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 chronic-pain affected person advocate, who has been featured beforehand in KFF Health News protection, spoke out on the social platform X about our “Payback: Tracking the Opioid Settlement Cash” challenge:
Oh, look a complete investigation, in fact partly by shatterproof, the place the settlement funds are going, and the place they need to go. Not one point out of ache sufferers as forgotten victims. Because we’ve truly been erased from the whole factor. https://t.co/LsHFs9tFwu
— Bev Schechtman🇮🇱 (@ibdgirl76) December 17, 2024
— Bev Schechtman, Clayton, North Carolina
Rooting Out the Root Cause of the Opioid Crisis
I learn with curiosity your detailed protection of how states are spending billions of funds from the opioid disaster (“Payback: Tracking Opioid Cash: How Are States Spending Opioid Settlement Cash? We Built a Database of Answers,” Dec. 16). The greater story is well being advocates and policymakers must march upstream if we’re to beat the “illness industry” gamers in illicit drug-making, distribution, and gross sales on our streets.
What shouldn’t be neglected by these fascinated about fixing this public well being disaster (legislators, well being division officers, and legislation enforcement and court docket system leaders) is that such downstream efforts, even when supported by unimaginable funding, does little to stop these pushing our residents into the quicksand of particular person, household, and group destruction and dying. Certainly, such mitigating and therapy applications and companies are wanted, however little consideration is given to rooting out the foundation explanation for the opioid/fentanyl epidemic.
It is simple and fashionable to rattling the company, but it surely takes braveness, actual work, and far danger to confront Mexico’s drug cartels, Mexico’s authorities officers, the Chinese Communist Party, and any of their ostensible “leaders.” Furthermore, it’s embarrassing to need to confront our personal public officers, from the president on down, to cease aiding and abetting this carnage!
If no critical motion is taken to work on upstream causes of our opioid disaster, no quantity of lifeguarding and posting of warning indicators will stop our bodies from struggling on this rip present of drug habit. The silence and omission of any motion from those that have taken the oath to defend and shield the general public is creating an ethical hazard for all residents. Consequently, many extra individuals will die, with nary a phrase in opposition to who’s pushing them to such destruction.
— Stephen Gambescia, Philadelphia
A retired assistant surgeon normal and epidemiologist weighed in on X about an article on the nation’s scarcity of major care suppliers:
Misdiagnosis. Young individuals selecting to not grow to be major care physicians after leaving med college won’t be mounted by free tuition for the highest paid occupation in America. Fix govt incentives about graduate medical training & reimbursementhttps://t.co/tPgeFVrzql
— Dr. Ali Khan (@DrAliSKhan) January 14, 2025
— Ali Khan, Omaha, Nebraska
Osteopaths Have Big Hand in Filling Primary Care Needs
I respect Felice J. Freyer’s insightful Jan. 13 article, “Can Medical Schools Funnel More Doctors Into the Primary Care Pipeline?” As an osteopathic doctor and medical educator, I can confidently reply this query with a powerful “Yes!” Osteopathic medical faculties have lengthy been on the forefront of this problem by emphasizing core rules of major care as they prepare future physicians, a mission embedded in our philosophy since 1874.
Osteopathic medication is based on 4 key tenets that emphasize the interconnected nature of the physique, thoughts, and spirit and the significance of whole-person care. These tenets have guided a lot of this nation’s nearly 150,000 DOs (medical doctors of osteopathic medication) into major care roles. More than half of DOs enter residencies within the major care specialties of household medication, inside medication, and pediatrics.
As talked about within the article, “Many medical students start out expressing interest in primary care. Then they end up at schools based in academic medical centers, where students become enthralled by complex cases in hospitals, while witnessing little primary care.” This is a significant a part of the issue. Most Americans, greater than 80%, won’t ever be handled in a big educational medical heart. Osteopathic medical faculties have flipped the script.
Osteopathic medical faculties, in addition to some newer MD-granting faculties, make use of a community-based distributed training mannequin, coaching college students in settings comparable to rural clinics, group well being facilities, and doctor places of work the place they are going to encounter underserved populations benefiting from major care therapy. Training in underserved areas makes medical college students virtually thrice as more likely to keep in these areas to apply, and 4 occasions as more likely to apply major care in these places.
I thank Freyer for shining a highlight on the important function of major care and the contributions of osteopathic medication. The osteopathic medical training group stays dedicated to working to make sure that underserved communities obtain the care they deserve, and that major care continues to thrive because the spine of our well being care system.
— Robert A. Cain, CEO and president of the American Association of Colleges of Osteopathic Medicine, Bethesda, Maryland
A household physician and trainer shared the article on X:
The reply is that they’ll, however they will not strive. Financial and public good incentives for faculties usually are not there. Can Medical Schools Funnel More Doctors Into the Primary Care Pipeline? https://t.co/REsfJtfmmh by way of @kffhealthnews
— John Frey (@jjfrey3MD) January 14, 2025
— John Frey, Grayslake, Illinois
On Immunity for Vaccine Makers
When discussing vaccination on the whole (“Childhood Vaccination Rates, a Rare Health Bright Spot in Struggling States, Are Slipping,” Jan. 16), please tackle the federal laws surrounding this subject.
According to 42 U.S. Code § 300aa–22, vaccine producers have immunity in civil court docket. It reads: “No vaccine manufacturer shall be liable in a civil action for damages arising from a vaccine-related injury or death associated with the administration of a vaccine after October 1, 1988, solely due to the manufacturer’s failure to provide direct warnings to the injured party (or the injured party’s legal representative) of the potential dangers resulting from the administration of the vaccine manufactured by the manufacturer.”
And there is just one federal National Vaccine Injury Compensation Program, often known as “vaccine court,” to listen to all vaccine-related harm instances involving youngsters. And its case backlog is no less than a decade lengthy.
In the whole lot else, when a services or products causes hurt, there may be accountability by the method of civil fits. What different producer of a product has such authorized immunity?
The problem with that is there is no such thing as a true measure to create accountability with vaccine merchandise. And vaccine makers aren’t required to show ingredient labels. So, we could also be injecting our kids with unknown substances, from a producer who has no judicial accountability if hurt outcomes from using the product.
Now, what father or mother desires to topic their baby to this? This is an enormous deterrent to oldsters vaccinating their youngsters. Emotional enchantment won’t dissuade mother and father, however correcting this authorized fallacy will.
— Alesia Wright, Tulsa, Oklahoma
An Indiana dad expressed his opinion on X:
Indiana’s childhood vaccination charges have dropped considerably because the pandemic too.Some individuals are simply going to need to be taught the onerous approach, apparently. Sad that the one approach that occurs, nevertheless, is by playing with their child’s well being.https://t.co/S9UgXAlAc6
— Steve Garbacz (@Steve_Garbacz) January 14, 2025
— Steve Garbacz, Fort Wayne, Indiana
As a retired major care doctor, I used to be typically pissed off that my administration of complicated medical situations was reimbursed at decrease charges resulting from a required therapy code (“Perspective: Removing a Splinter? Treating a Wart? If a Doctor Does It, It Can Be Billed as Surgery,” Dec. 13). Blaming the doctor for the discrepancy is inappropriate. The Centers for Medicare & Medicaid Services has strict laws on billing. We are mandated to code per the laws. We can’t give “discounts” for procedures. To accomplish that can be problematic within the weird catch-22 world of Medicare billing. We are mandated to report our companies precisely utilizing solely the codes out there. 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 or thief has extra rights within the judicial system.
Medicare determines the bottom reimbursement price; the opposite carriers pay a better price based mostly on that price. If a person doctor accepts Medicare, he/she should settle for that price. Only a non-participating doctor (not accepting Medicare) can supply a decrease price. The exception is that if the service is offered without charge. Should the affected person demand the service be offered free?
I’m reminded of the plumber charging $100 to switch a washer: 10 cents for the washer and $99.90 to know the right way to substitute it.
— Robert Sullivan, Adairsville, Georgia
On X, a New England surgeon summed up his views:
We have misplaced “caring” – “How Everything Became Surgery” from The Washington Post. Read on @Doximity https://t.co/msHja8wsg5
— Rafael Grossmann, MD, MSHS, FACS 🇻🇪🇺🇸 (@ZGJR) December 20, 2024
— Rafael Grossmann, Bangor, Maine
KFF Health News is a nationwide newsroom that produces in-depth journalism about well being points and is among the core working applications at KFF—an unbiased supply of well being coverage analysis, polling, and journalism. Learn extra about KFF.
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