To the Editor:

The mistakes described in “Overloaded Pharmacists Warn They’re Making Fatal Mistakes” (front page, Feb. 1) keep me up at night. Even one medication error is too many.

Unfortunately, the current system sets pharmacists up to fail. The weight of the potentially dire consequences of filling the wrong prescription or missing dangerous drug interactions is crushing pharmacists, personally and professionally.

The solution comes from taking a hard look at how pharmacies are reimbursed and who profits from inadequate patient care.

Pharmacy benefit managers make piles of money with no proof they serve patients. They say they keep prices and premiums down but fight efforts to demystify how they achieve this. If it’s not greedy, let’s see how it works. If it really helps patients, tell us how. But they won’t. It’s indefensible.

Patient safety must always remain a priority. We need change now.

Thomas E. Menighan
Washington
The writer is chief executive of the American Pharmacists Association.

To the Editor:

Re “The Triumph of Fiscal Hypocrisy” (column, Feb. 7):

Paul Krugman explains how the Republicans have gained political advantage by blocking fiscal stimulus when it was badly needed during the Great Recession, then supporting profligate stimulus policies well after the economy had recovered.

Add to this fiscal folly the rollback of environmental regulations, even as we are facing a climate crisis of enormous economic consequence.

Yes, the deregulation has likely added some small percentage of short-term G.D.P. growth. But it comes at a potentially staggering cost to future generations, as methane regulations and fuel economy standards are reversed, and critical support for an international climate response is withheld.

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What’s left of the Republican reputation for competent fiscal stewardship has now gone up in flames.

Ken Swensen
Redding, Conn.

To the Editor:

Re “Cashless Businesses? City Council Says No” (news article, Jan. 24):

It is disheartening to see the New York City Council follow the lead of Philadelphia and San Francisco in banning cashless retail establishments.

This measure only attacks a symptom of discrimination, not the root cause. Far too many people lack access to the banking system, which studies show is essential to improving their income-earning ability over time. So why not give banks more incentives to serve low-income people?

For example, Congress could change the Community Reinvestment Act to incentivize banks to issue debit cards, without overdraft provisions. Instead of fighting against the digital economy, government leaders should be doing more to ensure that their residents can participate in it.

Fred P. Hochberg
Miami Beach
The writer is the author of “Trade Is Not a Four-Letter Word” and a former chairman of the United States Export-Import Bank.



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