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.
On Alcohol Abuse: Seeing a Double Standard
I have done quite a bit of research on alcohol-related deaths and I track reports from the Centers for Disease Control and Prevention. Now, my No. 1 question is: Why are the government and the media not holding the alcohol industry accountable for the deaths that its products cause?! The tobacco industry was held accountable for its products and now pharmacies are being held accountable for the opioid crisis. It seems to me that there’s a double standard that’s been ongoing for years, especially since alcohol-related deaths far outnumber opioid deaths. Can anyone working for the government or the media explain why I see more articles about the possible dangers of opioids or marijuana (“Legal Pot 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 Choice in How They Claim VA Disability Benefits
While I appreciate KFF Health News’ interest in the ongoing debate about private sector services helping veterans navigate the Department of Veterans Affairs’ disability claims process (“Some Private Companies Charge Hefty Fees to Help Veterans With Disability Claims,” April 28), your coverage left the impression that private benefit guides generally overcharge for their services and provide little value to veterans. That is an unfair characterization, and your readers deserve additional context.
Honorable companies like Veteran Benefits Guide, where I work, are providing a needed service to veterans, helping guide them through the complex claims process and ensure they receive the full benefits they earned from their service. As a company founded by a veteran and staffed by many veterans and family of veterans, we are proud that our clients receive an average increase to annual benefits of $13,200, benefits they would not receive without our help.
Veterans service organizations (VSOs) are intended 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 county VSOs nationwide, acknowledged that it does not have enough representatives nor funding to meet veterans’ demand for assistance.
Your article described $2,800 as a “hefty” fee being charged by one private benefit guide and quoted the National Organization of Veterans’ Advocates, a group representing accredited attorneys and agents, calling for tighter regulation of the industry, but then failed to mention that those attorneys and agents often charge veterans significantly more. In fact, accredited attorneys charge between 20% and 33% of a veteran’s backpay, which can exceed $50,000 on complicated cases. In nearly every scenario, an attorney will charge multiples more than a private benefit guide and take years longer to achieve the same result.
At Veteran Benefits Guide, our focus is on ensuring Veterans submit fully developed, accurate claims to the VA, which helps get the correct rating for the Veteran the first time, avoids the need for costly appeals and speeds up the final benefits decision. Attorneys, on the other hand, are only paid to assist Veterans during an appeals process. And they are incentivized to drag out appeals, since they are paid a percentage of the Veteran’s backpay. The longer an appeal takes, the more the attorney is paid.
Veteran Benefits Guide and other honorable 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 seeking to take advantage of veterans, establish safeguards to prevent conflicts of interest, and institute caps to prevent unreasonable fees — while still preserving the right of veterans to seek assistance from the private sector. It would have been helpful context for your readers to know that such reasonable legislation has been introduced and is being considered in Congress right now.
— Michael Licari, chief legal officer of Veteran Benefits Guide, Las Vegas
— Ellen Fink-Samnick, Burke, Virginia
Bracing for a Wave of Denials
Patients and physicians alike are shocked by the increasing number of absurd and sometimes dangerous barriers insurance companies put in place (“Denials of Health Insurance Claims Are Rising — And Getting Weirder,” May 26). Not only are coverage denials happening after the fact, but care is also disrupted before patients have a chance to get the drugs and services they need.
Through a process called prior authorization, insurance companies force doctors to submit requests for care, and the insurance company representatives, who are not necessarily specialists or even medical doctors, have the power to determine if care is necessary or not. At best, it delays care and can force patients to wait; at worst, medical care can be outright denied.
One egregious example is UnitedHealthcare’s unprecedented prior authorization policy for most endoscopies and colonoscopies, starting on June 1. Even if you have blood in your stool or suffer severe gastrointestinal pain, you will need to get preapproval 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 U.S. and Crohn’s disease and colitis affecting more than a million Americans, time is of the essence to catch problems quickly. I fear that UnitedHealthcare’s prior authorization policy will deter Americans from getting timely care and exacerbate existing disparities.
The gastrointestinal community calls on UnitedHealthcare to honor its recent promise to slash prior authorization — and rescind 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 applaud Judith Graham for her article “How to Grow Your Social Network as You Age” (April 28), which also published April 22 in The Washington Post. It aptly highlights the importance of social connections for older adults and emphasizes that “it’s never too late to develop meaningful relationships.” I 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.
In the past decade, an antidote to social isolation has emerged nationwide through the “Villages Movement” whereby local “communities” of neighbors help one another to successfully age in place.
Most Villages are volunteer organizations offering a range of social activities and basic services. There are approximately 350 Villages nationwide and 74 in the Washington, D.C., metro area. While each Village operates differently, they share the mission to improve the quality of life for seniors 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 adults. Whether they attend a Village seminar, luncheon, art tour, or bridge tournament, they are building those critical connections and having fun!
During the pandemic lockdown, our Potomac Community Village helped to reduce isolation by offering frequent Zoom programs as well as friendly phone calls and check-ins with members.
Villages are a great solution. I’d 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, him, él), Potomac Community Village Board of Directors vice president, Village to Village Network, Potomac, Maryland
— Alex Heard, Santa Fe, New Mexico
Remote Work Alone Won’t Solve Caregivers’ Challenges
I am a health care professional and have relied upon the work of KFF’s health policy research and KFF Health News over the years. Reading a recent article you produced, “Remote Work: An Underestimated Benefit for Family Caregivers” (May 19) by Joanne Kenen, I would strongly suggest a deeper view. Below are specific points I’d love to help bring to the attention of your readership, given my extensive work in the space of caregiving, health, and the working caregiver. I am a registered nurse, family caregiver, caregiving expert, and co-founder of two organizations that have been supporting family caregivers for the past eight years.
Remote work is helpful, yes. But it’s only part of the answer. Without the adequate tools, resources, and support to work and carry the load of caring 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 wholistic view and address the underlying factors of stress, and the myriad of challenges that plague every caregiver.
For example, communication challenges do not go away when working from home — not unless that working caregiver has the technology and resources to connect all the disparate communications in order to better coordinate among other family members involved in caring and with the 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’s happening, adjust care plans, and engage providers of care more effectively with the family caregiver at home managing the care, then work productivity, stress, and the employee’s well-being still takes a big hit, regardless of working remotely or not.
We need to go several layers deeper. Remote work is a good benefit, but it cannot stop there. Without the adequate support, technology, and tools to engage and better coordinate the mess, many working caregivers slog through every day, and the overall impacts will be far less than desired.
— Deb Kelsey-Davis, Chicago
— Catherine Arnst, New York City