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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.
Debunking Abortion Myths
I want to send a big THANK YOU to Matt Volz for writing a fact-checking article on the nonsense rhetoric around “abortion up until and after birth” that has run wild and unchallenged in the media (“GOP’s Tim Sheehy Revives Discredited Abortion Claims in Pivotal Senate Race,” July 9). Thanks for putting abortion later in pregnancy in context and debunking false assumptions.
I am a near-third-trimester abortion patient (nonviable pregnancy, terminated at 26 weeks), and I am so sick of hearing politicians like Tim Sheehy talk about something they have never experienced or bothered to learn about. It is as though I am watching the entire nation maliciously gossip about me and other parents like me. Those of us in the termination for medical reasons (TFMR) community have walked through hell only to have our voices, at best, be ignored or, more commonly, be insulted and threatened.
And I imagine watching this political circus is just as hurtful for parents who lost an infant shortly after birth and had to provide palliative care. That is who they are talking about with “abortion after birth”; they are talking about comfort care for infants who will not survive.
Thank you again for bringing a dose of reality to a conversation that never should have become political. These are impossible decisions that only parents should make. It was really refreshing to read Volz’s article and know that some journalists are still willing to fact-check the absurd claims floating around. It was encouraging to know that someone does see us.
— Anne Angus, Bozeman, Montana
A physician and Yale professor of radiology and biomedical imaging took to the social platform X to share feedback:
.@SenatorTester is a great Senator. And his opponent is a great liar. Both the GOP presidential candidate and Tim Sheehy have perpetuated this lie. Please push back every time you hear it. https://t.co/1LBGPgOA2u
— (((Howard Forman))) (@thehowie) July 9, 2024
— Howard Forman, New Haven, Connecticut
I just read your article at PolitiFact on Republican Senate candidate Tim Sheehy’s statement about abortion, and I would like to point out (what I believe) are a couple of errors.
1. In paragraph 10, you quote KFF’s Alina Salganicoff saying that “in the good-faith medical judgment of the treating health care provider, continuation of the pregnancy would pose a risk to the pregnant patient’s life or health.” Now, you may know that almost at the same time that the Roe v. Wade decision was released, there was a decision called Doe v. Bolton that interpreted “health” to mean almost anything. That broad interpretation of health is found in your article in paragraph 24: “Women have abortions later in pregnancy either because they find out new information or because of economic or political barriers,” [Katrina] Kimport said.
When a woman can have an abortion after viability because she offers any reason that can be interpreted as “health,” then abortion would be legal throughout all nine months of pregnancy. I believe that you are wrong in your interpretation. Democrats do not want to name any restriction on abortion during all nine months, and every mention of “health” is a fig leaf that does not restrict abortion at all. Every abortion advocate knows that.
2. Whether late-term abortions are rare or not is logically irrelevant to whether late-term abortions should be restricted.
Why don’t you know these things?
— Darryl A. Linde, Tahlequah, Oklahoma
An Air Force veteran added his two cents on X:
Dems have the facts. Republicans spread fear and lies.https://t.co/6CWfKhqxJZ
— James Knight (@jamesUSAF_vet) July 12, 2024
— James Knight, Reno, Nevada
Making a Healthy Difference for the Homeless
Thank you for printing this story (“A California Medical Group Treats Only Homeless Patients — And Makes Money Doing It,” July 19). It really piqued my interest and portrayed a positive solution for getting care to the people.
Up here in the Bay Area, I believe there are a couple of groups who go out and find what needs doing instead of waiting for people to come to them — but nothing like this. Makes me curious about what we actually have going on here.
— Laurie Lippe, El Cerrito, California
A self-described “nurse turned health tech nerd” commended the effort on X:
“They distribute GPS devices so they can track their homeless patients. They keep company credit cards on hand in case a patient needs emergency food or water, or an Uber ride to the doctor”This is healthcare at its best 💕https://t.co/UhM1dgTPH7
— Rik Renard (@rikrenard) July 22, 2024
— Rik Renard, New York City
A senior policy director at the National Health Care for the Homeless Council shared the post on X — while stressing that her tweets reflected her own opinions and not those of her organization:
I’m with @DrJimWithers: “I do worry about the corporatization of street medicine and capitalism invading what we’ve been building, largely as a social justice mission outside of the traditional health care system.” https://t.co/IOjazvrvqP
— Barbara DiPietro (@BarbaraDiPietro) July 19, 2024
— Barbara DiPietro, Baltimore
On X, a physician who says she champions “physicians, patients, public health, and the patient-physician relationship” reacted to our coverage surrounding the Federal Trade Commission’s rule banning the use of noncompete agreements in employment contracts:
FTC #noncompete crackdown may not protect doctors and nurses at ~64% of US community hospitals that are tax-exempt nonprofits or government-owned.But, @FTC said some nonprofits could be bound by the rule if they do not operate as true charities. https://t.co/9fDbfVflTH
— Marilyn Heine (@MarilynHeineMD) May 28, 2024
— Marilyn Heine, Langhorne, Pennsylvania
Without a Noncompete Ban on All Employers, Rural Access to Care Suffers
When news broke that the Federal Trade Commission would be banning noncompete agreements in employment contracts, many of us in the medical profession celebrated. However, until nonprofit hospitals and health care facilities benefit from the same ban, access to care — particularly in rural regions — will suffer.
As reported in “Health Worker for a Nonprofit? The New Ban on Noncompete Contracts May Not Help You” (June 5), about two-thirds of U.S. community hospitals are nonprofit or government-owned. This means that most hospitals nationwide may continue to enforce noncompete agreements among their employees, a practice that will have an outsize impact on rural medical professionals.
As a rheumatologist in a rural area, I’ve seen how detrimental limited access to care is for patients. Noncompete agreements serve only to further limit access to much-needed care. Due to the physician shortage being particularly acute in rural America, there are oftentimes only a few specialty physicians servicing a large region. Suppose one of these specialists is employed by a large health system and wants to transition to a private practice. It reduces the number of accessible specialists in the area when their noncompete agreement prohibits them from practicing near any of the health care facilities associated with the system. And increasing consolidation across health care means many rural regions may have only a single health system that operates across the entire state and surrounding areas. A geographically limiting noncompete agreement essentially stops a physician or medical professional from practicing entirely in the area, or they must uproot their life and move away from the major health system.
I hope the FTC takes further action to include nonprofit health care employers in its noncompete ban. I also urge nonprofit employers to consider their rural patients’ access to care when requiring providers to sign noncompete agreements. It’s in the best interest of our patient’s health to get rid of these agreements entirely.
— Chris Phillips, chair of the American College of Rheumatology’s Committee on Rheumatologic Care, Paducah, Kentucky
The president of the Texas Medical Board also posted on X with feedback:
Is it a coincidence that this affects everyone, except those who work for nonprofit hospitals and health care facilities, which employs the largest number of medical professionals?The FTC and it’s selective enforcement and rules is blatantly obvious! https://t.co/RzXInqiJ8D
— Sherif Zaafran, MD (@szaafran) June 16, 2024
— Sherif Zaafran, Houston
Repurposing Newspaper Boxes for Public Health
I recently read your article by Mara Silvers regarding the state’s intended use of public health vending machines (PHVMs) to help fight the opioid overdose epidemic (“Montana’s Plan To Curb Opioid Overdoses Includes Vending Machines,” July 18). Working on the covid-19 response for almost four years now, and with our American Rescue Plan Act funding coming to an end, we recently used a byline in our equipment budget to purchase and place “resource kiosks” in the community.
In 2022, after researching the use of vending machines for test distribution, we discovered vending machines have high barrier-to-entry costs and high maintenance costs. And even if purchasing isn’t possible, rental contracts come with high fees. We decided it was better to use a lower-cost resource that could be purchased in greater quantity, easily placed with community partners, and required no maintenance: the refurbished newspaper kiosk.
We decided to purchase double-decker boxes, which have a secondary door, creating another shelf, for roughly $410 apiece and stocked them with covid tests, nasal naloxone, injectable naloxone, fentanyl test strips, xylazine test strips, various types of condoms, and lubrication packets. We are in the process of securing a supply of gun locks and adding links to our pilot landing page for individual free gun lock deliveries, as well as links for free sexually transmitted infection test kits. We have investigated providing dental supplies and other items, but long-term funding is a constant concern. Grant money for most programs (likely all ARPA dollars) is running out, so the viability of these types of pilot programs is tentative without a buy-in from state or federal agencies.
Mara’s article hinted at criteria for possible placements and, similarly, we didn’t use locational overdose data, which can be “othering” to communities, but instead placed these kiosks with community partners that have been accomplished supporters of their at-risk populations throughout the covid response. Each community partner helped protect the communities they served through increased access to resources and provided information as trusted messengers. Truly meeting people where they are.
While money quickly appeared to fight the covid pandemic, and states spirited away dollars for pet projects, that sea of funding has dried up, and there doesn’t seem to be a plan for any continued funding. Covid-related functions have all been folded back into communicable disease epidemiology programs, which were already underfunded; in our state, the money funding the naloxone bulk fund is also drying up. Covid deaths might be down, but there is always a new bug (H5N1), STI infections are up, and gun-related deaths grow year over year. Funding population-level health interventions is our next pandemic.
With enough funding, kiosk-sized PHVMs could be swiftly added to any public health agency’s or community program’s quiver of tools to help increase access to resources and information for the most vulnerable residents.
Thank you for publishing a great article about the emerging opportunities to respond to changing public health needs!
— Christopher Howk, Arapahoe County Public Health’s covid-19 testing and logistics coordinator, Greenwood Village, Colorado
A retiree with a PhD in quantum chemistry tweeted his surprise over the news:
Montana’s Plan To Curb Opioid Overdoses Includes Vending Machineshttps://t.co/kNxYjnIOEO(What???!! Vending machines for opioids?)
— John Lounsbury (@jlounsbury59) July 18, 2024
— John Lounsbury, Lake Frederick, Virginia
Misappropriation of Opioid Settlement Funds
OK, so I see how all these states got all these lump sums of money for people like us who became addicted and whose lives were devastated by Purdue Pharma, Vicodin, and all the pharmacies (“Lifesaving Drugs and Police Projects Mark First Use of Opioid Settlement Cash in California,” July 12). How come all these states got all the money but those of us who have suffered have to wait, hire lawyers, and wait years for the money that was just handed over to these states? We’re the ones whose lives were devastated. My son was hooked, I was hooked, and my wife, and yet we must sit here penniless after the addiction, while all these states take the money — and they don’t do what they’re supposed to with it, and everyone knows it.
— Michael Stewart, Des Moines, Iowa
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