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.

Many readers responded to our data-driven protection of how moral and non secular directives issued by the U.S. Convention of Catholic Bishops have an effect on care choices at Catholic and Catholic-affiliated hospitals in the USA. And we encourage different readers to share their suggestions.

A communications specialist in Seattle said her opinion bluntly in an X publish.

“An increasing number of ladies are operating into obstacles to acquiring care as Catholic well being techniques have aggressively acquired secular hospitals in a lot of the nation.”Faith is harming healthcare. https://t.co/O4L9mIzP5K

— JoAnne Dyer (@7Madronas) February 27, 2024

— JoAnne Dyer, Seattle

The Proper to Separation of Church and Care

At my most up-to-date OB-GYN appointment, I used to be warned that our greatest hospital, Covenant Medical Middle, is affiliated with the Roman Catholic denomination, as is its string of major care and different clinics, Grace Clinics.

Trying to regain some sense of management over my physique, I made a decision to create an advance well being directive to clarify I don’t need to be taken to any medical facility related to that denomination, to keep away from my medical care being curtailed or impacted by moral and non secular directives, often known as ERDs, issued by Roman Catholic bishops (“The Highly effective Constraints on Medical Care in Catholic Hospitals Throughout America,” Feb. 17). To do that, I needed to know which amenities are so affiliated. It is vitally laborious to search out that out.

First, I checked out Grace Clinic and Covenant Medical Middle web sites. No point out of affiliation with the church, or ERDs, or how ERDs restrict the varieties of medical therapies a affected person might be supplied (and even knowledgeable of the existence of).

After I known as Grace Clinic, they denied affiliation with the Catholic Church. After I known as Covenant Medical Middle, additionally they denied affiliation. They’re owned by Windfall, which is Roman Catholic, although it’s a must to do a deep dive into the web site to determine that out.

Both the workers are mendacity or are stored in ignorance so the sufferers might be stored in ignorance. How can a affected person decide whether or not a hospital will deny them care due to non secular beliefs, if the group conceals its affiliation with stated beliefs?

These hospitals have the suitable to imagine no matter they need. It seems they presently even have the suitable to mislead sufferers about it. How can sufferers learn well being care shoppers if they will’t entry the knowledge they want, and are affirmatively given incorrect info from the organizations?

I’ve contacted Windfall by means of its web site asking whether it is affiliated with the Roman Catholic Church and, if that’s the case, the place I can discover a record of varieties of sufferers that gained’t be handled in accordance with American Medical Affiliation requirements, in addition to which therapies, procedures, and drugs won’t be supplied or supplied solely on a restricted foundation due to that affiliation.

I’ve heard nothing.

— Helen Liggett, Lubbock, Texas

An assistant professor on the Cincinnati Kids’s Hospital Medical Middle additionally weighed in on X:

Essential reporting from @KFFHealthNews on the impression of Catholic hospital care together with their ethics evaluation course of:https://t.co/0k2mJpPhY0

— Elizabeth Lanphier (@EthicsElizabeth) February 19, 2024

— Elizabeth Lanphier, Cincinnati

Life at All Prices Is Expensive

One facet of IVF that’s not being mentioned is the discarding of embryos discovered to have critical medical defects (‘What the Well being?’: Alabama Court docket Guidelines Embryos Are Kids. What Now? Feb. 22). For instance, a household might carry a devastating situation and want to display screen potential offspring, or defects might come up spontaneously. The Alabama Supreme Court docket’s determination means that these embryos, too, have to be implanted.

The court docket’s determination additionally impacts infants born with extreme defects. How a lot help have to be supplied a child born with out elements of the mind and cranium (anencephaly), which isn’t terribly unusual? Or one born with out kidneys? Or one with a most extreme type of brittle-bone illness (osteogenesis imperfecta), the place each contact can break bones? It sounds as if Alabama legislation now requires most help in each occasion — in my view, this might be holier-than-thou sadism. How does the court docket outline life? Merely a beating coronary heart? I can’t think about a nurse or physician not leaving/quitting when compelled to torture these infants. Then there’s the mother and father’ torment. That is godly?

— Gloria Kohut, Grand Rapids, Michigan

On X, an anesthetist and emergency drugs physician promoted the “What the Well being?” podcast episode that delved into the subject:

Try the newest episode of KFF Well being Information’ “What the Well being?” podcast, the place the Alabama Supreme Court docket’s ruling on embryo rights sparks a nationwide debate. Plus, potential abortion bans and Catholic hospital care. Pay attention at: https://t.co/4hrsEaWXVb#well being, #healthpolicy, …

— David Moniz (@DrDavidMoniz) February 22, 2024

— David Moniz, Chilliwack, British Columbia

Distilling Statistics on Girls’s Ingesting

Whereas the distilled spirits business is against extreme consumption by any phase of our society, it’s necessary to notice that your latest article on ladies and alcohol failed to incorporate federal information exhibiting reductions in alcohol abuse amongst ladies in the USA (“Extra Girls Are Ingesting Themselves Sick. The Biden Administration Is Involved,” March 28). For instance, the newest Nationwide Survey on Drug Use and Well being information signifies binge-drinking amongst ladies 21 and older declined greater than 6% prior to now 5 years (from 2018 to 2022).

Moreover, claims within the article that the covid-19 pandemic “considerably exacerbated binge-drinking” will not be supported by a number of federal information sources that point out that the pandemic didn’t produce lasting will increase in consuming or dangerous consuming.

For example, a 2023 examine utilizing federal information confirmed that, whereas gross sales did rise on the very starting of the pandemic, this didn’t essentially translate to elevated binge-drinking or general consumption within the months following. Slightly, consuming decreased — each days per thirty days consuming and drinks per day — as did binge-drinking. Furthermore, the identical federal NSDUH information referenced above signifies practically 9 out of 10 U.S. adults 21 years and older (89%) say they drink the identical quantity or lower than they did pre-pandemic.

The article additionally cites an outdated World Burdens of Illness report revealed in 2018 to again up claims that “no quantity of alcohol is secure” whereas ignoring the up to date GBD report revealed in 2022. Importantly, this most up-to-date GBD analysis concluded there are consuming ranges “at which the well being threat is equal to that of a non-drinker” and that “for people age 40+, consuming small quantities of alcohol isn’t dangerous to well being.”

Reporting on alcohol analysis offers necessary info for shoppers, so it’s crucial that such reporting appropriately displays the newest proof on alcohol and well being. We encourage all adults who select to drink — ladies and men — to drink moderately, to comply with the recommendation of the Dietary Tips for People, and to speak to their well being care suppliers who may also help decide what’s greatest for them based mostly on particular person components and household historical past.

— Amanda Berger, vice chairman of science and well being, Distilled Spirits Council of the USA, Washington, D.C.

A lawyer who makes a speciality of preventing insurance coverage denials really useful our March “Invoice of the Month” characteristic in an X publish:

All too usually insurance coverage suppliers declare medical therapy isn’t medically crucial. This text explains a #Cigna denial. #healthinsurance #medicalnecessity https://t.co/rpMwsSOOup

— Scott Glovsky (@ScottGlovskyLaw) March 25, 2024

— Scott Glovsky, Pasadena, California

Working Inside a Damaged Well being Care System

Due to Molly Citadel Work for the wonderful article in regards to the England household’s struggles with our damaged well being care system (“A Mother’s $97,000 Query: How Was Her Child’s Air-Ambulance Trip Not Medically Needed?” March 25). One avenue of decision that was not famous in your wonderful article is the California Division of Managed Well being Care. I’m a doctor, and we had a special, but additionally very costly ($90,000), well being care invoice. It took two years and two appeals to that division, however, finally, we had been reimbursed by our insurance coverage firm. It is a useful resource that needs to be extra broadly recognized.

— Erica Buhrmann, Berkeley, California

An Unfair Burden on These Most in Want

It’s obscure why these most weak in society, who’ve issue buying medical insurance, are required to pay extra for companies with the identical medical doctors and amenities than insurance coverage corporations pay. Insurers profit from “negotiated pricing.” These with no insurance coverage are required to pay the whole “inflated” invoice for medical companies. Most occasions, the distinction between the quantity a health care provider or medical supplier payments, in contrast with the precise cost medical doctors obtain from insurance coverage corporations, is roughly 20% of the quantity billed.

It’s patently unfair to require uninsured sufferers to pay greater than insurance coverage corporations pay. Uninsured people have an unfair bargaining energy, in contrast with insurance coverage corporations. instance is demonstrated in your article of the lady who obtained an uncovered emergency medical flight earlier than her dying, and her heirs had been left with an outrageous invoice of $81 (“With out Medicare Half B’s Protect, Affected person’s Household Owes $81,000 for a Single Air-Ambulance Flight,” Feb. 27). If her household was instructed they had been chargeable for $81,000 for the air ambulance, the transport wouldn’t have occurred.

The follow of holding uninsured individuals chargeable for “whole” medical payments usually, in essence, causes somebody who doesn’t have protection — largely due to affordability — to complement the income of medical doctors and medical suppliers by being required to pay the total inflated quantity billed for medical companies.

Insurance coverage corporations defend this follow of “negotiated pricing,” when, in essence, it’s used to power those that can least pay to complement losses suffered by the medical doctors for discounted funds from insurers.

There must be regulation that prohibits medical suppliers from price-gouging the uninsured, forcing them to complement medical doctors’ and suppliers’ revenue to make up for underpayments from insurers. Many occasions, uninsured people are already residing at or close to poverty ranges earlier than incurring sudden medical obligations. Being hit with a shock invoice for an air-ambulance trip costing $81,000 is ample to trigger the affected person to file for chapter. Within the U.S., the No. 1 purpose folks file for chapter safety is due to medical payments.

Our present system of administering well being care and funds for such is damaged and must be mounted. As soon as this disparate system of funds is rectified, well being care ought to turn out to be way more accessible to most people.

— Ronald B. Kaplan, Holbrook, Massachusetts

On X, a public well being scholar shared our article in regards to the unwanted side effects of the anti-vaccine motion:

A TN legislation now means they foster mother and father, social employees & different caregivers can’t present permission for childhood vaccines — an important a part of well being care for youths. We have to take antivaxxers critically as a result of they’re critically harming public well being. https://t.co/6jX7ltNq4i

— jenn kauffman ✨ (@jennaudrey) March 12, 2024

— Jenn Kauffman, Washington, D.C.

Not Vaccinated? Get Education Elsewhere

I’m a father and a major care doctor. I simply learn Amy Maxmen’s article “How the Anti-Vaccine Motion Pits Parental Rights In opposition to Public Well being” (March 12) and commend her for her balanced and fact-based presentation.

I really feel that an necessary facet is lacking from such articles — that being the rights of nearly all of mother and father who help vaccination to have their kids within the most secure potential setting in public faculties. We all know that no vaccine is ideal, and that our youngsters are nonetheless in danger for measles, covid, and different ailments, regardless of benefiting from the confirmed advantages of vaccines.

I imagine that oldsters who train their rights to not have their kids vaccinated needs to be required to homeschool, or to ship their kids to non-public faculties having insurance policies with which they agree. I’m conscious that solely a tiny proportion of People would agree with me.

— John Cottle, Mendocino, California

Scientific psychologist Carl Hindy appeared impressed by our article on a expensive new postpartum melancholy therapy:

[Instead of gender reveal parties, we can have Pharma baby showers 😢] A New $16,000 Postpartum Despair Drug Is Right here. How Will Insurers Deal with It? – KFF Well being Information https://t.co/1CVZEX7yf8

— Carl Hindy, Ph.D., HSP, Scientific Psychologist (@DrCarlHindy) March 18, 2024

— Carl Hindy, Exeter, New Hampshire

Tending to New Moms’ Wants

It was heartbreaking to learn that personal well being insurers have successfully delayed the supply of a revolutionary therapy for postpartum melancholy, a debilitating situation that makes it tough for brand spanking new mother and father to care for his or her households, work, and even get off the bed (“A New $16,000 Postpartum Despair Drug Is Right here. How Will Insurers Deal with It?” March 12).

As one of many 1 in 5 new moms who struggled with this horrible sickness when my very own son was born, I can solely hope zuranolone is made broadly obtainable very quickly. As an advocate for the rights of pregnant employees, I hope that psychological well being care suppliers are conscious that there’s one other new and revolutionary device that’s at their disposal right this moment to help sufferers fighting prenatal and postpartum psychological well being situations. A brand new federal legislation, the Pregnant Employees Equity Act, offers employees the suitable to obtain adjustments at work wanted for pregnancy-related psychological well being situations. The Pregnant Employees Equity Act, which applies to employers with 15 or extra workers, requires they supply cheap lodging for being pregnant, childbirth, and associated medical situations, as long as it doesn’t impose an undue hardship. For instance, a brand new mom experiencing a perinatal psychological well being situation could also be eligible to obtain a modified schedule, time without work to attend psychological well being appointments, a extra non-public workspace, permission to earn a living from home, or every other “cheap lodging” that can deal with their wants. Psychological well being care suppliers ought to help their sufferers by discussing their work-related challenges, serving to to determine office modifications, and writing efficient work notes to their sufferers’ employers.

Well being care suppliers and their sufferers can entry free sources from the College of California Regulation-San Francisco Middle for WorkLife Regulation on office lodging for perinatal psychological well being situations at pregnantatwork.org. Well being care suppliers or workers with questions can contact the Middle for WorkLife Regulation’s free and confidential authorized helpline at 415-703-8276 or hotline@worklifelaw.org.

— Juliana Franco, San Francisco

Concern of Needles Is Typically Unfounded

I learn your article “Needle Ache Is a Massive Downside for Children. One California Physician Has a Plan” (March 20). I can let you know from expertise that the needle isn’t the supply of the ache. After a bone marrow transplant from a donor, I needed to get all these childhood vaccines and people for adults 65 and older. The needle stick can barely be felt; it’s the treatment moving into that’s painful. The realm you get the vaccine in is then sore for a number of days. That has been my expertise.

— Patsy Rowan, Los Angeles

Radiologist Ian Weissman chimed in on X about pain-reduction methods:

Researchers have helped develop a 5 step plan to assist forestall what they name “unnecessary ache” for kids getting injections or their blood drawnhttps://t.co/mCi8Tx6ILn

— Ian Weissman, DO (@DrIanWeissman) March 29, 2024

— Ian Weissman, Milwaukee

Knowledgeable on the Distinction Between Mis- and Disinformation

First, I’m grateful to your continued investigative reporting on covid-19.

Second, I’m writing to share a perspective that I belief you may share with the author of “4 Years After Shelter-in-Place, Covid-19 Misinformation Persists” (April 1). My focus is on the time period “info” and its variants.

Particularly, I discover it useful to tell apart linguistically three variants:

• “Data” is info that one offers to others that the informer believes to be correct.
• “Misinformation” is info that one offers to others that the informer believed was correct, but was supplied info that signifies the knowledge was lower than correct at some degree. As such the informer points an erratum and corrects the “mis” of the “mis-information.”
• “Disinformation” is info that one offers to others with demonstrable data that this info isn’t correct and shares with an intent to illicit thought and motion for ulterior motives — motives which can be usually nefarious and should lead to hurt, similar to growing particular person and/or inhabitants morbidity and mortality.

I discover the conflation of “mis” and “dis” to be in and of itself dangerous to those that convey “mis” after which appropriate in addition to giving those that use “dis” for less-than-honorable functions cowl, a secure haven, and a “get-out-of-jail card.”

For instance, it’s well-known that Fox Information internally adhered to info based mostly on scientific information and medical proof throughout the covid-19 pandemic state of emergency. Concurrently, it parlayed info externally that may solely be characterised as “dis.”

What I discover stunning is the very fact (I stand to be corrected ought to I be misinformed) that nobody has discovered at the least one particular person who acted upon Fox Information’ disinformation that resulted in morbidity and/or mortality — or wrongful dying litigation.

Sustain the great work.

— Ed Shanshala, CEO of Ammonoosuc Group Well being Companies, Littleton, New Hampshire

A communications specialist outdoors Chicago known as out disinformation in an X publish:

Disinformation is public well being enemy 1. Those that begin it and unfold it are poisonous for our society.

— Michelle Rathman 🟧 (the true one) (@MRBImpact) April 1, 2024

— Michelle Rathman, Geneva, Illinois

States Ought to Not Spend Opioid Settlement Money on Unproven Tech

Aneri Pattani did a wonderful job reporting on the occasion in Cellular, Alabama, on Jan. 24, the place the Poarch Band of Creek Indians offered a examine for $500,000 from the tribe’s opioid settlement funds to the Helios Alliance (“Statistical Fashions vs. Entrance-Line Employees: Who Is aware of Greatest Find out how to Spend Opioid Settlement Money?” March 5).

Helios, which incorporates for-profit and nonprofit organizations, will use funds to construct a proprietary simulation mannequin to assist leaders resolve find out how to spend settlement funds. Based on Helios, the preliminary system won’t be accomplished earlier than spring 2024.

As a digital product supervisor for the previous 20 years, I perceive the potential of expertise to enhance well being care, however settlement funds shouldn’t be financing early-stage, proprietary applied sciences developed by private-sector corporations. Helios’ pitch is: “… spend 5% [of settlement funds] so that you get the most important impression with the opposite 95%,” says Rayford Etherton, who shaped the alliance. However given the nationwide settlement is $50 billion over the subsequent 18 years, 5% signifies that $2.5 billion would go to a doubtlessly proprietary resolution.

Whereas the promise of a brand new expertise simulation mannequin is thrilling, it’s additionally high-risk. Furthermore, whereas revered specialists like Stephen Loyd are concerned with Helios, there aren’t skilled synthetic intelligence engineers, digital product specialists, information scientists, or safety specialists listed on the Helios web site.

Any expertise developed utilizing opioid settlement funds needs to be open-source and free to all states. Extra transparency from Helios is required to explain possession, consumer entry phrases, and licensing charges.

Settlement funds needs to be deployed to confirmed, evidence-based options. Given the opioid disaster has been raging for 20 years, well being care specialists have already got data-driven insights on find out how to repair this: enhance entry to medication-assisted therapy; cut back obstacles to doctor licensing for buprenorphine, methadone, and naltrexone; enhance schooling in faculties; improve social companies similar to employment and youngster care; and enhance funding to legislation enforcement to struggle unlawful opioids (particularly, fentanyl).

Slightly than placing giant settlement investments right into a not-yet-built simulation mannequin, states ought to use a human-centered design method based mostly on analysis from sufferers, suppliers, members of the family, and group teams which were battling the opioid disaster for many years to drive preliminary investments throughout the ecosystem of opioid disaster drivers. As soon as Helios has a working simulation product examined and in manufacturing, states can think about small investments to pilot utilization and see if the product truly produces the specified outcomes.

The continued mantra of “public-private partnerships” is a good concept, however the public sector shouldn’t find yourself paying the invoice and taking over all the danger.

— Kelly O’Connor, Washington, D.C.

A professor in Weill Cornell Medication’s Division of Inhabitants Well being Sciences shared insights on X:

Fascinating article. On the one hand “Knowledge doesn’t save lives. Numbers on a pc don’t save lives,” vs town has an obligation to make use of its settlement funds “in a method that’s going to do essentially the most good…as a substitute of merely guessing.” https://t.co/w4QJ7zOkgM

— Bruce Schackman (@BruceSchackman) March 6, 2024

— Bruce Schackman, New York Metropolis