Letters to the Editor is a periodic characteristic. We welcome all feedback and can publish a variety. We edit for size and readability and require full names.
Sounding the Alarm for Ambulances
Thanks 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 companies throughout Colorado and the nation (“Insurers Combat State Legal guidelines Limiting Shock Ambulance Payments,” July 9). Whereas it’s very important to guard sufferers from “shock” payments — one thing your protection highlights — it’s equally vital to acknowledge the opposite aspect of the equation.
Ambulance suppliers usually obtain reimbursements properly beneath the precise value of delivering care. A latest trade report discovered that ambulance companies are beneath‑reimbursed by a mean 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 firms have a stronger voice on this dialog. Reimbursement charges aren’t simply numbers — they decide whether or not crews can keep on the street, keep readiness, and put money into very important cellular well being care companies. Emergency preparedness depends on steady funding, and when that funding falls quick, communities undergo.
By spotlighting the reimbursement disaster, this text helps lay the groundwork for coverage options. However let’s go a step additional: We have to elevate the voice of ambulance companies themselves, so lawmakers and insurers perceive that honest 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:
Households hit exhausting without warning ambulance bills-some see money owed soar even with insurance coverage. Extra states are performing, however a nationwide resolution 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 Taking part in Political Scorching Potato With My Well being’
I’m 60, self-employed, and residing with congestive coronary heart failure. My ejection fraction is dangerously low, and the Inexpensive Care Act is the explanation I can see a physician, take my treatment, and keep alive.
Now Congress is taking part in political scorching potato with my well being. In the event that they don’t prolong the ACA’s enhanced subsidies by August, my $30 premium might leap to over $800. That’s over 25 instances as a lot. I’m not a hedge fund supervisor — I’m an unbiased contractor. Until I begin promoting organs (not very best when your coronary heart’s the problem), 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 received’t pay attention, I’m asking you — the press — to assist. Inform this story, or one similar to it. Hundreds of thousands of People are quietly panicking, strolling the identical tightrope. These coverage modifications aren’t simply math — they’re about human lives.
As a result of if nothing modifications, lots of us received’t be round to jot down letters subsequent 12 months.
— Kevin Bahn, Tamarac, Florida
People Pay the Worth for a Sick Well being Care System
I’m positive your readers can be focused on how American well being care prices examine with these of the European Union and Switzerland (“Invoice of the Month: A Texas Boy Wanted Safety From Measles. The Vaccine Value $1,400,” June 30).
In France, the non-public worth for the MMR vaccine is round $13 (in U.S. {dollars}), offered you might have a prescription. Any pharmacy can administer the jab for about the identical.
Right here in Switzerland, the costliest nation in Europe, this vaccine prices beneath $40, as a personal buy.
I’ve moved 18 instances with household throughout Western and Japanese Europe and have had expat workers in 35 international locations on 4 continents.
It’s very clear to me now that the majority nationwide makes an attempt at well being care are a pricey failure, with few notable exceptions: Germany and, surprisingly, Spain. Then there’s Switzerland, which has among the many finest well being care techniques on this planet — near excellent. Fundamental protection phrases are federally mandated and value round $430 a month with a $2,500 annual deductible, regardless of age, after 26. And with a $300 yearly deductible, the premiums are about 40% increased.
One thing could be very off within the USA. It’s not that difficult.
— Clement Cohen, Geneva, Switzerland
A registered nurse shared his resolution for taming Medicaid fraud in a put up on X:
“They’ll provide you with a bone in case you keep within the mud.It’s comparatively simple to repair the profit cliff: simply section in a graduated premium for Medicaid based mostly on earnings above the edge. If we had political will to do that, it will prompted self-sufficiency.https://t.co/4fxSnmETRd
— Jacob Larsen 🇺🇸 🇩🇰 🇺🇦 (@SLCPaladin) July 22, 2025
— Jacob Larsen, St. George, Utah
Why ‘Begin From Scratch’ Vaccine Testing Can Be Harmful
I anticipate we’ll be listening to extra dialogue round the usage of “inert” placebos — like saline options — because the Advisory Committee on Immunization Practices and the Facilities for Illness Management and Prevention method new vaccine suggestions (“Kennedy’s Vaccine Advisers Sow Doubts as Scientists Protest US Pivot on Pictures,” June 27). Such a messaging appears poised to achieve traction with the general public, regardless of its moral implications.
More and more, I’m seeing criticism that vaccine growth doesn’t depend on inert placebos. This argument is usually used to advocate for brand spanking new scientific trials — even for vaccines already confirmed efficient — and to justify starting booster growth from scratch.
Whereas inert placebos might have been used and had been applicable in early levels of analysis for vaccines, their use turns into ethically problematic when a protected, efficient vaccine already exists. In such circumstances, withholding safety from members in a placebo group can put them at actual threat, particularly through the growth of up to date or booster doses of vaccines.
I consider it’s important that organizations like KFF Well being Information 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 Well being Information and admire the way in which your reporting attracts in readers with accessible, partaking headlines — and that your articles can be found for syndication to different shops.
Two key factors I discovered buried in an American Academy of Pediatrics article stood out:
- “Many childhood vaccines had been examined initially in randomized scientific trials that included placebo or comparability teams. If the vaccine is for a illness that presently has no vaccine, the placebo could also be saline or one other substance identified to be protected. If the vaccine is a possible alternative for an current, older vaccine, the comparator group might obtain the older vaccine that has already been examined somewhat than an inert placebo.”
- “When a protected, efficient vaccine already exists towards a illness, giving kids within the placebo group no safety towards that illness is unethical. Unvaccinated kids can contract harmful sicknesses. Mother and father of youngsters within the placebo group wouldn’t know they didn’t get the vaccine and that their baby is unprotected.”
That brings up one other vital query: Who would volunteer for a randomized, double-blind, managed trial involving an inert placebo for an current vaccine? Folks hesitant about vaccines are unlikely to take part, for worry they are going to obtain the vaccine. And those that assist vaccination could also be reluctant to threat receiving an inert placebo as a substitute of testing the present, older confirmed model towards a brand new proposed model.
— Alice Henneman, Lincoln, Nebraska
A virologist and podcaster chimed in on the June installment of our “Invoice of the Month” collection:
A put up doctoral fellow at UTMB couldn’t afford the college’s insurance coverage possibility for his household so he purchased a separate plan. It value him $1400 to get his baby the measles vaccine. Throughout an outbreak. Get your vaccines now, earlier than they aren’t coated. https://t.co/f3wWRouevA
— Heather McSharry, PhD (@PathogenScribe) July 1, 2025
— Heather McSharry, Austin, Texas
A Premium Shell Recreation?
I learn Michelle Andrews’ article right this moment, printed within the San Francisco Chronicle (“Have Job-Based mostly Well being Protection at 65? You Might Nonetheless Need To Signal Up for Medicare,” June 18). Thanks for reporting on this vital subject.
You describe as contributing elements: ignorance of the worker, the dearth of any requirement that Medicare notify the worker, and the failure of the dealer to inform.
Maybe I missed it, however I consider there’s an vital extra issue you didn’t point out: the revenue of the industrial insurance coverage service. In my expertise, people don’t discover that their major insurance coverage has modified to Medicare primarily as a result of their employer continues to be deducting the premium for his or her industrial group medical insurance.
Isn’t it fraud for the insurance coverage service to gather premiums for a coverage for which the subscriber is visibly not eligible by legislation?
There’s a monetary incentive for the industrial service to not inform the subscriber that their protection has ended, and they’re now eligible for a Medicare Benefit supplemental coverage (with a a lot decrease premium) in the event that they join Medicare: The industrial service can acquire excessive premiums, then decline to pay advantages.
You point out that Medicare representatives be aware they aren’t required to inform subscribers. Why? Coincidence? Extra doubtless, the industrial insurance coverage firms actively foyer towards notification.
Additionally, there’s a monetary incentive for hospitals to carry out procedures on sufferers who’re 65 or older and nonetheless on a industrial plan. Fairly positive the hospital billing workplace is aware of fairly properly they are going to ultimately be capable of invoice the affected person the retail payment, which is usually 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. Nevertheless 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 ageing inhabitants:
Normalized hashish use now will yield a giant public well being downside later and all the information factors in that course…👇🏼“As Hashish Customers Age, Well being Dangers Seem To Develop” https://t.co/xNrqqz1k1L by way of @kffhealthnews
— Brandon M. Macsata 🎗️ (@Purple_Strategy) June 9, 2025
— Brandon M. Macsata, New Haven, Connecticut
Getting Forward of Recognized and Unknown Threats
As highlighted in your article “‘MAHA Report’ Requires Combating Power Illness, however Trump and Kennedy Have Yanked Funding” (July 2), proposals to eradicate the Nationwide Heart for Power Illness Prevention and Well being Promotion don’t align with efforts to handle our nation’s persistent 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 Belief for America’s Well being estimates, $5.60 in downstream prices might be saved nationwide — and this determine is even increased in some states.
However simply as cuts to persistent well being analysis will hamper the federal authorities’s targets 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’ capability to cease outbreaks of measles, drug overdoses, or hepatitis, amongst many different preventable circumstances.
Investments in public well being have saved lives and strengthened our nation. Figuring out rising threats shortly — whether or not they come from infectious illnesses, zoonotic sicknesses, accidents, or accidents — is important to mitigating them. Sadly, federal cuts to very important public well being funding streams and packages make it more and more troublesome for our nation’s leaders to grasp the threats dealing with their communities and take advantage of knowledgeable selections attainable to assist their communities.
Throughout the nation, public well being departments are scaling again workers and delaying plans to undertake higher expertise as a result 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 substitute federal funding are at biggest threat.
With out continued funding in public well being infrastructure — from the federal authorities in addition to state, territorial, native, and tribal governments — the influence of future well being dangers will likely 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 really enhance public well being, our leaders at each stage of presidency needs to be doubling down on public well being techniques, each infrastructure and expertise, as the muse and path to maintain America wholesome.
— Eric Whitworth, CEO of InductiveHealth, Atlanta
The CEO of 4sight Well being had this recommendation, posted on X:
Do not 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 decide up the persistent illness prevention torch. https://t.co/SgWYe3KCtp
— David Johnson (@4sighthealth_) July 8, 2025
— David Johnson, Chicago
Preventive Bodily Remedy Can Spare You From Damage — And Rehab
Thanks for not too long ago highlighting the important want for high quality bodily remedy (“How To Discover the Proper Medical Rehab Providers,” July 15) and offering a complete information on navigating rehabilitation companies after hospitalization. It is usually vital to notice the preventive energy bodily remedy has earlier than an acute harm strikes.
Bodily and occupational remedy companies will not be only a type of post-accident care however are additionally proactive, non-pharmaceutical methods to protect power, steadiness, and independence — particularly for our ageing inhabitants. And analysis exhibits that when bodily remedy is the first line of remedy for sure circumstances like decrease again ache — somewhat than injections or surgical procedure — Medicare Half A/B prices drop by 19% in contrast with sufferers selecting injections first and by 75% in contrast with surgery-first circumstances.
Furthermore, bodily therapist-led fall prevention packages have been proven to cut back fall threat, whereas additionally chopping emergency room visits, hospitalizations, and opioid use amongst older adults. These numbers matter deeply in an ageing America the place 30 million older adults fall annually and the lifetime medical value of treating falls is over $100 billion yearly. And but, the Medicare system usually prioritizes put up‑harm remedy 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. A technique lawmakers might help is by supporting and passing the bipartisan Stopping Habit and Falls for the Aged, or SAFE, Act (H.R. 1171). This commonsense laws would enable Medicare beneficiaries to entry no-cost falls threat assessments from the autumn prevention specialists: bodily and occupational therapists.
Incorporating bodily remedy into major and preventive care has the potential to lower hospital visits, decrease well being care spending, and protect our seniors’ independence — targets all of us share. It’s time to shift the coverage highlight upstream. Bodily remedy has already proved it saves cash and improves lives.
— Nikesh Patel, govt director of the Alliance for Bodily Remedy High quality and Innovation (APTQI), Sugar Land, Texas