Letters to the Editor is a periodic characteristic. We welcome all feedback and can publish a range. We edit for size and readability and require full names.
Well being Care as a Human Proper
If there’s something to remove from my over half a century {of professional} expertise on the crossroads of legislation, drugs, and well being care — together with my being delivered to Congress to advise lawmakers because the Reasonably priced Care Act was being crafted in 2009-10 — it’s that People imagine well being care is a proper — and must be reasonably priced — and never a privilege for under these rich sufficient to pay for the suitable sort of protection. In any case, with out the flexibility to amass, keep, or regain our well being, none of us is way good to ourselves or our households, buddies, family members, and communities, and definitely to not our employers. It’s extra pricey for any of us to be sick than nicely.
The idea of well being care being a proper goes again many, many a long time, and the ACA is the newest incarnation of that perception — regardless of ongoing political dangers. The most recent gamble has been the almost six-week shutdown and solely the promise that the Senate will vote inside a month to handle the ACA’s enhanced subsidies (“Why Democrats Are Casting the Authorities Shutdown as a Well being Care Showdown,” Oct. 6).
It’s consequently not hyperbole to say that the ACA was meant as, and nonetheless stays, an indeniable lifeline for hundreds of thousands to realize well being. After all, that aim is in jeopardy, or at a minimal an open query, for the reason that subsidies will both be eradicated by yr’s finish if the promised vote on the Democrats’ Senate invoice fails in that chamber, or, if it passes, by no means turns into legislation. Regardless, notices to insureds of giant premium will increase with out the subsidies have began reaching mailboxes.
From my perch (and with out contemplating the brouhaha over additionally limiting Medicaid and reduces in Medicare supplier funding that turned legislation courtesy of this yr’s finances invoice), it’s incredulous and maddening to undergo by way of the longest authorities shutdown within the nation’s historical past with out sincere, credible, and earnest negotiation. All this as a result of a gift majority of our federal legislative department, together with a sparse variety of Senate Democrats and one impartial now breaking with their caucus, imagine denying People the suitable to be wholesome stays a instrument for political leverage.
— Miles Zaremski, Highland Park, Illinois
Shock Payments Whereas on Medicaid
I simply learn your article in regards to the household that had wages garnished to pay medical payments although they have been lined by Medicaid (“Employees’ Wages Siphoned To Pay Medical Payments, Regardless of Client Protections,” Oct. 2). I dwell in Chaffee County, Colorado. The native nonprofit hospital, the Coronary heart of the Rockies Regional Medical Middle, billed my household on 4 separate events (from mid-2021 by way of late 2023) whereas we have been on Medicaid. Outrageous!
Luckily, I knew that we weren’t speculated to be getting these payments. I known as the state Medicaid workplace each time, and it issued notices concerning unlawful billing actions. I’ve saved copies of all these letters. Only a fully ridiculous state of affairs, and I’m wondering what number of of my neighbors on Medicaid went forward and paid such unlawful payments.
— Melanie Jacobs, Salida, Colorado
A Menace Metastasized
How are you going to publish the article “‘Most cancers Doesn’t Care’: Citizen Lobbyists Unite To Push Previous Washington’s Ugly Politics” (Oct. 21) and never:
1) Deal with that President Donald Trump and the Republicans have lower funding for quite a few most cancers research-related initiatives within the identify of unfair DEI (range, fairness, and inclusion)?
2) Deal with that it’s Trump and the Republican Social gathering who received’t negotiate on well being care advantages?
3) Ask the Republicans (and Democrats) quoted on this piece what they give thought to the above? Did it not happen to you to ask Mary Catherine Johnson what she thinks of those insurance policies, given her personal most cancers?
KFF Well being Information appears unable to name out fascism for what it’s and maintain folks accountable for his or her votes. Is a straightforward “Who did you vote for and do you agree with these insurance policies?” an excessive amount of to ask?
Being scared to name out the Trump administration and its insurance policies is shameful.
— James Martinez, Tucson
The Lengthy Arm of KFF Well being Information
Your fabulous 2019 scoop on the key FDA database on medical system antagonistic occasions (“Hidden FDA Stories Element Hurt Attributable to Scores of Medical Gadgets,” March 7, 2019) made an ideal influence. It served as the premise for this follow-up, displaying how the info, as soon as public, vastly altered the trade. Huzzah!
— Jeff Bailey, Denver
The Balkanization of Well being Funding
Jim Mangia’s proposal to tax Los Angeles County residents for group well being middle funding is each strategically sensible and deeply troubling (“Well being Facilities Face Dangers as Authorities Funding Lapses,” Oct. 3). As a grasp of public well being pupil designing an analogous poll measure for Nevada, I’m turning into an skilled in what I can solely describe as managed abandonment.
My thesis examines the growth of federally certified well being facilities in Nevada, a state rating close to the underside in main care supplier entry. After federal grants have been frozen in January and with Medicaid dealing with large cuts, my tutorial venture turned a case examine in well being care feudalism: Entry to main care now is determined by your county’s wealth and political composition.
Right here’s the arithmetic that haunts me: Nevada has about 3.2 million residents throughout 17 counties. Clark County (with a inhabitants of two.3 million folks and encompassing Las Vegas) may doubtlessly go a well being tax producing $90 million-$100 million yearly. Eureka County has round 1,800 residents. You see the issue.
Mangia, who’s president and CEO of St. John’s Group Well being, is correct that federal and state governments are unreliable. A Clark County poll measure may hold FQHCs open and sufferers alive. That’s emergency triage. However let’s be clear about what we’re designing: 3,000 separate county well being care methods during which rich city areas present care and poor rural counties can’t.
I’m serving to design Nevada’s model anyway, as a result of folks want care as we speak. However I’m documenting what this represents: not innovation, however the devolution of a federal accountability to native governments least outfitted to deal with it equitably.
County well being taxes are thought of hurt discount for well being care entry, like offering naloxone whereas combating habit’s root causes. They’re mandatory. They’re inadequate. They usually’re harmful exactly as a result of they could work nicely sufficient in sufficient locations to let Congress off the hook.
My thesis will suggest multitiered advocacy: county poll measures the place possible, state emergency funding for rural areas that can’t tax themselves adequately, regional compacts for resource-sharing, and relentless federal stress for restoration of the Group Well being Middle Fund and for Medicaid growth.
However right here’s what retains me awake: Each hour I spend designing county poll measures normalizes the concept well being care funding is an area accountability. Each profitable native tax makes it simpler for Congress to justify reducing federal packages.
We’re educating the subsequent technology of public well being professionals to triage federal abandonment. We’re getting good at it. That’s what terrifies me.
Once we look again in 10 years at a well being care system balkanized by county, the place your entry is determined by native elections and poll measures, we have to keep in mind: This wasn’t innovation. This was what we did when the federal security web collapsed. And we knew it was unjust on the time.
— Pragya Thakur, Bartonsville, Pennsylvania
Paying as I Go
I learn with curiosity your article about hospitals arguing with insurance coverage firms over the outcomes of out-of-network standing (“Well being Care Helpline: So Your Insurance coverage Dropped Your Physician. Now What?” Oct. 29). One possibility you didn’t point out was self-pay.
I’m a retired monetary adviser who went again to graduate faculty at age 62. I’m in wonderful well being and see a physician just for my annual checkups. So I self-insure.
The fascinating factor is that self-pay prices are sometimes discounted by 90% or extra. I lately wanted a process that might have price $25,000 on the hospital vs. $2,500 at a specialist physician’s workplace.
— Paula Schoenhoff, Louisville
KFF Well being Information is a nationwide newsroom that produces in-depth journalism about well being points and is without doubt one of the core working packages at KFF—an impartial supply of well being coverage analysis, polling, and journalism. Study extra about KFF.
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