Letters to the Editor is a periodic function. We welcome all feedback and can publish a range. We edit for size and readability and require full names.
Sounding the Alarm for Ambulances
Thanks for shedding much-needed gentle on the exorbitant prices and lack of reimbursement which have develop into a harsh actuality for a lot of ambulance providers throughout Colorado and the nation (“Insurers Combat State Legal guidelines Proscribing 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 aspect of the equation.
Ambulance suppliers usually obtain reimbursements properly under the precise value of delivering care. A latest business report discovered that ambulance providers are underneath‑reimbursed by a median of $1,526 per transport, with Medicare alone paying almost $2,334 lower than the 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 highway, preserve readiness, and put money into very important cellular well being care providers. Emergency preparedness depends on steady funding, and when that funding falls brief, communities undergo.
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 businesses themselves, so lawmakers and insurers perceive that truthful cost isn’t a bonus — it’s important to maintain us secure.
— Patrick Fahey, Weymouth, Massachusetts
A DevOps engineer shared the NPR model of the article on social media:
Households hit exhausting unexpectedly ambulance bills-some see money owed soar even with insurance coverage. Extra states are appearing, however a nationwide resolution could also be wanted for actual safety. pic.twitter.com/HRSW5mCdiu
— Michael Bennett (@M1keB_77) July 11, 2025
— Michael Bennett, Denver
‘Congress Is Taking part in Political Scorching 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 Reasonably priced Care Act is the explanation I can see a health care provider, take my remedy, and keep alive.
Now Congress is enjoying political sizzling potato with my well being. In the event that they don’t prolong the ACA’s enhanced subsidies by August, my $30 premium might soar to over $800. That’s over 25 instances as a lot. I’m not a hedge fund supervisor — I’m an impartial contractor. Except I begin promoting organs (not preferrred when your coronary heart’s the problem), I can’t sustain.
I’m too younger for Medicare and don’t have 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 modifications aren’t simply math — they’re about human lives.
As a result of if nothing modifications, a variety of us received’t be round to jot down letters subsequent yr.
— Kevin Bahn, Tamarac, Florida
Individuals Pay the Value for a Sick Well being Care System
I’m certain your readers can be considering 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 non-public worth for the MMR vaccine is round $13 (in U.S. {dollars}), supplied you will have a prescription. Any pharmacy can administer the jab for about the identical.
Right here in Switzerland, the most costly nation in Europe, this vaccine prices underneath $40, as a non-public buy.
I’ve moved 18 instances with household throughout Western and Japanese Europe and have had expat workers in 35 nations 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 finest well being care methods on the earth — near excellent. Fundamental protection phrases are federally mandated and price round $430 a month with a $2,500 annual deductible, regardless of age, after 26. And with a $300 yearly deductible, the premiums are about 40% greater.
One thing could be very off within the USA. It’s not that sophisticated.
— Clement Cohen, Geneva, Switzerland
A registered nurse shared his resolution for taming Medicaid fraud in a put up 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 based mostly on earnings 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 strategy new vaccine suggestions (“Kennedy’s Vaccine Advisers Sow Doubts as Scientists Protest US Pivot on Photographs,” June 27). Such a messaging appears poised to achieve 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 usually used to advocate for brand spanking new medical trials — even for vaccines already confirmed efficient — and to justify starting booster improvement from scratch.
Whereas inert placebos could have been used and have been applicable in early phases of analysis for vaccines, their use turns into ethically problematic when a secure, efficient vaccine already exists. In such instances, withholding safety from members in a placebo group can put them at actual danger, particularly through the improvement of up to date or booster doses of vaccines.
I consider it’s vital that organizations like KFF Well being Information assist make clear this concern 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 admire the way in which your reporting attracts in readers with accessible, partaking 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 presently has no vaccine, the placebo could also be saline or one other substance identified to be secure. If the vaccine is a possible substitute for an present, older vaccine, the comparator group could obtain the older vaccine that has already been examined relatively than an inert placebo.”
- “When a secure, efficient vaccine already exists towards a illness, giving youngsters within the placebo group no safety towards that illness is unethical. Unvaccinated youngsters can contract harmful sicknesses. Mother and father of youngsters 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 present vaccine? Folks hesitant about vaccines are unlikely to take part, for worry they’ll obtain the vaccine. And those that assist vaccination could also be reluctant to danger receiving an inert placebo as an alternative 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” collection:
A put up 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 aren’t lined. https://t.co/f3wWRouevA
— Heather McSharry, PhD (@PathogenScribe) July 1, 2025
— Heather McSharry, Austin, Texas
A Premium Shell Sport?
I learn Michelle Andrews’ article in the present day, printed 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 concern.
You describe as contributing components: 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 business insurance coverage provider. In my expertise, people don’t discover that their major insurance coverage has modified to Medicare primarily as a result of their employer continues to be deducting the premium for his or her business group medical insurance.
Isn’t it fraud for the insurance coverage provider to gather premiums for a coverage for which the subscriber is visibly now not eligible by legislation?
There’s a monetary incentive for the business provider 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 business provider can gather excessive premiums, then decline to pay advantages.
You point out that Medicare representatives word they aren’t required to inform subscribers. Why? Coincidence? Extra probably, the business 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 business plan. Fairly certain the hospital billing workplace is aware of fairly properly they’ll ultimately have the ability to invoice the affected person the retail charge, which is usually 10 instances as a lot (or extra) than the Medicare-discounted charge.
In my expertise, this isn’t a health care provider concern, because the doctor hardly ever pays any consideration to insurance coverage particulars. However it’s very a lot a billing workplace concern.
— 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 a giant public well being downside later and all the info factors in that course…👇🏼“As Hashish Customers Age, Well being Dangers Seem To Develop” by way of @kffhealthnews
— Brandon M. Macsata 🎗️ (@Purple_Strategy) June 9, 2025
— Brandon M. Macsata, New Haven, Connecticut
Getting Forward of Identified and Unknown Threats
As highlighted in your article “‘MAHA Report’ Requires Combating Persistent Illness, however Trump and Kennedy Have Yanked Funding” (July 2), proposals to eradicate the Nationwide Heart for Persistent Illness Prevention and Well being Promotion don’t align with efforts to deal with our nation’s continual 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 correctly.
For every greenback invested in illness prevention, the Belief for America’s Well being estimates, $5.60 in downstream prices could be saved nationwide — and this determine is even greater in some states.
However simply as cuts to continual well being analysis will hamper the federal authorities’s targets 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’ capability to cease outbreaks of measles, drug overdoses, or hepatitis, amongst many different preventable situations.
Investments in public well being have saved lives and strengthened our nation. Figuring out rising threats shortly — whether or not they come from infectious illnesses, zoonotic sicknesses, accidents, or accidents — is significant to mitigating them. Sadly, federal cuts to very important public well being funding streams and applications make it more and more tough for our nation’s leaders to know the threats going through their communities and take advantage of knowledgeable selections attainable to assist their communities.
Throughout the nation, public well being departments are scaling again workers and delaying plans to undertake higher know-how as a consequence of funding constraints; due to this fact, 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 affect of future well being dangers will probably be multiples greater 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 really enhance public well being, our leaders at each stage of presidency must be doubling down on public well being methods, each infrastructure and know-how, 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 continual 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 vital want for high quality bodily remedy (“How To Discover the Proper Medical Rehab Companies,” 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 harm strikes.
Bodily and occupational remedy providers should not only a type of post-accident care however are additionally proactive, non-pharmaceutical methods to protect power, steadiness, and independence — particularly for our getting old inhabitants. And analysis reveals that when bodily remedy is the first line of therapy for sure situations like decrease again ache — relatively 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 applications have been proven to scale back fall danger, whereas additionally reducing 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 put up‑harm therapy over preventive care, delaying entry to important bodily remedy till after injury happens.
In gentle 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 may also help is by supporting and passing the bipartisan Stopping Habit and Falls for the Aged, or SAFE, Act (H.R. 1171). This commonsense laws would enable 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 — targets 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
