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.
Trump Team’s Rhetoric Doesn’t Match Actions
The current KFF Health News article “Beyond Ivy League, RFK Jr.’s NIH Slashed Science Funding Across States That Backed Trump” (April 17) struck a nerve. The fast succession of suspended National Institutes of Health grants that swept the nation shortly after President Donald Trump’s election have left us struggling to grasp why such important analysis — the bedrock of our potential to help the general public’s well being — can be handled as pointless or, worse, dangerous.
People typically suppose analysis, per se, doesn’t instantly have an effect on them. But analysis kinds the idea for what we all know will finest work to deal with, stop, and handle sickness, from power ailments similar to diabetes, hypertension, and HIV, to psychological well being issues. In addition to primary and utilized analysis, NIH grants present companies on to people and households, they usually construct community-based programs of take care of its residents. We all profit.
One space the place federally funded analysis and applications have been particularly impactful is in addressing the substance use disaster in America. With comparatively modest investments, habit science has led to huge private, societal, and financial advantages. Accomplishments embrace the remedies we use to interrupt the cycle of habit for tens of millions of individuals, methods for communities to help households with substance-related issues, prevention applications that divert youth away from substance use, and insurance policies that cut back crime, suicide, overdose, and substance-related situations like hepatitis and liver illness. Although we’re not accomplished but by any measure, these accomplishments have produced appreciable returns on funding in private and financial phrases that at the moment are in danger.
Out of a excessive degree of concern, a gaggle of profession scientists shaped the Addiction Science Defense Network to guard habit analysis and evidence-based follow from actions by this administration. The variety of researchers, practitioners, folks with lived expertise, and nationwide organizations expressing their help for ASDN’s mission is rising into the a whole lot. The Trump administration touts its dedication to decreasing habit, however its motion don’t match the rhetoric. By curbing analysis and funding for science-based options, we’re virtually assuring that the issue will proceed to worsen over time. And, as underscored in Rae Ellen Bichell and Rachana Pradhan’s article, provided that charges of drug overdose are highest in crimson states, predictions are that Trump supporters might undergo most of all.
— Diana Fishbein, Nova Institute for Health scholar, ASDN Coordinating Committee member, and University of North Carolina senior scientist, Chapel Hill, North Carolina
Staying Afloat Amid Federal Funding Cuts
Your article “Moms in Crisis, Jobs Lost: The Human Cost of Trump’s Addiction Funding Cuts” (April 25) talked about that the Niyyah Recovery Initiative could also be affected by shedding federal funding. But it has been offered a state grant not related to federal cash within the sum of $200,000 a 12 months via 2027. Presumptive hypothesis on how its companies can be affected ought to have been disclosed.
— John Smythe, Fort Lauderdale, Florida
[Editor’s note: A bill to provide Niyyah Recovery Initiative a one-time $200,000 appropriation was introduced in the Minnesota Legislature in April 2025. As of May 12, it had not received a hearing or vote, meaning the payment had not been made.]
Count the Blessings of Direct Primary Care
While I’m nearly at all times a fan of the work that KFF Health News and NPR publish, notably collectively, the article “In Rural Massachusetts, Patients and Physicians Weigh Trade-Offs of Concierge Medicine” (April 16) contained a mischaracterization that was fairly disappointing.
The creator suggests, and a photograph caption states, that “direct primary care is similar to concierge medicine but does not accept insurance.” While it’s true DPC sufferers and concierge sufferers each pay membership charges, they couldn’t be extra completely different. The membership price for concierge practices simply will get you within the door — sufferers nonetheless pay copays/coinsurance or, in some circumstances, full out-of-network value, for each service. With direct major care, your month-to-month price — sometimes (I’ll hedge, although I haven’t seen any exceptions) — consists of limitless visits, in-house procedures and assessments, and telemedicine appointments. Many even provide the power to text-message your physician whenever you want medical recommendation on a extra pressing foundation.
I’m not affiliated with the DPC business in any manner, I’m only a former affected person. DPC modified my life. I felt for the primary time as an grownup (I’m 33) as if I had precise, real well being care. Not worrying concerning the drudgery of fee-for-service meant I didn’t hesitate to get, say, examined for flu and covid-19 after I had a respiratory sickness, have pores and skin points checked out, or lastly get take care of long-standing points. The incontrovertible fact that I had a high-deductible well being plan solely not often mattered. For $100 a month, it was an absolute steal, and I used to be a cheerleader for everybody in my space who may afford it. At least just a few people who had been uninsured or severely underinsured obtained well being care due to that follow, which sadly is now not serving major care.
DPC has its thorns. Certainly, not everybody can afford a month-to-month price. Access may be restricted by capped affected person hundreds. But, on the entire, DPC is a blessing for many individuals, and it’s merely unfair to color it with the identical brush as concierge drugs. I hope to see higher from KFF Health News and its companions sooner or later.
— James Joyce, Opelika, Alabama
I obtained fed up with the sensation of being on a medical hamster wheel and switched to a concierge physician. I really feel like a affected person as an alternative of a reputation on a chart.
— Nailyard (@nailyard.bsky.social) 2025-04-16T16:34:19.766Z
— Ian Carter, Hillsboro, Oregon
Some Medical Debt Is Clearly Fraud
Be conscious that false unpaid medical payments are bought to assortment corporations in bulk together with authentic paid fees (“Diagnosis: Debt: Blockbuster Deal Will Wipe Out $30 Billion in Medical Debt. Even Backers Say It’s Not Enough,” April 7).
I went via most cancers therapy in 2023. I paid all my authentic fees after my Medicare Advantage plan paid. I paid often and on time. But I made positive I acquired my rationalization of advantages (EOB) from my insurance coverage firm earlier than I paid any further charges. Those EOB statements listing authorized fees and billing.
In February 2024, I acquired new statements from SSM Healthcare for the infusion middle, docs, and hospital. These statements had been for fees that had been a 12 months previous and listed as paid in full in 2023. The SSM system bought a few of that faux debt to a group company. I despatched that assortment firm proof of fee and the paid-in-full statements that had been nonetheless within the MyChart billing system.
Patients who undergo chemotherapy, surgical procedures, and coverings for extreme disabling situations typically even have cognitive deficits afterward. These cognitive issues could also be short-term, however they are often excessive. False medical billing and fraudulent fees are sometimes purposely utilized in these conditions to benefit from sufferers’ cognitive deficits. The medical programs make the most of the false debt rip-off to promote it to assortment corporations to make a revenue on primarily nonexistent debt. This system defrauds sufferers and the debt assortment business.
The aged and disabled sufferers find yourself paying the authentic debt and the fraudulent debt. The “unpaid” medical debt is bundled in such a manner as to be unimaginable to determine as fraudulent or authentic. Disadvantaged people aren’t able to managing the documentation to show their debt was paid, and the gathering corporations frighten and bully these people.
How a lot of the debt written off by Undue Medical Debt was authentic? No one will ever know. But there’s a a lot bigger problem than the easy perception that folks don’t pay medical payments. Organizational fraud is probably going answerable for a big proportion of the debt that corporations like Undue buy and make the most of for revenue.
— Diana Rickles, Ballwin, Missouri
Blockbuster Deal Will Wipe Out $30 Billion in Medical Debt. Even Backers Say It’s Not Enough. — sure, it is not sufficient, nevertheless it’s one thing https://t.co/0G06f8DoHh by way of @kffhealthnews
— Ellen Andrews (@cthealthnotes) April 7, 2025
— Ellen Andrews, Hamden, Connecticut
Don’t Hesitate To Sound the Alarm
I’m a daily watcher of “CBS Mornings” and at all times appreciated Dr. Céline Gounder’s experiences throughout the covid-19 pandemic. But I discovered her report March 28 on CBS a lot too meek within the face of a devastating effort on the a part of Robert F. Kennedy Jr. to slash the Department of Health and Human Services workforce by 25%.
This is catastrophic for illness prevention and future medical science — in addition to the flight of expertise from the U.S. to different international locations. Dr. Gounder talked about folks from Yale leaving for Toronto. But Dr. Gounder ought to have been extra assertive and sounded a larger alarm than simply saying the impression of those cuts “remains to be seen.” For heaven’s sake! These cuts are catastrophic — not just for America’s well being, however for the 20,000 proficient individuals who have been proven the door. Dr. Gounder: You must be extra assertive and alert Americans that it is a tragedy.
— Uldis Kruze, El Cerrito, California
Today in NIMBY Land: Neighbors at the moment are stopping hospitals in SIX completely different states from opening up psychiatric facilities for kids amidst a psychiatric mattress scarcity. Ugh. Great story from @EricLBerger @KFFHealthNews: pic.twitter.com/5XrHy2Zqjt
— Lawson Mansell (@lawsonhmansell) April 23, 2025
— Lawson Mansell, Washington, D.C.
We Must Prioritize Children’s Mental Health
As a involved member of our psychological well being help group, I write to focus on an pressing problem that too typically goes unnoticed: the psychological well being of our kids (“More Psych Hospital Beds Are Needed for Kids, but Neighbors Say Not Here,” April 11). With rising charges of hysteria, despair, suicide, and behavioral challenges amongst youth, it’s crucial that we take collective motion to prioritize psychological well-being simply as significantly as we do bodily well being.
Children right now face a novel set of stressors — from tutorial stress and social media to household instability and international uncertainty. These components can considerably have an effect on their emotional improvement and total well-being. Yet, regardless of the rising want, entry to certified psychological well being professionals, faculty counselors, and group help companies stays restricted or unaffordable for a lot of households. Not all hospitals are geared up for psychological well being circumstances, and the variety of psychiatric beds obtainable is usually little to none. A toddler in psychological well being disaster shouldn’t have to attend days or even weeks to seek out remedies. Parents shouldn’t have to observe their baby wrestle and never have their issues taken significantly. If a baby goes right into a hospital with a damaged bone, it’s instantly handled; the mother and father aren’t given numbers for locations to name in hopes that they are often seen in just a few days.
We should advocate for insurance policies that guarantee psychological well being screenings in colleges, develop funding for youth-focused companies, and promote coaching for educators to determine early indicators of misery. Hospitals and psychological well being services must be ready and geared up to soak up sufferers, not flip them away. Children ought to by no means be unable to obtain therapy due to an absence of a mattress. Our kids needs to be our precedence, not an afterthought of what a care facility will do to the neighborhood. No baby ought to undergo in silence as a consequence of an absence of sources or consciousness.
Investing in kids’s psychological well being isn’t just compassionate — it’s good. Healthy, supported kids usually tend to succeed academically and socially and, finally, turn out to be well-adjusted adults. Let’s be certain that each baby has entry to the assistance they want.
— Jennifer Groseclose, Leeton, Missouri
src=”//platform.twitter.com/widgets.js” charset=”utf-8″>
