Out-of-pocket cost problem doesn't hit all equally, and other letters

Regarding the Jan. 11 editorial “What's behind the out-of-pocket cost problem," it is important to understand that the “out-of-pocket cost problem” does not affect all people equally. Those with life-threatening, chronic and rare diseases who require specialty medications are disproportionately burdened by high out-of-pocket costs. Unfortunately, this is often people on Medicare, many of whom do not qualify for low-income subsidies but also cannot afford the cost-sharing required by Medicare Part D.

Daniel Klein

Regarding the Jan. 4 guest commentary by VA Undersecretary for Health Dr. David Shulkin (“VA needs skilled healthcare leaders to speed system reforms”), there are many, myself included, who believe that the VA system cannot be reformed until the VA leadership has the authority to swiftly terminate those VA employees who are an impediment to system reforms.

Steven Smith

The Republican House and Senate have moved forward again to repeal the Affordable Care Act, which has been a thorn in their side for years. However, Speaker Paul Ryan uses only placating words when he states that a better plan will be presented.

It has been more than five years since these statements were first offered, but the Republicans have done little to improve healthcare access to millions in this country. They have not shown any understanding of the current movement in healthcare to lower costs, improve access and to improve quality while focusing on the most important element of healthcare—the patient, or in broader terms, the healthcare consumer. Many of the efforts under the ACA are now focused on how to improve the quality of healthcare through accountable care organizations and similar efforts.

Thomas Tiffany, Ph.D