Immigration Reform Now!

We all recognize the images in recent news. Buses transport people to discard and abandon them in some “sanctuary” city or anywhere else, relegated to the whims of leaders, in Florida or Texas for example, as if they are dealing with cattle, viciously, mockingly and with contempt for the most rudimentary human rights and to satisfy partisan whims – as if they were playing some disgusting, macabre game. The news and the images leave us somewhere between perplexed and indignant and show us the serious, shameful deterioration and moral and social degradation that the political management of the immigrant situation has in this nation.

This is a nation that presents itself to the world as a model of democracy and respect for human rights, without considering the enormous suffering that takes place in a thousand different ways on long journeys and that awaits all who want to achieve “the American dream.”

In our world and times, human immigration is culminating into an unsuspected drama and the human tragedies (separation of families, diseases, violence, displacement, hunger, death, etc.) this causes fall beyond the control of governments and nations. This results in a Dantesque and catastrophic situation, with thousands of human lives in subhuman conditions, and speaks very poorly of our human spirit while we boast of our times of globalization and scientific and technological advances.

Material progress is of little use if we do not advance or, worse, we regress in humanization, solidarity, and justice. All this speaks ill of our degree of civilization and the search for the common good—and not for individual and corrupt interests—that must guide us. This also speaks ill of our leaders here and in the countries from which these migrants come.

Since the most recent IMMIGRATION REFORM, we have been hearing for decades in this nation about the urgency of this issue. Unfortunately, today’s politicians manipulate, politicize, and exploit the issue of Immigration Reform, not for the desire to do justice and seek humanity, but with the electoral interest of one side or the other.

Each political party blames the other in this petty and perverse electoral game; they change the subject; they block it indefinitely. They leave important issues unresolved, causing suffering and uncertainty for the millions of people who—already within our borders and residing here for many years—seek to legalize and normalize their status as citizens in this nation, with all the duties and rights that this entails, so they can stop living in fear, ostracism, in the shadows and at the mercy of so many of those who abuse human and civil rights. These abusers find in undocumented immigrants the opportunity to pay cheaply for labor, exploit labor and persecute those who do not submit to their violence and injustices.

But there are interests that must rank above partisan, demagogic and electoral interests that we must reclaim and prioritize to resolve stalled and urgent immigration reform. These issues include the recognition of human and civil rights, the recognition of the valuable cultural contributions and work that immigrants have contributed in the construction of the development and progress of this great nation, the right to a dignified life and homeland and the need for the stability of this nation to be based on respect for the human being and values such as equity, justice, social peace and respect for life.

 Through humanitarian actions and other contributions, social organizations and churches, among others, seek to relieve this pain and reduce the human drama of migrants inside and, awaiting entry, outside our borders. At SOMOS Community Care, a medical organization where I serve as CEO, for example, we offer medical care needed by newly arrived migrants to our city of New York.

But these are all “first-aid bandages” that do not solve the root of the problem and that—perhaps—achieve the opposite, unwanted effect: that of prolonging the nightmare suffered by millions of our brothers and sisters.

The solution to this serious, complex human problem lies with legislators. Enough of postponing a strong, definitive legal solution for undocumented migrants in our nation! Those who have taken up the task of legislating for the common good must find their political will and determination!

We must remember that this resolution also involves joint work with the governments of the countries from where these migrant majorities originate. These governments—almost always—shoulder blame for this multitudinous exodus, through administrative corruption that impoverishes and creates all kinds of social inequalities, injustices and violence that force so many to leave everything they have and have earned to seek better living conditions.

In the United States, within our communities, our political, social and religious leaders must solve this enormous human, social and international problem, and it occurs to me, right now, that this includes, especially, Hispanic community leaders. IMMIGRATION REFORM as a political and legal action requires commitment, organization, the unification of all forces and demonstrations as an instrument of social pressure before our lawmakers.

Our present-day migratory phenomenon differs from that of decades ago. Humanity and its history are dynamic and ever-changing. Therefore, the IMMIGRATION REFORM that we need right now must consider today’s new realities and cultural and social changes.

When a human being suffers, humanity suffers. So, no one is without blame or disconnected from the phenomenon of migration and its sufferings. We all bear responsibility, and we can and must do our best, invest our best efforts, to find a definitive legal solution that will restore the right to a dignified life and hope for a better tomorrow to millions of men and women who need and deserve it.

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Quality Care for the Underserved: The Story of SOMOS

At the heart of the success of a unique network of 2,500 independent physicians serving one million of New York City's most vulnerable Medicaid patients lies the conviction that medicine is more than a diagnosis, treatment, or cure. Instead, the medical profession is called to integrate a humanistic element that faith, life experience, or drive shapes in every doctor, and that is decisive in how physicians ply this ancient trade of seeking to prevent illness and heal the sick.

Before creating the physician's network, SOMOS Community Care, SOMOS Chairman and Founder Dr. Ramon Tallaj, an immigrant from the Dominican Republic, learned that independent doctors were isolated. They occasionally crossed paths, but in their private practices, they were exposed to a system that increasingly devoured them in every sphere: pressure from insurance companies, competition with hospitals, and the demands of government bureaucracy.

Dr. Tallaj set out to unite doctors, inviting them to join the Corinthian Medical Group, a precursor of SOMOS. Working together, they were able to benefit from respective individual experiences and unite as a collective in negotiating with insurers and providers. Joining CMG proved to be a significant step toward the progress and stability of doctors' practices.

In August 2014, SOMOS began participating in the application for the DSRIP or Delivery System Reform Incentive Payment (DSRIP) program, an initiative launched by former New York Governor Andrew Cuomo to significantly reduce Medicaid expenses and reform the reigning healthcare model as much as possible.

DSRIP embraced a noble purpose, seeking to improve medical care for those most in need. But from its inception, the hospitals tried to set the tone and prevent a network of independent doctors such as SOMOS – not affiliated with a hospital system and with many of its doctors living in the same neighborhoods as their patients – from being included among the 25 medical service provider systems that would be approved to join the initiative. Hospital systems were very interested in removing SOMOS from New York City's medical landscape. Vested interests put up major roadblocks for SOMOS. But in the end, SOMOS became a Performing Provider System under DSRIP serving African Americans, Chinese Americans, and Hispanics, including many immigrants.

Still, SOMOS was not deemed reliable. Hence, a hospital was imposed upon the organization as a trustee, charged with monitoring SOMOS spending and approving organizational decisions. Happily for SOMOS, Montefiore Hospital was eventually engaged as a SOMOS trustee, leading to the creation of a robust and collaborative partnership.

For decades, the US healthcare system has focused on maintaining the status quo. Even when there were Hispanic leaders at the helm of hospital systems, health care was always dependent solely on hospitals. The United States has the best disease service in the world, but not the best health service that puts a premium on prevention. The underserved, elderly, immigrants, etc., have had to go to hospital emergency rooms even for a headache. And then, the astronomical bills come. All this has been known for years, but no one wanted to do anything. It was better to stay on the side of the big powerful groups than to risk a political career to benefit the neediest.

It should be noted that, under DSRIP, SOMOS was paid only for services rendered. The SOMOS Board closely managed its spending. Nothing is approved with the mere stroke of a pen, without prior consultations, discussion, and, above all, verification.

SOMOS booked notable success: by keeping patients out of the ER and hospital beds, it saved the federal government $48M a year for five straight years; New York State taxpayers saved more than $300M due to a 25 percent reduction in visits to the ER and hospitalizations; pilot programs enhanced the quality of the services rendered to patients; and SOMOS earned Innovator status in New York State, in recognition of its pioneering work featuring the Value-Based Payment formula, enhancing physicians' fees in accord with patients' longer-term health outcomes.

Key to SOMOS' success has been the cultivation of strong doctor-patient relationships. A major factor in this regard is the fact that many SOMOS doctors live and work in the same neighborhoods as their patients, with whom, in many cases, they share the same language and cultural background. Plus, aided by Community Health Workers, doctors get a sense of the social, family, and emotional circumstances of their patients' lives—the so-called Social Determinants of Health. For example, poverty may prevent families from consuming nutritious meals, which may cause obesity, or diabetes, along with attendant stress.

Unlike hospitals and the countless Urgent Care facilities, SOMOS doesn't wait for patients to show up at their doctor's door. Since the beginning of DSRIP, SOMOS has been developing extensive health education campaigns and distributing healthy eating models and plans. Working with invited personalities from the Latino world, it developed an app with exercise plans and nutritional suggestions. Health education is provided in medical offices, at community gatherings, in churches, and on the street.

SOMOS seeks out, talks to, teaches, and educates people so that they do not come to their doctor with perfectly preventable diseases. SOMOS sees the patient holistically, within a 360-degree viewing radius, considering many factors that other healthcare approaches do not consider. The highest moral principles inspire SOMOS staff and doctors in their pursuit of the common good. They are dedicated to the health and well-being of the people served by SOMOS.

The SOMOS difference between hospitals and the traditional health system lies in the formula of prevention before treatment. Our doctors are in the neighborhoods, immersed in the same life dynamic as many of their patients, whom they also know and have cared for generations. This intimate familiarity with patients' lives is key to preventive care. It is ironic that what was once traditional, the family or neighborhood doctor, is now revolutionary. This has its explanation in the stalemate that large hospital systems have created as the defining power of health care for years. Hospital systems, in general, evolved from healthcare facilities to interest groups and lobbyists that influence and determine health policies at the state and federal levels. This makes them key factors in a disease-based health system, but not a healthcare system that has the patient at the center of its vision and mission.

For these large systems established on the idea that the sicker people are, the better the economic results, it is a nuisance that a group of 2,000 independent doctors has acquired power and reputation with their work within the community. They are also concerned that they are losing money on emergency room visits because SOMOS doctors are treating hundreds of thousands of people, trying to keep them from getting chronically ill, or having to go to emergency rooms because they have no one to treat them. In the SOMOS vision, hospitals attend to only patients with the most urgent and prioritized needs.

The end of the first DSRIP mandate coincided with the onset of the COVID-19 pandemic. On this front, too, SOMOS took a course decidedly different than that of the healthcare establishment, which focused on hospitalization and the purchase of costly ventilators and other medical equipment. SOMOS focused on educating the community as to the importance of isolating people struck by the virus and protecting family members living together in close quarters. Here, too, the focus was on prevention rather than treatment of the disease. SOMOS fought hard every day so that our message of isolation and protection reached all communities. The strategy flew in the face of large institutions seeking to maintain the status quo of a disease system.

Our doctors took to the streets. SOMOS bought and set up tents in different neighborhoods to administer COVID-19 tests which SOMOS often bought with its own funds. SOMOS took to the radio stations, television stations, and the press with messages that people had to social-distance, and that they had to isolate the sick, especially from the elderly. Messages were delivered in English, Spanish, and Chinese. SOMOS educational campaigns were comprehensive and efficient. Eventually, SOMOS convinced authorities of the need for people to isolate themselves and of the importance of educational and outreach campaigns among those most in need.

When, after lengthy delays, SOMOS was mandated to distribute the COVID-19 vaccine, it did so at distribution points in the community, going to the people and facilitating access to the vaccine for the neediest. From the start of the pandemic, SOMOS also delivered food to the neighborhoods, working in tandem with major charitable organizations. SOMOS is yet to be reimbursed by the State for all its work and contributions in fighting the pandemic.

Dr. Tallaj, concluding a recent report on the history of SOMOS, put it thus: "My mission, and as such the mission of the network of doctors I lead, is to educate our community, our children, and our youth today; and treat them preventively, if possible, to prevent avoidable chronic diseases from conditioning their lives in the future."

"This has an economic benefit for the government as a beneficiary of health programs and for insurance companies. But the greatest benefit is for the person, the human being, who will be able to live and function well in our society. If we manage to see the role of the doctor like this, if we can convince politicians of the fundamental importance of the primary physician (general practitioner or family doctor) and of the need to allocate funds to those doctors so that the neighborhoods, regardless of the social class that resides in them, become conglomerates of healthy people, it will have been worth facing so many challenges... and to have kept fighting."

 

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The faith, or lack of it, of US Hispanics

Though it remains the faith to which most US Hispanics belong, it also is the faith that is losing more Latinos than any other religious group, with an increasing number of Hispanics identifying as religiously unaffiliated. These were some key findings of a Pew Research Center report released April 13. 

In 2010, 67 percent of Hispanics said they were Catholics. That figure has dropped significantly to 43 percent in 2022. That figure stood at 49 percent in 2018. Almost one-in-four US Hispanics are former Catholics. Of the 65 percent of Hispanics who said they were raised Catholic, 23 percent report that they no longer identify as Catholics. Some have joined another faith, becoming mostly Protestants, while many no longer belong to a Church. 

Protestants are the second largest faith group to which Hispanics belong, accounting for 21 percent of US Hispanics. Among Hispanics, 39 percent say religion is “very important.” Of Hispanic evangelicals, 73 percent say religion is very important, with 46 percent of Catholic Hispanics saying so. Among US Hispanic Catholics, 22 percent attend Church weekly or more often. Just 1 percent of religiously unaffiliated do so.

The share of Hispanics who identify as atheist, agnostic, or “nothing in particular” stands at 30 percent. That compares to 10 percent belonging to this category in 2010 and 18 percent in 2013. It should be noted that 29 percent of Hispanics who say they do not belong to any faith continue to pray at least weekly. Almost a quarter of all US Hispanics are former Catholics.

The abandonment of Catholicism is most pronounced among young people ages 18-29. Of this group, 49 percent identify as religiously unaffiliated. The 50-64 and 65-plus age groups are least likely to identify as unaffiliated, with respectively 20 percent and 18 percent claiming religiously unaffiliated status. Those are still significant numbers. 

Among foreign-born immigrant Hispanics, 52 percent belong to the Catholic Church, with 21 percent identifying as religiously unaffiliated. By contrast, 36 percent of US-born Hispanics say they are Catholic, while 39 percent say they are religiously unaffiliated. Language also plays a role, with 56 percent of Spanish-dominant individuals identifying as Catholic, compared with 32 percent of English-dominant saying they are Catholic. That figure stands at 42 percent of bilingual respondents.

The decline in the number of Hispanics embracing the Catholic faith—especially but not exclusively among young people—should give Hispanic Church leaders pause. It calls for innovative evangelization efforts that consider what is most important in people’s lives, which for many revolves around material success. Hispanics going to Mass and living a Catholic life can no longer be taken for granted.

It seems clear that the American way of life, predicated on entertainment and the acquisition of money and material goods, numbs Hispanics with respect to their Catholic roots and values. It leaves them empty in critical ways. People are working two or three jobs to keep up, which pushes reflection and spirituality to the sidelines. There is a sharp decline in the appreciation of the faith that has shaped and sustained the cultures of Latin America. For hundreds of years, the Church has played a vital role in US Hispanics’ countries or cultures of origin, while Catholicism is also the foundation of the formation of the human person.

For Church leaders, the task ahead is presenting Catholicism in a more dynamic form that drives home the historical and contemporary importance of the faith. Somehow, the Church must engage and convincingly challenge the dominant culture to present a viable alternative in a culture driven by materialism and the ambition to succeed. The Church can borrow a page from the evangelical playbook and its commitment to going out to the people rather than waiting for the people to come to the Church.

There also is a political and ideological battle that must be waged. Former Catholics, the Pew survey notes, cite the Church’s lack of LGBTQ inclusivity, the clergy sex abuse scandal, and the ban on women priests as key factors that prompted them to leave the Church. On this front, too, the Church must demonstrate sensitivity and sophistication to make a compelling case for its teachings.

Failing a concerted, creative effort on the part of the Church, the loss of Hispanic Catholics will continue apace, further undermining a faith that goes to the heart of the Hispanic community.

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Urgently Seeking "Passage"

The Hebrew word "pesah/pesaj" and the Spanish word "pascua" both mean "passage." With these words, we commemorate the "passage" of the people of the Old Testament across the Red Sea and their resulting liberation from slavery in Egypt as well as the "passage" of the first Christians to their "new" life, i.e., the transformation of their lives following the death of Jesus of Nazareth. This is a transformation and new life that they attribute to the Crucified One, to whom they now confess as the "Risen One," because this transformed their lives.

During these weeks, Catholics find ourselves celebrating the Easter season when we commemorate the Resurrection of Christ and our resurrection through Him, a resurrection that embodied, among the first disciples and must embody today in us—as I said—a "passage" to a different, transformed, and new life that seeks the construction of better existences, societies, histories and a better humanity. 

This inspires in me some reflections that I will share with you within these lines, through which I intend to compare the men, women, lifestyles, and society of our historical conjuncture against the "new man," as St. Paul calls him, stemming from his own conversion experience and detailed in his theological explanation of the paschal event.

I do not shrink from my position as a believer in Christ, but I understand that the truths and criteria of the Gospel have universal validity insofar as they coincide with the deepest and most genuine values engraved in the heart and human nature of every man and woman, believer, or non-believer. These are values that every human being expresses as tendencies. They are: life, goodness, truth, love, solidarity, justice, peace, etc.

Jesus of Nazareth lived and taught these values, which constitute the criteria and logic of the Gospel and contrast against the logic of our world. These are the values that are constituted in the "renewed mentality" of the "new" man and that we see in the ways that those who are new and good live and work. 

It falls to us to live in this global culture and time, in this transition from modernity to postmodernity, characterized by principles and values that contradict the human and universal values mentioned above.

Ours is a historical juncture characterized—following two world wars and countless failures—by the meaninglessness of history, a history with no future, a funeral of hope. We live immersed in a consumerist culture and society where everything can be negotiable, fashion determines moral behavior, and the abundance of material things is the reason for living. 

This generates materialistic societies and standards of living where "having" prevails over "being," in an immanentism and reluctance to place oneself higher, to transcend. 

Apathy for the greater good and our society as a whole characterizes this "light" man, culture, and society because it is within this individual, personal and private "sanctuary" that happiness occurs. This leads—where universal truths and certainties are lacking—to a "moral relativism," subjectivism, sentimentality, moral permissiveness, and laxity. 

In a world where each person constructs "à la carte" their own half-truths of consumption through mediocre life projects, where "truth is defined by what is convenient for each individual person" and in which the happiness, enjoyment, and pleasure of the immediate, here and now, are imposed as the norm and measure of life.

Our societies are naïve. They are lacking in hard work and sacrifices. They are lightweight, with lifestyles imbued with facilitation, and surrounded by the disposable, superficial, and banal, by façades and appearances, exteriority, and the disengaged.

Confronted by this panorama, our society and world urgently need models of humanity who pursue well-being and happiness by following the principles of the Beatitudes, taught by the master of Nazareth, and eschewing our culture's siren songs that have been built upon the shifting sands of worldly vanities.

We have grown tired of clay-footed models elevated by "light" advertising. We need men and women who are role models, witnesses and examples of authority and truth, who model coherence in life, their words and deeds, and their professional titles and lifestyles.

Today's world urgently needs rulers, religious leaders, parents, teachers, and professionals in all fields who have moral authority and live lives worthy of being followed and replicated.

We are fed up with social leaders in all fields, who do not "lead by example." We have grown tired of social authorities and dishonest professionals who live public and private lifestyles that disregard the noblest values that should guide every human being and moderately healthy society.

Our society and all humanity urgently need "new" women and men, authentic and capable of building, through their deeds, words, and attitudes, new paths that enable "new" societies, i.e., just, solidary, fraternal societies, in which we can hope for better times.

Those who—foolishly, ostentatiously, and boastfully—dedicate themselves to "losing themselves" in the "craziness of life," in the traffic of this frivolous, superficial and materialistic world, the banal and light world of brands and labels, the hedonistic and pansexualist world, a world of comforts, luxuries, waste and bacchanals, proceed through life confusing immediate success with happiness. They attack fundamental human values, but they—also—insensibly turn their lifestyles into an impudence, a shame, and an affront to a world plagued by needs and the needy, by hunger, inequities, fratricidal wars, violence, injustices that cry out to heaven, etc.

"To whom more is given, more is demanded." Our society urgently needs leaders in all fields and professionals in all branches of knowledge who lead consistent, adequate lives and conform to the exercise of our social roles. They must lead exemplary and integral lives and not the double lives and double standards that today, in this world of moral relativism, are so celebrated and applauded.

I invite us all to ask ourselves about the coherence between our deeds and words, between what we believe and what we live, to ask ourselves about the coherence between our private lives and the public exercise of our professions, about the coherence between the lives we live and the society and the world for which we yearn.

I invite everyone to live life as an everlasting "Pascua," or journey, a daily and permanent "passage" to be better human beings and professionals who seek the construction of a better society and a "new" world.

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Easter Forever

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Our Holy Week, Every Day

 

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Ten Years of Good Shepherding

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