Letters to the Editor is a periodic characteristic. We welcome all comments and can publish a variety. We edit for size and readability and require full names.
A Duty To Report On Surgery Centers
Your article concerning unreported dangerous outcomes from outpatient surgical procedure facilities (“Lax Oversight Leaves Surgery Center Regulators And Patients In The Dark,” Aug. 9) had been a priority of mine for a while. I’m a retired radiologist and have personally seen dangerous outcomes and puzzled if they’re a public security problem and go unreported. Accredited hospitals should preserve monitor of outcomes, however the outpatient surgical procedure facilities are variable. Good investigative journalism as yours gives a invaluable service to the general public and can save lives.
— James LaManna, Gillette, Wyo.
On Twitter, a backbone surgeon identified what he sees as holes within the story. Dr. Paul Kraemer, a specialist at North Meridian Surgery Center in Carmel, Ind., argued that the story was based mostly on the false assumption that hospitals have higher skilled workers than do surgical procedure facilities. Rather than arrange the dichotomy of surgical procedure middle vs. hospital, he advised KHN, the article ought to have differentiated between generalist and specialty facilities — that’s, these performing backbone procedures sometimes vs. every single day. At specialty facilities, the nurses within the restoration room can spot an issue — particularly an airway downside — and alert a surgeon or anesthetist to intervene, he mentioned. They see what’s regular and acknowledge early warning indicators of bother, whether or not the process is straightforward or advanced.
1. No point out of tens of millions who’ve had surgical procedure safely to supply perspective.
2. No point out that very same complication can occur in hospital (seen it)
three. No point out of conflicts inherent in hospital information selling and funding story
four. No point out of steps taken to forestall tragedy
— Paul Kraemer MD (@PK_Spine) August 1, 2018
— Dr. Paul Kraemer, Carmel, Ind.
Dr. Ronald Hirsch of Illinois advised KHN he has been attempting for a 12 months to get perception from the Centers for Medicare & Medicaid Services on its fast-track approval of more and more advanced procedures — whereas oversight lags.
And but, @CMSGov permits @Humana to authorize “Inpatient Only” surgical procedures to be executed at surgical procedure facilities on Medicare Advantage beneficiaries. Hip fracture restore? Open cholecystectomy? Carotid artery stenting? https://t.co/0BZ0JSDlwf
— Ronald Hirsch, MD (@signaturedoc) August 10, 2018
— Dr. Ronald Hirsch, Elgin, Ill.
Glenn Krauss of Vermont defined why he avoids surgical procedure facilities in any respect prices.
— Glenn Krauss, Burlington, Vt.
Filling A Gnawing Need On Campus
“Insuring Your Health” columnist Michelle Andrews did her homework on options for a rampant downside: meals insecurity amongst faculty college students (“For Many College Students, Hunger Can ‘Make It Hard To Focus In Class,” July 31). Readers similar to J.Ok. Devine of Gainesville, Ga., joined a refrain of these commending universities for coming to assistance from hungry students.
Enjoyed studying your story about faculty college students going hungry. The University of North Georgia is a kind of universities that has began meals pantries on three of its 5 campuses to assist college students, college and workers who want it.
— J.Ok. Devine (@JKDevine1) July 31, 2018
— J.Ok. Devine, Gainesville, Ga.
A Californian shared her firsthand expertise with starvation as a school freshman.
I bear in mind freshmen 12 months going to mattress hungry each evening, wishing I used to be dwelling so I may at the least have cereal. I did have a dinning corridor cross, however social anxiousness and peak dinner instances don’t combine.
— Korahline (@Krhddg) August 1, 2018
— Paola Viveros, Oxnard, Calif.
Doctors for America, a coalition of 18,000 physicians and medical college students whose aim is to enhance entry to well being care, additionally rallies to struggle starvation, particularly amongst medical college students who’re prone to being saddled with tuition debt.
While the US is the wealthiest nation, as much as a half of all faculty college students undergo from meals insecurity. We should not enable future medical college students to undergo from such a niche. All whereas the US is declining their contribution to scholar monetary help https://t.co/rHgWlrMpKm
— Doctors for America (@Drsforamerica) August 3, 2018
Zachary LeClaire of California has adopted the philosophy that he would quite go hungry than let his faculty payments add up. On Twitter, he mused: Are dad and mom doing sufficient to are likely to the monetary wants of their “dependents”?
One of the principle issues with that is many faculty college students are underneath the age of 24 and are thought-about “dependent students” no matter whether or not or not they’re dad and mom truly give them any cash. Also I might quite eat 1 meal a day than be in debt for the remainder of my life
— A ineffective thinker (@GenYDiogenes) July 31, 2018
— Zachary LeClaire, Huntington Beach, Calif.
Although vitamin wants are being addressed the place she lives in Washington state, Erin Davis appeared on the massive image.
Proud and grateful that my establishment has a meals financial institution for college students. Food insecurity amongst group faculty college students is a pervasive downside that additionally wants bigger, systemic options.
— Erin Davis (@FreckleErin) August 1, 2018
— Erin Davis, Spokane, Wash.
Second Thoughts On Single-Payer
In nearly 100 p.c of the discussions on well being protection plans, it’s assumed that suppliers will each exist and can work for regardless of the plan pays them (“Once Its Greatest Foes, Some Doctors Are Now Embracing Single-Payer,” Aug. 7). Most folks, once they hear “single-payer,” anticipate that every thing can be coated with minimal copay and deductible. They are unsuitable, however nobody will admit it upfront.
The alleged protection disaster — whereby medical insurance coverage was conflated with service availability, leading to Obamacare — was attributable to the federal government. Both Medicaid and Medicare well being advantages have been initially designed to supply primary well being providers whereas paying suppliers little greater than direct prices, permitting non-public pay and industrial insurance coverage funds to cowl overhead and revenue. Medicaid and Medicare weren’t anticipated to be a big share of any supplier’s follow. Over time, the good-hearted liberals saved increasing the scope of advantages with marginal enhancements in reimbursement calculations and definitely with out consideration of “unintended consequences,” particularly the predictable ones pertaining to demand and price.
Experience exhibits that A) any nationwide single-payer system can be run at the least in addition to the VA and the Indian Health Services and B) our Fearless Leaders will exempt themselves from the system.
— Ed Connelly, Shaftsbury, Vt.
On Twitter, Ryan Quattro of Michigan puzzled how an overhaul in well being care coverage would possibly play in opposition to the backdrop of precarious overseas, protection and different home insurance policies.
We must have a dialog on what single-payer means for US position on the earth.
End of position in NATO and severely diminished army means diminished affect in world. Then there may be the difficulty of infrastructure. $2.5 trillion. America is a sizzling mess.
— Ryan Quattro (@forzaquattro77) August 2, 2018
— Ryan Quattro, Ann Arbor, Mich.
A reader in Iowa warned that the flip aspect of single-payer means docs would earn far lower than they historically do, and that American innovation can be sacrificed.
Wait till these new physicians must pay again their scholar loans on single payer compensation…good luck…oh, say goodbye to innovation, too. #ShameOnce Its Greatest Foes, Doctors Are Embracing Single-Payer https://t.co/MSpDmvkv2k by way of @khnews
— Sean Yolish (@SeanYolish) August 8, 2018
— Sean Yolish, West Des Moines, Iowa
Power to the youthful technology, was the message from an Idaho tweeter.
The youngin’s are gonna change our nation for the higher. I consider that. Enough is sufficient.
— IndiraShanti (@IndiraShanti) August 2, 2018
— Tina Neidig, Boise, Idaho
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