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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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Politics

‘Urgent’ review announced into foreign interference in British politics

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'Urgent' review announced into foreign interference in British politics

Sir Keir Starmer has authorised an “urgent” review into the extent of foreign interference in British politics, as he prepares to change the law to tighten donation rules.

Ministers have initiated a rapid inquiry into current financial rules on donations and election safeguards, which will report at the end of March.

It will be led by Philip Rycroft, the former permanent secretary of the Brexit department.

Politics latest: Who could lead Labour instead of Starmer?

The inquiry is a direct response to the jailing of Nathan Gill, the former leader of Reform UK in Wales, who admitted accepting tens of thousands of pounds in cash to make pro-Russian statements to the media and European Parliament.

In this case, officers said that they believed some individuals had a direct link to Vladimir Putin.

Communities Secretary Steve Reed, who announced the inquiry to the Commons on Tuesday, wants Mr Rycroft to assess how well the rules work at the moment and promised the report will be published in full.

More from Politics

Mr Reed told MPs that the “conduct [of Gill] is a stain on our democracy”.

“The independent review will work to remove that stain,” he said.

The review could then lead to changes in the Elections Bill, due this spring, which could significantly change the way elections are financed.

Tuesday’s announcement is likely to ignite a firestorm of criticism.

Among the changes that could result from the Rycroft report could be a clampdown on cryptocurrency donations, which Reform UK leader Nigel Farage has said in the past would be a direct attack on his party.

It could introduce new rules for donations to thinktanks, which fall outside any regulatory regime at the moment, and could see new rules around foreign donations.

Philip Rycroft will carry out the review
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Philip Rycroft will carry out the review

Foreign donors can effectively give money if they have a trading UK subsidiary at the moment.

The government has already promised to clamp down on “shell” companies, but this could give more clarity over how this will work.

It could also look at funding of “troll farms” – vast banks of social media accounts based overseas designed to try and sway public opinion as part of state disinformation campaigns.

However, the financial affairs of and donations to Labour MPs could be in the scope of the review, and those named in the report could face fresh disciplinary consequences.

The government also singled out Christine Lee, the UK-based lawyer accused of working covertly on behalf of the Chinese Communist Party, as another case of concern.

Christine Lee is accused of working on behalf of the CCP
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Christine Lee is accused of working on behalf of the CCP

Nevertheless, other parties are likely to suggest this is an attempt to change the donation rules in Labour’s favour, after promising to lower the voting age to 16 and cancelling some mayoral elections because of a local government re-organisation.

The review will invite all party leaders to take part in “in-depth assessment of the current financial rules and safeguards and offer recommendations to further mitigate risks from foreign political interference”.

Mr Rycroft cannot compel politicians to give evidence, but he will have access to the security services, though the extent of their cooperation is unclear.

The conduct around the Brexit referendum has been specifically excluded in the terms of reference, and Mr Rycroft will be instructed to focus on more “recent” cases, although there is no specific start date.

The 12-week timeline for the inquiry, alongside the lack of statutory powers, is likely to make it hard for Mr Rycroft to uncover substantial new incidents of bribery or corruption and prove them to a standard necessary to put details in the public domain.

The publication date, at the end of March, comes just five weeks before local elections in which Reform UK is expected to do well, and opposition politicians are likely to question the timing.


How worried should we be about Russia bribing politicians?

Mr Rycroft has previously locked horns with Boris Johnson.

He argued that, at times, Mr Johnson was a PM who “only speaks for England”, his government was “not sensitive to the niceties of constitutional convention” and had “imperious disregard” for devolved policies, fuelling the breakup of the UK.

In June last year, just before the election, when Rishi Sunak was PM, he signed a letter to The Times which said: “Trust in politics, and in the people and institutions of public life, is at an all-time low.

“This is a serious problem for the health of our democracy and is indicative of the need for substantial improvement in the governance of the UK.”

Mr Rycroft has previously expressed his caution about the relationship between big tech and politics, telling Sky News two years ago: “Politicians do have to be a little bit careful in this space.

“Nobody’s elected Elon Musk, his opinions are those of a businessman, he is not a statesman.

“Clearly, they can court business people for their investment, but they shouldn’t look as though they’re kowtowing to them in terms of their regulatory concepts.

“They should listen to their views, but it should be democratically elected politicians that take those really, really important decisions, and let’s hope that’s the case in the UK.”

It comes as Reform and the Conservatives both received significantly higher donations than Labour in the first three quarters of this year.

They included the largest ever political donation from a living person: £9m to Reform UK from British-Thai businessman Christopher Harborne.

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Politics

Justice Secretary Angela Constance survives no confidence vote amid grooming gangs row

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Justice Secretary Angela Constance survives no confidence vote amid grooming gangs row

Scotland’s justice secretary has survived a vote of no confidence amid claims she misrepresented a leading expert on grooming gangs and therefore misled parliament.

MSP Angela Constance has ignored calls to stand down and has First Minister John Swinney’s full backing in the wake of comments she made about Professor Alexis Jay.

Mr Swinney led her defence, describing her as a “sincere minister” who was “getting on with the job of making Scotland safer”.

Both Scottish Labour and the Scottish Conservatives lodged motions of no confidence, with a debate held at Holyrood on Tuesday afternoon.

Scottish Labour, the Scottish Tories and the Scottish Liberal Democrats joined forces to vote against Ms Constance, but the motion failed due to the backing of the SNP and Scottish Greens.

More on Grooming Gangs

Justice Secretary Angela Constance at Holyrood on Tuesday. Pic: PA
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Justice Secretary Angela Constance at Holyrood on Tuesday. Pic: PA

MSP Russell Findlay, leader of the Scottish Conservatives, said: “Shameless SNP and Green MSPs put partisan politics before truth and integrity, to the understandable fury of grooming gang victims.

“To any reasonable person, Angela Constance’s position is untenable. She misled parliament by misrepresenting Professor Jay, tried to cover it up and then publicly lied after being caught.

“She twisted Professor Jay’s words to reject our calls for a Scottish grooming gangs inquiry and then failed to correct the record.

“It’s an open-and-shut case of a ministerial code breach for which she should lose her job.”

The row revolves around a comment made by Ms Constance as MSPs debated the Victims, Witnesses and Justice Reform (Scotland) Bill in September.

Amid a failed Scottish Conservative amendment for a public inquiry to be established into grooming gangs in Scotland, Ms Constance insisted Professor Jay agreed with her that such a probe was not needed.

However, emails made public by the Scottish government last week revealed the professor – who led the Independent Inquiry into Child Sexual Exploitation in Rotherham in 2014 – later contacted Ms Constance to say she would “appreciate” her position “being clarified”.

Professor Jay added that her comments quoted by Ms Constance had “nothing to do” with the situation in Scotland.

Read more: Scottish government orders review of grooming gangs evidence

Scottish Labour leader Anas Sarwar said he supported the motion as “victims and survivors of grooming gangs and child sexual exploitation have lost confidence in this justice secretary”.

He added: “The justice secretary misrepresented Professor Jay’s views in order to find an excuse not to have an inquiry into grooming gangs.

“Victims and survivors should be able to rely on their justice system, and their government, to tell the truth, to act with integrity and to put them first.

“On this, the justice secretary has failed.”

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During First Minister’s Questions last week, Mr Swinney claimed Ms Constance “was making a general comment” on the situation as he gave his justice secretary his full backing.

He reiterated his support for Ms Constance during the debate, saying: “The cabinet secretary in the debate in September did not state that Professor Jay was speaking directly about the amendment.

“She made a general point drawing on the publicly stated views of Professor Jay.

“But I acknowledge that members of parliament and members of the public will draw different conclusions from the words we all use.”

Mr Swinney described Ms Constance as a “sincere minister who would never address parliament in a way that would in any way mislead parliament or the public”.

The first minister added: “She’s never shied away from asking tough questions about our approach to justice.

“Nor has she ever avoided tackling some of the biggest issues that we face.

“For these reasons, Angela Constance has my full confidence as justice secretary.

“She’s getting on with the job of making Scotland safer, and I urge members to enable her to continue doing that by rejecting this motion today.”

The motion was defeated by 57 votes to 67, with one abstention

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World

Imran Khan’s sons ‘fear they may never see him again’ as former Pakistan PM ‘held in death cell’

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Imran Khan's sons 'fear they may never see him again' as former Pakistan PM 'held in death cell'

The sons of former Pakistani prime minister Imran Khan have said they fear they might never see their father again as he is being “psychologically tortured” in a “death cell”.

Speaking to Sky News’ The World with Yalda Hakim, Kasim and Sulaiman Khan said they had not spoken to their father, who has been in prison since August 2023, for months.

Imran Khan's sons being interviewed by Yalda Hakim
Image:
Imran Khan’s sons being interviewed by Yalda Hakim

Kasim described the conditions the former Pakistani leader has been kept, saying: “He’s been in a solitary confinement cell for over two years where he’s had filthy water, he is around inmates who are dying of hepatitis, the conditions are disgusting and also he is completely isolated from any human contact.”

He continued: “It’s getting harder to see a route out at this point. We’re trying to have faith. But at the same time, right now, the conditions are getting worse.

“It’s very hard to see a way out… We’re now worried we might never see him again.”

Kasim said his father was being subjected to “psychological torture tactics” as even the prison guards weren’t allowed to communicate with the former Pakistani leader, who led the country between 2018 and 2022.

Imran Khan, pictured in March 2023 before his arrest on corruption charges. File pic: Reuters
Image:
Imran Khan, pictured in March 2023 before his arrest on corruption charges. File pic: Reuters

Sulaiman said his father’s cell, where he allegedly spends 23 hours a day, has been described as a “death cell”.

More on Imran Khan

He said an army spokesperson announced on Friday that Imran Khan, who has in the past been shot three times, was now officially in full isolation.

He added that Imran Khan was being kept in “completely substandard conditions that don’t meet international law for any sort of prisoner”.

The brothers’ words echo what one of Khan’s sisters reported after being allowed to meet the former cricketer in prison at the start of the month.


Who is Imran Khan?

Uzma Khanum said at the time that Khan was facing isolation and psychological strain in prison following weeks in which his family said access had been blocked.

The former leader was jailed after being convicted in a string of cases that he says were politically driven following his ousting in a 2022 parliamentary vote.

Before launching his political career, Imran Khan was best known as a star of international cricket and for leading Pakistan to Cricket World Cup victory in 1992.

Kasim said his father would “never take a deal and leave all of his other party members in jail to die and fester in these jails…

“Instead he stays in those conditions, happy to rot and it means that he can move towards his goal of ridding Pakistan of corruption, a goal that he has stated to us a million times.”

Mosharraf Zaidi, a Pakistani government spokesperson, will be speaking to Yalda Hakim tonight on Sky News from 9pm.

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