Complementary and alternative medicine CAM ; has growing social, economic, and clinical significance in the US. It is important for providers to understand the implications of CAM for their patients: what it is, who uses it, and why. CAM covers a broad range of healing philosophies, approaches, and therapies that the US medical community does not commonly use, accept, or study. Kaczmarczyk and Burke, 2003 ; . CAM The National Center for Complementary and Alternative Medicine NCCAM ; defines CAM as: "a broad range of healing philosophies schools of thought ; , approaches, and therapies that mainstream Western conventional ; medicine does not commonly use, accept, study, understand, or make available. A few of the many CAM practices include the use of acupuncture, herbs, homeopathy, therapeutic massage, and traditional oriental medicine to promote well-being or treat health conditions. "People use CAM treatments and therapies in a variety of ways. Therapies may be used alone, as an alternative to conventional therapies, or in addition to conventional, mainstream therapies, in what is referred to as a complementary or an integrative approach. "Many CAM therapies are called holistic, which generally means they consider the whole person, including physical, mental, emotional, and spiritual aspects." Cited in US DHHS, 2003a ; . Use Wide variety of practices. The use of non-Western medicine among AAPIs ranges from healing rituals to massage, acupuncture, and herbal intake. Suggestions Health care providers need to be aware of the multiple forms of traditional medicine practiced by AAPI groups in their specific locales. They should respect the role of traditional medicine and explore ways that traditional medicine can complement biomedical health care systems. Providers should also be aware of the issues that may be raised by the mixing of medical systems. Kaiser Permanente, 1999 ; . Providers build trust with their patients by demonstrating an interest in and a respect for patients' efforts to care for themselves. Respect goes beyond tolerating or overlooking other forms of healing, and showing interest does not necessarily indicate a sharing of common beliefs. Yu, 1999.
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Mr. Eggen: But how could the hon. minister know that human health was not negatively affected by the explosion of this toxic brew of chemicals unless follow-up testing is done on emergency personnel, workers, and nearby residents? I think they owe that to them. Mr. Boutilier: Mr. Speaker, once again, our investigation is ongoing. Once again, our air monitoring from Alberta protection were on the command site within minutes of the event taking place. Once again, our investigation is ongoing. We're investigating all of the air monitoring that we've done as well as the preliminary air monitoring we did on the day of the accident. Mr. Speaker, our first objective is working with emergency officials to put out the darn fire and, at the same time, continue to work in terms of protecting the environment well into the future. Our investigation is ongoing, and I can assure this hon. member that we'll continue to do the utmost to protect our citizens. The Speaker: The hon. Member for Calgary-Fort, followed by the hon. Member for Lethbridge-East. Workers' Compensation Mr. Cao: Well, thank you, Mr. Speaker. During the last few years there were two important government-commissioned reviews of WCB administrative actions to ensure fairness and accountability towards injured workers. Reflecting questions from my constituents, my question is to the hon. Minister of Human Resources and Employment. What has the government done with the recommendations from these reviews? The Speaker: The hon. minister. Mr. Cardinal: Thank you very much, Mr. Speaker. That's a very good question. The two committees made a total of 59 recommendations, of which 49 were accepted or accepted in principle. Of course, extensive public feedback was held, including a symposium on the workers' compensation system and also round-table discussions on accountability. As no doubt you're aware, the government passed Bill 26 in 2002, Mr. Speaker, which saw a number of changes in the whole compensation system. Some include annual reports by Workers' Compensation, performance reports to the Auditor General and also the minister; annual WCB general meetings, open to the public of course, a streamlined WCB decision review body, and a new medical panel process for resolving differences that required medical opinion. There's also the Appeals Commission, separated from the Workers' Compensation Board, and of course the Workers' Compensation Board now implements the appeals program. The Speaker: The hon. member. Mr. Cao: Well, thank you, Mr. Speaker. Given that there is a resolution that was passed at the recent PC Association of Alberta convention to ask the government to monitor and report on the implementation of those recommendations, my question is to the same minister. Hon. minister, what action, process, and time frame are you going to take for this important monitoring? Mr. Cardinal: Thank you very much, Mr. Speaker. I can do that very quickly. The committee has met 12 times since they were put in place, and they'll be reporting to me on the implementation of the recommendations very soon, for example, flomax eye surgery.
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After Japan won the 2007 Worldcon, Smofs promptly restocked the shelves with fresh NASFiC and Worldcon bids. One reason things moved so quickly is that some groups only needed to put a new year on an old bid. 2007 NASFiC: The selection of a Worldcon site outside North America mandated a 2007 NASFiC. Voters will choose where to hold the NASFiC in a vote to be held in 2005 at Cascadiacon, the Seattle NASFiC. Two bidders have already surfaced. St. Louis, Missouri bidders advanced the most detailed proposal, to piggyback the NASFiC onto the annual Archon. The con might take place either of two suggested weekends, August 9-12 or October 4-7, 2007. The former date would be selected if they decided to hold the con at the Adam's Mark Hotel in downtown St. Louis. Otherwise, Archon's normal date and venue would be in October at the Collinsville, IL convention center and hotel complex. Website: : archonstl nasfic ; Ocean City, Maryland is proposed for the 2007 NASFiC by bidders from the Baltimore Science Fiction Society who run the annual Balticon. They also need to firm up their dates, and are currently negotiating for August 22-26 or September 19-22, 2007. Website: : ocin07 ; . 2008 Worldcon: The 2008 Chicago Worldcon bid has changed leadership. The committee selected Dave McCarty to take over as Bid Chair when Dina Krause resigned in July for health reasons that she termed "serious, but not life threatening." McCarty is a 37-year-old software consultant who lives in the Chicago area. His resume includes leadership of Capricon, a local Chicago annual con that he chaired three times in recent years. Website: : chicagoworldcon7 ; Chicago was the lone bidder for 2008 until recently. Now the field is crowded. The Columbus group, which lost its 2007 bid to Japan, reportedly will make an official announcement at SMOFcon that they are now bidding for the 2008 Worldcon. Chair Kim Williams shared this information with fans last weekend at Windycon, and personally delivered the news to a member of Chicago in 2008. There also is a Denver in 2008 Worldcon bid led by Kent Bloom. He would like to run the con August 6-10, 2008 at the Colorado Convention Center. The facility has over 2.2 million square feet of exhibition space, including 6 Exhibit Halls, 62 meeting rooms, 2 ballrooms, and a theater with 15, 000 fixed seats. Website: facilities are essentially the same as at Denvention II in 1981, with the very significant additions of an 1, 100 room hotel adjacent to the convention center, a light rail line connecting the center with overflow hotels half a mile away those were the main hotels in 1981 ; , and a revitalized downtown area that won't look gloomy and threatening to fen who venture outside." Also, Chicago must contend with voters who feel that a city which has hosted six Worldcons has had its share. The latest change to the WSFS Constitution will result in the 2008 site will be voted upon at L.A.con IV in 2006. There will be no site selection at the 2005 Worldcon in Glasgow. See sidebar story. ; 2009 Worldcon: Interestingly, fears about "carpetbagging" have also been voiced about the new Montreal in 2009 bid which materialized over Labor Day weekend at Noreascon 4. The October issue of Impulse, newsletter of the Montreal club MonSFFA Montreal Science Fiction and Fantasy Association ; , reported "News of a local bid to host the 2009 Worldcon here in Montreal came as a surprise to local fans, raising concern among some that active Montreal fandom is too tiny a group and not ready to tackle such a grand project. A few are miffed that the bid, dubbed Anticipation, was, in their view, launched prematurely, before the local fans whose support the bid will surely need could be consulted on the plan. Other locals, however, are not nearly as worried. Most members of MonSFFA, at least, seem favourable enough to the idea." Ren Walling told Impulse that his casual question at Noreascon 4 about whether there would be support for a Montreal bid lit the fuse on the whole thing. Numerous presupporting memberships were handed to him on the spot. The bid was announced in Noreascon 4's daily newzine and a quicklyorganized bid party raised the presupporter total to 150. Supporters include veteran leaders of the Winnipeg Worldcon 1994 ; , Bruce Farr, Robbie Bourget, John Mansfield and Linda Ross-Mansfield. Montreal locals Walling, Terry Fong and Eugene Heller are also involved. A bid discussion website has been established: : total ~sylvst anticipation 200 9 ; Kansas City, meanwhile, has risen from the ashes to bid for 2009. Their website explains, "The amazing and highly gratifying ; level of support we received during the 2006 bidding process, along with the constant queries of `When are you going to go again?' afterwards, led inexorably to only one conclusion: we should give it another try or we're out of our and
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OWNERSHIP OF MAIL-ORDER PHARMACIES that plan sponsors were concerned about non-price dimensions of service, such as benefit design, the extent of the retail network, and the quality of mail-order service. The Commission collected data on the amounts that PBMs pay to the plan sponsor to help defray the costs of switching to the PBM at the start of a new contract or bonus amounts to obtain or retain the plan sponsor as a customer. 29 The data revealed that large PBMs and retailer-owned PBMs often make these payments, but they usually do not total more than $100, 000 per client. There were exceptions. In 2002 and 2003, some PBMs made payments to plan sponsors that ranged between $1.5 and $20 million per client. The Commission staff's review of PBM contracts with plan sponsors suggested that member satisfaction, dispensing accuracy rates, turn-around time at mail pharmacies, wait time for customer service calls, distance to a network retail pharmacy, and timeliness of management reports are also key factors in any contract. 30 Most PBM-plan sponsor contracts included performance guarantees e.g., prescription fill time, call center response time, and generic substitution rates ; that required the PBM to make specified dollar payments to the plan sponsor if the PBM failed to meet the guarantees. 31 PBMs often work with plan sponsors to create plan designs with copayments, coinsurance, or deductibles that provide members with incentives to comply with a plan s formulary. 32 Those incentives range from differential copayments to complete denial of coverage for out-of-network or off-formulary purchases. Plan sponsors and PBMs also may negotiate over incentives for enrollees to use mail-order pharmacies for maintenance medications. 33 The PBM's contract with a plan sponsor covers the amount that the plan sponsor will pay to the PBM for each prescription dispensed at a network retail pharmacy. The PBM's charge to the plan sponsor per prescription is similar in form to the retail pharmacy contract. For brand drugs, it is a discount off AWP plus a dispensing fee and an administrative charge per script, e.g., "AWP minus 10% plus $1.50 plus $0.10." For generic drugs, the charge is similarly calculated, but the discount is usually off of the price specified on the PBM's MAC list. 34 Some PBMs earn revenues and profits through the "spread" between the amount charged to a plan sponsor and the amount paid for the drug product, including a dispensing fee if any, to the retail or mail-order.
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Agnes Rosemarie Her schedule of appointments and medications was so complicated I thought I may as well turn my many notes into a full-fledged journal. I asked Mom if it would be okay for me maybe to write about this episode in her life. She looked at me with a slight smile and that powerful determination that always settled in her jaw. She wanted to be clear that she planned to claim those promised four years. "Okay, " she told me, "but your story has no ending." "That's the good part, " I said. The plan was for my sisters and me to get her through the next six weeks and buy her those years. My journal would record her treatment and recovery. Instead, two weeks later I would leave her, and my journal entries would end abruptly because of my own illness. Monday, July 3, 2000 I see that Monet is big in the cancer world. Those water lilies of his are in every waiting room we sit in today. This is Mom's first of three straight days of chemotherapy at an oncology clinic in nearby Lincoln. One round is now, the other in three weeks. Her six weeks of radiation are through a Lincoln hospital, at eleven in the morning. Monday through Friday for the next six weeks. In the half-hour drive, I tell Mom that I hope she's not beating herself up about smoking. She's not, she says. She has always enjoyed smoking, it's the only thing she ever found that stimulates her and calms her at the same time. She knew the risks, she says, and I admire her for telling me that. 2.
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