Letters to the Editor<\/a>\u00a0is a periodic feature. We\u00a0 welcome all comments<\/a>\u00a0and will publish a selection. We edit for length and clarity and require full names.<\/em><\/p>\n

Debunking Abortion Myths<\/strong><\/p>\n

I want to send a big THANK YOU to Matt Volz for writing a fact-checking article on the nonsense rhetoric around \u201cabortion up until and after birth\u201d that has run wild and unchallenged in the media (\u201cGOP\u2019s Tim Sheehy Revives Discredited Abortion Claims in Pivotal Senate Race<\/a>,\u201d July 9). Thanks for putting abortion later in pregnancy in context and debunking false assumptions.<\/p>\n

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.<\/p>\n

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 \u201cabortion after birth\u201d; they are talking about comfort care for infants who will not survive.<\/p>\n

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\u2019s 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.<\/p>\n

\u2014 Anne Angus, Bozeman, Montana<\/em><\/p>\n

A physician and Yale professor of radiology and biomedical imaging took to the social platform X to share feedback:<\/p>\n

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.@SenatorTester<\/a> 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<\/a><\/p>\n
\u2014 (((Howard Forman))) (@thehowie) July 9, 2024<\/a><\/p><\/blockquote>\n
\u2014 Howard Forman, New Haven, Connecticut<\/em><\/p>\n
I just read your article at PolitiFact on Republican Senate candidate Tim Sheehy\u2019s statement about abortion, and I would like to point out (what I believe) are a couple of errors.<\/p>\n
1. In paragraph 10, you quote KFF\u2019s Alina Salganicoff saying that \u201cin the good-faith medical judgment of the treating health care provider, continuation of the pregnancy would pose a risk to the pregnant patient\u2019s life or health.\u201d Now, you may know that almost at the same time that the Roe v. Wade<\/em> decision was released, there was a decision called Doe v. Bolton<\/em> that interpreted \u201chealth\u201d to mean almost anything. That broad interpretation of health is found in your article in paragraph 24: \u201cWomen have abortions later in pregnancy either because they find out new information or because of economic or political barriers,\u201d [Katrina] Kimport said.<\/p>\n
When a woman can have an abortion after viability because she offers any reason that can be interpreted as \u201chealth,\u201d 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 \u201chealth\u201d is a fig leaf that does not restrict abortion at all. Every abortion advocate knows that.<\/p>\n
2. Whether late-term abortions are rare or not is logically irrelevant to whether late-term abortions should be restricted.<\/p>\n
Why don\u2019t you know these things?<\/p>\n
\u2014 Darryl A. Linde, Tahlequah, Oklahoma<\/em><\/p>\n
An Air Force veteran added his two cents on X:<\/p>\n
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Dems have the facts. Republicans spread fear and lies.https:\/\/t.co\/6CWfKhqxJZ<\/a><\/p>\n
\u2014 James Knight (@jamesUSAF_vet) July 12, 2024<\/a><\/p><\/blockquote>\n
\u2014 James Knight, Reno, Nevada<\/em><\/p>\n
Making a Healthy Difference for the Homeless<\/strong><\/p>\n
Thank you for printing this story (\u201cA California Medical Group Treats Only Homeless Patients \u2014 And Makes Money Doing It<\/a>,\u201d July 19). It really piqued my interest and portrayed a positive solution for getting care to the people.<\/p>\n
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 \u2014 but nothing like this. Makes me curious about what we actually have going on here.<\/p>\n
\u2014 Laurie Lippe, El Cerrito, California<\/em><\/p>\n
A self-described \u201cnurse turned health tech nerd\u201d commended the effort on X:<\/p>\n
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“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 \ud83d\udc95 https:\/\/t.co\/UhM1dgTPH7<\/a><\/p>\n
\u2014 Rik Renard (@rikrenard) July 22, 2024<\/a><\/p><\/blockquote>\n
\u2014 Rik Renard, New York City<\/em><\/p>\n
A senior policy director at the National Health Care for the Homeless Council shared the post on X \u2014 while stressing that her tweets reflected her own opinions and not those of her organization:<\/p>\n
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I\u2019m with \u2066 @DrJimWithers<\/a>: \u201cI do worry about the corporatization of street medicine and capitalism invading what we\u2019ve been building, largely as a social justice mission outside of the traditional health care system.\u201d https:\/\/t.co\/IOjazvrvqP<\/a><\/p>\n
\u2014 Barbara DiPietro (@BarbaraDiPietro) July 19, 2024<\/a><\/p><\/blockquote>\n
\u2014 Barbara DiPietro, Baltimore<\/em><\/p>\n
On X, a physician who says she champions \u201cphysicians, patients, public health, and the patient-physician relationship\u201d reacted to our coverage surrounding the Federal Trade Commission\u2019s\u00a0rule\u00a0banning the use of noncompete agreements in employment contracts:\u00a0<\/p>\n
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FTC #noncompete<\/a> crackdown may not protect doctors and nurses at ~64% of US community hospitals that are tax-exempt nonprofits or government-owned.But, \u2066 @FTC<\/a>\u2069 said some nonprofits could be bound by the rule if they do not operate as true charities. https:\/\/t.co\/9fDbfVflTH<\/a><\/p>\n
\u2014 Marilyn Heine (@MarilynHeineMD) May 28, 2024<\/a><\/p><\/blockquote>\n
\u2014 Marilyn Heine, Langhorne, Pennsylvania<\/em><\/p>\n
Without a Noncompete Ban on All Employers, Rural Access to Care Suffers<\/strong><\/p>\n
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 \u2014 particularly in rural regions \u2014 will suffer.<\/p>\n
As reported in \u201cHealth Worker for a Nonprofit? The New Ban on Noncompete Contracts May Not Help You<\/a>\u201d (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.<\/p>\n
As a rheumatologist in a rural area, I\u2019ve 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.<\/p>\n
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\u2019 access to care when requiring providers to sign noncompete agreements. It\u2019s in the best interest of our patient\u2019s health to get rid of these agreements entirely.<\/p>\n
\u2014 Chris Phillips, chair of the American College of Rheumatology\u2019s Committee on Rheumatologic Care, Paducah, Kentucky<\/em><\/p>\n
The president of the Texas Medical Board also posted on X with feedback:<\/p>\n
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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<\/a><\/p>\n
\u2014 Sherif Zaafran, MD (@szaafran) June 16, 2024<\/a><\/p><\/blockquote>\n
\u2014 Sherif Zaafran, Houston<\/em><\/p>\n
Repurposing Newspaper Boxes for Public Health<\/strong><\/p>\n
I recently read your article by Mara Silvers regarding the state\u2019s intended use of public health vending machines (PHVMs) to help fight the opioid overdose epidemic (\u201cMontana\u2019s Plan To Curb Opioid Overdoses Includes Vending Machines<\/a>,\u201d 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 \u201cresource kiosks\u201d in the community.<\/p>\n
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\u2019t 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.<\/p>\n
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.<\/p>\n
Mara\u2019s article hinted at criteria for possible placements and, similarly, we didn\u2019t use locational overdose data, which can be \u201cothering\u201d 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.<\/p>\n
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\u2019t 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.<\/p>\n
With enough funding, kiosk-sized PHVMs could be swiftly added to any public health agency\u2019s or community program\u2019s quiver of tools to help increase access to resources and information for the most vulnerable residents.<\/p>\n
Thank you for publishing a great article about the emerging opportunities to respond to changing public health needs!<\/p>\n
\u2014 Christopher Howk, Arapahoe County Public Health\u2019s covid-19 testing and logistics coordinator, Greenwood Village, Colorado<\/em><\/p>\n
A retiree with a PhD in quantum chemistry tweeted his surprise over the news:<\/p>\n
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Montana\u2019s Plan To Curb Opioid Overdoses Includes Vending Machines https:\/\/t.co\/kNxYjnIOEO<\/a>(What???!! Vending machines for opioids?)<\/p>\n
\u2014 John Lounsbury (@jlounsbury59) July 18, 2024<\/a><\/p><\/blockquote>\n
\u2014 John Lounsbury, Lake Frederick, Virginia<\/em><\/p>\n
Misappropriation of Opioid Settlement Funds<\/strong><\/p>\n
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 (\u201cLifesaving Drugs and Police Projects Mark First Use of Opioid Settlement Cash in California<\/a>,\u201d 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\u2019re 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 \u2014 and they don\u2019t do what they\u2019re supposed to with it, and everyone knows it.<\/p>\n
\u2014 Michael Stewart, Des Moines, Iowa<\/em><\/p>\n<\/div>\n