
Pharmacist Nasir Mahmood, Pine Plains Pharmacy, is advocating for independent community pharmacies to allow them to continue serving their communities.
Leila Hawken
Pharmacist Nasir Mahmood, Pine Plains Pharmacy, is advocating for independent community pharmacies to allow them to continue serving their communities.
Local pharmacies are historically central to community life and have been for generations. If they offered a soda fountain counter with round swivel stools, so much the better.
Today’s family pharmacists throughout the area, however, are struggling under an oppressive pharmaceutical insurance middleman system that strips away profit from their prescription counter.
Beginning in the 1960s, Pharmacy Benefits Managers (PBMs) came upon the scene to process drug claims for insurance companies. By the 1970s they were serving as middlemen between manufacturers, insurance companies and pharmacies, adjudicating prices.
Today, PBMs not only adjudicate claims, but now they develop and manage pharmacy networks, determine the list of drugs to be covered by insurance, set co-pay amounts and serve to channel the patient to a particular choice of pharmacy.
According to the Pharmacists Society of the State of New York (PSSNY), PBMs can own their own pharmacies, retail and mail order, and profit from sales and services. The work of the PSSNY is to propagate and protect community pharmacies.
The effect of this progression as PBMs have become “invisible middlemen” has been devastating to local family-owned pharmacies in area towns in New York and Connecticut, endangering their existence and the invaluable service they provide to their patients and the communities they serve.
Today, the three largest PBMs control nearly 80% of the prescription benefits market share in the U.S., according to the PSSNY.
“We are so lucky to have this pharmacy. It’s a blessing,” said Pine Plains resident Ann Noone, a regular customer of the Pine Plains Pharmacy, commenting on Monday, April 8 about the local business and its pharmacist. “He’s done a lot for this town.”
Pharmacist at the Pine Plains Pharmacy since 1989, and owner of the historic corner drug store since 2006, Nasir Mahmood has witnessed the financial squeeze on area pharmacies with some forced to close their doors, victims of the PBM system.
It is the PBMs that pre-determine how much each drug covered under the plan should cost, and this is the amount it reimburses all pharmacies except the large-chain ones they own. Often the reimbursement rates are well below the cost of the drug, putting pharmacies in the position of having to fill a prescription at a loss.
“We cannot wait for PBM reform,” said Mahmood on Wednesday, March 27, describing the current tenuous status of bi-partisan federal legislation awaiting vote in Washington, D.C.
Having served as president of the PSSNY for two years in 2008-09 and having finished a two-year term as chairman of the PSSNY Board in March, Mahmood now continues as a member of that board. He also serves on the National Legislative Committee within the National Community Pharmacists Association (NCPA) working with other pharmacists’ professional organizations promoting new legislation to place limits on PBMs and create an equitable structure of reform and accountability.
Bipartisan bills have passed out of committee and are awaiting floor vote that would provide strict regulation and transparency to the work of the PBMs, improve patient access and lower costs, Mahmood said. The NCPA has achieved some recent success in the long process of bringing bills to the floor for a vote.
A series of Senate and House bills received bipartisan support and convincing vote margins as they emerged from committees. With passage, the various pieces of legislation would bring lower drug costs, greater transparency in the process, require the Centers for Medicare and Medicaid Services (CMS) to define their contract terms, and require PBMs to operate with greater transparency.
The legislation was attached to the government funding package that was passed in late March to avoid a government shutdown, but Mahmood said that at the last minute the PBM bills were stripped out of the package.
Continuing their commitment to PBM reform, however, Senate Finance Committee Chairman Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-ID) pledged to press on with efforts to enact the legislation before the end of this congressional year.
The NCPA further reported that on Friday, March 22, a bipartisan group of 21 senators and 51 house representatives signed a letter to their respective leadership, asking for immediate action on PBM reform measures.
Advocacy groups are actively pursuing passage of the legislation having arranged a conference drawing pharmacists from across the U.S. to the national headquarters of the NCPA in Alexandria, Virginia, for a two-day meeting to begin on Wednesday, April 17.
“We’ve come a long way with continued advocacy year after year,” Mahmood said, contemplating his participation in the upcoming meeting. Senators and representatives will be reporting to the conference and encouraging continued advocacy strategies to promote passage of the bipartisan PBM legislation.
One bill would bring transparency to Medicaid drug pricing with annual savings of $1 billion. Another would remove PBMs from negotiating CMS services, and the third would provide for greater transparency, oversight and enforcement through the Federal Trade Commission (FTC).
Independent pharmacies throughout the area have expressed their concern about the issue and joined in the hope that the current efforts toward passing legislation will be successful.
Meanwhile, local and area pharmacists remain in the balance, squeezed by the PBM system and locked out of the price negotiation process. During an interview, Mahmood noted that there is not one independent community pharmacy left open in Columbia County.
“It’s not fair,” he said.
Paquito D’Rivera performs at the Mahaiwe in Great Barrington on April 5.
Natalia Bernal is the Mahaiwe Performing Arts Center’s education and community engagement manager and is, in her own words, “the one who makes sure that Mahaiwe events are accessible to all.”
The Mahaiwe’s community engagement program is rooted in the belief that the performing arts should be for everyone. “We are committed to establishing and growing partnerships with neighboring community and arts organizations to develop pathways for overcoming social and practical barriers,” Bernal explained. “Immigrants, people of color, communities with low income, those who have traditionally been underserved in the performing arts, should feel welcomed at the Mahaiwe.”
Partnerships with organizations like Volunteers in Medicine Berkshires (VIM), the W.E.B. Du Bois Legacy Committee, and Community Access to the Arts (CATA) have helped bridge that gap. But for the Latinx community, there’s an even more targeted effort: the Spanish-language Community Advisory Network (SCAN).
“Six years ago, we started an advisory group of Spanish speakers in the community,” Bernal said. “They tell us what the community wants to see, how they’d like their culture represented. Today, SCAN has 12 members. We meet four times a year and are in constant communication. It’s because of them that we’ve hosted free Spanish-language film screenings and live performances.”
For Bernal, this work is personal. “When I first moved to the U.S. in 2003, it was because I got a Latin American scholarship to study at Berklee College of Music. That first year, I went home to Uruguay for Christmas and saw Paquito D’Rivera perform at a jazz festival. I was determined to meet him, and I did. Later that year, Paquito came to Berklee and invited me on stage.”
Now, two decades and 16 Grammys later, Paquito D’Rivera is coming to the Mahaiwe on April 5, and there’s a chance history might repeat itself. “He saw a post we made about his concert and commented, ‘Ay, chica, que maravilla, are you gonna sing a song with us?’ I almost died,” Bernal laughed. “I don’t know if it will happen, but it would be a dream.”
About the possibility of a guest appearance by Bernal, D’Rivera said, “Natalia is a very dear, valuable colleague, and jazz is about improvisation, so the surprise factor is always part of the fun here.”
D’Rivera’s concert is just one example of how the Mahaiwe is making world-class performances accessible. “My whole day has been about offering ‘pay what you can’ tickets for this show,” Bernal says. “We also issued a 50% discount to our partners. We work with ESL teachers, public libraries, literacy agencies, anyone who can help us get the word out.”
That kind of grassroots effort has been transformative. “Last year, we screened ‘Florencia en el Amazonas,’ the first opera written in Spanish ever performed at the Met,” Bernal said. “I sat in the Mahaiwe in tears. As someone who loves opera, it was the first time I heard one written in my own language. It was so powerful.”
Natalia Bernal, Mahaiwe’s education and community engagement managerPhoto by Martin Cohen
For Bernal, it all comes back to representation, on stage and in the audience. “My son is eight. I bring him to everything I can. Spanish shouldn’t just be something that happens at the dinner table. It should be in the world, in all these shapes and forms.”
And that’s what SCAN is helping build: a future where Latinx voices aren’t just included, they are central. “Our SCAN advisors are volunteers, cultural ambassadors,” Bernal said. “They help us distribute surveys, talk to the audience, and strengthen the community. Nobody should feel alone. Everybody should feel like they belong here.”
Education and outreach are central to D’Rivera’s work as well. He said, “It is an important part of our mission to plant and nurture the seed of quality music in our communities.” He continued to say, “Using our visibility and influence in favor of justice is always a very effective vehicle in denouncing violations of human rights around the world.”
This shared mission of education and social justice extends beyond the Mahaiwe. “We are one of the few arts organizations in a monthly meeting with BASIC (Berkshire Alliance for Immigrant Services). We have direct ties to the Berkshire Immigrant Center, VIM, and others so that we are well-informed and ready to serve,” said Bernal.
That commitment to community, culture, and access is why Bernal’s dream panel—Women in the Music Business—would feature Paquito’s wife and longtime manager, Brenda Feliciano. “She’s a tower of power. She’s been managing his career for at least 45 years. If I could organize an event one day, she would be the cherry on the cake.”
Until then, Bernal will keep doing what she does best: making sure the Mahaiwe is a place where everyone, regardless of language, income, or background, feels at home. And maybe, just maybe, she’ll find herself back on stage with Paquito D’Rivera, just like that first time, all those years ago.
For more info and tickets to Paquito D’Rivera, visit mahaiwe.org
There is magic in a home filled with the things we love, and Mary Randolph Carter, affectionately known as “Carter,” has spent a lifetime embracing that magic. Her latest book, “Live with the Things You Love … and You’ll Live Happily Ever After,” is about storytelling, joy, and honoring life’s poetry through the objects we keep.
“This is my tenth book,” Carter said. “At the root of each is my love of collecting, the thrill of the hunt, and living surrounded by things that conjure up family, friends, and memories.”
The creative director at Ralph Lauren for almost four decades, Carter began writing this book during the pandemic, a time of rediscovering comfort. “I found more time to appreciate those special things that give our homes warmth and connection.” Working with Ralph Lauren, she learned that the best spaces tell a personal story. “His desk was filled with toy cars, miniature shoes, superheroes, English dandies, cowboys on horseback. The walls? A gallery of his children’s paintings, iconic photos of Frank Sinatra and Gary Cooper. Everything told a story.”
Carter acknowledges how homes can become overwhelmed with stuff but sees a difference between clutter and collection. “To live happily, create environments that inspire and comfort rather than encumber you! Look around and ask, ‘What is truly meaningful? What makes you smile? What recalls the people and places you cherish?’” Then, she added, “weed out the rest with discipline and courage!”
Provided
Each home in Carter’s book reflects its inhabitant’s spirit. “The first time I walked into Bethann Hardison’s apartment, I knew right away how authentic it was to who she is.” Hardison’s walls are lined with artwork from friends Keith Haring, Jean-Michel Basquiat, and Haitian paintings, testaments to a life well lived. “Though her mantra is, ‘the lighter the load, the freer the journey,’ she also admits some things ‘delight your environment’ and can’t be parted with. Amen to that!”
Having survived two childhood fires, Carter deeply understands what truly matters. “It’s not the things, but the people and memories they evoke.” She loves her collections, but they don’t possess her. “They make me happy, but they do not define me.”
She delights in how people showcase treasures. Paula Grief, for instance, lives in a ten-foot-wide house and had to part with many books. “She tucks the ones she can’t live without through the rungs of her staircase. I love that ingenuity!”
When asked about her most cherished possession, Carter tells a story of loss and serendipity. A childhood portrait of her in a blue velvet dress was lost in a fire. “Years later, the artist’s daughter found another version. Now, it hangs in our apartment, surrounded by flea market art and one of my favorite saints, Our Lady of Guadalupe.”
Adding to the cozy feeling of this book, Carter’s son, Carter Berg, took the photographs, and her sister, Cary, contributed the illustrations. “Cary once stayed in our apartment and painted a dozen objects from our cluttered kitchen. I hung them immediately. When I started this book, I knew she had to capture my favorite objects.”
Four of the featured homes are local to the Northwest Corner, including Carter’s in Millerton, Joan Osofsky’s in Lakeville, Robin Bell’s in Salisbury, and Paula Grief’s in Hudson. They all gathered at the White Hart/Oblong Speaker Series on March 27.
After perusing the richly colored pages of this book, you may feel tempted to shop. “You don’t need money to create a meaningful home,” Carter insisted. “Some of my favorite paintings cost no more than $10 or $25. Value is personal. It’s not about provenance but the story an object tells you or the one you make up.”
Carter’s advice? “Fall in love with the wackiest thing. Surround yourself with what matters, and you’ll live happily ever after.”
On Saturday, April 5, at 3 p.m., The Triplex Cinema in Great Barrington and Jacob’s Pillow, the dance festival in Becket, Massachusetts, are presenting a special benefit screening of the cinematic masterpiece, “The Red Shoes,” followed by a discussion and Q&A. Featuring guest speakers Norton Owen, director of preservation at Jacob’s Pillow, and dance historian Lynn Garafola, the event is a fundraiser for The Triplex.
“We’re pitching in, as it were, because we like to help our neighbors,” said Norton. “They (The Triplex) approached us with the idea, wanting some input if they were going to do a dance film. I thought of Lynn as the perfect person also to include in this because of her knowledge of The Ballets Russes and the book that she wrote about Diaghilev. There is so much in this film, even though it’s fictional, that derives from the Ballets Russes.” Garafola, the leading expert on the Ballets Russes under Serge Diaghilev, 1909–1929, the most influential company in twentieth-century theatrical dance, said, “We see glimpses of that Russian émigré tradition, performances we don’t see much of today. The film captures the artifice of ballet, from the behind-the-scenes world of dressers and conductors to the sheer passion of the audience.”
Hailed as one of the greatest films about ballet, “The Red Shoes,” 1948, is a dazzling fusion of dance and cinema, featuring a mesmerizing 17-minute ballet sequence performed by Scottish ballet dancer and actress, Moira Shearer. Directed by Michael Powell and Emeric Pressburger, the film’s breathtaking use of Technicolor and evocative storytelling continues to captivate audiences, including legendary filmmakers like Martin Scorsese, Brian De Palma, and Steven Spielberg all of whom have cited the film as an influence on their work.
Garafola recalled seeing the film as a young dancer. “I remember being more taken with the plot then, but seeing it again recently, it was the color, the fantasy, and the glamour that struck me. Given how gray England was after the war, the film’s vibrant costumes and settings create an almost dreamlike escape.”
Owen echoed Garafola’s sentiment. “It’s magical. Color was their thing, and this latest restoration makes it even more breathtaking.”
The film underwent an extensive digital restoration at the UCLA Film and Television archive between 2006 and 2008 and premiered at the Cannes Film Festival in 2009. This is the version of the film which will be screened at the Triplex.
Owen said, “I love the depiction of young ballet audiences racing to their seats. That kind of enthusiasm is contagious. It’s what draws young dancers in.” Both Owen and Garafola epressed hope that young dancers will attend the event, sharing in the film’s enduring inspiration.
Owen and Garafola’s Q&A is sure to be lively and educational as they delve into the film’s legacy in both dance and cinema. “It’s not just a film for dance lovers. It’s a filmmaker’s film, too,” Owen added.
Join The Triplex and Jacob’s Pillow for this rare opportunity to experience “The Red Shoes” on the big screen, a film that continues to enchant, inspire, and ignite artistic passion.
Tickets are available for $75 at www.thetriplex.org.