How money, mail and power affect our health
Marty Makary’s July 12 op-ed, “For a wasteful Medicare rule, location is everything,” made a clear case: Too many Americans have been blindly led into a health-care affordability crisis. Even if they never set foot in a hospital, patients receiving care from hospital-affiliated providers face higher prices caused by so-called site-of-service payment differentials. As a community oncologist, it angers me to see these disparities sometimes triple costs for services such as chemotherapy.These payment differentials incentivize hospitals to acquire independent practices to boost their revenue. The differentials also drive health systems to further expand their market share through anti-competitive tactics. After my practice refused an acquisition attempt from a large health system, my oncology privileges were revoked — leaving me unable to provide care to my own cancer patients when they were admitted to the hospital. Restricting trusted care teams leaves patients confused, frustrated and in the dark.This trend is bad news for everyone — except hospitals. To prevent such practices from becoming widespread, Congress must pass the Lower Costs, More Transparency Act without delay.Moshe Chasky, Bensalem, Pa.So-called site-neutral policies fail to recognize that not all care sites are created equal. Current payment rates appropriately take into account that hospitals treat sicker, lower-income and more complex patients compared with other sites. Hospitals are also held to higher regulatory and safety standards, and they provide benefits such as 24/7 capacity for emergencies. The argument also disregards the fact that the lower rate paid to physicians is completely inadequate, as we hear from them all the time.Medicare already reimburses hospitals just 82 cents for every dollar spent caring for patients. Additional site-neutral cuts, like those supported by the writer, would exacerbate these shortfalls. Medicare also fails to cover the full costs of resident salaries for teaching hospitals, which is a far cry from the “big bonuses” the author alleged Medicare’s graduate medical education program gives to hospitals.Physician polling data has shown that the burden from corporate insurers is driving physicians away from independent practices. Physicians are also seeking to become integrated with hospitals because of the costs associated with technologies such as electronic health records. And it is corporate health insurers that have been driving independent practice acquisitions for the past five years, not hospitals.Instead of advocating flawed policy proposals, let’s focus on ways we can support hospitals and health systems and ensure they can be there for their communities.The writer is president and chief executive of the American Hospital Association.The mail isn’t just mailRegarding Postmaster General Louis DeJoy’s July 8 online op-ed, “We’re fixing the Postal Service. We can’t stop now.”:Within the past three years, many of Mr. DeJoy’s proposed “cost-saving measures” include closing some processing centers and trucking mail to other consolidation centers. This might sound good at first glance, but it fails in reality.The Upper Peninsula Processing Facility in Kingsford, Mich., processes mail for the entire Upper Peninsula, which it has done faithfully for years. Now, there is talk of closing it. Mail from the region would be shipped to Green Bay, Wis., a four-hour round-trip drive in good weather. If the processing center closes, jobs will be lost and the fragile mail-delivery system will be further threatened.Before there was any talk of closure, the Postal Service changed its trucking schedule and stopped offering overnight shipping, which endangered the health of every man, woman and child who lives in the Upper Peninsula of Michigan. How so? Two words: water samples. The Environmental Protection Agency requires that drinking water in the United States be tested for bacterial infection. Such testing is critical to fighting waterborne illnesses such as dysentery and typhoid fever.For water testing to be accurate, it must be completed within a short time frame. There is only one lab in the Upper Peninsula, White Water Associates, that tests all of the water samples from the region. Until Jan. 8, it had been possible for water samples sent anywhere in the Upper Peninsula to reach White Water Associates in time for testing. That is no longer possible, which is resulting in expired samples. Without valid water testing, the chances of outbreaks of waterborne illnesses greatly increase. The shipping changes have made it next to impossible for water to be tested within the required time frame.The Postal Service is vital for Americans. It doesn’t just deliver letters and packages; it also delivers medicine, water testing kits and, yes, absentee ballots. Postal workers are doing their best to deliver our nations’ mail, and they deserve to work under a postmaster general who understands the effects of his policies. The postmaster general should not care only about swift delivery of packages. He or she should also understand that, for many people who live in rural America, mail is a lifeline to the rest of the world.Mr. DeJoy’s actions have endangered that lifeline, and for that, he should be replaced. To ensure the health of our nation’s water supply, Postal Service trucking schedules must return to how they were before Jan. 8. To refuse to do so is to raise the question: Is the Postal Service attempting to save money at the expense of Americans’ lives?Tracy Asanuma, Iron Mountain, Mich.In a stunning display of denial, Postmaster General Louis DeJoy’s recent op-ed attempts to sugarcoat the disastrous effects of his leadership.Mr. DeJoy suggests the Postal Service was a sinking ship upon his arrival, but his “Delivering for America” plan — which raised prices, slashed services and shuttered post offices nationwide — has only made a precarious situation worse. His publicly proclaimed goal to hike prices to “uncomfortable” rates shows a shocking disregard for the needs of everyday Americans, including seniors, rural residents and small-business owners. His plan to close and consolidate up to 10,000 offices, stations, branches and annexes betrays the Postal Service’s mission to serve every community. Just look at Georgia, where the plan’s initial stages have thrown mail delivery into chaos.But don’t just take it from us. After congressional leaders urged the Postal Regulatory Commission to reject the latest price increases, the commission itself expressed concern that the plan “does not reflect reasoned consideration of the potential widespread effects,” is imprudent and is not in the best interests of stakeholders. This stinging critique underscores the urgent need for a change in leadership. Mr. DeJoy has attempted to run the Postal Service like a hedge fund manager intent on gutting an enterprise to show short-term revenue improvements. But America needs the Postal Service for the long term; it is an institution that binds the country together, providing critical deliveries on items like Social Security checks, medications and mail-in ballots. We need investments and innovation, not service cuts.The future of the Postal Service depends on bold leadership and an unwavering commitment to its public service mission. Time and time again, Mr. DeJoy has shown he is simply not up to the task.Raja Krishnamoorthi and Robert Weissman, WashingtonRaja Krishnamoorthi, a Democrat, represents Illinois’s 8th Congressional District in the House. Robert Weissman is co-president of public interest at Public Citizen.Postmaster General Louis DeJoy’s op-ed failed to mention the relentless price hikes under a well-intended but struggling strategic plan. July 14 marked the fifth increase in three years, covering mail, newspapers, magazines, catalogues and more. Package prices have also been raised significantly, and the price of the first-class “forever” stamp is now 73 cents.These recent price increases total more than 184 percent of inflation. Businesses and customers are stressed trying to keep up, not only on price but also as service has declined.America needs a reliable, affordable postal system for everyone. We urge Congress to better invest Postal Service funds and strengthen regulatory oversight to preserve the Postal Service’s viability and sustainability.The writer is executive director of the Coalition for a 21st Century Postal Service.Postmaster General Louis DeJoy’s op-ed was outrageous. Mail delivery is worse than ever in Houston, and it interferes with doing business. And the danger for mail-in ballots with a reduced Postal Service is alarming. The blame is squarely on the postmaster general, not the local postmasters or carriers who cannot believe what is happening.Fredericka Hunter, HoustonPower in TexasMore than 1 million of us in Houston had no power for days after Hurricane Beryl. I was one of them.This isn’t the first time this has happened. It happened in 2021, when more than 200 Texans died because of power outages from extreme cold. Massive outages also happened with Hurricanes Harvey and Ike. More than 15 years after Ike, there is still no “Ike Dike.”The Texas GOP can’t keep the lights on while it wastes billions of dollars on a wall on the southern U.S. border. During Hurricane Beryl, Gov. Greg Abbott (R) was off in Asia. The chief executive of CenterPoint Energy makes more than $1 million as a base salary, not to mention other bonuses. Meanwhile, we regular people sit in the dark and sweat.Michael Fjetland, Houston
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Marty Makary’s July 12 op-ed, “For a wasteful Medicare rule, location is everything,” made a clear case: Too many Americans have been blindly led into a health-care affordability crisis. Even if they never set foot in a hospital, patients receiving care from hospital-affiliated providers face higher prices caused by so-called site-of-service payment differentials. As a community oncologist, it angers me to see these disparities sometimes triple costs for services such as chemotherapy.
These payment differentials incentivize hospitals to acquire independent practices to boost their revenue. The differentials also drive health systems to further expand their market share through anti-competitive tactics. After my practice refused an acquisition attempt from a large health system, my oncology privileges were revoked — leaving me unable to provide care to my own cancer patients when they were admitted to the hospital. Restricting trusted care teams leaves patients confused, frustrated and in the dark.
This trend is bad news for everyone — except hospitals. To prevent such practices from becoming widespread, Congress must pass the Lower Costs, More Transparency Act without delay.
Moshe Chasky, Bensalem, Pa.
So-called site-neutral policies fail to recognize that not all care sites are created equal. Current payment rates appropriately take into account that hospitals treat sicker, lower-income and more complex patients compared with other sites. Hospitals are also held to higher regulatory and safety standards, and they provide benefits such as 24/7 capacity for emergencies. The argument also disregards the fact that the lower rate paid to physicians is completely inadequate, as we hear from them all the time.
Medicare already reimburses hospitals just 82 cents for every dollar spent caring for patients. Additional site-neutral cuts, like those supported by the writer, would exacerbate these shortfalls. Medicare also fails to cover the full costs of resident salaries for teaching hospitals, which is a far cry from the “big bonuses” the author alleged Medicare’s graduate medical education program gives to hospitals.
Physician polling data has shown that the burden from corporate insurers is driving physicians away from independent practices. Physicians are also seeking to become integrated with hospitals because of the costs associated with technologies such as electronic health records. And it is corporate health insurers that have been driving independent practice acquisitions for the past five years, not hospitals.
Instead of advocating flawed policy proposals, let’s focus on ways we can support hospitals and health systems and ensure they can be there for their communities.
The writer is president and chief executive of the American Hospital Association.
The mail isn’t just mail
Regarding Postmaster General Louis DeJoy’s July 8 online op-ed, “We’re fixing the Postal Service. We can’t stop now.”:
Within the past three years, many of Mr. DeJoy’s proposed “cost-saving measures” include closing some processing centers and trucking mail to other consolidation centers. This might sound good at first glance, but it fails in reality.
The Upper Peninsula Processing Facility in Kingsford, Mich., processes mail for the entire Upper Peninsula, which it has done faithfully for years. Now, there is talk of closing it. Mail from the region would be shipped to Green Bay, Wis., a four-hour round-trip drive in good weather. If the processing center closes, jobs will be lost and the fragile mail-delivery system will be further threatened.
Before there was any talk of closure, the Postal Service changed its trucking schedule and stopped offering overnight shipping, which endangered the health of every man, woman and child who lives in the Upper Peninsula of Michigan. How so? Two words: water samples. The Environmental Protection Agency requires that drinking water in the United States be tested for bacterial infection. Such testing is critical to fighting waterborne illnesses such as dysentery and typhoid fever.
For water testing to be accurate, it must be completed within a short time frame. There is only one lab in the Upper Peninsula, White Water Associates, that tests all of the water samples from the region. Until Jan. 8, it had been possible for water samples sent anywhere in the Upper Peninsula to reach White Water Associates in time for testing. That is no longer possible, which is resulting in expired samples. Without valid water testing, the chances of outbreaks of waterborne illnesses greatly increase. The shipping changes have made it next to impossible for water to be tested within the required time frame.
The Postal Service is vital for Americans. It doesn’t just deliver letters and packages; it also delivers medicine, water testing kits and, yes, absentee ballots. Postal workers are doing their best to deliver our nations’ mail, and they deserve to work under a postmaster general who understands the effects of his policies. The postmaster general should not care only about swift delivery of packages. He or she should also understand that, for many people who live in rural America, mail is a lifeline to the rest of the world.
Mr. DeJoy’s actions have endangered that lifeline, and for that, he should be replaced. To ensure the health of our nation’s water supply, Postal Service trucking schedules must return to how they were before Jan. 8. To refuse to do so is to raise the question: Is the Postal Service attempting to save money at the expense of Americans’ lives?
Tracy Asanuma, Iron Mountain, Mich.
In a stunning display of denial, Postmaster General Louis DeJoy’s recent op-ed attempts to sugarcoat the disastrous effects of his leadership.
Mr. DeJoy suggests the Postal Service was a sinking ship upon his arrival, but his “Delivering for America” plan — which raised prices, slashed services and shuttered post offices nationwide — has only made a precarious situation worse. His publicly proclaimed goal to hike prices to “uncomfortable” rates shows a shocking disregard for the needs of everyday Americans, including seniors, rural residents and small-business owners. His plan to close and consolidate up to 10,000 offices, stations, branches and annexes betrays the Postal Service’s mission to serve every community. Just look at Georgia, where the plan’s initial stages have thrown mail delivery into chaos.
But don’t just take it from us. After congressional leaders urged the Postal Regulatory Commission to reject the latest price increases, the commission itself expressed concern that the plan “does not reflect reasoned consideration of the potential widespread effects,” is imprudent and is not in the best interests of stakeholders. This stinging critique underscores the urgent need for a change in leadership. Mr. DeJoy has attempted to run the Postal Service like a hedge fund manager intent on gutting an enterprise to show short-term revenue improvements. But America needs the Postal Service for the long term; it is an institution that binds the country together, providing critical deliveries on items like Social Security checks, medications and mail-in ballots. We need investments and innovation, not service cuts.
The future of the Postal Service depends on bold leadership and an unwavering commitment to its public service mission. Time and time again, Mr. DeJoy has shown he is simply not up to the task.
Raja Krishnamoorthi and Robert Weissman, Washington
Raja Krishnamoorthi, a Democrat, represents Illinois’s 8th Congressional District in the House. Robert Weissman is co-president of public interest at Public Citizen.
Postmaster General Louis DeJoy’s op-ed failed to mention the relentless price hikes under a well-intended but struggling strategic plan. July 14 marked the fifth increase in three years, covering mail, newspapers, magazines, catalogues and more. Package prices have also been raised significantly, and the price of the first-class “forever” stamp is now 73 cents.
These recent price increases total more than 184 percent of inflation. Businesses and customers are stressed trying to keep up, not only on price but also as service has declined.
America needs a reliable, affordable postal system for everyone. We urge Congress to better invest Postal Service funds and strengthen regulatory oversight to preserve the Postal Service’s viability and sustainability.
The writer is executive director of the Coalition for a 21st Century Postal Service.
Postmaster General Louis DeJoy’s op-ed was outrageous. Mail delivery is worse than ever in Houston, and it interferes with doing business. And the danger for mail-in ballots with a reduced Postal Service is alarming. The blame is squarely on the postmaster general, not the local postmasters or carriers who cannot believe what is happening.
Fredericka Hunter, Houston
Power in Texas
More than 1 million of us in Houston had no power for days after Hurricane Beryl. I was one of them.
This isn’t the first time this has happened. It happened in 2021, when more than 200 Texans died because of power outages from extreme cold. Massive outages also happened with Hurricanes Harvey and Ike. More than 15 years after Ike, there is still no “Ike Dike.”
The Texas GOP can’t keep the lights on while it wastes billions of dollars on a wall on the southern U.S. border. During Hurricane Beryl, Gov. Greg Abbott (R) was off in Asia. The chief executive of CenterPoint Energy makes more than $1 million as a base salary, not to mention other bonuses. Meanwhile, we regular people sit in the dark and sweat.
Michael Fjetland, Houston