The Capitol Connection - Aug 8, 2005
I was recently in Guatemala and needed a prescription refilled but didn't have the necessary paperwork. No problem - in Guatemala, like in much of the rest of the world, you can go directly to a pharmacy to get a new prescription. This works to the advantage of many people, including poor people who could never afford to go through the requisite medical doctor to get medicine. In fact, there are some people who might describe the need to have a doctor's prescription in this country as "The Full Employment For Physicians Act." Medical doctors in the U.S. have such a stranglehold on our state legislature and our congress that it will be a cold day in hell before we see any changes here.

I can see all the docs sitting at their typewriters right now, not bothering to finish reading this column before they write. They will say, "Chartock is an idiot. If the wrong prescriptions falls into the wrong hands, people will die." They will say that people must be examined by trained physicians. They will talk about the potential for addicts getting their hands on dangerous medications. You know, somehow folks in the rest of the world get by but not in the state of New York or most of the other United States.

Then, too, there is the matter of where you draw the line. Some very dangerous drugs are being sold over the counter these days. There have been numerous medical studies about aspirin and ibuprofen and sleeping pills. For most people, they are fine and beneficial but for some, they are quite dangerous. Nevertheless, we can and do buy them without asking anyone.

Many nurse practitioners and physician assistants have had the power to prescribe for years. In the case of the new morning after (intercourse) pill that has been stupidly vetoed by outgoing Governor George Pataki, the pharmacist would be the one to consult about a so-called "open prescription." Some will be surprised to know that pharmacists now must attend school for a mandatory sixth year. I have had discussions about various medications with one pharmacist or another over the years and trust me, they often know more about the drugs in question than some of the doctors. If I had my way, I would take my chances on pharmacists although allowing them to prescribe might mean that their insurance rates would increase.

Of course, there are others who should have the right to prescribe medicine. Some psychologists (not MD's) have long argued that they should be allowed to prescribe the new classes of psychiatric medications. Right now, it takes a visit to a cooperating MD's office to get the necessary hands laid on for a prescription.

Someone who gets bitten by a Lyme tick and needs antibiotics should be allowed to go into a pharmacy and get what he or she needs rather than go through an emergency room. Look at it this way - you go into an emergency room, tell them your symptoms and at great cost (billions of taxpayer dollars) they give you the requisite drug. At a time when everyone is talking about the costs of health care to employers and the tax payer, going directly to the pharmacy could mean a major saving for us all.

To know what a tall order this is, you've got to understand what our state legislatures are all about. Talk about "fee for service." You had better believe that if you don't have a major stable of lobbyists working on the legislators, paying them off with campaign donations and other incentives, your chances at seeing any changes in the status quo are significantly diminished. Forget about what's good for all of us. Everyone talks a good game but it usually comes down to the bottom line. Everyone has a doctor and that includes legislators. I remember once getting on a treadmill for a stress test and being given quite a lecture about "...how your friend Mario Cuomo is ruining this state." When your doctor talks, you tend to listen.

The chances that we are going to catch up with the rest of the world aren't that good. But my idea is sensible. When employers can no longer afford health insurance for their workers and when it makes sense to think about what's best for everyone, things will finally change, even in the state of New York.
- posted by Raymond @ 8/08/2005 11:49:00 AM

 
I Publius: Who needs tourists? We do
First published in the Berkshire Eagle, 8/6/05

Anyone who doesn't understand just why our visitors to this region are our most precious resources just isn't thinking.
The Berkshires are beautiful, and we have been able to keep them that way. There aren't smokestack-belching factories. There aren't prisons of the type that have been proposed from time to time. There is cultural activity unlike any other place in the world, and we owe it all to the folks of all faiths and religions and regions who come here and support what we have to offer.

We have been left alone by those who make decisions about what goes where because they know we have to remain relatively unspoiled.

In 1970, Roselle and I moved to the Berkshires full time. We had been visitors and then weekenders, and then we did what so many other folks have done. We bought a little house in Alford, had our kids and made
a life. Almost 20 years ago, we moved to Great Barrington. Sure, there were times when houses went up around us where cows once grazed but, hey, that's the way of the world. Not once did we ever yell, "Pull up the ladder, we're the last ones in." In fact, I have made it a personal crusade to try to help out the folks who need to know where they can go to eat or how to get somewhere.

In this, I do not think I am alone. I think most of us understand how important our visitors and second-home owners are to us.



The point is, like the man wrote in the song "Love and Marriage": "You can't have one without the other." We can't have the beautiful Berkshires without our tourists and second-home owners. There are those, of course, who would slander and defile visitors and second-home owners. Like the swallows returning to Capistrano, it happens every year that someone writes to this newspaper, or writes in this newspaper, making fun of tourists and their New York accents. Since all prejudice -- we versus them -- emanates from differences in everything from religion to skin color, this becomes dangerous stuff.

There will always be prejudices, and there will always be those who will exploit the human inner weakness that would scapegoat one group or another. Most of us -- Irish, Jewish, Catholic, Latinos, blacks -- have suffered incidents of prejudice that have infuriated us and damaged our psyches.

It is fascinating how so many people who have suffered as a result of prejudice are all too willing to turn around and do the same insidious thing that was done to them.

Ask Jim Ruberto, the mayor of Pittsfield, whether he isn't trying to encourage more tourism in his city and you'll get a big fat "yes." All over the country, there are development people being paid big bucks to set up festivals and to try to emulate what we have right here in the Berkshires. There's a wonderful woman, Megan Whilden, who is doing a sensational job as cultural czar in Pittsfield. She has diplomacy, tact and, above all, a sense of humor, and before our very eyes the arts scene in Pittsfield is turning around.



Of course, there are some who take advantage of our tourists. I have been on a tear for years to warn incoming folks of the speed trap in Egremont. Their insane 20 mph speed limit has ensnared many people with New York and New Jersey license plates.

Imagine, if you can, what a first-time visitor to the Berkshires will go away with if his or her first experience is to get nailed in an unreasonable speed trap in one of the few entranceways to the Berkshires. In this case, we have the classic need of a town to fill its coffers with a greater responsibility to the whole effort to bring new guests into our area.

Some people reading this will be shaking their heads in disgust. They will say unreasonable things about some of our guests who push ahead of the lines in the ice cream shop or who speak on their cell phones and ruin it for all of us trying to eat dinner at one of our great restaurants or who talk about their hedge funds or their jobs. But, as one good letter writer to this newspaper pointed out, there are foolish people who live here year-round and those who are visitors. What we can't do is to stereotype a whole group.

When I grew up, my family spent the summers on Fire Island, where the government used to prominently post rules ranging from "No bicycles" to "No eating on the walks." As a result, the community of Ocean Beach was known as "The Land of No." We don't want to do that here.

Alan Chartock, a Great Barrington resident, is president and CEO of WAMC Northeast Public Radio and a professor emeritus of communications at SUNY-Albany.
- posted by Raymond @ 8/08/2005 11:10:00 AM