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.
‘Solo Agers,’ Join the Crowd!
Enjoyed your panel dialogue (Watch: ‘Going It Alone’ — A Conversation About Growing Old in America, Dec. 12). I’m 85, retired at 55. Traveled (birding) in 65 international locations. In 2010, I created the First Friday Ideas Salon. We simply had our 171st gathering, by way of Zoom. I curate every gathering. Last month, we hosted a conservator and a scientist from the Getty Museum. The month earlier than: a Caltech professor on robotics. I’ve had many professors, a Nobel Prize winner, MacArthur Foundation “genius grant” recipients, a presidential candidate, and many others.
Recently, I got interested within the problem of how retirees whose professions outlined their persona can, after age 80, as a “senior senior,” proceed to be an individual of substantiality. I created the Glorious Age of Aging to have a look at this problem over six hourlong conferences over three months. The focus was on “action steps.”
So, for me, as a “solo ager,” the important thing has been to take motion. That mentioned, I fear in regards to the time when my physique doesn’t sustain with my thoughts. Actually, I’d say my physique has declined and my potential to handle issues required in my life. So, I’ve ready meals delivered. I rent individuals to assist with my beloved succulent backyard and with different chores — up to now, younger individuals in my neighborhood. I stay in Los Angeles with famously poor public transportation. I exploit Uber in addition to drive. So I ponder if I will proceed to search out companies that may help my residing alone. And the actual fear is the method of dying — not demise — I don’t worry about that. Recently, I’ve determined that I have to create an “intentional community,” which will likely be there after I want it. I’m simply starting to consider how to do that.
— Edna R.S. Alvarez, Los Angeles
A social companies company that has been delivering meals to homebound seniors in all 5 of New York City’s boroughs for 43 years weighed in on X:
“It’s exhausting to be on my own a lot of the time. It’s lonely.” It’s vital to understand how isolation increases the risk of health problems for older adults: https://t.co/uQDBysqmQW
— Citymeals on Wheels (@Citymeals) December 14, 2024
— Citymeals on Wheels, New York City
Keeping Pace With Solo Agers
As Judith Graham makes clear (“Going it Alone: Homebound Seniors Living Alone Often Slip Through Health System’s Cracks,” Dec. 2), extra Americans live on their very own as they age, counting on a patchwork of well being care companies to get by.
That’s why the Program of All-Inclusive Care for the Elderly (PACE) is so essential to this dialog. PACE helps older Americans — 91% of whom are 65 or older and have persistent well being circumstances — keep secure and wholesome in their very own houses.
The program affords at-home help with every day duties, like dressing, bathing, and consuming, and transportation to the PACE day heart, the place contributors can socialize and obtain medical care. Unlike different settings, the PACE program coordinates all elements of a participant’s care, from scheduling medical appointments to offering meals and dietary recommendation.
PACE physicians and nurse practitioners’ complete method to care advantages those that are homebound and should not in any other case have an in-home caregiver to depend on. PACE can also be a very promising choice for these with dementia, as this system permits older adults to obtain reminiscence care within the consolation and familiarity of their houses.
It’s additionally extra reasonably priced than many various care choices. States have reported that PACE prices taxpayers 13% less than the price of different Medicaid companies, all with out copays, deductibles, or out-of-pocket bills for contributors.
The program has been quietly remodeling our nation’s senior care system, but it surely stays underutilized. Only a fraction of older Americans are at the moment eligible for this system, however its advantages can lengthen far past this group. It’s essential for lawmakers to advance insurance policies that broaden entry to PACE companies in order that we will set extra older Americans up for achievement as they age at house.
— Jerry Wilborn, chief medical officer of One Senior Care, Erie, Pennsylvania
Gone But Not Forgotten
In February 2023, I got here throughout an article by Tony Leys about the closing of Iowa’s Glenwood Resource Center, which left me reflecting deeply on each the residents who nonetheless lived there and people who had handed away and at the moment are buried on the establishment. Among them is my great-grandmother, Margarita Hedlund. As I learn, I couldn’t assist however take into consideration the many individuals like her, who spent extra of their lives at Glenwood than they ever did with their households, and who now relaxation within the cemetery there.
Nearly two years later, I learn one other article by Mr. Leys expressing concern for the over 1,300 residents buried within the Glenwood Cemetery and who will take duty for sustaining their graves (“After Institutions for People With Disabilities Close, Graves Are at Risk of Being Forgotten,” Nov. 21). The considered my great-grandmother’s grave and the graves of so many others being uncared for is deeply troubling.
Margarita Petterson was born in Sweden in 1866. She got here to America as a younger little one and married Erik Hedlund, additionally from Sweden. They had 5 youngsters collectively, however Erik handed away in 1900, simply months earlier than their youngest little one was born. My great-grandmother lived together with her oldest daughter, however in 1912, for causes unknown to me, she was despatched to Glenwood. She remained there till her demise in 1949. Although I knew she had lived at Glenwood, I used to be by no means advised why, and after I reached out to the establishment for data, I acquired solely a quick document. It acknowledged she had a average mental incapacity (IQ between 35-49) and died of cirrhosis of the liver. The solely different element I realized was that her son had determined to have her buried within the cemetery there.
I can’t assist however really feel unhappiness and frustration that she was buried so removed from her husband, who handed away practically half a century earlier. There are probably many extra households with comparable tales — of family members deserted or forgotten in a spot like Glenwood, with little greater than a reputation and a grave marker to honor them.
Reading in regards to the destiny of Glenwood’s residents and the continued concern in regards to the cemetery upkeep solely deepens my need to know extra about my great-grandmother’s life and her time there. When it’s your personal member of the family, the necessity for solutions is private. I hope others who could also be in the identical state of affairs discover methods to study extra about their family’ lives at Glenwood and that we, as a neighborhood, keep in mind and care for many who had been forgotten too lengthy.
— Marlys Adkins, Clare, Iowa
Disability Scoop, a 16-year-old information web site that gives every day protection of autism, mental incapacity, cerebral palsy, Down syndrome and different points important to the developmental incapacity neighborhood, shared the article on LinkedIn.
ER Care Goes Beyond Doctors
This is a wonderful story to remind individuals to assume forward and make the most of pressing care amenities (“Bill of the Month: A Toddler Got a Nasal Swab Test but Left Before Seeing a Doctor. The Bill Was $445,” Nov. 27). But why is that this household’s invoice shocking? I discover it affordable. There was the all-important preliminary screening by educated personnel — a baby could also be extra sick than the mum or dad appreciates. The medical historical past was obtained, temperature and different vitals taken, and swabs for the famous assessments. That’s all effort and time that might have been spent on one other affected person. That’s presupposed to be free? Surely you’re not implying that ER workers aside from the docs are nugatory.
I keep in mind the ’50s, when our native hospital’s ER workers was “on call.” No cost then should you left earlier than you had been seen.
— Gloria Kohut, Grand Rapids, Michigan
An emergency doctor in Ontario chimed in on X:
A Toddler (in Canada) Got a Nasal Swab Test however Left Before Seeing a Doctor. The Bill Was $0. If the swab was optimistic they’d get a telephone name by a health care provider once more costing $0. https://t.co/NPaPUWASTq by way of @kffhealthnews pic.twitter.com/qkVuZZFFr0
— Raghu Venugopal MD (@raghu_venugopal) December 12, 2024
— Raghu Venugopal, Toronto
Watch Your Language
It is just too dangerous that an inflammatory article was written just like the one titled “How Measles, Whooping Cough, and Worse Could Roar Back on RFK Jr.’s Watch” (Dec. 6). “Could” is only a speculative phrase and could also be related to fear-mongering. Your bias appears clear. It’s troublesome to search out unbiased health-related articles these days. I request that you simply write an article regarding RFK Jr. that’s not biased — that’s not from Big Pharma’s viewpoint. You aren’t conscious that the Centers for Disease Control and Prevention, FDA, and different authorities businesses are industry-captured?
— Wayne Carpenter, Omak, Washington
An infectious illness specialist and senior scholar on the Johns Hopkins Center for Health Security had this to say on X:
“Vaccine development requires millions of dollars. Unless there is prospect of profit, commercial companies are not going to do it.” — why would firms even spend money on vaccines if there reward is demonization https://t.co/F6jAv5cdhe
— Amesh Adalja (@AmeshAA) December 9, 2024
— Amesh Adalja, Pittsburgh
Gathering Intel on Plant-Based Diets
I simply needed to say how a lot I appreciated your roundup of stories about prioritizing plant-based proteins (“Morning Briefing: Eat More Plant-Based Foods, According To Dietary Guidelines Advisory Panel,” Dec. 11). The concept that our meals decisions can come from a spot of moral consumption appears so faraway from a lot of the world at this time. So many individuals have questions and issues about changing into plant-based — is it wholesome? What will my family and friends assume? and many others. But what your publication clearly exhibits is it’s not about what leaving animal merchandise off one’s plate takes away however as an alternative how a lot attempting a plant-based meal offers to the people, the animals, and the atmosphere.
Thank you for uplifting change with out creating worry. Our future is determined by extra protection like this.
— Sara Crane, Toronto
A Slice of Real Life
I actually loved your article “Perspective: Removing a Splinter? Treating a Wart? If a Doctor Does It, It Can Be Billed as Surgery” (Dec. 13). The actual factor occurred to our household, and I believed we had been an anomaly. My daughter obtained a 1-centimeter minimize above her eye after falling off the bed. I took her to MUSC Children’s Health After Hours Care in Mount Pleasant, South Carolina (principally a health care provider’s workplace that’s open late). It’s not an ER or pressing care. When we arrived, the receptionist mentioned, “We don’t do stitches here.” I checked in my daughter anyway for the reason that receptionist mentioned the physician may be capable of apply glue to assist maintain the minimize closed. The physician cleaned the minimize with sterile saline, utilized glue, and positioned just a few Steri-Strips. We had been billed for “minor surgery” regardless of no scalpel, no stitches, no lidocaine. I regarded up the ICD-10 code, and certain sufficient “application of tissue adhesive” is a “minor surgery” code. Our out-of-pocket was round $830 with UnitedHealthcare. I nonetheless have all of the payments. “Liquid bandage” and Steri-Strips might be bought at Walgreens.
I’ve by no means emailed the author of an article, however this obtained me fired up! Thanks for bringing this to mild.
— Cailin Lutz, Charleston, South Carolina
Continuing the surgical thread on X was a professor of drugs and pharmacy on the University of Pittsburgh:
I’m glad that is being checked out: Removing a Splinter? Treating a Wart? If a Doctor Does It, It Can Be Billed as Surgery https://t.co/YVUR9B8BkO by way of @kffhealthnews
— Bernie Good (@CBGood23) December 13, 2024
— Bernie Good, Pittsburgh
As a retired main care doctor, I used to be typically annoyed that my administration of complicated medical circumstances was reimbursed at decrease charges than the illustrated splinter, or different “surgical treatments” as talked about in Elisabeth Rosenthal’s article. However, blaming the doctor for this discrepancy is inappropriate. The Centers for Medicare & Medicaid Services has strict laws on billing. We are mandated to code per the laws. We can not give “discounts” for these procedures. To accomplish that could be problematic within the weird catch-22 world of Medicare billing.
We are mandated to report our companies precisely utilizing solely the codes accessible. To do in any other case is taken into account fraud by Medicare. When a doctor is accused of fraud, he/she is presumed responsible and pays vital monetary penalties till innocence is confirmed. Even a assassin and thief have extra rights within the judicial system.
Medicare determines the bottom reimbursement charge; the opposite carriers pay the next charge based mostly on that charge. If a person doctor accepts Medicare, he/she should settle for that charge. Only a non-participating doctor (not accepting Medicare) can provide a decrease charge. The exception is that if the service is supplied for free of charge. Should the affected person demand the service be supplied free?
I’m reminded of the plumber charging $100 to interchange a washer: 10 cents for the washer and $99.90 to know how you can change it.
— Robert Sullivan, Adairsville, Georgia
No Free Pass for Drug Ads
After studying this text by Elisabeth Rosenthal, “Perspective: With TV Drug Ads, What You See Is Not Necessarily What You Get” (Sept. 9), I needed to share an opinion in regards to the federal courtroom’s determination to deem worth disclosure on pharmaceutical ads a violation of the First Amendment. Commercial promoting has much less safety beneath the First Amendment than particular person speech. According to the Central Hudson Test, business speech, at baseline, should concern a lawful exercise and never be false, misleading, or deceptive. Even if the speech meets all these standards, the federal government can intervene if there may be “substantial” authorities curiosity. If there may be additional regulation from the federal government on business promoting, it should be no extra in depth than essential to serve the federal government’s curiosity. Essentially, if there may be intervention, it should be warranted, and the regulation should be affordable when in comparison with the restriction (U.S. Constitution, Amendment 1.7.6.2).
In the case of pharmaceutical adverts, particularly people who promote oncology drugs, they don’t meet the baseline {qualifications} to be thought-about “not false, deceptive, or misleading.” It has been proven that pharmaceutical adverts can depend on emotional response over rational attraction (Main, et al., 2004). If the advert goes to focus on an emotional response of a weak inhabitants, then what’s being offered should be correct. If they will promote a chemotherapy that will not be the most suitable choice (however presumably have probably the most adversarial unwanted side effects), then there’s a authorities duty to guard this inhabitants and to be extra discerning when figuring out what’s truthful. Furthermore, even when the adverts met the essential {qualifications}, they may nonetheless be regulated additional as a result of authorities curiosity in each public well being and well being care price. Requiring that the drug price be proven on pharmaceutical adverts is acceptable federal intervention that I consider is greater than affordable when in comparison with the restriction.
— Molly Hilliard, New York City
A nationwide drug security advocate and public speaker tweeted on X:
Did you realize drug firms spend over $1B a month on drug adverts lately? Last 12 months, the highest 3 promoting spenders on TV had been drug firms.I’ve spent my whole profession in promoting and Big Pharma is protecting our {industry} afloat. https://t.co/0cTHTAOSAt
— Kim Witczak 💜 (@woodymatters) September 9, 2024
— Kim Witczak, Minneapolis
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