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Op-Ed By Tiffany Cabán: New York City’s Healthcare System Must Be Proactive, Not Reactive

Tiffany Caban (Photo: CabanForQueens)

Feb. 6, 2021 By: Tiffany Cabán

New York City is facing an unconscionable health crisis.

Twenty hospitals have closed over the last decade, most of them safety net institutions here in Queens that serve the un- or underinsured. Meanwhile, the City spends $12 billion more on incarceration and policing, than it does on care and supportive services.

But numbers cannot even begin to convey the devastating degree to which our health system fails us. That three by six-foot hospital mattress that is needed and managed and visited by so many people over a single day, becomes something much bigger: it captures all matters public and private, of dignity and disgrace, for this generation and the next.

Right now, thousands of people are left on their own to deal with the COVID-19 pandemic and the economic disaster it has caused. If you have a bad back and your kitchen light goes out – tough. If you fall while trying to replace the bulb, and you’re un- or underinsured – tough.

This tough-on-care mindset is the same one that pervades thinking across our government. It leaves people suffering and isolated. It causes a collective hopelessness and despair.

We need a proactive healthcare approach that aims to meet the needs of everyone – from the chronically ill to the healthiest individuals. The reactive approach we currently rely on in healthcare has led to inequities in all of our institutions.

This system has driven mass incarceration and disproportionately impacted Black and brown communities. Those disparities were abundantly clear when COVID-19 hit New York City. At a time when a pandemic has exacerbated every existing social inequity, it’s time for a paradigm shift.

We have to remember: What happens to one of us happens to all of us. Where you live shouldn’t determine whether you live.

In this unprecedented moment, we must make an unprecedented movement toward justice.

As we roll out vaccines as rapidly as possible, we must also take specific steps to build a more resilient city. That means taking steps to both build out the number of hospitals and beds that we have, while also setting up neighborhood-level comprehensive healthcare services, which include mental healthcare and peer support.

We need to create more capacity and to build infrastructure to adopt a proactive healthcare approach.

We need community safety centers with local clinics that include healthcare responders, de-escalation experts, peer support, holistic services, civilian crisis teams and trained door-to-door support providers hired from local communities, all backed by universal health insurance coverage.

We need integrated service facilities in every neighborhood that offer communities quality and accessible care including substance use treatment and overdose prevention programs as well as comprehensive legal support, including when healthcare issues arise.

We need a vaccine program that reaches the places most impacted by COVID-19. Vaccines only work if they can reach people and if people agree to get them. Rapid vaccination programs staffed by people from our communities with full accessibility and language justice that identifies and proactively reaches out to every person living in our city in order to maximize our vaccinated population is essential to creating public awareness and demand.

The rollout of COVID-19 vaccines and therapeutics should strengthen the broader healthcare system – not strain it. Community networks need to be prepared to fully administer and utilize COVID-19 vaccines, therapeutics and other essential tools to stop the spread of this virus.

We can do this. We can take those steps. We can build those systems.

A community leader at Astoria Houses recently told me, “We say it takes a village to raise a child – but who is taking care of and uplifting the village?” That is the role of government in our society, and it’s time for our government to step up and take care of our village, so we can take care of our people.

A care-based economy would fully fund good-paying union jobs for people from communities to take care of each other. It would mean people could be paid to go door-to-door to address daily healthcare-related needs, from chores that are physically harder for some people based on circumstances, to preventative routines like healthy food provision and wellness checks.

This isn’t a wishful framework. This is based on what is working already, and can be a reality right here.

It would mean that everyone has access to the healthcare they need – including mental health. These essential services should no longer be a privilege or a luxury.

It would mean a more resilient healthcare system, more capable of meeting the systemic shocks that this century might bring, and more prepared to prevent harm.

It would mean an economy rooted in caring for one another, where success is conditioned in the opportunity, stability and well-being of the most vulnerable among us.

It would mean we, the people, getting the system we deserve.

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This article is written by someone who wants you to believe in something. That doesn’t solve our problems.

The author quickly writes that spending money on police, or incarcerated criminals, means less money for healthcare. That’s not true, and budgets for each service have evolved over time in response to different needs.

Even if we moved every dollar from policing and jails to health care, what would we spend it on? Creating capacity, or building out beds is mentioned a few times. But thankfully, we never ran out of hospital beds—even during the worst of COVID. Queens has low hospital capacity because having extra beds for no reason is expensive. Emergency actions during the pandemic worked to accommodate the temporary surge in demand.

But maybe that isn’t the proactive healthcare approach the author wants. So, what is it?

Apparently, a vision of community driven wellspring. Each and every community filled with healthcare workers, nonprofit groups, civilians, and more—with arms locked, caring for one another. And they’re all specialized and unionized. And universal health care, too (don’t ask how we achieve that—just close your eyes, and picture the community in your mind).

Of course there are unprecedented challenges facing New Yorkers. After reading this article, it’s hard to imagine Tiffany Cabán can actually handle those challenges.

Paul Kersey

What is the love affair with this person? She wants to spend money that doesn’t exist on some fairy tale concept. The city is flat broke, people are leaving in droves, crime is out of control, homelessness is growing in leaps and bounds and she wants some 1950s leave it to Beaver crap. Add in some buzzwords to get the rabid liberals in lockstep and somehow what she says matters?

You have choices

If you are a registered Democrat, Leo Bullaro is the only candidate that deserves your vote. Everyone else running has identical policies to Caban without the popular appeal. We have a good alternative, time for reasonable people to rally behind him and get us back to focusing on a clean, safe neighborhood where we can raise our families and care for our seniors.


What we need is a national healthcare system. Universal coverage, single payer. No insurance companies as middlemen that both restrict care and take a cut-driving up costs. We need a federal based regulation on the price of prescriptions. And yes, we must recognize that mental health care is medical care. Thank you, Ms. Caban, for starting a discussion on these issues.


NYC was thriving until the looney left took over. And this ones idea is to have some interconnected welfare state that’s financially unsustainable and unaccountable.


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