Letters to the Editor is a periodical column. We welcome all comments and will post a selection. We edit for length and clarity and require full names.
On alcohol abuse: Seeing a double standard
I’ve done quite a bit of research on alcohol-related deaths and keep track of reports from the Centers for Disease Control and Prevention. Now, my question no. 1 is: why don’t the government and the media hold the alcohol industry responsible for the deaths caused by its products?! The tobacco industry was held accountable for its products and now pharmacies are held accountable for the opioid crisis. It seems to me that there is a double standard that has been going on for years, especially since alcohol-related deaths far outnumber opioid-related deaths. Can someone who works for the government or the media explain why I see more articles about the possible dangers of opioids or marijuana (Legal Weed Is More Potent Than Ever and Still Largely Unregulated, May 9) instead of alcohol-related deaths?
Stephen Hubbard, Independence, Missouri
John Schroyer, Denver
Veterans deserve a choice in how to apply for VA disability benefits
While I appreciate KFF Health News’ interest in the ongoing debate about private sector services that help veterans navigate the Department of Veterans Affairs disability claim process (Some private companies charge high fees to help veterans with Disability Claims, April 28), your coverage has left the impression that private benefit guides generally overburden their services and provide little value to veterans. This is an unfair characterization and your readers deserve some additional context.
Reputable companies like Veteran Benefits Guide, where I work, are providing a needed service to veterans, helping guide them through the complex claims process and making sure they receive all the benefits they have earned from their service. As a company founded by a veteran and made up of many veterans and veterans’ families, we are proud that our customers receive an average annual benefit increase of $13,200, benefits they would not receive without our help.
Veterans Service Organizations (VSOs) aim to help free of charge, but too often they are understaffed and inadequately trained. In congressional testimony, the National Association of County Veterans Service Officers, which represents the county’s VSOs nationwide, acknowledged that it does not have enough representatives or funds to meet the demand for veterans’ assistance.
Your article described $2,800 as a hefty fee charged by a private benefit guide and cited the National Organization of Veterans Advocates, a group that represents accredited attorneys and agents, calling for stricter regulation of the industry, but then said failed to mention that those lawyers and agents often charge veterans much more. In fact, accredited attorneys charge between 20% and 33% of a veteran’s back pay, which can exceed $50,000 in complicated cases. In almost all scenarios, an attorney will charge more for a private benefits drive and take years longer to get the same result.
At Veteran Benefits Guide, our goal is to ensure that veterans submit fully developed and accurate applications to the VA, which helps get the veteran evaluation right the first time, avoids the need for costly appeals, and expedites the final benefit decision. . Lawyers, on the other hand, are only paid to assist veterans during an appeals process. And they have an incentive to delay appeals, since they get a percentage of the veterans’ backlog. The longer an appeal takes, the more the lawyer gets paid.
Veteran Benefits Guide and other reputable companies have strongly supported efforts to establish guardrails and crack down on bad actors, such as the recently introduced PLUS for Veterans Act, which would impose criminal penalties on those who seek to take advantage of veterans, establish safeguards to prevent conflicts of interest, and institute limits to avoid unreasonable taxes while preserving the right of veterans to seek assistance from the private sector. It would have been some helpful context for your readers to know that such sensible legislation has been introduced and is currently under consideration in Congress.
Michael Licari, chief legal officer of Veteran Benefits Guide, Las Vegas
Ellen Fink-Samnick, Burke, Virginia
Prepare for a wave of denials
Patients and doctors alike are shocked by the growing number of absurd and sometimes dangerous barriers that insurance companies put in place (Health insurance claims denials are growing and getting weirder, May 26). Not only do coverage denials occur after the fact, but care is also stopped before patients have a chance to get the drugs and services they need.
Through a process called prior authorization, insurance companies force doctors to make claims for treatment, and insurance company representatives, who are not necessarily specialists or even doctors, have the power to determine whether or not treatment is needed. At best, it delays treatment and may force patients to wait; at worst, medical assistance may be denied altogether.
A prime example is UnitedHealthcares’ unprecedented prior authorization policy for most endoscopy and colonoscopies, effective June 1. Even if you have blood in your stool or have severe gastrointestinal pain, you’ll need to get pre-approval before you can receive a procedure to diagnose or treat your condition. With colorectal cancer being the second leading cause of cancer deaths in the United States and Crohn’s disease and colitis affecting more than one million Americans, time is of the essence to identify problems quickly. I worry that UnitedHealthcares’ prior authorization policy will discourage Americans from getting timely care and exacerbate existing disparities.
The gastrointestinal community is calling on UnitedHealthcare to honor its recent pledge to reduce prior authorization and reverse this absurd policy before patients suffer real harm.
Barbara Jung, president-elect of the American Gastroenterological Association, Seattle
Lindsay Resnick, Chicago
Aging takes a village
I appreciate Judith Graham for her article How to Grow Your Social Network as You Age (April 28), also published April 22 in the Washington Post. She rightly emphasizes the importance of social connections for seniors and points out that it’s never too late to develop meaningful relationships. Could not agree more.
We are increasingly learning about the consequences of isolation and loneliness on the emotional, physical and cognitive health of older adults.
Over the past decade, an antidote to social isolation has emerged nationwide through the Village Movement, where local communities of neighbors help each other to age successfully in place.
Most villages are voluntary organizations offering a range of social activities and basic services. There are approximately 350 villages nationwide and 74 in the Washington, DC metropolitan area. While each village operates differently, they share a mission to improve the quality of life for the elderly and reduce isolation.
My work with villages, both nationally and locally, has allowed me to witness firsthand how villages are improving the lives of older people. Whether they’re attending a village workshop, luncheon, art tour, or bridge tournament, they’re building those foundational connections and having a great time!
During the pandemic lockdown, our Potomac Community Village has helped reduce isolation by offering frequent Zoom programs, friendly phone calls, and member check-ins.
Villages are a great solution. I would encourage readers to consider joining a Village where they can find new friends and a renewed sense of community. For more information, see vtvnetwork.org.
Edgar E. Rivas (he, he, l), Vice Chairman of the Board of Potomac Community Village, Village to Village Network, Potomac, Maryland
Alex Heard, Santa Fe, New Mexico
Remote working alone will not solve the challenges for healthcare professionals
I am a healthcare professional and have relied on the health policy research work of KFF and KFF Health News over the years. Reading a recent article you produced, Remote Working: An Underrated Advantage for Family Caregivers (May 19) by Joanne Kenen, I would strongly suggest a deeper look. Below are specific points I’d like to help bring to readers’ attention, given my extensive work in the care, health, and working caregiver space. I am a registered nurse, family carer, caregiving expert, and co-founder of two organizations that have supported family caregivers for the past eight years.
Remote work is useful, yes. But that’s only part of the answer. Without the proper tools, resources, and support to work and carry the burden of care at home, working caregivers will still experience stress, burnout, hits to their productivity, loneliness, and the list goes on.
We need to take a more holistic view and address the underlying factors of stress and the myriad challenges facing every caregiver.
For example, communication challenges do not go away when working from home unless the working caregiver has the technology and resources to connect all disparate communications in order to better coordinate among other family members involved in care and with providers involved in managing their care. Post-it notes, texts, emails and phone calls are no way to communicate and are simply ineffective.
Having remote patient monitoring devices at home is good, but if they are not connected to a platform to better coordinate what is happening, adjust care plans and engage care providers more effectively with the family assistant at home that manages care, so work productivity, stress and employee well-being still takes a hit, whether you work remotely or not.
We have to go several levels deeper. Remote work is a good advantage, but it can’t stop there. Without the proper support, technology, and tools to better engage and coordinate chaos, many healthcare workers are toiling every day, and the overall impacts will be far less than desired.
Deb Kelsey-Davis, Chicago
Catherine Arnst, New York City
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