Her Majesty Queen Elizabeth II referred to 1992 as an “annus horribilis,” Latin for “horrible year.” Why? That was a year that three royal marriages dissolved, a fire destroyed much of Windsor Castle, and there were some tabloid scandals. With typical understatement, she said, “1992 is not a year on which I shall look back with undiluted pleasure.”
Frankly, that all seems like child’s play compared with what we’ve been through in 2020. Since the spring, we have had to face anxiety and uncertainty, hardships, and unprecedented challenges. The COVID-19 pandemic brought great pain and suffering to New York. The State has more than half a million confirmed cases and tens of thousands of New Yorkers have died. As if that weren’t enough, the pandemic took place against job losses, killings by police that sadden and anger us, a divisive political landscape, and destructive weather. If I were to channel Her Royal Majesty, I’d probably say, “2020 hasn’t been the best.”
We’ve probably all shared the same thought: when will things get better? I don’t have a crystal ball, but I believe they will. I believe better days are ahead. I believe in the resilience of New Yorkers who have yet to meet a challenge that we couldn’t rebound from. It’s become a December tradition for me to establish a wish list for the year ahead, and this year is no different. So here goes:
1. Care and a cure for COVID-19. Presumably, this tops everyone’s wish list for 2021: an end to the devastation of the pandemic. Over the last nine months, we’ve learned so much about the novel coronavirus and how to prevent transmission and treat symptoms. But with cases, hospitalizations, and deaths spiking this fall, we are again at risk of hospitals — and health care workers — being overwhelmed. Businesses, communities, and individuals are continuing to grapple with the economic consequences of the pandemic. I long for the New York that I know and love — particularly New York City, with its great restaurants, theaters, sports, cultural institutions, and street life that make it so celebrated — to return.
There is hope on the horizon: several vaccines are on track for emergency approval, with the possibility of widespread vaccination availability by summer. An enormous amount of work remains; challenges include implementing an equitable distribution of vaccines and ensuring that a large percentage of Americans actually take the vaccine once it’s available (a challenge given rampant misinformation about COVID-19 as well as vaccines more broadly). In the meantime, all of us have a responsibility to curtail the spread by taking commonsense precautions: wearing masks, washing our hands, and keeping our distance from those outside our own households.
2. Stable and affordable health coverage for all. This is a perennial wish list topic, largely because health insurance coverage has been under near-constant attack for the last 10 years. Last month, the Supreme Court heard oral arguments in yet another challenge to the Affordable Care Act (ACA), which has faced more than 1,700 lower court lawsuits and 70 attempts at congressional repeal. Most experts agree that the Supreme Court will issue a decision in the first half of 2021 to uphold the ACA, which is good news. Without it, 3.2 million New Yorkers — including 2.1 million people on Medicaid — would lose their coverage. As I wrote in a blog post last month, New York State has long been a leader in health insurance coverage and it’s positioned to do a better job than most states at protecting its residents’ health if the ACA does fall. But without the ACA’s federal subsidies, it would be tough for New York or any state to maintain affordable coverage at current levels, which would be particularly disastrous during the pandemic.
3. Nourishing food for everyone. Food is one of our most basic needs, but 2.3 million New Yorkers lack food security. The COVID-19 pandemic has made the problem even more dire. We have all heard tragic stories and seen photos of food pantry lines stretching for blocks and miles over the past year. The numbers are troubling: from April through June 2020, approximately 1 in 10 New Yorkers reported household food scarcity in the prior week. And racial and ethnic disparities persist; during the pandemic, Black and Hispanic households in New York State experienced food scarcity at rates three to four times higher than white New Yorkers. The pandemic also upended the food system and food labor force in many regions of the State, exposing frailties that threaten to widen deep-seated inequities.
There are some bright spots. It is likely that the incoming Biden administration will rescind Trump-era rules intended to restrict access to benefits like the Supplemental Nutrition Assistance Program (SNAP) and to weaken school nutrition standards. The pandemic has also sparked innovations and additional public funding to support healthy food access and restore food security. These innovations and changes present an opportunity to work toward healthier, more equitable systems. And I’m proud that, beginning in 2021, the New York State Health Foundation is launching a new program area — called Healthy Food, Healthy Lives — that will advance policies and programs that connect New Yorkers with the food they need to thrive.
4. Justice for veterans. This is a wish that was on my list for 2018. And 2019. And 2020. But I won’t let go of it until it comes true, and I believe that 2021 is the year it will finally happen: a high-quality Veterans Treatment Court (VTC) for every New Yorker who needs one. VTCs provide treatment rather than incarceration for veterans who have been charged with low-level offenses and who struggle with mental health and substance use issues. First established in Buffalo, VTCs have now been implemented across the country. And they’re effective; research has found that VTCs are associated with improvements related to recidivism, alcohol and substance use, mental health, housing, employment, and interpersonal relationships. Today, a veteran’s access to a VTC in New York State depends on geography: if your county doesn’t have a VTC, it’s not an option for you. But a simple transfer policy would allow veterans to go through a VTC in a neighboring county.
Such a policy has broad support among judges, prosecutors, law enforcement, State officials, and veterans themselves — and it wouldn’t cost a penny to implement it. Bills have been proposed in both houses of the New York State legislature and Governor Cuomo has expressed support for expanded access to VTCs, but nothing has yet made it over the finish line. Particularly with increases in mental health needs and substance use issues among veterans, as well as the desire to keep people out of crowded jails during the pandemic, the time is right for New York to implement a transfer policy that would allow universal access to Veterans Treatment Courts.
That’s a lot to wish for. Yet, I’m not quite done: I also wish for a new and improved future. The principle of “Build Back Better” is generally understood to use disasters as triggers to create more resilient societies than before. As much as we all want to get back to normal, we don’t have to go back to exactly the way everything was before COVID-19 — because that wasn’t good enough. We can aim higher: preserving what works, discarding what doesn’t, spreading opportunity more broadly and equitably. 2020 has changed us, unalterably and maybe in ways we don’t even yet understand. Better days are coming; it’s up to us to decide how they will look.
Most of all, I wish health and peace to you and your families in the days ahead.
By David Sandman, President and CEO, New York State Health Foundation
Published in Medium on December 7, 2020