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.
Sounding the Alarm for Ambulances
Thanks for shedding much-needed gentle on the exorbitant prices and lack of reimbursement which have grow to be 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 important to guard sufferers from “shock” payments — one thing your protection highlights — it’s equally necessary to acknowledge the opposite aspect of the equation.
Ambulance suppliers typically obtain reimbursements properly beneath 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 associated fee incurred. These shortfalls are unsustainable and threaten the monetary viability of emergency responders.
It’s essential that ambulance firms 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 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 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 laborious unexpectedly ambulance bills-some see money owed soar even with insurance coverage. Extra states are performing, 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 Enjoying 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 Inexpensive Care Act is the explanation 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 prolong 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 perfect 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 gained’t pay attention, I’m asking you — the press — to assist. Inform this story, or one similar to it. Tens of millions of People 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 gained’t be round to write down letters subsequent yr.
— Kevin Bahn, Tamarac, Florida
People Pay the Value for a Sick Well being Care System
I’m certain your readers could be excited by 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}), offered you might 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 personal buy.
I’ve moved 18 occasions with household throughout Western and Jap 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 finest well being care methods on the planet — near good. 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 difficult.
— 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 in case you keep within the mud.It’s comparatively simple to repair the profit cliff: simply section in a graduated premium for Medicaid primarily based on earnings above the brink. If we had political will to do that, it could 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). This kind of messaging appears poised to realize traction with the general public, regardless of its moral implications.
More and more, I’m seeing criticism that vaccine growth doesn’t depend on inert placebos. This argument is commonly used to advocate for brand spanking new scientific trials — even for vaccines already confirmed efficient — and to justify starting booster growth from scratch.
Whereas inert placebos could have been used and had been acceptable in early phases of analysis for vaccines, their use turns into ethically problematic when a secure, efficient vaccine already exists. In such circumstances, withholding safety from contributors in a placebo group can put them at actual danger, particularly through the growth of up to date or booster doses of vaccines.
I imagine it’s crucial 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 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 had been examined initially in randomized scientific 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 identified to be secure. If the vaccine is a possible substitute for an current, older vaccine, the comparator group could obtain the older vaccine that has already been examined slightly 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. Dad and mom of kids within the placebo group wouldn’t know they didn’t get the vaccine and that their youngster is unprotected.”
That brings up one other necessary 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 are going to 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 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 youngster 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 right now, printed within the San Francisco Chronicle (“Have Job-Primarily based Well being Protection at 65? You Might Nonetheless Need To Signal Up for Medicare,” June 18). Thanks for reporting on this necessary concern.
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 imagine there’s an necessary further 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 continues to be deducting the premium for his or her industrial group medical 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 legislation?
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 notice they don’t seem to be required to inform subscribers. Why? Coincidence? Extra possible, the industrial insurance coverage firms 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 certain the hospital billing workplace is aware of fairly properly they are going to finally be capable to invoice the affected person the retail payment, which is usually 10 occasions as a lot (or extra) than the Medicare-discounted payment.
In my expertise, this isn’t a health care provider concern, because the doctor not often 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 growing older inhabitants:
Normalized hashish use now will yield a giant public well being drawback later and all the info factors in that path…👇🏼“As Hashish Customers Age, Well being Dangers Seem To Develop” https://t.co/xNrqqz1k1L through @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 eradicate the Nationwide Middle for Power Illness Prevention and Well being Promotion don’t align with efforts to handle our nation’s persistent illness disaster. These plans additionally additional underscore the significance of strengthening America’s public well being infrastructure not solely to save lots of lives, but in addition 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 might be saved nationwide — and this determine is even greater 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’ potential 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 shortly — whether or not they come from infectious illnesses, zoonotic sicknesses, accidents, or accidents — is important to mitigating them. Sadly, federal cuts to 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 choices attainable to assist their communities.
Throughout the nation, public well being departments are scaling again employees and delaying plans to undertake higher expertise attributable to 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 substitute 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 greater on each the nationwide well being care system and the assets (together with authorities funding) wanted to handle no matter could also be coming subsequent.
To actually enhance public well being, our leaders at each degree of presidency needs to be doubling down on public well being methods, 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 just 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. It’s also necessary 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 power, stability, and independence — particularly for our growing older inhabitants. And analysis exhibits that when bodily remedy is the first line of remedy for sure circumstances like decrease again ache — slightly 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 circumstances.
Furthermore, bodily therapist-led fall prevention packages have been proven to cut back fall danger, whereas additionally chopping emergency room visits, hospitalizations, and opioid use amongst older adults. These numbers matter deeply in an growing older America the place 30 million older adults fall every year and the lifetime medical value of treating falls is over $100 billion yearly. And but, the Medicare system typically prioritizes submit‑damage remedy over preventive care, delaying entry to important bodily remedy till after harm 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 method 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 — 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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