Letters to the Editor is a periodic characteristic. We welcome all feedback and can publish a range. We edit for size and readability and require full names.
Lawmakers Should Shield Residence Well being To Alleviate Hospital Bottlenecks
The stark actuality that numerous seniors lie stranded in emergency rooms throughout the nation ready for care underscores the necessity for fashions of care that higher assist older Individuals (“Stranded within the ER, Seniors Await Hospital Care and Endure Avoidable Hurt,” Might 6). As KFF Well being Information experiences, even when sufferers have to be admitted, at occasions, there are merely no rooms accessible.
As famous within the article, the backlog of sufferers ready to be discharged to house well being care has partly contributed to this downside in ERs. Medicare’s house well being care program allows complicated, disabled, and older sufferers to obtain care and rehabilitation in their very own properties after their hospitalization. Not solely is that this the popular web site of care by sufferers and their households, but it surely additionally helps open wanted hospital beds and lessens the burden on emergency rooms and hospital workers.
Sadly, years of Medicare cuts are making it tougher for house well being suppliers to satisfy rising demand and supply important care. The Facilities for Medicare & Medicaid Providers has repeatedly reduce the Medicare house well being program, and extra cuts are anticipated in future years, already totaling $19 billion in cuts by 2029. Regardless of Medicare’s personal information displaying that house well being saves taxpayers cash, the cuts proceed forcing house well being suppliers to cut back the companies they will present, making it harder to recruit and retain workers, which in the end harms affected person entry.
To guard house well being and liberate capability in hospitals, Congress should move the Preserving Entry to Residence Well being Act (S 2137/HR 5159), which might stop Medicare from implementing steep fee cuts to the Medicare Residence Well being Program in 2025 and past.
No affected person ought to have to attend hours in an ER hallway whereas sick or injured. By stopping these cuts to the Medicare house well being program, Congress may give sufferers entry to high-quality care whereas additionally assuaging the burden on hospitals in disaster.
— Joanne Cunningham, CEO of the Partnership for High quality Residence Healthcare, Washington, D.C.
Your current article on seniors stranded within the ER was an fascinating learn. Nonetheless, as a doctor, I need to level out that you just uncared for an vital challenge. So many individuals use the emergency rooms as main care services, with nonemergency visits: continual points akin to complications, earaches, coughs, and fatigue which were happening for weeks and months. Sadly, due to a lack of awareness of the place to go for therapy, or lack of insurance coverage, ERs should see these sufferers, which completely clogs up the ER. If you wish to attempt to make a change, tackle these points.
— Ira Shivitz, Nashville, Tennessee
On the social platform X, a reader weighed in on an article from KFF Well being Information-CBS Information’ “When Medical Gadgets Malfunction” investigative collection, which targeted on a controversial dental equipment:
WHY can we fund the #fda???https://t.co/CMQAaDZUqy
— Me2 (@BCREIGNS) Might 14, 2024
— Monica Raybon, Cellular, Alabama
Dropping Rights in Oklahoma?
Home Invoice 3013 in Oklahoma would criminalize abortion-inducing medication, which might punish an individual who’s intently trafficking these substances (“Anti-Abortion Exhausting-Liners Communicate Up,” Might 23). An individual may get a wonderful of as much as $100,000 or imprisonment for as much as 10 years. Remedy that’s prescribed for different makes use of however could cause an abortion wouldn’t be thought-about an abortion-inducing drug. Plan B will not be restricted in HB 3013, and there’s no indication that the use or sale might be prohibited.
Abortion has been made unlawful in lots of states, together with Oklahoma. Since abortion is against the law, many ladies now look towards abortion capsules. Ladies have undesirable pregnancies that may be attributable to Plan B contraceptives not working or because of a sexual assault. Because of this, ladies search abortion capsules since they can’t have an expert carry out an abortion process.
The abortion tablet has an 87%-98% effectiveness, whereas the abortion process is 98%-99% efficient. The abortion tablet can have negative effects akin to blood clots within the uterus, extreme bleeding, and elevated infertility. Despite the fact that a medicine abortion has these results, ladies nonetheless resolve to endure it as a result of lots of them would not have entry to an expert abortion process.
Taking away the one useful resource ladies have entry to in Oklahoma can be detrimental. Ladies have already had their proper to an abortion taken from them. Ladies ought to have the ability to resolve what’s finest for them and in the event that they need to finish their being pregnant by taking the abortion tablet. Though many argue that having an abortion results in extreme psychological well being points, each lady has completely different outcomes. Everybody ought to contact their representatives to vote no on payments like these. This invoice would make selections for a lot of ladies when each lady ought to have the ability to make their very own selections.
— Lizbeth Hernandez, McLoud, Oklahoma
An Ohio reader hopped to a conclusion on the social platform X about an article on the distinction between sunscreens accessible in the USA vs. different international locations:
Sunscreens are labeled as medication within the US and we are able to’t have the good things the remainder of the world makes use of except somebody squirts it in bunny eyes first.https://t.co/N5kUY3Voh2
— 5chw4r7z (@5chw4r7z) Might 8, 2024
— Bob Schwartz, Cincinnati, Ohio
The Backdrop of Dietary Selections
When analyzing the impression of food regimen on well being outcomes, it’s important to interpret the context of dietary decisions. The intersection of socioeconomic standing, entry to nutritious meals, and well being disparities can’t be neglected when investigating particular well being situations amongst racial teams (“Dietary Selections Are Linked to Larger Charges of Preeclampsia Amongst Latinas,” April 5).
The article identified the correlation between preeclampsia and situations akin to weight problems, hypertension, and continual kidney illness. Whereas true, it’s essential to underscore that weight problems charges are disproportionately larger amongst Black and Hispanic populations in the USA, in line with the Facilities for Illness Management and Prevention. This disparity will not be merely a mirrored image of cultural dietary preferences however is deeply intertwined with the structural limitations that restrict entry to wholesome, inexpensive meals choices for these communities.
Furthermore, these well being disparities are exacerbated by socioeconomic components. Information from the U.S. Census Bureau signifies that 25.8% of Black Individuals and 23.8% of Hispanic Individuals lived beneath the poverty line in 2019, in contrast with 10.1% of non-Hispanic whites. This financial divide considerably impacts the flexibility of those communities to entry contemporary produce and nutritious meals choices, additional entrenching well being disparities.
Addressing this challenge requires greater than advising people to change their consuming habits. It necessitates systemic adjustments to make more healthy meals choices extra accessible and inexpensive. Initiatives just like the “Sugar-Sweetened Drinks” tax, which has been carried out in a number of U.S. cities, show a proactive strategy to discouraging unhealthy dietary decisions by making sugary and overly refined meals costlier. A research revealed simply months after this was enacted in Berkeley, California, in 2015 discovered a big lower in SSB consumption coupled with elevated water consuming. In a bigger research finished throughout a number of cities, it was discovered that tax implementation resulted in a 33% decline in SSB purchases. Nonetheless, parallel efforts should be made to subsidize and decrease the price of nutritious meals, guaranteeing that wholesome choices are inside attain for all, no matter earnings or ZIP code. Different in style concepts on this area embrace growing agricultural subsidies to decrease the price of produce. Together with growing the costs of sugary meals, this might function an efficient technique to advertise more healthy consuming habits.
Whereas cultural preferences certainly play a big function in dietary habits, we should not overlook the structural limitations that stop many from making more healthy decisions. By addressing these systemic points, we are able to take a big step towards decreasing the prevalence of preeclampsia and different diet-related situations, significantly amongst our most susceptible populations.
— Lillian Levy, Berkeley, California
A New Yorker shared insights on the social platform X about an article in our collection monitoring the spending of opioid settlement funds:
A lot of curiosity in how #opioidsettlement funds are getting used nationwide to handle impression of #habit. Flexibility permits for inventive and culturally numerous responses, like this #tribal sweat lodge on Mi’kmaq land in #Maine. Story by way of @KFFHealthNews https://t.co/TNiHaRYGmJ
— Lilo Stainton (@LiloStainton) Might 15, 2024
— Lilo Stainton, Brooklyn, New York
Put an Finish to Choosing Sufferers’ Pockets
In 2022, U.S. residents spent $471.4 billion on out-of-pocket prices for well being care and pharmaceuticals. This was a 6.6% improve from the earlier yr. A number of methods may be carried out to cut back Individuals’ out-of-pocket prices (“A Battle Between Drugmakers and Insurers Hits Sufferers within the Pockets,” March 20). First, Congress should move HR 830, the HELP (Assist Guarantee Decrease Affected person) Copays Act. The invoice grants enrollees the chance to use sure funds (coupons, vouchers, prescription help packages, and so on.) towards cost-sharing necessities, permitting enrollees to succeed in their deductibles and out-of-pocket prices a lot sooner. There’s a perception that coupon packages will improve the utilization of high-priced medication; that is incorrect. Drug producers negotiate with pharmacy profit managers to put their medication on an insurer’s formulary. PBMs then listing these medicines as most well-liked or put them on a tier system; formulary medication will price an enrollee lower than a non-formulary drug. Some PBMs allow insurers to formulate their formulary or have an open formulary. Nonetheless, the insurer will incur extra prices for these strategies.
Secondly, legal guidelines designed to control PBM operations are loosely enforced. This has to alter. Some states (Arkansas, California, Louisiana, Maine, and New York) have handed laws requiring transparency from PBMs; in these states, PBMs report drug pricing, charges charged, and the quantities of rebates acquired and retained. If PBMs don’t adhere to the laws, penalties might be enforced. The federal authorities ought to take the lead from these 5 states to enact a federal legislation requiring transparency of PBMs, and mandate flat-rate rebates for generic and brand-name medication. The flat charges ought to replicate the market.
Thirdly, patent reform. Presently, drugmakers can lengthen their preliminary exclusivity interval by submitting extra patents on the identical medication in several types and completely different administration routes, what’s often known as a “patent thicket.” Producers will patent the medication’ generic variations as properly. Patent thickets improve drug costs and delay generics from coming into the market. Moreover, the federal authorities ought to cap drug costs. Producers use analysis and improvement as an excuse to overcharge. In different developed international locations, well being know-how assessments decide the worth for innovation, conserving prices decrease.
Now, some would say that’s an excessive amount of authorities and it’s affecting our capitalist society, however what’s extra vital than one’s well being? These restrictions is not going to stop the producer from making a revenue.
Lastly, the U.S. may leverage its bargaining energy and negotiate straight with drugmakers. How? Flip over the negotiations to the Division of Well being and Human Providers. This regulatory physique would characterize U.S. residents with business and federal insurance coverage and negotiate cost-effective charges for pharmaceuticals.
— Tameka Houston, Baltimore, Maryland
