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Sunday, January 29, 2023
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  • Automotive
    4 Common Mistakes To Avoid With Car Restorations

    4 Common Mistakes To Avoid With Car Restorations

    Signs That It Might Be Time To Get a New Car

    Signs That It Might Be Time To Get a New Car

    Mercedes-Benz Charging Network

    Mercedes-Benz to Launch Global Branded High-Power Charging Network in North America

    Ways To Surprise Your Partner Who Loves Cars

    Ways To Surprise Your Partner Who Loves Cars

    5 Important Tips for Every New Jeep Owner

    5 Important Tips for Every New Jeep Owner

    The Best Ways To Increase the Value of Your Car

    The Best Ways To Increase the Value of Your Car

    Why Jeeps Are Awesome for Off-Roading Adventures

    Why Jeeps Are Awesome for Off-Roading Adventures

    What To Know Before Purchasing Your First Motorcycle

    What To Know Before Purchasing Your First Motorcycle

    How To Ensure Proper Motorcycle Maintenance

    How To Ensure Proper Motorcycle Maintenance

    Trending Tags

    • Mercedes-Benz
    • Mustang
  • Business
    How To Host a Music Festival During Colder Months

    How To Host a Music Festival During Colder Months

    Tips for Designing an Effective Beverage Label

    Tips for Designing an Effective Beverage Label

    Delta now accepting flight attendant applications

    Delta now Accepting Flight Attendant Applications

    Common Mistakes That Every Manager Makes

    Common Mistakes That Every Manager Makes

    Important Safety Features in Commercial Buildings

    Important Safety Features in Commercial Buildings

    Removing Barriers to Considering ESG Factors in Retirement Plan Investments

    Reasons Why You Should Show Workers Appreciation

    Reasons Why You Should Show Workers Appreciation

    Ways To Maintain Your Business’s Parking Lot

    Ways To Maintain Your Business’s Parking Lot

    Tips for Ensuring You Get the Right People for Your Business

    Tips for Ensuring You Get the Right People for Your Business

    Trending Tags

    • Fashion
      Make a Bold Style Statement With These Wide-Leg Pants

      Make a Bold Style Statement With These Wide-Leg Pants

      Power Your Winter Workouts With The Best Zip Hoodies for Men

      Power Your Winter Workouts With The Best Zip Hoodies for Men

      The Ultimate Watch Buying Guide

      The Ultimate Watch Buying Guide

      Outdoor Enthusiasts, Take Note: These Watches Are as Tough as You

      Outdoor Enthusiasts, Take Note: These Watches Are as Tough as You

      Our 7 Favorite Field Jackets for Tackling Fall Weather

      Our 7 Favorite Field Jackets for Tackling Fall Weather

      The Best Leather Jackets for Guys – No Matter Your Budget

      The Best Leather Jackets for Guys – No Matter Your Budget

      Campus-Ready Backpacks for Storing *All* the Books

      Campus-Ready Backpacks for Storing *All* the Books

      Trust Us: These Corduroys Should Be Your Go-To Winter Pants

      Trust Us: These Corduroys Should Be Your Go-To Winter Pants

      The Best Henley Shirts to Ace Rugged Fall Layering

      The Best Henley Shirts to Ace Rugged Fall Layering

      Trending Tags

      • Food & Drink
        Cheese Tortellini in Creamy Marinara

        Cheese Tortellini in Creamy Marinara

        Unusual Products That Come From Animals and Their Uses

        Unusual Products That Come From Animals and Their Uses

        Tips for Creating a Homemade Wine Cellar

        Tips for Creating a Homemade Wine Cellar

        How the wine you choose can help you have an eco-friendly home

        How the Wine You Choose Can Help You have an Eco-Friendly Home

        Rum and Cola Holiday Ham

        Special Centerpieces for Holiday Celebrations

        ChefsGiving 2020

        This Holiday Season, How about Cooking for a Cause?

        Iced Cold Moscow Mule cocktail with lime and pomegranate

        Holiday Spirits: The Cranberry Smash Moscow Mule

        The Most Beautiful Liquor Bottles in the World

        The Most Beautiful Liquor Bottles in the World

        Tao Group Virtual Chef Experience

        Entertain Your Guests Virtually This Fall ?

        Trending Tags

        • Health
          Part II: The State of the Abortion Debate 50 Years After ‘Roe’

          Part II: The State of the Abortion Debate 50 Years After ‘Roe’

          Part I: The State of the Abortion Debate 50 Years After ‘Roe’

          Part I: The State of the Abortion Debate 50 Years After ‘Roe’

          Florida Gov. DeSantis Falsely Claims Bivalent Booster Boosts Chances of Covid Infection

          Florida Gov. DeSantis Falsely Claims Bivalent Booster Boosts Chances of Covid Infection

          Wave of Rural Nursing Home Closures Grows Amid Staffing Crunch

          Wave of Rural Nursing Home Closures Grows Amid Staffing Crunch

          Unmet Needs: Critics Cite Failures in Health Care for Vulnerable Foster Children

          Unmet Needs: Critics Cite Failures in Health Care for Vulnerable Foster Children

          Transgender People in Rural America Struggle to Find Doctors Willing or Able to Provide Care

          Transgender People in Rural America Struggle to Find Doctors Willing or Able to Provide Care

          Abortion Debate Ramps Up in States as Congress Deadlocks

          Abortion Debate Ramps Up in States as Congress Deadlocks

          NFL Has Been Slow to Embrace Mental Health Support for Players

          NFL Has Been Slow to Embrace Mental Health Support for Players

          Rural Seniors Benefit From Pandemic-Driven Remote Fitness Boom

          Rural Seniors Benefit From Pandemic-Driven Remote Fitness Boom

          Trending Tags

          • Lifestyle
            Why is desalination so difficult?

            Why is desalination so difficult?

            Passive Income Ideas for Making Money in 2023

            Passive Income Ideas for Making Money in 2023

            How To Host a Music Festival During Colder Months

            How To Host a Music Festival During Colder Months

            Delta now accepting flight attendant applications

            Delta now Accepting Flight Attendant Applications

            A Brief History of Paper and Why It Matters for Artists

            A Brief History of Paper and Why It Matters for Artists

            4 Tri4 Tricks for Staying Warm at Home This Wintercks for Staying Warm at Home This Winter

            4 Tricks for Staying Warm at Home This Winter

            What Makes Leather Such a Useful Material?

            What Makes Leather Such a Useful Material?

            9 Tips to Save on Holiday Shopping

            9 Tips to Save on Holiday Shopping

            Reasons Why LA Is the Best Place To Ride an E-bike

            Reasons Why LA Is the Best Place To Ride an E-bike

            Trending Tags

            • Politics
              Business interests spent $3.5 billion on federal political contributions during the 2022 cycle

              Business interests spent $3.5 billion on federal political contributions during the 2022 cycle

              Federal lobbying spending reaches $4.1 billion in 2022 — the highest since 2010

              Federal lobbying spending reaches $4.1 billion in 2022 — the highest since 2010

              Sanctioned-Oligarch-Connected Andrew Intrater’s GOP Donations Go Beyond Just George Santos

              Sanctioned-Oligarch-Connected Andrew Intrater’s GOP Donations Go Beyond Just George Santos

              Campaign finance reform advocates put pressure on Virginia General Assembly

              Campaign finance reform advocates put pressure on Virginia General Assembly

              ‘Dark money’ groups have poured billions into federal elections since the Supreme Court’s 2010 Citizens United decision

              ‘Dark money’ groups have poured billions into federal elections since the Supreme Court’s 2010 Citizens United decision

              Senate Judiciary Committee grills Live Nation in hearing on impact of industry consolidation

              Senate Judiciary Committee grills Live Nation in hearing on impact of industry consolidation

              Wall Street ally Sen. Thom Tillis tapped to join GOP leadership

              Wall Street ally Sen. Thom Tillis tapped to join GOP leadership

              Drought

              The Politics of Drought Management

              ‘A missed opportunity’: Virginia subcommittee on campaign finance reform has little to show after 2-year study

              ‘A missed opportunity’: Virginia subcommittee on campaign finance reform has little to show after 2-year study

              Trending Tags

              • Real Estate
                How To Make Your Rental Property More Eco-Friendly

                How To Make Your Rental Property More Eco-Friendly

                Things To Consider Before Investing in Real Estate Overseas

                Things To Consider Before Investing in Real Estate Overseas

                Incredible Areas in Florida To Buy a Vacation Home

                Incredible Areas in Florida To Buy a Vacation Home

                Helpful Home Staging Tips for Virtual Tours

                Helpful Home Staging Tips for Virtual Tours

                Ways To Decorate and Design a Lake House

                Ways To Decorate and Design a Lake House

                Challenges To Managing a Rental Property

                Challenges To Managing a Rental Property

                The Best Landlord: How To Show Tenants You Care

                The Best Landlord: How To Show Tenants You Care

                The Best Locations To Invest in a Second Home

                The Best Locations To Invest in a Second Home

                How a Nice Garden Can Impress Buyers

                How a Nice Garden Can Impress Buyers

                Trending Tags

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                  • Technology
                  • Travel
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                • Automotive
                  4 Common Mistakes To Avoid With Car Restorations

                  4 Common Mistakes To Avoid With Car Restorations

                  Signs That It Might Be Time To Get a New Car

                  Signs That It Might Be Time To Get a New Car

                  Mercedes-Benz Charging Network

                  Mercedes-Benz to Launch Global Branded High-Power Charging Network in North America

                  Ways To Surprise Your Partner Who Loves Cars

                  Ways To Surprise Your Partner Who Loves Cars

                  5 Important Tips for Every New Jeep Owner

                  5 Important Tips for Every New Jeep Owner

                  The Best Ways To Increase the Value of Your Car

                  The Best Ways To Increase the Value of Your Car

                  Why Jeeps Are Awesome for Off-Roading Adventures

                  Why Jeeps Are Awesome for Off-Roading Adventures

                  What To Know Before Purchasing Your First Motorcycle

                  What To Know Before Purchasing Your First Motorcycle

                  How To Ensure Proper Motorcycle Maintenance

                  How To Ensure Proper Motorcycle Maintenance

                  Trending Tags

                  • Mercedes-Benz
                  • Mustang
                • Business
                  How To Host a Music Festival During Colder Months

                  How To Host a Music Festival During Colder Months

                  Tips for Designing an Effective Beverage Label

                  Tips for Designing an Effective Beverage Label

                  Delta now accepting flight attendant applications

                  Delta now Accepting Flight Attendant Applications

                  Common Mistakes That Every Manager Makes

                  Common Mistakes That Every Manager Makes

                  Important Safety Features in Commercial Buildings

                  Important Safety Features in Commercial Buildings

                  Removing Barriers to Considering ESG Factors in Retirement Plan Investments

                  Reasons Why You Should Show Workers Appreciation

                  Reasons Why You Should Show Workers Appreciation

                  Ways To Maintain Your Business’s Parking Lot

                  Ways To Maintain Your Business’s Parking Lot

                  Tips for Ensuring You Get the Right People for Your Business

                  Tips for Ensuring You Get the Right People for Your Business

                  Trending Tags

                  • Fashion
                    Make a Bold Style Statement With These Wide-Leg Pants

                    Make a Bold Style Statement With These Wide-Leg Pants

                    Power Your Winter Workouts With The Best Zip Hoodies for Men

                    Power Your Winter Workouts With The Best Zip Hoodies for Men

                    The Ultimate Watch Buying Guide

                    The Ultimate Watch Buying Guide

                    Outdoor Enthusiasts, Take Note: These Watches Are as Tough as You

                    Outdoor Enthusiasts, Take Note: These Watches Are as Tough as You

                    Our 7 Favorite Field Jackets for Tackling Fall Weather

                    Our 7 Favorite Field Jackets for Tackling Fall Weather

                    The Best Leather Jackets for Guys – No Matter Your Budget

                    The Best Leather Jackets for Guys – No Matter Your Budget

                    Campus-Ready Backpacks for Storing *All* the Books

                    Campus-Ready Backpacks for Storing *All* the Books

                    Trust Us: These Corduroys Should Be Your Go-To Winter Pants

                    Trust Us: These Corduroys Should Be Your Go-To Winter Pants

                    The Best Henley Shirts to Ace Rugged Fall Layering

                    The Best Henley Shirts to Ace Rugged Fall Layering

                    Trending Tags

                    • Food & Drink
                      Cheese Tortellini in Creamy Marinara

                      Cheese Tortellini in Creamy Marinara

                      Unusual Products That Come From Animals and Their Uses

                      Unusual Products That Come From Animals and Their Uses

                      Tips for Creating a Homemade Wine Cellar

                      Tips for Creating a Homemade Wine Cellar

                      How the wine you choose can help you have an eco-friendly home

                      How the Wine You Choose Can Help You have an Eco-Friendly Home

                      Rum and Cola Holiday Ham

                      Special Centerpieces for Holiday Celebrations

                      ChefsGiving 2020

                      This Holiday Season, How about Cooking for a Cause?

                      Iced Cold Moscow Mule cocktail with lime and pomegranate

                      Holiday Spirits: The Cranberry Smash Moscow Mule

                      The Most Beautiful Liquor Bottles in the World

                      The Most Beautiful Liquor Bottles in the World

                      Tao Group Virtual Chef Experience

                      Entertain Your Guests Virtually This Fall ?

                      Trending Tags

                      • Health
                        Part II: The State of the Abortion Debate 50 Years After ‘Roe’

                        Part II: The State of the Abortion Debate 50 Years After ‘Roe’

                        Part I: The State of the Abortion Debate 50 Years After ‘Roe’

                        Part I: The State of the Abortion Debate 50 Years After ‘Roe’

                        Florida Gov. DeSantis Falsely Claims Bivalent Booster Boosts Chances of Covid Infection

                        Florida Gov. DeSantis Falsely Claims Bivalent Booster Boosts Chances of Covid Infection

                        Wave of Rural Nursing Home Closures Grows Amid Staffing Crunch

                        Wave of Rural Nursing Home Closures Grows Amid Staffing Crunch

                        Unmet Needs: Critics Cite Failures in Health Care for Vulnerable Foster Children

                        Unmet Needs: Critics Cite Failures in Health Care for Vulnerable Foster Children

                        Transgender People in Rural America Struggle to Find Doctors Willing or Able to Provide Care

                        Transgender People in Rural America Struggle to Find Doctors Willing or Able to Provide Care

                        Abortion Debate Ramps Up in States as Congress Deadlocks

                        Abortion Debate Ramps Up in States as Congress Deadlocks

                        NFL Has Been Slow to Embrace Mental Health Support for Players

                        NFL Has Been Slow to Embrace Mental Health Support for Players

                        Rural Seniors Benefit From Pandemic-Driven Remote Fitness Boom

                        Rural Seniors Benefit From Pandemic-Driven Remote Fitness Boom

                        Trending Tags

                        • Lifestyle
                          Why is desalination so difficult?

                          Why is desalination so difficult?

                          Passive Income Ideas for Making Money in 2023

                          Passive Income Ideas for Making Money in 2023

                          How To Host a Music Festival During Colder Months

                          How To Host a Music Festival During Colder Months

                          Delta now accepting flight attendant applications

                          Delta now Accepting Flight Attendant Applications

                          A Brief History of Paper and Why It Matters for Artists

                          A Brief History of Paper and Why It Matters for Artists

                          4 Tri4 Tricks for Staying Warm at Home This Wintercks for Staying Warm at Home This Winter

                          4 Tricks for Staying Warm at Home This Winter

                          What Makes Leather Such a Useful Material?

                          What Makes Leather Such a Useful Material?

                          9 Tips to Save on Holiday Shopping

                          9 Tips to Save on Holiday Shopping

                          Reasons Why LA Is the Best Place To Ride an E-bike

                          Reasons Why LA Is the Best Place To Ride an E-bike

                          Trending Tags

                          • Politics
                            Business interests spent $3.5 billion on federal political contributions during the 2022 cycle

                            Business interests spent $3.5 billion on federal political contributions during the 2022 cycle

                            Federal lobbying spending reaches $4.1 billion in 2022 — the highest since 2010

                            Federal lobbying spending reaches $4.1 billion in 2022 — the highest since 2010

                            Sanctioned-Oligarch-Connected Andrew Intrater’s GOP Donations Go Beyond Just George Santos

                            Sanctioned-Oligarch-Connected Andrew Intrater’s GOP Donations Go Beyond Just George Santos

                            Campaign finance reform advocates put pressure on Virginia General Assembly

                            Campaign finance reform advocates put pressure on Virginia General Assembly

                            ‘Dark money’ groups have poured billions into federal elections since the Supreme Court’s 2010 Citizens United decision

                            ‘Dark money’ groups have poured billions into federal elections since the Supreme Court’s 2010 Citizens United decision

                            Senate Judiciary Committee grills Live Nation in hearing on impact of industry consolidation

                            Senate Judiciary Committee grills Live Nation in hearing on impact of industry consolidation

                            Wall Street ally Sen. Thom Tillis tapped to join GOP leadership

                            Wall Street ally Sen. Thom Tillis tapped to join GOP leadership

                            Drought

                            The Politics of Drought Management

                            ‘A missed opportunity’: Virginia subcommittee on campaign finance reform has little to show after 2-year study

                            ‘A missed opportunity’: Virginia subcommittee on campaign finance reform has little to show after 2-year study

                            Trending Tags

                            • Real Estate
                              How To Make Your Rental Property More Eco-Friendly

                              How To Make Your Rental Property More Eco-Friendly

                              Things To Consider Before Investing in Real Estate Overseas

                              Things To Consider Before Investing in Real Estate Overseas

                              Incredible Areas in Florida To Buy a Vacation Home

                              Incredible Areas in Florida To Buy a Vacation Home

                              Helpful Home Staging Tips for Virtual Tours

                              Helpful Home Staging Tips for Virtual Tours

                              Ways To Decorate and Design a Lake House

                              Ways To Decorate and Design a Lake House

                              Challenges To Managing a Rental Property

                              Challenges To Managing a Rental Property

                              The Best Landlord: How To Show Tenants You Care

                              The Best Landlord: How To Show Tenants You Care

                              The Best Locations To Invest in a Second Home

                              The Best Locations To Invest in a Second Home

                              How a Nice Garden Can Impress Buyers

                              How a Nice Garden Can Impress Buyers

                              Trending Tags

                              • More…
                                • Sports
                                • Technology
                                • Travel
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                              Mr. Glitterati
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                              Readers and Tweeters Diagnose Greed and Chronic Pain Within US Health Care System

                              January 21, 2023
                              in Health
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                              Readers and Tweeters Diagnose Greed and Chronic Pain Within US Health Care System
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                              Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names.

                              U.S. Health Care Is Harmful to One’s Health

                              Thank you for publishing this research (“Hundreds of Hospitals Sue Patients or Threaten Their Credit, a KHN Investigation Finds. Does Yours?” Dec. 21). I am a psychotherapist and have written about this problem in my blog. The mercenary American health care system is hypocritical in the stressful financial demands and threats it imposes on so many patients. Stress due to health care-related bankruptcy, or the threat of bankruptcy, is harmful to one’s health. A health care system that is supposed to treat illness and restore health can, in fact, cause serious illness and/or exacerbate existing medical problems. The higher levels of stress and the threat of bankruptcy that all too frequently follow needed medical care can be harmful to individuals with cardiovascular issues such as high blood pressure and heart arrhythmia, and can trigger panic attacks in those who suffer from anxiety disorders. There may be digestive issues associated with higher levels of stress, and the patient’s sleep may be adversely affected. The individual may have to cut back on essentials such as food and medications because of unpaid medical bills, aggressive calls from collection agencies, and the threat of bankruptcy.

                              All of this in the name of “health care” delivered by professions and organizations that proclaim the importance of beneficence, justice, and non-malfeasance within their respective codes of ethics. Curative stress? Therapeutic bankruptcy? The hypocrisy is palpable.

                              American history is replete with examples of discrimination against certain groups, including racial discrimination, the disenfranchisement of women, child labor, and others. Eventually, political measures were enacted to correct these injustices. It’s only a matter of time until the American health care system, including the pharmaceutical industry, is forced to reform itself for the sake of the men, women, and children in need of essential health care. It’s not a question of if, but when.

                              — Fred Medinger, Parkton, Maryland

                              I find this infuriating! Especially the nonprofit organizations. Hundreds of US Hospitals Sue Patients or Threaten Their Credit, a KHN Investigation Finds | Kaiser Health News https://t.co/87TTYPVE0P

                              — Jan Oldenburg ☮️ (@janoldenburg) December 21, 2022

                              — Jan Oldenburg, Richmond, Virginia

                              Thanks for the article about hospitals suing patients. I just switched health plans in New York state. Reasons: My previous insurer raised my premium over 90% last year, paid very little of my claims (leaving Medicare to pay most of the claims), and sent me to collections. This, even though I worked two full-time jobs for most of my 46 years of teaching. How do insurance companies and hospitals get away with this unethical and outrageous behavior?

                              — George Deshaies, Buffalo, New York

                              Great story by @KHNews‘ @NoamLevey, which found that at least 297 hospitals in MN, 56%, sue patients for unpaid medical bills. 90, or 17%, can deny patients nonemergency medical care if they have past-due bills.Mayo is one of those hospitals. See🧵https://t.co/p5dHdbZKou

                              — Molly Work (@mollycastlework) December 21, 2022

                              — Molly Work, Rochester, Minnesota

                              Unhappy New Year of Deductibles and Copays

                              Listened to a conversation between Noam N. Levey and NPR’s Ari Shapiro, regarding Levey’s article on Germany’s lack of medical debt (“What Germany’s Coal Miners Can Teach America About Medical Debt,” Dec. 14). Levey passed along the tidbit that Affordable Care Act plans purchased through state exchanges would pay a maximum out-of-pocket amount of $9,000 a year. Likely Mr. Levey knows the actual details of the ACA at least as well as I, but I had well over $20,000 in out-of-pocket expenses for my own care last year (in addition to annual premiums of over $15,000). The deductible/copay aspect of health insurance is rigged against folks who actually use their insurance. The in-network and out-of-network provider scheme is likewise designed to benefit providers as opposed to patients.

                              I’ve had health insurance for about 40 years, since I graduated from college. Always a plan paid for by myself, never through an employer. I’ve had my first year of using a lot of heath care services (colon cancer surgery and chemo follow-up), and the bills are quite astronomical. Still awaiting the final negotiations between Stanford Hospital and Blue Shield of California for the $97,000 bill for services for the surgery and stay in the hospital. Though my surgery was in September, the two had not resolved the bill by year-end. Now all my copays and deductibles have reset, and I’ll be back at the starting gate, dollar-wise.

                              We need health care payment reform.

                              — George McCann, Half Moon Bay, California

                              Tx @NoamLevey for this important comparative piece on how Germany’s private healthcare system does not create #medicaldebt. We need to do better. @RIPMedicalDebt https://t.co/PoAduYljXq

                              — Allison Sesso (@AllisonSesso) December 14, 2022

                              — Allison Sesso, president and CEO of RIP Medical Debt, Long Island City, New York

                              Greedy to the Bone?

                              In orthopedics, surgery is where the money is (“More Orthopedic Physicians Sell Out to Private Equity Firms, Raising Alarms About Costs and Quality,” Jan. 6). Just as a private equity-controlled ophthalmology group tried to persuade me to have unnecessary cataract surgery (three other eye doctors agreed it wasn’t necessary), too many orthopedic patients can expect to be pushed to unnecessary surgeries.

                              — Gloria Kohut, Grand Rapids, Michigan

                              As #private #equity firms acquire #physician practices, the issue of non-competes and #restrictive covenants become even more relevant in #healthcare @AAOS1 @AmerMedicalAssn @JHU_HBHI @linakhanFTC @KHNews https://t.co/fTfilK4WEX

                              — Amit Jain, MD, MBA (@AmitJainSpine) January 8, 2023

                              — Dr. Amit Jain, Baltimore

                              The Painful Truth of the Opioid Epidemic

                              In a recent article, Aneri Pattani and Rae Ellen Bichell discussed disparities in the distribution of settlement funds from lawsuits against major pharmaceutical companies, especially in rural areas (“In Rural America, Deadly Costs of Opioids Outweigh the Dollars Tagged to Address Them,” Dec. 12).

                              We suggest that the merit of many of the lawsuits that led to these large settlements remains unproven. While Purdue Pharma clearly overstated the safety of prescription opioids in treating chronic pain, judges in two high-profile cases ruled in favor of the pharmaceutical companies stating that prosecutors falsely inflated the danger of opioids and noted that opioids used per FDA guidelines are safe and effective, remaining a vital means to treat chronic pain. Also, many cases involving Purdue Pharma, Johnson & Johnson, and others were settled based on expediency, rather than merit. This may have been due to the reasoning that continuing their defense against prosecutors having access to limitless public funds would lead to bankruptcy.

                              The primary cause of America’s overdose crisis is not physicians’ “overprescribing” opioids. Dr. Thomas Frieden, former head of the Centers for Disease Control and Prevention, noted that the rise in prescription opioids paralleled the increase in opioid deaths up to 2010, leading the CDC to create guidelines in 2016 limiting opioid use to treat chronic pain. However, cause-and-effect relationships between the legitimate use of prescription opioids and opioid deaths remain unclear. For example, the National Institute on Drug Abuse noted in 2015 that since 2000, misuse of prescription drugs preceded the use of heroin in most cases. But legitimate prescriptions by physicians to patients with chronic pain constituted only 20% of the cases leading to heroin addiction. Prescription drugs used by heroin addicts were from family members or friends in 80% of the cases leading to heroin use.

                              Since at least 2010, the volume of prescription opioids dropped by over 60% — yet overdose deaths have skyrocketed to over 100,000 cases in 2021. The opioid overdose death crisis is now driven mainly by illegally imported fentanyl and in part by a misguided crackdown of the Drug Enforcement Administration against physicians who legitimately prescribe opioids to chronic pain patients, forcing them to seek out street drugs.

                              Statistics from Michigan indicate that nearly 40% of primary care clinics will no longer see new patients for pain management. The CDC, in its 2022 updated guidelines, attempted to clarify misunderstandings, including inappropriate rapid tapering and individualizing care. However, the public health crisis of undertreated pain remains. Some states have passed intractable pain laws to restore access to opioids to chronic pain patients with a legitimate need, indicating the shortfalls of the CDC guidelines to treat pain.

                              — Richard A. Lawhern, Fort Mill, South Carolina, and Dr. Keith Shulman, Skokie, Illinois

                              Important reporting from @aneripattani and @raelnb in @KHNews: National settlements are being paid out by #opioids manufacturers, but #rural communities are often getting less funds to address the #OpioidCrisis than their urban and suburban counterparts. https://t.co/qeoXtqKfpo

                              — Joanne Conroy (@JoanneConroyMD) December 15, 2022

                              — Dr. Joanne Conroy, Lebanon, New Hampshire

                              We’re fighting to hold accountable the companies that helped create and fuel the opioid crisis so we can help people struggling with opioid use disorder across North Carolina and the country get resources for treatment and recovery. We need this money now to save lives.

                              To that end, I wanted to flag one concern about the article on rural counties and opioid funding. It looks as if the comparison and the maps about North Carolina funding by county and overdose deaths may not correlate. The reporting seems to reflect overdose deaths on a per capita basis, but funding is indicated by total dollars received.

                              This spreadsheet might be helpful. It ranks each North Carolina county by the amount of funds they will receive from the distributor and Johnson & Johnson settlements (as posted on www.ncopioidsettlement.org) per capita, using 2019 population figures. In per capita rankings, rural and/or less populous counties are typically receiving more funding per capita than larger counties. For example, the 10 counties receiving the most per capita funding are all rural and/or less populous counties (Wilkes, Cherokee, Burke, Columbus, Graham, Yancey, Mitchell, Clay, Swain, and Surry). Wake County, our most populous county, is ranked 80th.

                              It’s also important to note that the formula was developed by experts for counsel to local governments in the national opioid litigation, who represent and have duties of loyalty to both large urban and small rural local governments. It takes into account opioid use disorder in the county (the number of people with opioid use disorder divided by the total number of people nationwide with opioid use disorder), overdose deaths as a percentage of the nation’s opioid overdose deaths, and the number of opioids in the county. Click here for more information.

                              Indeed, one of the special masters appointed by U.S. District Judge Dan Polster in the national opioid litigation found that the national allocation model “reflects a serious effort on the part of the litigating entities that devised it to distribute the class’s recovery according to the driving force at the heart of the lawsuit — the devastation caused by this horrific epidemic.” (See Page 5 of this report of Special Master Yanni.)

                              You’re absolutely right that rural counties were often the earliest and hardest hit by the opioid epidemic, and it’s critical that they receive funds to help get residents the treatment and recovery resources they need. We’re hopeful that these funds, whose allocation was determined in partnership by local government counsel, will help deliver those resources.

                              — Nazneen Ahmed, North Carolina Attorney General’s Office, Raleigh, North Carolina

                              This article is a great example of equality ≠ equity regarding opioid settlement funds disbursement. Really thoughtful article by @aneripattani & @raelnb https://t.co/vRbksffwqP

                              — Kate Roberts, LCSW (@KateandOlive_) December 14, 2022

                              — Kate Roberts, Durham, North Carolina

                              A Holistic Approach to Strengthening the Nursing Workforce Pipeline

                              As we face the nation’s worst nursing shortage in decades, some regions are adopting creative solutions to fill in the gaps (“Rural Colorado Tries to Fill Health Worker Gaps With Apprenticeships,” Nov. 29). To truly solve the root of this crisis, we must look earlier in the workforce pipeline.

                              The entire nation currently sits in a dire situation when it comes to having an adequate number of nurses — especially rural communities. With the tripledemic of covid-19, influenza, and RSV tearing through hospitals, it’s never been more evident how vital nurses are to the functioning of our health care system. A recent McKinsey report found that we need to double the number of nurses entering the workforce every year for the next three years to meet anticipated demand. Without support from policymakers and health care leaders, we cannot meet that.

                              As a health care executive myself, I’ve seen firsthand how impactful apprenticeships can be because they help sustain the health care workforce pipeline. From high school students to working adults, these “earn while you learn” apprenticeships allow students to make a living while working toward their degree, and my system’s apprenticeship program has even reduced our turnover by up to 50%. It provides a framework to support a competency-based education rooted in real-life skills and hands-on training for key nursing support roles, all while team members earn an income.

                              Education is key to developing competent, practice-ready nurses. Not just through apprenticeships but early on in students’ educational journey, too. According to the newest data from the nation’s report card, students in most states and most demographic groups experienced the steepest declines in math and reading ever recorded. As we continue to see the devastating impact the pandemic had on young learners, it’s crucial we invest more in remediation and support, so students graduate from secondary school with a deep understanding of these core competencies and are ready to pursue nursing. A recent survey of nearly 4,000 prospective nursing students from ATI Nursing Education found that a lack of academic preparedness was the top reason for delaying or forgoing nursing school.

                              Without intervention now, our nursing workforce shortage will only worsen in the future. We need our leaders to face these challenges head-on and invest in a holistic approach to strengthen our nursing pipeline. There’s no time to waste.

                              — Natalie Jones, executive director of workforce development at WellStar Health System, Atlanta

                              1 solution to the staffing crisis: Apprenticeship programs put students directly into long-term care professions. Rural areas benefit the most since they have more residents who are 65 or older & fewer direct care workers to help people w/ disabilities. https://t.co/vnbHAJYWvY

                              — OK Health Action (@ok_action) November 30, 2022

                              — Oklahoma Health Action Network, Oklahoma City

                              Planning Major Surgery? Plan Ahead

                              I read Judith Graham’s good article “Weighing Risks of a Major Surgery: 7 Questions Older Americans Should Ask Their Surgeon” (Jan. 3) on CNN. Thought I should add some personal experience. At age 78, my mother had back surgery in 2016. When she was getting prepped, she was given multiple documents to sign. Once signed, she was immediately taken to surgery. There was not enough time to read any of them. In hindsight, we are certain the documents were mostly for release of liability if something goes wrong. After surgery, she had “drop foot” — total loss of use of her left foot. Never heard of it. She was told she would regain use in about six months. Never happened. She had to use a walker and still had numerous falls in which her head had hit the ground multiple times. She slowly slid into long-term “confusion” that was attributed to her falls and passed away at age 84.

                              My story is about my abdominal aorta aneurysm surgery in 2022 at age 62. I did not have an overnight recovery — tube taken out of my throat, catheter removed, and was immediately transferred to a room. An IV pump of saline was left on and my arm swelled up — I thought my arm was going to burst. Five days later, I was discharged. Everything seemed rushed. The only postsurgical “instructions” I received were to keep the incision clean and not to play golf, and I don’t even play golf. I recuperated at home, and after five months I still have abdominal pain that I’ll always have.

                              Both of our surgeries were done on a Friday. I’m certain our experiences were due to hospital staff wanting to leave early on Friday, and weekend staffers are mostly the “B” team. So, my advice is to suggest to the elderly not to have surgery scheduled on a Friday unless there is absolute urgency in choosing the date.

                              — Paul Lyon, Chesapeake, Virginia

                              Reality bites, doesn’t it.https://t.co/sHe0EV1DQG

                              — suzette sommer (@suzette_sommer) December 28, 2022

                              — Suzette Sommer, Seattle

                              I am writing to express my concerns over the significant misinformation in the article about what older Americans should ask their surgeon before major surgery.

                              Most abdominal aortic aneurysms are treated with endovascular methods. These minimally invasive procedures still require general anesthesia (with a breathing tube), but most patients have the tube removed before leaving the operating room, and many patients leave the hospital the next day with minimal functional limitations due to surgery being performed through half-inch incisions in each groin.

                              The “best case” surgical scenario described in your article describes open abdominal aortic aneurysm repair, which is recommended for fewer than 20% of patients requiring aortic aneurysm repairs.

                              In essence, you’re threatening everyone who comes in for a tuneup with an engine rebuild.

                              Abdominal aortic aneurysms are still undertreated in the U.S., with many patients not receiving screening recommended by Medicare since 2006. Your article misrepresents the “best case” scenario and may dissuade patients from receiving lifesaving care.

                              — Dr. David Nabi, Newport Beach, California

                              I read, with interest, Judith Graham’s article about older Americans preparing for major surgery. But you failed to mention the life-altering effects of anesthesia. My independent 82-year-old mother had a minor fall in July and broke her hip. After undergoing anesthesia, she is required to have 24/7 care as her short-term memory has been forever altered. Was there a choice not to have hip surgery? I didn’t hear one. Did anyone explain the issues that could (and often do) occur with an elderly brain due to anesthesia? No. And now we are dealing with this consequence. And what happens when you don’t have money (like most people in the U.S.) for 24/7 care? I hope you’ll consider writing about this.

                              — Nancy Simpson, Scottsdale, Arizona

                              Shouldn’t more people wonder why MA plans are profitable while our own gov’t MC is losing money. Only 5% of MA plans are audited yearly. Yet they are getting 8.5% increase in payment & docs (the folks taking care of the pts) are getting cut. https://t.co/UiFiiQ9wre via @khnews

                              — Madelaine Feldman (@MattieRheumMD) December 15, 2022

                              — Dr. Madelaine Feldman, New Orleans

                              The High Bar of Medicare Advantage Transparency

                              Unfortunately, KHN’s article “How Medicare Advantage Plans Dodged Auditors and Overcharged Taxpayers by Millions” (Dec. 13) provided a misleading, incomplete depiction of Medicare Advantage payment.

                              This story focuses largely on audits that, in some cases, are more than a decade old. While KHN’s focus is on alleged “overpayment,” the same audits show that many plans were underpaid by as much as $773 per patient.

                              More recent research demonstrates Medicare Advantage’s affordability and responsible stewardship of Medicare dollars. For example, an October 2021 Milliman report concludes “the federal government pays less and gets more for its dollar in MA than in FFS,” while the Department of Health and Human Services’ fiscal year 2021 report shows that the net improper payment rate in Medicare Advantage was roughly half that of fee-for-service Medicare.

                              KHN’s article is right about one thing: Only a small fraction of Medicare Advantage plans are audited each year — denying policymakers and the public a fuller understanding of the program’s exceptional value to seniors and the health care system. That is why Better Medicare Alliance has called for regulators to conduct Risk Adjustment Data Validation (RADV) audits of every Medicare Advantage plan every year.

                              There are opportunities, as outlined in our recent policy recommendations, to further strengthen and improve Medicare Advantage’s high bar of transparency and accountability, but that effort is not well served by this misleading article.

                              — Mary Beth Donahue, president and CEO of the Better Medicare Alliance, Chevy Chase, Maryland

                              Targeting Gun Violence

                              I’m curious why KHN neglected to actually get into all the “meat and potatoes” regarding its report on Colorado’s red flag law (“Colorado Considers Changing Its Red Flag Law After Mass Shooting at Nightclub,” Dec. 23). Specifically, it failed to report that the suspect in this case used a “ghost gun” to execute the crime in Colorado Springs, and more importantly what impact any red flag law is going to have on a person who manufactures their own illegal firearm. Lastly, why is it the national conversation regarding the illegal use and possession of firearms curiously avoids any in-depth, substantive conversation of access to firearms by mentally ill people? Quite frankly, this is the underlying cause of illegal firearms use and no one wants to step up to the plate and address the issue at any in-depth level. It’s categorically embarrassing for American journalism.

                              — Steve Smith, Carbondale, Colorado

                              KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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