Letters to the Editor is a periodic function. We welcome all comments and can publish a range. We edit for size and readability and require full names.
Referring to Family members of Lonely Dementia Sufferers
I used to be despatched the article by Judith Graham on older adults with dementia residing alone (“Going It Alone: Millions of Aging Americans Are Facing 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 loo. 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 advanced and complex for caregivers. Making use of for Medicaid is a nightmare, as is looking for reminiscence care amenities. The considered truly transferring her is heartbreaking and so irritating. Once more: Thanks for sharing that others with dementia reside 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 one million! I learn your article “Going It Alone: Historic Numbers of Americans Live by Themselves as They Age” (Sept. 17) within the Las Vegas Review-Journal and associated to it on a serious degree. As a senior residing alone, I’m experiencing among the identical “social isolation” expressed by your interviewees. Since I like to write down, I assumed it might be fascinating to contain among the individuals talked about in a nationwide pen pal affiliation. This is able to place little or no demand on their price range (apart 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 anyplace, and expertise the reward of sitting down and studying excellent news from afar.
I respect our advances in know-how and I take advantage of it moderately sparingly. Nonetheless, I come from a technology that writes in cursive, is aware of the 5 parts of letter writing, and understands what a return handle 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 Stay by Themselves as They Agehttps://t.co/lwpfrhJauWEssential, 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 college 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 buddies with Eben Kermit, who was a bioengineer. He was creating the unique pulse oximeter on infants within the neonatal intensive care unit (“Systemic Sickness: FDA’s Promised Guidance on Pulse Oximeters Unlikely To End Decades of Racial Bias,” Oct. 7). He examined solely white infants. That’s as a result of white dad and mom might come to the NICU within the daytime, which is when Eben was at work within the NICU. Black dad and mom might come solely at night time as a result of their work wouldn’t give them day off to look after a really sick child. Since nobody was there to signal consent varieties, at night time, with the Black dad and mom, no Black youngsters had been included. Discrimination in opposition to Black dad and mom by their employers is constant to cascade by means of the Black neighborhood by means of the exclusion of Black folks from the event of medical know-how.
— Zoe Joyner Danielson, a toxicology biologist, Woodland, California
This X put up 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 Steerage on Pulse Oximeters Unlikely To Finish Many years 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 techniques (“Does Fluoride Cause Cancer, IQ Loss, and More? Fact-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 house with 5-gallon bottles of purified consuming water, or have reverse osmosis water filtration techniques put in at their sink.
So even when RFK Jr. removes fluoride from public water techniques, I can’t see that there could be a drastic improve in dental points. Additionally, whenever you get your enamel cleaned on the dentist, they provide you a fluoride therapy (until you decide out). So on this challenge of eradicating fluoride, would this be a drastic challenge figuring out 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 example:
The Oct. 18 aggregation “Former Medicare Chief Warns About Medicare Advantage Pay Rates” hyperlinks to Stat Information, the place the article can’t be learn with out a subscription. If you’re doing this as a way to supply subscribers to them, too unhealthy.
In any case, this follow doesn’t characterize your group nicely because it helps the pattern that solely those that can afford it get to be told. I hope you rethink this follow.
The monetary obstacles to accessing essential data are hurting us as people and as a society. It’s costly for most individuals to have entry to a mainstream publication, however it will get cost-prohibitive to have entry to a number of factors of view, to study, cause, and make up our personal minds. Most often, the one various obtainable is to get “bites of data” from the “free” social media. The outcomes are as one would anticipate: We develop into much less conscious of what’s actually happening as we’re guided into silos of ignorance.
Thanks.
— Carl Loben, Bellevue, Washington
On X, a know-how journalist in Spain shared the article about pregnant folks 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 latest article “Pay First, Deliver Later: Some Women Are Being Asked To Prepay for Their Baby” (Nov. 15) successfully highlights the emotional and monetary uncertainty dealing with suppliers and sufferers. I commend the creator for capturing how this uncertainty, rooted in empathy and equity, should be higher understood and addressed.
I write to attract consideration to market developments and federal laws aimed toward assuaging this challenge. Till lately, well being plans thought of 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 reveals that it’s attainable to construct a extra pragmatic and empathic out-of-pocket expertise right into a well being plan, bettering care accessibility and affordability with out eradicating affected person duty. This strategy has been confirmed, throughout hundreds 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 assessment and repay the stability — 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 acquired a easy month-to-month assertion to repay in full or over time from the consolation of her house. 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 understand there’s vital actuarial worth, supplier financial savings, and member conduct change attributable to bettering an individual’s capability 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 by way of @kffhealthnews
— Prof. Jim Dockins (@DrDockins) November 15, 2024
— Jim Dockins, Kansas Metropolis, Missouri
On Hospital Gatekeepers and Tolls
Regarding the article “Pay First, Deliver Later: Some Women Are Being Asked To Prepay for Their Baby” (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 identical hospital in 1963; at the moment, my father-in-law was knowledgeable by the hospital that he couldn’t take her house till the invoice was paid in full. He contacted a pal who was an legal professional who advised him to let the hospital know that will be thought of kidnapping and that he could 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 Defend Medicare Benefit plan and, for the previous a number of years, it has supplied a house evaluation with a reward of $25. I’ve participated in this system up to now however declined this 12 months 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 Advantage Influence Machine” (Sept. 30), the explanations for the evaluation appear to be greater than bettering the beneficiary’s well being and well-being, which is what I believed. I’m comparatively wholesome and lively, so it might not seem that BCBS discovered any new diagnoses that it might 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 stating the failed forms @CMS I’ve been speaking about for years. You’ll be able to’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 providers follow chief offered a 90-minute interview with two reporters for a narrative they stated was about “issues with Deloitte’s eligibility techniques 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 techniques, the know-how that sustains them, and the complexity of the well being and human providers packages they assist.
The eligibility techniques are owned by the states, not Deloitte; they’re uniquely constructed for every state (in some circumstances, by different distributors many years in the past); and we work on the course of our purchasers to keep up and improve these techniques to adjust to state-specific insurance policies, guidelines, and processes, and evolving federal rules.
Two tales subsequently ran: “Medicaid for Millions in America Hinges on Deloitte-Run Systems Plagued by Errors” (June 24) and “Errors in Deloitte-Run Medicaid Systems Can Cost Millions and Take Years To Fix” (Sept. 5).
Most of the points reported as “widespread” are remoted to particular conditions or contain delicate knowledge that can’t be refuted by Deloitte because of consumer confidentiality obligations. That stated, there are lots of the explanation why somebody might lose protection or now not be eligible for a profit they as soon as acquired.
Not each “challenge” a constituent faces is the results of a system “error,” and challenges with particular person circumstances in particular person techniques aren’t because of some basic drawback in the way in which Deloitte helps state Medicaid packages.
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 world pandemic — that require modifications to a state’s know-how, change orders aren’t solely vital however acceptable.
They don’t characterize errors in a system that should be fastened.
All through the unwinding of the covid-19 public well being emergency — as applied sciences developed and insurance policies modified — Deloitte labored intently 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, employees, and neighborhood companions to assist the 34 million folks of their care.
Our purchasers perceive that enormous system implementations are difficult as a result of complexity of the packages they assist, and that every one IT techniques 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 techniques, and why trade analysts like Forrester and Gartner constantly rank Deloitte as a frontrunner 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 techniques 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 in regards to the new $2,000 restrict for out-of-pocket funds for Medicare Half D (“Medicare Drug Plans Are Getting Better Next Year. Some Will Also Cost More,” Oct. 21). As somebody with very excessive drug prices, I used to be very enthusiastic about this modification. Nonetheless, as soon as I researched the totally different drug plans obtainable for me and my husband, I spotted that the cash we spend on medication which might be prescribed by a physician however not lined by our plan won’t depend towards the $2,000 restrict. Subsequently, our price for vital medication will proceed to be exorbitant.
I believe that there are lots of seniors who might be very disenchanted as soon as they understand this.
— Pia Stampe, Eureka, California
In sharing the article on X, a Florida legal professional 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 Legislation 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 ‘Healthy’ and Treatable Teeth To Profit From Implants, Experts Warn,” Nov. 1). The details introduced are harrowing for a retired practitioner with a number of specialties who tried a lifetime to protect enamel and promote human well being.
As you would possibly know, oral biofilm is the largest enemy of oral well being and even common well being. Dental clinicians haven’t been in a position to visualize and establish the presence of pathogenic oral microbiome till lately. Pathogenic oral micro organism are among the many vital turbines of exhausting and smooth tissue deterioration, comparable to tooth decay, gum illnesses, and even an infection of dental implants. Probably the most trusted and used analysis process continues to be the X-ray.
X-rays can establish solely established illnesses. Sadly, radiologic analysis continues to be essentially the most trusted diagnostic device 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, turbines of caries, gum illnesses, and so forth., generate so-called porphyrins, which, as soon as excited by a particular wavelength, emit mild at a unique wavelength. Extremely dependable and simple-to-use applied sciences have been created lately to assist direct visualization and point-of-care identification of this pathogenic micro organism by means of the above-described process. These units assist the diagnostic course of and assist the dental clinician by guiding the therapy execution and figuring out when the therapy objective has been achieved. Dental therapy protocols using “Fluorescence-Enhanced Theragnosis” have develop into dependable and fewer invasive.
The excessive lack of human lives within the ICUs in the course of the pandemic because of ventilator-associated pneumonia might have been dramatically diminished utilizing the above protocol.
Wound-care science has already carried out fluorescence and is present process an amazing 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 the very best on the earth. 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
