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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.

On Alcohol Abuse: Seeing a Double Standard

I have done quite a bit of research on alcohol-related deaths and I track reports from the Centers for Disease Control and Prevention. Now, my No. 1 question is: Why are the government and the media not holding the alcohol industry accountable for the deaths that its products cause?! The tobacco industry was held accountable for its products and now pharmacies are being held accountable for the opioid crisis. It seems to me that theres a double standard thats been ongoing for years, especially since alcohol-related deaths far outnumber opioid deaths. Can anyone working for the government or the media explain why I see more articles about the possible dangers of opioids or marijuana (Legal Pot Is More Potent Than Ever And Still Largely Unregulated, May 9) instead of alcohol-related deaths?

Stephen Hubbard, Independence, Missouri

This kind of mainstream #cannabis coverage is ignorant and reminiscent of the 1980's. It oversimplifies an incredibly complex topic, demonizes #marijuana, and outright ignores health benefits for millions. I'd expect more from USA Today. @DavidHilzenrath https://t.co/AlOkAlM5ac— John Schroyer (@Johnschroyer) May 8, 2023

John Schroyer, Denver

Veterans Deserve Choice in How They Claim VA Disability Benefits

While I appreciate KFF Health News interest in the ongoing debate about private sector services helping veterans navigate the Department of Veterans Affairs disability claims process (Some Private Companies Charge Hefty Fees to Help Veterans With Disability Claims, April 28), your coverage left the impression that private benefit guides generally overcharge for their services and provide little value to veterans. That is an unfair characterization, and your readers deserve additional context.

Honorable companies like Veteran Benefits Guide, where I work, are providing a needed service to veterans, helping guide them through the complex claims process and ensure they receive the full benefits they earned from their service. As a company founded by a veteran and staffed by many veterans and family of veterans, we are proud that our clients receive an average increase to annual benefits of $13,200, benefits they would not receive without our help.

Veterans service organizations (VSOs) are intended to help free of charge, but too often they are understaffed and inadequately trained. In congressional testimony, the National Association of County Veterans Service Officers, which represents county VSOs nationwide, acknowledged that it does not have enough representatives nor funding to meet veterans demand for assistance.

Your article described $2,800 as a hefty fee being charged by one private benefit guide and quoted the National Organization of Veterans Advocates, a group representing accredited attorneys and agents, calling for tighter regulation of the industry, but then failed to mention that those attorneys and agents often charge veterans significantly more. In fact, accredited attorneys charge between 20% and 33% of a veterans backpay, which can exceed $50,000 on complicated cases. In nearly every scenario, an attorney will charge multiples more than a private benefit guide and take years longer to achieve the same result.

At Veteran Benefits Guide, our focus is on ensuring Veterans submit fully developed, accurate claims to the VA, which helps get the correct rating for the Veteran the first time, avoids the need for costly appeals and speeds up the final benefits decision. Attorneys, on the other hand, are only paid to assist Veterans during an appeals process. And they are incentivized to drag out appeals, since they are paid a percentage of the Veterans backpay. The longer an appeal takes, the more the attorney is paid.

Veteran Benefits Guide and other honorable companies have strongly supported efforts to establish guardrails and crack down on bad actors, such as the recently introduced PLUS for Veterans Act, which would impose criminal penalties on those seeking to take advantage of veterans, establish safeguards to prevent conflicts of interest, and institute caps to prevent unreasonable fees while still preserving the right of veterans to seek assistance from the private sector. It would have been helpful context for your readers to know that such reasonable legislation has been introduced and is being considered in Congress right now.

Michael Licari, chief legal officer of Veteran Benefits Guide, Las Vegas

This is unacceptable #SDoHwarriors!

Veterans and members of the military already face a higher than expected incidence and prevalence of #SDoH, now this???

RISE @tdahlborg @pauldvet
Jenn Kerfoot @JoSchneier
Toni Tashiro #mhttps://t.co/ffbcLONGJf https://t.co/EyFCg3xByU— Ellen Fink-Samnick (@epflcswccm) April 28, 2023

Ellen Fink-Samnick, Burke, Virginia

Bracing for a Wave of Denials

Patients and physicians alike are shocked by the increasing number of absurd and sometimes dangerous barriers insurance companies put in place (Denials of Health Insurance Claims Are Rising And Getting Weirder, May 26). Not only are coverage denials happening after the fact, but care is also disrupted before patients have a chance to get the drugs and services they need.

Through a process called prior authorization, insurance companies force doctors to submit requests for care, and the insurance company representatives, who are not necessarily specialists or even medical doctors, have the power to determine if care is necessary or not. At best, it delays care and can force patients to wait; at worst, medical care can be outright denied.

One egregious example is UnitedHealthcares unprecedented prior authorization policy for most endoscopies and colonoscopies, starting on June 1. Even if you have blood in your stool or suffer severe gastrointestinal pain, you will need to get preapproval before you can receive a procedure to diagnose or treat your condition. With colorectal cancer being the second-leading cause of cancer deaths in the U.S. and Crohns disease and colitis affecting more than a million Americans, time is of the essence to catch problems quickly. I fear that UnitedHealthcares prior authorization policy will deter Americans from getting timely care and exacerbate existing disparities.

The gastrointestinal community calls on UnitedHealthcare to honor its recent promise to slash prior authorization and rescind this absurd policy before patients suffer real harm.

Barbara Jung, president-elect of the American Gastroenterological Association, Seattle

Denials of #health insurance claims are more & more common, boosting company profits but often defying medical standards of careand sheer logic. https://t.co/0oA6ZuPFan— Lindsay Resnick (@ResnickLR) May 26, 2023

Lindsay Resnick, Chicago

Aging Takes a Village

I applaud Judith Graham for her article How to Grow Your Social Network as You Age (April 28), which also published April 22 in The Washington Post. It aptly highlights the importance of social connections for older adults and emphasizes that its never too late to develop meaningful relationships. I could not agree more.

We are increasingly learning about the consequences of isolation and loneliness on the emotional, physical, and cognitive health of older adults.

In the past decade, an antidote to social isolation has emerged nationwide through the Villages Movement whereby local communities of neighbors help one another to successfully age in place.

Most Villages are volunteer organizations offering a range of social activities and basic services. There are approximately 350 Villages nationwide and 74 in the Washington, D.C., metro area. While each Village operates differently, they share the mission to improve the quality of life for seniors and reduce isolation.

My work with Villages, both nationally and locally, has allowed me t witness firsthand how Villages are improving the lives of older adults. Whether they attend a Village seminar, luncheon, art tour, or bridge tournament, they are building those critical connections and having fun!

During the pandemic lockdown, our Potomac Community Village helped to reduce isolation by offering frequent Zoom programs as well as friendly phone calls and check-ins with members.

Villages are a great solution. Id encourage readers to consider joining a Village where they can find new friends and a renewed sense of community. For more information, see vtvnetwork.org.

Edgar E. Rivas (he, him, l), Potomac Community Village Board of Directors vice president, Village to Village Network, Potomac, Maryland

Worthwhile story, but this shot of people playing "yard petanque" Disrespects My #bocce Bing. https://t.co/XSSzrlFGFj pic.twitter.com/Ql4VpBAN9F— Alex Heard (@alexheard) April 23, 2023

Alex Heard, Santa Fe, New Mexico

Remote Work Alone Wont Solve Caregivers Challenges

I am a health care professional and have relied upon the work of KFFs health policy research and KFF Health News over the years. Reading a recent article you produced, “Remote Work: An Underestimated Benefit for Family Caregivers” (May 19) by Joanne Kenen, I would strongly suggest a deeper view. Below are specific points I’d love to help bring to the attention of your readership, given my extensive work in the space of caregiving, health, and the working caregiver. I am a registered nurse, family caregiver, caregiving expert, and co-founder of two organizations that have been supporting family caregivers for the past eight years.

Remote work is helpful, yes. But its only part of the answer. Without the adequate tools, resources, and support to work and carry the load of caring at home, working caregivers will still experience stress, burnout, hits to their productivity, loneliness, and the list goes on.

We need to take a more wholistic view and address the underlying factors of stress, and the myriad of challenges that plague every caregiver.

For example, communication challenges do not go away when working from home not unless that working caregiver has the technology and resources to connect all the disparate communications in order to better coordinate among other family members involved in caring and with the providers involved in managing their care. Post-it notes, texts, emails, and phone calls are no way to communicate and are simply ineffective.

Having remote patient monitoring devices at home is good, but if they are not connected to a platform to better coordinate whats happening, adjust care plans, and engage providers of care more effectively with the family caregiver at home managing the care, then work productivity, stress, and the employees well-being still takes a big hit, regardless of working remotely or not.

We need to go several layers deeper. Remote work is a good benefit, but it cannot stop there. Without the adequate support, technology, and tools to engage and better coordinate the mess, many working caregivers slog through every day, and the overall impacts will be far less than desired.

Deb Kelsey-Davis, Chicago

The overlooked benefit of remote work for #caregivers: Employers and co-workers understand the need to take time off to care for a baby. But theres a lot less understanding about time to care for anyone else. by @JoanneKenen @khnews https://t.co/Q30mLggH55 via @usatoday— Catherine Arnst (@cathyarnst) May 17, 2023

Catherine Arnst, New York City Related Topics Aging Caregiving Letter To The Editor Marijuana Substance Misuse Contact Us Submit a Story Tip

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World

Ukraine ‘ready to meet’ Russia after Putin call for peace talks on Thursday, says Zelenskyy

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Ukraine 'ready to meet' Russia after Putin call for peace talks on Thursday, says Zelenskyy

Volodymyr Zelenskyy has said his country is “ready to meet” Russian representatives after Vladimir Putin suggested peace talks in Istanbul from Thursday.

Russia‘s president put forward the proposal as European leaders including Sir Keir Starmer threatened him with fresh sanctions if Russia failed to comply with an unconditional 30-day ceasefire starting on Monday.

Reacting to Mr Putin’s suggestion, US President Donald Trump said it was “a potentially great day for Russia and Ukraine” and he would “work with both sides to make sure it happens”.

Mr Zelenskyy has also welcomed the proposal, but reiterated his call for a ceasefire.

Split of Putin and Zelenskyy.

He said: “It is a positive sign that the Russians have finally begun to consider ending the war. The entire world has been waiting for this for a very long time. And the very first step in truly ending any war is a ceasefire.

“There is no point in continuing the killing even for a single day. We expect Russia to confirm a ceasefire – full, lasting, and reliable – starting tomorrow, May 12th, and Ukraine is ready to meet.”

On Saturday, the prime minister met the Ukrainian president alongside French President Emmanuel Macron, recently elected German Chancellor Friedrich Merz and Polish Prime Minister Donald Tusk in Kyiv.

More on Russia

Announcing the 30-day ceasefire proposal, the leaders said they had secured the backing of Mr Trump after briefing him on the progress made on the so-called “coalition of the willing” plans in a 20-minute phone call.

What Trump does next is crucial


Dominic Waghorn - Diplomatic editor

Dominic Waghorn

International affairs editor

@DominicWaghorn

Russian President Vladimir Putin is playing for time and may have been caught on the hop by European leaders, backed by US President Donald Trump, demanding a 30-day ceasefire during their visit to Kyiv yesterday.

Russia’s proposal of talks in Istanbul on Thursday appears hurriedly conceived, announced as it was in the early hours of the morning by Putin.

There is an added symbolism to his suggestion of Istanbul as a venue. Russia has long blamed Ukraine for walking away from peace talks in the same city in 2022.

The key thing is that diplomatic movement of sorts is happening.

Ukraine and its European colleagues want to capitalise on Trump’s renewed enthusiasm for a ceasefire and his potential scepticism of how ready Putin actually is to make peace.

The Europeans will hope this isn’t drawn into a protracted period of negotiations, or simply talking about the idea of negotiations.

What President Trump does next will be crucial.

Speaking at the Kremlin in the early hours of Sunday, Mr Putin did not directly address the proposal but instead offered to restart peace talks Russia and Ukraine held in 2022.

“We propose the Kyiv authorities resume the negotiations they interrupted at the end of 2022… to resume direct negotiations… without any preconditions… to begin without delay next Thursday 15 May in Istanbul,” he said.

Speaking to Sky News Russia correspondent Ivor Bennett after the statement, Kremlin spokesperson Dmitry Peskov said Moscow does not “share the view of Starmer”.

“We think that the seriousness is to propose negotiations,” he said, denying the move was a delaying tactic.

Mr Peskov said there had to be negotiations to find a way for a ceasefire, adding: “A simplistic approach to a ceasefire is inappropriate.”

European leaders hold call with Ukraine. Pic: Number 10
Image:
European leaders including Volodymyr Zelenskyy hold call with Donald Trump. Pic: Number 10

Russia’s own unilateral three-day ceasefire, declared for the 80th anniversary of victory over Nazi Germany, expired on Saturday, and Ukraine said Russian forces have repeatedly violated it.

After the summit in Kyiv, Sir Keir said: “All of us here, together with the US, are calling Putin out.

“So we are clear, all five leaders here – all the leaders of the meeting we just had with the coalition of the willing – an unconditional ceasefire, rejecting Putin’s conditions, and clear that if he turns his back on peace, we will respond.

“Working with President Trump, with all our partners, we will ramp up sanctions and increase our military aid for Ukraine’s defence to pressure Russia back to the table.”

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During Mr Putin’s statement on Sunday, he insisted he would support peace talks, adding: “We are committed to serious negotiations with Ukraine.”

He told reporters: “Their purpose is to eliminate the root causes of the conflict, to establish a long-term, lasting peace.

“We do not rule out that during these negotiations it will be possible to agree on some new truces, a new ceasefire.”

Read more:
Will Trump force Putin to comply with ceasefire?
Russia’s VE Day parade felt like celebration of war
Michael Clarke Q&A on Ukraine war
Ukraine and Russia argue over ceasefire breaches

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Responding to Mr Putin’s proposal, Mr Macron said the Russian leader was “looking for a way forward, but he still has a desire to buy time”.

Mr Putin’s proposed negotiations are “a first step, but they are not sufficient,” he told French broadcaster BFM.

“An unconditional ceasefire is not preceded by negotiations, by definition.”

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Politics

UK-US trade deal ‘isn’t worth the paper it’s written on’, says Nobel Prize-winning economist

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UK and US announce trade deal to save thousands of British jobs, Starmer says

A Nobel Prize-winning economist has told Sky News the recently announced UK-US trade deal “isn’t worth the paper it’s written on”.

Sir Keir Starmer and Donald Trump announced the “first-of-a-kind” agreement with a live, televised phone call earlier this week – and the British prime minister hailed the deal as one that will save thousands of jobs in the UK.

Politics latest: Tories criticise proposals to tackle immigration

But leading economist Joseph Stiglitz has told Sunday Morning with Trevor Phillips he “wouldn’t view [the deal] as a great achievement”.

“Any agreement with Trump isn’t worth the paper it’s written on,” he said, pointing out the president signed deals with Canada and Mexico during his first term – only to slap them with hiked tariffs within days of returning to the White House this year.

“I would view it as playing into Trump’s strategy,” he said.

“His strategy is divide and conquer, go after the weakest countries, and sort of put the stronger countries in the back.”

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How good is the UK-US deal?

The scramble to secure a UK-US trade deal was sparked by Mr Trump’s ‘Liberation Day’ announcement last month, which saw the president hike import tariffs for multiple countries and subsequently send global markets crashing.

China initially faced tariffs of 34% and when Beijing hit the US with retaliatory rates, a trade war quickly ensued.

The US and China now impose tariffs of above 100% on each other, but representatives from the two countries have this weekend met for high-stakes negotiations.

Read more:
Key details in the UK-US deal
Analysis – the challenge Starmer faces

President Donald Trump, center, with from l-r., Vice President JD Vance, and Britian's ambassador to the United States Peter Mandelson, making remarks on a trade deal between U.S. and U.K. in the Oval Office of the White House, Thursday, May 8, 2025, in Washington. (AP Photo/Evan Vucci)
Image:
Donald Trump, with US vice president JD Vance and Britain’s ambassador to the US Peter Mandelson, announcing the deal. Pic: AP

Britain's Prime Minister Keir Starmer speaks on the phone to US President Donald Trump at a car factory in the West Midlands, Thursday, May 8, 2025.(AP Photo/Alberto Pezzali, Pool)
Image:
Sir Keir Starmer dialled in for the deal announcement. Pic: AP

With its response to Mr Trump, Beijing “made it very clear that the US is very dependent on China in so many ways,” Mr Stiglitz said.

“So they’re beginning now to negotiate, but from a position of strength.”

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Asked if he thinks the UK should have focused on its relationship with the EU instead of the US, Mr Stiglitz said: “Very much so.

“My view is that if you had worked with the EU to get a good deal, you could have done better than what you’ve done.

“If it turns out, in the end, when you work it all out, Trump is unhappy, he’ll run. If he’s unhappy, I pray for you.”

Among the terms in the UK-US trade deal are reduced tariffs on British car and steel exports to the US, while the UK has agreed to remove a tariff on ethanol, used to produce beer.

The agreement also opens a new agricultural exchange, with US farmers being given access to the UK for the first time – though UK food standards on imports have not been weakened.

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Environment

Saudi oil giant Aramco posts 5% dip in first-quarter profit on weaker crude prices

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Saudi oil giant Aramco posts 5% dip in first-quarter profit on weaker crude prices

Members of media chat before the start of a press conference by Aramco at the Plaza Conference Center in Dhahran, Saudi Arabia November 3, 2019. 

Hamad I Mohammed | Reuters

Saudi Aramco’s first-quarter net profit fell 5% year-on-year amid lower oil prices and production.

Net income for the three months to March 31 came in at $26 billion, down from $27.3 billion for the same period last year, the company reported. The figure was slightly above analyst expectations of $25.3 billion.

Aramco announced its free cash flow for the quarter at $19.2 billion, down from $22.8 billion in the first quarter of 2024, and cash flow from operating activities at $31.7 billion compared to last year’s $33.6 billion.

The figures signal continuing strain for the Saudi state oil giant’s balance sheet as crude prices show no sign of recovering and global demand slows in line with pressures on trade.

The company in March announced it would be slashing its performance-linked dividend payout for the fourth quarter of 2024 to $200 million — down from $10.2 billion the previous quarter — and repeated that $200 million figure for the first-quarter of this year, to be paid in the second quarter.

Its first-quarter base dividend excluding the performance-based payouts increased by 4.2% year-on-year to $21.1 billion. But if assessed in total, the dividend fell from $31 billion in the same period last year to $21.36 billion now, due to the cut to its performance-linked element.

Lower oil prices will weigh on Middle East economies, but they're still well-cushioned: S&P Global

“Global trade dynamics affected energy markets in the first quarter of 2025, with economic uncertainty impacting oil prices,” Aramco CEO Amin Nasser said in a statement accompanying the earnings report.

“In this context, Aramco’s robust financial performance once again demonstrated the Company’s unique scale, its reliability and flexibility, the value of its lowcost operations … Such periods also highlight the importance of disciplined capital planning and execution while we continue to take a long-term view.”

Nasser added, “In volatile times Aramco’s resilience underpins both our financial performance and our sustainable and progressive base dividend.”

Bearish oil market ahead

The massive dividend reduction eases pressure on Aramco itself, but means less revenue for the Saudi government as it faces widening deficits and mounting debt due to costly megaprojects and lower oil prices.

The kingdom also constrained its oil revenue potential by maintaining months of coordinated OPEC+ production cuts meant to stabilize the market. That policy changed dramatically after Saudi Arabia and several of its OPEC+ allies announced a shock acceleration to production increase plans in April, even as markets and crude prices were tanking on the news of U.S.-imposed global tariffs.

In early May, OPEC+ again raised its production target for June by 411,000 barrels per day — the second consecutive month of accelerated unwind of the 2.2 million-barrel per day voluntary cuts that had been in place since the start of 2024.

Banks and energy agencies have steadily downgraded their oil price outlooks for the year, anticipating large supply gluts and weak demand. The U.S. Energy Information Administration’s latest forecast sees Brent crude averaging $65.85 per barrel this year, while Morgan Stanley cut its price outlook to $62.50 per barrel in the second half of this year, down by $5 per barrel from the bank’s previous forecast.

Morgan Stanley also predicts a market glut of up to 1.1 million barrels per day in the second half of 2025 — an increase of 400,000 bpd from its previous surplus call.

$60 oil is likely to have a 'significant' impact on the deficits of GCC countries, says Goldman Sachs

Goldman Sachs, meanwhile, sees Brent averaging $60 per barrel in the remainder of 2025, compared to $63 previously, and $56 per barrel in 2026, compared to $58 previously.

Saudi Arabia needs oil at more than $90 a barrel to balance its budget, the International Monetary Fund estimates. Goldman Sachs in mid-April warned that Brent crude at $62 a barrel — its price forecast at the time — could more than double the kingdom’s 2024 budget deficit of $30.8 billion.

“In Saudi Arabia, we estimate that we’re probably going to see the deficit go up from around $30 to $35 billion to around $70 to $75 billion, if oil prices stayed around $62 this year,” said Farouk Soussa, MENA economist at Goldman Sachs. The bank’s forecast for the rest of 2025 now sits at $60 per barrel.

“That means more borrowing, probably means more cutbacks on expenditure, it probably means more selling of assets, all of the above,” Soussa told CNBC last month. “And this is going to have an impact both on domestic financial conditions and potentially even international.”

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