Letters to the Editor | Aug. 31, 2023

The struggles of patients like Sally Nix highlight the need for comprehensive reform in prior authorization practices by health insurers. Patients are turning to social media to share their stories, exposing systemic flaws, and driving change. While federal reforms are in the pipeline, their scope must include all Americans for meaningful impact. One critical solution is the implementation of a more streamlined prior authorization process. By collaborating closely, insurers and health-care providers could establish clear guidelines outlining when prior authorization is necessary, standardizing the review process. The integration of electronic health records alongside digital communication could expedite the exchange of crucial information, enabling quicker decisions while minimizing disruptions to patient care. Social media serves as a potent tool for amplifying these voices, compelling insurers to reconsider decisions. By channeling this momentum, we can demand transparency and accountability from insurers, ensuring patients receive the rightful care they deserve.

Pragat Patel, Philadelphia

As a pediatric resident physician, I support Gov. Josh Shapiro’s state-funded initiative to provide all public school students with free breakfast this school year. It’s well documented that children who do not have consistent access to food have more hospitalizations, reduced academic achievement, and increased rates of depression and suicidality. Studies show these negative outcomes persist even beyond childhood, leading to conditions such as diabetes and heart disease in adulthood. Giving kids free meals at school helps ensure they are adequately nourished, preventing disease and eliminating the chronic stress experienced when worrying about their next meal.

Only 31% of students in Philadelphia last year ate their school-offered free breakfast. I commend the Norristown district’s shift to serving breakfast during homeroom rather than before the school day begins, as children might struggle to get to school early due to long bus commutes and already early start times preventing adequate sleep. Eliminating an application process similarly reduces a barrier to utilization. More districts should follow Norristown’s example, and school leaders as well as pediatricians should counsel families on the availability of free breakfast. Further, consider that the greatest insight into why kids aren’t eating their free breakfast is the kids themselves — ask them. Involve them in decisions surrounding what is served to eat and when.

Allison Neeson, Philadelphia

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