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Letters to the Editor is a periodic function. We welcome all comments and can publish a variety. We edit for size and readability and require full names.
Many readers responded to our data-driven protection of how moral and non secular directives issued by the U.S. Convention of Catholic Bishops have an effect on care choices at Catholic and Catholic-affiliated hospitals in america. And we encourage different readers to share their feedback.
A communications specialist in Seattle said her opinion bluntly in an X submit.
“Increasingly more girls are working into limitations to acquiring care as Catholic well being techniques have aggressively acquired secular hospitals in a lot of the nation.”Faith is harming healthcare. https://t.co/O4L9mIzP5K
— JoAnne Dyer (@7Madronas) February 27, 2024
— JoAnne Dyer, Seattle
The Proper to Separation of Church and Care
At my most up-to-date OB-GYN appointment, I used to be warned that our largest hospital, Covenant Medical Heart, is affiliated with the Roman Catholic denomination, as is its string of major care and different clinics, Grace Clinics.
Making an attempt to regain some sense of management over my physique, I made a decision to create an advance well being directive to clarify I don’t wish to be taken to any medical facility related to that denomination, to keep away from my medical care being curtailed or impacted by moral and non secular directives, often called ERDs, issued by Roman Catholic bishops (“The Powerful Constraints on Medical Care in Catholic Hospitals Across America,” Feb. 17). To do that, I wished to know which amenities are so affiliated. It is vitally exhausting to search out that out.
First, I checked out Grace Clinic and Covenant Medical Heart web sites. No point out of affiliation with the church, or ERDs, or how ERDs restrict the sorts of medical therapies a affected person will likely be supplied (and even knowledgeable of the existence of).
Once I known as Grace Clinic, they denied affiliation with the Catholic Church. Once I known as Covenant Medical Heart, additionally they denied affiliation. They’re owned by Providence, which is Roman Catholic, although you need to do a deep dive into the web site to determine that out.
Both the workers are mendacity or are saved in ignorance so the sufferers will likely be saved in ignorance. How can a affected person decide whether or not a hospital will deny them care due to spiritual beliefs, if the group conceals its affiliation with mentioned beliefs?
These hospitals have the best to imagine no matter they need. It seems they presently even have the best to misinform sufferers about it. How can sufferers be told well being care customers if they will’t entry the knowledge they want, and are affirmatively given incorrect info from the organizations?
I’ve contacted Windfall via its web site asking whether it is affiliated with the Roman Catholic Church and, if that’s the case, the place I can discover a listing of sorts of sufferers that received’t be handled in accordance with American Medical Affiliation requirements, in addition to which therapies, procedures, and drugs won’t be offered or offered solely on a restricted foundation due to that affiliation.
I’ve heard nothing.
— Helen Liggett, Lubbock, Texas
An assistant professor on the Cincinnati Kids’s Hospital Medical Heart additionally weighed in on X:
Essential reporting from @KFFHealthNews on the impression of Catholic hospital care together with their ethics evaluate course of:https://t.co/0k2mJpPhY0
— Elizabeth Lanphier (@EthicsElizabeth) February 19, 2024
— Elizabeth Lanphier, Cincinnati
Life at All Prices Is Pricey
One side of IVF that’s not being mentioned is the discarding of embryos discovered to have critical medical defects (‘What the Well being?’: Alabama Court Rules Embryos Are Children. What Now? Feb. 22). For instance, a household could carry a devastating situation and want to display potential offspring, or defects could come up spontaneously. The Alabama Supreme Court docket’s choice means that these embryos, too, have to be implanted.
The courtroom’s choice additionally impacts infants born with extreme defects. How a lot assist have to be offered a child born with out components of the mind and cranium (anencephaly), which isn’t terribly unusual? Or one born with out kidneys? Or one with a most extreme type of brittle-bone illness (osteogenesis imperfecta), the place each contact can break bones? It sounds as if Alabama regulation now requires most assist in each occasion — for my part, this may be holier-than-thou sadism. How does the courtroom outline life? Merely a beating coronary heart? I can’t think about a nurse or physician not leaving/quitting when compelled to torture these infants. Then there’s the mother and father’ torment. That is godly?
— Gloria Kohut, Grand Rapids, Michigan
On X, an anesthetist and emergency drugs physician promoted the “What the Well being?” podcast episode that delved into the subject:
Try the newest episode of KFF Well being Information’ “What the Well being?” podcast, the place the Alabama Supreme Court docket’s ruling on embryo rights sparks a nationwide debate. Plus, potential abortion bans and Catholic hospital care. Pay attention at: https://t.co/4hrsEaWXVb#health, #healthpolicy, …
— David Moniz (@DrDavidMoniz) February 22, 2024
— David Moniz, Chilliwack, British Columbia
Distilling Statistics on Girls’s Consuming
Whereas the distilled spirits business is against extreme consumption by any phase of our society, it’s essential to notice that your current article on girls and alcohol failed to incorporate federal information displaying reductions in alcohol abuse amongst girls in america (“More Women Are Drinking Themselves Sick. The Biden Administration Is Concerned,” March 28). For instance, the latest Nationwide Survey on Drug Use and Well being information signifies binge-drinking amongst girls 21 and older declined greater than 6% up to now 5 years (from 2018 to 2022).
Moreover, claims within the article that the covid-19 pandemic “considerably exacerbated binge-drinking” aren’t supported by a number of federal information sources that point out that the pandemic didn’t produce lasting will increase in ingesting or dangerous ingesting.
As an illustration, a 2023 study utilizing federal information confirmed that, whereas gross sales did rise on the very starting of the pandemic, this didn’t essentially translate to elevated binge-drinking or total consumption within the months following. Somewhat, ingesting decreased — each days per thirty days ingesting and drinks per day — as did binge-drinking. Furthermore, the identical federal NSDUH information referenced above signifies almost 9 out of 10 U.S. adults 21 years and older (89%) say they drink the identical quantity or lower than they did pre-pandemic.
The article additionally cites an outdated World Burdens of Illness report revealed in 2018 to again up claims that “no quantity of alcohol is secure” whereas ignoring the updated GBD report revealed in 2022. Importantly, this most recent GBD research concluded there are ingesting ranges “at which the well being danger is equal to that of a non-drinker” and that “for people age 40+, ingesting small quantities of alcohol shouldn’t be dangerous to well being.”
Reporting on alcohol analysis supplies essential info for customers, so it’s crucial that such reporting appropriately displays the newest proof on alcohol and well being. We encourage all adults who select to drink — ladies and men — to drink sparsely, to comply with the recommendation of the Dietary Guidelines for Americans, and to speak to their well being care suppliers who may help decide what’s greatest for them based mostly on particular person elements and household historical past.
— Amanda Berger, vice chairman of science and well being, Distilled Spirits Council of america, Washington, D.C.
A lawyer who makes a speciality of preventing insurance coverage denials advisable our March “Invoice of the Month” function in an X submit:
All too typically insurance coverage suppliers declare medical therapy shouldn’t be medically crucial. This text explains a #Cigna denial. #healthinsurance #medicalnecessity https://t.co/rpMwsSOOup
— Scott Glovsky (@ScottGlovskyLaw) March 25, 2024
— Scott Glovsky, Pasadena, California
Working Inside a Damaged Well being Care System
Due to Molly Citadel Work for the superb article in regards to the England household’s struggles with our damaged well being care system (“A Mom’s $97,000 Question: How Was Her Baby’s Air-Ambulance Ride Not Medically Necessary?” March 25). One avenue of decision that was not famous in your wonderful article is the California Division of Managed Well being Care. I’m a doctor, and we had a special, but additionally very costly ($90,000), well being care invoice. It took two years and two appeals to that division, however, in the end, we had been reimbursed by our insurance coverage firm. This can be a useful resource that ought to be extra broadly recognized.
— Erica Buhrmann, Berkeley, California
An Unfair Burden on These Most in Want
It’s obscure why these most susceptible in society, who’ve problem buying medical health insurance, are required to pay extra for companies with the identical medical doctors and amenities than insurance coverage firms pay. Insurers profit from “negotiated pricing.” These with no insurance coverage are required to pay the complete “inflated” invoice for medical companies. Most occasions, the distinction between the quantity a physician or medical supplier payments, in contrast with the precise cost medical doctors obtain from insurance coverage firms, is roughly 20% of the quantity billed.
It’s patently unfair to require uninsured sufferers to pay greater than insurance coverage firms pay. Uninsured people have an unfair bargaining energy, in contrast with insurance coverage firms. A great instance is demonstrated in your article of the girl who acquired an uncovered emergency medical flight earlier than her demise, and her heirs had been left with an outrageous invoice of $81 (“Without Medicare Part B’s Shield, Patient’s Family Owes $81,000 for a Single Air-Ambulance Flight,” Feb. 27). If her household was instructed they had been accountable for $81,000 for the air ambulance, the transport wouldn’t have occurred.
The follow of holding uninsured individuals accountable for “whole” medical payments typically, in essence, causes somebody who doesn’t have protection — largely due to affordability — to complement the income of medical doctors and medical suppliers by being required to pay the total inflated quantity billed for medical companies.
Insurance coverage firms defend this follow of “negotiated pricing,” when, in essence, it’s used to power those that can least pay to complement losses suffered by the medical doctors for discounted funds from insurers.
There must be regulation that prohibits medical suppliers from price-gouging the uninsured, forcing them to complement medical doctors’ and suppliers’ revenue to make up for underpayments from insurers. Many occasions, uninsured people are already residing at or close to poverty ranges earlier than incurring surprising medical obligations. Being hit with a shock invoice for an air-ambulance journey costing $81,000 is enough to trigger the affected person to file for chapter. Within the U.S., the No. 1 cause folks file for chapter safety is due to medical payments.
Our present system of administering well being care and funds for such is damaged and must be mounted. As soon as this disparate system of funds is rectified, well being care ought to turn out to be way more accessible to most of the people.
— Ronald B. Kaplan, Holbrook, Massachusetts
On X, a public well being scholar shared our article in regards to the unwanted side effects of the anti-vaccine motion:
A TN regulation now means they foster mother and father, social staff & different caregivers can’t present permission for childhood vaccines — an important a part of well being care for teenagers. We have to take antivaxxers significantly as a result of they’re significantly harming public well being. https://t.co/6jX7ltNq4i
— jenn kauffman ✨ (@jennaudrey) March 12, 2024
— Jenn Kauffman, Washington, D.C.
Not Vaccinated? Get Education Elsewhere
I’m a father and a major care doctor. I simply learn Amy Maxmen’s article “How the Anti-Vaccine Movement Pits Parental Rights Against Public Health” (March 12) and commend her for her balanced and fact-based presentation.
I really feel that an essential side is lacking from such articles — that being the rights of nearly all of mother and father who assist vaccination to have their kids within the most secure potential surroundings in public faculties. We all know that no vaccine is ideal, and that our youngsters are nonetheless in danger for measles, covid, and different illnesses, regardless of benefiting from the confirmed advantages of vaccines.
I imagine that folks who train their rights to not have their kids vaccinated ought to be required to homeschool, or to ship their kids to non-public faculties having insurance policies with which they agree. I’m conscious that solely a tiny proportion of People would agree with me.
— John Cottle, Mendocino, California
Medical psychologist Carl Hindy appeared impressed by our article on a pricey new postpartum melancholy therapy:
[Instead of gender reveal parties, we can have Pharma baby showers 😢] A New $16,000 Postpartum Despair Drug Is Right here. How Will Insurers Deal with It? – KFF Well being Information https://t.co/1CVZEX7yf8
— Carl Hindy, Ph.D., HSP, Medical Psychologist (@DrCarlHindy) March 18, 2024
— Carl Hindy, Exeter, New Hampshire
Tending to New Moms’ Wants
It was heartbreaking to learn that non-public well being insurers have successfully delayed the provision of a revolutionary therapy for postpartum melancholy, a debilitating situation that makes it tough for brand new mother and father to care for his or her households, work, and even get off the bed (“A New $16,000 Postpartum Depression Drug Is Here. How Will Insurers Handle It?” March 12).
As one of many 1 in 5 new moms who struggled with this horrible sickness when my very own son was born, I can solely hope zuranolone is made broadly obtainable very quickly. As an advocate for the rights of pregnant staff, I hope that psychological well being care suppliers are conscious that there’s one other new and revolutionary software that’s at their disposal right this moment to assist sufferers scuffling with prenatal and postpartum psychological well being situations. A brand new federal regulation, the Pregnant Employees Equity Act, offers staff the best to obtain modifications at work wanted for pregnancy-related psychological well being situations. The Pregnant Employees Equity Act, which applies to employers with 15 or extra staff, requires they supply affordable lodging for being pregnant, childbirth, and associated medical situations, as long as it doesn’t impose an undue hardship. For instance, a brand new mom experiencing a perinatal psychological well being situation could also be eligible to obtain a modified schedule, day without work to attend psychological well being appointments, a extra non-public workspace, permission to make money working from home, or another “affordable lodging” that can deal with their wants. Psychological well being care suppliers ought to assist their sufferers by discussing their work-related challenges, serving to to determine office modifications, and writing efficient work notes to their sufferers’ employers.
Well being care suppliers and their sufferers can entry free assets from the College of California Legislation-San Francisco Heart for WorkLife Legislation on office lodging for perinatal psychological well being situations at pregnantatwork.org. Well being care suppliers or staff with questions can contact the Heart for WorkLife Legislation’s free and confidential authorized helpline at 415-703-8276 or hotline@worklifelaw.org.
— Juliana Franco, San Francisco
Worry of Needles Is Typically Unfounded
I learn your article “Needle Pain Is a Big Problem for Kids. One California Doctor Has a Plan” (March 20). I can inform you from expertise that the needle shouldn’t be the supply of the ache. After a bone marrow transplant from a donor, I needed to get all these childhood vaccines and people for adults 65 and older. The needle stick can barely be felt; it’s the remedy entering into that’s painful. The world you get the vaccine in is then sore for a number of days. That has been my expertise.
— Patsy Rowan, Los Angeles
Radiologist Ian Weissman chimed in on X about pain-reduction methods:
Researchers have helped develop a 5 step plan to assist forestall what they name “pointless ache” for youngsters getting injections or their blood drawnhttps://t.co/mCi8Tx6ILn
— Ian Weissman, DO (@DrIanWeissman) March 29, 2024
— Ian Weissman, Milwaukee
Knowledgeable on the Distinction Between Mis- and Disinformation
First, I’m grateful in your continued investigative reporting on covid-19.
Second, I’m writing to share a perspective that I belief you’ll be able to share with the author of “Four Years After Shelter-in-Place, Covid-19 Misinformation Persists” (April 1). My focus is on the time period “info” and its variants.
Particularly, I discover it useful to tell apart linguistically three variants:
- “Data” is info that one supplies to others that the informer believes to be correct.
- “Misinformation” is info that one supplies to others that the informer believed was correct, but was offered info that signifies the knowledge was lower than correct at some stage. As such the informer points an erratum and corrects the “mis” of the “mis-information.”
- “Disinformation” is info that one supplies to others with demonstrable information that this info shouldn’t be correct and shares with an intent to illicit thought and motion for ulterior motives — motives which can be typically nefarious and should end in hurt, akin to growing particular person and/or inhabitants morbidity and mortality.
I discover the conflation of “mis” and “dis” to be in and of itself dangerous to those that convey “mis” after which right in addition to giving those that use “dis” for less-than-honorable functions cowl, a secure haven, and a “get-out-of-jail card.”
For instance, it’s well-known that Fox Information internally adhered to info based mostly on scientific information and medical proof throughout the covid-19 pandemic state of emergency. Concurrently, it parlayed info externally that may solely be characterised as “dis.”
What I discover shocking is the very fact (I stand to be corrected ought to I be misinformed) that nobody has discovered not less than one particular person who acted upon Fox Information’ disinformation that resulted in morbidity and/or mortality — or wrongful demise litigation.
Sustain the nice work.
— Ed Shanshala, CEO of Ammonoosuc Neighborhood Well being Companies, Littleton, New Hampshire
A communications specialist exterior Chicago known as out disinformation in an X submit:
Disinformation is public well being enemy 1. Those that begin it and unfold it are poisonous for our society.
— Michelle Rathman 🟧 (the actual one) (@MRBImpact) April 1, 2024
— Michelle Rathman, Geneva, Illinois
States Ought to Not Spend Opioid Settlement Money on Unproven Tech
Aneri Pattani did a superb job reporting on the occasion in Cell, Alabama, on Jan. 24, the place the Poarch Band of Creek Indians introduced a examine for $500,000 from the tribe’s opioid settlement funds to the Helios Alliance (“Statistical Models vs. Front-Line Workers: Who Knows Best How to Spend Opioid Settlement Cash?” March 5).
Helios, which incorporates for-profit and nonprofit organizations, will use funds to construct a proprietary simulation mannequin to assist leaders resolve how you can spend settlement funds. In line with Helios, the preliminary system won’t be accomplished earlier than spring 2024.
As a digital product supervisor for the previous 20 years, I perceive the potential of expertise to enhance well being care, however settlement funds shouldn’t be financing early-stage, proprietary applied sciences developed by private-sector firms. Helios’ pitch is: “… spend 5% [of settlement funds] so that you get the largest impression with the opposite 95%,” says Rayford Etherton, who fashioned the alliance. However given the nationwide settlement is $50 billion over the following 18 years, 5% implies that $2.5 billion would go to a doubtlessly proprietary resolution.
Whereas the promise of a brand new expertise simulation mannequin is thrilling, it’s additionally high-risk. Furthermore, whereas revered consultants like Stephen Loyd are concerned with Helios, there aren’t skilled synthetic intelligence engineers, digital product consultants, information scientists, or safety consultants listed on the Helios web site.
Any expertise developed utilizing opioid settlement funds ought to be open-source and free to all states. Extra transparency from Helios is required to explain possession, person entry phrases, and licensing charges.
Settlement funds ought to be deployed to confirmed, evidence-based options. Given the opioid disaster has been raging for 20 years, well being care consultants have already got data-driven insights on how you can repair this: improve entry to medication-assisted therapy; scale back limitations to doctor licensing for buprenorphine, methadone, and naltrexone; improve schooling in faculties; improve social companies akin to employment and little one care; and improve funding to regulation enforcement to battle unlawful opioids (particularly, fentanyl).
Somewhat than placing giant settlement investments right into a not-yet-built simulation mannequin, states ought to use a human-centered design strategy based mostly on analysis from sufferers, suppliers, members of the family, and neighborhood teams which were battling the opioid disaster for many years to drive preliminary investments throughout the ecosystem of opioid disaster drivers. As soon as Helios has a working simulation product examined and in manufacturing, states can contemplate small investments to pilot utilization and see if the product really produces the specified outcomes.
The continued mantra of “public-private partnerships” is a good concept, however the public sector shouldn’t find yourself paying the invoice and taking over all the chance.
— Kelly O’Connor, Washington, D.C.
A professor in Weill Cornell Medication’s Division of Inhabitants Well being Sciences shared insights on X:
Fascinating article. On the one hand “Information doesn’t save lives. Numbers on a pc don’t save lives,” vs town has an obligation to make use of its settlement funds “in a means that’s going to do probably the most good…as an alternative of merely guessing.” https://t.co/w4QJ7zOkgM
— Bruce Schackman (@BruceSchackman) March 6, 2024
— Bruce Schackman, New York Metropolis
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