the treatment profile. Expectant mothers “treated health problems much less frequently, used both OTC and Rx medicines in the home less often, and contacted the physician less often for problems,” the survey showed. They also tended to make more use of home remedies.

Income apparently has little impact on responses to health problems. However, it is something of a surprise to find that upper-income people are “more likely to ignore health problems” or to use an OTC, while families making below $10,000 were found more often to use an Rx drug already in the home or to contact a professional when they needed treatment. Observed PA: “There is no sign that the less advantaged ‘make do’ without doctors by using less expensive [OTC)) alternatives."

The survey uncovered nine problems for which nontreatment was most frequent among the adults surveyed, leading with "age spots," bruises, and baldness. On the other hand, researchers identified seven complaints for which most of the survey respondents would reach for an OTC medication.

The study found that when people used OTCs, they averaged 1.09 products per problem, and "more than 40% said they used an OTC product for only one day." When consumers stopped taking a nonprescription drug, 90% did so because the problem went away; only 4% indicated that the medication did not work. In addition, 93% said they would use the same product again if the problem recurred.

The highest satisfaction ratings were for OTCs used to treat pain and digestive system problems; the lowest level of satisfaction (76%) was for OTCs used for problems of "general well-being," such as fatigue and sleeplessness.

In general, the respondents indicated a respectful attitude toward the benefits and the proper use of over- the-counter medicines. For example, 95% or more agreed aht "one should be careful when using OTCs." Roughly an equal number (96%) agreed that medication "should be taken only when [it is] absolutely necessary.”

With four times as many health problems treated with OTCs rather than being referred to doctors (35 versus 9%), PA pointed out, “it seems clear that professional medical resources would quickly be overwhelmed in trying to deal with all the headaches as well as all the heart disease in the population.”

Noting that “fewer than half” of the 9,148 health problems reported during the survey were treated by either doctors or medicine, the association declared that “this is hardly consistent with the ‘pill for every ill’ philosophy so popular with some health-care critics. Rather,c it went on, “it suggests that Americans are generally conservative in self-treatment and do not run to the medicine cabinet for every ache and pain.”

Also, “contrary to the more paternalistic critics of self-medication, the study indicates that people do read instructions, they do understand that OTCs are not candy but real medicines and therefore not to be taken casually. Furthermore, people appear to know taht taking OTCs too often may make the medicines less effective when really needed. This is more than basic knowledge; it indicates sophistication,” PA remarked.

The “most remarkable case of conservatism” is among pregnant women, said the association. “They handle almost 70% of potentially self-treatable problems without doctors and without medicines. … Pregnant women apparently are getting the message their physicians, the government, and the medicine industry are sending them.”

Finally, the survey found that people “choose treatment appropriate to their problems,” PA maintained. “Trivial problems,” such as minor fatigue, go untreated, while annoying problems amenable to OTC treatment (e.g., headaches or heartburn) “are generally the ones for which OTCs are used.” The more serious complaints– ulcers, for example–”most frequently result in professional contact.”

In short, “people seem to understand the limitations of OTC medicines and their own abilities to self- treat,” PA commented.

Potential users of the survey information, according to Harry Heller Research Corp., include:

Pharmacists–to “help them understand the types of products and concerns and the satisfactions and dissatisfactions in the self-medication area”;

Physicians–who are able to determine in what areas self-medication is practiced;

Regulatory agencies–to determine “how, why, and to what extent people do what they do”; and

Congress–to help in the “development of legislative programs related to proprietary products.”

“The study is a beginning, not an end,” PA remarked. “It may well arise as many questions for future research as it provides answers. That, in fact,” the association concluded, “may be its most useful contribution.?

 

The Prevention Program’s 3-2-1 eating plan and our guide to Heart-Healthy Food Choices steer you toward the best foods to maximize your intake of these heart-healthy nutrients. (See “Have You Signed On down below)

But sometimes, it seems, the healthiest diet may not be enough. Case in point: vitamin E. Two large studies recently made a connection between vitamin E intake and risk of heart attacks. One of these studies involved over 87,000 female nurses. In it, the women taking at least 100 international units of vitamin E per day for two or more years had 36 percent fewer heart attacks than those who didn’t supplement their diets.

Doctors say they are not yet willing to recommend vitamin E supplementation until more research is conducted. But with such promising data at hand, some researchers admit that they have begun to supplement their own diets.

One thing to consider is the fact that a heart-smart diet–one that’s very low in fat and cholesterol–limits foods like eggs and seed oils (i.e., sunflower or sesame-seed oil) that are key sources of vitamin E. Whole grains, kale and spinach–all super foods in a heart-healthy diet–are good, not great, sources of vitamin E. Consider, too, that aside from the cost, taking vitamin E supplements (up to 400 I.U. per day) doesn’t appear to have any negative effects.

By contrast, vitamin C and beta-carotene, the two other promising antioxidants science is aggressively studying, are readily available in fruits and vegetables–the core ingredients in a heart-healthy, low-fat diet.

Despite this, a multivitamin/mineral may protect against the diet fluctuations we all face. Prevention advisor Dean Cornish, M.D., who advocates a very-low-fat diet to reverse heart disease, suggests that his patients take a daily multiple supplement.

WHAT ABOUT IRON?

You may have heard about a recent study linking high levels of iron in the blood with a higher risk of heart attack. Those findings created a big stir. Our question: Should we trash our daily iron-formula multivitamins, iron-fortified cereals and high-iron foods in the name of heart health?

The bottom line is, we can’t tell from a single study whether high amounts of iron compromise your heart health. Experts point out that there are some research flaws.

The take-home message has two parts, says Sonja Connell, M.S., R.D., research associate professor of clinical nutrition at Oregon Health Sciences University and expert on nutrition and heart disease. “First, if you cut back on animal sources of fat, using small amounts of vegetable oils and margarine, and eat more fruits, vegetables, grains and beans, you don’t need to worry about getting too much or too little iron.”

Take-home message, part two: “No one should take iron supplements without a demonstrated need for them,” Connell says. That even goes for people at risk for low iron levels like premenopausal women, vegetarians, or people with bleeding ulcers or bleeding disorders. If you are in a high-risk category, ask your doctor to perform a serum ferritin test, a special blood test that measures the amount of stored iron in your body, before you start supplementing. Some people–perhaps as many as one in 300-have a genetic disorder that makes them susceptible to iron overload, which could lead to liver damage, diabetes or heart problems. If you have a family history of this problem, known as he-monochromatosis, avoid iron supplements and seek a doctor’s or dietitian’s advice about your diet.

HEALTHY SOURCES OF CARDIO-NUTRIENTS

VITAMIN C: * broccoli * cantaloupe * citrus fruits * red peppers * strawberries VITAMIN E: * kale * spinach * sunflower

seeds * wheat germ * whole grains BETA-CAROTENE: * butternut

squash * carrots * pumpkins * spinach * sweet

potatoes

WHAT ABOUT NIACIN?

You’ve probably heard–even read here in Prevention–that niacin’s a super nutrient when it comes to having a healthy heart. And it’s true–in fact, many studies have shown that it’s the best choice for people who haven’t had any cholesterol-lowering luck with diet, exercise, smoking cessation and other lifestyle changes. It’s been known to increase the level of HDL cholesterol–the good stuff–by as much as 30 percent, with fewer side effects than other cholesterol-lowering drugs.

But it takes mega doses of niacin to achieve those results–doses so high that it’s considered a drug, not a vitamin. Large amounts of niacin should be taken only under a doctor’s supervision. Niacin may aggravate stomach ulcers, liver problems, diabetes or arthritis. Unless your cholesterol profile and risk factors put you at high risk, you probably get as much niacin as you need following the Prevention Program eating plan and taking your daily multimineral/multivitamin. If you think you need therapeutic doses of niacin, talk to your doctor.

HAVE YOU SIGNED ON?

THE EATING PLAN Divide your day into morning, afternoon and evening. During each of those periods, apply the 3-2-1 rule–have three servings of legumes or grains, two servings of fruits of vegetables, and one serving of low-fat dairy, fish or lean meats. Of course, go for the lowest-in-fat, highest-in-fiber, vitamin- and mineral-packed foods.

THE ACTIVITY PLAN Your mission: Rack up 60 minutes of activity a day. Spend 30 minutes of that in continuous, uninterrupted aerobic exercise, like fitness walking or stationary cycling. Three days a week, add a 20-minute resistance-training session. Then complete your daily 60-minute total with “lifestyle workouts,” like taking the stairs instead of the elevator, walking to the grocery store instead of driving, or giving your house a thorough cleaning.

 

Even among large U. S. corporations, only about 30% conduct “post-hospital-discharge audits,” says Bill Hembree, executive director of the Health Research Institute (HRI), Walnut Creek, Calif. But, he notes, companies that do take the time and trouble to scrutinize their bills–or, more commonly, to hire an outside auditor to do it for them–typically save 2.3% of their total health-care bill.

Considering that about 65% of companies’ medical-insurance payments go to hospitals, that suggests that U. S. employers could have saved as much as $2 billion of the $134 billion they shelled out in health-care payments in 1984.

Private firms that specialize in auditing hospital bills for companies and insurers believe the potential savings are even greater. Intracorp, a Wayne, Pa.-based watchdog firm, says that it finds errors in 90% of the 7,000 bills it audits monthly. (In one case, a 14-year-old boy was charged for a breast implant]) Intracorp says it typically uncovers overcharges amounting to about 6% of clients’ hospital bills.

Another hospital-auditing firm, Equifax Services Inc., Atlanta, reports that 98% of the hospital bills exceeding $10,000 that it audited in late 1984 and early 1985 contained errors. After the errors were discovered, the bills were reduced by an average of 4.9%.

The bills were large and included many pages of detailed information. One patient was charged $9,000 for “sterile gloves.” The hospital had billed him for a case of gloves, instead of a pair. In another instance, a patient was charged $4,000 for a 40-cent pill.

ERRONEOUS ZONES.

Hospital billing is only one of four claims-processing areas in which errors are made, notes Daniel O’Talley, a Pittsburgh-based consultant with Towers, Perrin, Forster & Crosby (TPF&C). He audits companies’ health-insurance plans not only to make sure that hospital bills are accurate, but also to: Verify claimants’ eligibility, ensure that the billed procedures are covered under the company’s medical plan, and verify that the payment is distributed correctly between the primary and secondary carriers. In each of these areas, he says, there is the potential for as much as a 30% error rate. In auditing one company’s health-plan administrator, TPF-C uncovered $420,621 in overcharges.

A major reason why most companies don’t audit their hospital bills is they assume that their insurance companies are doing it for them. But Mr. Hembree at HRI cautions that insurers don’t routinely go into hospital-charting rooms and study individual medical records, as do firms like Intracorp and Equifax.

Like Chrysler, many companies have grown suspicious that their third-party claims administrators aren’t aggressive enough in uncovering either hospital errors or their own errors. And, like Chrysler, they’re hiring outside auditors to scrutinize the entire claims-processing operation.

REWARDS.

More and more companies are offering incentives to their employees to help uncover billing errors. Two years ago, Chrysler started its “One Check Leads to Another” program that reimburses employees 50% of any overcharges they discover on hospital bills–up to a limit of $1,000. So far, two employees have received the maximum award.

In 1982, Lydall Inc., a Manchester, Conn., diversified manufacturer with about 1,500 employees, instituted a “Double-check All Bills” campaign that gives salaried workers half the amount of overcharges they discover.

“It hasn’t been a big moneysaver for the company, but it has educated employees to look carefully at their medical bills,” says Millard Pryor Jr., Lydall’s chairman and CEO.

Some companies say the payback to both employees and the company can be well worth the small investment they typically have to make in such saving-sharing programs. Since 1983, Safeway Stores Inc., Oakland, Calif., has sponsored a “Cost Awareness Recovery Effort” program that reimburses salaried workers 25% of all charges that a hospital agrees are invalid.

In 1984 and 1985, only 54 of Safeway’s 16,000 employees took advantage of the incentive. But that small minority managed to uncover $29,000 in hospital overcharges.

“We think the potential for savings is substantial if we can convince more of our employees to use it,” says Gloria Albetta, manager of health-care alternatives and planning.

HRI’s Mr. Hembree, however, cautions that employers shouldn’t expect workers to shoulder the burden of uncovering errors. “Frankly,” he says, “employees are not very good at finding errors, because it’s so hard to read and interpret hospital and insurance bills.”

AUDIT WARS.

In fact, the trend of auditing hospital bills more closely has sparked retaliation by hospitals. Some now charge outside auditors up to $50 an hour for access to medical records. Others have begun insisting that companies and insurers pay their hospital bills in part or in full before allowing them to start an audit.

“Don’t let hospitals get away with that,” advises Mr. Hembree. “I certainly would not pay the bill if a hospital wouldn’t let me see my own–or my employees’–medical charts.”

Many hospitals now hire their own examiners to scrutinize bills before third-party firms conduct their audits.

Some employee-benefits managers warn that companies need to protect employees from becoming losers in the audit wars. For example, if an outside auditor feels a procedure isn’t necessary and the insurer refuses to pay for it, the hospital usually bills the patient directly. In such cases, hospitals “are supposed to withdraw the charges, not shift the costs to employees,” asserts Terri Quinn, manager of employee benefits at Lydall Inc. “If you’re just balance-billing the patient, it defeats the whole purpose of health-care cost containment.”

Employers shouldn’t expect long-term savings as a result of auditing their bills, advises Mr. Hembree. “This is an area of cost containment where you’ll probably get one big bang for your buck over a period of two or three years,” he says. “Hospitals have to get audited only so many times before they begin to clean up their act.”

If hospitals and insurers don’t clean up their billing act, government agencies may try to do it for them. Consumer advocate Ralph Nader has launched a “Bills Project” to lobby for state and federal “truth in billing” laws–aimed largely at health-claims processors.

CONFUSION.

Anyone who has ever had to handle medical claims for a family member knows that he paperwork canbe overwhelming. So it is easy to sympathize with James V. Shannon, a Rochester Hills, Mich., business executives who found it frustrating to deal with $30,000 in family medical claims. Mr. Shannon says he was driven to distraction attempting to deal with doctors’ and hospitals’ billing and primary and secondary insurance-processing demands and errors.

“No one’s ID system is compatible with another,” Mr. Shannon adds, “and the information included with the printouts is so sketchy that misapplication and confusion are rife.” He cites this “funny and sad” example:

“I received a rejection demanding detailed information about a doctor and procedure, listed as ‘FOREIGN DOCTOR, $10.00′. I couldn’t turn up anything that seemed to fit, so I just didn’t respond.

“Four months later I got a printout identifying the doctor and procedure and saying they had paid him $1. He had been paid over four months previously. Postage to deny the claim, then send a correction, mail the check to the doctor, and (eventually) have him return it to me amounts to 88[.

“I discovered that a claim had been erroneously filed with the secondary insurer. I called to warn them so they could catch it and deny it. I got a dandy dressing-down for bothering them, as they had systems that catch that sort of thing.

“One week later,” he says, “they paid it and I had to arrange for a refund.”

The average company manager may or may not be competent to judge medical matters, Mr. Shannon adds. But “the non-medical costs we are competent to judge, for we are management professionals. And the excess costs here are due to management failure.”

Starting about 15 years ago, soon after the creation of Medicare and Medicaid brought a fresh infusion of federal funds into the health-care economy, a major new industry was born. I call it the “medical-industrial complex” because of its resemblance to the “military-industrial complex” that Dwight Eisenhower warned about as he was retiring from the presidency in 1961. Both complexes are huge, highly profitable, and political influential industries that supply essential high-technology goods and services and depend heavily on federal subsidies.

The medical-industrial complex consists of a large network of for-profit corporations that operate general and psychiatric hospitals, nursing homes, ambulatory surgery centers, walk-in clinics, emergency rooms, rental dialysis centers, home health services, diagnostic laboratories, diet clinics, alcoholism treatment centers, and many other health services. These services were formerly the almost exclusive responsibility of individual or small groups of medical practitioners, or of non-profit or public tax-supported hospitals.

The new health-care businesses currently own about 15 percent of all the acute-care general hospitals in the country, more than 60 percent of all nongovernment psychiatric hospitals, nearly 75 percent of all nursing homes, and about 40 percent of all dialysis units. Many of these businesses are owned by individual entrepreneurs or small groups of investors, but the industry is becoming increasingly dominated by large, publicly owned corporations, a few of which have gross revenues of several billion dollars a year.

To many hard-pressed communities, selling out to an investor-owned hospital chain seems like an ideal way to modernize or replace an aging nonprofit or public hospital, without having to raise money or increase taxes. Proponents of the hospital corporations point not only to their acknowledged success in raising new capital but also to putative advantages in efficiency of operations and quality of care. However, such advantages have never been demonstrated. There is, in fact, much reason to question the wisdom of turning over hospital care, or any sector of the personal health-care system, to the commercial market. The result could well be a gradual reversion to the two-tiered system of care that existed before Medicare and Medicaid. This system includes one tier for those who can afford to pay and another, less accessible and less adequate, for the poor.

Business investment was inevitably attracted to the health-care sector with the advent of Medicare and Medicaid. These tenets, which have been the main form of payment for the majority of hospitalized patients since the sixties, virtually guaranteed profits to any hospital owner.

While private, non-profit hospitals do often generate operating surpluses (“profits”), they have found it increasingly difficult to raise the new capital needed for building and modernizing plants and equipment. Private philanthropy, upon which many non-profit hospitals heavily depend, has begun to dry up as a major source of support. Furthermore, high commercial interest rates have limited the funds that can be generated through debt. Tax-supported hospitals have also faced increasing problems in maintaining and replacing their facilities because of rapidly rising costs and growing public resistance to higher taxes.

The investor-owned hospital chains, on the other hand, have had no problem raising new capital by borrowing private funds or issuing stock. Their rapid expansion, and the prospects of large returns on equity, have attracted eager investors in great numbers. These hospital chains have used this advantage to help them acquire and modernize existing hospitals, and to buy smaller hospital chains. The result of such mergers and acquisitions is that the hospital market is now dominated by five or six large corporations.

Unfortunately, empirical evidence on the performance of for-profit hospitals is in short supply. Making economic comparisons between hospitals is tricky because costs depend on the size and technical sophistication of a hospital, the extent of its teaching and research programs, the economics of the region in which it is situated, the social demography of its patients, and the severity and complexity of the diseases it treats. No comparisons between for-profit and not-for-profit hospitals have controlled for all these factors, or even taken note of them all.

Nevertheless, a few published studies have compared relatively large groups of similarly sized, nonteaching hospitals in terms of easily measured economic characteristics. These studies, based on data from 1978 to 1981, all show essentially the same thing: the investor-owned chain hospitals are not less expensive to operate. Their costs are at least as high as those of comparable non-profit hospitals, and in some instances, a few percentage points higher. What is more, their charges–and the revenues collected from third-party payers–are considerably higher. Advocates for the investor-owned hospital industry often make statements to the contrary, but no systematic studies in professional journals support those claims. If these advocates have data that can stand up to peer review, they should publish them. More Tests at Higher Prices

Two published studies have failed to support the claims of the investor-owned health-care industry. One such study, published in 1981, compared 53 investor owned hospitals with 53 similar non-profit ones in California, Texas, and Florida. The researchers at Lewin and Associates in Washington, D.C., found that charges per admission were 17 percent higher for the investor-owned hospitals, and collections of unpaid bills were 12 percent higher. The higher revenues stemmed from higher charges for ancillary services such as laboratory tests and x-rays. Total operating expenses per admission were 4 percent higher in the investor-owned hospitals, yet these hospitals managed to generate a greater net income than the nonprofit hospitals because of their higher charges.

In a more recent study, researchers from the Western Center for Health Planning in San Francisco analyzed data from 114 private non-profit hospitals, 53 investor-owned hospitals, and 35 public hospitals in California, all comparable in size and services. The researchers found that total inpatient charges per admission were 24 percent higher in the investor-owned chains than in the nonprofit hospitals, while actual collections were about 10 percent higher. The higher revenues again came from the increased use of ancillary services, as well as from higher prices per procedure. The California study also showed that total operating expenses per admission were 2 percent higher in the investor-owned hospitals.

Comparative information on the quality of health care is even harder to find and interpret. The resources and technical capabilities of the for-profit hospitals do not appear to be different from those of their non-profit counterparts, except that the for-profits use slightly fewer employees per bed. The average length of stay is about 3 percent shorter in the for-profits, but we don’t know whether that reflects differences in the nature or severity of the illnesses treated or the speed with which patients are handled. Neither do we have any information about the medical outcome of treatment in the two kinds of hospitals. However, significant differences are unlikely, since the training and competence of the medical and nursing staffs are probably similar.

 

I suspect that the quality of care at these two kinds of hospitals is much the same. The only difference is that the bill is higher in the investor-owned hospitals, mainly because they do more tests and charge more for them. Since medical practice largely reflects the judgment and professional style of individual doctors, care in investor-owned hospitals costs more probably because they attract physicians with expensive styles and encourage them to use technical procedures. For instance, executives of investor-owned hospital chains will buy any type of medical technology–no matter how expensive or redundant–if physicians want the device and will use it often enough to produce a profit. That includes highly sophisticated NMR and CAT scans, as well as more common diagnostic tests. The chain hospitals also recruit young physicians by setting them up in practice, guaranteeing their initial income and helping them with office equipment and rent. To qualify for this assistance, all the physicians must do is agree to send their patients to the sponsoring hospital.

Why medical care in the for-profit sector is more expensive is easily understood if we consider the economic imperatives of health-care corporations. To prosper, they must continually expand their net revenues. One way to do this is to acquire new hospitals, but another is aggressively to market and sell profitable services. Everyone knows that an a-la-carte menu is the most expensive for consumers and the most profitable for providers. As long as health insurers are willing to pay charges on a piecework basis, the investor-owned companies will try to sell as many individual items as possible. If, and when, payment for hospital care changes to a system of fixed prices for services, incentives will of course change. Profits will then be made by increasing certain types of admissions, shortening length of stay, and reducing the number and cost of services supplied to each patient. It remains to be seen how the investor-owned hospitals will fare under such a system.

Defenders of investor-owned corporations are fond of pointing out that economic incentives in the non-profit hospital sector are not much different. They argue that all hospitals, unless they are tax-supported or can rely on substantial philanthropic support, must generate more revenue than expenses to stay viable. An operating surplus is necessary if any institution, for-profit or not-for-profit, is to accumulate enough capital to maintain and renew its plant. But this argument ignores the fact that profit per se is not the prime economic goal of investor-owned corporations. It is the prospect of an increase in the value of stock that attracts investors, and it is the opportunity to acquire profitable stock options that enriches top management. To ensure that the company’s stock will rise, managers must make sure the business continues to grow. This economic imperative dominates the managerial decisions of the investor-owned hospitals, resulting in policies different from those of most non-profit institutions.

The Florida Hospital Cost Containment Board as published data showing that when for-profit companies purchase hospitals, charges and costs usually rise precipitously. A recent study by the U.S. General Accounting Office has documented the increased costs to third-party insurers (estimated at over $50 million the first year) that followed the purchase of a chain of hospitals by the Hospital Corporation of America.

 

The need to expand net revenues motivates for-profit hospitals to discourage the admission of poor or uninsured patients, and to avoid unprofitable services. When an investor-owned chain acquires a non-profit hospital, all indigent patients are henceforth shunted to another institution.

In this country, we have always depended on a significant degree of charity and cross-subsidization by the non-profit, tax-exempt hospitals to provide health care for the poor. Competition from the for-profit sector, which is skimming away a large number of paying patients and profitable services, is impairing the ability of many non-profit hospitals to shoulder their share of the free-care burden. The shunting of indigent patients to public hospitals already suffering from reduced tax support can only mean deterioration in services and less care for the poor.

An example of this phenomenon can be found in the Tampa Bay area of Florida. As shown in a recent documentary on public television, the Tampa General Hospital, a public institution, is feeling the burden of competition from new for-profit hospitals. These hospitals have been siphoning off paying patients while referring their poor patients to Tampa General. As a result, the financial health of Tampa General–the only hospital in the region that provides free care–is being seriously threatened.

In an effort to survive in an increasingly competitive marketplace, many non-profit hospitals are adopting the same policy as the for-profits: aggressively marketing their services, charging higher fees, and referring their poor patients to other institutions. However, most indigent patients still receive care in non-profits–either tax-supported facilities or the large, non-profit teaching hospitals. Although the large hospital corporations could well afford to provide the same proportion of free care, they don’t. Neither do they make much of a contribution to medical research or education. This is particularly disappointing in view of the extent to which they benefit from the new technologies and procedures developed at the teaching hospitals.

If the for-profit system continues to expand, the traditional concept that hospitals are obligated to serve local communities will vanish. Health care will become a commodity distributed largely by a commercial market and ruled by the bottom line. Teaching and research may be considered costly and unprofitable “frills.” The success of the for-profit chains could also bring a return to the grossly unequal two-tiered system of health care that existed before Medicare and Medicaid.

Do we want this to happen? Can we afford this new medical-industrial complex? Who will really benefit from the commercialization of health care? These questions require careful examination and public debate. We may be witnessing the beginnings of a new and more efficient system of health care. But we may also be in the midst of an aberration in our social and political history that will sooner or later have to be corrected.