Letters to the Editor is a periodic characteristic. 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 spiritual directives issued by the U.S. Convention of Catholic Bishops have an effect on care choices at Catholic and Catholic-affiliated hospitals in the US. And we encourage different readers to share their feedback.
A communications specialist in Seattle acknowledged her opinion bluntly in an X put up.
“An increasing number of ladies are working into boundaries to acquiring care as Catholic well being methods 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 greatest hospital, Covenant Medical Heart, is affiliated with the Roman Catholic denomination, as is its string of main 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 spiritual directives, often known as ERDs, issued by Roman Catholic bishops (“The Powerful Constraints on Medical Care in Catholic Hospitals Across America,” Feb. 17). To do that, I needed to know which services are so affiliated. It is extremely laborious 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 varieties of medical remedies a affected person will probably be supplied (and even knowledgeable of the existence of).
After I referred to as Grace Clinic, they denied affiliation with the Catholic Church. After I referred to as Covenant Medical Heart, in addition they denied affiliation. They’re owned by Providence, which is Roman Catholic, although it’s a must to do a deep dive into the web site to determine that out.
Both the staff are mendacity or are saved in ignorance so the sufferers will probably 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 correct to consider no matter they need. It seems they presently even have the correct to deceive sufferers about it. How can sufferers learn well being care shoppers if they will’t entry the data they want, and are affirmatively given incorrect data from the organizations?
I’ve contacted Windfall by way of its web site asking whether it is affiliated with the Roman Catholic Church and, in that case, the place I can discover a checklist of varieties of sufferers that received’t be handled in accordance with American Medical Affiliation requirements, in addition to which remedies, 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 Youngsters’s Hospital Medical Heart additionally weighed in on X:
Essential reporting from @KFFHealthNews on the affect of Catholic hospital care together with their ethics overview course of:https://t.co/0k2mJpPhY0
— Elizabeth Lanphier (@EthicsElizabeth) February 19, 2024
— Elizabeth Lanphier, Cincinnati
Life at All Prices Is Expensive
One facet of IVF that’s not being mentioned is the discarding of embryos discovered to have severe 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 screen 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 help have to be offered a child born with out elements 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 legislation now requires most help in each occasion — in my view, this is able to 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 pressured 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, doable abortion bans and Catholic hospital care. Hear at: https://t.co/4hrsEaWXVb#health, #healthpolicy, …
— David Moniz (@DrDavidMoniz) February 22, 2024
— David Moniz, Chilliwack, British Columbia
Distilling Statistics on Ladies’s Consuming
Whereas the distilled spirits trade is against extreme consumption by any section of our society, it’s vital to notice that your latest article on ladies and alcohol failed to incorporate federal knowledge displaying reductions in alcohol abuse amongst ladies in the US (“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 knowledge signifies binge-drinking amongst ladies 21 and older declined greater than 6% previously 5 years (from 2018 to 2022).
Moreover, claims within the article that the covid-19 pandemic “considerably exacerbated binge-drinking” will not be supported by a number of federal knowledge sources that point out that the pandemic didn’t produce lasting will increase in consuming or dangerous consuming.
For example, a 2023 study utilizing federal knowledge confirmed that, whereas gross sales did rise on the very starting of the pandemic, this didn’t essentially translate to elevated binge-drinking or general consumption within the months following. Moderately, consuming decreased — each days per 30 days consuming and drinks per day — as did binge-drinking. Furthermore, the identical federal NSDUH knowledge 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 consuming ranges “at which the well being danger is equal to that of a non-drinker” and that “for people age 40+, consuming small quantities of alcohol just isn’t dangerous to well being.”
Reporting on alcohol analysis offers vital data for shoppers, 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 — men and women — to drink moderately, to comply with the recommendation of the Dietary Guidelines for Americans, and to speak to their well being care suppliers who can assist decide what’s finest for them based mostly on particular person components and household historical past.
— Amanda Berger, vp of science and well being, Distilled Spirits Council of the US, Washington, D.C.
A lawyer who makes a speciality of combating insurance coverage denials advisable our March “Invoice of the Month” characteristic in an X put up:
All too typically insurance coverage suppliers declare medical therapy just isn’t medically vital. 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 Fortress Work for the superb article concerning 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, finally, we had been reimbursed by our insurance coverage firm. This can be a useful resource that must be extra extensively recognized.
— Erica Buhrmann, Berkeley, California
An Unfair Burden on These Most in Want
It’s obscure why these most weak in society, who’ve issue buying medical health insurance, are required to pay extra for providers with the identical docs and services than insurance coverage firms pay. Insurers profit from “negotiated pricing.” These with no insurance coverage are required to pay all the “inflated” invoice for medical providers. Most occasions, the distinction between the quantity a physician or medical supplier payments, in contrast with the precise cost docs 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 very good instance is demonstrated in your article of the lady 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 advised they had been answerable for $81,000 for the air ambulance, the transport wouldn’t have occurred.
The follow of holding uninsured individuals answerable for “whole” medical payments typically, in essence, causes somebody who doesn’t have protection — principally due to affordability — to complement the income of docs and medical suppliers by being required to pay the total inflated quantity billed for medical providers.
Insurance coverage firms defend this follow of “negotiated pricing,” when, in essence, it’s used to drive those that can least pay to complement losses suffered by the docs for discounted funds from insurers.
There must be regulation that prohibits medical suppliers from price-gouging the uninsured, forcing them to complement docs’ and suppliers’ revenue to make up for underpayments from insurers. Many occasions, uninsured people are already dwelling 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 adequate to trigger the affected person to file for chapter. Within the U.S., the No. 1 motive individuals 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 fastened. As soon as this disparate system of funds is rectified, well being care ought to turn into much more accessible to most people.
— Ronald B. Kaplan, Holbrook, Massachusetts
On X, a public well being scholar shared our article concerning the unwanted side effects of the anti-vaccine motion:
A TN legislation 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 severely as a result of they’re severely 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 main 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 vital facet is lacking from such articles — that being the rights of nearly all of mother and father who help vaccination to have their kids within the most secure doable surroundings in public colleges. We all know that no vaccine is ideal, and that our kids are nonetheless in danger for measles, covid, and different illnesses, regardless of making the most of the confirmed advantages of vaccines.
I consider that oldsters who train their rights to not have their kids vaccinated must be required to homeschool, or to ship their kids to personal colleges having insurance policies with which they agree. I’m conscious that solely a tiny proportion of Individuals would agree with me.
— John Cottle, Mendocino, California
Medical psychologist Carl Hindy appeared impressed by our article on a pricey new postpartum despair 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 supply of a revolutionary therapy for postpartum despair, a debilitating situation that makes it tough for brand new mother and father to care for his or her households, work, and even get away from 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 extensively 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 instrument that’s at their disposal in the present day to help sufferers fighting prenatal and postpartum psychological well being situations. A brand new federal legislation, the Pregnant Staff Equity Act, offers staff the correct to obtain adjustments at work wanted for pregnancy-related psychological well being situations. The Pregnant Staff Equity Act, which applies to employers with 15 or extra workers, 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 personal workspace, permission to do business from home, or another “affordable lodging” that can tackle their wants. Psychological well being care suppliers ought to help their sufferers by discussing their work-related challenges, serving to to establish 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 Regulation-San Francisco Heart for WorkLife Regulation on office lodging for perinatal psychological well being situations at pregnantatwork.org. Well being care suppliers or workers with questions can contact the Heart for WorkLife Regulation’s free and confidential authorized helpline at 415-703-8276 or hotline@worklifelaw.org.
— Juliana Franco, San Francisco
Concern of Needles Is Generally 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 just isn’t 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 moving into that’s painful. The realm 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 stop what they name “useless 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 to 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 “data” and its variants.
Particularly, I discover it useful to tell apart linguistically three variants:
- “Data” is data that one offers to others that the informer believes to be correct.
- “Misinformation” is data that one offers to others that the informer believed was correct, but was offered data that signifies the data was lower than correct at some stage. As such the informer points an erratum and corrects the “mis” of the “mis-information.”
- “Disinformation” is data that one offers to others with demonstrable information that this data just isn’t correct and shares with an intent to illicit thought and motion for ulterior motives — motives which might be typically nefarious and will end in hurt, comparable to rising 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 data based mostly on scientific knowledge and medical proof throughout the covid-19 pandemic state of emergency. Concurrently, it parlayed data 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 at the very least one particular person who acted upon Fox Information’ disinformation that resulted in morbidity and/or mortality — or wrongful demise litigation.
Sustain the great work.
— Ed Shanshala, CEO of Ammonoosuc Neighborhood Well being Companies, Littleton, New Hampshire
A communications specialist exterior Chicago referred to as out disinformation in an X put up:
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 Cellular, Alabama, on Jan. 24, the place the Poarch Band of Creek Indians introduced a test 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 determine how you can spend settlement funds. In keeping 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 know-how 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 affect with the opposite 95%,” says Rayford Etherton, who fashioned the alliance. However given the nationwide settlement is $50 billion over the subsequent 18 years, 5% signifies that $2.5 billion would go to a probably proprietary answer.
Whereas the promise of a brand new know-how 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, knowledge scientists, or safety consultants listed on the Helios web site.
Any know-how developed utilizing opioid settlement funds must 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 must 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: enhance entry to medication-assisted therapy; scale back boundaries to doctor licensing for buprenorphine, methadone, and naltrexone; enhance training in colleges; improve social providers comparable to employment and youngster care; and enhance funding to legislation enforcement to battle unlawful opioids (particularly, fentanyl).
Moderately 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, relations, and group teams which have been 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 think about small investments to pilot utilization and see if the product really produces the specified outcomes.
The continuing mantra of “public-private partnerships” is a superb concept, however the public sector shouldn’t find yourself paying the invoice and taking up all the danger.
— Kelly O’Connor, Washington, D.C.
A professor in Weill Cornell Drugs’s Division of Inhabitants Well being Sciences shared insights on X:
Fascinating article. On the one hand “Knowledge 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 essentially the most good…as a substitute of merely guessing.” https://t.co/w4QJ7zOkgM
— Bruce Schackman (@BruceSchackman) March 6, 2024
— Bruce Schackman, New York Metropolis
