Odds and ends

This column has no subject, just three things I think are worth saying. The first is pure fantasy, the second is remorseful and the third is serious.

Borders

Borders Book Store is now an empty shell. Before Dunkin Donuts buys the building, tears it down and replaces it with one of their drive through donut stands, imagine this:

The Chestnut Hill Borders becomes a first class performance space for music and comedy. The Hill could have its own music venue, a hipper version of the Keswick Theater — hey it has no parking either, but people figure out how to get to Fab Faux concerts just fine.

Chestnut Hill could really use a music venue if even to accommodate the many talented local acts. Chestnut Hill would definitely provide enthusiastic crowds for classical and jazz concerts. Stand up comedians and an occasional indie rock band would be nice, too.

Now imagine an American Idol audition held there. Imagine 10,000 tone-deaf 20-somethings with delusions of superstardom milling around the Avenue … I think we’ll all be wishing for a Walgreens by then. For a better idea, see CHBA president Greg Welsh’s idea for Borders on page 5

So long, Mr. Hoffmann

After a year and a half, one of the best cleanup hitters in Chestnut Hill Local History, Joel Hoffmann, left the team to do much more complicated work with the Office of the Inspector General of the City of Philadelphia.

During his time here, Joel tackled the toughest tales on the Hill. He covered Caruso’s closing, a resident uprising at Chestnut Hill Village and a fire at a Roxborough apartment building. He honed his investigative skills here — skills he’ll find great use for in his new work.

His leaving us is bittersweet.

The downside is we will greatly miss Joel’s talents — he was the first and only Local staffer to win a distinguished writing award from the Pennsylvania Newspaper Association.

The upside is that corruption in the city will not be safe as long as Joel is taking his swings with the Inspector General.

Good luck, Joel

What more can you say?

Anyone not moved by the devastation in Haiti last week has no heart.

That has not been a problem for several local businessmen who have stepped up in a big way. Miguel Castenada, owner of Cuba restaurant, 8609 Germantown Ave. is giving 20 percent of his restaurant sales to the Red Cross’ Hati relief Fund. Joe Borelli, owner of the Chestnut Hill Gallery, 8117 Germantown Ave., will donate 30 percent of the proceeds from a weeklong art sale, Feb 2 to Feb. 5, to Doctors Without Borders.

It’s truly great to see these locals lend a hand. There’s plenty of time for us to do more, too. It’s going to be a long time and take a lot of dollars to get Haiti on its feet again, if that phrase is even appropriate for one of the poorest country’s in the western hemisphere.

Taking part of these local sales is a great way to give here. Another great resource is the Clinton Bush Haiti Fund at clintonbushhaitifund.org. You can make safe contributions at the site.

Pete Mazzaccaro

Commentary: Faith and the health care dilemma
by Rabbi George M. Stern

How are we to make sense of the health care reform debate currently consuming the Congress and providing fodder for the pundits? We’re beset by versions real and imaginary, commentators who hyperventilate over what they deem “anti-American” plans, rumors and misinformation. There isn’t even agreement on what “reform” means: Is it about providing care to those without it, cutting costs, making the system more equitable, maintaining choice (in its various meanings), reigning in insurance and pharmaceutical companies, maintaining capitalism, instituting socialism, some of the above, all of the above, or none of the above? Indeed, is it about reform at all?

The fundamental disagreement would seem to be over this question: What obligation do we citizens have to one another, as demonstrated by the laws we pass and the tax money we allocate? In the current situation, do we collectively have an obligation to assure that every citizen of the United States has adequate health care? Despite the fact that our founding documents speak of the government’s obligation to see to “the general welfare,” we have been unwilling to place health care in the same category as national defense, the building of airports and roads, and homeland security – i.e., those services for which the public, through taxes, has an obligation to pay. (By the way, education is another large area where we as a collective deny universal responsibility.)  

As a member of a faith community, I try to discern ethical and moral principles from my faith tradition – in my case, liberal Judaism. And because I am the director of an interfaith organization with long-standing concerns for the welfare of all citizens, I seek to assure that basic shared faith values are part and parcel both of the programs Neighborhood Interfaith Movement runs and of the issues I write and speak about in the community.

Neither Moses, Jesus, Muhammad, the Buddha, nor other ancient faith leaders made statements about “universal health care.” Indeed, the concept was no more within the breadth of their worldview than were current advances in medicine and technology. Neither I nor anyone else can honestly claim to know what they would say about the specifics of the ongoing debate. But I do know that all major religious traditions consider saving a life to be a highest ideal. They also agree that we have an obligation to use our God-given talents for the benefit of all of society. There are so many places in ancient Scripture where the concerns for the poor and meek are highlighted that it strains credibility to believe that our faith traditions could possibly approve of the kind of disparity of care currently rampant in our health system – a disparity determined largely by accidents of class or geography or by the ability to organize and overcome formidable financial and corporate interests. 

I feel confident in saying that an ethical health plan of which the United States could be proud would assure quality care to all, including the “least among us.”

It is abundantly clear that, while the very best medical care is available in the United States, it is neither universally accessible nor universally affordable. So while in theory we have the “best system” in the world, in practice there is a significant gap between what could be and what is – and we pay much more for poorer overall care than our friends in other first-world countries. Life expectancy in the United States is several years less than in countries that spend a third of what we spend on health care. So in order to provide ongoing and universal quality care, costs must be contained.

A major debate is looming over how to pay for expanded care. The Senate bill taxes “expensive” health plans; the House taxes those wealthy individuals who benefited most from major tax reductions in the past decade. I am concerned that the Senate plan would cause employers, including the government, to offer less expensive plans that in fact merely pass costs on to workers in the form of higher co-pays. That might lead to fewer visits to doctors rather than better health. I also would fear any bill that pits one class of citizens against another. No one should feel that his or her health care is being jeopardized.

When I was in Washington recently, I happened upon a Tea Party demonstration led by Minnesota Congresswoman Michele Bachmann. I took a moment to speak with one of the demonstrators, who spoke fervently about “choice.” (When I asked whether she supported a woman’s right to choose, she “went off” on me.) In theory, choice is a good thing – when we are asked to choose among alternatives we can understand. My experience helping my mother deal with Medicare D has taught me that, when it comes to health and insurance issues, most of us have no rational basis for making choices – and we easily end up making a choice that is not to our benefit. If our moral goal is adequate and universal health care, then we should measure each plan according to those criteria, not on the right to make choices we don’t fully comprehend.

What about “rationing”? First, it is an issue only for those who have real money to spend on health care. Second, we cannot expect individuals to make rational decisions based on science that they do not understand. Nor can individuals engage in rational cost analysis when faced with personal or familial life-or-death decisions. If there are legitimate savings to be had by reducing the use of specific procedures, then we should institute a rational way to make decisions about when to withhold care. Such “rationing” is far superior to the current system, in which we dole out health care based on one’s wealth or who one knows – while denying that we are “rationing.” Our religious traditions need to come to grips with modern medical advances and health care systems that earlier generations could not have imagined when they expounded on the sanctity of life. Neither “life” nor “holiness” nor “sanctity of life” is a static concept divorced from what we know about human nature or from changing technology. 

Politics is the “art of the possible”; the final bill will not be perfect. But we must not relax our moral antennae:  Every provision in the final bill that fails to expand coverage, assure quality care, and control costs fairly is a provision that compromises ethics. It will be very important over time to maintain vigilance and demand changes to make the health care system more efficient, cost-effective – and fair.

Rabbi George Stern is executive director of Neighborhood Interfaith Movement (NIM), a coalition of 60 Christian, Jewish, Muslim, and Unitarian congregations and faith institutions dedicated to building a more just and sensitive community through learning, service, and advocacy. NIM is located at 7047 Germantown Avenue.

Commentary: Reclaiming Borders
by Greg Welsh,
President CHBA

These difficult economic times require all of us to rethink how we manage our family and business budgets.  The concerns published in this paper the last few weeks bring into focus the need to explore ways to control the destiny of our community; to address the quality of life, not simply a bottom-line return.

By bringing together key local developers and private residents in Chestnut Hill we could purchase these key anchor properties and find the most suitable tenants. One way to realize this goal could be by forming a REIT — Real Estate Investment Trust.

A private/public REIT opens the option to explore available government economic dollars as has been done in other communities. This REIT concept is not new. It was used in the 70’s in Chestnut Hill to develop several retail buildings. The complex where the liquor store is currently located is just one example.

Imagine the Borders building as a community Town Hall and commercial venture. The second floor could house the Local, Chestnut Hill Business Association, Chestnut Hill Community Association, Historical Society, city/state constituent services office (long absent from this community) and a central conference room. The need for additional space for all our organizations has been a constant lament. Centralizing these organizations would allow them to work and communicate more closely, reduce operating costs and allow each group the option to rent or sell their existing properties to retail operations along the Avenue.

The first floor could be available for commercial ventures - indoor/outdoor restaurants, independent bookstore, boutique shops or perhaps one strong business. The concepts are limitless.

More questions are raised than answered by this proposal but it certainly should be explored as soon as possible. This community has the resources to make this a reality. It’s about coming together, talking about our collective vision and making it happen.

Commentary: Tales from the labyrinth
by Clark Groome

If you don’t think the health care system needs fixing, you’re either not paying attention or don’t care how much it all costs.

The health care system is a mess. Let me tell you a story about an incident that should illuminate just how screwed up it all is. There are, to paraphrase TV’s The Naked City, two million stories like this in the health care system.

I have glaucoma; have had since I was 30. It runs in the family. It has been well controlled by great doctors and some really good drugs.

One of those drugs is Timoptic. Its generic is Timolol. It comes in a couple of strengths and in a twice-a-day or once-a-day version.

I’ve been using the once-a-day version for many years. It’s formally known as Timolol Maleate Gel Forming Solution .5 percent. It has always been covered by my medical insurance.

When I became eligible for Medicare two years ago I shopped around for the best Part D plan, making sure that it covered all the drugs I was taking. Found one, signed up and all was as advertised until 10 days ago when I called the mail-order pharmacy in Kansas we’re required to use to get the best price.

I was told my insurer no longer covered Timolol GFS .5 percent. Odd news, that, since the drug is listed in two different places in the health plan’s formulary (which is the fancy name these plans give to the list of drugs they cover). It’s even listed as a “tier 1” drug, which is the one that carries the lowest cost to the patient.

After chatting with the pharmacy, I called the insurer. “Sure,” they said, “that drug’s covered. It’s just a glitch in the system. We’ll fix it, and if you’ll call back in two or three days to check, all should be OK. You won’t run into that problem again.”

I did call back and was told that indeed all was fixed. Two days later I got a call from the mail-order pharmacy saying that I hadn’t authorized charging Timolol’s full price to my credit card. Wow, I thought, maybe I won’t have to fill in a reimbursement form. I told them what the insurer had said: that we were good to go as had always been the case in years past. Since they hadn’t charged me they ran it again. Still came up as not covered.

Back to the insurance company. It now said that in fact the drug was covered but the particular manufacturer, Falcon Pharmaceuticals, was not. Falcon produces the only Timolol my mail-order pharmacy carries.

What to do? After more than two hours of conversations with the insurer and the pharmacy the insurer said that I should try my local pharmacy and see if they carried a different manufacturer’s Timolol, since that would be covered – although the co-pay would be higher since it wasn’t their prescribed mail-order house.

The next day I did just that. Went to my local pharmacy, talked about the Flyers recent successes and then popped the question: “Can I get this Timolol GFS .5 percent here from someone other than Falcon?”

“No,” the druggist told me, after checking his suppliers, “Falcon is the only company that makes generic Timoptic.”

He then ran it through his system and the drug still came up as not covered.

What can I do? How about we try the non-gel forming, twice-a-day version? Yup, he said, that goes through fine.

Guess who makes that drug? Falcon, of course.

Here’s my theory: The insurer has made a mistake programming its system. Either that or it’s not getting enough of a deal from Falcon. But what would that matter since other Falcon products are covered?

If any of this makes sense, I’ve missed it. So has the good local pharmacist and the distant but trying-to-be-helpful-though-at-the-insurance-company’s-mercy mail order place.

Timoptic is a valuable, proven, widely prescribed and necessary drug. Yet a major insurance company refuses to either (A) cover it or (B) admit its mistake. Meanwhile every patient on the once-a-day Timolol is being screwed while the insurance company makes a ton of money.

I have no idea if the current health care measures being debated in Congress are the answer. If nothing else, they are a start. Something needs to be done now to protect us from those health care providers who claim they have the patients’ best interests at heart but clearly don’t give a damn.