Current Events in August 2013

It was 2-1 for the domestic flights in terms of unacceptable tarmac delays in June.

In other words, airlines reported two tarmac delays of more than three hours on domestic flights and one tarmac delay of more than four hours on an international flight, according to the Transportation Department's (DOT) Air Travel Consumer Report.

In May, carriers reported 5 such tarmac delays for domestic flights, but none for international flights.

The 16 carriers that file their on-time performance data with DOT reported that 71.9% of their flights arrived on time in June, compared with the 80.7% on-time rate from June 2012 and the 79.4% mark from May 2013.

The report also includes data on cancellations, chronically delayed flights, and the causes of flight delays, along with information on airline bumping, mishandled baggage reports filed by consumers with the carriers, and consumer service, disability, and discrimination complaints. Reports of incidents involving the loss, death, or injury of pets traveling by air, are also covered.

The complete report is available om the DOT website.

Beijing Capital Tyre (BCT) is recalling 2,711 Autoguard LT245/75R16 tires manufactured June 25th, 2012, through November 11th, 2012. These tires failed the endurance test standards of FMVSS 139 and contain incorrect maximum load load data on the sidewall.

During use, the tires may crack in the tread area leading to sudden air loss, and tire failure. Additionally, owners may unknowingly overload the tires which may lead to tire failure. Either condition increases the risk of a crash.

BCT will notify owners and dealers will replace the tires, free of charge. The manufacturer has not yet provided a notification schedule.

Owners may contact Tire Group International, Inc., BCT's U.S. contact, at 1-305-696-0096 extension 5538.

Dr. Maggie Zingman has been seeking justice for nearly a decade, but now her pursuit may be derailed by something as seemingly mundane as car trouble.

In late September of 2004, Zingman’s daughter, 18-year-old Brittany Phillips, was murdered in Tulsa by an unknown assailant. Since then, her mother has found a unique way to seek the public’s help in tracking down the killer.

Brittany, a student at Tulsa Community College, was raped and strangled in her second-floor Tulsa apartment. Her body was found three days later and she was buried on her 19th birthday. Police have DNA samples that they believe were left by the killer but have no active suspects whose DNA matches the sample, according to local news reports.

Zingman is a psychologist in Chandler, Okla., a small town located between Tulsa and Oklahoma City whose official motto is “The Best-Kept Secret in Central Oklahoma.” She has spent years travelling the country on one-woman “caravans,” driving first a Toyota RAV4 and, since 2011, a Nissan Cube, both covered in a vinyl “wrap” featuring pictures of her daughter and a description of the killer’s profile.

“It was [inspired by] the frustration of at first just standing on a corner… passing out fliers, and then trying to have stuff on my car that would get people talking,” Zingman said.  “[The wrap] just draws people in.” Since beginning the project in 2007 with the Toyota, Zingman says she’s traveled 67,000 miles to 46 states and talked to more than 100 reporters.

Cube issues

Recently, however, Zingman said her Cube has had mechanical issues that may ground it long-term and short-circuit her campaign.

A few weeks ago, “it started making a rattling noise,” Zingman said. She brought it to her mechanics, who initially thought that the problem was with the transmission, which she had already replaced once. She has since discovered that the car needs a catalytic converter and may have other issues. Zingman’s car troubles have forced her to postpone what was to be her 12th and final caravan.

“It just seems like [Cubes] have so many problems,” Zingman said. “It’s been more than a year [since the last caravan] and it just kills me when I can’t get out there.”

According to Zingman, when she initially brought her Cube in to her mechanics, “they had never seen any,” but since then, three more have been brought in. “I don’t know if [Cubes] are starting to get to the age where they’re doing it more,” Zingman said.  “Not a lot of people own this car. You still don’t see it a lot here in Oklahoma.”

But it's not just in Oklahoma that Cubes are getting to be a familiar sight in repair shops, according to Internet postings reviewed by ConsumerAffairs. Many of the posted gripes deal with the little car's continuously variable transmission, or CVT -- a shiftless transmission that is supposed to provide better fuel economy than the traditional transmission that has a fixed number of gears.  

“So here I am again a year letter getting yet another transmission. And my Cube was second in line to the other Cube getting a new transmission,” said a poster called Shanoree of Killeen, Texas, on CarComplaints.com.

“Needed a new transmission within a year,” said eal802 of New Haven, Vt. “They covered it under warranty but the dealership I have to use that I bought it from is horrible.”

No response from Nissan

Over at JustAnswer.com, transmission specialist Glenn Bradley replied to questions about the Cube CTV with the observation that while standard transmissions have been around for 100 years, the CTV is still new technology.

“My experience with CVT's is that they have a high failure rate and are yet to be proven as reliable as regular automatic transmissions which were designed in the early 1900's,” he said, adding that Nissan has not been very forthcoming with information about the problems.

“Nissan are very closed on the subject and because of this the dealers are mostly just saying that in 2011 the transmissions have been updated," Bradley said.

Adding to the deafening silence, Nissan representatives did not respond to multiple telephone requests from ConsumerAffairs seeking comment on this story. 

Bradley, meanwhile, cautioned readers not to put too much faith in the replacement trannies. 

“It's hard to know how long the 'updated' transmission will last as they are still too new to be proven,” he said. “One thing to keep in mind is that the upgraded CVT warranty of 10 years/200,000km applies from the date of purchase of the car when new, the warranty on the new transmission does not re-start from the date it's installed.

Caravan sidelined

Zingman’s issues with her Cube may have farther-reaching implications for her as well. “These additional problems also make me unsure if I can take the job I was offered… it is better pay but it is 2 1/2 hours from my home. I might have to commute 240 miles round trip, 5 days a week,” Zingman said in an e-mail. “I cannot afford to let this car die. But I am unsure if I can afford to drive it that many days that far.”

Zingman says she has made contact with a Nissan representative to talk about the transmission issues. If the discussion isn’t fruitful, Zingman says she “tends to sometimes go up the ladder, which I may do, depending on my conversation with her.”

Zingman said that the fate of her car, and thus her caravan campaign, remains uncertain. “Although I still dream that I could do caravans year round, telling her story, I accept the toughness of being able to raise funds to do it full-time,” she said in an e-mail. “After the last 4 weeks, I am just praying I can do one more before the car dies.”

In a challenge to Indian tribes that say they are exempt from state laws, New York's Attorney General is suing payday lenders who promised fast cash at high interest rates to consumers who urgently needed money, charging that they violated New York's usury and lending laws.

"Western Sky and CashCall charged exorbitant interest rates on their loans to scam New Yorkers out of millions of dollars,” said Attorney General Eric Schneiderman. 

Schneiderman alleges Western Sky and CashCall "mistakenly assert" that laws of the Cheyenne River Sioux Tribe apply to their loans. He said Western Sky is not owned by the tribe, as several courts have already held. The lawsuit charges that Western Sky made the loans, when it then sold to WS Funding, a CashCall subsidiary. 

The companies charged annual rates of interest ranging from 89% to more than 355% to thousands of New York consumers, Schneiderman said, rates that far exceed the maximum rate allowed under New York law, which is limited to 16% for most lenders not licensed by the state. The companies are not licensed in New York.

Tribes push back

Indian tribes have been pushing back against attempts by state and federal regulators to make them comply with laws prohibiting usury. On Monday, a group of 16 tribes sent a letter to New York's top banking regulator, saying they would not comply with cease-and-desist orders he issued last week.

The companies took advantage of consumers by charging extremely high rates of interest that were above New York State’s usury caps, the suit charges. For example, consumers who received loans of $1,000 were charged an interest rate of more than 234%, and had to repay as much as $4,942 in interest and principal over just two years.

New York borrowers who questioned the legality of these loans were falsely told by the companies that New York law did not apply, Schneiderman said. Some consumers were also targeted with deceptive debt collection calls in further violation of New York law.

$185 million in interest

Since 2010, the companies have made at least 17,970 loans to New York consumers, lending more than $38 million in principal. New York consumers owed more than $185 million on these loans in finance charges alone.

The Attorney General's lawsuit -- which is based on an investigation that began last fall -- seeks a court order prohibiting the companies and individuals from engaging in further illegal lending or enforcing existing usurious loan contracts, cancellation of all outstanding loans, restitution for New Yorker borrowers of all interest collected above the legal limit of 16% interest, and disgorgement of profits. The lenders also face penalties of up to $5,000 per violation for deceptive acts and practices.

I'm a pescatarian, someone who eats fish but not other animal flesh, but I eat a lot of vegetarian food and alternative meat. One thing I love doing is searching around my area for new vegetarian restaurants and recently I've been noticing an interesting change.

Whether it was through talking to a customer at a vegan place or talking to one of the workers there, I've noticed there are more meat eaters  at vegetarian restaurants these days.

Plus, a good number of my steak-loving friends will accompany me to a vegetarian restaurant once in a while, just because they like a dish there, and a Mintel survey shows this kind of thing is happening all over the United States. 

The survey shows that just 7% of people in the United States consider themselves vegetarians but 36% say they eat "fake" meat. And most of these people are eating fake meat part of the time. They're not replacing real meat entirely.

Beth Bloom, a food and drink analyst at Mintel says people are eating fake meat for all kinds of reasons these days.

"This data suggests that participation in the alternative meat category stretches far beyond necessity and creates an opportunity for future growth based on the products' ability to meet general consumer food interests, such as health, price, variety and convenience," said Bloom.

"The bottom line is that vegetarians and vegans aren't the only people eating fake meat, meat eaters are also exploring this new-found protein superpower."

And a big reason for that is that an increasing number of companies are making a higher quality mock meat and they're coming up with a variety of styles and flavors.

According to statistics, there were 110 mock meat products added to grocery stores in 2010 and 2011, and in 2011 alone, sales for meat alternatives reached the $267 million mark, according to the company IRI.

Not just here 

The meatless trend isn't just growing here in the United States. It's growing in other parts of the world too.

According to research conducted by the mock meat company Quorn, 69% of households in the UK have no problem eating a meatless meal, mainly because these meals are perceived to be healthier.

"Historically our audience has been a vegetarian one that eats meat-free and adds Quorn in to their diet," said Chris Wragg, Quorn's marketing director. "But increasingly we are seeing weight managers or slimmers, and healthy eaters."

Mark Bittman, food and cooking writer for The New York Times, said he went partially vegetarian because of health reasons. And this was after his doctor told him to cut out meat entirely.

Being a staunch meat eater, Bittman refused to go completely meatless, so instead, he ate meat only after 6 p.m. He didn't mention eating mock meat, but he said going partially vegetarian really worked for him.

"I decided to do this sort of vegan til 6 plan," Bittman wrote. "I didn't have huge thoughts or plans about it. I just thought it was worth a try. Within three or four months, I lost 35 pounds, my blood sugar was normal, cholesterol levels were again normal and my sleep apnea indeed went away."

"All these good things happened, and it wasn't as if I was suffering so I stayed with it. I have not eliminated anything completely from my diet," Bittman wrote.

Healthier than real meat

Mintel's research shows that 51% of meat eaters who eat fake meat believe it's healthier than real meat, and 31% say they do it because they're trying to lower their meat intake. Plus, another 31% say they eat the fake stuff because they like the taste.

But not everyone is willing to give up meat. Not even partially.

Research shows that 67% of people still prefer real meat over fake and 34% say they don't like the taste of mock meat at all. In addition, about 20% of people said they don't care for the texture of alternative meat.

But despite that, Bloom says it's currently a good time for people who don't eat meat and for people who just want to eat less of it. 

"While meat alternatives have the potential to meet a range of consumer needs, targeted health positioning has the potential to attract the specific attention of consumers," she says.

"While, at one time, products in the category were seen as a substitute for meat consumption, the expansion of formats and flavors has allowed the category to grow beyond one of necessity to become one of desire."

"Product manufacturers and marketers have a chance to come out from behind the veil of substitute and stake a claim as a food option that stands on its own," said Bloom." 

It was back in 2005 that ConsumerAffairs reported that retailers were beginning to collect information about which customers are more likely to return purchases, using a company then known as The Return Exchange.

The goal was to ferret out consumers who returned so many items so often that they were a drain on the bottom line, and also to identify those who were perhaps engaging in criminal activity.

The word has gotten around and even The Associated Press has caught up with it, reporting ominously that, "It's not just the government that might be keeping tabs on you. Many retailers are tracking you too -- or at least your merchandise returns."

The Return Exchange that we reported on in 2005 is still around though it's now known as The Retail Equation and boasts that more than 10% of all general retail sales are now processed through its "return optimization solutions." 

Weed out fraud

The goal is still the same: to discourage excessive returns and to weed out fraudulent ones. The retail industry estimates that consumers return $264 billion worth of merchandise each year, almost 9% of total sales. Worse, retailers say they lose big bucks to fraud, an estimated $8.9 billion in 2012, $2.9 billion of it during the holiday season, according to the National Retail Federation.

"Return fraud comes in a variety of forms and continues to present challenges for retailers trying to grapple with the sophisticated methods criminals are using to rip off retailers,” said NRF Vice President of Loss Prevention Rich Mellor. “Even more troubling is the fact that innocent consumers often suffer because companies have to look for ways to prevent and detect all types of crime and fraud in their stores, oftentimes resorting to shorter return windows and limitations on the types of products that can be returned.” 

According to the survey, nearly all (96.5%) retailers polled say they have experienced the return of stolen merchandise in the last year, and 84.2% say they have experienced the return of merchandise purchased on fraudulent or stolen tender.

The line between fraud and consumers simply being particular can, of course, be a fine one. Take "wardrobing," for example. This is the common practice of buying an expensive item like a designer dress, wearing it once and then returning it. The consumers who do this probably consider it clever, while most retailers consider it fraudulent. 

Store employees are often involved in return fraud. More than 80% of retailers said in a survey that that had been a problem for them in the past year.

Privacy concerns

Back in 2005, consumer outrage was mostly focused on actual incidents in which shoppers were turned away when they tried to return merchandise. Today, the concern centers more around privacy, as in the AP's sensationalistic lead comparing return policies to government snooping.

The U.S. Public Interest Research Group is up in arms about it, issuing a statement that said, in part: "There should be no secret databases. That's a basic rule of privacy practices."

Retailers argue that the databases are not secret and that, in fact, the return policies that are displayed in stores and printed on receipts state that returns may be subject to clearance procedures.

The Return Equation argues that its data collection enables retailers to be more liberal in accepting returns than might otherwise be the case, saying: "The Retail Equation’s Verify Return Authorization solution was launched almost 10 years ago and provides the retailers you shop the ability to extend more flexible and liberal return policies, while still taking a proactive approach to curbing the problem of return fraud and abuse."

The Retail Equation's website contains instructions on how consumers who were warned or denied a return or exchange can get a copy of their "return activity report."   

The company's practices have so far survived legal challenges. A privacy lawsuit against Best Buy was thrown out recently. 

When you apply for a loan, whether it's to purchase a home or an automobile, the lender is going to make a determination about your creditworthiness. If they decide you have good credit, you'll get better terms and a competitive interest rate. If they decide you are not creditworthy, you are likely to end up with a subprime loan.

During the run-up to the housing collapse, many people purchased homes with subprime loans. The interest rates were low to start, but quickly reset to very high rates, raising the monthly payments, in some cases, to unaffordable levels.

The housing crisis may be over but a lot of borrowers are still being saddled with subprime loans. Let's be clear – if you have blemished credit, a subprime loan may be the best you can do. But it turns out that people with pretty good credit can be lumped into that category.

A 2007 analysis by the Wall Street Journal showed that, of the $2.5 trillion in subprime loans made since 2000, an increasing proportion went to people who should have qualified for prime loans.

Racial disparity

A New York University (NYU) study of Home Mortgage Disclosure Act (HMDA) data since 2006 — the peak of the previous decade's housing boom – shows something a bit disturbing. African-American and Latino mortgage applicants were more likely to be denied prime loans, even though they were in relatively high income brackets.

"These findings offer strong evidence for the continuing significance of race in one specific, but crucial, aspect of the housing market: the mortgage application process," said Jacob Faber, a doctoral fellow at NYU's Furman Center for Real Estate and Urban Policy. "The historical absence of affordable credit in communities of color and for applicants of color, which created a market void into which subprime lenders grew, was not accidental. While it is not possible, in this study, to identify personal prejudice on behalf of lenders, racial disparities in subprime lending are nonetheless part of a long trajectory of structural, race-based disenfranchisement."

That suggests that if you are a minority, you are more likely to be placed into the subprime category, even if you have the income and credit history to qualify for a prime loan. In fact, even if you are not a minority, you should be aware of the differences in prime and subprime loans and try to avoid being sold a subprime loan if you can avoid it.

Identifying a subprime loan

But how can you tell? Home Mortgage Disclosure Act (HMDA) data does not include a field that identifies whether an individual loan application is a subprime loan application.

The first giveaway is the interest rate. Subprime loan rates can range from 1% to 2% to over 10% higher than the cost of a conventional loan, depending upon a lender’s rates and the borrower’s credit history. That's why you should be aware of what the prevailing interest rate is for the type of loan you are seeking.

Over time – and remember a mortgage is usually for 30 years – the difference in interest rates and monthly payments between prime and subprime loans can be thousands of dollars. The difference in prime and subprime interest rates for a $100,000, 30-year, fixed rate mortgage loan can be as much as 50%.

Know your credit score before sitting down with a loan officer. If you have a good credit score – 720 or above – and a good income, there should be no reason you can't qualify for a prime loan, with the best terms. Knowing where you stand will help you spot a subprime loan offering.

A subprime loan may not only have a higher interest rate, it may also not be at a fixed rate. Rather, it may be an adjustable rate loan. And chances are, the rate is going to adjust higher, not lower. That's what happened during the housing boom.

Avoid finance companies

Where you borrow may also be important. If you are buying a car on credit, you are less likely to get stuck with a subprime loan if you borrow from your bank or credit union that if you get financing from a lender associated with the dealer. According to the Louisiana State University Ag Center, borrowers are more likely to be classified subprime if they do business with a finance company rather than a bank or credit union.

Despite their drawbacks, subprime loans can allow people with blemished credit to purchase a vehicle or a home. But there is a price to be paid. If you have good credit and a solid income, there is no reason you should be placed in that category.

Remember, subprime loans are not necessarily predatory loans, though they can be. Rather, a subprime loan compensates the lender for additional risk.

But if you have a good credit score, a lender is not taking on additional risk by making a loan to you. That's a good reason to know your credit score and to be aware of the prevailing terms for the kind of loan you are seeking. If you suspect that you are being sold a subprime loan when you can qualify for something better, it's a good reason to walk away and talk to another lender.

Minorities should be watchful

In light of the NYU study, minorities perhaps should be even more sensitive to this issue. The study showed that even wealthier black and Latino applicants received less-advantageous loan terms than did their white counterparts. Once they cleared the loan-approval hurdle, African-American and Latino applications were 2.4 times more likely to result in a subprime loan than were whites. Asians were 28 percent less likely than whites to be offered a subprime loan.

"Lenders have argued that subprime loans, with their higher costs, were intended to pass more of the risk along to borrowers they deemed less likely to meet the repayment schedule of a mortgage loan," Faber said. "But these findings don't substantiate lender claims that subprime loans were for riskier borrowers — higher incomes, regardless of race, should have indicated lower risk for the lender and less need for a high cost loan."

Consumers continued to do their part during July to keep the economy growing.

Government figures show retail sales were up 0.2% last month, building on an revised increase of 0.6% in June. It was the fourth consecutive month that retail sales were higher. The last decline came in March, when sales slipped 0.3%

Retail sales are closely monitored as consumer spending accounts for about two-thirds of all economic growth.

The July advance was in line with expectations from economists surveyed by Briefing.com, who had projected growth of 0.2% in July.

Ups and downs

Major contributors to the increase in retail sales included clothing stores and gasoline stations with sales jumps of 0.9%, and food and beverage stores which saw an increase of 0.6%

Sales fell at furniture and home furnishing stores (1.4%) and motor vehicle and parts dealers (-1.0%)

Excluding the volatile auto sector, retail sales in July were up 0.5%

The full July retail sales report is available on the Commerce Department website.

Consumers appear to be paying closer attention to the debt they're running up on their plastic.

TransUnion reports the national credit card delinquency rate -- the ratio of borrowers 90 or more days past due -- decreased to 0.57% in the second quarter from 0.63% the same period a year ago. On a quarter-over-quarter basis, credit card delinquencies dropped from 0.69% in the first quarter.

In fact, the credit card delinquency rate ended the second quarter only one basis point from the all-time low of 0.56%, set in the second three months of 1994.

Average credit card debt per borrower remained nearly unchanged over the last year, dropping from $4,971 in a year earlier to $4,965 in this year's second quarter. On a quarterly basis, card debt increased from $4,875 in the first three months of this year.

"Despite recent improvements in the employment situation, consumers continue to value their credit card relationships as a primary means of liquidity. This is best demonstrated by the historically low credit card delinquency rates we observe today," said Ezra Becker, vice president of research and consulting in TransUnion's financial services business unit. "Credit card debt also remains relatively low, and while we did observe a quarterly rise in debt, we would need to see a few more quarters of increases to describe it as a significant trend. Having said that, the data supports that consumers will continue to prioritize their credit card relationships over other credit obligations, and delinquencies should remain low into the near future."

The continuing trend

Since 2000, the average 90-day credit card delinquency rate for the second quarter of the year has been 1.07%. In that same time period, average credit card debt in the second quarter has averaged $5,169.

Only two states -- Indiana and New Hampshire -- saw rises in their delinquency rates year over year, though the magnitudes of the increases were small.

On a more granular level, 74% of metropolitan statistical areas (MSAs) saw declines in their respective delinquency rates in in the second quarter relative to one year ago. This is an improvement over the previous quarter, when 65% of MSAs experienced year-over-year decreases.

Some of the MSAs that experienced the largest year-over-year decreases in this year's second quarter included Seattle (26.5% decline from 0.49% to 0.36%), Denver (21.4% decline from 0.56% to 0.44%) and Minneapolis (21.3% decline from 0.47% to 0.37%).

Looking ahead

Based on current economic assumptions, TransUnion sees credit card delinquencies remaining relatively flat in the third quarter -- closing at about 0.6%. This forecast is based on seasonality effects and various other economic factors such as anticipated gross state product, consumer sentiment, disposable income, and employment conditions.

The forecast changes as the economy deviates from a conservative economic outlook, if there are unanticipated shocks to the economy affecting recovery, or if lenders materially change their underwriting standards.

Lasers are cool! Just ask anyone who has seen Luke Skywalker battle Darth Vader with a lightsaber.

Cool as they might be, the highly-concentrated light from lasers -- even those in toys -- can be dangerous, causing serious eye injuries and even blindness when operated unsafely, or without certain controls. And not just to the person using a laser, but to anyone within range of the laser beam.

Because of this, the Food and Drug Administration (FDA) has issued a draft guidance document on the safety of toy laser products.

According to Dan Hewett, health promotion officer at FDA's Center for Devices and Radiological Health, "A beam shone directly into a person's eye can injure it in an instant -- especially if the laser is a powerful one."

However, laser injuries usually don't hurt, and vision can deteriorate slowly over time. Eye injuries caused by laser light may go unnoticed, for days and even weeks, and could be permanent, he says.

Regulating lasers

A laser creates a powerful, targeted beam of electromagnetic radiation that is used in many products, from music players and printers to eye-surgery tools. FDA regulates radiation-emitting electronic products, including lasers, and sets radiation-safety standards that manufacturers must meet. Hewett explains that this includes all laser products that are marketed as toys.

Some examples of laser toys are:

• lasers mounted on toy guns that can be used for "aiming;"
• spinning tops that project laser beams while they spin;
• hand-held lasers used during play as "lightsabers;" and
• lasers intended for entertainment that create optical effects in an open room.

Toys with lasers are of particular interest to the FDA because it's often children who are injured by these products, says Hewett. He notes that because advertisers promote them as playthings, parents and kids alike may believe they're safe to use.

"For toys to be considered minimal risk, we recommend that the levels of radiation and light not exceed the limits of Class 1, which is the lowest level in regulated products," Hewett says. Lasers used for industrial and other purposes often require higher radiation levels, he explains. But in toys, those levels are unnecessary and potentially dangerous.

In recent years, lasers have increased markedly in power and have gone way down in price. And while adults may buy a laser pointer for use in work, kids often buy them for amusement.

"Low-cost, compact laser pointers used to be quite low in power," Hewett says; but, in the last 10 years, many laser pointers have increased in power 10-fold and more. The fact that lasers can be dangerous may not be evident, particularly to the children who use them as toys, or to the adults who supervise them.

What to do

FDA offers these tips to keep in mind when handling lasers:

• Never aim or shine a laser directly at anyone, including animals. The light energy from a laser aimed into the eye can be hazardous, perhaps even more than staring directly into the sun.
• Do not aim a laser at any reflective surface.
• Remember that the startling effect of a bright beam of light can cause serious accidents when aimed at a driver in a car or otherwise negatively affect someone who is engaged in other activity (such as playing sports).
• Look for a statement that it complies with 21 CFR (the Code of Federal Regulations) Subchapter J on the label.

"If you buy a laser toy or pointer and you don't see this information in the labeling, it's best not to make any assumptions about its safety," Hewett says.

Tivicay (dolutegravir), a new drug to treat HIV-1 infection, has won the approval of the U.S. Food and Drug Administration .

Tivicay, a pill taken daily in combination with other antiretroviral drugs, is an integrase strand transfer inhibitor that interferes with one of the enzymes necessary for HIV to multiply.

The drug is approved for use in a broad population of HIV-infected patients. It can be used to treat HIV-infected adults who have never taken HIV therapy (treatment-naive) and HIV-infected adults who have previously taken HIV therapy (treatment-experienced), including those who have been treated with other integrase strand transfer inhibitors.

Tivicay is also approved for children ages 12 years and older weighing at least 40 kilograms (kg) who are treatment-naive or treatment-experienced but have not previously taken other integrase strand transfer inhibitors.

“HIV-infected individuals require treatment regimens personalized to fit their condition and their needs,” said Edward Cox, M.D., M.P.H., director of the Office of Antimicrobial Products in the FDA’s Center for Drug Evaluation and Research. “The approval of new drugs like Tivicay that add to the existing options remains a priority for the FDA.”

Series of trials

Tivicay’s safety and efficacy in adults was evaluated in 2,539 participants enrolled in four clinical trials. Depending on the trial, participants were randomly assigned to receive Tivicay or Isentress (raltegravir), each in combination with other antiretroviral drugs, or Atripla, a fixed-dose combination of efavirenz, emtricitabine and tenofovir. Results showed Tivicay-containing regimens were effective in reducing viral loads.

A fifth trial established the pharmacokinetics, safety and activity of Tivicay as part of treatment regimens for HIV-infected children ages 12 years and older weighing at least 40 kg who have not previously taken integrase strand transfer inhibitors.

Common side effects observed during clinical studies include difficulty sleeping (insomnia) and headache. Serious side effects include hypersensitivity reactions and abnormal liver function in participants co-infected with hepatitis B and/or C. The product label gives advice on how to monitor patients for the serious side effects.

Tivicay is manufactured by GlaxoSmithKline, based in Research Triangle Park, N.C. Isentress is marketed by Whitehouse Station, N.J.-based Merck, and Atripla is marketed by San Francisco, Calif.-based Gilead.

About 50,000 Americans become infected with HIV each year and about 15,500 died from the disease in 2010, according to the Centers for Disease Control and Prevention.

As gasoline prices at the pump have climbed over the last four years, so have U.S. exports of refined petroleum products, primarily diesel fuel.

U.S. Energy Information Administration data suggests net exports of refined products will hit a record level of 1.54 million barrels a day this month – more than twice the level of last August's exports. Ironically, the surge in exports coincides with a steady decline this month in U.S. fuel prices.

The reason for the decline in prices is falling demand and the process of switching over to winter-blend gasoline from the more expensive summer blend. It turns out the U.S. just has that much oil these days, and enough refining capacity to ship millions of barrels of diesel fuel overseas.

Some analysts have even declared that the U.S. is fast becoming “petroleum refiner to the world.” Just two years ago the U.S. became a net exporter of petroleum products. Now we're the world's biggest exporter.

Swimming in oil

The U.S. is now swimming in oil, thanks to the oil shale revolution that has turned places like North Dakota into the new Saudi Arabia. The U.S. still has a law on the books – passed during the oil shock of 1979 – that prohibits the export of crude oil, except to Canada and Mexico. The law, however, makes no mention of oil that has been refined into gasoline or diesel fuel.

It's diesel fuel that is leading the petroleum export surge. The profit margins are higher and the international demand is stronger for diesel than gasoline. Much of the world's automobile fleet runs on diesel.

But a number of consumer advocates have wondered aloud in recent months whether this rush to sell refined petroleum products to the rest of the world hasn't hurt the U.S. consumer. If we have so much excess petroleum product, why aren't U.S. pump prices lower? The answer may not be that simple.

Some experts agree

Even some industry experts agree that exports keep fuel prices higher for U.S. consumers, although they disagree over how much. Francisco Blanch, a commodities expert at Bank of America Merrill Lynch, believes the difference is significant. He recently told NBC News that if there were a ban on U.S. petroleum exports, U.S. prices would be much lower while fuel prices would be much higher elsewhere in the world.

The fact that U.S. crude oil can't be exported, he says, also keeps prices down for U.S. consumers. This is an opinion consumers may want to keep in mind, as the Wall Street Journal reports there are whispers in Washington that the law banning crude oil exports needs to be revised.

In fact, during a recent interview President Obama predicted that the Keystone Pipeline will one day carry U.S. crude oil to Gulf Coast terminals for shipment around the world. That can't happen unless the current law is modified or repealed.

Arguments for lifting the ban

In a recent editorial, Bloomberg News called for a reversal of the crude oil export ban, pointing out circumstances have changed drastically since the law was passed. The editorial warns that the ban threatens to put a damper on the U.S. shale oil boom.

OPEC, however, probably hopes the ban remains in place. Prince Alwaleed bin Talal, an OPEC official and a member of the Saudi royal family, recently warned his government that the boom in U.S. shale oil and gas could reduce demand for Saudi crude.

Just a little stability, please

What's best for the U.S. consumer? If you conducted a survey at the gas pump, you would probably find that a large majority favor retaining enough petroleum product in the U.S. to keep prices competitive and predictable. When prices yo-yo as they do throughout the year, it plays havoc with the family budget.

Drivers on the East Coast, meanwhile, would probably like to see the lower gasoline prices drivers in the Southeast enjoy. One reason they pay significantly more for fuel, however, is that their crude oil doesn't come from the new bounty of the oil shale revolution. Instead, East Coast refineries import oil from Europe and the Middle East.

Why can't the plentiful oil from America's heartland be shipped east? It can, but only if transported aboard U.S.-registered tankers. There's a law that requires that.

The refineries say U.S. ships cost more, which would actually result in even higher prices at the pump. It's cheaper, they say, to import the oil they need to produce motor fuel.

If you're a parent, there's a good chance that you've either researched or downloaded an app to help you document your child's development, get nutritional information or help you find a bunch of useful services.

But what about pet owners? What apps are out there for them?

There are a number of apps floating around that can do everything from helping you locate the nearest dog park to connecting you with other pet owners to get advice and make new friends.

So to help pet owners sift through the best apps out there, we've selected a few of them like the Fido Factor, made by the company Appetyte. This app lets people know which places allow dogs, whether it's a department store, restaurant, bar or just about anyplace else.

In addition, the app gives you specific rules for each place, so you'll know things like the leash rules or the fees you'll have to pay.

And if you find a new location that allows dogs, you can add it to the app's website FidoFactor.com to let others know where it is, and you can write a review to let others know if it's truly dog-friendly or not. Plus, you can read reviews of each location to see if it's worth bringing your dog there, because just because a place says it allows dogs, it doesn't necessarily mean that it's a great place for your dog to be.

To find a dog-friendly location you can either search by business name or type of location and get things like directions, hours of operation and the place's phone number. And FidoFactor allows you to take photos of your dog at these locations and upload them for other users to see and comment on.

Healthcare advice

Rudy Trematerra, the creator of The Pets Diary app, says he's created the first app that lets you know how to properly care for your pet, in terms of vaccinations and vet visits.

If you have multiple pets, you can create multiple folders so you can manage each pet's information. And you can follow a calendar so you'll know when your pet needs a certain type of care.

Additionally, the app lets you add other reminders like when your pet needs to be groomed and once added, the app tells you when these things need to be done. 

Although The Pets Diary is used and enjoyed by many, some say one thing it lacks is the ability to document a particular ailment.

"I wish it let you put more details such as diet, weight and my pet's monthly meds like heart worm," one user wrote. "There is a way around the meds and keeping records. I just save the med as a vaccine and write a comment. As for keeping track of sickness, I just put it in as a vet visit and I just write a comment. It works alright."

In case of emergency

This next app is kind of in the same category as The Pets Diary, as it helps with the care and the well-being of your dog or cat. But instead of telling you when to take your pet to the vet, it tells you what to do in an emergency.

Whether your pet has a bad accident of some sort or whether he's choking on something, Pet First Aid: for Your Dog, Cat, Puppy, or Kitten will tell you the right steps to take.

The app has news articles and emergency tips on poisoning, drowning, bleeding, animal CPR, muzzling, burns and a bunch of other topics. So you would really use the app and read these things before an emergency occurs and hopefully, you'll have a better understanding of what to do.

All of the information on Pet First Aid is updated by PetTech of Vacaville, Calif., who are said to be experts on pet emergencies and emergency preparedness.

And just like The Pets Diary, this app can tell you when your pet will need preventative care, but most people use it for emergency purposes.

"I own a pet resort and thought this would be a great app to add to my iPhone," wrote one user. "Never did I think I would use it and save the life of my own dog. My dog was acting strange after a day of relaxing and I referred to this app for help."

"Within minutes I had figured out what was wrong and rushed him to the emergency animal hospital. Surgery was required and saved my dog's life. The doctor told me if I had waited till the next morning, he would not have survived. This is the best money I ever spent on an app," the user wrote.

It was one of those things that sounded too good to be true but actually turned out to be just as advertised. While it lasted.

PerkStreet Financial, which has been offering a no-fee debit card and checking account, told its customers today that it is going out of business.

However, the company said customers' money is safe and they will continue to be able to access their funds, use their debit cards and write checks through The Bancorp Bank, which has been PerkStreet's servicing institution since PerkStreet arrived on the scene five years ago. Accounts will be automatically converted, the company said.

What won't continue are the perks that gave PerkStreet its name. To encourage customers to use their cards, PerkStreet awarded rebates -- or "perks" -- that could reach 2% of total purchases for customers who maintained a $5,000 balance. In March 2012, the company scaled that back to 1%, saying that not many customers were keeping enough on deposit to hit the 2% threshold anyway.

Instead, it substituted 2% rebates on purchases at select online sites, including Walmart, Target and Amazon. PerkStreet CEO and founder Dan O'Malley said he thought that making 2% rebates more widely available, without requiring a minimum deposit, would benefit more customers.

Rebates? Who cares?

Perhaps, but it could also be that many customers were like me and were so delighted with the free checking and debit card that they didn't bother with the perks. After writing about PerkStreet in December 2011 in a story titled "What if the bank paid you to have an account?" I opened an account to see if PerkStreet was all it claimed to be, vowing to write a withering exposé if it turned out to be just the usual fluff.

I didn't get the exposé but I wound up with a great little checking account and debit card to serve as my slush fund, using it to buy movie tickets, groceries at Trader Joe's and bottles of wine here and there. I also set up automatic payment of a couple of utility bills, condo fees and other annoyances.

Then, with great pleasure, I dropped by the local Wells Fargo branch and closed the personal account that I had maintained there at great expense and with much aggravation. Even though I paid no attention to PerkStreet's rebates, I occasionally got automatic $30 or $40 rebates that simply perked up in my account.

What was best for me was the simple fact that the account was free, whereas the Wells Fargo account had been loaded with fees too numerous to count and constant errors and glitches in trying to manage the account online.

Promoting the debt-free life

Back in 2011, PerkStreet's O'Malley, a former Capital One executive, explained how he dreamed up the idea of a debit card that paid rebates, instead of the much more common rebate-paying credit card.

"I realized the product I was selling was designed to get people into debt," O'Malley said then.  "A majority of families are not going to be able to pay off their credit card debts.  I found it distasteful."

O'Malley vowed to set up a reward program using debit cards, something that would reward consumers who spent only as much money as they had in their account.

It worked great for its customers but not, apparently, as a business.

"Ultimately ... we could not find the financial success required to continue building the business," the company said in an email to its customers. "Over the last 6 months we have been pursuing additional investment to grow our business to the point it could be self-sustaining. Unfortunately, we were unable to secure more funding and now must begin the process of closing the company."

"We started PerkStreet with the seemingly impossible goal of making banking more rewarding for the average person. We were able to give cash back for spending money that was already earned, not risking going into debt by spending on a credit card," the company's statement said. "We believed we could reward everyone, not just the people who would tell you it takes money to make money. The last 5 years were an incredible journey. We've given out over $4 million dollars in perks and done groundbreaking things to create our amazing online community. We are deeply saddened to see it end."

Have you ever slept next to a noise that sounds like part broken fog horn, part wild animal?  Meaning, does your partner keep you up with a bunch of loud snoring every night?

If so, you're not alone, because according to a National Sleep Foundation study, 67% of U.S. adults say their partner snores. Aeparate study conducted in the UK found that the average married person loses about 730 hours of sleep each year because their spouse snores or moves around.

And in yet another survey that shows what people are doing about it, 30 to 40% of couples choose to sleep in different beds.

"People will say they sleep better [together], but when we actually monitor their brains we see that their brain is not getting into deeper stages of sleep because they're continuously being woken up by movement or sound," said Dr. Colleen Carney, director of Ryerson's Sleep and Depression Laboratory, in a published interview. "It creates a lot of problems."

Lot of problems

In addition, Carney says couples shouldn't feel their relationship will suffer because they sleep in separate beds. In fact, she said oftentimes it can improve the relationship, because both people are getting enough sleep.

"People can have very good and satisfying relationships sleeping apart," said Carney. "Some people might be headed to divorce and then they actually sleep apart and find this new way to connect."

Social beings

Wendy Troxel, a clinical psychologist and behavioral scientist, at the RAND Corporation, said it's hard for a lot of couples to sleep alone, because wanting someone next to you during the night is a natural feeling.

"Humans are inherently social beings and we derive a sense of safety and security from our social environment," said Troxel. "This fundamental need for safety and security at night may explain why we generally prefer to sleep with another human being, even when sharing a bed may not always result in the best quality sleep."

But it's not only snoring and movements that will keep a couple awake, it's other things too.

In the UK survey, 40% said their partner hogged the bed and 30% said they fought over the covers. Plus, 47% said they would put up with it, because they feared sleeping in separate beds would harm their level of intimacy.

Pre-sleep intimacy

But that's not necessarily true, said Troxel. She said the few hours before bed is actually a better time to be close with your partner. 

"Ultimately, the time couples spend together before falling asleep may be the most important time for connecting, being intimate and just being alone together, without all of the other distractions of the day" she said.

"Whether couples sleep in the same bed or separate beds, they need not give up on that important and satisfying pre-sleep time together. Perhaps the real benefits of sleeping together are realized in the precious lull before sleep comes."

The folks at the National Association of Home Builders said by 2015, 60% of homes in the U.S. will have two master bedrooms and experts say couples shouldn't feel like there's anything wrong with their relationship if they want to sleep apart. 

"People don't like to talk about sleeping in separate beds because there's a stigma that there must be something dysfunctional in the relationship," said marriage therapist Allison Cohen in a published interview. "But for those people who put tremendous value on getting a good night's sleep, which I think most of us do but are afraid to say, it can be an incredibly creative solution that is really effective for the relationship."

Just not possible

One woman, who goes by the user name Dollbaby 710, told MSN that she'd love to share a bed with her spouse, but it just isn't possible. And she has no regrets about it.

"I would love to sleep in the same bed with my husband but it is pretty much impossible," she wrote. "He starts snoring loudly the minute he falls asleep and it continues all night long. After about four months of me not getting much sleep after we married, we came to a mutual decision to sleep in separate rooms. We are both happier now because now I am not so grouchy from being sleep deprived every night."

This might be the answer for you, if you've been going back and forth about sleeping in separate rooms, but it's different for each couple.

"There is no one-size-fits all approach," said Troxel. "Couples need to decide what works best for them and consider how to optimize their sleep as well as their time together so that they can be the best possible partner for their loved one."

Hypertension, or high blood pressure, has been called the silent killer because many who have it are unaware they have a condition that can shorten their life. Recognizing that you have the condition, however, is just the first step. Next, you have to treat it.

First, let's define our terms. When we say “high blood pressure” we are talking about a blood pressure reading above 140/90 – the 140 being the systolic number, which measures the the pressure in the arteries when the heart beats. The 90 is the diastolic number, which measures the pressure between beats.

While the National Heart, Blood and Lung Institute – part of the National Institutes of Health (NIH) – declares 140/90 to be normal, most physicians now want their patients to have a reading of 130/80 or below.

Get healthy

Adopting a healthy lifestyle is an effective first step in both preventing and controlling high blood pressure. If lifestyle changes alone are not effective in keeping your pressure controlled, it may be necessary to add blood pressure medications. In fact, most people with high blood pressure take one or more prescription medications.

One of the older class of medications is the beta blocker. Beta blockers reduce nerve impulses to the heart and blood vessels, slowing the heart, so it doesn't work as hard.

Angiotensin converting enzyme, or ACE, inhibitors prevent the formation of a hormone called angiotensin II, which can cause blood vessels to narrow. The ACE inhibitors cause the vessels to relax and blood pressure goes down.

Angiotensin antagonists shield blood vessels from angiotensin II. As a result, the vessels become wider and blood pressure goes down. Calcium channel blockers, or CCBs, keep calcium from entering the muscle cells of the heart and blood vessels. This causes the blood vessels to relax and pressure goes down.

Alpha blockers reduce nerve impulses to blood vessels, which allows blood to pass more easily, causing the blood pressure to go down. Alpha beta blockers work the same way as alpha blockers but also slow the heartbeat, as beta blockers do. As a result, less blood is pumped through the vessels and the blood pressure goes down.

Cheap and under-used

Perhaps the simplest drug is a diuretic, also called a water pill. It works in the kidneys and flushes excess water and sodium from the body. It's cheap and, according to one blood pressure expert, under-used. In 2012 Dr. Samuel J. Mann, a nationally-known hypertension specialist at New York-Presbyterian Hospital/Weill Cornell Medical Center, questioned the widespread use of today's most popular hypertension drugs.

"Despite their best intentions many physicians continue to place their hypertensive patients on blood pressure medications, drug combinations or doses that may not be the best treatment available to them, Mann said. "I believe that with the medications we have, we can do much better than we are doing.

Mann's view may be gaining wider acceptance. Many physicians are now emphasizing a healthy diet, reducing sodium consumption, maintaining a healthy weight and reducing alcohol use.

Doctors at the Mayo Clinic have come up with “10 ways to control blood pressure without medication.” They include losing weight, reducing sodium, getting regular exercise and maintaining a healthy diet. 

If you are currently taking blood pressure medication, don't stop taking it without consulting with your doctor first. Even if you continue to take medication, making lifestyle changes to promote a normal blood pressure can only improve your health.

Ranking high on the list of a mom and dad's nightmares is being told their small child needs surgery.

Questions by the dozens run through their heads: Does my child really need the operation? Will the operation take care of the problem? How long will recovery take? Another question they ought to be asking is: Does anesthesia affect my child's developing brain?

Because more than a million children in the U.S. under the age of 4 need anesthesia for surgery each year, the Food and Drug Administration (FDA) and other health organizations have teamed up to answer this question.

Studies yield mixed results

Previous scientific studies in young animals have shown that commonly used anesthetics can be harmful to the developing brain. However, results have been mixed in children. Some studies of infants and young children undergoing anesthesia have reported long-term deficits in learning and behavior, while other studies have not.

These conflicting results make it obvious that more research is needed to understand fully the risks anesthesia may pose to very young patients.

To close these research gaps, FDA and the International Anesthesia Research Society (IARS) started an initiative called SmartTots (Strategies for Mitigating Anesthesia-Related neuroToxicity in Tots). SmartTots seeks to ensure that children under age 4 will be as safe as possible when they need anesthesia. Studies have shown that this is a period of significant brain development in young children.

"Our hope is that research funded through SmartTots will help us design the safest anesthetic regimens possible," says Bob Rappaport, M.D., director of the Division of Anesthesia, Analgesia and Addiction Products at FDA. "This research can potentially foster the development of new and safer anesthetic drugs for use in pediatric medicine."

According to SmartTots steering committee co-chair James Ramsay, M.D., young children usually do not undergo surgery unless the procedure is vital to their health. "Therefore, postponing a necessary procedure may itself lead to significant health problems and may not be an option for the majority of children," Ramsey says.

Continuing research

SmartTots was launched in 2010 in part to fund research that would build on the work done at FDA and several universities.

Since 2003, Merle Paule, Ph.D., director of the Division of Neurotoxicology at FDA's National Center for Toxicological Research (NCTR), and colleagues have been exploring the effects of ketamine -- an anesthetic commonly used on children-on the brains and learning ability of young rhesus monkeys.

"Earlier research has shown that exposing young rat pups to ketamine caused learning problems when they became adults, but we wanted to see what would happen with primates," said Paule. Primates, such as the rhesus monkey used in this research, more closely resemble humans in physiology and behavior.

"The learning of concepts such as matching (see a triangle, match it with another triangle from among other symbols) took much longer in the ketamine-treated monkeys And even after basic concepts were learned, the ketamine-exposed animals performed less accurately than animals in the control group," Paule says.

The same holds true for the test monkeys even today, Paule says. Six years after their ketamine treatment, they're still showing below-normal brain function.

Children and ketamine

What might that mean for young children who have been exposed to ketamine or other anesthetics during surgery?

"We can't know with certainty at this time," says Rappaport, a member of the steering committee that coordinates, manages and oversees the SmartTots initiative. "We need to definitively answer the questions of whether anesthetic use in children poses a risk to their development and, if so, under what circumstances."

FDA and other health-related organizations recognize the importance of learning more on this topic. For example, do other forms of anesthesia similarly affect the brain's ability to, learn and remember? How long might these deficits last?

SmartTots Paves the Way

The SmartTots partnership is working to mobilize the scientific community around this issue, stimulate dialogue among leaders in the anesthesia community and work to raise funding for the necessary research ahead.

As part of these efforts, SmartTots issued a consensus statement that's been endorsed by organizations including the FDA, American Academy of Pediatrics, the American Society of Anesthesiologists and the European Society of Anaesthesiology in December, 2012. The statement acknowledged that, in the absence of conclusive evidence, it would be unethical to withhold sedation and anesthesia when necessary.

SmartTots is funding research underway at Columbia University and the University of Iowa on the effects of anesthesia on infant brain development, and on cognitive and language ability. All research first undergoes approval by an Institutional Review Board (IRB), a committee formally designated to approve, monitor, and review biomedical and behavioral research involving humans. The top priority of IRBs is to protect human subjects from physical or psychological harm.

In the meantime, Ramsay says parents and other caretakers should talk to their pediatrician or other health care professionals about the risks and benefits of procedures requiring anesthetics and weigh them against the known health risks of not treating certain conditions.

It doesn't pay to get sick. Aside from the serious health issues an illness raises, there is a strong economic concern too.

People faced with a chronic health condition often find they have to spend thousands of dollars over time on treatment. A recent Harvard study found that illness or medical bills contributed to 62.1% of all bankruptcies in 2007.

Now, researchers writing in the American Journal of Preventive Medicine have put a price tag on the cost of developing type 2 diabetes, a preventable condition most often brought on by obesity or a poor diet.

Younger is worse

The younger you are when diagnosed with the disease, the more it will cost to treat it over your lifetime. For example, for men diagnosed with type 2 diabetes between the ages of 25 and 44, the lifetime direct medical cost of treatment is $124,700. Diagnosed between the ages of 55 and 64, the condition costs $84,000 to treat.

The treatment costs are higher for women, the researchers found. Women diagnosed between the ages of 25 and 44 can expect to pay $130,800 for treatment over the remainder of their lives.

“Over the lifetime, type 2 diabetes imposes a substantial economic burden on healthcare systems,” the researchers conclude. “Effective interventions that prevent or delay type 2 diabetes and diabetic complications might result in substantial long-term savings in healthcare costs.”

According to the American Diabetes Association, type 2 is the most common form of diabetes. Though it can be hereditary, type 2 diabetes is, in many cases, a preventable disease.

Insulin resistance

When you have type 2 diabetes, your fat, liver, and muscle cells do not respond correctly to insulin, a condition known as insulin resistance. As a result, blood sugar does not get into these cells to be stored for needed energy.

In most cases type 2 diabetes develops slowly. Most people with the disease are overweight when they are diagnosed. Increased fat makes it harder for your body to use insulin correctly. Maintaining a healthy weight and diet and getting regular exercise is one way to prevent this condition.

Other conditions can also be expensive to treat. In addition to increasing your risk of heart attack and stroke, high blood pressure carries an economic cost as well. It may require one or more prescription medications and, should you have a heart attack or stroke, can result in hospitalization and a lengthy recovery.

High cholesterol

Having too much cholesterol in your blood is another potentially costly condition. Cholesterol is a waxy substance that's found in the fats, or lipids, in your blood. While your body needs cholesterol to continue building healthy cells, having high cholesterol can increase your risk of heart disease.

Some people who develop high cholesterol have a genetic predisposition to the condition. However, many have too much cholesterol because of an unhealthy diet and lifestyle.

Statins, a class of drugs to treat high cholesterol, are among the most commonly prescribed drugs in the U.S. and tend to be very expensive. Suffering a stroke because of high cholesterol is even more expensive, not to mention a threat to your life.

Drinking too much alcohol can lead to inflammation of the liver and, eventually, cirrhosis. In extreme cases it can require a liver transplant.

Obesity may be key

Obesity is another mostly-avoidable condition that can lead to a lifetime of high medical bills and may be a key to preventable diseases. In addition to being a contributing factor to type 2 diabetes, high blood pressure and high cholesterol, obesity can place undue stress on all the body's internal organs.

In 2012 researchers at Lehigh University reported obesity alone adds $190 billion in U.S. medical expenses each year. The figure includes prescription medications, hospitalizations and higher health insurance premiums.

For individuals, physicians say maintaining a healthy weight, getting regular exercise and eating a healthy diet is not only a good way to protect your health but, over the long run, to reduce the amount of money you have to spend on health care.