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OPINION
Sttnes
gainesvilletimes.com
Tuesday, November 20, 2018
Shannon Casas Editor in Chief | 770-718-3417 | scasas@gainesvilletimes.com
Submit a letter: letters@gainesvilletimes.com
The First Amendment: Congress shall make no law respecting an establishment of religion, or
prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right
of the people peaceably to assemble, and to petition the Government for a redress of grievances.
LETTERS
It’s time to
Do more to prevent wildfires
create step
therapy reform
in Georgia
Imagine a patient with Type 2 diabetes goes
to her local pharmacy to pick up her prescrip
tion for medication to manage her blood sugar
levels.
When she goes to the prescription counter,
her pharmacist explains that her insurance
company will not cover the medication without
her first “failing” on other medications — in
some cases medications she’s already tried.
This process is what’s known as step therapy.
It’s a scenario I hear all too often from patients
in my role as a diabetes educator — and it
affects far more than just Georgians living with
diabetes.
Step therapy is utilized by health insurance
plans in an attempt to contain costs. It requires
patients to “try and fail” medications the
insurer dictates before receiving the treatment
determined by their physician to be the most
appropriate and effective.
Unfortunately, very little oversight of step
therapy exists. There is also a lack of evidence
showing these “fail first” policies are effective
or take into consideration adverse effects of
insurance company’s preferred medications.
Some of the common chronic disease states
that are targeted for step therapy are diabetes,
cancer, hypertension, HIV/AIDs, rheumatoid
arthritis and hepatitis C.
Patients put through step therapy commonly
face lengthy appeal processes, which lack
appropriate health care professional oversight,
as well as inconsistent and outdated guidelines
for medication recommendations.
Already, 18 states have passed legislation that
is designed to reign in step therapy. I hope Geor
gia will soon become one as well.
During the 2018 legislative session earlier this
year, Rep. Sharon Cooper, long-term serving
chairwoman of the Health and Human Services
Committee, and Sen. Kay Kirkpatrick intro
duced bills to reform step therapy in Georgia.
These bills would have limited step therapy
and fail first protocols and were championed by
patient groups from across the state, many of
whom had personal stories of how step therapy
had affected their members.
The diligent work of Chairwoman Cooper
paid off when her bill passed the House unani
mously. Unfortunately, despite support from
a number of lawmakers in the Senate, the bill
ultimately did not advance.
Regardless, the work done by Chairwoman
Cooper and Sen. Kirkpatrick deserves applause,
and it is my hope that during the upcoming ses
sion, both the Georgia House and Senate will
take action to cut through the red tape of step
therapy on behalf of Georgia patients.
Mandy Reece
Gainesville
Unrealistic, closed-minded
thinking isn’t going to help
A recent letter writer on Nov. 17 decried the
fact that 10 major issues divide the nation.
He asks for wisdom, but fails to see that his
own narrow views preclude meaningful discus
sion and resolution of his issues.
For one, the injection of rigid, personal reli
gious views into any issue is not conducive to
understanding. In this case, reproductive free
dom and nontraditional marriage are consid
ered to be violations of religious tenets — no
discussion allowed.
Second, there seems to be an assumption that
a large federal government, business regula
tion, globalization and taxes violate fundamental
American values.
The fact is that the tiny U.S. nation of 1787
bears no resemblance to the vastness, inter
connectedness and complexity of the modern
world. Any government must have the funding,
resources and capabilities to deal with the reali
ties that it faces.
The writer seems to be unaware that the weak
U.S. governments of the 1800s did virtually noth
ing to prevent numerous devastating business
depressions.
It took us well over 100 years to realize that
we needed a government with sufficient power
to constrain the excesses of pure capitalism, as
well as deal with other complicated matters.
A closely related topic is that of health care.
Despite its immense failures, we are supposed
to accept that free-market health care is the best
solution. But the fact is that Medicare is by far
the most efficient health care system in the U.S.
There is no skimming off the top of admin costs
and profits.
Yes, taxes pay for Medicare but are far less
than premiums paid for traditional health
insurance.
The writer casts our differences as those
between liberal and conservative.
In actuality, solutions to problems primarily
revolve around realistic assessment and practi
calities. Unexamined truisms really have noth
ing to offer and often put us on the wrong path.
Open-mindedness and wisdom will work far
better.
Jim Grattan
Gainesville
To submit letters: Send submissions by email to
letters@gainesvilletimes.com or from the form at
www.gainesvilletimes.com. Please include your
full name, hometown and phone number.
By McClatchy California Opinion Editors
The Camp Fire has claimed more than
60 victims, and rescue workers continue
to search for hundreds who are still
missing.
The Tubbs Fire, around Santa Rosa,
killed 22 in 2017. Mudslides following the
Thomas Fire in Southern California killed
20 people last year. Just months ago,
seven people perished in the Carr Fire in
Redding.
There are nearly 9,000 firefighters bat
tling blazes this week in Malibu and Butte
County.
Californians are anxious. And with our
attention fixed on Paradise, we wonder:
who will be next?
Scientists predict extreme fire danger
across much of the West will become the
new normal by the middle of the 21st cen
tury, per a recent report by the U.S Forest
Service. Jerry Brown, California’s outgo
ing governor, says we’re already living in
the new abnormal.
Our hearts go out to those who have
lost family, friends, pets and homes. One
of the most-read stories on SacBee.com
this week is about how to help, and there’s
no question your support is needed and
appreciated.
But when it comes to tangible steps that
will reduce tragedies, we face a long road.
State and federal agencies, environ
mentalists, businesses and homeown
ers must take seats at the same table.
We need a clear understanding of risks
and tradeoffs and we need strategies
to reduce the likelihood of another
catastrophe.
There is room for optimism.
“Sometimes out of catastrophe comes
greater unity,” Interior Secretary
Ryan Zinke told The Bee’s Dale Kasler
Wednesday in Butte County. Brown said
Wednesday we should “learn how to do
this together.”
There are plenty of places to dig in:
■ Are we doing enough to build fire
resistance into our communities? Should
building (or rebuilding) be allowed in
fire-prone communities? Why spend mil
lions on a mansion in the hills if we risk
loss of life to defend it? Can homeown
ers or homeowners’ associations accept
responsibility for the risk that comes with
a view of beautiful, old-growth trees out
the kitchen window?
As homeowners, we must take personal
responsibility for maintaining our land.
■ For those who already live in high-
risk areas, let’s be proactive about cutting
power lines that spark fires. What are the
safest steps in areas where it’s difficult,
or even impossible, to bury lines? Are we
prepared to live off generators during
red-flag conditions?
■ Evacuation routes are inadequate.
What can we put in place as we move
forward — sirens, improved reverse 911
calls or other solutions?
■ We must improve forest manage
ment. We’ve been talking about this for
decades. The biggest threat to our forests
is not tree loss from harvesting. It is cata
strophic events such as wildfires. Forests
will continue to burn and they will burn
into our cities if we do not work together
to reduce fuel. Sawmills can be retrofit
ted to accommodate smaller-diameter
trees, those that are now serving as kin
dling for major fires. How can we respon
sibly remove those trees and cut down on
chaparral and brush?
■ We can also look at roadways,
which are major flashpoints for human-
caused fires. State lawmakers are
working on a proposal to thin vegetation
growing near along forest roads, a logical
solution to make fire-prone areas more
defensible.
■ One of Gavin Newsom’s first priori
ties as governor must be to convene an
inclusive and thoroughly serious summit
on this issue. He must provide it with
direction and deadlines.
■ Breathing the smoke from these
fires is dangerous. Period. The chemicals
and particulates it contains worsen virtu
ally every respiratory condition; often
severely. Realize we all are in danger
from these fires.
Private landowners, environmen
talists, the federal government and
California’s incoming governor and
lawmakers all have a role. All of us have
a responsibility to demand change and
to acknowledge that it comes only if we
work together.
If we do not, California will continue
to burn. Our friends and family will con
tinue to be at risk for homelessness and,
as we have seen this week, far worse.
This editorial was crafted by opinion
editors in McClatchy’s five California
newsrooms: The Sacramento Bee, The
Fresno Bee, The Modesto Bee, The Merced
Sun-Star and The Tribune in San Luis
Obispo.
OK...
concede
ABRAMS TIME
JIM POWELL I For The Times
TV media puts Trump on a pedestal
BY ROB COHEN
The Baltimore Sun
Much is being made of the president’s
targeting of CNN’s Jim Acosta, but TV
news bears as much blame as anyone
for our democracy’s dystopian decline,
culminating in the presidency of an igno
ramus with a personality disorder.
With Congress supine and the courts
packed by Sen. Mitch McConnell, read
ily consumable news stands as the last
guardrail of American democracy. Yet
rather than fulfilling that vital role, TV
news unwittingly amplified Donald
Trump’s propaganda during the 2016
presidential election and now perpetu
ates it with such blind reliability that it
must surprise even him.
They must immediately stop doing
three things: repeating his demagoguery
verbatim, playing the outrage game and
focusing on him to the exclusion of other
important stories. Instead, they must
embrace their solemn duty and educate
the population about our great chal
lenges — ratings be damned.
A famous journalist once said “The
vitality of democracy itself depends
today upon the popular knowledge of
complex questions.” How far we are
from that ideal — and President Trump
needs it that way.
His strategy to distract and divide the
country is so obvious at this point that we
have no excuse not to counter it. He has
stated repeatedly that “all press is good
press.” He intentionally does something
outrageous, such as insulting a sexual
assault survivor or prisoner of war, and
TV news always reacts predictably.
In their shameless quest for ratings,
anchors read his tweets verbatim or
show clips of his vile behavior. They then
spend hours fomenting outrage instead
of covering myriad other worthy stories.
They project him into our subconscious
from TVs in airports, gyms and office
buildings. Reluctant Trump supporters
feel the backlash from the media, whom
they already distrusted, which drives
them closer to him.
President Trump swore an oath to
defend the Constitution “against all ene
mies foreign and domestic,” yet he vio
lates that oath nearly every day. Sadly,
due to either myopia or greed, TV news
has abetted his effort to remake America
in his image, making them currently no
less destructive than he.
If they intend by their behavior to
protect American democracy, it isn’t
working. Domestic terrorism is on the
rise. Meanwhile, Brett Kavanaugh got
confirmed to the Supreme Court in part
because major news outlets ran with
some salacious but dubious allegations
of sexual assault. By stooping to his
level, CNN gave Sen. Lindsey Graham
an excuse to draw moral equivalency
and remind Trump supporters why they
hated the media. Democrats lost major
ground in Senate races.
We are re-learning old wisdom:
“Never wrestle with a pig; you’ll both get
dirty, and the pig likes it.”
In short, American democracy’s Achil
les’ heels are ignorance and demagogu
ery, and the amoral Donald Trump will
exploit them as long as we allow him
to. If we keep behaving in the way that
fueled his rise, we should not expect a
different result. That isn’t fair, but fair
ness isn’t on the menu. We should not
expect fairness in an existential fight
against an amoral man.
TV news must therefore stop reward
ing President Trump’s behavior, even
if it means their ratings decrease in the
short-term.
When I was deployed to Kuwait and
Iraq in 2015,1 watched disgustedly as
CNN focused for months on Rachel
Dolezal, Caitlyn Jenner and Malaysia
Flight 370, instead of the war we were
fighting or the climate change destroying
our future. CNN followed this debase
ment with a year of wall-to-wall cover
age of Donald Trump, becoming his
useful idiot.
It is not a coincidence that the stupe
faction of CNN immediately presaged
President Trump’s rise. TV news has dug
a hole, and it’s time to stop digging.
Dr. Rob Cohen is a physician, Army
veteran and host of The Democrises
Podcast.
She Stines
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