2020 Presidential Election - Your Vote is Your Voice

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Hoping for Better Times / Con Esperanza en Tiempos Mejores

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Praying for Prayer

 

In the sum of the dimensions that we are as human beings, there is one, the most important: that which elevates us above everyday life, which frees us from tangible, perishable and postmodern consumerist materiality, which makes us fly, which allows us to create ideals and goals, dream of utopias and no longer resign ourselves to the narrowness, precariousness, and limitations of our existence; this is the transcendent dimension of the life of every human being.

This human dimension brings man to divinity, yearning for fulfillment, perfection, infinity, and eternity, and it also explains why all human beings establish relationships with the Transcendent in our daily lives or during the special occasions of our existence.

We do this by attempting communication with the one which each of us believes and confesses as our God, our Transcendent being, our Creator. ... And, in general, this communication attempt is called—in most of humanity's religious systems—prayer.

To pray and try to enter into a dialogue with the divine, human beings use rites, devotions, recite hymns, chants, etc. In general, we use traditional formulas, socially and culturally learned, which—in Spanish and Catholic theology—we call REZAR (PRAYING), that is to say: reciting… And we dedicate the time and space of our existence to prayer.

But, PRAYING (reciting formulas, conversing with the Transcendent through rites, devotions, etc.) is an instrument that we have to open us up and push us to PRAYER, that is, to live life in harmony, in accordance and in coherence with our confessions of faith or religion, with what we believe and profess.

Thus, it is possible to pray a lot and live lives totally divorced from what we believe in and from the most fundamental human values ​​(such as love, peace, justice, truth, freedom, life) in the same way that it is possible to have little time and space to pray and, nevertheless, be protagonists and builders of better human relationships and societies that are more fraternal.

Prayers, therefore, are an instrument and accompaniment for a life of PRAYER. And while praying is a conscientious and momentary matter in daily life, prayer involves the religious believer's whole life.

Praying opens us to a life of prayer, to the deep will of God in man: to love and to serve. Praying is not, then, an instrument of myth and magic, a fetish, an act of magic to force the will of the divine so that everything happens according to our convenience, as we want it and according to our whims and interests, almost always petty.

Praying is at the service of prayer. In other words, ritual practices and religious devotions must be at the service of lives lived deeply and honestly in a human and humanizing way.

When we do not see prayers as instruments and manifestations of a whole life lived in prayer and prayer is not understood as a life that needs and manifests in moments of praying, individually or collectively, a scandalous divorce occurs between faith and life, between religious practices and our daily practices, between what we believe and what we live, between what we profess and what we practice.

The painful and challenging situation of the time in which humanity lives today undoubtedly urges us all to establish more and better relationships with the Transcendent, to seek more and better moments of prayer and worship. And, because of these same religious practices, may we feel more called upon to live a life of prayer, doing the will of God who—in all religions—asks us to love and serve one another to a greater extent.

The construction of a better world is delegated by God to the intelligence and freedom of man. It is false, a religious experience in which the human being, through rites and devotions, is not responsible for building a better world. A religious experience in which man asks God to do what is purely the responsibility of the human race is false and cynical.

May our religious life push us to build a better world as God's will in man. May we pray to live in prayer, to love one another and, living in prayer, loving and serving each other, we pray for each other, for all our best intentions and most profound needs and those of all humanity.

Vatican body calls for an ethical, moral transformation in the battle against COVID-19

FUNDAMENTALLY, every document produced by the Vatican is addressed to all of humanity, but in matters of faith, of course, Catholics are the prime audience.  A new set of reflections on the coronavirus, however, published by the Pontifical Academy for Life, targets explicitly all members of the global human family, the humana communitas.

In “Humana communitas in the age of pandemic: untimely meditations on life’s rebirth,” the Academy, which is dedicated to promoting the Catholic Church's consistent life ethic, calls for a radical reorientation in the fight against the pandemic. It calls attention to “our common responsibility for the human family,” a renewed appreciation of the gift of life, and an awareness of and concrete response to the fact that the most vulnerable members of society—specifically the elderly and the poor around the world, as well as “prisoners [and] the abandoned destined to oblivion in refugee camps from hell”—suffer the brunt of the pain inflicted by the pandemic.

Arguing for the fundamental dignity of every human being, the reflections are labeled “untimely,” explained Archbishop Vincenzo Paglia, president of the Academy, “to indicate the urgency of finding a conception of community, which, apparently, is no longer fashionable.” The document calls on government leaders, social elites, and ordinary individuals in the wealthy developed world to not let selfishness and economic self-interest outweigh the care and concern due to those without means to protect themselves from the impact of the pandemic and other “diseases despite the availability of cures too expensive to afford.”

Hence the vaccine for the virus, once it comes on the market, should not be treated as merchandise promising profit, the document suggests, but, in solidarity with the poor and most vulnerable, be distributed to all who need it and those most at risk. It should not only be in wealthy nations, “where people can afford the requirements of safety.” 

In the end, moreover, says the document, “frail is what we all are, radically marked by the experience of finitude at the core of our existence,” even though the Western world manages to obscure its vulnerability by economic prowess. In wealthy nations, governments and individuals alike are driven by “an ethic of calculative rationality bent toward a distorted image of self-fulfillment, impervious to the responsibility of the common good on a global, and not only national scale.” 

“Human interdependence” as well as “common vulnerability,” the meditations continue, “calls for international cooperation as well, and the realization that a pandemic cannot be withstood without adequate medical infrastructure, accessible to everyone at the global level.” This requires the “sharing of information, the provision of help, the allocation of scarce resources, which all have to be addressed in a synergy of efforts.” Plus, for example, the US assisting Mexico in fighting the pandemic obviously benefits both nations.

The document calls for “a renewed appreciation of the existential reality of risk: all of us may succumb to the wounds of disease, the killing of wars, the overwhelming threats of disasters. In light of this, there emerge particular ethical and political responsibilities toward the vulnerability of individuals who are at greater risk for their health, their life, their dignity.” It’s a question of ethics: “To focus on the natural genesis of the pandemic, without heed to the economic, social, and political inequalities among countries in the world, is to miss the point about the conditions that make its spread faster and more difficult to address.”

That embrace of an “ethics of risk,” declares the document, means “we need to flesh out a concept of solidarity that extends beyond generic commitment to helping those who are suffering. A pandemic urge all of us to address and reshape structural dimensions of our global community that are oppressive and unjust, those that a faith understanding refers to as ‘structures of sin.’” In the end, “access to quality health care and essential medicines must be effectively recognized as a universal human right.”

“Ultimately, the moral, and not just strategic, meaning of solidarity is the real issue in the current predicament faced by the human family. Solidarity entails responsibility toward the other in need, itself grounded in the recognition that, as a human subject endowed with dignity, every person is an end in itself, not a mean. The articulation of solidarity as a principle of social ethics rests on the concrete reality of a personal presence in need, crying for recognition. Thus, the response required of us is not just a reaction based on sentimental notions of sympathy; it is the only adequate response to the dignity of the other summoning our attention, an ethical disposition premised on the rational apprehension of the intrinsic value of every human being.” Selfishness in all our affairs must make way for genuine altruism.

“If there is no awakening of consciousness,” said Archbishop Paglia, “we will just fix a few organizational problems, but everything will be like it used to be. Instead, we need to rethink our models of development and coexistence, so that they are increasingly worthy of the human community. And therefore, they must be appropriate for the vulnerable people, not beyond their limits, as if they did not exist; within those limits, in fact, there are men, women, and children who deserve better care. All of them, not just ours.”

The archbishop ended his remarks on an optimistic note: “from the ‘dry run’ of this pandemic, we expect a burst of pride from the humana communitas. It can make it if it wants to.”

To read the full text of the meditations, please click here.

A Single Race

These days, the people of the United States continue their march amidst the headlines, the tension, and the protests surrounding the murder by asphyxiation —as determined by the autopsy— of George Floyd, an African-American man, at the hands of four police officers led by Derek Chauvin. This tragedy has even overshadowed news of the COVID-19 pandemic, which has already infected and killed thousands of people across this nation.

The life of one human being is invaluable, and the lives of many human beings, even more so. Therefore, why, suddenly, on the national scene, has the death of one person become more critical and more newsworthy than the death of thousands? It is because the passing of George Floyd painfully revives, in the hearts of the people of the United States, the atrocious ghost of racism: a plague and terrible pandemic that has accompanied— from its origins—the history of this country.

Yes. Sadly, painfully, throughout the trajectory of our national events, we have had to live with the social and moral plague of discrimination and racial inequality. It is true that the US Constitution abolished slavery. It is also true that, during the presidency of Lyndon B. Johnson in 1964, the so-called Civil Rights Act was signed and enacted, and that there are many gains and achievements that citizens of so-called minority groups have accomplished in this nation. And yet, living side by side with legal and constitutional formalities, it is no less true that George Floyd's death reveals to us our shortcomings, our hypocrisies, and the flaws in our social fabric. It also calls attention to the work we all have left to do in building and achieving a truly democratic society, that is, one that is truly equitable, just, compassionate, and humane.

We abolished slavery, but racism—its worst byproduct—lays simmering. Nearly six decades after Martin Luther King's famous speech in Washington, George Floyd's death reveals the hypocritical coexistence of two nations within one: the billionaires and those with nothing, those living in luxury and those in the ghettos, those who have everything and every opportunity; and the many who lack even minimal political and social opportunities to live with dignity.

The vast majority of African-Americans, like the vast majority of other people from "minority" groups, live in this nation lacking the quality and dignity of elements that are essential to human life. These include education, housing, employment, and health. They also live subjected to permanent legal and police abuses, amid the injustice and inequality in the application of rights and opportunities, an injustice and inequality that segregates, discriminates, marginalizes, discards, tramples, crushes, that fills prisons and eventually kills.

This moral and social plague of racism is, to our misfortune, an almost institutional, systemic, systematic, and endemic structural issue in our lives in the United States. That is to say: it is a matter rooted and injected into the core of this nation. Racism works and manifests itself, sometimes subtly, other times shamelessly and savagely, in our mental structures, in our daily interrelationships, in our educational system, in the configuration and landscape of our urban planning, in our legislation, etc.

In this most recent case, four police officers, who should represent government protection for citizens, became a vile and brutal instrument against the life of an African-American man, until he was assassinated; thus becoming a page in the bloody and shameful history of racism in this country.

Consequently, the United States has lived for two weeks through public protests—occurring throughout the entire country and legitimately protected by the Constitution—objecting the murder of George Floyd. And, shamefully, President Trump's role, in this difficult and dangerous situation, as has been repeatedly pointed out in this and other occasions, has not been to unite the people, but has instead divided them and tried to play down the just claims of these public protests, labeling the protesters—among other words—as terrorists.

All this is more serious, given that these events are happening in the country that represents an example of political, economic, and social achievement, and that serves as a model for democracy for the world community of nations on this earth.

There were those who, hidden and camouflaged within, and infiltrating these legitimate protests, veered from their primary purpose, to object the death of George Floyd and racism. These people dedicated themselves to all sorts of outrageous acts committed against private property and businesses in the cities where the demonstrations occurred. These acts have two main implications and consequences: the abuse of a minority and vulnerable population, e.g., the majority of those protesting, which resulted, in a matter of hours, in the loss of property and businesses of many poor men and women which took many years of work, effort, and sacrifices to build. And, on the other hand, with these abusive behaviors, the miscreants are validating and justifying the discourse of racists in our society.

George Floyd's murder reminds us that we have failed, and we are failing as a society and that despite our accomplishments as a nation, we need to strive for something much bigger. At the same time, it shows us that we all must move forward together to create a country that is truly egalitarian, free, diverse, plural, just, united, reconciled, equitable, and democratic. Racial equality cannot be reduced to a "dream," to a paragraph in the Constitution, or to frustration or rage that sporadically manifests itself publicly. Racial equality must be a daily goal for everyone and must manifest itself in all our behaviors, attitudes, and relationships.

At the same time, it is encouraging that it is the young population that overwhelmingly took to the streets to protest. We can expect a better future from those who are taking charge of our national destiny. The resolution of all the demands given voice in the recent protests surrounding the death of Mr. Gregory Floyd will very much impact on the nation's immediate future, its progress, its inner well-being, and its role as the political leader of humanity.

Enough! Let Mr. Floyd's death not be in vain.  I invite you to continue dreaming with Martin Luther King that days will arrive when "the sons of former slaves and the sons of former slave owners will be able to sit together at the table of brotherhood" and live in a country where no one is judged "by the color of their skin but by the content of their character" and that henceforth and forever, we only talk about a single race: the human race!

THE FIRST STEP… Beyond the Pandemic

Timidly, humans begin to look out toward the streets. The most terrible days of the fear, tribulation, anguish, and mourning wrought by the COVID-19 pandemic caused by the coronavirus appear to be behind us. As I write this article, the "official" global figures count almost 3.5 million people infected—suffering in the most absolute solitude, a million more who have recovered, and 250,000 who died alone, anonymous, without mourners or the rites of funerals.

All humanity has lived through an unusual and unprecedented situation of closing ourselves in, compulsory seclusion, confinement on a global level, quarantine, and social isolation—the most effective remedy to prevent contagion, to preserve and care for the invaluable gifts of health and life.

This is, without a doubt, the largest health crisis of our time, which overturned all our daily routines and "normality" and tore down all our certainties, security, and traditions. This crisis created a suspicion among us, shook our ideas of solidarity and brotherhood, and of being together, close to each other, and produced a still incalculable global economic slowdown, which is manifesting—first and foremost—in the terrifying number of unemployed people.

No one doubts that this pandemic is a milestone in the history of humanity and a turning point for our way of life, of being and living on this earth. During these days, we all wonder how to get back to what is being called the “new normal.” And although humanity has experienced earlier plagues and pandemics, this pandemic is the one during which we happen to be living. It is about this pandemic that I share here some brief reflections that, being realistic, positive, and hopeful, I hope to mitigate the exaggerated optimism that says that—following the pandemic—the world will be “new,” “distinct,” and radically “different” from what we have known, as if by some magic, the virus will turn us into better human beings and cast away the fatalistic pessimism of those proclaiming disaster, chaos, catastrophe, and death.

First of all, let me summarize—in addition to what I already mentioned above—other realizations and lessons that the pandemic leaves us. Suddenly, we are discovering the uselessness of the thousands of things that we had considered important and the usefulness of those that count: a life with meaning, with direction, with values… because the pandemic makes us confront the reality that nothing else matters when we do not have health or life.

Likewise, the pandemic teaches us that there is no economy or any other area of life in society if we do not have health and life, fundamental values of human existence. For the same reason, too, the pandemic suddenly and crudely revealed to us who is who in society. Who is socially useful and who is useless: because today a hospital’s stretcher-bearer or a restaurant’s delivery driver is more important to society than a soccer player, movie star, or a shoddy, chattering politician to whom we give such worship and platitudes. … Suddenly, health personnel and science professionals—to whom we give so little and no social recognition—were on the front lines of society in the fight against the pandemic.

We also learned about the planetary and ecumenical condition of human beings: that we are deeply and universally together in good and in evil. Quite literally, when someone sneezes in China, there is a fever at the other end of the earth. And, for the same reason, nothing that interests one human being can be alien to the rest of humanity or leave them indifferent. As Pope Francis has continually said, during these days, “no one is saved alone.” We all share the same “common house.”

We learned that although goodness and altruism have not disappeared and have manifested themselves these days in a thousand initiatives of solidarity with the most vulnerable in society, they coexist with the forms of unconsciousness, selfishness, corruption, and evil manifested these days, especially in the lack of cooperation and carelessness in not protecting others against infection, and in the theft of government aid meant for the poorest among us.

Politically speaking, if there was anything that exposed this health crisis, it was the insufficiency and shortcomings of the much-publicized "globalization" and of governmental institutions to face it. Society has tried to solve a global problem with local measures. Large cracks and structural flaws have been discovered within societies, exposing failures through which thousands of forms of structural inequity and injustice cannot go on.

We are also aware of a total absence of world leadership. The United States lost the opportunity to exercise it and those of us who dreamed of a new multilateral world order suddenly woke up, literally “distraught,” without a north, aimless, disoriented. ...

All this gives rise to the danger that—under the pretext of the pandemic— abusers in certain regimes and governments will, in turn, take advantage of collective fears to trample and violate human rights, and civil and individual liberties, by implementing—for example—emergency rule, curfews, states of emergency to legislate, greater police and military intervention to contain the population on the streets, etc. This is a danger that would, unfortunately, lead to new forms of autocracies, authoritarianism, populism, totalitarianism, dictatorships, protectionism, isolationism, nationalism, and xenophobia, which would revert achievements and successes we have already attained in societal life and our democracy.

Curiously and painfully too, society experienced this pandemic largely without the spiritual company of religious institutions. In societies already openly atheistic in relationships and social structures, each human being has had to solve alone—in personal and intimate confinement—the most distressing and fundamental questions about the meaning of life and the proximity of death and what lies beyond.

But this is not the end of human life on earth, nor can it be the end of trust, solidarity, and hope. This crisis must give us all a new and different attitude towards life and others. This crisis may represent an opportunity for the governments of the world to apply new paradigms in all fields of societal life: family, health, education, work, housing, public services, etc. ... This immeasurable crisis is a unique opportunity to adjust human and social values, to right the road. ... Now is not just for beating the virus, but also for overcoming our vain and arrogant failures—both human and global—that have been laid bare by the pandemic.

This crisis urges us all toward new forms of international cooperation and less harmful and healthier forms of globalized solidarity for all so that we can deal with present and future crises such as hunger, wars, climate change, etc. … all themes that involve the entire human family.

From the pandemic, we learn that the health-economy tradeoff is false. That, from now on, the public good requires that the economy be placed at the service of our collective health. ... How we solve and manage the lessons that this pandemic leaves us will depend—in large part—on the near-term future of humanity. The virus will not end economic inequality, nor will it end the animosity between leaders and the led. The virus will not miraculously work a mutation into the human spirit. Yes, from now on, fraternal solidarity, equal opportunities, honest work, and trust—without fear or anguish—in ourselves, in others, and in our institutions will save us.

May we have a vaccine soon! May the joy of life return! May the next pandemic be that of solidarity and fraternal love! “Light is the task where many share the toil,” said Homer. And “a journey of a thousand miles begins with the first step,” said Lao-Tse. Well ... Let's take the first step!

SOMOS INNOVATION—the post-DSRIP future

As our city, our state, our nation and our world are struggling with the coronavirus pandemic, I first of all want to express my gratitude and admiration for your work on the frontlines of caring for coronavirus victims and protecting New Yorkers across the board. May you and your staff stay safe—and know you have the support of the entire SOMOS organization.

As you know, the DSRIP program formally concluded on March 31, 2020. It is a great disappointment that federal and state authorities opted not to renew the program’s mandate despite DSRIP’s many achievements. However, SOMOS will continue it groundbreaking work on behalf of the city’s poorest patients through SOMOS INNOVATE. It’s with an eye on that new chapter that I have drafted these notes.

The following draws on the recommendations and observations found in a report produced by the Helgerson Solutions Group (HSG), which earlier this year completed a strategic audit of SOMOS, precisely to map out its post-DSRIP future. HSG’s founder and principal is Jason Helgerson, the former New York State Department of Health Medicaid director and visionary behind DSRIP. He and this team know the health-care landscape intimately. It is a landscape being radically transformed by the Value-Based Payment (VBP) model and SOMOS INNOVATE will be our doctors’ guide and advocate.

As such, the HSG report proclaims that SOMOS INNOVATE is “about more than just being a VBP innovator. … SOMOS has the potential to revolutionize health and social care … and being a light in the wilderness for physicians and physician groups around the country.” As pioneered by DSRIP, the VBP model, a move away from the traditional Medicaid  fee-for-service payment formula, allows networks of independent physicians to bypass hospital systems and “contract directly with insurers (or the government) and take control of the total health care dollar and the flexibility those payment models offer to revolutionize care.”  With SOMOS INNOVATE at their side, our doctors can continue “to rise up and take control of their own destiny.”

SOMOS INNOVATE will continue the transformation of health care for New York City’s most vulnerable patients by continuing to “institutionalize cultural competence, empower patients and address the true root causes of bad health and social outcomes.” The fact that so many of our doctors share the same cultural background as the people they serve makes for “an exceptional closeness to their patient base, something that is very hard to achieve and harder to replicate by other organizations.”

To strengthen its clout and grow our network of providers, SOMOS INNOVATE will aim to engage other IPAs. It will also put a premium on partnerships with Community-Based Organizations to address Social Determinants of Health, a critical component in providing patients with comprehensive, wholistic care. Such care has the power to improve “community happiness” by “fully embrac[ing] the health, social and economic needs of the community.” It’s a model of care that revolves around the neighborhood-based primary care physician as trusted community leader.

To stave off competition, SOMOS INNOVATE will consider establishing “creative partnerships” with hospitals which might otherwise make access to specialty care more difficult. It will also pursue VBP contracts with Managed Care Organizations that would welcome SOMOS INNOVATION as a hospital competitor.

SOMOS INNOVATION has been operational for some time and continues to implement a rapid development strategy. The SOMOS Board of Directors appointed 20-year health-care industry veteran Dan McCarthy as CEO of SOMOS INNOVATION. An expert in value-based care, Dan has spent the bulk of the past year building up the organization and putting in place his management team.

The time is now, says the HSG report: “SOMOS is on the right side of health-care history. After years of delay, the health-care world is finally starting up really embrace value. New York State and Medicare are continuing their push to get virtually all providers into the VBP arrangement.” The goal is to position SOMOS INNOVATION on the forefront of publicly funded health-care innovation, state-wide and even nationally.

Achieving that objective will be critical if SOMOS INNOVATION is to succeed in enabling its doctors to remain competitive in a time of rapid change and in the face of the potential challenge of the Big Four—Apple, Google, Amazon and Microsoft—entering the arena of “technological innovation that will revolutionize the provision of many health-care services over the next decade,” stresses HSG.

In the form of robotics and Artificial Intelligence, “technology may replace as much as 80 percent of what doctors currently do and SOMOS will need to stay ahead of that curve on their physicians’ behalf.” A premium must be put on building “productive partnerships between doctors and machines.” Increasingly sophisticated technology will free up doctors from “routine tasks so that they can re-focus their time and attention to supporting their patients psychologically and helping them understand—as well as act upon—their medical condition.” Surely, this increasingly intimate attention paid to patients will be essential for delivering optimal value-based care.

Among the technological tools of the future will be smartphone apps that allow for 24/7 monitoring of patients. There will be sharp growth in the kinds of “wearable technology, biometric sensors as well as apps,” all working in sync to create an “Internet of the body.” “Doctors in the future will prescribe apps” allowing for patients’ self-diagnosis. Overall, technology will drive a “long-term shift from managing sickness to preventing it.”

The report says that in future, doctors may well be “dispensing their advice through chatbots, instant messaging and video calls instead of sitting in an office with a line of patients to see them.” Noting that SOMOS doctors “already excel at some of the inter-relational aspects of the job by virtue of being in, and of, the community in which they serve,” they will need training in acquiring a “new basket of skills” “to make the pivot to a more interpretative and context-providing role on its own.”

HSG notes that telemedicine, remote patient care, will have a $130B market share by 2025; and “the healthcare artificial intelligence market is projected to reach $19B by 2026.” All that innovation means that “the future of medicine will be more precise, personalized, participatory and preventive. These attributes align perfectly with SOMOS’ existing values.”

Indeed, helping and training our doctors “plan and prepare for the technological disrup4tions of the future” will be a hallmark of SOMOS INNOVATION. It is part and parcel of its overall commitment to empower our providers to offer the best possible care to New York City’s most vulnerable patients, and to bring about lasting reform of publicly funded health-care delivery.