Letters to the Editor is a periodic function. We welcome all feedback and can publish a range. We edit for size and readability and require full names.
Well being Care as a Human Proper
If there’s something to remove from my over half a century {of professional} expertise on the crossroads of regulation, drugs, and well being care — together with my being delivered to Congress to advise lawmakers because the Inexpensive Care Act was being crafted in 2009-10 — it’s that Individuals imagine well being care is a proper — and needs to be reasonably priced — and never a privilege for less than these rich sufficient to pay for the correct kind of protection. In spite of everything, with out the flexibility to accumulate, preserve, or regain our well being, none of us is far good to ourselves or our households, buddies, family members, and communities, and positively to not our employers. It’s 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 most recent gamble has been the almost six-week shutdown and solely the promise that the Senate will vote inside a month to deal with the ACA’s enhanced subsidies (“Why Democrats Are Casting the Authorities Shutdown as a Well being Care Showdown,” Oct. 6).
It’s consequently not hyperbole to say that the ACA was meant as, and nonetheless stays, an indeniable lifeline for hundreds of thousands to attain well being. In fact, that aim 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 regulation. 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 regulation courtesy of this yr’s finances invoice), it’s incredulous and maddening to endure 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 Individuals the correct to be wholesome stays a software for political leverage.
— Miles Zaremski, Highland Park, Illinois
Shock Payments Whereas on Medicaid
I simply learn your article in regards to the household that had wages garnished to pay medical payments regardless that they had been lined by Medicaid (“Staff’ Wages Siphoned To Pay Medical Payments, Regardless of Client Protections,” Oct. 2). I stay in Chaffee County, Colorado. The native nonprofit hospital, the Coronary heart of the Rockies Regional Medical Heart, billed my household on 4 separate events (from mid-2021 via late 2023) whereas we had been on Medicaid. Outrageous!
Thankfully, I knew that we weren’t speculated to be getting these payments. I known as the state Medicaid workplace each time, and it issued notices relating to unlawful billing actions. I’ve stored copies of all these letters. Only a fully ridiculous state of affairs, 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 will you publish the article “‘Most cancers Doesn’t Care’: Citizen Lobbyists Unite To Push Previous Washington’s Ugly Politics” (Oct. 21) and never:
1) Tackle 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) Tackle that it’s Trump and the Republican Get together who received’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 Well being Information appears unable to name out fascism for what it’s and maintain individuals accountable for his or her votes. Is an easy “Who did you vote for and do you agree with these insurance 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 Lengthy Arm of KFF Well being Information
Your fabulous 2019 scoop on the key FDA database on medical system antagonistic occasions (“Hidden FDA Stories Element Hurt Attributable to Scores of Medical Units,” March 7, 2019) made a fantastic affect. It served as the idea for this follow-up, exhibiting how the info, as soon as public, vastly altered the trade. Huzzah!
— Jeff Bailey, Denver
The Balkanization of Well being Funding
Jim Mangia’s proposal to tax Los Angeles County residents for group well being middle funding is each strategically good and deeply troubling (“Well being Facilities Face Dangers as Authorities Funding Lapses,” Oct. 3). As a grasp of public well being pupil 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 educational undertaking grew to become a case research in well being care feudalism: Entry to main care now relies on your county’s wealth and political composition.
Right 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 doubtlessly move 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 Neighborhood Well being, 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. However let’s be clear about what we’re designing: 3,000 separate county well being care programs by which rich city areas present care and poor rural counties can not.
I’m serving to design Nevada’s model anyway, as a result of individuals want care immediately. However I’m documenting what this represents: not innovation, however the devolution of a federal duty to native governments least geared up to deal with it equitably.
County well being taxes are thought-about hurt discount for well being care entry, like offering naloxone whereas preventing habit’s root causes. They’re mandatory. They’re inadequate. They usually’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 Neighborhood Well being Heart Fund and for Medicaid growth.
However right here’s what retains me awake: Each hour I spend designing county poll measures normalizes the concept that well being care funding is a neighborhood duty. Each 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.
After we look again in 10 years at a well being care system balkanized by county, the place your entry relies on native elections and poll measures, we have to keep in mind: This wasn’t innovation. This was what we did when the federal security internet 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 firms over the outcomes of out-of-network standing (“Well being Care Helpline: So Your Insurance coverage Dropped Your Physician. Now What?” Oct. 29). One possibility you didn’t point out was self-pay.
I’m a retired monetary adviser who went again to graduate college at age 62. I’m in glorious 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 just 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
KFF Well being Information is a nationwide newsroom that produces in-depth journalism about well being points and is likely one of the core working packages at KFF—an unbiased supply of well being coverage analysis, polling, and journalism. Study extra about KFF.
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