Link to Owner Dr. Robert B. Pamplin Jr.



This week, readers share their thoughts about caregiving and medical billing.

Thankful for congresswoman's view on elder care

I just read the My View article by Rep. Suzanne Bonamici regarding care for aging parents. The only changes I would make to that article if it was my own are that my mother is 92 years old, and I don't attend any congressional hearings.

I deeply appreciate Rep. Bonamici's true compassion and commitment to push the Dignity in Aging Act. Will our other members of Congress join her?

Henry Kantor, Northwest Portland

Health care bill has promise, but also has serious flaw

The legislation in Congress for surprise medical billing has the potential to improve our health care system, but not if it includes benchmark rates. Although the proposed benchmark rate law might lower current out-of-pocket costs for patients, it will have unintended consequences for local patients and providers.

I approach the surprise medical billing problem as a licensed clinical social worker. My clinic, the Firefly Institute, specializes in trauma-informed care and addressing adverse childhood experiences. Benchmarking would require my clinic to use insurers' rates when a patient receives out-of-network care. This affects our ability to contract with insurers because benchmarking is a take-it-or-leave-it scenario. Even if we turn down the insurers' rates, we cannot earn more than insurers' rates as out-of-network providers.

This unfair negotiating table will force more providers to deliver services out-of-network. Patients will lose the ability to see whichever doctors and specialists they like and trust. For rural patients, the search for an in-network provider will become even harder.

Many patients currently drive an hour or more from rural areas to receive specialized services at my clinic. They would not be able to obtain these services closer to home. I worry about the prospect of fewer in-network providers for these patients who already travel so far.

Health insurance is important. It helps patients manage care. Congress should ensure fair negotiations between insurers and healthcare providers so that patients have fewer surprise bills and sufficient networks for care.

Michelle Pliske

President, National Association of Social Workers Oregon Chapter


We need to talk about kinship care

I have recently noticed that the discussion surrounding kinship care is somewhat lacking.

Most of the research and discussion that surrounds kinship care is about how kinship care affects parental stress and how kinship care is possibly a better alternative to foster care. Both things are important; however, there is so much more to talk about with kinship care. It isn't just the parents, children and caregivers that are affected — the entire family's dynamic is scrambled.

I have two firsthand experiences with kinship care. The most dramatic instance was when I was 12 and my family of four became a family of nine for a few months. The second experience was when I was 14 and we took in my cousin permanently, so my family of four became a family of five.

These events changed the way I grew up. At 12, I became a caregiver because both my parents worked full-time jobs, so in between school and when my parents got home, I watched the younger kids.

I believe that kinship care is a wonderful thing. It improves the child's well-being. Being placed with family increases stability by decreasing placement changes and school changes. It also helps keep children connected to their siblings and extended family. Studies show that kids in kinship care show less behavioral and mental issues compared to kids in foster care. Kinship care should be considered when a child needs to be removed from their parent's care.

But I also believe that caregivers need to be aware of how kinship care can affect the rest of their family. We are all aware of the benefits, but no one really talks about the challenges. I hope that by writing this letter I have opened the discussion surrounding how kinship care can affect family dynamics.

Anyssa Markowich, Forest Grove

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