Opinion editor's note: Star Tribune Opinion publishes letters from readers online and in print each day. To contribute, click here.
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The closing of CVS pharmacies and the fact that Minnesota has lost more independent pharmacies than any other state will worsen the phenomenon known as "pharmacy deserts." The article ("Target to lose many CVS pharmacies," Jan. 13) correctly notes that "low-income neighborhoods tend to feel the brunt of the cuts."
Access to prescription drugs helps Minnesotans manage their chronic diseases. And specific populations here suffer disproportionately from chronic diseases. For example, hypertension and diabetes are more prevalent in low-income groups, rural areas and communities of color. These disparities lead to preventable and costly care, such as an avoidable trip to an emergency room or hospitalization.
Minnesota's 17 community health centers are located in the state's low-income rural and urban areas. While all community health centers provide primary medical, dental and behavioral health services, only a handful provide on-site pharmacy services. Most Minnesota community health center patients access prescription drugs at the chain and independent pharmacies that are disappearing throughout our state.
Medication adherence is problematic for low-income patients. According to a national study, patients who access community health centers with on-site pharmacies have better outcomes for their chronic diseases or behavioral health needs. With the increasing closure of pharmacies in Minnesota, we anticipate that our patients will experience lower medication adherence rates and continued worsening of health disparities.
State Medicaid laws and regulations prevent most community health centers from establishing on-site pharmacies. An on-site community health center pharmacy has proven to be an effective strategy to address health outcomes as patients can access their prescriptions at the same place they see their primary care provider.
As the 2024 Minnesota Legislature convenes next month, we encourage policymakers and the Department of Human Services to adopt changes to state policy so that community health centers can house pharmacies on-site. A policy change would mitigate the increasing "pharmacy deserts" in our state and ensure that our communities do not feel the brunt of the cuts to pharmacy services.
Jonathan Watson, Minneapolis
The writer is CEO of the Minnesota Association of Community Health Centers.
CIVIL WAR
The centrality of slavery
In his recent column, "Dogmas of the stormy present confuse Civil War debate" (Opinion Exchange, Jan. 10), D.J. Tice asserts that "what everyone knew at the time was that secession, not slavery, was what turned a bitter political and moral conflict into a bloodbath."
President Abraham Lincoln, whom Tice quotes more than once in support of his assertion, would beg to differ.
Early in his magnificent Second Inaugural, which Tice conveniently ignores though he quotes from the first, Lincoln succinctly and pointedly recapped what everyone understood in April 1861: "All knew that this interest [i.e., Southern slavery] was somehow the cause of the war. To strengthen, perpetuate and extend this interest was the object for which the insurgents would rend the Union even by war while the government claimed no right to do more than to restrict the territorial enlargement of it."
Ironically, moreover, Tice, who believes he is injecting a corrective complexity into what he judges an unsophisticated debate about the Civil War, takes Lincoln's famous public letter to Horace Greeley (from which he quotes) at face value. He apparently is unaware of the analysis by James M. McPherson and other Civil War historians showing that the letter, coming one month before Lincoln's preliminary Emancipation Proclamation of Sept. 22, 1862 (the specific context matters), was a shrewd move by the president to prepare Northern public opinion for the emancipation officially proclaimed on Jan. 1, 1863.
At bottom, Tice's commentary, like Nikki Haley's recent answer about the cause of the war (an answer Tice himself characterizes as blundering), is yet another among countless examples of how difficult it still is for at least some Americans, nearly 160 years after the war's end, to acknowledge without qualification or obfuscation what Lincoln articulated so clearly and unequivocally — the inescapable and bloody centrality of slavery to the revolutionary conflict that resulted in "a new birth of freedom."
Greg Kaster, Minneapolis
The writer is a professor of history at Gustavus Adolphus College.
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With all the talk about the causes of the Civil War, I am surprised that no one has mentioned John C. Frémont's Emancipation Proclamation. Fremont was an explorer in the West who was the first Republican candidate for president in 1856. He strongly opposed slavery. When the Civil War broke out in 1861, Lincoln made Fremont general of the Western Department, which was headquartered in St. Louis.
Fremont, acting on his own, wrote an Emancipation Proclamation ending slavery in Missouri. Lincoln read about this in the newspaper. Lincoln said that Fremont exceeded his authority. Other border states might secede. Lincoln ordered Fremont to rescind the order, declared Fremont incompetent and removed him from command. Sixteen months later, Lincoln had his own Emancipation Proclamation. But Fremont's reputation never recovered and he died in poverty. Those who think Lincoln always took the strongest stand possible against slavery should remember the Fremont story.
David Wiljamaa, Minneapolis
PRISON PROGRAMS
A right to preach to prisoners?
I was dumbfounded by the article "DOC sued over Christian prison program ban" (Jan. 12). Anthony Schmitt claims that the DOC has "caused harm to [his] dignity by violating his constitutional rights and thus treating him as a lesser member of society than others with different viewpoints." But then Schmitt wants the government to provide access to a government-run prison and literally a captive audience for the right to impose his patriarchal religious belief that women and non-heterosexuals are lesser human beings then Schmitt. I would guess Schmitt would find an atheist like me a lesser human, as I find his version of Christianity unethical since it sets forth a doctrine of one group is better than another. Last time I checked, our Constitution treats all citizens as equal under the law.
I support Schmitt's right to believe whatever gobbledygook he wants, but it is just plain wrong to use the government to indoctrinate others to that belief. He can preach that in his home, at his church and in the public square but not in a taxpayer-supported government facility.
Steve Petersen, Shoreview
AIRPORT
Thanks to all who cleaned me up
A follow-up thanks to the support people at the Minneapolis-St. Paul International Airport in Terminal 1. Last week I committed a major traveler's faux pas by attempting to negotiate, as an older (OK, old) person, an airport escalator with multiple suitcases. I went down and rode up upside and backward. Medical and security people were quickly on the scene, abetted by shuttle service employees and passersby. We all had a nice, humorous visit together while I was bandaged up for the trip home. I'm doing fine now, though my shins look like cribbage boards. I truly appreciate all the care received from these professional people.
Tom Obert, Alexandria, Minn.
