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Letters to the Editor is a periodic function. We welcome all feedback 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 USA. And we encourage different readers to share their suggestions.
A communications specialist in Seattle acknowledged her opinion bluntly in an X submit.
“Increasingly ladies are operating into obstacles 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 Middle, 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 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 spiritual directives, often called 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 extremely onerous to search out that out.
First, I checked out Grace Clinic and Covenant Medical Middle web sites. No point out of affiliation with the church, or ERDs, or how ERDs restrict the varieties of medical therapies a affected person can be provided (and even knowledgeable of the existence of).
After I known as Grace Clinic, they denied affiliation with the Catholic Church. After I known as Covenant Medical Middle, additionally they denied affiliation. They’re owned by Windfall, which is Roman Catholic, although it’s important 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 can 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 fitting to consider no matter they need. It seems they at the moment even have the fitting to deceive sufferers about it. How can sufferers learn well being care customers if they will’t entry the data they want, and are affirmatively given incorrect info from the organizations?
I’ve contacted Windfall by 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 therapies, procedures, and drugs is not going to 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 Middle additionally weighed in on X:
Vital 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 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 Court docket Guidelines Embryos Are Kids. What Now? Feb. 22). For instance, a household might carry a devastating situation and want to display potential offspring, or defects might come up spontaneously. The Alabama Supreme Court docket’s choice means that these embryos, too, have to be implanted.
The court docket’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 regulation now requires most help in each occasion — in my view, this is able to 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 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 medication 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#well being, #healthpolicy, …
— David Moniz (@DrDavidMoniz) February 22, 2024
— David Moniz, Chilliwack, British Columbia
Distilling Statistics on Ladies’s Ingesting
Whereas the distilled spirits business is against extreme consumption by any phase of our society, it’s necessary to notice that your latest article on ladies and alcohol failed to incorporate federal knowledge displaying reductions in alcohol abuse amongst ladies in the USA (“Extra Ladies Are Ingesting Themselves Sick. The Biden Administration Is Involved,” 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% up to now 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 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. Slightly, 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 International Burdens of Illness report revealed in 2018 to again up claims that “no quantity of alcohol is secure” whereas ignoring the up to date GBD report revealed in 2022. Importantly, this most up-to-date GBD analysis concluded there are consuming ranges “at which the well being threat is equal to that of a non-drinker” and that “for people age 40+, consuming small quantities of alcohol shouldn’t be dangerous to well being.”
Reporting on alcohol analysis supplies necessary info for customers, so it’s crucial that such reporting accurately displays the newest proof on alcohol and well being. We encourage all adults who select to drink — ladies and men — to drink carefully, to comply with the recommendation of the Dietary Tips for Individuals, 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 the USA, Washington, D.C.
A lawyer who focuses on combating 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 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 Fortress Work for the superb 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 Experience Not Medically Crucial?” 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 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 have been reimbursed by our insurance coverage firm. It is a useful resource that needs to be extra extensively identified.
— 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 providers with the identical docs and amenities than insurance coverage corporations pay. Insurers profit from “negotiated pricing.” These with no insurance coverage are required to pay all the “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 corporations, is roughly 20% of the quantity billed.
It’s patently unfair to require uninsured sufferers to pay greater than insurance coverage corporations pay. Uninsured people have an unfair bargaining energy, in contrast with insurance coverage corporations. instance is demonstrated in your article of the girl who acquired an uncovered emergency medical flight earlier than her loss of life, and her heirs have been left with an outrageous invoice of $81 (“With out Medicare Half B’s Protect, Affected person’s Household Owes $81,000 for a Single Air-Ambulance Flight,” Feb. 27). If her household was instructed they have been chargeable for $81,000 for the air ambulance, the transport wouldn’t have occurred.
The observe of holding uninsured individuals chargeable for “whole” medical payments typically, in essence, causes somebody who doesn’t have protection — largely due to affordability — to complement the income of docs and medical suppliers by being required to pay the complete inflated quantity billed for medical providers.
Insurance coverage corporations defend this observe of “negotiated pricing,” when, in essence, it’s used to pressure 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 dwelling 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 enough to trigger the affected person to file for chapter. Within the U.S., the No. 1 motive 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 grow to be way more accessible to most people.
— Ronald B. Kaplan, Holbrook, Massachusetts
On X, a public well being scholar shared our article concerning the unwanted effects of the anti-vaccine motion:
A TN regulation now means they foster mother and father, social employees & different caregivers can’t present permission for childhood vaccines — an important a part of well being care for youths. 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 main care doctor. I simply learn Amy Maxmen’s article “How the Anti-Vaccine Motion Pits Parental Rights Towards 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 mother and father 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 kids are nonetheless in danger for measles, covid, and different ailments, regardless of profiting 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 pricey 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 non-public well being insurers have successfully delayed the provision 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 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 extensively accessible very quickly. As an advocate for the rights of pregnant employees, I hope that psychological well being care suppliers are conscious that there’s one other new and revolutionary software that’s at their disposal immediately to help sufferers fighting prenatal and postpartum psychological well being circumstances. A brand new federal regulation, the Pregnant Staff Equity Act, provides employees the fitting to obtain adjustments at work wanted for pregnancy-related psychological well being circumstances. The Pregnant Staff Equity Act, which applies to employers with 15 or extra workers, requires they supply cheap lodging for being pregnant, childbirth, and associated medical circumstances, 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, break day to attend psychological well being appointments, a extra personal workspace, permission to work at home, or some other “cheap lodging” that can deal with 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 Middle for WorkLife Legislation on office lodging for perinatal psychological well being circumstances at pregnantatwork.org. Well being care suppliers or workers with questions can contact the Middle for WorkLife Legislation’s free and confidential authorized helpline at 415-703-8276 or [email protected].
— Juliana Franco, San Francisco
Concern of Needles Is Generally Unfounded
I learn your article “Needle Ache Is a Massive Downside for Youngsters. One California Physician Has a Plan” (March 20). I can let you know 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 treatment entering 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 “pointless 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 on 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 “4 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 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 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 will end in hurt, comparable 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 appropriate 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 knowledge and medical proof in the course of the covid-19 pandemic state of emergency. Concurrently, it parlayed info externally that may solely be characterised as “dis.”
What I discover stunning 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 loss of life litigation.
Sustain the great work.
— Ed Shanshala, CEO of Ammonoosuc Neighborhood Well being Providers, Littleton, New Hampshire
A communications specialist outdoors 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 offered a verify for $500,000 from the tribe’s opioid settlement funds to the Helios Alliance (“Statistical Fashions vs. Entrance-Line Staff: Who Is aware of Finest Find out 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 accordance with Helios, the preliminary system is not going to 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 corporations. Helios’ pitch is: “… spend 5% [of settlement funds] so that you get the most important impression with the opposite 95%,” says Rayford Etherton, who shaped the alliance. However given the nationwide settlement is $50 billion over the following 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 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: enhance entry to medication-assisted therapy; cut back obstacles to doctor licensing for buprenorphine, methadone, and naltrexone; enhance schooling in faculties; improve social providers comparable to employment and baby care; and enhance funding to regulation enforcement to struggle unlawful opioids (particularly, fentanyl).
Slightly than placing massive settlement investments right into a not-yet-built simulation mannequin, states ought to use a human-centered design method 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 think about small investments to pilot utilization and see if the product truly 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 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
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