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.
Health Care as a Human Right
If there’s something to remove from my over half a century {of professional} expertise on the crossroads of legislation, medication, and well being care — together with my being dropped at Congress to advise lawmakers because the Affordable Care Act was being crafted in 2009-10 — it’s that Americans imagine well being care is a proper — and ought to be inexpensive — and never a privilege for less than these rich sufficient to pay for the suitable kind of protection. After all, with out the power to amass, keep, or regain our well being, none of us is way good to ourselves or our households, mates, family members, and communities, and definitely to not our employers. It is extra pricey for any of us to be sick than effectively.
The idea of well being care being a proper goes again many, many many years, and the ACA is the newest incarnation of that perception — regardless of ongoing political dangers. The newest gamble has been the practically six-week shutdown and solely the promise that the Senate will vote inside a month to handle the ACA’s enhanced subsidies (“Why Democrats Are Casting the Government Shutdown as a Health Care Showdown,” Oct. 6).
It is consequently not hyperbole to say that the ACA was supposed as, and nonetheless stays, an indeniable lifeline for tens of millions to attain well being. Of course, that objective is in jeopardy, or at a minimal an open query, because the subsidies will both be eradicated by yr’s finish if the promised vote on the Democrats’ Senate invoice fails in that chamber, or, if it passes, by no means turns into legislation. Regardless, notices to insureds of giant premium will increase with out the subsidies have began reaching mailboxes.
From my perch (and with out contemplating the brouhaha over additionally limiting Medicaid and reduces in Medicare supplier funding that grew to become legislation courtesy of this yr’s funds invoice), it’s incredulous and maddening to undergo via the longest authorities shutdown within the nation’s historical past with out sincere, credible, and earnest negotiation. All this as a result of a gift majority of our federal legislative department, together with a sparse variety of Senate Democrats and one unbiased now breaking with their caucus, imagine denying Americans the suitable to be wholesome stays a device for political leverage.
— Miles Zaremski, Highland Park, Illinois
Surprise Bills While on Medicaid
I simply learn your article concerning the household that had wages garnished to pay medical payments though they had been coated by Medicaid (“Workers’ Wages Siphoned To Pay Medical Bills, Despite Consumer Protections,” Oct. 2). I reside in Chaffee County, Colorado. The native nonprofit hospital, the Heart of the Rockies Regional Medical Center, billed my household on 4 separate events (from mid-2021 via late 2023) whereas we had been on Medicaid. Outrageous!
Fortunately, I knew that we weren’t imagined to be getting these payments. I referred to as the state Medicaid workplace each time, and it issued notices relating to unlawful billing actions. I’ve stored copies of all these letters. Just a very ridiculous scenario, and I’m wondering what number of of my neighbors on Medicaid went forward and paid such unlawful payments.
— Melanie Jacobs, Salida, Colorado
A Menace Metastasized
How are you able to publish the article “‘Cancer Doesn’t Care’: Citizen Lobbyists Unite To Push Past Washington’s Ugly Politics” (Oct. 21) and never:
1) Address that President Donald Trump and the Republicans have lower funding for quite a few most cancers research-related initiatives within the title of unfair DEI (range, fairness, and inclusion)?
2) Address that it’s Trump and the Republican Party who gained’t negotiate on well being care advantages?
3) Ask the Republicans (and Democrats) quoted on this piece what they consider the above? Did it not happen to you to ask Mary Catherine Johnson what she thinks of those insurance policies, given her personal most cancers?
KFF Health News appears unable to name out fascism for what it’s and maintain individuals accountable for his or her votes. Is a easy “Who did you vote for and do you agree with these policies?” an excessive amount of to ask?
Being scared to name out the Trump administration and its insurance policies is shameful.
— James Martinez, Tucson
The Long Arm of KFF Health News
Your fabulous 2019 scoop on the key FDA database on medical machine opposed occasions (“Hidden FDA Reports Detail Harm Caused by Scores of Medical Devices,” March 7, 2019) made an excellent influence. It served as the premise for this follow-up, displaying how the info, as soon as public, vastly altered the business. Huzzah!
— Jeff Bailey, Denver
The Balkanization of Health Funding
Jim Mangia’s proposal to tax Los Angeles County residents for neighborhood well being middle funding is each strategically good and deeply troubling (“Health Centers Face Risks as Government Funding Lapses,” Oct. 3). As a grasp of public well being scholar designing the same poll measure for Nevada, I’m turning into an knowledgeable in what I can solely describe as managed abandonment.
My thesis examines the growth of federally certified well being facilities in Nevada, a state rating close to the underside in main care supplier entry. After federal grants had been frozen in January and with Medicaid going through huge cuts, my tutorial undertaking grew to become a case research in well being care feudalism: Access to main care now is dependent upon your county’s wealth and political composition.
Here’s the arithmetic that haunts me: Nevada has about 3.2 million residents throughout 17 counties. Clark County (with a inhabitants of two.3 million individuals and encompassing Las Vegas) may probably cross a well being tax producing $90 million-$100 million yearly. Eureka County has round 1,800 residents. You see the issue.
Mangia, who’s president and CEO of St. John’s Community Health, is true that federal and state governments are unreliable. A Clark County poll measure may hold FQHCs open and sufferers alive. That’s emergency triage. But let’s be clear about what we’re designing: 3,000 separate county well being care techniques by which rich city areas present care and poor rural counties can’t.
I’m serving to design Nevada’s model anyway, as a result of individuals want care at the moment. But I’m documenting what this represents: not innovation, however the devolution of a federal accountability to native governments least outfitted to deal with it equitably.
County well being taxes are thought of hurt discount for well being care entry, like offering naloxone whereas preventing dependancy’s root causes. They’re vital. They’re inadequate. And they’re harmful exactly as a result of they may work effectively sufficient in sufficient locations to let Congress off the hook.
My thesis will suggest multitiered advocacy: county poll measures the place possible, state emergency funding for rural areas that can’t tax themselves adequately, regional compacts for resource-sharing, and relentless federal stress for restoration of the Community Health Center Fund and for Medicaid growth.
But right here’s what retains me awake: Every hour I spend designing county poll measures normalizes the concept well being care funding is a neighborhood accountability. Every profitable native tax makes it simpler for Congress to justify reducing federal packages.
We’re educating the following era of public well being professionals to triage federal abandonment. We’re getting good at it. That’s what terrifies me.
When we glance again in 10 years at a well being care system balkanized by county, the place your entry is dependent upon native elections and poll measures, we have to keep in mind: This wasn’t innovation. This was what we did when the federal security web collapsed. And we knew it was unjust on the time.
— Pragya Thakur, Bartonsville, Pennsylvania
Paying as I Go
I learn with curiosity your article about hospitals arguing with insurance coverage corporations over the outcomes of out-of-network standing (“Health Care Helpline: So Your Insurance Dropped Your Doctor. Now What?” Oct. 29). One choice you didn’t point out was self-pay.
I’m a retired monetary adviser who went again to graduate faculty at age 62. I’m in wonderful well being and see a health care provider just for my annual checkups. So I self-insure.
The fascinating factor is that self-pay prices are sometimes discounted by 90% or extra. I lately wanted a process that might have price $25,000 on the hospital vs. $2,500 at a specialist physician’s workplace.
— Paula Schoenhoff, Louisville
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