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.
Sounding the Alarm for Ambulances
Thanks for shedding much-needed mild on the exorbitant prices and lack of reimbursement which have turn out to be a harsh actuality for a lot of ambulance providers throughout Colorado and the nation (“Insurers Struggle State Legal guidelines Limiting Shock Ambulance Payments,” July 9). Whereas it’s very important to guard sufferers from “shock” payments — one thing your protection highlights — it’s equally vital to acknowledge the opposite facet of the equation.
Ambulance suppliers usually obtain reimbursements effectively beneath the precise value of delivering care. A current business report discovered that ambulance providers are below‑reimbursed by a mean of $1,526 per transport, with Medicare alone paying almost $2,334 lower than the associated fee incurred. These shortfalls are unsustainable and threaten the monetary viability of emergency responders.
It’s essential that ambulance corporations have a stronger voice on this dialog. Reimbursement charges aren’t simply numbers — they decide whether or not crews can keep on the street, keep readiness, and put money into very important cell well being care providers. Emergency preparedness depends on steady funding, and when that funding falls quick, communities endure.
By spotlighting the reimbursement disaster, this text helps lay the groundwork for coverage options. However let’s go a step additional: We have to elevate the voice of ambulance companies themselves, so lawmakers and insurers perceive that honest fee isn’t a bonus — it’s important to maintain us protected.
— Patrick Fahey, Weymouth, Massachusetts
A DevOps engineer shared the NPR model of the article on social media:
Households hit onerous without warning ambulance bills-some see money owed soar even with insurance coverage. Extra states are appearing, however a nationwide answer could also be wanted for actual safety. https://t.co/Efb6me3Png pic.twitter.com/HRSW5mCdiu
— Michael Bennett (@M1keB_77) July 11, 2025
— Michael Bennett, Denver
‘Congress Is Taking part in Political Sizzling Potato With My Well being’
I’m 60, self-employed, and residing with congestive coronary heart failure. My ejection fraction is dangerously low, and the Inexpensive Care Act is the rationale I can see a health care provider, take my remedy, and keep alive.
Now Congress is enjoying political scorching potato with my well being. In the event that they don’t lengthen the ACA’s enhanced subsidies by August, my $30 premium might bounce to over $800. That’s over 25 occasions as a lot. I’m not a hedge fund supervisor — I’m an impartial contractor. Except I begin promoting organs (not supreme when your coronary heart’s the difficulty), I can’t sustain.
I’m too younger for Medicare and haven’t any employer plan. I’ve labored, paid taxes, and managed my situation responsibly. So why am I being priced out of care?
If Congress received’t hear, I’m asking you — the press — to assist. Inform this story, or one identical to it. Thousands and thousands of Individuals are quietly panicking, strolling the identical tightrope. These coverage adjustments aren’t simply math — they’re about human lives.
As a result of if nothing adjustments, plenty of us received’t be round to write down letters subsequent 12 months.
— Kevin Bahn, Tamarac, Florida
Individuals Pay the Value for a Sick Well being Care System
I’m positive your readers can be concerned about how American well being care prices examine with these of the European Union and Switzerland (“Invoice of the Month: A Texas Boy Wanted Safety From Measles. The Vaccine Value $1,400,” June 30).
In France, the personal worth for the MMR vaccine is round $13 (in U.S. {dollars}), supplied you could have a prescription. Any pharmacy can administer the jab for about the identical.
Right here in Switzerland, the costliest nation in Europe, this vaccine prices below $40, as a non-public buy.
I’ve moved 18 occasions with household throughout Western and Japanese Europe and have had expat employees in 35 international locations on 4 continents.
It’s very clear to me now that the majority nationwide makes an attempt at well being care are a expensive failure, with few notable exceptions: Germany and, surprisingly, Spain. Then there’s Switzerland, which has among the many greatest well being care techniques on this planet — near excellent. Fundamental protection phrases are federally mandated and value round $430 a month with a $2,500 annual deductible, no matter age, after 26. And with a $300 yearly deductible, the premiums are about 40% increased.
One thing could be very off within the USA. It’s not that sophisticated.
— Clement Cohen, Geneva, Switzerland
A registered nurse shared his answer for taming Medicaid fraud in a submit on X:
“They’ll offer you a bone should you keep within the mud.It’s comparatively simple to repair the profit cliff: simply part in a graduated premium for Medicaid primarily based on revenue above the brink. If we had political will to do that, it might prompted self-sufficiency.https://t.co/4fxSnmETRd
— Jacob Larsen 🇺🇸 🇩🇰 🇺🇦 (@SLCPaladin) July 22, 2025
— Jacob Larsen, St. George, Utah
Why ‘Begin From Scratch’ Vaccine Testing Can Be Harmful
I anticipate we’ll be listening to extra dialogue round the usage of “inert” placebos — like saline options — because the Advisory Committee on Immunization Practices and the Facilities for Illness Management and Prevention method new vaccine suggestions (“Kennedy’s Vaccine Advisers Sow Doubts as Scientists Protest US Pivot on Pictures,” June 27). One of these messaging appears poised to realize traction with the general public, regardless of its moral implications.
More and more, I’m seeing criticism that vaccine improvement doesn’t depend on inert placebos. This argument is commonly used to advocate for brand new medical trials — even for vaccines already confirmed efficient — and to justify starting booster improvement from scratch.
Whereas inert placebos might have been used and have been acceptable in early phases of analysis for vaccines, their use turns into ethically problematic when a protected, efficient vaccine already exists. In such instances, withholding safety from contributors in a placebo group can put them at actual danger, particularly throughout the improvement of up to date or booster doses of vaccines.
I consider it’s crucial that organizations like KFF Well being Information assist make clear this difficulty for the general public. KFF is a extremely revered, nonpartisan supply with highly effective communication attain. I’m a subscriber to KFF Well being Information and recognize the best way your reporting attracts in readers with accessible, participating headlines — and that your articles can be found for syndication to different shops.
Two key factors I discovered buried in an American Academy of Pediatrics article stood out:
- “Many childhood vaccines have been examined initially in randomized medical trials that included placebo or comparability teams. If the vaccine is for a illness that at present has no vaccine, the placebo could also be saline or one other substance recognized to be protected. If the vaccine is a possible substitute for an current, older vaccine, the comparator group might obtain the older vaccine that has already been examined fairly than an inert placebo.”
- “When a protected, efficient vaccine already exists towards a illness, giving kids within the placebo group no safety towards that illness is unethical. Unvaccinated kids can contract harmful diseases. Mother and father of kids within the placebo group wouldn’t know they didn’t get the vaccine and that their little one is unprotected.”
That brings up one other vital query: Who would volunteer for a randomized, double-blind, managed trial involving an inert placebo for an current vaccine? Folks hesitant about vaccines are unlikely to take part, for worry they’ll obtain the vaccine. And people who help vaccination could also be reluctant to danger receiving an inert placebo as a substitute of testing the present, older confirmed model towards a brand new proposed model.
— Alice Henneman, Lincoln, Nebraska
A virologist and podcaster chimed in on the June installment of our “Invoice of the Month” sequence:
A submit doctoral fellow at UTMB couldn’t afford the college’s insurance coverage choice for his household so he purchased a separate plan. It value him $1400 to get his little one the measles vaccine. Throughout an outbreak. Get your vaccines now, earlier than they don’t seem to be coated. https://t.co/f3wWRouevA
— Heather McSharry, PhD (@PathogenScribe) July 1, 2025
— Heather McSharry, Austin, Texas
A Premium Shell Sport?
I learn Michelle Andrews’ article at the moment, revealed within the San Francisco Chronicle (“Have Job-Based mostly Well being Protection at 65? You Could Nonetheless Need To Signal Up for Medicare,” June 18). Thanks for reporting on this vital difficulty.
You describe as contributing elements: ignorance of the worker, the shortage of any requirement that Medicare notify the worker, and the failure of the dealer to inform.
Maybe I missed it, however I consider there’s an vital extra issue you didn’t point out: the revenue of the industrial insurance coverage service. In my expertise, of us don’t discover that their major insurance coverage has modified to Medicare primarily as a result of their employer remains to be deducting the premium for his or her industrial group medical health insurance.
Isn’t it fraud for the insurance coverage service to gather premiums for a coverage for which the subscriber is visibly now not eligible by regulation?
There’s a monetary incentive for the industrial service to not inform the subscriber that their protection has ended, and they’re now eligible for a Medicare Benefit supplemental coverage (with a a lot decrease premium) in the event that they join Medicare: The industrial service can acquire excessive premiums, then decline to pay advantages.
You point out that Medicare representatives word they don’t seem to be required to inform subscribers. Why? Coincidence? Extra probably, the industrial insurance coverage corporations actively foyer towards notification.
Additionally, there’s a monetary incentive for hospitals to carry out procedures on sufferers who’re 65 or older and nonetheless on a industrial plan. Fairly positive the hospital billing workplace is aware of fairly effectively they’ll finally be capable to invoice the affected person the retail price, which is usually 10 occasions as a lot (or extra) than the Medicare-discounted price.
In my expertise, this isn’t a health care provider difficulty, because the doctor not often pays any consideration to insurance coverage particulars. Nevertheless it’s very a lot a billing workplace difficulty.
— John S. Smolowe, Menlo Park, California
A reader in Connecticut tweeted his opinion on the dangers of hashish for an getting old inhabitants:
Normalized hashish use now will yield an enormous public well being drawback later and all the information factors in that route…👇🏼“As Hashish Customers Age, Well being Dangers Seem To Develop” https://t.co/xNrqqz1k1L by way of @kffhealthnews
— Brandon M. Macsata 🎗️ (@Purple_Strategy) June 9, 2025
— Brandon M. Macsata, New Haven, Connecticut
Getting Forward of Recognized and Unknown Threats
As highlighted in your article “‘MAHA Report’ Requires Preventing Power Illness, however Trump and Kennedy Have Yanked Funding” (July 2), proposals to get rid of the Nationwide Middle for Power Illness Prevention and Well being Promotion don’t align with efforts to deal with our nation’s persistent illness disaster. These plans additionally additional underscore the significance of strengthening America’s public well being infrastructure not solely to avoid wasting lives, but additionally to make sure taxpayer {dollars} are used properly.
For every greenback invested in illness prevention, the Belief for America’s Well being estimates, $5.60 in downstream prices may be saved nationwide — and this determine is even increased in some states.
However simply as cuts to persistent well being analysis will hamper the federal authorities’s objectives of stopping diabetes, coronary heart illness, and weight problems, so too do cuts to broader public well being funding streams inhibit state and native well being departments’ capacity to cease outbreaks of measles, drug overdoses, or hepatitis, amongst many different preventable circumstances.
Investments in public well being have saved lives and strengthened our nation. Figuring out rising threats rapidly — whether or not they come from infectious illnesses, zoonotic diseases, accidents, or accidents — is important to mitigating them. Sadly, federal cuts to very important public well being funding streams and packages make it more and more tough for our nation’s leaders to know the threats dealing with their communities and take advantage of knowledgeable selections doable to assist their communities.
Throughout the nation, public well being departments are scaling again employees and delaying plans to undertake higher expertise on account of funding constraints; subsequently, many departments lack the assets to detect and reply to threats in a well timed method. Rural and underserved communities which have fewer assets to maintain or change federal funding are at best danger.
With out continued funding in public well being infrastructure — from the federal authorities in addition to state, territorial, native, and tribal governments — the impression of future well being dangers might be multiples increased on each the nationwide well being care system and the assets (together with authorities funding) wanted to deal with no matter could also be coming subsequent.
To actually enhance public well being, our leaders at each stage of presidency needs to be doubling down on public well being techniques, each infrastructure and expertise, as the inspiration and path to maintain America wholesome.
— Eric Whitworth, CEO of InductiveHealth, Atlanta
The CEO of 4sight Well being had this recommendation, posted on X:
Do not take heed to what the regime says. Watch what it does. What this story calls “contradictions” and “inconsistencies” are lies and diversions from its anti-health agenda. The market should decide up the persistent illness prevention torch. https://t.co/SgWYe3KCtp
— David Johnson (@4sighthealth_) July 8, 2025
— David Johnson, Chicago
Preventive Bodily Remedy Can Spare You From Damage — And Rehab
Thanks for lately highlighting the crucial want for high quality bodily remedy (“How To Discover the Proper Medical Rehab Providers,” July 15) and offering a complete information on navigating rehabilitation providers after hospitalization. Additionally it is vital to notice the preventive energy bodily remedy has earlier than an acute damage strikes.
Bodily and occupational remedy providers aren’t only a type of post-accident care however are additionally proactive, non-pharmaceutical methods to protect energy, steadiness, and independence — particularly for our getting old inhabitants. And analysis exhibits that when bodily remedy is the first line of therapy for sure circumstances like decrease again ache — fairly than injections or surgical procedure — Medicare Half A/B prices drop by 19% in contrast with sufferers selecting injections first and by 75% in contrast with surgery-first instances.
Furthermore, bodily therapist-led fall prevention packages have been proven to scale back fall danger, whereas additionally slicing emergency room visits, hospitalizations, and opioid use amongst older adults. These numbers matter deeply in an getting old America the place 30 million older adults fall annually and the lifetime medical value of treating falls is over $100 billion yearly. And but, the Medicare system usually prioritizes submit‑damage therapy over preventive care, delaying entry to important bodily remedy till after injury happens.
In mild of our nation’s want for extra preventive care, it’s time for our Congress to allow simpler, earlier entry to bodily remedy. A technique lawmakers can assist is by supporting and passing the bipartisan Stopping Dependancy and Falls for the Aged, or SAFE, Act (H.R. 1171). This commonsense laws would permit Medicare beneficiaries to entry no-cost falls danger assessments from the autumn prevention specialists: bodily and occupational therapists.
Incorporating bodily remedy into major and preventive care has the potential to lower hospital visits, decrease well being care spending, and protect our seniors’ independence — objectives all of us share. It’s time to shift the coverage highlight upstream. Bodily remedy has already proved it saves cash and improves lives.
— Nikesh Patel, govt director of the Alliance for Bodily Remedy High quality and Innovation (APTQI), Sugar Land, Texas
KFF Well being Information is a nationwide newsroom that produces in-depth journalism about well being points and is without doubt one of the core working packages at KFF—an impartial supply of well being coverage analysis, polling, and journalism. Study extra about KFF.
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