OPINION
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Chronicle
Ernest H. Pitt PubiishtrCo-Founder
ELAINE Pitt Business Manager
Michael A. Pitt Marketing
T. Kevin Walker Managing Editor
File Photo
Car jam the new gas station on Liberty Street.
Real Change
Needed
President-Elect Barak Obama continuously called for
change during the nearly two years of his presidential cam
paign.
It was obvious early on that most people in America were
tired of the same old divisiveness that has been used to keep
people broke, oppressed and mad.
What Obama represented then and now is a view of one
America. No blue states, no red states; no black, no white;
just America. We totally agree and understand where Obama
is coming from. Unfortunately, too many of this city's old
guard simply does not get it. They talk about inclusion, but
they themselves continue to exclude. We have a "haves vs.
have-nots" society here. As a city, we, so far, have only paid
lip service to the concept of inclusion.
When we say inclusion, we mean in all things positive.
This includes building affordable housing in places east of
Highway 52. Decent housing is a catalyst for all economic
development. Although we are very encouraged by the
efforts of the Liberty Street Community Development
Corporation, we know that if something is not done to break
up the ghettos surrounding the new businesses on Liberty
Street, merchants are not going to thrive, and new ones are
not going to choose to relocate there.
We have to stop being the ones that spend all our the
money to make others rich. It is now time for others to spend
money with us - in our neighborhoods and communities.
It seems to us that we need some new, younger leadership
in our community. We need leaders that are capable, pious
and reliable; leaders with integrity who are willing to put
forward a new agenda. This new agenda should be in lock
step with President-elect Obama and Governor-elect Bev
Purdue. We should support this new leadership as they put
forth an agenda that is truly comprehensive and holds firm in
projecting inclusion.
It really is time for change. However, those who have
long held the reins of power are not going to do it. Why?
Because it ain't in their best interest.
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Community Organizers: True Champions
Dr. David
Mount
Guest
Columnist
What is Community
Organizing without
Volunteers? The last 72 hours
approaching the election, and
indeed, the next 100 days after
the election, will represent
some of the most galvanizing
moments our Triad community
has ever known.
With this new excitement
comes significant challenge
and great responsibility for our
local community. There are
folks behind the scene continu
ing to mount a call to duty and
conscientious service that will
transcend traditional ideolo
gies that blend both messages
of 'Country First' and Change
You Can Believe In'. Before
many of us can even fathom
the idea of moving beyond
political party lines and singu
lar thinking, community
organizers had long envisioned
both a changing of the guard
and the promise of change to
come. But, with change comes
the embodied energy of
Americans both young and old?
to identify and remove barriers
that seek to promote the toxic
social 'isms' ranging from
ageism, sexism/genderism,
racism, classism, as well as
bias and/or discrimination
based on disability, religious
affiliations and/or sexual ori
entation. Nested in the height
ed awareness of toxic social
'isms' is our driving passion to
develop, define and model
healthy, yet challenging dia
logues about personal respon
sibility, social responsibility
and policy accountability. It is
simply not an either/or issue
but rather a coming of age
proposition that reasons from a
both/ and position.
While our politicians
grabbed onto the Wall Street
Main Street debate, it was the
community advocates on the
ground keeping attention on
this very critical issue. Amidst
all of this, there was attention
to the community organizing
practices of organizations such
as ACORN. Given the high
media attention to this organi
zation, there is the potential for
-viewing community organiz
ing efforts in less than desir
able terms. Community organ
izing is being turned into a
dirty word. But, we should
take comfort as it was the voic
es and blogging of community
organizers that reminded us
that simple sound bites fail to
capture the real emotional
atmosphere permeating com
munities and neighborhoods. I
take pause in this observation,
as there exists real threat of
further breakdown of commu
nity relationships and weak
ened neighborhood investment
if we de-emphasize the value
of the work of community
organizers.
But why this focus on
community organizers? We
must remember that communi
ty organizers are better known
by the name of volunteers. The
image that comes to mind is
the motivated, tirelessu and
unselfish persons in the church
who arrange the ecumenical
outreach and interfaith dia
logues; the parents spending
countless hours organizing the
PTA; the persons seeking to
increase attention around
chronic diseases; the non
profit grassroots organizations
strengthening neighborhood
leadership capacities; and the
people volunteering their time,
talents, and personal resources
to champion hope for the
hopeless, bridge opportunities
for the misguided, and donate
countless hours in the service
of reversing injustice on behalf
of the wrongfully accused. The
point is that we are surrounded
by volunteers whose service is
likened to a suspension bridge
connecting both familiar and
unfamiliar communities in our
region and throughout the
nation.
In the weeks, months and
years ahead of us, we will need
to start thinking, planning and
organizing to promote sustain
able volunteerism as a vehicle
for community social invest
ment and community engage
ment on a range of topics from
mental health reform, high
school dropouts, affordable
healthcare and health equity
promotion, to job creation,
affordable higher education,
community empowerment,
public policy transparency
and community outreach, just
to ndme a few. This will
require a sizable humanitarian
effort. I o
n short, we are not in a cri
sis of confidence about com
munity organizing, but we are
in a crisis about the transparen
cy of social, educational and
healthcare policies that contin
ue to disadvantage large seg
ments of our community.
Whether you opt to call
them community organizers,
volunteers, helpers, and/or jus
tice advocates, we will be very
dependent on volunteers to
organize with us to face the
psychological, cultural, social,
economic, and spiritual chal
lenges ahead. Based upon my
many conversations with vol
unteers, there would be great
benefit to them if we devel
oped methods to help them
keep track of their hours
donated to volunteerism. We
need this transcendent group to
further cultivate a humanitari
an spirit of community social
investment and community
engagement. But, the question
remains as to whether we are
truly prepared to take volun
teerism seriously.
Dr. David L. Mount, a
community health psycholo
gist, is an assistant professor
of internal medicine at Wake
Forest University School of
Medicine and co-Director of
Community Outreach of the
school 's Maya Angelou Center
for Health Equity. He is also
the board chairman of
Neighbors for Bettef
Neighborhoods and Triad
Cultural Arts Inc.; and a mem
ber of the ECHO Council and
the Health Equity Action Task
Force of the Forsyth
Department of Public Health.
Medicine's one size approach
Dr. Richard
Williams
Guest
Columnist
In medicine - one size
does not fit all; the patient's
health, not the insurance com
pany's financial bottom line, is
primary. The best judge of a
patient's drug needs is the doc
tor.
Those have long been
basic principles in medicine.
No longer.
Today, cost-driven drug
switching is endangering those
basic principles. And it's
endangering our health.
Health insurers are pres
suring doctors to take patients
off a medicine that works well
for them and to switch to a
substitute medicine, often with
different active ingredients,
not out of concern for the
patient's well being, but to
save money.
Cost-based drug switching
is an ethically dubious and
potentially dangerous trend
that is fast becoming a com
mon practice across the nation.
In Massachusetts, news
reports recently revealed that
health insurers are giving doc
tors incentives, sometimes in
cash, to switch patients from a
brand-name cholesterol-low
ering medication to generic
brands. These payments are
legal, but they raise ethical
questions if patients are not
told the reasons behind the
switch.
Last year in Michigan,
Blue Care Network paid 2,400
doctors $2 million to switch
their patients - at a rate of
$100 per patient - from the
name brand cholesterol drug to
a generic simvastatin.
And just a few months ago.
Blue Shield of California
mailed thousands of letters to
member doctors and coupons
to patients urging them to
switch from Lipitor to Zocor.
The reason: to lower costs for
the insurance company.
What's the harm? The
practice is hurting patient safe
ty
Those who insist that drug
switching is safe should pick
up a copy of the British
Journal of Cardiology study
that is sounding the emergency
alarm.
In the study, patients who
switched from Lipitor to a
generic version were more
likely to suffer strokes, heart
attacks, and death, according
to the study. Researchers
reported a 30 percent increase
in risk for major cardiac events
or deaths from all causes
among patients who switched
from Lipitor to the generic
simvastatin.
Medicines intended to treat
the same condition have dif
ferent active ingredients and
work in different ways.
Physicians should always
be the ones to consider the
many factors when they pre
scribe medicine for a patient,
factors that insurance compa
nies do not consider or even
know about when they encour
age switching.
But pressure by health care
providers to switch to less
costly drugs is stubbornly
interfering in the physician
patient relationship. Patient
safety and health is compro
mised when insurance compa
nies meddle with treatment
decisions made between
physicians and patients.
Cost-driven switching
affects not^ just individual
patients but the entire health
care system. The short-term
savings that may result from
switching to a less expensive
substitute drug will inevitably
be offset by higher costs in
consultations with physicians,
increase in prescriptions,
increases in emergency room
visits, as well as longer-term
health consequences.
Considering that more than
34 million Americans suffer
from high cholesterol, and
nearly 65 million suffer from
high blood pressure, pervasive
insurance company-driven
switching will have a major
impact on the health of
Americans.
Many minority medical
practitioners also strongly
believe that the growing sub
stitution of generic drugs rep
resents the rise of a second
class form of medicine, espe
cially for racial and ethnic
groups, the elderly and others.
Minorities are being sub
jected to a form of social
inequality that places them on
the systemic "bottom shelves"
which are stocked with cheap
er, less effective, or question
ably effective medications.
The practice is insidious
because it comes under the
benevolent guise of cost-sav
ings for low-income people.
But, cost-based drug
switching carries even more
risk to the poor, elderly and
minority populations, groups
that are already underserved
These patients should not be
forced into substandard health
care by the system simply
because of their financial situ
ation.
Physicians with stetho
scopes, working Closely with
their patients, are the ones who
should be making treatment?
decisions, and not insurance
companies with calculators
Dr. Richard Allen Williams
is a cardiologist and founder
of the Minority Health
Institute based in Encino,
California. Dr. Williams edited
the hook, "Eliminating
Healthcare Disparities in
America." ,