Queens Gazette

Letters To The Editor

SHAREing & CAREing

The following letter was received by the offices of the Queens Gazette: Dear Friends & Family:

I am happy to be writing this letter to you to promote SHAREing & CARE­ing’s Annual Benefit and Silent Auction at Russo’s On The Bay. This year’s Hon­orees are wonderful representatives in their respective communities, and we look forward to celebrating these incred­ible individuals:

– Ed Randall, Founder & Chief Ad­vocacy Officer, Fans for the Cure and WFAN/SiriusXM Radio Host

– Uff. Cav. Joseph V. Scelsa Ed.D., Founder and President, Italian American Museum

– Michael Serao, Executive VP and Chief Administrative Officer, First Cen­tral Savings Bank

– Rev. Msgr. David L. Cassata, NYPD Chaplin

– Rev. Msgr. Jamie J. Gigantiello, Pastor – Our Lady of Mount Carmel An­nunciation of the Blessed Virgin Mary

For those unfamiliar, SHAREing & CAREing is a cause near and dear to my heart. For over two decades I have served as President’s Counsel to the or­ganization helping to promote and grow its mission.

SHAREing & CAREing provides free bilingual supportive services to can­cer survivors and their families, partic­ularly those who are under or uninsured and who have the least resources of all.

I am seeking your support in order to reach our fund raising goals and ask that you please consider donating and at­tending this event through our many sponsorship opportunities.

You can register to attend, donate or purchase a sponsorship here on the SHAREing & CAREing website: bit.ly/sc2023benefit

This year’s Benefit and Silent Auc­tion will commemorate 29 years of SHAREing & CAREing’s service to the Queens Community and beyond, and as Master of Ceremonies of this wonderful event and proud supporter of this organ­ization, I hope you will join us at this spectacular event. My family and I look forward to seeing each one of you on October 19th at Russo’s On The Bay.

Sincerely Yours,
Joe Pistilli
President’s Counsel, SHAREing & CAREing
Executive Chairman of the Board, First Central Savings Bank

MTA Underestimates

To The Editor:

Some key information is missing from the MTA 2025 – 2044 Twenty Year Capital Needs Assessment Plan. It ap­pears that the estimated costs for over 20 potential enhancement and expansion projects would be about $85 billion based upon 2027 construction cost esti­mates. The problem is that this would be the third year of a 20-year horizon. Vir­tually all of these projects would need several years or more beyond 2027 to complete any environmental review, de­sign and engineering. Many might also involve property easements, business re­location, land acquisition and various utility relocations before being able to proceed into construction. These esti­mated costs based upon 2027 will easily grow by billions more over the 20-year time period.

There is also inflation, periodic re­cessions, potential supply chain issues, increasing fuel prices, rising material costs and labor shortages in specialized trades which will result in cost estimates going up over coming years, prior to award of any construction contracts for these potential projects.

There is no explanation for potential city, state or federal funding sources to pay for these projects.

There is no explanation as to which projects will follow the National Envi­ronmental Policy Act (NEPA) to pre­serve the ability to obtain federal funding.

The Federal Transit Administration’s Capital Investment Grant national com­petitive discretionary Core Capacity/System Expansion program, various formula and other national dis­cretionary competitive grant programs are possible funding sources.

There is no timetable as to which of the four upcoming Five Year Capital Program would include any of these in­dividual projects.

The MTA still needs to meet prom­ised previous commitments for trans­parency. This includes cost, budget, fund­ing source and milestones as part of fu­ture development of capital projects and programs.

The first priority for the MTA should be to reach and maintain a state of good repair. This includes every operating agency, including NYC Transit subway and bus, Staten Island Railway, Long Is­land Rail Road, and Metro-North Rail­road. Categories for each agency include such assets as existing bus, subway and commuter rail fleet, stations and eleva­tors to meet Americans with Disabilities Act, escalators, track including switches, signals and interlockings, communica­tions, line structures including painting, protective netting on elevated structures and bridges, line equipment including tunnel lighting, pump rooms and emer­gency exits, traction power, power sub­stations, maintenance shops, yards, employee facilities and supervisory vehi­cles than fund any system expansion projects.

Funding for $7.7 Second Avenue Sub­way Phase 2 and $5.5 billion Brooklyn/Queens Light Rail Connector would be better spent on reaching a state of good repair, safety, bringing most NYC subway stations into compliance with the Americans With Disabilities Act (ADA) and having open clean safe bath­rooms for longer hours.

Any survey of riders would tell you an overwhelming majority of 5-million-plus pre-COVID-19 customers would prefer on-time, safe, reliable services at a fair price before system expansion.

Larry Penner
Great Neck

Medical Crisis

To The Editor:

Linda Milazzo, one of my many neighbors, asked me to write about what she calls the medical crisis. She is distraught about the status of medical care and the challenges of accessing comprehensive, quality care that is local and affordable. She stated that she feels unsafe riding subways into Manhattan when she needs to see a specialist there, consequently, she pays the high cost of a cab instead. When I offered the suggestion of Access-A-Ride, she noted the lack of reliability that would simply add more stress to her situation. According to Linda, a roundtrip to Manhattan can cost as much as $100 when it is all said and done. She adds that she struggles to make sense out of the health care system, but relies on her fierce determination and independent use of what she calls her common sense to get what she needs. Even so, she wonders why the task of seeking medical care is being made so difficult.

She remembers a different time when you had a relationship with your doctor, not the billing department of a health insurance company. Linda, like so many of us, has experienced many losses, among them are the loss of doctors as a result of a variety of causes. To her, it feels like “everything is upside down” and she believes that the doctors are equally caught up in a tangled system that has drastically changed the mission and delivery system of health care.

Because of system-wide changes, some doctors don’t see a patient or perform treatment interventions until there is a problem that lingered long enough that a patient overcomes their fears about the cost, finally deciding to see a doctor. This decision meets with another challenge, namely, scheduling in the midst of delays. Prompt appointments are rare, and the anxiety about what will be covered by insurance further complicates this picture. Dental visits and eye care add another dimension to the medical crisis being faced by many. Also, with certain types of insurance, there are restrictions to what services and treatments are covered. If one doesn’t have a prescription plan, the challenges mount as patients are forced to pay out of pocket provided they have the means to utilize this option. Sometimes patients are held hostage to imposed demands even for life saving drugs. An obvious byproduct of this system is stress and anxiety, long waiting periods on the telephone trying to work through system errors and billing questions, as well as a debilitating sense that you are trapped in this system. In essence, medical care has become more like medical scare and Linda is sounding the alarm on behalf of countless others. She expressed her hope that by writing about this issue, something might change for the better.

I certainly can’t guarantee positive change or easily address the complex interplay between patients and health care companies, but I do have an older version of medical care that I dust off when I want to remember that the Hippocratic oath underscores the importance of “first do no harm.” Linda and I, as well as many of my other neighbors know what good care looks and feels like. Most times what we get doesn’t even come close because a growing number of physicians have, by necessity, been swept up in the business end of medicine. Fortunately, I have a great primary care physician whose father was also a doctor. That lineage carries a longstanding connection to the healing arts and patient-centered care. In contrast, I recall that I used to have a doctor many years ago who practiced medicine and was a lawyer, as well. He would interrupt our visits by taking calls related to his obvious preoccupation with covering two ends of the continuum of how we often view medicine, either as a money-making concern or a malpractice issue. He was clearly focused on self-interest and the profit-making aspect of both professions.

Here is where Linda has helped me to tease out what we recall from the traditional practice of medicine, compared to the 2023 version of dollar-focused care that has doctors’ offices calling up patients about their coverage or the lack thereof. Many good and bad doctors have retired and this thinning of the herd has created yet another part of the medical crisis. I wonder how the new doctors view their profession which, from our vantage point, looks like an assembly line industry.

Good, bad or indifferent there are countless people in need of help and the likelihood that they will get it is hampered by a lack of insurance, or because the insurance that they have makes lots of promises, but delivers very little provision for prevention and treatment.

A recent visit to the emergency room with another neighbor qualifies me to comment on what acute care in a reputable hospital looks like. Sadly, it resembled what one might find delivered by medics on a field of battle with the addition of a few meager amenities such as a blanket. My neighbor was seen briefly over roughly a five hour period by three different doctors who appeared not to have read the intake information. Overall, they were not terribly interested in what the patient had to say. The absence of active listening devalued the patient’s role in this exchange. Blood was taken, an IV inserted and at one point she was carted off for a series of tests without ample discussion about the context that supported these procedures. One can presume that most emergency rooms are extremely busy and that accounts for the brevity and haste, however, this does not excuse poor practice. After some time, I ventured out to ask the desk staff about a timeframe for test results and next steps. They seemed amused by my question and were dismissive. I suppose I should have known that this was a foolish thing to ask, but I saw it as an effort to lower the stress and anxiety that was surely brewing with my neighbor.

Stress is, in fact, a major cause of disease and needs to be taken seriously by all of us. When we had arrived, the patient advocate gave her a page indicating the things that he could be helpful with, then he walked over to his desk, stared at his computer screen until he finally left for the day without ever checking back. What initially appeared to be an effort to minimize patient stress became just another empty gesture. My observations of our health care system have sharpened my awareness that it is not the practice of medicine at all, and Linda was correct to label what we have as a medical crisis.

Locally, and I suspect, across the nation, people are getting sick and sicker as they struggle with the barriers to care, or seek to prevent or cure disease. According to a reputable source: “The United States ranks last overall (August 4, 2021) despite spending far more of its gross domestic product on health care. The U.S. ranks last on access to care, administrative efficiency, equity, and health care outcomes, but second on measures of care process.”

Another source reports (January 31, 2023): “The United States spends dramatically more on health care than other high-income nations but has the worst health outcomes on nearly every metric.” Before we attempt to make this a partisan issue, remember the efforts that were made to create a national health care system that was blocked, and finally rendered into the convoluted system that is the product of deals and compromises, not an honest effort to protect and safeguard the welfare of the people of our nation.

Follow the money and see how goodwill was handcuffed by greed and profit driven wealth building that made us hostages in a broken system of care. Even as a business model and not a health care system, how do you make money out of failure and poor performance? Linda is right: everything is upside down. We have more hospitals and clinics, drugs for everything, a food system that causes diseases of our bodies, eyes and teeth, but we don’t have health for all the money spent. Where is the money going that gives us that second place ranking on measures of care process? It is painful to admit that we are paying an inflated cost in health and lives lost from a failing system.

There was a time in the early 1960’s when a spark set off the war on poverty and the creation of targeted programs that included Medicaid, Medicare, Head Start and Food Stamps to address inequities experienced by the poor within a largely affluent American society. A colleague sent me a recent article that surveys the movement away from these types of social programs, and the evolving efforts that are creating holes in the safety net, placing most people at risk and putting them in survival mode. What I find interesting is that the “middle class” have joined the ranks of those in jeopardy because of health care coverage issues, cost increases, barriers to care and poor related outcomes. The picture that is coming into focus shows how the majority of Americans are being used and exploited while struggling to maintain health. Needless to say, it is not a good look for a powerful nation.

I do a lot of reflection. It takes me to the lessons I learn by paying attention to my experiences and listening to family, friends and neighbors. This week, I was doing a lot of walking with my husband because our car needs servicing. During one exceptionally long walk, I noticed a pain in my left heel, but I had to get home with a heavy cart after the bus failed to show up. I was irritated about the bus and more interested in getting home than pausing to investigate the source of the pain. I had walked many blocks at a high speed and the sharp pain persisted, but I just kept going. Just as I reached the parking lot behind the entrance to my building, I finally stopped and took off my shoe to find that the nail from a tap on my shoe’s heel had penetrated the bottom of my shoe. I was walking with a nail in my foot. My point is that we can endure a lot and keep going, but at some point we have to stop and check out what is causing the pain. I and mine are ready to take the nail out. If you are ready too, find a way to address poor quality health care and the health care process. Vote for a positive change. Speak out about discriminatory treatment within the health care system and call or write to the U.S. Department of Health and Human Services (26 Federal Plaza, Suite 4114, New York, NY 10278/212-264-4600), the State Medical Licensing Board, or the American Medical Association when you receive poor medical care at a hospital. If you have a problem with Medicare, call 800-MEDICARE; TTY users can call 1-877-468-2048, and hold them accountable to their mission to enhance “the health and well-being of all Americans.”

Dr. Sharon M. Cadiz
Long Island City
To read the full letter, visit qgazette.com.

Honoring Columbus

To The Editor:

I’m Grand Knight of St. Anastasia Knights of Columbus Council #5911, in Douglaston. We support the fact that Christopher Columbus, with his faults like the rest of the human race, opened up a new world with many possibilities, which includes freedom for all. That also includes freedom of religion for the many. This is one of many reasons we took on his name. Since 1882 the order was founded by the Blessed Father Michael J. McGivney, a Catholic Priest. The organization I belong to was created to help the incoming immigrants and the poor. That is why I say I praise Christo­pher Columbus for all he tried to accom­plish for the good of the many.

Frederick Robert Bedell Jr.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.