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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Kudos to state Attorney General Keith Ellison and the other attorneys general for scrutinizing the unfair and dangerous business practices of pharmacy benefit managers, or PBMs ("AGs want high court to review PBM case," June 12). In the article, the Pharmaceutical Care Management Association (PCMA) spokesperson proclaimed, "Requiring plan sponsors to include unsafe or inefficient pharmacies in their provider networks, and forbidding health plans from using common cost-containment tools like preferred networks, will increase prescription drug costs for plans and patients." The association does not regulate or decide which pharmacies are safe or unsafe. Pharmacies are regulated by state Boards of Pharmacy, which will shut them down if they are deemed "unsafe."

Regarding the PBMs having to include "inefficient" pharmacies in their networks: Of the 521 independent community pharmacies that existed in Minnesota in 2002, nearly 80% of these dedicated entrepreneurs providing health care services to their communities were apparently "inefficient" — only around 120 are left. It is difficult to be efficient when the drug manufacturer/wholesaler is controlling what you pay and the PBMs are controlling what you get paid.

The net effect is that community pharmacies are losing money on approximately 50% of the prescriptions they dispense. The net winners of this game are the PBMs, which are extracting money from the manufacturers, the wholesalers, the insurance companies, government contracts and community and health system pharmacies. The net losers: You and me who are paying more (through premiums and copays) for less accessibility to prescription, immunization and pharmacy care services.

Jason Varin, Eden Prairie

The writer is a pharmacist.


MIFEPRISTONE

If you're so worried, then ...

Today I listened to Republicans defend the ending of mifepristone use for abortions ("Justices uphold broad access to abortion pill," front page, June 14). They spoke of some of the rare but significant and dangerous health consequences of its use. This argument begs a response. If Republicans are so worried about the health of pregnant women and their babies, why aren't they working even harder to assure that all mothers and babies have adequate health care? Or even any health care? Such a policy would do far more to prevent deaths of both babies and mothers.

Joan Felice, Roseville


WATER USE

Draining away a priceless resource

"Elko New Market OK to pump more water" (June 14): We are going to send our Minnesota water out of state and subsidize the project by $3 million? Where is the head of the Department of Natural Resources to allow such a thing? Does she not recognize water is the 21st-century gold? And everyone will be coming for it. We have already seen that, as there was a proposal a few years ago to ship Minnesota water to the Southwest. Climate change is the supreme risk of the near future, and water is the point of the coming conflict.

Duane Dana White, Edina


MINNEAPOLIS POLICE

Not all mistakes are misconduct

It seems like the feeding frenzy on what's left of the Minneapolis Police Department will never end. "Police hid misconduct with secretive process," proclaimed the Star Tribune on May 30.

Two examples of this misconduct in the story are the accidental firing of a weapon in precinct station and an unleashed K-9 dog attacking a civilian. I have a feeling that this is not the first firearm accidentally discharged in a police station. I have a feeling this is not the first time a police dog has attacked someone. These examples are not misconduct, they are avoidable mistakes. They are exactly where mentoring the officer is the correct response.

My uncle was a Minneapolis cop, and he was not a perfect person. But he was a good cop. My point being that despite good training, these people will make mistakes because they are human. Teachers, plumbers, mayors, parents, reporters and nuclear physicists all make mistakes. They can learn and get better at what they do.

When these mistakes happen, mentoring is the best way to deal with it. If a police officer's actions are truly misconduct, they should be treated as such with the proper response and paperwork. Bring on the pejorative headlines.

You know, there are good and honest people trying to rebuild the Minneapolis Police Department these days. It's not easy. The department used to have around 850 officers, but only around 500 are left to make the city safe and to help people. This surviving cohort is truly on a mission to resurrect the department from the abyss of the George Floyd killing. They need support, not scary headlines and shallow reporting.

Al Zdon, Mounds View


GOVERNMENT

Notable failures to highlight

There are two recent examples of leadership failures in the DFL Party: State Sen. Nicole Mitchell and her arrest in the early morning in Detroit Lakes, and Education Commissioner Willie Jett, whose department oversaw one of the nation's largest COVID fraud cases. (Jett took over the agency in 2023.)

I managed the commissioning of both USS Minnesota (SSN 783) in 2013 and USS Minneapolis-Saint Paul (LCS 21) in 2022 in Duluth. Between the two ships I have known the eight commanding officers. If any one of them had failed as poorly as Jett or Mitchell, they would have been immediately relieved of their commands.

When you choose to be in a leadership role, you are responsible for the actions of your team. In the case of Jett, he willingly accepted the position and the responsibility that comes with it. [Opinion editor's note: The fraud case relates to reimbursements made by the federal government and overseen by the state Education Department before and during the pandemic. Jett took over the department in 2023 and defended it during a hearing at the State Capitol last week.] The Walz administration needs to request his resignation and remove him if he will not do so.

Mitchell is also a lieutenant colonel in the Wisconsin Air National Guard in a leadership role. I'm mystified why she hasn't been relieved. In the case of the military and Mitchell, her command is responsible for relieving her. I suspect her command is waiting for the determination of the criminal complaint, but the fact of her arrest and the 911 transcript should be enough to support relief. In the Navy a commanding officer of a guided missile submarine was immediately relieved after receiving a DWI. No grace and no waiting on the criminal justice system. A former USS Minnesota commander now has that boat.

Leadership accepts the responsibility of the roles given. The failure of the DFL Senate caucus to immediately remove Mitchell and the Walz administration from removing Jett is difficult to understand.

Brian D. Skon, St. Michael


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We should not be surprised by the inefficiencies of COVID-era government programs; it's really to be expected ("Audit faults agency on COVID pay," June 12). Deep down we have all come to accept that our state government will spend $80 million to deliver a $20 million benefit, and our federal government will spend $80 billion to deliver a $20 billion benefit (or weapon) — and using borrowed money to boot.

Jack Kohler, Plymouth


URBAN-RURAL TENSION

Let's stoke the divide that matters

Regarding the column about the obnoxious boor in a small-town restaurant ("A tourist made a rural hostess cry. Don't be that guy," June 10): Why not use this story to create unity between urban and rural Minnesotans and agree that the guy was a jerk from Chicago?

Clay Gustafson, Minneapolis