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PRIOR AUTHORIZATION OR NOT? I am writing to provide a correction to a statement in the Feb. 25 article by Josh Feit titled "Let Them Eat Prozac." Mr. Feit alleged that prior authorization programs in which physicians are required to get approval from insurers before prescribing certain drugs are "common in privately run HMOs like Kaiser Permanente...." There may be such requirements in other HMOs but not at Kaiser Permanente. Our physicians do not need--and never have needed--to get prior authorization in any form to prescribe medications. Here's how it does work. After assessing a patient's condition, a Kaiser Permanente physician can order any necessary medications using a computerized system. This lets us see what other prescription medicines a patient is taking, allowing us to prevent the kind of dangerous medication interactions Mr. Feit described in his article. The physicians and pharmacists on our formulary committee review drugs' overall efficacy, side effects and long-term effectiveness, and recommend those they believe are the best for particular health problems. While Kaiser Permanente physicians find this information useful, the final prescribing decision is theirs alone. We can and often do prescribe medications that are not on the formulary if, in our medical judgment, that's the best option for the patient. Kaiser Permanente physicians can do this without asking anyone for permission or "prior authorization." When non-formulary drugs are medically justified by a Kaiser Permanente physician in this way, patients pay the same amount they would have if a formulary medication had been ordered. Our physicians have many tools to help them make the best therapeutic choices for our members, but prior authorization is certainly not one of them. Lauretta Young, MD, Chief of Mental Health,
Kaiser Permanente Northwest
BLAME IT ON HIS MID-LIFE CRISIS When one reads such vicious comments as "formulaic gag and schoolyard wordplay...," "...will serve as a cash cow...; "trite Broadway pantomime...," one must assume she has thrown good money after bad in purchasing season tickets ("Put to Sleep," WW, Feb. 25, 1998). However an assertion that audience laughter is similar to an open drain is unacceptable arrogance. Mr. Silvis' demonstration of arrogance abrogated his disdain. Nothing would have kept me from the show. It was a performance quite undeserving of Mr. Silvis' acid tongue. Players were true to the roles provided by Mr. Gurney's script. Kathryn Heasly grew in her part, as costume changes occurred. Mr. Chambers had great fun in his cross-dressing roles. The full house of seniors and high school students (quite a range of generations) enjoyed themselves. Let us hope for a more balanced review from Mr. Silvis. (Is he, perhaps, facing middle-age trauma?) His editor should alert him to the folly of assuming he knows far more than theater-going patrons. Bonnie J. Hubbard, Southwest 3rd Avenue
WRONG FREQUENCY Jacob Pander's statement in your "Timbre" column last week [WW, March 4, 1998] that electronica in Portland is only now "emerging from people's basements" came as a surprise to all of us who have been performing experimental music here for the past few years. Even more confusing was the fact that while the Pander Brothers' "Secret Broadcast" show ostensibly documented Portland's underground electronic music scene, it failed to include any of the performers who have been its lifeblood. Where were Eternal Golden Void, Humyn+1, Solenoid, Axiomatic, Mothra, Office Products, Anathema, Jesse James, Slow Pulse Planet, Mos Eisley, and the many others who have helped to create one of the most organized, most diverse, and friendliest underground scenes in the country? I certainly don't wish to criticize any of the performers involved in the Pander Brothers' show, as many are enormously talented and original musicians, but to tout these groups as representative of the Portland scene is misleading. If any of your readers are interested in the real live electronic scene in the city I would urge them to come down to the Frequency shows while they last, the monthly Hypnotica series (which recently had its two-year anniversary) at the Bean, or the weekly Aural Fixation series at the Paris Theater. Yes, Arnold and Jacob, there is an exciting and inspirational electronic music scene here in the City of Roses, but unfortunately you seem to have overlooked it. Josh Banke, Northeast Couch Street
THE TRAGEDY OF A POOR EDUCATION The recent cover story on Brandon Brooks looked as if the only reason someone figured out there is a problem is because Brandon is so talented with a basketball ["The Education of Brandon Brooks," WW, March 4, 1998]. The real tragedy is when it is disclosed that Brandon is one of the many Talented and Gifted (TAG) kids that get isolated and abandoned to classes below their learning rate and level. The Portland Public School has a complaint filed against it for this very action. Salem-Kaiser already has been sued and assessed as wanting. Mostly, folks think this is a middle-class, above-average-kid, so-what problem. It is politically correct, in some circles, to laugh at TAG programs as elitist. The true fact is that kids smart enough to "get it" in classrooms the first time, when teachers are taught to show the point 15 times, get bored and quit learning regardless of ethnic background. Other students don't look up to TAG kids, but students who are just a bit "smarter" than they are. Isolated TAG kids can turn into Brandon without the talent in basketball. Yes, most get identified and cluster together with other such kids. But there are many, like Brandon, who become "problems." Small surprise that a gunned-down gang member was once described in the same way Brandon is painted in your article. If education was valued, Brandon would be heading to Stanford to be the next "Tiger Wood" [sic] over current worries about heading to the land of what could have been. No one showed him and hooked him on the value of learning before he was in the fourth grade. The problem is not at Grant or Jefferson. It is when the lights go out in these kids' eyes early on. So why should Brandon have bothered? For this, people will blame Brandon. If I can, with confidence, predict there will be another Brandon, then the fault is with us as a society which says one thing about valuing education and whose actions say another. The fact that basketball was the focal point in your article makes Brandon a poster spokesperson for TAG kids who were not appropriately educated. If we can't serve the most talented, we will get disfunctional smart folks. Just what we don't need to make tomorrow better! J. Michael Reid, Northeast 24th Avenue CALLAHAN CARTOON UNFAIR I am appalled and saddened by the Callahan cartoon on page 4 of the March 11, 1998, issue of Willamette Week. I expect Willamette Week to exhibit a more enlightened, inclusive and fair position. To the many people who fight for equal rights and equal justice for the gay and lesbian citizens of our country, this cartoon is offensive. At a time when gays and lesbians still have no substantive protections under the law from harassment and discrimination in the workplace, and many people are working daily for the same rights that their heterosexual fellow citizens enjoy, we need support from our press, not ridicule. Domestic partner benefits are the right thing to do. Many fair-minded businesses are now extending such benefits to their employees, without much government support, I might add. As an avid reader of Willamette Week, I am disappointed. Scott Osburne, Vancouver, Wash. |
