MEDICATIONS

Why advocacy groups care about rule changes

On the April 25 Opinion Exchange page, Paul John Scott delivered another commentary against access to medications and against "illness awareness groups." It's important to note that more than 9 million people are on Medicare not because of their age but due to serious health conditions such as a mental illness, HIV/AIDS or multiple sclerosis. For these and other conditions, medication is one part of effective treatment.

In arguing for limiting the number of medications, Mr. Scott states that there is no evidence that one medication, particularly with antidepressants or antipsychotics, works better than another. But what he fails to point out is that because it takes more than two years for adults with disabilities to get on Medicare, these individuals are not newly diagnosed and have already been through a trial-and-error process to find the medication that works best for them. You cannot confuse efficacy as a class with efficacy for an individual. One single antidepressant, for example, will not work for everyone with depression. People respond differently to medications and experience different side effects.

Part D Medicare plans already have cost-saving strategies at their fingertips. They can use step therapy and prior authorization for someone starting on a protected-class drug. Generic medications are also available and are used. Forcing people to change their medication could lead to destabilization and higher health care and human costs.

Anyone who has ever bothered to learn more about the various organizations that advocate for people with serious illnesses knows that our advocacy goes well beyond medications. Research, evidence-based practices, community supports, affordable housing, supportive housing, in-home supports, employment and freedom from discrimination are just a few of the items for which we advocate.

Sue Abderholden, BILL TIEDEMANN and SARAH DANEN

The writers, respectively, represent NAMI Minnesota, the Minnesota AIDS Project and the National Multiple Sclerosis Society, Upper Midwest Chapter.

TRANSPORTATION BILL

Look further: More are onboard for transit

Make no mistake about it: The Minnesota business community supports investments in transportation, ("All are not aboard for Minnesota's transportation bill," Lori Sturdevant column, April 27). Businesses both large and small depend on transportation to get goods and services to market, employees to work and customers to their doors. Our state's founders understood the importance of transportation as well, making it one of only two funding mandates in our Constitution.

Unfortunately, Sturdevant cited just one business organization, the Minnesota Chamber of Commerce. This chamber does not want to increase investments in transportation; it argues that "there's money flowing." From our perspective, Minnesota's current transportation funding limits our economic potential. For the last 10 years, the state has put the brakes on transportation funding, creating a backlog of unmet needs. Investing in transportation will make our state more economically competitive by attracting and retaining employers and talent, and increasing access to jobs and goods.

Many owners of small and independent businesses — along with local chambers and related business organizations, which are close to the communities and the constituents they serve — support transportation. We spoke at Transit Day at the State Capitol, made transportation a legislative priority, have contacted our legislators and published articles, and are at the ready to be called upon for consultation.

Audrey Britton and Chris Hanson

The writers, respectively, represent Small Business Minnesota and Metro IBA.

THE BIG BANG

Reclaiming mystery from the idea of a god

I applaud David Pence for his assurance that materialists have no greater claim to the Big Bang than do Christians, but I wish he had broadened his argument to show the compatibility of science with all religions and with nonreligious belief in spiritual reality. I wish he had not referred to the Source of All That Is as a "he" and a "father." Materialists can be forgiven for scoffing at religious belief that turns the Transcendent Mystery into a god.

I am a Catholic atheist — Catholic because it happens to be the way I was trained to relate to spiritual reality and atheist because I do not believe in a god. I reject the "father" form of theism.

Pence's argument is weakened by limiting spiritual reality to the Christian story. God is not a god, and God is not three guys in the sky.

Jeanette Blonigen Clancy, Avon, Minn.

• • •

I'm grateful for and agree with Pence's reflection. However, his reference to the "pomposity of Carl Sagan" is unfortunate. I had the privilege of serving on a select committee of scientists, theologians and legislators in the early 1990s who looked at ways to address many of our environmental challenges. I found Sagan to be humble, approachable and completely open to the views of others, including Christian believers. When pressed on the question of faith, he stated that he had profound respect for believers, but needed more evidence before he himself could believe.

One incident is particularly instructive. Knowing that I am a master gardener, Sagan admitted to me one day that though he knew much about the universe, he could not distinguish a weed from a flower. Hardly the admission of a pompous scientist.

Herbert W. Chilstrom
St. Peter, Minn.
SIXTH DISTRICT VOTING

Letter writer was wrong to cite Stillwater

I was incensed when I read the Letter of the Day on April 27 unfairly attacking my city of Stillwater ("They vote Republican in the land of no diversity"). But I decided to check my facts before I replied. I have just spent the morning researching the history of each Stillwater precinct election return in the 2006 through 2012 races in the Sixth Congressional District. Rep. Michele Bachmann has never carried Stillwater — we knew better. And, by the way, most of Stillwater is now in the Fourth District.

Becci Dawson Cox, Stillwater