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.
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 suggestions.
A communications specialist in Seattle acknowledged her opinion bluntly in an X publish.
“An increasing number of girls are working into limitations to acquiring care as Catholic well being programs 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.
Trying 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 need 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, generally known as ERDs, issued by Roman Catholic bishops (“The Highly effective Constraints on Medical Care in Catholic Hospitals Throughout 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 varieties of medical remedies a affected person will probably be provided (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 Windfall, which is Roman Catholic, although it’s a must 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 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 stated beliefs?
These hospitals have the best to consider no matter they need. It seems they at present even have the best to deceive sufferers about it. How can sufferers be told well being care customers if they’ll’t entry the data they want, and are affirmatively given incorrect data from the organizations?
I’ve contacted Windfall by means of 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 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 supplied or supplied 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:
Vital reporting from @KFFHealthNews on the affect of Catholic hospital care together with their ethics evaluation course of:https://t.co/0k2mJpPhY0
— Elizabeth Lanphier (@EthicsElizabeth) February 19, 2024
— Elizabeth Lanphier, Cincinnati
Life at All Prices Is Expensive
One side of IVF that’s not being mentioned is the discarding of embryos discovered to have severe medical defects (‘What the Well being?’: Alabama Courtroom Guidelines Embryos Are Youngsters. What Now? Feb. 22). For instance, a household might carry a devastating situation and want to display screen potential offspring, or defects might come up spontaneously. The Alabama Supreme Courtroom’s resolution means that these embryos, too, have to be implanted.
The court docket’s resolution additionally impacts infants born with extreme defects. How a lot help have to be supplied 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 — for my part, this could be holier-than-thou sadism. How does the court docket 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 dad and mom’ 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:
Take a look at the most recent episode of KFF Well being Information’ “What the Well being?” podcast, the place the Alabama Supreme Courtroom’s ruling on embryo rights sparks a nationwide debate. Plus, doable 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 trade is against extreme consumption by any phase of our society, it’s necessary to notice that your latest article on girls and alcohol failed to incorporate federal knowledge displaying reductions in alcohol abuse amongst girls in america (“Extra Girls Are Consuming Themselves Sick. The Biden Administration Is Involved,” March 28). For instance, the newest Nationwide Survey on Drug Use and Well being knowledge signifies binge-drinking amongst girls 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” should not supported by a number of federal knowledge sources that point out that the pandemic didn’t produce lasting will increase in ingesting or dangerous ingesting.
As an illustration, a 2023 examine 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. Relatively, ingesting decreased — each days per thirty days ingesting 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 printed in 2018 to again up claims that “no quantity of alcohol is protected” whereas ignoring the up to date GBD report printed in 2022. Importantly, this most up-to-date GBD analysis 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 isn’t dangerous to well being.”
Reporting on alcohol analysis offers necessary data for customers, so it’s crucial that such reporting accurately displays the most recent proof on alcohol and well being. We encourage all adults who select to drink — men and women — to drink moderately, to observe the recommendation of the Dietary Tips for Individuals, and to speak to their well being care suppliers who can assist decide what’s finest for them primarily based 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 focuses on preventing insurance coverage denials beneficial our March “Invoice of the Month” function in an X publish:
All too usually insurance coverage suppliers declare medical therapy isn’t medically obligatory. 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
Because of Molly Fort Work for the wonderful article concerning the England household’s struggles with our damaged well being care system (“A Mother’s $97,000 Query: How Was Her Child’s Air-Ambulance Journey Not Medically Obligatory?” March 25). One avenue of decision that was not famous in your glorious article is the California Division of Managed Well being Care. I’m a doctor, and we had a distinct, but in addition 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 needs to be extra broadly identified.
— Erica Buhrmann, Berkeley, California
An Unfair Burden on These Most in Want
It’s obscure why these most weak in society, who’ve problem buying medical health insurance, are required to pay extra for providers with the identical docs and amenities than insurance coverage firms pay. Insurers profit from “negotiated pricing.” These with no insurance coverage are required to pay the whole “inflated” invoice for medical providers. Most instances, 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 superb instance is demonstrated in your article of the girl who obtained an uncovered emergency medical flight earlier than her dying, and her heirs had been left with an outrageous invoice of $81 (“With out Medicare Half B’s Defend, Affected person’s Household 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 usually, 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 instances, uninsured people are already residing at or close to poverty ranges earlier than incurring sudden medical obligations. Being hit with a shock invoice for an air-ambulance trip costing $81,000 is adequate to trigger the affected person to file for chapter. Within the U.S., the No. 1 purpose 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 fastened. As soon as this disparate system of funds is rectified, well being care ought to develop into much more accessible to most of the 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 dad and mom, social staff & different caregivers can’t present permission for childhood vaccines — an important a part of well being care for youths. We have to take antivaxxers critically as a result of they’re critically 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 Motion Pits Parental Rights In opposition to Public Well being” (March 12) and commend her for her balanced and fact-based presentation.
I really feel that an necessary side is lacking from such articles — that being the rights of the vast majority of dad and mom who help vaccination to have their youngsters within the most secure doable atmosphere 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 consider that oldsters who train their rights to not have their youngsters vaccinated needs to be required to homeschool, or to ship their youngsters to non-public faculties 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
Scientific psychologist Carl Hindy appeared impressed by our article on a expensive new postpartum despair therapy:
[Instead of gender reveal parties, we can have Pharma baby showers 😢] A New $16,000 Postpartum Melancholy Drug Is Right here. How Will Insurers Deal with It? – KFF Well being Information https://t.co/1CVZEX7yf8
— Carl Hindy, Ph.D., HSP, Scientific Psychologist (@DrCarlHindy) March 18, 2024
— Carl Hindy, Exeter, New Hampshire
Tending to New Moms’ Wants
It was heartbreaking to learn that personal well being insurers have successfully delayed the provision of a revolutionary therapy for postpartum despair, a debilitating situation that makes it troublesome for brand new dad and mom to care for his or her households, work, and even get off the bed (“A New $16,000 Postpartum Melancholy Drug Is Right here. How Will Insurers Deal with 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 device that’s at their disposal in the present day to help sufferers combating prenatal and postpartum psychological well being situations. A brand new federal legislation, 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 off to attend psychological well being appointments, a extra personal workspace, permission to make money working from home, or every other “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 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
Concern of Needles Is Typically Unfounded
I learn your article “Needle Ache Is a Large Drawback for Children. One California Physician Has a Plan” (March 20). I can let you know from expertise that the needle 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 treatment getting 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 “unnecessary ache” for kids 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 possibly can share with the author of “4 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 differentiate linguistically three variants:
- “Info” 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 supplied data that signifies the data was lower than correct at some degree. 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 isn’t correct and shares with an intent to illicit thought and motion for ulterior motives — motives which can be usually nefarious and will lead to hurt, akin 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 appropriate in addition to giving those that use “dis” for less-than-honorable functions cowl, a protected haven, and a “get-out-of-jail card.”
For instance, it’s well-known that Fox Information internally adhered to data primarily based on scientific knowledge and medical proof through the covid-19 pandemic state of emergency. Concurrently, it parlayed data externally that may solely be characterised as “dis.”
What I discover stunning is the actual fact (I stand to be corrected ought to I be misinformed) that nobody has discovered no less than one particular person who acted upon Fox Information’ disinformation that resulted in morbidity and/or mortality — or wrongful dying litigation.
Sustain the great 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 publish:
Disinformation is public well being enemy 1. Those that begin it and unfold it are poisonous for our society.
— Michelle Rathman 🟧 (the true one) (@MRBImpact) April 1, 2024
— Michelle Rathman, Geneva, Illinois
States Ought to Not Spend Opioid Settlement Money on Unproven Tech
Aneri Pattani did a wonderful job reporting on the occasion in Cellular, Alabama, on Jan. 24, the place the Poarch Band of Creek Indians offered a examine for $500,000 from the tribe’s opioid settlement funds to the Helios Alliance (“Statistical Fashions vs. Entrance-Line Employees: Who Is aware of Greatest Learn how to Spend Opioid Settlement Money?” March 5).
Helios, which incorporates for-profit and nonprofit organizations, will use funds to construct a proprietary simulation mannequin to assist leaders determine tips on how to spend settlement funds. In response to 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 doubtlessly proprietary resolution.
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 needs 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 needs 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 tips on how to repair this: improve entry to medication-assisted therapy; cut back limitations to doctor licensing for buprenorphine, methadone, and naltrexone; improve training in faculties; improve social providers akin to employment and youngster care; and improve funding to legislation enforcement to battle unlawful opioids (particularly, fentanyl).
Relatively than placing massive settlement investments right into a not-yet-built simulation mannequin, states ought to use a human-centered design strategy primarily based on analysis from sufferers, suppliers, members of the family, and group 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 continuing 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 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 approach 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