Letters to the Editor is a periodic function. We welcome all comments and can publish a range. We edit for size and readability and require full names.
Savings For All?
Your criticism about former Vice President Joe Biden’s “Medicare for All” price estimates is spot-on however leaves out necessary financial savings (“KHN & PolitiFact HealthCheck: Would ‘Medicare For All’ Cost More Than U.S. Budget? Biden Says So. Math Says No,” Feb. 14). Under Biden’s plan, personal insurance coverage stays intact, which means there are premiums and point-of-service prices that don’t seem as taxes however are added to the nation’s well being care expense. Medicare for All, alternatively, is zero on the level of service, which means Americans would don’t have any monetary qualms looking for complete care. Public choices add bureaucratic prices, are topic to non-public earnings fluctuations and have deductibles and copays. We rely on organizations like yours to current the total image. Here’s hoping you’ll, within the public’s curiosity.
― Dr. Donald Green, Pennington, New Jersey
I am for common healthcare, however not for leaping into it with out a transition plan. That’s why I like the general public choice as a approach to shift towards medicare for all.https://t.co/l0h8Ixs3J9
— ✌️ Maxwell (@manuelofreire) February 24, 2020
— Manuel Freire, Fort Lauderdale, Florida
For Alzheimer’s Patients Like Me, Knowing Is Half The Battle
I wish to thank Judith Graham for her piece discussing the uncertainty and concern sufferers really feel when confronted with the potential onset of Alzheimer’s illness or dementia (“Stalked By The Fear That Dementia Is Stalking You,” Feb. 21).
As an Alzheimer’s affected person with a confirmed analysis, I do know all too nicely how unsettling it may be to endure from cognitive decline with out figuring out the character of your situation. For me, it began with little issues like forgetting a reputation or misplacing a set of home keys. Still, it wasn’t till I utilized to take part in an Alzheimer’s medical trial and acquired a PET scan figuring out amyloid protein buildup in my mind did I definitively know I had the illness.
Like lots of the sufferers mentioned within the article, coping with these early warning indicators will be an unlimited supply of tension — particularly when it’s unclear whether or not or not the trigger is Alzheimer’s or one other cognitive situation. That’s why getting a exact analysis was such a vital step for myself and my husband, Jim.
As talked about within the article, amyloid PET scans aren’t absolutely coated by Medicare, a critically necessary element, which I consider have to be remedied. As the prevalence of Alzheimer’s continues to develop as our inhabitants ages, increasing entry to diagnostic instruments that may determine this illness will develop into ever extra vital. I stay optimistic that our representatives in Washington can come collectively and tackle this situation ― so extra sufferers like me don’t must dwell beneath a cloud of uncertainty.
— Geri Taylor, New York City
An Infusion Of Debt
Glad you might be pointing this out (“Patients Stuck With Bills After Insurers Don’t Pay As Promised,” Feb. 7). It’s taking place once more, post-Affordable Care Act. For us, it’s my husband’s battle with a number of sclerosis, however extra the battle together with his insurer. It accredited his therapy price for a brand new drug, despatched a letter saying all the pieces was coated. Then, lo and behold, we get a invoice for $four,000 that it stated we needed to pay. No purpose or rationale given. So now we’re on a cost plan with the hospital that gave him his infusion. Not certain why we even trouble with paying our premiums within the first place, contemplating the out-of-pocket expense and worthlessness of preapprovals; it doesn’t actually matter. Please preserve writing these articles ― it helps.
― Margaret Paez, Los Angeles
When Choice Of Hospitals Is A Life-Or-Death Choice
Thanks a lot in your protection of death-with-dignity conditions (“Terminally Ill, He Wanted Aid-In-Dying. His Catholic Hospital Said No,” Jan. 29). We all must know as a lot as doable concerning the establishments and buildings which will forestall sufferers from selecting a dignified dying. Please take into account linking to the Catholic ethics guidelines so readers can learn them for themselves. Please make us a map of Colorado displaying the hospitals which are abiding by these guidelines. Please clarify that emergency companies in rural areas could don’t have any selection however to take sufferers to the closest (presumably non-law-abiding) hospital. Rewired has written about Eastern hospitals the place critical being pregnant points have been poorly handled by Catholic hospitals.
Many of us don’t perceive that hospital selection could develop into a life selection and physician selection may develop into a life selection. And, please, additionally function commonly and loudly all of the practitioners and organizations being fashioned to guard sufferers’ authorized proper to die. Thanks a lot for the great work that you simply do.
― Diane Curlette, Boulder, Colorado
Taking Pains Over Statistics
In tales concerning the opioid disaster (“No Quick Fix: Missouri Finds Managing Pain Without Opioids Isn’t Fast Or Easy,” Feb. 13), I at all times see whole dying statistics however by no means a breakdown of how lots of the fatalities signify accountable authorized customers vs. unlawful customers.
Plenty of us aged of us have a really onerous time getting our ache meds these days. Thirty used to final me 5 to seven months, and I took them solely after I couldn’t get to sleep on account of ache all through my physique. We have mentioned it on our seniors’ webpage in our rural space and many people used to get them. Overdoses and habit aren’t the norm and aren’t even within the realm of our experiences. Why do now we have to pay for others’ errors? They don’t outlaw vehicles though many individuals die from wrecks attributable to dangerous drivers!
― William Scriven, Valley Springs, California
Such therapies are extra time-consuming and concerned than merely getting a prescription. A restricted variety of suppliers provide various therapy choices… And maybe the most important downside? These therapies don’t appear to work for everybody.https://t.co/rpRchsS42e
— Nicolas Terry (@nicolasterry) February 21, 2020
— Nicolas Terry, Indianapolis
Collateral Damage From Insurers’ Dispute
When I learn Brian Krans’ article concerning the Dignity-Cigna dispute (“Patients Caught In Crossfire Between Giant Hospital Chain, Large Insurer,” Feb. 6), I used to be reminded of my very own scenario: In California, Oscar dropped protection for all UCLA care services in its Covered California (Affordable Care Act) plans, as of this 12 months. I don’t know the way many individuals use Oscar, however the UCLA system is a serious well being care supplier right here in West L.A. There’s no indication that there’s a dispute — that is represented as a last determination. UCLA is gone!
I figured I may get comparable care from the Providence community, however my first selection for a major care doctor proved a bit odd: On our first go to, he introduced at the very least 4 concepts that appear exterior the medical mainstream. With some embarrassment, I requested for a unique PCP. That doctor ordered lab work however stated nobody within the constructing was licensed by Oscar to do blood attracts, so I used to be despatched to a facility in one other metropolis … which turned out to be out of enterprise. I used to be lastly referred to a 3rd facility, which turned out to be extra handy than the final ― however the inconvenient run-around for one thing so simple as a blood draw and the penny-pinching by my insurance coverage firm don’t bode nicely for the way forward for American medication.
This is the second disruption I’ve had in insurance coverage suppliers because the ACA started, and one other indication that our present well being care system remains to be very damaged.
— Gary Davis, Los Angeles
Health insurance coverage corporations run authorized Ponzi schemes. Profit is ALL that issues. These corporations bankrupt sick folks each single day. #MedicareForAll
Patients Caught In Crossfire Between Giant Hospital Chain, Large Insurer – Kaiser Health News https://t.co/h2fHhgkxOL
— Scott J Gordon (@colonel_gordon) February 9, 2020
— Scott Gordon, Fennimore, Wisconsin
Raising A Red Flag On Animal Rights Group
As a registered dietitian, I don’t promote the keto food plan. Mentioned within the article “As VA Tests Keto Diet To Help Diabetic Patients, Skeptics Raise Red Flags” (Feb. three) is the group Physicians for Responsible Medicine, which is an excessive animal rights group with ties to PETA. About three% of its members are physicians. Attending a seminar on diet for heart problems, I used to be dismayed to see the speaker had ties to Physicians for Responsible Medicine. After listening to about all of the horrible results of consuming animal merchandise, when the speaker may not comprise himself and shouted out, “You don’t eat dead animals, do you?” I walked out and referred to as my skilled affiliation to complain. Please don’t give credibility to this group.
― Mary Lucius, Beavercreek, Ohio
This sounds fairly fishy as to the connection. no touch upon the food plan facet. lobbying by former Rep on the Veterans’ affairs committee. As VA Tests Keto Diet To Help Diabetic Patients, Skeptics Raise Red Flags https://t.co/M2ZCzBdrLt through @khnews
— nancy coney (@nsconey) February 3, 2020
— Nancy Coney, South Bend, Indiana
Price-Gouging At Its Core
I learn your most up-to-date story on shock medical billing (“When Your Doctor Is Also A Lobbyist: Inside The War Over Surprise Medical Bills,” Feb. 12) and located it to be largely one-sided towards physicians and, considerably, hospitals. Although personal fairness definitely is an affect within the dialog, little or no to any time was spent discussing the efforts of insurance coverage corporations to repeatedly drive down reimbursements. Furthermore, after we have a look at Medicare charges, which insurance coverage corporations charges are based mostly on, the precise reimbursement has not considerably elevated over the previous few many years while you account for inflation or the patron worth index. So to color the image that physicians try to gouge sufferers doesn’t appear very reasonable. While there are at all times just a few dangerous apples and opportunists, the vast majority of physicians merely wish to be paid pretty. Remember: Over the previous few years, insurance coverage corporations have reported report income — billions per fiscal quarter. Why are we not speaking about why extra of our premiums aren’t going to the supply of well being care and as an alternative to shareholders? I feel the article fails to color your entire image for a lay viewers. Nowhere does it report the sum of money spent on lobbying by the insurance coverage trade.
― Dr. Shamie Das, Atlanta
Why are bicycle deaths rising? One critical purpose is the silly goonerment goonsquad rule that claims they have to observe car guidelines and journey on the RIGHT aspect of the highway. When I used to be younger we particularly rode on the LEFT so we may see threats… https://t.co/CZBrBLp6Mn
— Christian Anarchist (@Gene1Christian) January 31, 2020
— Gene Christian, Memphis, Tennessee
Health Care’s High-Cost Formula Goes Beyond Drug Prices
What sufferers care about greater than drug costs is how a lot they must pay out-of-pocket for his or her vital drugs (“Watch: Let’s Talk About Trump’s Health Care Policies,” Feb. four). Because of high-deductible well being plans and tiered formularies, what sufferers pay on the pharmacy counter usually has much less to do with the checklist worth of the medication they want and extra to do with the design of their well being advantages. It is particularly troubling that high-value medication for power circumstances like diabetes are sometimes topic to unaffordable price sharing that hits disproportionately initially of the profit 12 months. Employers and well being plans must exempt these medication from excessive deductibles as now permitted by the IRS. The similar goes for Medicare Part D, which massively penalizes severely in poor health sufferers firstly of every 12 months after they have but to achieve the catastrophic threshold.
Clearly, the issue of excessive drug costs must be addressed, however this may require a scientific and complete method that’s sure to be resisted by one vested curiosity or one other. In the meantime, sufferers want fast aid from unaffordable out-of-pocket prices. Some steps that ought to be taken instantly embody exempting high-value care from plan deductibles and capping and smoothing out-of-pocket prices in Medicare Part D. Much, if not all, of the price related to these measures will be offset by not paying for low- and no-value care that prices billions per 12 months.
― Daniel Klein, president & CEO of the Patient Access Network (PAN) Foundation, Washington, D.C.
Cause For Investigation
The instance you give presents an criminality by the house well being company (“Why Home Health Care Is Suddenly Harder To Come By For Medicare Patients,” Feb. three). At a minimal, that company ought to have a criticism registered towards them, if not investigated by the Office of the Inspector General. The company lied about Medicare not protecting the affected person’s wants. And they need to have had the affected person signal an ABN/NOMNC (Advance Beneficiary Notice/Notice of Medicare Non-Coverage) and defined it to the affected person as required, so he may select to attraction with the Quality Improvement Organization (QIO) for protection of medically obligatory care.
Kaiser Health News wants to supply schooling for the aged and households to verify they don’t fall prey to such a conduct. If the company merely says “I don’t have the staff to cover you,” they’re accountable to help the affected person find one other company. But they can’t elect to only cease offering a medically obligatory service, simply as they can’t preserve seeing somebody when it isn’t medically obligatory. Key right here is to get folks to know their rights as a Medicare beneficiary.
― Edward Dieringer, Salt Lake City
Q for @DNC & particular person candidates: PDGM is only one of quite a few regulatory treatments that drive modifications in plans of care every year for Medicare FFS. Why is it a good suggestion to reveal the nation to M4All when this can be a norm for this system? https://t.co/wbRP286XxY HT @judith_graham
— Tom Cassels (@Tom_Cassels) February 3, 2020
— Tom Cassels, Arlington, Virginia
Let’s not confuse modifications within the cost system with dangerous implementation selections by Home Health Agencies. I am glad that Judith Graham [no relation] ended her article with the message that Smart, High Quality Agencies proceed…https://t.co/xlM8Me3gox https://t.co/jhn0o9lOOi
— Peg Graham (@kbbtr) February 3, 2020
— Peg Graham, Washington, D.C.
Privacy Concern: I Lack Seamless Access To My Own Records
I work in a medical middle and have taken HIPAA coaching repeatedly through the years. I’ve additionally famous the staggering sum of money spent on medical digital information. Yet in 4 makes an attempt over a 20-year interval, I’ve but to get my medical information despatched from one physician or apply to a different. I couldn’t get information of my husband’s hospital keep despatched to his major doctor, dental information despatched from one dentist to a different and, this fall, the pertinent information when my rheumatologist modified practices. My insurance coverage paid for blood exams 4 occasions a 12 months and X-rays over a five-year interval. I’ve contacted the services and submitted a criticism to HHS Office for Civil Rights, which seems to be the proper workplace.
I discover it unacceptable that, with all of the speak about how costly medical care is, exams over time aren’t simply out there to sufferers when requested. I learn Kaiser Health News commonly and at the very least I really feel knowledgeable about what can go incorrect. Thank you.
— Susan Klimley, New York City
This. And insulting Medicare reimbursements working with advanced older adults; limitless medical pupil loans; sub par educational salaries; a damaged medical system. Beyond Burnout: Docs Decry ‘Moral Injury’ From Financial Pressures Of Health Care https://t.co/DB2u6z8pHj
— Sarah Nguyen, MD (@sarahanguyen) February 9, 2020
— Dr. Sarah Nguyen, Los Angeles