New Year and Hope

 

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The “Christmas Spirit”

 

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AI and the practice of medicine

 

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“Giving Thanks” Challenges Us All

 

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A call to humanize medical technology and ensure health care for the poor around the world.

 

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A call to open our hearts to migrants and refugees

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To Learn, We Have to Unlearn

 

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Imagine and Build Happiness

 

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FUNDAMENTALLY EQUAL!

 

It is a sign of our times: the situation of millions of men and women, the elderly, young people and children who, in today's world, feel forced or are compelled to leave their places of origin, their villages or nations, for many and varied reasons, including conflicts, violence, administrative corruption, unemployment, natural disasters, and political persecution. They leave to immigrate and take refuge in other places on earth in search of better living conditions. This sign of our times cries out to the heavens and becomes a disgrace for humanity because—in the vast majority of cases—the national governments in the countries of origin and destination of the migratory waves have not found or given dignified, humane, and definitive solutions to the serious humanitarian problem that the phenomenon represents. 

We would say that this is, if not the largest, one of the most significant and worst tragedies that humanity faces today in the many corners of this planet. The United States does not escape this phenomenon. On the contrary, this nation—throughout its history—has been one of the main points of attraction for large waves of immigrants.

From the first day of his Pontificate, Pope Francis has shown great human sensitivity, an enormous concern, and interest in the subject and the grave situation of the world's immigrants. Through a massive number of messages and interventions, he has taught us that to face and give a humane and adequate solution to the problem we must first resolve our fears and prejudices; our intolerances and inner walls; open ourselves in compassion and love to all; be capable of empathy for our fellow human beings; be capable of respect, justice, and mercy for all human beings, for those who are fundamentally equal to us in everything; be capable of not excluding and not discriminating against anyone and of putting the least among us first, of creating spaces of dignity for the "discarded" and those who suffer most in our societies; be capable of building the world as a great table and the earth as our home, the home of all.

For more than three decades in this nation, we have advocated for a radical and definitive solution to the issue of undocumented immigration, represented by the millions of men and women who, right now and for decades, have arrived in this country, seeking better living conditions for right now and in the future, for both themselves and their families, here and in their places of origin, contributing their work to the development and progress of this great nation.

But, without regulation and documentation allowing them to live and function as citizens with all their human and civil rights protected by law and the constitution, they are forced to live in the shadows, as in an underworld, a subculture, in which millions of men, women and entire families of undocumented immigrants live subjected to uncertainty, abuses, persecutions, discriminations, labor exploitation, social marginalization, lack of opportunities and free access to social benefits and all kinds of injustices and violence, etc.

Right now, and for decades, the United States has been an example of democracy, respect for the law, and human rights for the world. The inhumane, unequal and unjust situation in which millions of undocumented immigrants live in this country is hypocritical and contradicts the founding principles of this nation and the Constitution that governs us. Therefore, we must reach a humane, dignified, reasonable, concerted, integral, definitive, and prompt solution without further truces or delays. To continue without solving this important sociopolitical issue is to prolong an unsustainable and inhumane situation, postpone dignified living conditions for millions of people, and to continue the national shame that this situation means for this nation before the eyes of the world.

All the parties and governments that in past decades have led the life of this nation have spoken of immigration as a priority issue in the electoral, economic, cultural, political, and social spheres. But the solution has not come. It is not coming. This is indeed an issue of enormous complexity due to the many sides and dimensions it contains and implies. On the part of politicians, it has become a popular issue and one of opportunism and electoral convenience that must be kept active.

On the part of employers, legal solutions that would force them to fairly pay their employees more do not suit them. On the part of the American people, there are many fears and prejudices (superiority or inferiority complexes, racial and cultural biases, labor fears) that allow them to reject and discriminate instead of accepting and welcoming them. On the part of undocumented immigrants—because they forget what is important to solve what is urgent: providing an immediate solution to their economic needs—they abandon more critical struggles for their better long-term living conditions and turn their stay in the country into an economic advantage instead of an integration with the new nation that welcomes them. On the part of the rulers of the nations sending immigrants: a definitive solution in the United States for their immigrant populations solves their problems and alleviates their negligence and administrative corruption.

But it is precisely the complexity of this issue that challenges our greatness as a nation so that, above all, through frank, open dialogue and national consensus, we can find a humane, dignified, and comprehensive solution. A solution for everything and everyone. A solution that recognizes every human dimension of each undocumented immigrant (housing, education, employment, political, social, and cultural integration into American society, etc.), their families, and all immigrants coming from the most diverse nations present in this country.

The vast majority of undocumented immigrants are noble and good men and women, selfless workers, deserving of a better life, who crossed the border or stayed to live in this country for many years without the required documentation, men and women who pay taxes, but do not see their efforts and contributions to the nation's progress rewarded with laws and social benefits. Yet, they choose to endure the new abuses to which our country subjects them rather than return to the worse living conditions they left behind. And as in every society and human community, there is also an undeniably immense minority among them who add, to their undocumented status, the status of illegal aliens for infractions to the laws or crimes they commit.

The entire nation must pay real attention to this serious problem. We must legalize the situation of millions of undocumented immigrants in the United States. Any abuse, inequity, and injustice that continues to occur on our soil will remind us that we have not been capable, that we have not done well, and that our leaders, politicians, and rulers were not and are not up to addressing the circumstances and the demands of our life as a nation. We need more proposals and fewer protests.

We must work together to overcome—once and for all—this stain and shame on our existence as an American people. The United States cannot continue to be a nation with first-, fifth- and last-class inhabitants. All inhabitants of the United States, fundamentally equal, must live in equity and justice, with equal living conditions for all and equal access to the same benefits and social opportunities.

Mario J. Paredes is the CEO of SOMOS Community Care: a network of 2,500 independent physicians—mostly primary care physicians— who serve nearly one million of New York City's most vulnerable Medicaid patients.

A call to open our hearts to migrants and refugees

 

POPE FRANCIS HAS URGED WORLD LEADERS and the people they govern to open their hearts to the stranger already in their midst or seeking desperately to gain entry to their countries. In his message for the 107th World Day of Migrants and Refugees—to be observed Sept. 26, 2021—the Pontiff presents his vision of a world in which “all peoples are united in peace and harmony, celebrating the goodness of God and the wonders of creation.”

The Pope said that “we must make every effort to break down the walls that separate us and, in acknowledging our profound interconnection, build bridges that foster a culture of  encounter. Today’s migration movements offer an opportunity for us to overcome our fears and let ourselves be enriched by the diversity of each person’s gifts. Then, if we so desire, we

can transform borders into privileged places of encounter.”

To turn “our borders into privileged places of encounter”—what a powerful call to humanize US immigration policy and move it beyond the legalism that protects narrow political and economic interests at the expense of millions of suffering men, women, and children.  Granted, the Pope’s perspective on a complex reality sets the bar very high. Yet, something  must be done to begin to abet the massive suffering of those seeking access to the US to flee tyranny, violence, hunger, or poverty.

First and foremost, immigration reform that even modestly echoes the papal vision has to be a bipartisan effort. Today, the issue is a political football, with both parties opposing genuine, far-reaching reform efforts that would promise to deliver votes to the party pushing for such change. The Biden Administration is making some welcome changes to Trump-era policies, but it is stopping short of transforming the system. Real change would put the spotlight on and acknowledge the human drama that—here and around the world—impels refugees and migrants to take huge risks in seeking safety and prosperity. 

US immigration policy remains a patchwork, while a holistic vision is urgently called for. What is needed is a significant overhaul that promises to bring comfort to millions living in fear and darkness, and suffering abuse and mistreatment. 

Some painful truths must be openly discussed. One is the fact that racism is a key factor obstructing change. At both the leadership and grassroots level, there is sheer prejudice against people of color and different cultural backgrounds. Some of it finds expression—in the US and around the world—in what Pope Francis calls “myopic and aggressive forms of nationalism.” 

Then there is the persistent myth that immigrants, legal and otherwise, take jobs away from US citizens. The truth is that the work these newcomers do—cleaning, dishwashing, various forms of hard labor, etc., all underpaid—is looked down upon and rejected by Americans. That is true also for the work that brings migrant workers to this country, backbreaking work tilling the soil. Lacking alternatives, these workers overstay their visas and end up like  bonded laborers, lacking any legal standing. It should also be noted that most undocumented workers—so highly vulnerable to exploitation—pay taxes! 

According to official data, there are an estimated 10.5 million undocumented immigrants in the US, but the actual total may be significantly higher. There are also untold millions of young men who were born here of undocumented parents or who arrived when they were very young. Many have gone to college. But because of their parents’ immigration status, they lack the documents that would allow them to fully integrate into US society—they are at risk of being deported, sent ‘home’ to a country where they never lived or which they left as very

young children. 

Leaving aside the multitudes clamoring at our border for entry, these young men, like their parents, are begging to stay in the US. There is a clear injustice here. The US should offer  both generations a path to citizenship that does not take 10 or20 years. As it stands, the  country has condemned them to live in the shadows without any rights for many years. 

It behooves us as a nation founded on Judeo-Christian principles to promote policies that respect the human dignity of all those seeking shelter in the US. We need laws that acknowledge the common humanity that unites us all, regardless of skin color, socio-economic status, or legal standing. The earth, said Pope Francis, is our “common home.” 

The Pope has called for “a personal and collective commitment that cares for all our brothers and sisters who continue to suffer, even as we work towards more sustainable, balanced, and inclusive development. A commitment that makes no distinction between natives and foreigners, between residents and guests, since it is a matter of a treasure we hold in common, from whose care and benefits no one should be excluded.” 

Now, there is a vision for immigration reform. In the end, said the Pontiff, “we are like many grains of salt, all different and unique but which together can form a beautiful beach, a true work of art.”

Mario J. Paredes is CEO of SOMOS Community Care, a network of 2,500 independent physicians—most of them primary care providers—serving close to a million of New York  City’s most vulnerable Medicaid patients.

Value-Based Payment is the Future of Funded Health Care

 

A NEW APPROACH TO MEDICAID SPENDING is poised to transform health care for the poor across the US. The development has yet to make headlines, but the medical establishment is taking notice of federal and state medical authorities embracing Value-Based Payment (VBP) or Pay-for-Performance. 

It is a radically different formula to set the compensation model for physicians serving the most vulnerable patients: doctors earn more for their services when the people they serve have better longer-term health outcomes. Simply put, doctors are rewarded for taking better care of their patients—and there are savings for taxpayers as people are kept out of emergency rooms and costly hospital beds. 

VBP stands in sharp contrast with the traditional Medicaid compensation model, under which providers are paid per transaction—an office visit or a test, for example—medical services that rarely if ever add up to a holistic, preventative care package. Such superior care is precisely the promise of VBP-driven health care. The new formula considers all the patients’ needs, not just medical but also behavioral and social, and care on all these fronts is carefully coordinated. 

VBP-driven care also stands for a ready welcome of the patient, whereas traditional Medicaid confronts the patient with a forbidding labyrinthine system that is decidedly not user-friendly. While the traditional Medicaid compensation model is prone to waste and fraud, the efficacy and success of VBP-driven care are demonstrated by the careful and comprehensive maintenance of electronic medical records that substantiate evidence of patients’ longer-term wellbeing. 

The VBP formula puts primary care physicians (PCPs) in the driver’s seat. It is these community-based doctors who are on the frontlines of providing care to the most vulnerable members of society; they are most often these patients’ first point of contact with the health-care system. As such, signing on to the VBP compensation model, PCPs are in an ideal position to become a catalyst for better quality health care.

That has been the experience of SOMOS Community Care, a network of community-based 2,500 physicians, most of them PCPs, that is providing superior care to one million of New York City’s most vulnerable Hispanics, African Americans, and Asian Americans. SOMOS launched in 2014 as a so-called Performing Provider System mandated by New York State’s Delivery System Reform Incentive Payment (DSRIP) program with VBP at its core. The organization developed what it labels Neighborhood-Based Primary Care, reinventing, reiterating, and restoring the role of the PCP as a trusted and pivotal leader in the community. 

SOMOS doctors work closely with Community Health Workers (CHWs), who visit patients’ homes, where they see first-hand what social conditions—such as poverty, substandard unhygienic housing, and unemployment—may aggravate medical conditions. Such non-medical factors are known as Social Determinants of Health, and taking these into account is a crucial dimension of VBP-driven care. This rounds out the intimate, comprehensive picture PCPs have of their patients’ needs—and that knowledge is key to establishing a relationship of trust between patient and doctor. This personal dimension is a long way from the relatively impersonal nature of doctor-patient relationships characteristic of the traditional Medicaid system. For SOMOS doctors, the fact that many share the same cultural background as their patients further strengthens the patient-doctor bond. 

SOMOS practices qualify as so-called Patient-Centered Medical Homes, a one-stop point of entry to a full spectrum of care, with the PCP aware of and coordinating all forms of care given to the patient. The doctor and his staff are responsible for maintaining, as noted, accurate and comprehensive electronic medical records—records that show SOMOS and subsequently the New York State Department of Health how well patients are doing. Data also serve to show how superior care translates into savings for taxpayers. SOMOS has managed to save more than $330M in Medicaid funding by reducing emergency room visits and hospital admissions by more than 35 percent. 

It is hard to argue with the VBP-driven health care’s combination of quality care, increased income for doctors, and greater freedom for them in practicing medicine, plus savings in public spending. Yet, some significant players in the healthcare universe have been slow to adopt VBP models, among them hospitals and Health Maintenance Organizations. These prefer to strictly control physicians’ fees and want to steer clear of signing contracts with their doctors. SOMOS doctors—remaining independent business owners—are required to sign contracts committing them to operate according to VBP provisions and foregoing fee-for-service compensation.

Undoubtedly, Value-Based Payment is here to stay. Beyond Medicaid, the model is clearly applicable to Medicare as well. In addition, the notion of providing better care and thus reducing costs in the longer run—even as payments made to doctors would go up—would seem to make sense for commercial insurance as well. It would require, of course, a leap of faith and letting go of established profit models. In the end, all parties—patients, doctors, and be it private or public funders—can benefit. 

Mario J. Paredes is CEO of SOMOS Community Care, a network of 2,500 independent physicians—most of them primary care providers—serving close to a million of New York City’s most vulnerable Medicaid patients.

We Are Easter People

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“For a Man Who Had Three Stars in His Soul...”

 

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SOMOS Network Physicians Will Give Vaccine

NEW YORK GOVERNOR ANDREW CUOMO has authorized a network of independent doctors in New York City to give the coronavirus vaccine to some of the city’s poorest residents, the bulk of them people of color—communities that have been underserved thus far in the distribution of the vaccine. SOMOS Community Care, a network of 2,500 physicians—most of them primary care physicians serving 1 million Hispanic, Asian-American, and African American Medicaid patients—will be given up to 1 million doses of the vaccine.

At a March 26, 2021 news conference in the Bronx announcing the move, Gov. Cuomo said that “the state is going to be providing vaccines directly to SOMOS so they can get those needles in those arms in those hard-to-reach communities.” The governor noted that New York City’s vaccination efforts have thus far failed to give sufficient access to minorities.

“We need to do vaccine equity,” he said, noting that, for example, the city is 27 percent black, yet only 19 percent of that population is vaccinated; by contrast, the city is 53 percent white and already 55 percent of these residents has been vaccinated.

Initially, 75 SOMOS medical practices will begin distributing the vaccine in the coming weeks; 100 practices will be involved in the effort pending supply of the vaccine. That means patients can make an appointment directly through SOMOS (somosvacunas.com), go to their regular doctor and get vaccinated right in the doctor’s office.

Thus far, New York State has relied primarily on hospitals and other medical facilities to distribute the vaccine, an infrastructure that is harder to navigate and gain access to for the poor, especially people of color. What’s more, Blacks and Hispanics, stressed the governor, have “less trust in the system” and have been skeptical about the safety and efficacy of the vaccine.

SOMOS doctors will rely on their unique relationship with their patients to create a level of trust and comfort, moving people to become willing to be vaccinated. That strong doctor-patient bond—with the physician functioning like the family doctor of old—hinges on several factors:

The majority of SOMOS doctors speak the same language and share the cultural background of the people they serve and in whose communities the physicians are based. This cultural competence has proven to be key factor in doctors understanding the needs of the people in their care.

The SOMOS network also puts a premium on the contribution of Community Health Workers, who visit patients’ homes, reminding them of medical appointments and assessing circumstances in the home or family that can impact people’s health. The latter fall in the category of the Social Determinants of Health—substandard housing, unemployment, criminal justice issues, etc. SOMOS doctors work closely with Community-Based Organizations that can address some of the issues.

SOMOS physicians also carefully integrate behavioral health into patients’ overall treatment. In sum, SOMOS doctors’ offices are a gateway to quality, holistic, comprehensive care, which makes for better longer-term health outcomes; and the doctors are compensated accordingly, earning more as their patients do better and, for example, stay out of costly hospital beds.

SOMOS has been functioning in accord with the Value-Based Payment system that rewards superior care—in contrast with the transactional payment formula of the traditional Medicaid model that is prone to waste and fraud.

SOMOS got its start thanks to Gov. Cuomo authorizing, in 2014, the Delivery System Reform Incentive Payment program, which ran through 2020 and laid the foundation that enabled SOMOS to provide superior care to New York City’s poorest residents. A new chapter in the SOMOS record of service to the most vulnerable has now begun with the vaccination program.

In his remarks at the news conference, Dr. Ramon Tallaj, founder and chairman of SOMOS, recalled that this is not the first time that New York’s governor called on the organization for vital aid. In March 2020, right at the start of the pandemic, the governor asked SOMOS to begin testing staff at the New York Stock Exchange, which it would do through the summer. SOMOS ran numerous testing sites throughout the city—as well as in Texas, Florida, and Georgia. To-date, said Dr. Tallaj, SOMOS has administered 1 million test and helped distribute 2 million meals to New York families hard-hit by unemployment as a result of the economic fall-out of the pandemic.

SOMOS doctors have success with their patients, said Dr. Tallaj, because “we understand their culture—because we are immigrants like them, we are the same people … we serve poor people in our neighborhoods, near their homes, near their apartments, because medicine is local and because people tend to choose doctors based on their values.”

Speaking of SOMOS’ new task, Dr. Tallaj said that his doctors—“champions of preventive medicine”—will distribute “the vaccine of hope to end the virus of loneliness, which has people dying.”

Mario J. Paredes is CEO of SOMOS Community Care, a network of 2,500 independent physicians—most of them primary care providers—serving close to a million of New York City’s most vulnerable Medicaid patients. 

"We remember them’"

 

IT WAS A YEAR AGO, on March 11, 2001, that the World Health Organization declared the COVID-19 pandemic. Media have abundantly noted the horrifying statistics: more than 2.5 million dead worldwide and more than 500,000 people who died of the coronavirus in the U.S. alone. 

But what about the human reality behind those numbers—the humanity of the many who died, and the many millions affected by the loss of loved ones or those who suffered severe economic hardship as measures to combat the pandemic decimated countless businesses? Few remember their name or can tell their story. Most of us have never heard about them.

To help remedy the situation, on March 12, 2021, America Media organized a tribute “We remember them: a virtual prayer service to remember those who died of Covid-19.” With this event, America Media, publisher of the Jesuit America Magazine, made a moving, compelling gesture to throw light on some of the wealth of human richness that perished largely unknown and without acknowledgment. 

As Father Matt Malone, SJ—president and editor in chief of America Media—made clear in his opening remarks, the group is more than a media company, “it is a Church ministry.” As such, it helped pay tribute to unsung heroes who lost their lives to the virus, leaving behind painful loss in their family, community, and work settings. 

The service underscored that the weight of individual human tragedies goes well beyond the statistics, which sound dramatic but fail to do justice to the immense value of the human persons wiped out by the pandemic. Nor do the numbers do justice to the untold suffering the victims’ passing leaves behind—the personal, profoundly human cost behind the numbers. Yet, this is how much of U.S. society marks the one-year anniversary of the pandemic—putting up the numbers yet again and recounting the economic cost, practical measures, etc. 

Important as these are, they amount to an impoverished way of taking stock of the wreckage caused by the pandemic. America Media’s “We remember them’ spiritual tribute to the victims of the coronavirus was an expression of Christian humanism—an acknowledgment, a celebration of the mystery of human suffering and the infinite depth of the human spirit.

It is a sad testimony to society’s growing indifference to the higher things of reality, to transcendent values that so little is done to capture and acknowledge the sickness, the pain, the isolation, the abandonment, and the lack of compassion experienced by so many victims as the disease ran its course.

In its tribute to COVID-19 victims, America Media was decidedly inclusive, saluting: family members “who gifted us with their gentle care, wisdom, and support;” essential workers, who sacrificed themselves for others; teachers, “whose devotion to their students and school communities shaped the next generation of those who will steward life on this earth;” consecrated men and women,  “who so desired God and devoted themselves to lives of heartfelt worship and generous service;” friends, “who through the friendship we shared with them showed us the face of God;” migrants, refugees and asylum seekers … “for all experiencing homelessness …; and for all who were ignored, forgotten and cast out by their communities—and even their loved ones;”; women and men who were incarcerated … whose dignity was never forgotten by God; and for all those who ministered to them and have died;” and “all who were unnamed and unclaimed who have died, who do not have others to remember them.”

In several of these categories of victims, witnesses—family members, friends, colleagues—in words and images introduced and remembered COVID-19 victims whom they loved and respected and whose loss has left them bereft. Dr. Ramon Tallaj, founder and Chairman of SOMOS Community Care, a network of 2,500 independent physicians serving New York City’s most destitute communities of color, paid tribute to 12 SOMOS doctors who gave their lives on the frontlines fighting the pandemic.

Dr. Tallaj noted the work of “immigrant doctors” like himself taking on the responsibility of caring for vulnerable people of color in New York City, especially Hispanics who suffered disproportionately from the virus due, in part, to small, cramped living conditions where infections happened readily. More than 8,000 Hispanics died in New York, many of whose names were never known or forgotten. The “We remember them” prayer service acknowledged many of them among the “unnamed and unclaimed.”

The prayer service should serve as a reminder and inspiration for churches, mosques, and synagogues across the country to pay tribute—every year— to those in their communities who died of the virus. The same is true for corporations, universities, and other major organizations. For a full and genuine recovery from the pandemic, it is vital to give human face to the brutal numbers and acknowledge and celebrate the human dignity of each of the victims.

Mario J. Paredes is C.E.O. of SOMOS Community Care, a network of 2,500 independent physicians—mostly primary care providers—serving close to a million of New York City’s most vulnerable Medicaid patients. He also is a member of the America/Media Board.

Pope Francis: Eight Years of Pastoral Zeal for the Common Home

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Will the pandemic spell the end of globalization?

AT THE END OF FEBRUARY 2021, the pandemic’s global toll is staggering: 113,467,303 confirmed cases worldwide and 2,520,400 deaths, including 510,000 fatalities in the US alone. Not a single country has gone untouched and for almost a year now, countless borders have been essentially closed. COVID-19—the first modern deadly global pandemic, rivaled only by the Black Death in the 14th century and the Spanish Flu (1918-20)—has brought to a screeching halt the free movement of peoples and goods across the world; the dream and promise of globalization have been dealt a blow from which they may not soon fully recover.

In fact, the reassertion of the individual state, throwing off the yoke of global forms of governance and policy making had already begun in recent years, well before the pandemic hit and made closed borders a necessity. President Donald Trump’s ‘America First’ model severely affected US trade with many countries, especially China; the Trump Administration also limited immigration and put the overall focus on building up the US, with international relations taking a back seat. 

In Europe, the United Kingdom withdrew from the European Union, in part to be exempt from liberal immigration policies and to re-establish the country’s sovereignty. Other examples include Hungary and Poland, which had been closing their border for non-Christian immigration. The pandemic, and all the emergency measures it triggered, will undoubtedly further diminish the globalization utopia, intensifying trends that have been already well underway. The global financial crisis in 2008 also put a major damper on the enthusiasm for—and workability of— globalization.

Globalization had gotten its main impulse from the neo-liberal policies of the 1980s in key countries, in particular Ronald Reagan’s America and Margaret Thatcher’s Great Britain. The role of the state was curtailed. Instead, free-market policies won the day and set many countries on the road to economic liberalization and the creation of a global network. Exceptions included the insular nations of the China and Russia, among others. The European Union, too, played a major role in promoting global trade and open borders.

With the arrival of the pandemic, governments were forced to strengthen state institutions, to protect citizens’ health, maintain social cohesion, and protect and repair national economies hard-hit by financial losses and liabilities due to the closure of businesses and the unemployment crisis. Not surprisingly, international solidarity has also declined, as most countries are failing to help nations that are particularly struggling; in that vein, Italy and Spain, both overwhelmed by the pandemic, complained about the lack of support from their northern neighbors.

The pandemic has interfered with the world economy in all its phases: production, distribution, and consumption. The increasing complexity of the distribution and supply-chain network, the lifeblood of the global economy, makes the structure very vulnerable. After the end of the Cold War, the victorious powers designed this complexity so that, for the sake of peace, countries would be interdependent. Any particular state would have to rely on other states for goods, materials and parts essential for the functioning of its economy.

That elaborate international system has now been dealt a blow by the pandemic, which has been prompting individual nations to try to become self-sufficient, within its borders, as within a closed system. The global economy, with all its moving parts, its delicate structure is very difficult to repair. Matter are made still worse by trade wars and accompanying tensions between major powers like the US and China—the two principal drivers of the world economy. What’s more it will be a long road for many countries before they are able to fully participate in the world economy before their own economic house is in order.

Aside from the health and food industries, rebuilding a country’s overall economic productivity will be extremely slow while—due to the pandemic—the systems of transportation and distribution are not optimally functional and when consumers are unable or hesitant to go shopping. Matters are made worse by the relative abandonment of the free-market system so eminently suitable to and essential for globalization, with its free movement of capital. Instead, just as happened in the wake of the financial crisis of 2008, the state begins borrowing and investing heavily in public services, especially health care. This dynamic scares off private investment, shrinking the free flow of capital so essential for the process of globalization.

Yet, this shift is called for in the battle against COVID-19, such as massive spending on the coronavirus vaccines, which is obviously a drain on the economy. And all this emergency spending is very likely to continue in one form or another once the pandemic has been truly defeated, such as spending on research on COVID-19 and other deadly virus strains, and on developing ways to protect the population from the next pandemic. 

It is thus that the pandemic will hurt globalization. Logistically, globalization will continue in the form of the rapid exchange and distribution of information, air travel, and commerce. What will likely also survive the pandemic is countries going it alone, downplaying international cooperation, taking care of their own, and manifesting a xenophobic bent. That inward-looking orientation will rob globalization of its humanist, internationalist soul.

SOMOS doctors actively do their part in fighting the pandemic

WITH MOST OF THE FOCUS on state, city and governments tackling the coronavirus pandemic, a remarkable network of doctors has been on the frontlines in the battle against COVID-19 in New York City since the very start. These physicians, who are the backbone of SOMOS Community Care, have not drawn the limelight but have quietly done their job fighting the ravages of the pandemic.

SOMOS has proven its effectiveness and earned its stripes. No doubt, its record in the battle against the coronavirus—showing that primary care physicians can play a key role—helped persuade New York State health authorities to give SOMOS doctors the privileged task of administering the vaccine.

This network of more than 2,500 community-based, independent physicians—most of them primary care providers—are caring for vulnerable African American, Hispanic and Chinese American Medicaid patients throughout the city. The populations have been particularly vulnerable to the virus, because of a high incidence of underlying conditions, cramped living conditions among other factors. These neediest patients have been the focus of SOMOS Community Care from the very start.

Months ago, when it came to encouraging people to get tested for the virus, SOMOS doctors’ close relationships with their patients—in whose lives they play the role of the family doctor of old—made all the difference. Plus, there is the fact that in many cases the physicians speak the same language and share the same cultural background as they people in their care.

These advantages also come into play now that these doctors have begun administering the vaccine. SOMOS doctors can establish patients’ trust and confidence about the safety of the vaccine and ensure the equitable distribution of the vaccine in communities of color.

The work of SOMOS’ fight against the virus began right when the pandemic first hit the US, in March 2020. At the request of Governor Andrew Cuomo, SOMOS doctors and staff began testing personnel at the New York Stock Exchange, a vital institution in the life of the US economy. The testing there began in mid-March and continued through the summer and fall of last year.

The organization has been operating more than 51 tri-lingual testing sites, with service in Spanish, English, and Chinese, based at Catholic and Protestant churches throughout New York City, while SOMOS is also testing at 33 office sites and two drive-thru locations. SOMOS, to-date, has administered more than 500,000 coronavirus tests. The count at SOMOS-run sites in Texas, Arizona, Florida, and Georgia bring the total up to 1 million. SOMOS has also been testing at more than 400 public schools in the city. Some 400 SOMOS practices—half of the total—play a part in the testing process.

At the same time, SOMOS partnered with restaurants and entrepreneurs in some of the communities it serves to provide meals to families hard-hit by the economic fall-out from the pandemic, families whose breadwinners lost their jobs and were plunged into poverty. To-date, more than 5M prepared meals have been distributed. SOMOS also worked with local grocers and other community-based organizations to purchase, package, and distribute food products. SOMOS also helped struggling small businesses in minority communities get back on their feet financially.

SOMOS has also finance the purchase and delivery of personal protective equipment (PPE) and consumable medical supplies necessary for COVID-19 testing; medical waste disposal related to COVID-19 testing; labor costs associated with medical staff providing COVID-19 testing; and additional costs for testing sites, including costs related to lease, mobilization, and demobilization costs, as well as certain operating and maintenance costs.

All the while SOMOS engaged in significant outreach and communications efforts to disseminate public information regarding health and safety measures and provide warnings about risks and hazards. This communication effort encompassed all forms of media, including radio, newspaper, pamphlets, and television. This work continues now in service of the vaccination process.

With hundreds of doctors now vaccinated, SOMOS doctors feel confident that they can immunize their entire patient body—at least those over 65—in the coming weeks. Mayor Bill de Blasio announced earlier this year that SOMOS doctors will be vaccinating first responders at Taft High School in the Bronx, George Wingate High School in Brooklyn, and Brandeis High School in Manhattan. SOMOS doctors is also administering the vaccine at Yankee Stadium and the Aqueduct Racetrack.

SOMOS’s participation in the vaccination process will balance hospital-based distribution and make getting the vaccine more convenient for many New Yorkers. The SOMOS doctors were engaged thanks to the lobbying efforts of SOMOS President Dr. Henry Chen and SOMOS Founder and Chairman Dr. Ramon Tallaj, who is an advisor for the execution of New York State’s COVID-19 Vaccination Program.

All of SOMOS’ activities dealing with the pandemic are closely coordinated with the New York State Department of Health and the City of New York. To help both the testing and vaccination process, SOMOS has stablished two urgent care centers: one in the Bronx and one in Manhattan.

SOMOS has been on the frontlines from the start and paid in treasure (some $20M) and blood—a dozen SOMOS doctors died from the virus and many fell ill doing their jobs. Meanwhile, more than half of SOMOS practices remain closed.

The fight will continue until the virus is defeated—and SOMOS will not quit.

Mario J. Paredes is the CEO of SOMOS Community Care.