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.
Coming Full Circle on Protections for Those With Disabilities
As a retired particular schooling trainer, I’m questioning why our aged in retirement houses aren’t lined by the American with Disabilities Act (“‘Impending Intergenerational Crisis’: Americans With Disabilities Lack Long-Term Care Plans,” Dec. 11). The act covers all the problems confronted by our aged in retirement houses as for youngsters with these identical wants. Students get a yearly prescription plan via a gathering with their dad and mom, all who are available in contact with them to offer providers, and an administrator. Why isn’t this yearly plan in place for our aged in retirement or nursing houses? Children go from newborns to toddlers, and on up via the expansion and maturity ladder. Our aged undergo these identical levels however in reverse. The care we give the aged ought to mirror the care given to kids albeit for, maybe, an extended time in every stage. This would necessitate some main modifications to present federal, state, and native laws. I get that each one however probably the most devoted and concerned would combat this concept and contemplate our older inhabitants as throwaways. As Florida Gov. Ron DeSantis mentioned, “Let them die.” Thank you for permitting this chance to throw in my two cents.
— Judy Galt, Orange Park, Florida
I hadn’t given this a lot thought however I do see it. Baby-boomer era will cross and disabled offspring could extra typically lack satisfactory plans: “Impending Intergenerational Crisis’: Americans With Disabilities Lack Long-Term Care Plans” | Kaiser Health News https://t.co/4VIOUwbLVk
— Carl Hindy, Ph.D., Clinical Psychologist (@DrCarlHindy) November 11, 2022
— Carl Hindy, Exeter, New Hampshire
Revoking the Disability Tax
Thank you a lot for highlighting the issue blind people have with medical payments (“The Disability Tax: Medical Bills Remain Inaccessible for Many Blind Americans,” Dec. 2). I virtually by no means see something associated to blindness and accessibility undergo my information feed, so though your findings are miserable, it made my day to know this difficulty was being highlighted within the nationwide information!
— Brandon Keith Biggs, Atlanta
Not stunned. I’m #deaf & medical suppliers nonetheless anticipate me to have the ability to hear & perceive vital data over the telephone. The Americans With Disabilities Act has no enamel. #blind #ada #kaiser #hhs #California #Indiana #aetna #anthem #MedTwitter #hoh https://t.co/1F9TusBBGa
— Jim Hankins (@ltecato) December 2, 2022
— Jim Hankins, Anaheim, California
I wish to personally thanks for reporting on this difficulty. There are workarounds for many people to get round them. Unfortunately, it’s a separate however equal predicament. And this isn’t simply with the medical system. Persons who’re blind, who make the most of know-how, typically depend on paid subscription providers for finishing visible duties. One of them is named Aira. Trained individuals information blind individuals via varied duties like navigating and filling out varieties on inaccessible web sites or take photos of payments and browse it to them.
The separate-but-equal standing is available in as a result of the final inhabitants is unaware the blind are unemployed or underemployed. The employment price for the blind is below 20% lower than convicted felons. The underemployment price is 78%, partially due to outdated subminimum wage legal guidelines below Section 14(c) of the federal Fair Labor Standards Act that permits disabled individuals in America to be paid beneath federal minimal wage by all the key firms, and every thing in between.
Again, thanks for reporting on info that most individuals and the media gained’t as a result of they aren’t the fluffy, fuzzy, feel-good points like blind individuals ending school or doing one thing most individuals with imaginative and prescient merely do each day.
— William F. O’Donnell, Austin, Texas
Good article on how plan sponsors seize producers’ copay assist & affected person help funds for themselves (as a substitute of for sufferers)Not information to Drug Channels readers, however nonetheless good to see mainstream press protection@Julie_appleby @KHNews https://t.co/V6WfPeUDc6
— Adam J. Fein (@DrugChannels) December 11, 2022
— Adam J. Fein, Philadelphia
A Benefit for Big Pharma
Who earnings from employer affected person help and worker copay plans? It ought to come as no shock that the wolf in sheep’s garments are, certainly, the pharmaceutical corporations.
Your article “Employers Use Patient Assistance Programs to Offset Their Own Costs” (Dec. 6) uncared for to report on a incessantly employed technique that represents a large return on funding for Big Pharma: A pharmaceutical producer will cowl the prices of a affected person’s copay, typically even your complete deductible, to maintain the affected person on its dearer product (over doubtlessly cheaper alternate options the affected person’s well being care plan would possibly want). Once the deductible is met the affected person’s well being care plan is compelled to pay 80% or extra of the affected person’s drug prices. And, as soon as the affected person reaches their most out-of-pocket (MOOP) threshold, their well being care plan begins paying 100% prices — and the drug firm returns to creating 100% revenue and not paying any help.
Pharmaceutical producers say the help applications are proof of their dedication to sustaining the affordability of prescribed drugs, however in accordance with a latest report by the Congressional Research Service, “Prescription Drug Discount Coupons and Patient Assistance Programs (PAPs),” whereas a drug low cost coupon could cut back the quantity an insured client should pay out-of-pocket for a drug, it typically doesn’t cut back the value charged to an insurer or authorities program for the drug.
The not too long ago revealed “Drug Manufacturers’ Billion-Dollar Scheme,” by the Regence Health Policy Center, requested this intriguing query: Are copay coupons “the solution for the unreasonable cost of specialty medications or a carefully crafted trojan horse disrupting affordability in our health care system?”
We know the reply, and it ought to have been addressed in your article, which in any other case portrays Big Pharma as heroes.
If pharmaceutical producers actually needed to help sufferers, they need to cease subsidizing affected person copays and deductibles, ripping off sufferers (and their well being care plans), and set up affordable drug costs within the U.S., as they do in each different developed nation.
— James Gelfand, president of The ERISA Industry Committee, Washington, D.C.
If corporations, together with insurers, channeled their creativity into making care higher and extra reasonably priced for sufferers, what a beautiful world it could be. https://t.co/s1M5V1UTZF Comment when you agree.
— David Johnson (@4sighthealth_) December 14, 2022
— David Johnson, Chicago
Community Health Centers Are Transparent, Trusted, and Essential
In what seems to be a sample, the KHN article by Phil Galewitz and Bram Sable-Smith about group well being facilities (“When Malpractice Occurs at Community Health Centers, Taxpayers Pay,” Nov. 28) makes use of selective knowledge and outlier circumstances to color a grossly inaccurate image of the life-sustaining care that group well being facilities present to 30 million Americans.
Contrary to the distorted conclusions drawn by the article’s concentrate on only a few proceedings, well being facilities present high-quality look after tens of tens of millions of underserved and weak sufferers within the U.S.
Given the essential position well being facilities play in well being care supply and the substantial improve within the variety of well being facilities and sufferers, malpractice claims are an unlucky actuality. KHN’s narrative focuses on a number of cherry-picked circumstances even because it acknowledges that “settlements and court judgments do not measure the clinics’ overall performance.” The article’s concentrate on claims payouts throughout 2018 and 2021, although tragic, represents a tiny fraction of 117 million sufferers served and 477 million visits — which means the reporters centered on far lower than 1 % of sufferers.
The bigger and unassailable story is that well being facilities implement rigorous safeguards to make sure the most effective affected person care. Federal Tort Claims Act protection — the federal protection that’s the focus of this text — shouldn’t be mechanically granted to well being heart grantees. Rather, well being facilities should implement stable high quality enchancment and threat administration applications to qualify for and keep FTCA protection. Such protection permits important well being care providers to stay reasonably priced and accessible to economically challenged sufferers when and the place they want it. Additionally, well being facilities are topic to on-site auditing of those processes to make sure they meet applicable requirements and performance as supposed. FTCA protection makes well being facilities much more vigilant on high quality of care — not much less.
Every greenback invested in well being facilities returns worth to American taxpayers. The program generates annual system-wide financial savings of $24 billion yearly as a result of fewer well being heart sufferers require emergency room visits and hospitalizations. More vital than {dollars} saved, well being facilities are clear, trusted, and important stewards of public well being. We stand by their lengthy and profitable observe file.
— Rachel Gonzales-Hanson, interim CEO and president of the National Association of Community Health Centers, Bethesda, Maryland
and one other latest story about malpractice at group well being facilities https://t.co/bh7XIMfVMA
— Taylor Emrey Glascock (@tayloremrey) November 30, 2022
— Taylor Emrey Glascock, Chicago
STD Testing: Don’t Try This at Home?
Though residence testing for sexually transmitted infections could be precious, maximizing the testing know-how we’ve now could be much more precious (“A New Use for Dating Apps: Chasing STDs,” Nov. 30). Sixty % of all STIs in high-risk individuals can’t be recognized through a urine pattern as a result of they’re extragenital (within the throat or rectum). STI testing ought to embrace screening urine in addition to throat and rectum swabs for many individuals. This could possibly be completed by labs giving shoppers swabs to self-collect, nevertheless Hologic (the corporate that produces the Aptima system pictured in your article) has not finished the validation research to permit its system for use on self-collected extragenital exams. Thus, a affected person should go to a supplier to get the swabs collected, moderately than simply go to the lab instantly after orders are submitted. This shouldn’t be a problem of recent know-how; this is a matter of making certain we’re utilizing what we’ve to its full capability, making certain satisfactory extragenital screening, and making certain it may be finished in probably the most handy means attainable. Molecular screens enable for home-based testing (collected at residence and despatched again to be processed). Halogen exams, the system utilized by Quest, Labcorp, CPL, and so on., don’t. Though having home-based fast outcomes could be nice (which, after all, would require self-collected samples), making certain we’re capable of maximize the know-how we’ve out there now could be an enormous step ahead.
— Christine Brennan, New Orleans
The use of apps could have exploded since, however we have been doing this 20 years in the past once I was an #EIS officer @CDCgov. In reality I needed to get entry to sure blocked web sites – it was attention-grabbing explaining that to the IT of us. https://t.co/8zsq887ECp
— Michael Greenberg MD (@greenbergepi) December 4, 2022
— Dr. Michael Greenberg, Bethlehem, Pennsylvania