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.
Regarding Family of Lonely Dementia Sufferers
I used to be despatched the article by Judith Graham on older adults with dementia residing alone (“Going It Alone: Thousands and thousands of Ageing People Are Dealing with Dementia by Themselves,” Oct. 15). I respect this text. My mother lives alone with dementia. My son lives subsequent door and checks on her, and my daughter comes when she is ready to vacuum flooring and to clean the kitchen and toilet. I deal with the payments, clear and alter her garments, wash her garments, seek for mail, and herald groceries. She refused to permit the house well being aide in, which complicates the care schedule. Neighbors be careful for her, together with police on the station throughout the road. It’s complicated and sophisticated for caregivers. Making use of for Medicaid is a nightmare, as is looking for reminiscence care amenities. The considered truly shifting her is heartbreaking and so hectic. Once more: Thanks for sharing that others with dementia live on their very own.
— Gail Daniels, Washington, D.C.
On the social platform X, a reader drew on her personal expertise:
Having cared for my mother towards the top of her journey with dementia, that is terrifying.For a lot of elders, there isn’t a household to cushion the insults of dementia and cognitive decline.https://t.co/LTZ76Ojgwg
— Shava Nerad – @shava23@bluesky 🌻 (@shava23) October 19, 2024
— Shava Nerad, Arlington, Massachusetts
Bonding — To the Letter
Thanks 1,000,000! I learn your article “Going It Alone: Historic Numbers of People Reside by Themselves as They Age” (Sept. 17) within the Las Vegas Evaluation-Journal and associated to it on a serious stage. As a senior residing alone, I’m experiencing a few of the similar “social isolation” expressed by your interviewees. Since I like to write down, I assumed it will be attention-grabbing to contain a few of the individuals talked about in a nationwide pen pal affiliation. This could place little or no demand on their funds (aside from postage and stationery), on their time, and with little or no journey concerned.
It’s breathtakingly exhilarating to obtain a letter from a pal or relative, a bundle from wherever, and expertise the reward of sitting down and studying excellent news from afar.
I respect our advances in expertise and I take advantage of it relatively sparingly. Nonetheless, I come from a technology that writes in cursive, is aware of the 5 components of letter writing, and understands what a return tackle is and the place it’s positioned on an envelope.
— Gloria Rankin, Las Vegas
A specialist in well being economics and coverage tweeted reward:
Historic Numbers of People Reside by Themselves as They Agehttps://t.co/lwpfrhJauWVital, impactful story by very good @judith_graham
— Paul Hughes-Cromwick (Pooge) (@cromwick) September 17, 2024
— Paul Hughes-Cromwick (Pooge), Ann Arbor, Michigan
On X, a gaggle of interdisciplinary school representing Johns Hopkins College shared KFF Well being Information’ protection about racial bias within the improvement and use of pulse oximeters:
In a @KFFHealthNews article, BDP @iwashyna explains how we transfer ahead from the racial bias of our present pulse oximeters.https://t.co/dmhqzoAfmK
— Bloomberg Distinguished Professors (@JHU_BDPs) October 23, 2024
A Slap on the Wrist for Pulse Oximeters
Between 1983 and 1988, I had 4 sons at Stanford Hospital. I used to be pals with Eben Kermit, who was a bioengineer. He was growing the unique pulse oximeter on infants within the neonatal intensive care unit (“Systemic Illness: FDA’s Promised Steering on Pulse Oximeters Unlikely To Finish A long time of Racial Bias,” Oct. 7). He examined solely white infants. That’s as a result of white dad and mom may come to the NICU within the daytime, which is when Eben was at work within the NICU. Black dad and mom may come solely at evening as a result of their work wouldn’t give them time without work to look after a really sick child. Since nobody was there to signal consent varieties, at evening, with the Black dad and mom, no Black kids had been included. Discrimination towards Black dad and mom by their employers is constant to cascade by means of the Black group by means of the exclusion of Black individuals from the event of medical expertise.
— Zoe Joyner Danielson, a toxicology biologist, Woodland, California
This X publish got here from a consulting and coaching agency that focuses on well being fairness points:
Reforms are wanted ASAP—these units have harmed so many #Black sufferers.FDA’s Promised Steering on Pulse Oximeters Unlikely To Finish A long time of Racial Bias https://t.co/5R9LH5XyTI by @ArthurAllen202 @kffhealthnews CC: @NohaAboelataMD @mlipnick @iculung @djcantillonmd @iwashyna pic.twitter.com/yliCxMdRvG
— HealthBegins (@HealthBegins) October 10, 2024
What’s All This Fuss About Fluoride?
Nobody appears to deal with the truth that not everybody drinks water from public water programs (“Does Fluoride Trigger Most cancers, IQ Loss, and Extra? Reality-Checking Robert F. Kennedy Jr.’s Claims,” Nov. 18). I see many individuals shopping for bottled water by the trunkful, or have a water fountain at residence with 5-gallon bottles of purified ingesting water, or have reverse osmosis water filtration programs put in at their sink.
So even when RFK Jr. removes fluoride from public water programs, I can’t see that there can be a drastic enhance in dental points. Additionally, if you get your tooth cleaned on the dentist, they offer you a fluoride therapy (except you decide out). So on this subject of eradicating fluoride, would this be a drastic subject realizing that many now aren’t getting fluoridated water?
— Suzann Lebda, Solar Lakes, Arizona
Hitting the Paywall
Why does your e-newsletter hyperlink to articles with paywalls? For instance:
The Oct. 18 aggregation “Former Medicare Chief Warns About Medicare Benefit Pay Charges” hyperlinks to Stat Information, the place the article can’t be learn with out a subscription. If you’re doing this as a method to supply subscribers to them, too dangerous.
In any case, this observe doesn’t signify your group properly because it helps the pattern that solely those that can afford it get to be told. I hope you rethink this observe.
The monetary boundaries to accessing vital data are hurting us as people and as a society. It’s costly for most individuals to have entry to a mainstream publication, but it surely will get cost-prohibitive to have entry to a number of factors of view, to study, purpose, and make up our personal minds. Generally, the one various obtainable is to get “bites of knowledge” from the “free” social media. The outcomes are as one would count on: We turn out to be much less conscious of what’s actually happening as we’re guided into silos of ignorance.
Thanks.
— Carl Loben, Bellevue, Washington
On X, a expertise journalist in Spain shared the article about pregnant individuals being requested by their suppliers to pay out-of-pocket charges sooner than anticipated:
Pay first, ship later: Some pregnant persons are being requested to prepay for his or her child https://t.co/NLWTeawgnk
— José María López (@gilead1984) November 16, 2024
— José María López, Badalona, Spain
A New Era of Well being Plans Overdue
The current article “Pay First, Ship Later: Some Ladies Are Being Requested To Prepay for Their Child” (Nov. 15) successfully highlights the emotional and monetary uncertainty dealing with suppliers and sufferers. I commend the writer for capturing how this uncertainty, rooted in empathy and equity, have to be higher understood and addressed.
I write to attract consideration to market tendencies and federal laws aimed toward assuaging this subject. Till lately, well being plans thought-about the out-of-pocket expertise as definitionally out-of-scope, leaving sufferers, and suppliers, to handle this rising uncertainty on their very own.
The proof exhibits that it’s doable to construct a extra pragmatic and empathic out-of-pocket expertise right into a well being plan, enhancing care accessibility and affordability with out eradicating affected person duty. This strategy has been confirmed, throughout 1000’s of employer well being plans, to really feel higher and financially profit everybody — sufferers, suppliers, and plans (employers/insurers).
On Oct. 15, 2024, the Medicare Prescription Cost Plan launched, providing practically 54 million People the choice to have their insurer pay their out-of-pocket bills upfront on the level of service giving members time to evaluation and repay the steadiness — with out curiosity or charges. If the affected person within the article had a well being plan with this functionality, her OB-GYN would have been paid, on her behalf, by her insurer. She would have obtained a easy month-to-month assertion to repay in full or over time from the consolation of her residence. Everybody advantages and it’s a higher member expertise.
This new, bipartisan, commonsense enchancment to one in all well being care’s most acute ache factors is quickly increasing as employers and insurers notice there may be important actuarial worth, supplier financial savings, and member habits change brought on by enhancing an individual’s potential to pay for care.
Brian Whorley, Columbia, Missouri
An affiliate professor within the well being care management program at Rockhurst College’s Helzberg Faculty of Administration additionally shared the article on X:
Pay First, Ship Later: Some Ladies Are Being Requested To Prepay for Their Child https://t.co/QEnX8GA3Ih through @kffhealthnews
— Prof. Jim Dockins (@DrDockins) November 15, 2024
— Jim Dockins, Kansas Metropolis, Missouri
On Hospital Gatekeepers and Tolls
Regarding the article “Pay First, Ship Later: Some Ladies Are Being Requested To Prepay for Their Child” (Nov. 15): Again in 1992, the hospital the place my son was going to be delivered required that the projected copay be paid to them one month earlier than the supply date or my spouse wouldn’t be admitted (a Catholic hospital, very charitable).
My spouse was born on the similar hospital in 1963; at the moment, my father-in-law was knowledgeable by the hospital that he couldn’t take her residence till the invoice was paid in full. He contacted a pal who was an lawyer who informed him to let the hospital know that may be thought-about kidnapping and that he can be calling the police in the event that they didn’t launch her.
— Andrew McGovern, Nice River, New York
Taken Benefit Of?
I belong to a Blue Cross Blue Protect Medicare Benefit plan and, for the previous a number of years, it has provided a house evaluation with a reward of $25. I’ve participated in this system up to now however declined this yr since I didn’t assume there was a lot worth to this system. I’m a retired registered nurse, and I felt that the nurse who did my evaluation didn’t do an particularly thorough job, and any questions I requested of her, she couldn’t reply. The nurse was additionally from out of state.
After studying your article on “The Medicare Benefit Affect Machine” (Sept. 30), the explanations for the evaluation appear to be greater than enhancing the beneficiary’s well being and well-being, which is what I believed. I’m comparatively wholesome and energetic, so it will not seem that BCBS discovered any new diagnoses that it may invoice Medicare for, however I assume that that’s not the case with different seniors.
— Bruce Gilman, Millis, Massachusetts
An economist in Florida had this to say on social media:
Thanks @KFFHealthNews for declaring the failed forms @CMS I’ve been speaking about for years. You possibly can’t learn this and never conclude DC bureaucrats are “captured” and coverage makers are beholden to Medicare Benefit foyer cash. #WhoWillCarehttps://t.co/rDGg8juoop
— Luke Neumann (@pglukeneumann) September 30, 2024
— Luke Neumann, St. Petersburg, Florida
In Protection of Deloitte
On March 12, 2024, in good religion and with respect for KFF Well being Information, Deloitte’s well being and human companies observe chief offered a 90-minute interview with two reporters for a narrative they stated was about “issues with Deloitte’s eligibility programs throughout the nation.”
We agreed to the interview as a result of we had heard from a number of of our state purchasers that they, too, had been contacted, and that the questions being raised confirmed a misunderstanding of built-in eligibility programs, the expertise that sustains them, and the complexity of the well being and human companies applications they help.
The eligibility programs are owned by the states, not Deloitte; they’re uniquely constructed for every state (in some instances, by different distributors many years in the past); and we work on the path of our purchasers to keep up and improve these programs to adjust to state-specific insurance policies, guidelines, and processes, and evolving federal laws.
Two tales subsequently ran: “Medicaid for Thousands and thousands in America Hinges on Deloitte-Run Programs Affected by Errors” (June 24) and “Errors in Deloitte-Run Medicaid Programs Can Value Thousands and thousands and Take Years To Repair” (Sept. 5).
Lots of the points reported as “widespread” are remoted to particular conditions or contain delicate information that can’t be refuted by Deloitte as a result of shopper confidentiality obligations. That stated, there are various the reason why somebody could lose protection or now not be eligible for a profit they as soon as obtained.
Not each “subject” a constituent faces is the results of a system “error,” and challenges with particular person instances in particular person programs aren’t as a result of some elementary downside in the best way Deloitte helps state Medicaid applications.
On the problem of contract adjustments, Deloitte rejected the declare in March that our state purchasers ship us a “change request … when a repair is required.” We stated that was inaccurate and defined that when there are coverage or rule adjustments — or a worldwide pandemic — that require modifications to a state’s expertise, change orders aren’t solely needed however applicable.
They don’t signify errors in a system that must be fastened.
All through the unwinding of the covid-19 public well being emergency — as applied sciences advanced and insurance policies modified — Deloitte labored carefully with states to attenuate challenges for these going by means of the Medicaid redetermination course of. The improvements and human-centered design processes we helped our purchasers implement enhanced the digital expertise for his or her constituents and made it simpler for caseworkers, workers, and group companions to help the 34 million individuals of their care.
Our purchasers perceive that giant system implementations are difficult because of the complexity of the applications they help, and that each one IT programs require ongoing upkeep, periodic enhancements and upgrades to software program and {hardware}, and database administration.
That’s the reason so many states proceed to pick out Deloitte to assist them keep their mission-critical programs, and why trade analysts like Forrester and Gartner constantly rank Deloitte as a pacesetter in system integration and enterprise transformation.
— Karen L. Walsh, Authorities & Public Providers, Deloitte Consulting LLP, Harrisburg, Pennsylvania
[Editor’s note: KFF Health News stands by its reporting on Deloitte and the state eligibility determination systems that Deloitte supports.]
An assistant professor at Harvard voiced her opinion on X:
That is such a grim abstract of the state of Medicaid eligibility and enrollment programs https://t.co/3hpVnJdPOm pic.twitter.com/Gdi2AF1pyr
— Adrianna McIntyre (@adrianna.bsky.social) (@onceuponA) September 5, 2024
— Adrianna McIntyre, Boston
Far Much less Than Meets the Eye
I learn your article concerning the new $2,000 restrict for out-of-pocket funds for Medicare Half D (“Medicare Drug Plans Are Getting Higher Subsequent 12 months. Some Will Additionally Value Extra,” Oct. 21). As somebody with very excessive drug prices, I used to be very enthusiastic about this variation. Nonetheless, as soon as I researched the totally different drug plans obtainable for me and my husband, I noticed that the cash we spend on medication which can be prescribed by a health care provider however not lined by our plan is not going to rely towards the $2,000 restrict. Due to this fact, our value for needed medication will proceed to be exorbitant.
I feel that there are various seniors who will probably be very disillusioned as soon as they notice this.
— Pia Stampe, Eureka, California
In sharing the article on X, a Florida lawyer merely shared their contact data:
“Medicare Drug Plans Are Getting Higher Subsequent 12 months. Some Will Additionally Value Extra:”https://t.co/9uEjVxTSGb Grady H. Williams, Jr., LL.M., Attorneys at Regulation P.A. 1543 Kingsley Avenue, Constructing 5 Orange Park, FL 32073 Tel: 904-264-8800 • Fax: 904-264-0155
— Grady H. Williams (@floridaelder) November 9, 2024
— Grady H. Williams, Orange Park, Florida
Shedding Mild on Fluorescence in Dental Care
Congratulations on a extremely impactful publication (“Dentists Are Pulling ‘Wholesome’ and Treatable Tooth To Revenue From Implants, Specialists Warn,” Nov. 1). The details introduced are harrowing for a retired practitioner with a number of specialties who tried a lifetime to protect tooth and promote human well being.
As you may know, oral biofilm is the most important enemy of oral well being and even basic well being. Dental clinicians haven’t been in a position to visualize and determine the presence of pathogenic oral microbiome till lately. Pathogenic oral micro organism are among the many important mills of onerous and mushy tissue deterioration, comparable to tooth decay, gum illnesses, and even an infection of dental implants. Probably the most trusted and used prognosis process remains to be the X-ray.
X-rays can determine solely established illnesses. Sadly, radiologic prognosis remains to be essentially the most trusted diagnostic instrument used and taught in dental schooling.
Microbiology, the microbiome science, makes use of fluorescence as its main identification process. Among the most aggressive oral micro organism, mills of caries, gum illnesses, and so forth., generate so-called porphyrins, which, as soon as excited by a selected wavelength, emit mild at a distinct wavelength. Extremely dependable and simple-to-use applied sciences have been created lately to help direct visualization and point-of-care identification of this pathogenic micro organism by means of the above-described process. These units help the diagnostic course of and assist the dental clinician by guiding the therapy execution and figuring out when the therapy purpose has been achieved. Dental therapy protocols using “Fluorescence-Enhanced Theragnosis” have turn out to be dependable and fewer invasive.
The excessive lack of human lives within the ICUs through the pandemic as a result of ventilator-associated pneumonia may have been dramatically lowered utilizing the above protocol.
Wound-care science has already applied fluorescence and is present process an incredible protocol change. Tumor surgical procedure celebrates fluorescence-guided surgical procedure as a milestone in its improvement.
Educational dental schooling is due for an pressing renewal. We should open the doorways and facilitate science translation to profit humankind!
— Liviu Steier, Needham, Massachusetts
A reader who manages a web site predicting the collapse of the American well being care system commented on X:
https://t.co/JTFn1h12rc 🙄😠👎Technically, American dentistry was as soon as ranked as one of the best on this planet. Sadly, It has a historical past of mismanagement and negligence. It’s a “reputational good” that’s been flooded with scams. Now it’s payback time. It’s demonstrating the…
— Francis Anthony Toto (@francisatoto) November 2, 2024
— Francis Anthony Toto, San Diego
