The Nov. 25 Style article “Donald Glover says he had a stroke, surgeries for hole in heart last year” told only part of the story. That “hole” is present in every fetus and typically closes after birth. In up to 25 percent of babies, the hole does not close and can cause a stroke. This hole is called a patent foramen ovale (PFO) and is easily closed through minimally invasive procedure (rather than open-heart surgery).
Glover fell into a low (but frightening) percentage of PFO patients who experience a stroke.
Glenn Easton, Chevy Chase
Wait for peer review before announcing breakthroughs
The Nov. 27 editorial “Thankful for breakthroughs in gene therapy” did a disservice to Huntington’s disease patients by describing what I would call “press release research results.” The editorial said that “a new treatment has shown remarkable promise” and provided a disclaimer that it was “not yet peer-reviewed.” However, if it has not been peer-reviewed (i.e., not yet accepted for publication in a peer-reviewed journal), then it should not be discussed by the press as if it were true. An announcement of a research finding by press release can reflect bias. Only peer review can validate the results. I’m glad the editorial included an appropriate disclaimer, but unfortunately it might be ignored by readers.
Edward Tabor, Bethesda
The writer is a former division director at the U.S. Food and Drug Administration and a former associate director at the National Cancer Institute.
A primary cause of health care woes
Lanhee J. Chen and Daniel L. Heil’s Dec. 3 op-ed, “Yes, Republicans can reform health care. Here’s how.,” was notable for its omission. The authors proposed “ideas that can lower costs, expand access to quality care and give patients greater control over their own health care,” without asking who will be left to administer those suggestions. The decline in primary care providers threatens the U.S. health care system.
The latest data from the Association of American Medical Colleges showed that for the Class of 2024, 71.2 percent of graduates finished with debt, at an average of $212,341. Beyond that, medical graduates generally commit to at least an additional two to five years of postgraduate training before they can take a job or start a practice. The combination of debt plus the years-long delay in potential earnings after college will continue to make a medical career less attractive. And for those who complete the arduous and expensive process, only 19.8 percent pursue primary care, with others pursuing careers in higher-paying specialties. The pay disparity is perpetuated by the Medicare Physician Fee Schedule, which favors procedures and specialty-based services rather than cognitive care, which includes history taking, clinical assessment, care coordination and management of multiple chronic conditions.
Ideas for health care reform should include one to cover education costs in exchange for an equivalent commitment in years to practice primary care in underserved communities as payback, to ease the shortage. Without an adequate supply of frontline providers, costs, access and outcomes will continue to suffer.
Dean R. Wasserman, Plymouth, Massachusetts
Make benefits portable but grounded in neighborhoods
Patrice Onwuka’s Nov. 29 op-ed, “An innovative approach to expanding health coverage is gaining steam,” correctly highlighted portable benefits as a vital solution for the 73 million Americans in the independent workforce. Early efforts in Utah, Georgia and Pennsylvania show real potential.
But as we build this new benefits infrastructure, we need to look beyond the app-based gig economy. There is a community gig economy of barbers, child care providers and neighborhood health workers who are the bedrock of trust in underserved areas. For them, flexibility is essential but isolation is the enemy. A purely individual, market-based portable-benefits account, though helpful, misses a crucial opportunity to strengthen the community fabric that makes their work possible.
I direct a pilot in West Baltimore, Charm City Chairside, in collaboration with the Greater Baltimore Medical Center. It combines portable benefits with a shared fund for each shop or block, building communal wealth alongside individual security. Without that neighborhood trust, no insurance card or health savings account will get people through a clinic door.
As Congress and state legislatures consider portable-benefits bills, they should ensure room for cooperatives and other community-based administrators, so benefits are not only portable but also rooted in the trust that keeps communities healthy.
Stephen B. Thomas, College Park
The writer is founding director of the Maryland Center for Health Equity at the University of Maryland School of Public Health and leader of the Health Advocates in Reach Network.
Needles aren’t the problem
I appreciate the coverage of the Trump administration’s efforts to dismantle America’s decades-long public health work to decrease infectious diseases. But many articles are invariably accompanied by photos of needles or someone getting a jab. I plead with editors to start using photos that show the effects of vaccine-preventable diseases: measles, whooping cough, hepatitis, flu, polio. The Post has an opportunity to educate the public; take it.
Karen DeCamp, Baltimore
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