Letters to the Editor is a periodic characteristic. We welcome all comments and can publish a range. We edit for size and readability and require full names.
Sounding the Alarm for Ambulances
Thank you for shedding much-needed mild on the exorbitant prices and lack of reimbursement which have turn into a harsh actuality for a lot of ambulance providers throughout Colorado and the nation (“Insurers Fight State Laws Restricting Surprise Ambulance Bills,” July 9). While it’s important to guard sufferers from “surprise” payments — one thing your protection highlights — it’s equally necessary to acknowledge the opposite facet of the equation.
Ambulance suppliers usually obtain reimbursements effectively under the precise value of delivering care. A current industry report discovered that ambulance providers are underneath‑reimbursed by a median of $1,526 per transport, with Medicare alone paying practically $2,334 lower than the price incurred. These shortfalls are unsustainable and threaten the monetary viability of emergency responders.
It’s essential that ambulance corporations have a stronger voice on this dialog. Reimbursement charges aren’t simply numbers — they decide whether or not crews can keep on the highway, preserve readiness, and put money into important cell well being care providers. Emergency preparedness depends on secure funding, and when that funding falls brief, communities undergo.
By spotlighting the reimbursement disaster, this text helps lay the groundwork for coverage options. But let’s go a step additional: We must elevate the voice of ambulance companies themselves, so lawmakers and insurers perceive that truthful cost isn’t a bonus — it’s important to maintain us protected.
— Patrick Fahey, Weymouth, Massachusetts
A DevOps engineer shared the NPR model of the article on social media:
Families hit exhausting abruptly ambulance bills-some see money owed soar even with insurance coverage. More states are performing, however a nationwide answer could also be wanted for actual safety. https://t.co/Efb6me3Png pic.twitter.com/HRSW5mCdiu
— Michael Bennett (@M1keB_77) July 11, 2025
— Michael Bennett, Denver
‘Congress Is Playing Political Hot Potato With My Health’
I’m 60, self-employed, and dwelling with congestive coronary heart failure. My ejection fraction is dangerously low, and the Affordable Care Act is the explanation I can see a physician, take my medicine, and keep alive.
Now Congress is taking part in political sizzling potato with my well being. If they don’t prolong the ACA’s enhanced subsidies by August, my $30 premium may leap to over $800. That’s over 25 instances as a lot. I’m not a hedge fund supervisor — I’m an impartial contractor. Unless I begin promoting organs (not splendid when your coronary heart’s the difficulty), I can’t sustain.
I’m too younger for Medicare and haven’t any employer plan. I’ve labored, paid taxes, and managed my situation responsibly. So why am I being priced out of care?
If Congress gained’t pay attention, I’m asking you — the press — to assist. Tell this story, or one similar to it. Millions of Americans are quietly panicking, strolling the identical tightrope. These coverage adjustments aren’t simply math — they’re about human lives.
Because if nothing adjustments, a whole lot of us gained’t be round to put in writing letters subsequent yr.
— Kevin Bahn, Tamarac, Florida
Americans Pay the Price for a Sick Health Care System
I’m certain your readers could be considering how American well being care prices examine with these of the European Union and Switzerland (“Bill of the Month: A Texas Boy Needed Protection From Measles. The Vaccine Cost $1,400,” June 30).
In France, the non-public worth for the MMR vaccine is round $13 (in U.S. {dollars}), offered you will have a prescription. Any pharmacy can administer the jab for about the identical.
Here in Switzerland, the most costly nation in Europe, this vaccine prices underneath $40, as a non-public buy.
I’ve moved 18 instances with household throughout Western and Eastern Europe and have had expat workers in 35 nations on 4 continents.
It’s very clear to me now that the majority nationwide makes an attempt at well being care are a expensive failure, with few notable exceptions: Germany and, surprisingly, Spain. Then there’s Switzerland, which has among the many finest well being care methods on the planet — near excellent. Basic protection phrases are federally mandated and value round $430 a month with a $2,500 annual deductible, no matter age, after 26. And with a $300 yearly deductible, the premiums are about 40% increased.
Something could be very off within the USA. It’s not that sophisticated.
— Clement Cohen, Geneva, Switzerland
A registered nurse shared his answer for taming Medicaid fraud in a submit on X:
“They’ll offer you a bone when you keep within the mud.It’s comparatively simple to repair the profit cliff: simply part in a graduated premium for Medicaid based mostly on revenue above the edge. If we had political will to do that, it could prompted self-sufficiency.https://t.co/4fxSnmETRd
— Jacob Larsen 🇺🇸 🇩🇰 🇺🇦 (@SLCPaladin) July 22, 2025
— Jacob Larsen, St. George, Utah
Why ‘Start From Scratch’ Vaccine Testing Can Be Dangerous
I anticipate we’ll be listening to extra dialogue round using “inert” placebos — like saline options — because the Advisory Committee on Immunization Practices and the Centers for Disease Control and Prevention strategy new vaccine suggestions (“Kennedy’s Vaccine Advisers Sow Doubts as Scientists Protest US Pivot on Shots,” June 27). This sort of messaging appears poised to achieve traction with the general public, regardless of its moral implications.
Increasingly, I’m seeing criticism that vaccine improvement doesn’t depend on inert placebos. This argument is usually used to advocate for brand new medical trials — even for vaccines already confirmed efficient — and to justify starting booster improvement from scratch.
While inert placebos might have been used and had been acceptable in early phases of analysis for vaccines, their use turns into ethically problematic when a protected, efficient vaccine already exists. In such circumstances, withholding safety from individuals in a placebo group can put them at actual threat, particularly in the course of the improvement of up to date or booster doses of vaccines.
I consider it’s important that organizations like KFF Health News assist make clear this subject for the general public. KFF is a extremely revered, nonpartisan supply with highly effective communication attain. I’m a subscriber to KFF Health News and recognize the best way your reporting attracts in readers with accessible, partaking headlines — and that your articles can be found for syndication to different retailers.
Two key factors I discovered buried in an American Academy of Pediatrics article stood out:
“Many childhood vaccines were tested originally in randomized clinical trials that included placebo or comparison groups. If the vaccine is for a disease that currently has no vaccine, the placebo may be saline or another substance known to be safe. If the vaccine is a potential replacement for an existing, older vaccine, the comparator group may receive the older vaccine that has already been tested rather than an inert placebo.”
“When a safe, effective vaccine already exists against a disease, giving children in the placebo group no protection against that disease is unethical. Unvaccinated children can contract dangerous illnesses. Parents of children in the placebo group would not know they didn’t get the vaccine and that their child is unprotected.”
That brings up one other necessary query: Who would volunteer for a randomized, double-blind, managed trial involving an inert placebo for an current vaccine? People hesitant about vaccines are unlikely to take part, for worry they may obtain the vaccine. And those that help vaccination could also be reluctant to threat receiving an inert placebo as an alternative of testing the present, older confirmed model in opposition to a brand new proposed model.
— Alice Henneman, Lincoln, Nebraska
A virologist and podcaster chimed in on the June installment of our “Bill of the Month” collection:
A submit doctoral fellow at UTMB couldn’t afford the college’s insurance coverage choice for his household so he purchased a separate plan. It value him $1400 to get his youngster the measles vaccine. During an outbreak. Get your vaccines now, earlier than they don’t seem to be coated. https://t.co/f3wWRouevA
— Heather McSharry, PhD (@PathogenScribe) July 1, 2025
— Heather McSharry, Austin, Texas
A Premium Shell Game?
I learn Michelle Andrews’ article at present, revealed within the San Francisco Chronicle (“Have Job-Based Health Coverage at 65? You May Still Want To Sign Up for Medicare,” June 18). Thanks for reporting on this necessary subject.
You describe as contributing components: ignorance of the worker, the dearth of any requirement that Medicare notify the worker, and the failure of the dealer to inform.
Perhaps I missed it, however I consider there’s an necessary extra issue you didn’t point out: the revenue of the industrial insurance coverage provider. In my expertise, of us don’t discover that their main insurance coverage has modified to Medicare primarily as a result of their employer remains to be deducting the premium for his or her industrial group medical insurance.
Isn’t it fraud for the insurance coverage provider to gather premiums for a coverage for which the subscriber is visibly not eligible by legislation?
There’s a monetary incentive for the industrial provider to not inform the subscriber that their protection has ended, and they’re now eligible for a Medicare Advantage supplemental coverage (with a a lot decrease premium) in the event that they join Medicare: The industrial provider can gather excessive premiums, then decline to pay advantages.
You point out that Medicare representatives notice they don’t seem to be required to inform subscribers. Why? Coincidence? More possible, the industrial insurance coverage corporations actively foyer in opposition to notification.
Also, there’s a monetary incentive for hospitals to carry out procedures on sufferers who’re 65 or older and nonetheless on a industrial plan. Pretty certain the hospital billing workplace is aware of fairly effectively they may ultimately have the ability to invoice the affected person the retail payment, which is often 10 instances as a lot (or extra) than the Medicare-discounted payment.
In my expertise, this isn’t a physician subject, because the doctor hardly ever pays any consideration to insurance coverage particulars. But it’s very a lot a billing workplace subject.
— John S. Smolowe, Menlo Park, California
A reader in Connecticut tweeted his opinion on the dangers of hashish for an growing older inhabitants:
Normalized hashish use now will yield an enormous public well being downside later and all the info factors in that route…👇🏼“As Cannabis Users Age, Health Risks Appear To Grow” https://t.co/xNrqqz1k1L through @kffhealthnews
— Brandon M. Macsata 🎗️ (@Purple_Strategy) June 9, 2025
— Brandon M. Macsata, New Haven, Connecticut
Getting Ahead of Known and Unknown Threats
As highlighted in your article “‘MAHA Report’ Calls for Fighting Chronic Disease, but Trump and Kennedy Have Yanked Funding” (July 2), proposals to eradicate the National Center for Chronic Disease Prevention and Health Promotion don’t align with efforts to handle our nation’s continual illness disaster. These plans additionally additional underscore the significance of strengthening America’s public well being infrastructure not solely to avoid wasting lives, but in addition to make sure taxpayer {dollars} are used properly.
For every greenback invested in illness prevention, the Trust for America’s Health estimates, $5.60 in downstream prices will be saved nationwide — and this determine is even increased in some states.
But simply as cuts to continual well being analysis will hamper the federal authorities’s objectives of stopping diabetes, coronary heart illness, and weight problems, so too do cuts to broader public well being funding streams inhibit state and native well being departments’ capacity to cease outbreaks of measles, drug overdoses, or hepatitis, amongst many different preventable situations.
Investments in public well being have saved lives and strengthened our nation. Identifying rising threats shortly — whether or not they come from infectious illnesses, zoonotic diseases, accidents, or accidents — is important to mitigating them. Unfortunately, federal cuts to important public well being funding streams and packages make it more and more tough for our nation’s leaders to know the threats going through their communities and take advantage of knowledgeable selections doable to assist their communities.
Across the nation, public well being departments are scaling again workers and delaying plans to undertake higher expertise as a consequence of funding constraints; due to this fact, many departments lack the assets to detect and reply to threats in a well timed method. Rural and underserved communities which have fewer assets to maintain or change federal funding are at best threat.
Without continued funding in public well being infrastructure — from the federal authorities in addition to state, territorial, native, and tribal governments — the impression of future well being dangers will probably be multiples increased on each the nationwide well being care system and the assets (together with authorities funding) wanted to handle no matter could also be coming subsequent.
To actually enhance public well being, our leaders at each degree of presidency must be doubling down on public well being methods, each infrastructure and expertise, as the muse and path to maintain America wholesome.
— Eric Whitworth, CEO of InductiveHealth, Atlanta
The CEO of 4sight Health had this recommendation, posted on X:
Don’t take heed to what the regime says. Watch what it does. What this story calls “contradictions” and “inconsistencies” are lies and diversions from its anti-health agenda. The market should choose up the continual illness prevention torch. https://t.co/SgWYe3KCtp
— David Johnson (@4sighthealth_) July 8, 2025
— David Johnson, Chicago
Preventive Physical Therapy Can Spare You From Injury — And Rehab
Thank you for lately highlighting the important want for high quality bodily remedy (“How To Find the Right Medical Rehab Services,” July 15) and offering a complete information on navigating rehabilitation providers after hospitalization. It can be necessary to notice the preventive energy bodily remedy has earlier than an acute harm strikes.
Physical and occupational remedy providers will not be only a type of post-accident care however are additionally proactive, non-pharmaceutical methods to protect energy, stability, and independence — particularly for our growing older inhabitants. And analysis reveals that when bodily remedy is the first line of treatment for sure situations like decrease again ache — slightly than injections or surgical procedure — Medicare Part A/B prices drop by 19% in contrast with sufferers selecting injections first and by 75% in contrast with surgery-first circumstances.
Moreover, bodily therapist-led fall prevention programs have been proven to scale back fall threat, whereas additionally slicing emergency room visits, hospitalizations, and opioid use amongst older adults. These numbers matter deeply in an growing older America the place 30 million older adults fall annually and the lifetime medical value of treating falls is over $100 billion annually. And but, the Medicare system usually prioritizes submit‑harm therapy over preventive care, delaying entry to important bodily remedy till after harm happens.
In mild of our nation’s want for extra preventive care, it’s time for our Congress to allow simpler, earlier entry to bodily remedy. One method lawmakers might help is by supporting and passing the bipartisan Stopping Addiction and Falls for the Elderly, or SAFE, Act (H.R. 1171). This commonsense laws would permit Medicare beneficiaries to entry no-cost falls threat assessments from the autumn prevention specialists: bodily and occupational therapists.
Incorporating bodily remedy into main and preventive care has the potential to lower hospital visits, decrease well being care spending, and protect our seniors’ independence — objectives all of us share. It’s time to shift the coverage highlight upstream. Physical remedy has already proved it saves cash and improves lives.
— Nikesh Patel, govt director of the Alliance for Physical Therapy Quality and Innovation (APTQI), Sugar Land, Texas
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