Think back to before Snyder, before Public Act 4 took effect. The city was broke then, too. Just as broke, in fact, as it is today. There was the threat of payless paydays, a recurring warning in the city these days. So what’s different now?

The state’s taking a firmer stance: Make big structural changes in Detroit government or no money from us, is the message coming from Lansing.

That’s why at a press conference last week, Mayor Dave Bing told reporters that, ultimately, he’s not the one calling the shots in these politically and financially stressful days. The State is. “I’m open minded but by the same token, the State is holding the cards at this point,” Bing said when asked whether he would reconsider terms of a contract that is necessary for acquiring state funds. Bing has brushed off City Council’s concerns of a conflict of interest with the controversial Miller Canfield contract.

If the state is holding the cards, a good poker face is in order.

Per the Snyder Administration’s deal with the Mayor’s Office, the City must hire and maintain private legal and turnaround firms, among other restructuring moves in order to get $30 million in bond sale funds. Now, heading into the New Year, the city is so broke it (apparently) can’t even pay attention to the simple legal requirements of holding a public meeting.

As Detroit faces a fiscal cliff of its own, the words “payless paydays” and “unpaid furloughs” have resurfaced as they have time and time before, especially over the past four years after former Mayor Kwame Kilpatrick left office and audits exposed the city’s financial nightmare. Essentially, the only difference between a payless payday and an unpaid furlough is notice not to come to work. And rhetoric. Either way, what usually would be a payday’s going to roll around and some unfortunate city workers are not getting paychecks. Either way, a check has to be missing a couple zeros or missing altogether.

We’ve heard it before, perhaps too many times: If the city doesn’t make drastic changes, it will crumble into the void. But by now Detroiters are a practically numb to the threat of running out of money. And that’s no good, especially if they city really is to run out of cash. But here’s the thing: it’s not.

The city won’t run out of cash any more than is has in the past. That’s not my opinion; it’s Detroit CFO Jack Martin’s. He spoke at a press conference last week declaring that a few unpaid furloughs will be enough to fill the cash gap. He and Bing last week promised “absolutely no payless paydays” and “no bankruptcy whatsoever.” But a slow trickle of furlough savings a $30 million lump sum is not.

 But really, how do the two even compare? If a few unpaid furloughs for non-public safety or revenue generating workers is enough to stave off a financial crisis, was how critical was the crisis in the first place? It’s a question that perhaps touches on root of the issue between the legislative and executive branch of Detroit government.

Obviously, unpaid furloughs are being used as a threat to get council members to approve a controversial contract. But if it doesn’t work, then what? More lawsuits from unions? More back-and-forth?

As Bing and Martin have said, bankruptcy at this point is far from an option. The city is not close to being eligible ... yet.

Now that the State-City Milestone agreement benchmarks have not been approved by the City Council, and now that the state’s emergency manager leverage has been repealed, it’s back to the drawing board. Back to the unpaid furloughs hotly contested in 2010.

As far as bankruptcy goes, there’s a good reason we want to avoid it: “Bankruptcy costs a lot of money, ironically,” Said Eric Scorsone, extension specialist in State and Local Government at Michigan State University. He said the city of Vallejo, California spent over $10 million on bankruptcy lawsuits in 2008. “If you can get the same outcome at a cheaper price, you do that.”

Let’s do that.

When Dr. Earlexia Norwood was 28 years old, she went to a dermatologist with her husband after experiencing post partum hair loss.

The skin doctor had one question for her: “Is this your pimp?” He asked, nodding toward her husband and donning gloves before using pencils to examine her scalp without touching it.

It didn’t occur to that doctor, a white male, that a black woman could be anything but a prostitute, let alone a Doctor. But at the time Norwood was a doctor herself, constantly fighting stereotypes and blazing trails for blacks in healthcare.

Today, Norwood is the physician in charge at the Troy Medical Center and President of OPAL—an organization dedicated in supporting African America leaders in health and sciences for Ford Health Systems.

Norwood shared this chilling experience of discrimination in healthcare at the unveiling of Real Times Media’s inaugural publication of Vital Signs: A tribute to African Americans in the Healthcare Industry last night.

Sadly, she said her story is far from unique, even today. “Most people that this kind of thing happens to are not doctors, they don’t have the letters PH.D behind their names,” she said. That’s why most people who face similar discrimination, especially when it comes to something as personal as healthcare, shrink into the shadows of embarrassment after such an encounter instead of fighting it, she added.

“We need culturally sensitive care and to make sure we never stereotype patients,” Norwood said. “We need people who understand our community, our people.”

The Vital Signs book unveiling party was appropriately held at the Charles H. Wright Museum of African History and served as a call to action among leading African Americans in the healthcare field.

Dr. Patricia Maryland, President and CEO of the St. John Providence Healthcare System, in an impassioned speech, told the crowd that the Vital Signs book is a crucial tool to organize black healthcare leaders. It also brings fresh diverse minds into the field of medicine and can be used to treat the "vital signs" of a stuggling community. She listed some grave statistics on the state of black health in Michigan, calling the health disparity between whites and blacks “startling”.

“We’ve got to bring more African Americans into the medical field. Cultural competence to deal with patients who are of African America heritage,” she said:

• The Mortality rate is 27 percent higher in African Americans than in Caucasian Americans
• African Americans are twice as likely to get diabetes than their Caucasian counterparts.
• The infant mortality rate in African Americans in Michigan is three times (3x!) as high as Caucasian Americans

“Take this book and use it,” Maryland urged, noting that the Vital Signs publication identifies the key black leaders in the field between its covers and in doing so makes these faces more accessible to black youth as mentors. The book also makes black healthcare leaders aware of their network so it’s much easier to collaborate for a healthier community.

“This book has the power of bringing us all together and identifying us. Now we have to figure out how to work together on changing some of these numbers,” Maryland said in her speech. She called for a “strategic forum” to organize around bringing more blacks into the field and collaborating to fight the health crisis. “How can we work together? That’s the call to action,” Maryland said.

Maryland ended her speech with a reference to Dr. Martin Luther King’s vision: “If you don’t feel good you can’t accomplish much,” she said. “His dream for our nation cannot be realized without healthy people and a healthy community.”