#klonis

By: Christina Klonis

The Affordable Care Act (ACA) has been highly contested since the bill’s origins in 2009. Congress has attempted to repeal the act over 70 times, and now yet again it is being brought to debate. The Supreme Court is currently discussing California v. Texas, which is mainly a debate over the mandate fee for not obtaining health insurance.

What does the ACA entail? 

The Affordable Care Act was proposed by the Obama administration, and has changed the United States healthcare system since. Its main goals are to expand the Medicaid program to cover adults in every state under 138% of the poverty level, support medical care delivery methods, and increase the availability of affordable health insurance, using methods like subsidies for lower income families. You can access it in its entirety here.

What does this mean for NY? 

New Yorkers have implemented and benefited greatly from the ACA. As of 2019, the state was at the lowest recorded uninsured rate, with over 95% of New Yorkers being insured. The prospect of the ACA being striked down is very dangerous to the empire state. It is estimated that 3.2 million New Yorkers would lose their insurance coverage, and the state would lose about $10 million of federal funding. The Essential Plan in New York State, which offers a $20 per month plan to cover essentials, would also be put to an end. After the first wave of COVID-19 in the US, the ACA has proved to be more essential than ever. With a large number of workers losing their jobs, and 57% of New Yorkers having employer based coverage, it is vital that there are plans to cover these patients.

What changes could we see? 

President-elect Biden has promised to expand and protect the ACA, and introduce a public healthcare option. Biden also wants to lower the age minimum for Medicare, and increase federal subsidies to help more afford private insurance. His goal seems to be to include a well priced, quality option for everyone. This is a great goal, but has one major flaw that we currently see in our system; it excludes undocumented immigrants, who may occupy about half of the uninsured population in New York. Most of the time, undocument immigrants cannot participate in programs like Medicaid, and are often unable to purchase insurance due to exchanges set under the ACA. New York has made progress in this, allowing Medicaid eligibility through Deferred Action for Childhood Arrivals (DACA), but there is still a long way to go. 

What’s the consensus? 

This case probably won’t be decided for about another year, but after oral arguments in the Supreme Court on November 10, 2020, it was predicted that the ACA will prevail. Legal scholars say although there is a chance they will deem the mandate that everyone must have health insurance unconstitutional, the courts would like to resolve the ACA as constitutional and end debates once and for all.

Sources:

https://medium.com/@davidsandman/what-saving-the-aca-could-mean-for-new-york-e258213b109

https://nyshealthfoundation.org/2016/05/23/the-american-dream-of-health-insurance-coverage/

https://www.ehealthinsurance.com/resources/affordable-care-act/history-timeline-affordable-care-act-aca

By: Christina Klonis

Early stage detection of breast cancer is vital. When diagnosed in an early stage, a woman has a 93% higher survival rate within the first five years. Late stage diagnoses are often due to a lack of screening, and the recent COVID-19 pandemic has been a leading cause of that. From March to June this year, about 285,000 breast cancer screenings were missed. This large decrease in screenings can have extremely detrimental effects to the patients and their survival, and it sets up the future for uncharted waters in breast care.

Many states hit hardest by the pandemic, especially New York, enforced strict lockdown policies during the peak. Since people were advised to stay home, many could not make it to routine screenings. In addition, the CDC had advised healthcare systems to delay and postpone elective care, which includes screenings, surgeries, and other treatments, in order to prioritize COVID-19 care. Screening rates dropped by 90% in March. Even by June, the rates were still down by about a third. Missed screenings will lead to later stage diagnoses, which significantly decreases chances of survival.

The pandemic made it difficult for women to access screenings, and the consequences are even stronger for uninsured women. The population we serve at BTTF is the most vulnerable to the pandemic. 

In addition, uninsured women generally don’t have access to regular screenings, which puts them at a higher risk of developing breast cancer and having it go unnoticed until later stages. Director of the National Cancer Institute Norman Sharpless, MD, predicts that this setback will result in upwards of 10,000 additional deaths due to breast and colorectal cancer. Other researchers predict that the US will have 33,890 additional deaths. These predictions are very unsettling, and it is important that steps be taken to try and mitigate the damage that has been done.

Screening centers are taking serious precautions to be able to see as many patients as safely possible. Some of these precautions include required mask usage, limited capacity, and temperature checks, although it depends from center to center. 

Conducting breast self-exams is still important. As always, you can find more information here. 

It is important to continue to attend routine screenings if you can. Despite the new risks of COVID-19, the risks for breast cancer haven't lessened.

Sources:

https://www.cancerhealth.com/article/covid19-leads-drop-cancer-diagnoses

By: Christina Klonis

When a nation undergoes collective trauma, reform inevitably emerges. After the Great Depression, President FDR’s New Deal policies provided relief, reform, and recovery for the country, and some of those policies are still in place today, like Social Security. After the tragic events of 9/11, national security and surveillance experienced a great increase. It is unavoidable that there will be changes in the healthcare world due to the COVID-19 pandemic. 

This pandemic has highlighted many flaws in our healthcare system. People without health insurance, which is the population that BTTF serves, are disproportionately affected by COVID-19. Those without health insurance are more likely to be low-income, and they fall victim to medical costs. This population is also most likely to be exposed to the virus, because many low paying jobs are deemed essential. 

Because this dangerous virus spreads so quickly, testing and treatment are necessary to try to contain the spread. Many without primary care providers feel they have nowhere to go for testing or regular medical help at this time. Other countries that have dealt with COVID-19 more efficiently than the United States tend to have something that we do not--a universal healthcare coverage system.

The pandemic has already changed the ways people access healthcare. The LA Times reported that physicians have said that their patient visits have dropped up to 75%. This decline is leading to economic strain on practices. Medicare has begun to provide advance payments to some medical providers. Still, some primary care providers may go out of business.

Telehealth, a fairly new practice of providing health services through online communication, has gained popularity, and is redesigning the way patients are met. This is a good way for patients to stay connected with doctors to track their ailments. On the other hand, this threatens the current popular pay-for-service system, in which payment is dependent on quantity of care. Some physicians have been reluctant to use telehealth because it is less profitable, but after this pandemic, this may be the path taken. Since the virus has highlighted that a stronger primary care system is necessary to try to keep patients healthy and out of the currently crowded hospitals, the next steps are crucial in helping our system. 

Although it is a large jump, a universal healthcare system may be something the country will finally consider after this pandemic. COVID-19 has brought to greater attention that uninsured populations are very susceptible to large hospital and healthcare bills, making many hesitant to get the necessary help to keep them and their communities safe and healthy. 

  For years,

Tears rolled down 

the curvature of my cheeks

out from under the sheath 

hiding my identity

substituted by jewels

  Papier-mâché,

thick as cement

pasted to my bare skin

Painful, yet no emotion

seeps through those circles

crafted for my eyes

motionless

             The veracity of the object

weighed the elasticity 

that proved my youth,

created saggy pits 

beneath my eyes,

but no one knew.

       The cherry blossomed lips,

that I once owned

sealed. 

My thoughts, 

my voice 

muffled. 

Aesthetically, beautiful.

         The animal 

that inhabited my face

became parasitic 

to my life.

Feathers jut out

the corners of my eyes

annoyed, as if in attack mode

as a constant reminder 

of how weak I really was.

Crazed and dehumanized.

      Swirls of glitter,

slits of acrylic paint,

dazzling rhinestones, 

and any other decorative item

cannot surmise.

There will be no substitute

for the profundity of

my opinions

my thoughts,

my own comeliness.

I am fatigued from this masquerade

entrenched in the depths of hell.

I will no longer dance,

I will no longer be

oppressed as I diligently peel away