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Readers sound off on community hospitals, an Adams appointee and checking on elders

Readers sound off on community hospitals, an Adams appointee and checking on elders

Yahoo13-03-2025
Manhattan: Re 'Two hospitals with two different paths' (op-ed, March 10): The picture painted in this commentary about Lenox Hill Hospital and its role in the future of hospital care in Manhattan is unfortunately misleading and built on flawed assumptions.
With a history spanning more than 160 years in the community, we are proud to serve our longtime neighbors. Still, more than one-third of our patients come from the outer boroughs, and a majority — 55% — are people of color. More than 60% rely on Medicare or Medicaid. The piece's inference that Northwell Health is an outside force is equally inaccurate and uninformed. Our doctors, nurses and staff live across the five boroughs, and our patients are New Yorkers from all walks of life. To dismiss our incredible team members and the essential care they provide as part of some 'deregulated marketplace failure' is a disservice to the 144,000 New Yorkers who depend on them for life-saving treatment every year.
Hospitals must adapt to meet an evolving health care landscape. When they don't, they face the unfortunate reality of closures — an experience too many communities face today. The investments we seek at Lenox Hill are about renewing a facility that has served New Yorkers for more than a century, ensuring that we can continue delivering high-quality care safely and sustainably. Northwell continues growing and investing across the city, and it is neither responsible nor helpful to pit one hospital's future against another's. The challenges facing health care in New York are real. We should work together to ensure all New Yorkers can access the care they deserve for decades to come. Daniel Baker, president, Lenox Hill Hospital
Bethlehem, Pa.: Re 'When crime goes down' (editorial, March 7): Police Commissioner Jessica Tisch has it. She and the great cops in the NYPD that we all support and rely on have it. Finally. Thank you so very much indeed. We love New York and we love the NYPD for that! Christoph Broubalow
Middle Village: I am pleased to see the big drop in shootings and homicides this year compared to the same period last year, and I congratulate the mayor, our terrific police commissioner and the entire NYPD for helping to make this happen. Now let's focus on the awful increase in rapes: 298 this year to date versus 229 last year, up 30%. We need to encourage women who are in abusive situations to report, and to add more street vigilance to remove from the streets those lurking to attack unsuspecting females of all ages. Mary Jane McCartney
Rockaway Park: If what you reported in your newspaper concerning the possibility that Commissioner of Probation Juanita Holmes has had nepotism involved in her hiring practices, she is only following the lead of the person who appointed her to that position, Mayor Adams. What are her qualifications that made her the right person for that job? All probation officers are college graduates. Anthony Johnson
Forest Hills: So, Juanita Holmes is under investigation, correct? No surprise there. When Holmes was a chief in the NYPD, she constantly did an end run around the police commissioner at the time (one of the best ever, Keechant Sewell) and went straight to Adams and got whatever she wanted from him. Holmes is the same person who thought an appearance by Cardi B ('WAP,' anyone?) was an excellent choice to motivate females to join the NYPD. Really? And again, despite the commissioner demanding that Cardi B's appearance be canceled, Holmes ran right to Adams, and he allowed that repugnant performer to perform. So Holmes is taking on her mentor Adams' act: pad the city payroll with corrupt, unqualified cronies with sky-high salaries. Please kick her to the curb and charge her with extreme corruption. J.M. Culley
New Rochelle, N.Y.: Voicer Marc Lavietes says, as a physician, that measles is a real killer, saying there were 500 deaths a year before the 1963 vaccine. Meanwhile, accidental ladder falls last year killed more Americans than the last 50 years of measles. This is because of MAGA, he says? Hey, Marc, your Trump Derangement Syndrome is showing! Tripp Hoffmann
Holbrook, L.I.: I read your editorial ('Untaxed tips is not so easy,' March 8) with interest and noticed, in my humble opinion, that you missed the point entirely. Trump doesn't care about those who work primarily on tips. It was all about trying to generate votes. But now it's a nod to the business community. Why? Because those who are paid mostly or significantly in tips will no longer cost their employers their required 6% contribution to Social Security taxes. Those who spend their working lives in places like New York or Las Vegas, where a worker can live well on tip jobs, will get hurt badly in the end. When the time for collecting Social Security comes, their check will be based on their lifetime total taxable income. Should the economy have a downturn and they lose their jobs, their unemployment insurance benefit will also be based on taxable income. Michael L. Wilson
Brooklyn: Are Trump and Vladimir Putin working in tandem to make Ukraine capitulate to agreeing to a peace agreement detrimental to Ukraine? It sure seems like it. Trump has absurdly blamed Ukraine for this war, claimed that Volodymyr Zelenskyy is not grateful and demanded repayment for U.S. aid. Now Putin has stepped up the bombing of Ukraine while Trump has pulled technological aid crucial to Ukraine's defense. Both leaders would love to see Zelenskyy gone and will pressure Ukraine to have elections to get a puppet president favorable to Russia. People who cherish freedom in Europe and America should be more alarmed at what is unfolding. Irwin Cantos
Little Egg Harbor, N.J.: What has happened to our elected officials, doing absolutely nothing while our government agencies are gutted by someone not elected by the people? From day one, a man who has had multiple bankruptcies has been able to choose another clown to destroy our government. Why are our elected officials allowing this disaster to continue? This incompetent loser must be impeached! I am certain that even Republicans elected by us to represent our needs must realize they were chosen to protect our government and our way of life — not protect somebody who disrespects our allies and is in love with our enemies all over the world. How long will this go on before someone wakes up and stops this disgrace to our values? Rose S. Wilson
Brooklyn: People supporting Mahmoud Khalil (' 'New Yorkers will have to take to the street,' says a demonstrator,' March 11) need a history lesson. Khalil wholeheartedly supports Hamas and Hezbollah, a group that murdered 241 sleeping American service members in 1983 and kidnapped, tortured and murdered Col. William Higgins. If supporting and advocating for enemies of this country are not a reason for deportation, what is? Rob Weissbard
Jamaica: To Voicer Michele P. Brown: The problem for the Arabs of Palestine was not the League of Nations, the British, the Zionists or the UN. It was their leader, the grand mufti, Haj Amin al-Husseini. He orchestrated massacres against peaceful Jewish communities in 1920, 1929 and 1936 and was responsible for the assassinations of prominent Arabs who favored coexistence with Jews. He rejected plans for an Arab state in 1937 and 1947 because each plan offered a state for Jews. He was an ally of Adolf Hitler and an active supporter of the Holocaust. Al-Husseini was influential in the Arab decisions to start the wars of 1947 and 1948, the cause of the Palestinian refugee problem. Ebere Osu
Bronx: In light of Gene Hackman and his wife dying so tragically and alone ('They died of illnesses,' March 8), with no loved ones or friends being aware for at least two weeks: People, call your elderly loved ones often, especially if one has Alzheimer's. It is heartbreaking to know that these people had family and no one got in touch with them. And if they called and got no response for several days, they could either go and check or ask the local police to do a wellness check. So sad. May they RIP. Pauline Graham Binder
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Vaccine-Preventable Disease: Could the Sky Fall?
Vaccine-Preventable Disease: Could the Sky Fall?

Medscape

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Vaccine-Preventable Disease: Could the Sky Fall?

It's been a tempestuous 2025 for the nation's healthcare infrastructure. I think the worst is yet to come, given cutbacks to Medicaid eligibility and coverage and the devolving recommendations by government healthcare agencies. Concern is also arising that third-party payers (Medicaid, Medicare, and private insurance) and Vaccines for Children may not cover some scientifically proven vaccines or some parts of scientifically based schedules. Vaccination rates and public trust in vaccines had been dropping since the pandemic, and only 69% of families trusted CDC vaccine recommendations in January 2025, even before recent shakeups in CDC committees. Declining postpandemic national vaccine rates now hover just above thresholds for losing herd immunity (Figure 1) also in part because of increasing vaccine exemptions (Figure 2). However, some local rates have dipped below thresholds in what I call 'vaccine deserts,' those geographic pockets where vaccine deniers comprise larger parts of the population — the measles outbreak being the poster child for this. In addition, discussions are emerging about limiting or removing school vaccine requirements or expanding exemptions. Other factors that imperil herd immunity have always reduced vaccine uptake, even in families that want to vaccinate their children: time and resource limitations for working parents, language barriers, limited or no medical care coverage, limited transportation, rural or inner-city residence, and uncovered vaccines. Some may say, 'So what?' We still have more than 90% uptake for most vaccines. Evidence suggests that even with relatively high uptake, vaccine-preventable disease still occurs in subpopulations, including vulnerable children. For example, a Boston group recently reported that, even before the drop in vaccination rates over the past 5 years, vulnerable children were more likely have more invasive pneumococcal disease (IPD). So, cracks in the proverbial dam existed in populations (those with comorbidities or lower socioeconomic status) even pre-pandemic and before current cutbacks. Massachusetts IPD data (ie, Optum Clinformatics DataMart and Merative MarketScan Medicaid Multi-State Database) from a time of Medicaid expansion (January 2015 through December 2019) were analyzed by insurance type and comorbidities. As expected, children younger than 2 years and particularly those younger than 1 year had the highest IPD rates regardless of insurance status, but children with Medicaid had higher IPD rates than commercially insured children. Of concern, these differences occurred despite statewide pneumococcal conjugate vaccine vaccination rates reported previously as being fairly high (92% with three or more doses by 2 years of age). Relative IPD rates for children with Medicaid vs those with commercial insurance were higher in infants (1.3, 95% CI, 0.9-1.9) and adolescents (3.4, 95% CI, 1.5-7.1). Among children with comorbidities, the IPD rate was about four times higher in infants and 10 times higher in 6- to 10-year-olds, regardless of insurance type. The authors cite three prior studies showing lower vaccine uptake in Medicaid recipients, suggesting that, among factors affecting Medicaid patients' IPD burden, lower vaccine uptake likely has a role. It seems logical that these prepandemic, pre-cutback data foreshadow darker times ahead due to a combination of increasing postpandemic public distrust, vaccine fatigue, and cutback-era policies. Not only is vaccine confidence still dropping and Medicaid becoming more restrictive at the federal level, but states may change Medicaid coverage when more costs are reassigned to them. The bottom line is that vaccine availability and access will likely decrease, even in non-economically vulnerable children. So, all children could be exposed to increased types of circulating infectious disease — resulting in increased IPD, particularly in vulnerable children. And here we are only considering one among many vaccine-preventable diseases. As pediatric providers, can we close the anticipated vaccine gaps as vulnerable families deal with healthcare cutbacks and likely become more economically vulnerable? One way is to rededicate ourselves to getting as many children as possible vaccinated (eg, reminder texts, emails, phone calls before vaccine due dates) according to schedules recommended by organizations that are politically independent and science-driven, such as the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists. It's not a time for 'business as usual.' We need to proactively confirm our belief in scientifically based vaccine schedules to the families of our patients. While I strongly believe in patient medical homes, there may be room for flexibility if vaccines become available from alternative sources that are economically helpful to families. We can hope charitable organizations, foundations, and some altruistic individuals will ramp up funding to fill the evolving voids. The answers are not simple nor are potential fixes easy. Yet, pediatric providers have always answered the call when children are in jeopardy. Let's keep as many children safe as possible.

Feds direct states to check immigration status of their Medicaid enrollees
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Yahoo

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  • Yahoo

Feds direct states to check immigration status of their Medicaid enrollees

A mother holds her daughter while she gets a vaccine at a clinic in Texas in March. Children and adults who receive health insurance through Medicaid or the Children's Health Insurance Program will now be subject to immigration or citizenship status checks, according to a new initiative announced this week by Robert F. Kennedy Jr., who oversees Medicaid as secretary of the U.S. Department of Health and Human Services. (Photo by) This week, the Trump administration's Centers for Medicare & Medicaid Services (CMS) announced an effort to check the immigration status of people who get their health insurance through Medicaid and the Children's Health Insurance Program. Medicaid is the public health insurance program for people with low incomes that's jointly funded by states and the federal government. For families that earn too much to qualify for Medicaid but not enough to afford private insurance, CHIP is a public program that provides low-cost health coverage for their children. The feds will begin sending states monthly enrollment reports that identify people with Medicaid or CHIP whose immigration or citizenship status can't be confirmed through federal databases. States are then responsible for verifying the citizenship or immigration status of individuals in those reports. States are expected to take 'appropriate actions when necessary, including adjusting coverage or enforcing non-citizen eligibility rules,' according to a CMS press release. 'We are tightening oversight of enrollment to safeguard taxpayer dollars and guarantee that these vital programs serve only those who are truly eligible under the law,' Robert F. Kennedy Jr., who oversees CMS as secretary of the U.S. Department of Health and Human Services, said in a press release announcing the new program. As of April, roughly 71 million adults and children nationwide have Medicaid coverage, while another 7 million children have insurance through CHIP. Immigrants under age 65 are less likely to be covered by Medicaid than U.S.-born citizens, according to an analysis from health research organization KFF. Immigrants who are in the country illegally aren't eligible for federally funded Medicaid and CHIP. Only citizens and certain lawfully present immigrants — green card holders and refugees, for example — can qualify. But some states have chosen to expand Medicaid coverage for immigrants with their own funds. Twenty-three states offer pregnancy-related care regardless of citizenship or immigration status, according to KFF. Fourteen states provide coverage for children in low-income families regardless of immigration status, while seven states offer coverage to some adults regardless of status. The tax and spending package President Donald Trump last month cuts federal spending on Medicaid by more than $1 trillion, leaving states to either make up the difference with their own funds or reduce coverage. But the new law also includes restrictions on coverage for certain immigrants, including stripping eligibility from refugees and asylum-seekers. Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@ Solve the daily Crossword

Dozens of OB-GYNs fled Idaho after its abortion ban. Medicaid cuts could make access to care even worse.

time2 hours ago

Dozens of OB-GYNs fled Idaho after its abortion ban. Medicaid cuts could make access to care even worse.

More than six months after Idaho's near-total abortion ban went into effect, a small town nestled in the state's northern mountain ranges lost its labor and delivery service -- and access to such care could now be imperiled further by looming Medicaid cuts. Bonner General Health, located in Sandpoint, Idaho, announced in March 2023 that it would no longer provide obstetrical care, citing the state's "legal and political climate" as one of the factors that drove the decision. Abortions in Idaho are illegal except in the cases of rape, incest and the life of the mother. The hospital in the city of around 10,000 people was one of three health systems in Idaho to shutter their labor and delivery services in recent years. The state has lost over a third of its OB-GYNs -- 94 of 268 -- since the ban was enacted in 2022, according to a new study in medical journal JAMA Network Open. Local health care providers and advocates ABC News spoke with said that Medicaid cuts could put additional labor and delivery services at risk of closing -- adding further pressure to Idaho's already strained maternal and reproductive health care system. More than 350,000 of the state's residents are insured by Medicaid, including those covered by the expansion plan voters approved through a ballot measure in 2018. Idaho was already seeking federal approval to institute its own work requirements after Gov. Brad Little signed a Medicaid cost bill this spring. Under the federal changes, the state could lose $3 billion in funding over the next decade and 37,000 residents could lose coverage, according to analysis by KFF. "We are living with the consequences of when you criminalize practicing medicine, you lose doctors, and I think that, coupled with these cuts at the federal level, are going to prove devastating for Idaho's already precarious rural health system," Melanie Folwell, the executive director of Idahoans United for Women and Families, the group spearheading a ballot initiative to restore abortion rights, told ABC News. After Bonner General closed its obstetric services, Kootenai Health, located an hour south, inherited its patients, which included residents across the northern tip of the state. Some women now have to drive two to three hours to get prenatal care or to deliver at Kootenai, according to one of its OB-GYNs, Dr. Brenna McCrummen. Traveling that far for care, especially in cases of complications, can endanger women and infants, McCrummen noted. "There have been patients that have delivered on the side of the road because they're not able to get to the hospital in time. There have been babies that have gone to the NICU who didn't do as well as they probably would have had they not had to travel long distances," she told ABC News. The loss of OB-GYNs in the state has hit rural areas like those in the north especially hard, the JAMA Network Open study noted. A vast majority of the remaining physicians providing obstetric care are concentrated in Idaho's seven most populated counties, leaving only 23 OB-GYNs to serve a population of over half a million across the rest of the state, according to the study. Those giving birth aren't the only ones affected by the shortage of physicians. OB-GYNs like McCrummen have packed schedules, leading to long wait times for other reproductive care. Patients seeking annual exams, for instance, often have to book five months in advance, McCrummen explained. These exams provide vital preventive health services, such as screenings for cervical and breast cancer. Across the U.S., more than 35% of counties are maternity care deserts -- areas that lack obstetrics clinicians -- according to Dr. Michael Warren, the chief medical and health officer of the March of Dimes, a nonprofit focused on maternal and infant health. Reductions to Medicaid funding could exacerbate the problem, Warren told ABC News. "The worry is that as these changes are happening in the Medicaid space, it's going to be harder, particularly for rural hospitals, to maintain those obstetric services, and if they discontinue those, we've got more maternity care deserts, and we've got a greater risk of both moms and babies having worse outcomes," Warren said. The Medicaid cuts were passed into law in July as part of President Donald Trump's massive tax and policy bill. Idaho Sen. Mike Crapo, a Republican who serves as chairman of the Senate Finance Committee, defended the bill in a press release earlier this month, saying that "targeting waste, fraud and abuse in the program ensures that it stays financially viable for the populations who need it most." Crapo has also argued that the legislation's $50 billion rural hospital fund is the "largest investment in decades in rural health care." In Idaho, Medicaid covers around a third of births, according to data from March of Dimes. Even before cuts to coverage, labor and delivery units were difficult to keep open, Toni Lawson, a vice president of the Idaho Hospital Association, told ABC News. Lawson explained that such units require "special equipment" and "specially trained staff" on call, which is expensive to maintain -- especially in rural areas with lower birth volumes and where Medicaid reimburses less than cost. Additionally, she said, hospitals have had difficulty recruiting and retaining qualified OB-GYNs amidst Idaho's abortion restrictions. As a result, looming reductions to Medicaid funding could push these healthcare systems over the edge, according to Lawson. "What you'll see in Idaho, before you see hospitals close, is we'll have more closures of labor and delivery services," she said. These cuts could also worsen outcomes for the women who lose coverage, physician assistant specialist Amy Klingler explained. "If patients don't have access to insurance and they don't have access to Medicaid, sometimes they delay prenatal care, we don't catch complications early enough, and it puts the baby and the mother's lives at risk," Klingler, who works in a small mountain town in central Idaho, told ABC News. The two problems can compound -- Klingler noted that the risk of not catching complications early on is heightened when the same women also have to travel further to receive care. While she is able to provide prenatal care to her patients, the closest hospital that can deliver babies is a 60-mile drive from her clinic -- a route she says that lacks cell service for 45 miles. "So in the best circumstances, it takes planning and forethought. And then when things are serious and complicated, it's much more dangerous," Klingler said. "Complicated pregnancies in Idaho are the scary ones right now," she added. In cases when the mother's health becomes at risk, health providers say that the state's abortion ban limits the emergency care they are able to provide. A state court issued a ruling in April slightly expanding the medical exception to the ban in response to a lawsuit filed by the Center for Reproductive Rights, but advocates still argue the existing law constricts physicians' ability to supply adequate care. The organization Idahoans United for Women and Families is currently gathering signatures to get a measure on the ballot in 2026 to return the state to the standard of abortion access it had before the Supreme Court overturned Roe v. Wade in 2022. However, Lawson said "there is no silver bullet" to solve depleted access to maternal and reproductive care. "It is going to have to be a combination of things and certainly removing barriers to recruitment is an important part of that," she said, adding that the state must also address rural hospitals' precarious financial position amid the projected loss of Medicaid funding. Breana Lipscomb, the senior manager of maternal health and rights at advocacy group the Center for Reproductive Rights, noted that all of these factors are "working in tandem" to restrict access. "It's making health care even further out of reach for people, and this is particularly concerning for Black people, for people living in rural areas, for low income folks and for people with capacity to birth," Lipscomb said. "I am really afraid of what we might see," she added.

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