Breast Treatment Task Force

Breast Treatment Task Force (BTTF) facilitates free breast screening, diagnostic follow-up, and treatment for patients without access to health insurance. BTTF began in December 2006 with the organization’s founding medical partner, Bellevue Hospital, and has then expanded to Woodhull Hospital, Union Square Imaging Center, Flushing Imaging Center, and Bay Ridge Medical Imaging in 2009 and 2010. Since its inception in December 2006, BTTF has facilitated more than $16 million in medical care for hundreds of uninsured patients. Join BTTF in providing free medical help to uninsured patients here.

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Patient Interview with Rachel

By Francesca D’Ovidio

What is your name, age, and where do you live?

Rachel is 34 years old. She was born and raised in Hawaii. She graduated from University of Hawaii at Manoa in 2009 and because of the competitive market, had difficulty finding a job right away. Rachel traveled to Washington DC before settling in New York City, where she has lived for the past 10 years. 

What is your job?

Rachel is a bartender in New York City, living off of $35,000 a year. However, because of the Coronavirus pandemic, she was unemployed for five months. Currently, there is no steady work for her because of the instability in maintaining restaurants and bars open with the high number of Coronavirus cases.

What do you enjoy (hobbies)?

Rachel is an outdoorsy person; she enjoys hiking and running half marathons.

When were you first introduced to the Breast Treatment Task Force?

After finding a lump in her breast that had doubled in size over the course of three months, Rachel booked a sonogram and a mammogram. However, upon arrival she discovered that her copay was $8,000, leaving her no choice but to leave the facility without treatment. Rachel is at high risk for cancer, her mother passed away at the age of 55 from aggressive breast cancer. Because of her family history, receiving basic preventative care was even more important for Rachel and her health. Rachel’s father then started doing research online for programs that help women with similar jobs and incomes as her and found the Breast Treatment Task Force. 

What procedures did you receive? At what facilities(s)?

Through BTTF, Rachel was able to do a sonogram, baseline mammogram, and a sonogram guided biopsy at Lenox Hill radiology. 

How did it feel knowing your services would be covered?

Rachel recalls feeling as though she had won the lottery. Being able to receive preventative care without any financial burden felt like a weight off of her shoulders. If it was not for the BTTF team, Rachel admits she probably would have risked it and not have gotten the preventative treatment, potentially putting her life in danger.

How did the BTTF team support you?

“They were amazing”, Rachel remarks; all of the appointments were scheduled by the BTTF, making the experience as stress free as possible. She refers to Janice Zaballero, the executive director, as her “guardian angel” through the whole process, being by her side every step of the way.

What do you wish more people knew about getting diagnostic care without insurance?

Rachel wishes more people knew about the variety of healthcare programs tailored to different people’s circumstances. 

How has access to breast care made a difference in your life?

Aside from the financial relief and reassurance of her health, receiving breast treatment gave Rachel hope. Researching all of the breast treatment programs made her optimistic for women in the future. Knowing that there are organizations who are fighting to help those who are ignored by the American healthcare system made Rachel want to be a part of the fight as well.

Because Rachel is under the age of 40, she is not eligible to receive free cancer screening and diagnostics from the state, leaving her with few possibilities to receive the treatment without going into debt. The Breast Treatment Task Force was founded on the belief that all individuals should have access to breast cancer treatment, and has worked to help women who have fallen between the cracks of the healthcare system to climb back up and receive the proper treatment they deserve. Because of women like Rachel, our medical partners have decided to continue to offer BTTF’s price-scale model for breast cancer screening and diagnostic services even beyond the duration of the BTTF. If you want to receive low cost or free services from our medical partners, which include CP Advanced Imaging, Bay Ridge Medical Imaging, Lenox Hill Radiology and Richmond University Medical Center, please contact Lorraine at 917-979-4646.

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The First Two Covid-19 Vaccines

By: Francesca D’Ovidio

As we are approaching our one year mark living in a COVID infected world, we are finally seeing advances in combating the COVID-19 crisis with the first vaccines being recently approved by the FDA this December. In the United States, there are currently two FDA approved vaccines being distributed: the Pfizer and Moderna vaccines. 

How Do The Two Vaccines Work?

1. The Pfizer vaccine injects mRNA, a type of genetic material that instructs cells to make proteins, into our cells, causing them to produce spike proteins. This protein migrates to the surface of a cell where the cell identifies it as foreign, allowing the cell to prepare its immune response for the coronavirus without triggering the disease. The cell then increases the production of antibodies against the spike protein as a response to the unexpected protein. In this way, if one becomes infected with the coronavirus, the accumulation of antibodies already in their body will protect them from contracting the disease. 

2. The Moderna vaccine functions very similarly to the pfizer vaccine, it too alters the genetic material in the cell to produce an immune response. However, one distinct difference between the two vaccines is the type of mRNA molecules in them. As a result, the two vaccines have different lipid delivery systems. Hence, the Moderna vaccine is able to be transported at a variety of temperatures, while the Pfizer vaccine must be kept in very cold temperatures. 

Who Gets the Vaccine First?

The distribution of the vaccine is divided into three phases, each in order of priority. The first phase, between December and February, is prioritized for healthcare workers and long term care facilities, including essential workers such as firefighters and transportation workers who are highly exposed to the virus. The majority of high risk individuals in this phase will be receiving the vaccine via their workplace or facility. Subsequently, during the second phase, beginning in February and ending in March, individuals with co-morbid conditions, adults over 65, and other workers like teachers and restaurant staff will be vaccinated. Finally, the third phase, which begins in April, will initiate the vaccination of the general public. It is anticipated that by summer of 2021, the vaccine will be accessible to anyone who wants it. 

How Long Does It Take For the Vaccine to be Effective?

Both the Moderna and Pfizer vaccines are two-dose vaccines, meaning that the vaccine recipients will need a second booster shot a few weeks after the first shot. The first shot prompts one’s body to become immune to the virus and the second shot strengthens that immunity. The second shot increases the effectiveness of the vaccine by 43% (according to studies on the Pfizer vaccine). Consequently, one can still contract the virus and spread it during the three to four week waiting period between the two doses. Once the second dose of the vaccine is administered, it can take around two weeks for the efficacy to reach 95%. This means that the process from start to finish can take about four to six weeks, if not more at times. 

Beyond the two FDA approved vaccines, there are currently three other vaccines being tested in phase 3 clinical trials, the final stage prior approval. In this phase of testing the prospective vaccines are administered to thousands of people to see the large scale efficacy of the vaccine. If approved, it is probable that a larger variety of vaccines will become accessible to the public in the coming months, increasing the number of people getting vaccinated, and therefore decreasing COVID-19 cases and deaths in the United States. 

Sources:

https://www.nytimes.com/interactive/2020/health/pfizer-biontech-covid-19-vaccine.html 

https://theconversation.com/how-mrna-vaccines-from-pfizer-and-moderna-work-why-theyre-a-breakthrough-and-why-they-need-to-be-kept-so-cold-150238 

https://www.cnn.com/2020/12/17/health/moderna-vaccine-what-we-know/index.html 

https://www.mass.gov/info-details/when-can-i-get-the-covid-19-vaccine 

https://www.huffpost.com/entry/how-long-before-coronavirus-vaccine-works_l_5fd6c66fc5b6218b42ea3760 

https://www.uab.edu/news/youcanuse/item/11758-what-you-need-to-know-about-the-pfizer-covid-19-vaccine 

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California v. Texas and What It Means for New Yorkers

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

https://www.scotusblog.com/2020/11/argument-analysis-aca-seems-likely-to-survive-but-on-what-ground/

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Voting For Our Healthcare

By Francesca D’Ovidio

The Presidential Election is right around the corner and the Trump and Biden campaigns are using their last resources in an attempt to win over indecisive voters. Healthcare remains one the most important drivers. It can be easy to feel overwhelmed by the conflicting information that social media outlets feed us and the growing divide of our country’s political stances. We may be susceptible to emotionally driven judgment that blinds us when trying to pick who we believe will best run our country. When we focus on the facts, we can arrive at an educated decision and make our vote truly count. 

Biden plans on establishing a government run public healthcare option, expanding the Affordable Care Act instituted in Obama's term to reduce cost of health insurance coverage. His public alternative would allow families earning more than $104,800 and people unsatisfied with their employer coverage to qualify for subsidies. Biden’s plan would account for those affected by the Medicaid expansion act, who make too much money to be eligible for Medicaid and too little to qualify for the Affordable Care Act subsidies in states that have opted out of the expansion act. 

Biden also intends to lower the age minimum for Medicare from 65 to 60, giving up to 18 million new people the opportunity to benefit from the program. According to Marc Goldwein, the senior VP of policy at the committee of a Responsible Federal Budget, this would result in up to $200 billion dollars which would be paid by general revenue. However, because of the larger appeal to Biden’s public health option, the majority in that age range would opt for the public option, lowering the 200 billion-dollar cost estimate. 

Both Biden and Trump intend to lower drug prices, however Biden believes that federal government intervention should be more central in the reform process. Biden’s plan allows the federal government to negotiate drug prices with pharmaceutical companies on behalf of Medicare. According to the Congressional Budget office, legalizing this direct negotiation with drugmakers would save the U.S. 456 billion dollars between 2023 and 2029. However, negotiating with drug developers would result in pharmaceutical companies making less revenue, and potentially hindering new clinical studies and research. 

Trump’s strategy for lowering prescription drug prices involves importing foreign price controls. This would allow for future drug prices to resemble those in other developed countries, which are typically much cheaper. However, implementation of new pricing may take time and will likely be challenged in court by pharmaceutical companies. While Biden intends to build further with the existing Affordable Care Act, Trump is fighting to dismantle this act in court. If successful, this would leave up to 23 million people without coverage during a global pandemic. The repeal of the act would also disproportionately affect women, as prior to the act, insurance companies would regularly charge women up to two to three times more than men for the same health needs. 

Trump plans to repeal and replace this act with America-First healthcare, but he has not yet established a comprehensive plan for his new healthcare system to the public. Washington Post journalist, Toluse Olorunnip, criticizes that Trump is simply rebranding the Affordable Care Act rather than repealing it. Trump also intends to end surprise medical billing by signing executive orders to establish price transparency requirements which would give patients precise cost assessments prior to receiving medical care. President Trump remarked, “We are going to hold insurance companies and hospitals totally accountable” when referring to surprise billings. 

As opposed to Biden, Trump supports limiting Medicaid by decreasing funding and implementing work requirements. He plans to ultimately privatize Medicare by strengthening Medicare Advantage, the private insurer alternative to Medicare. The prioritization of Medicare Advantage could potentially lead to a rise in traditional Medicare prices and the depletion of the Medicare trust fund. 

Biden and Trump have two significantly different views on healthcare in the United States. Both parties have positive and negative aspects to their plan, so it is up to you to make an informed decision on who you want to represent our country. 

We hope that everyone votes on November 3rd in one of the most crucial elections in recent history.

Sources:

https://www.nytimes.com/2020/09/13/us/politics/trump-executive-order-drug-prices.html 

https://www.whitehouse.gov/briefings-statements/remarks-president-trump-ending-surprise-medical-billing/ 

https://www.americanprogress.org/issues/healthcare/news/2019/10/11/475646/trumps-plan-privatize-medicare/ 

https://www.nytimes.com/2020/07/13/opinion/obamacare-aca-trump-women.html?auth=linked-google

https://joebiden.com/healthcare/ 

https://www.washingtonpost.com/politics/trump-health-care-affordable-care-act/2020/09/24/e1cd928a-fe6b-11ea-9ceb-061d646d9c67_story.html 

https://www.healthcaredive.com/news/5-key-pillars-of-bidens-healthcare-plan/576656/ 

https://www.healthline.com/health-news/where-biden-and-trump-stand-on-11-key-healthcare-issues#7 

https://www.vox.com/policy-and-politics/2020/8/20/21372511/joe-biden-obamacare-health-care-plan

https://www.fool.com/retirement/2020/08/30/2-big-medicare-changes-joe-biden-wants-to-make/ 

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COVID-19’s Effect on Breast Cancer Diagnoses

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

https://www.breastcancer.org/treatment/covid-19-and-breast-cancer-care

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Medical Racism in America

By: Christina Klonis

“Medical racism” is discrimination in healthcare that impacts patients’ health and treatment. This is a problem that has plagued our society since the beginnings of the formal medical field. America has a long history of racism in medicine that persists today in a variety of forms, including differential treatment, institutional racism, discriminatory concepts, and racism itself negatively impacting the health of those affected. 

The origins of modern medical practices have deep roots in racism. Dr. James Marion Sims is known as “the father of modern gynecology,” but his work, beginning in 1844, consisted of cruel experiments on enslaved women. He took three women, Lucy, Anarcha, and Betsey, from local slave owners and used them as objects in his experiments. He believed that Black women had a higher threshold for pain than others, which is a false idea that some medical professionals today still believe and act on. These women were subject to gruesome operations that were up for observation from other doctors, and were given no pain relief. Gynecology and women’s reproductive health was built on the dehumanization of and experimentation on Black women against their will. Today in America, Black women are two to three times more likely than white women to die from pregnancy and childbirth related issues (CDC). In addition, the medical needs of Black people are constantly overlooked due to prejudice and that false idea that their pain is not valid. The healthcare system is yet another system in our country that fails to serve and protect Black people.

Another example of the medical field using Black lives as experimental objects is the Tuskegee Study. In 1932, the Tuskegee Institute and the Public Health Service began the “Tuskegee Study of Untreated Syphilis in the Negro Male”. The study originally started with 600 Black men, but grew as it lasted 40 years. They told the patients that they were being treated for illnesses, and were given promises such as free meals, medical exams, and burial insurance. The men were not treated for their ailments, and were unknowingly a part of this experiment that caused many horrible deaths in poor, rural African American men. 

Henrietta Lacks was a young woman who died of cervical cancer in 1951. The use of her cells after she died, nicknamed “HeLa” cells, led to breakthroughs in medicine, diseases, and vaccines. Many scientists, doctors, pharmacists, wealthy patients, and others benefited from her cells, while her family had no knowledge of their use and did not have access to proper healthcare themselves. Henrietta Lacks didn’t consent to this before she died, and she is often not credited for her own cells. The impact of her cells on medicine is profound. This is yet another example in history of Black people being taken advantage of in medicine. These racist beginnings in modern medicine have led to medical racism’s prominent role in healthcare today. 

Racial bias in healthcare is an extremely pressing issue. Black people are continuously given lower quality healthcare than their white counterparts, and also don’t have trusting relationships with their physicians. The National Institutes of Health reports that minority patients (including Black patients) have a higher chance of being treated by a less proficient physician in comparison to white patients. This means that even if insurance and access were not an issue, Black people would still receive less desirable or effective treatments, and overall worse care. This leads to higher rates of mortality for Black people. A partial reason for this is the biases of physicians themselves. This is why having difficult conversations with peers and family members about racism is vital- having racist people in all fields lead to many bad things, in this case death. Acknowledging personal bias and racism is an important step to continuously combat it in this system that is so deeply rooted in racism.

Although bias on the level of the doctor is a large issue in this, medical racism goes broader than that, on a systemic level. Our healthcare system provides lower quality health to those who can’t afford private health insurance. According to the National Institutes of Health, Black people have lower rates of healthcare coverage in comparison to white people. The COVID-19 pandemic highlighted these issues, as Black people faced about 25% of the COVID-19 deaths in America, while only comprising 13% of the population. Many Black people are left without proper healthcare, and are disproportionately affected by the pandemic.

The effects of racism on the body show another level of medical racism. Police brutality brings physical injuries, and sometimes death, to Black people. In addition, the burden of living with the fear and experiences of this violence brings trauma and chronic stress. In addition, Black people are 1.5 times more likely to have a high exposure to pollutants that have extremely detrimental health effects. Black people are more often exposed to these pollutants due to residential segregation, which is present throughout the country.

Racism is embedded into all systems in our country, and it is vital that we all work to change this and bring true equality. BTTF believes that Black lives matter, and everyone should have access to high quality healthcare. We pledge to work solely with service providers and community partners who take the steps to mitigate and eliminate the racism and institutional bias within their organizations, and we follow up with our patients to identify if they feel they have encountered any racism in their services, in order to listen and improve.

Sources:

Bulatao, Rodolfo A. “Health Care.” Understanding Racial and Ethnic Differences in Health in Late Life: A Research Agenda., U.S. National Library of Medicine, 1 Jan. 1970, www.ncbi.nlm.nih.gov/books/NBK24693/.

“Disparities in the Impact of Air Pollution.” American Lung Association, www.lung.org/clean-air/outdoors/who-is-at-risk/disparities.

“Health Disparities between Blacks and Whites Run Deep.” News, 15 Apr. 2016, www.hsph.harvard.edu/news/hsph-in-the-news/health-disparities-between-Blacks-and-whites-run-deep/.

“Implicit Bias and Racial Disparities in Health Care.” American Bar Association, www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/racial-disparities-in-health-care/.

“Infographic: Racial/Ethnic Disparities in Pregnancy-Related Deaths - United States, 2007–2016.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 4 Feb. 2020, www.cdc.gov/reproductivehealth/maternal-mortality/disparities-pregnancy-related-deaths/infographic.html.

“Tuskegee Study - Timeline - CDC - NCHHSTP.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2 Mar. 2020, www.cdc.gov/tuskegee/timeline.htm.

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Scan Van Protocol

By: Nora Resk

As the curve in New York City begins to flatten, BTTF, along with the rest of New York City, will begin implementing COVID-19 recovery measures. Businesses and other 501(c)3 organizations have had to put growth opportunities and regular business on hold to ensure the safety of all of their clients, employees, and fellow New Yorkers. With recovery slowly starting to kick in, BTTF wants to resume our previous programs that have been essential to our patients.

One of our most important partnerships is with Project Renewal's ScanVan, as it fuels our mission to provide free breast screenings to low income patients across the city. However, in order to run this program successfully and safely, there will be additional measures and precautions put in place to ensure that everyone who wants this care will be able to receive it:

-Community organizations will distribute medical and consent forms before patient appointments so that they can be filled out in advance, effectively minimizing patients’ time in the Van.

-Before they enter the ScanVan, all patient temperatures will be taken, and they will be asked if they have been experiencing any COVID-19 symptoms. Those with any COVID-19 symptoms will not be permitted to enter the ScanVan.

-Every patient will be provided with a mask and gloves before entry as well. 

-All surfaces people come into contact with will be wiped down with both alcohol and germicidal wipes.

-Frequent hand washing will be enforced.

-There will be a capacity limit of those allowed on board. Instead of scheduling two patients every 15 minutes, it will be more like 1 patient for every 20-30 minutes. This new scheduling protocol will allow workers more time to disinfect the van between patients, and ensure the safety of those seeking diagnostic treatment. 

These measures will help keep everyone safe in this time of uncertainty, while also providing the life saving diagnostic treatment that our patients rely on. BTTF looks forward to continuing to provide for our patients during this time. Thank you for your cooperation.

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Healthcare in a Post-COVID-19 World

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. 

BTTF believes that everyone deserves access to healthcare, regardless of insurance status, income, race, age, and sexuality. Hopefully, a better future for healthcare will be an outcome of this disastrous pandemic.

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COVID-19: Governor Cuomo’s Plan to Un-Pause NYC

By Xiaoyu Huang 

Ever since the first COVID-19 cases were confirmed in the US, Governor Andrew Cuomo has been working to fight the spread of COVID-19  in New York. Within two months, the first patient tested positive for COVID-19 in New York City. Immediately after, Cuomo signed a $40 million emergency management authorization for New York’s COVID-19 response, giving him the responsibility of New York during the pandemic. Since then, he has directed the Department of Public Service to prevent utilities such as National Grid from cutting off power and heat, urged the President to implement an aggressive, national strategy against COVID-19, signed an executive order that requires hospitals to increase capacity by a minimum of 50% and many more.

With the city in panic, Cuomo has outlined a blueprint that began to work on “unpausing”  New York starting on April 16th. With the goal of getting people back to work and easing the social situation, the blueprint provides detailed information on precaution and prevention. The first step is to control the rate of infection, which includes the requirement of wearing masks in public and continuing to social distance. The plan also includes the extension of the NYC Pause order until May 15th. The second step is to ensure that hospitals amongst New York and boroughs are able to provide PPE, personal protective equipment, and other medical equipment as well as medical attention to people in need. The third step is to test and trace the number of people that the COVID-19  has affected through both diagnostic (swab test) and antibody (blood draw) testing.

The fourth, and probably most difficult, step is the “New Normal”.  Businesses will open in phases based on the following priorities: those that are considered “more essential” with low risks of infection will open first. Businesses that present a higher risk of infection to the workplace and customers will slowly follow as the infection rate declines. The blueprint to “Un-Pause NY” further details practices that businesses should take to guide them into the “new normal.” One of them is transportation: to wear masks and gloves while using public transit or requiring employees to telecommute or work from home. In the workplace, where it can be easily crowded, it is best to keep desks six feet apart or sit a distance away from people. Again, those who can, should telecommute or work from home. Customer interaction is an important part of this guideline. To limit as much contact with customers as possible, interacting employees will have gloves, masks, and other supplies. In addition, businesses should consider having a Proactive Infection Plan that provides the employee a work from the home plan if any symptoms of COVID-19 are developed or tested positive for.

COVID-19  has changed the lives of many. Approximately 26 million people filed for unemployment since it has forced people to close their businesses and leave their jobs. One in six Americans has lost their jobs since Mid-March. Non-essential workers and non-essential businesses are affected economically. A $2 trillion-plus stimulus package was signed last month that made self-employed, contractors, gig workers, etc., eligible for unemployment. The problem is that most states have not approved the unemployment applications because they are trying to reprogram their systems to do so. As a result, many people that have been laid off haven’t been able to receive aid. On top of that, cases of COVID-19 are more prevalent in low-income communities in part because they don’t have access to tests. Many people still risk going to work because their families need the money to survive.

Essential workers like nurses, doctors, sanitation workers, and food couriers are facing threats to their safety every day. Lack of supplies and the overwhelming amounts of patients are taking an emotional toll on all the workers inside the hospitals. They often face additional stress because they are away from their families, not wanting to bring anything home. With the uncertainty of every shift, they are dealing with the situation as they go.

New York City has become the epicenter of the pandemic within weeks of its first COVID-19 infection. Even though the latest numbers show a decline, the deaths are still high.  As of April 24th, there are at least 263,490 total positive cases of COVID-19 in the state with about 146,000 of the cases being in New York City. Cuomo promises to save lives in our community by ensuring all hospitals get the equipment they need. It is starting with the blueprint and refining the healthcare system so that the vulnerable population gets all the protection they need. It is also important to show appreciation for essential workers by smiling and saying thank you to them. Every night at 7 PM, people cheer for essential workers, showing how strong and united New York and other cities can be.

It is no different at BTTF. We want to make sure the health and safety of our patients come first.  It is very important that each of our patients receive immediate healthcare services if they ever have contact with the virus. All the interns and staff are adjusting our plans to raise money to serve our patients.  We have plans to move forward with our ride event and are doing our best to proceed with that.

For more information on the Blueprint: https://www.governor.ny.gov/news/amid-ongoing-covid-19-pandemic-governor-cuomo-outlines-blueprint-un-pause-new-york

To donate to our Ride:

https://charity.gofundme.com/o/en/campaign/ride-for-bttf-2020”

[thebttf]

BTTF During COVID-19

By Nora Resk

With the emergence of COVID-19, New York City, and much of the rest of the world has been put on pause. All major events have been postponed indefinitely, and all businesses and employees deemed as “not essential” are now unemployed or working from home. This has caused major ripples in the economy, as unemployment claims skyrocket and business growth becomes stagnant. An overall feeling of financial unease has permeated across the board in every region of the world. This is an unprecedented time in global history, and it is hard to imagine what a new “normal” may look like, and when exactly everything will resume. Like all the other businesses and nonprofit organizations across the country, many business projects, strategic growth opportunities and economic forecasts of first and second quarter growth have been put on hold. However, this does nothing to change the effort, hard work, and compassion BTTF has previously dedicated to serve the New York City Community, and plans to reschedule all patients this summer.

BTTF has always been committed to providing free breast screening, diagnostic follow-up, treatment, and education to low-income patients without access to health insurance in New York City. We believe that all individuals should have access to these services, regardless of age, race, financial status or their inaccessibility to health insurance in either not qualifying for coverage or simply just not being able to afford it. It is important for us to establish credibility with assisting our patients most in need and taking actions toward eliminating medical cost barriers that prevent people from receiving this care. Our programs are designed to provide more personal and customizable support to those who need it. 

Our mission hasn’t changed, but, the work shifts during this global pandemic.  BTTF serves a vulnerable population, one which has been profoundly impacted by this virus. People have lost their jobs, received pay cuts, and lost coverage altogether. As a result of this impact, we are expecting to see an influx of need in the coming months. Our existing patients will have an increased financial burden that we will support. In order to meet these critical needs, BTTF hopes to pivot and position itself as an organization, stronger than ever before as New York City seeks to recover from this pandemic.

Employees and volunteers will have to face additional challenges moving forward, needing to learn more about community resources for client needs. There will be a larger percentage of incoming requests over the summer, and we may need to spend more time communicating more effectively than in the past. BTTF and all our community partners want to ensure access to these and all other services, as this will become a focus in the coming months. 

These are all tasks we have always achieved, only now, we need to try harder. We want to help everyone in a tangible and meaningful way. Like so many businesses in New York City, BTTF will unavoidably have to book more hours rescheduling and planning appointments in the near future. We will do it!

[thebttf]

New NYC Healthcare Legislation: Where is the change?

Christina Klonis

In January 2019, NYC Mayor Bill De Blasio announced a new healthcare initiative. “NYC Care” is De Blasio’s recent healthcare strategy to provide healthcare to all New Yorkers. This grand plan was set to begin in the Bronx on August 1st, and eventually reach the rest of the city. NYC Care is supposed to provide healthcare to those who cannot afford insurance. NYC Care members are to receive an NYC Care card, which gives them access to a doctor and a customer service line for assistance in making appointments and paying fees. 

NYC Care reinforces the pre-existing system with more customer service, to push members to utilize these resources. The initiative was introduced through a grand announcement, but the new initiative itself does not bring much change. Customers still face fees, and benefits are limited to public hospital care. NYC H+H has been providing these same services for decades, but now NYC Care publicizes it more.

In August of 2019, Manhattan Councilman Mark Levine and Councilwoman Carlina Rivera introduced new legislation that aims to fill the holes left by NYC Care. This legislation would provide for medical homes available in every community district in NYC. These medical homes would include H+H facilities, as well as federally qualified health centers (FQHCs), and other not-for-profit and private medical service providers. The legislation would also provide a “health concierge” to help members navigate their resources. This initiative has no participation fee, only possible service fees on a sliding scale. Its goal is to provide healthcare to New Yorkers on a personalized, culturally competent, and localized scale. It would guarantee primary care for New Yorkers, whether they are undocumented, uninsured, or underinsured. 

This new legislation is exciting, with the potential to cover many underrepresented groups in healthcare. It aligns with the goal of the Breast Treatment Task Force to provide people with essential healthcare regardless of immigration status or income. As an organization that brings these health services to uninsured groups of all immigration statuses, we are very curious here at BTTF about the execution of this legislation. 

Despite the great promise of this program, we are left with two major unanswered questions. When will we see this program take effect in NYC? It was announced in August, and planned to begin hearings in the fall. There is no further information on the bill on the city council website besides the initial announcement, and it has been many months. The legislation has no status update or bill number, and we would like to know where this plan has gone. Now more than ever, in the midst of the COVID-19 pandemic that has caused a national state of emergency, access to healthcare is vital. At the moment, New York has the highest number of confirmed cases as a state. It is necessary for everyone to be able to get tested and treated if they are showing symptoms, and this bill would have a great impact in making sure of it. How will this bill distinguish itself from NYC Care? It is a great idea, but at the moment we have no proof of any advancement of this plan. We would love to be able to track the bill, and watch it go into effect to actually help these groups that are left behind by the current healthcare system.

The new legislation proposed by Mark Levine and Carlina Rivera is very promising. As an extension of NYC Care, it is inclusive of all New Yorkers regardless of immigration status, insurance, or other barriers such as language. This bill would be very beneficial, but its advancements are unknown. At BTTF, we want answers to our questions on this legislation because it is vital in our planning and expansion. 

[thebttf]

Canvassing for BTTF

By Emeline Blohm

In my AP U.S. Government class at my high school, we just wrapped up our unit on interest groups. We learned primarily about large interest groups, industries, and companies, like AARP and the AMA, that are able to allocate millions of dollars to hiring professional lobbyists to directly influence public policy. Many of these lobbyists rely on personal connections with legislators to influence government action that benefits the interests they represent. It’s not surprising that many lobbyists have prior experience working in government.

As interns at BTTF, we help organize events and initiatives that raise funds that help BTTF continue providing low-income and uninsured women with free breast screenings, diagnostics, and treatment. Recently, BTTF applied for discretionary funding from multiple New York City Council members, including Carlina Rivera of District 2 (Manhattan) and Laurie Cumbo of District 35 (Brooklyn), whose constituents receive care through BTTF and BTTF affiliated community partners. This funding is awarded to nonprofit organizations that provide community-based services in New York. 

To aid in our efforts to receive the requested funds, we garnered support in the neighborhoods represented by targeted Council members. In small groups, we went out into these districts and collected signatures and messages of support from their constituents. None of us had ever gone canvassing before and, though we weren’t quite sure what to expect, we were excited to try something new by engaging with strangers who might not always be receptive to us.

We ended up collecting far more signatures than we expected. More than once, someone walked past us, avoiding eye contact, but then turned around and asked to sign our paper once they had overhead our pitch. It was really exciting when someone didn’t have to think twice about signing their name, or exclaimed midway through our elevator pitch, “Of course!” or “This is amazing! I want to support this!” I think the most memorable interactions, however, came from those with people who opened up to us about being breast cancer survivors themselves, or having a close family member or friend who is one. We walked away from canvassing feeling empowered, motivated, and a just a little bit hungry. Later that week, we hand delivered the signatures, along with information about BTTF, to Council members.

In school, we focused mainly on looking at government at the national level, but not the local level. When starting this work on getting funding from the City Council, I didn’t know how canvassing worked, or the process by which the City Council allocates funding to different organizations. I’ll admit I didn’t even know who my City Council member was. However, by canvassing on NYC sidewalks and engaging directly with staffers at the City Council members’ offices, we got a glimpse into what lobbying at the local level looks like and what the opportunity is for high school students to engage with local government.

[thebttf]

Black Women and Breast Cancer

By: Christina Klonis

At the Breast Treatment Task Force, 21% of the patients we serve are black women. Statistics show that although the breast cancer incidence rates are lower in comparison to women of other races and ethnicities, mortality rates among black women for breast cancer are significantly higher than those among white women. 

According to the Centers for Disease Control and Prevention, the breast cancer mortality rate for black women is 40% higher than for white women. A possible reason for this is the lack of mammogram follow-ups. The Susan G. Komen Breast Cancer Foundation reports that black women have more frequent delays of mammogram follow-ups after unusual or concerning results than white women. This lack of follow-up can play a key role in the lower survival rates, because the earlier breast cancer is identified and treated, the higher the  chances of survival will be. BTTF works to give women these necessary screenings and begin treatment earlier on, to enhance the likelihood of survival.

Triple-negative breast cancer is a breed of cancer that is more aggressive and difficult to get rid of than most other types. It has a worse prognosis than other cancers, it is more challenging to deal with because it does not respond to hormone therapy treatments, and it is more likely to spread to other parts of the body. This type of cancer is most prevalent in black women, although it is currently unknown exactly why. The triple-negative breast cancer type is another contributor to the great disparity between breast cancer mortality rates for black women in comparison to other races.

At BTTF we believe that all individuals should have access to breast cancer screening, diagnostic follow-up, and treatment, regardless of age, race, financial status, and access to health insurance. We serve to provide these screenings and treatments to populations in need. Earlier detection and proper follow-ups are vital in increasing the likelihood of beating breast cancer. Black women face many disparities in breast cancer detection and treatment, and BTTF works to lessen that.

Sources:

https://ww5.komen.org/BreastCancer/RacialEthnicIssuesinScreening.html

https://www.cdc.gov/cancer/dcpc/research/articles/breast_cancer_rates_women.htm

[thebttf]

Meal Prepping Your Way Into The New Year

By: Christina Klonis

One of the most popular New Year’s resolutions is to eat healthier, but many don’t know where or how to start, especially on top of their already busy schedules. This is where meal prep comes in, not as a temporary resolution, but as a consistent way of staying healthy. 

Meal prepping is an efficient way to plan out your meals for the week and to save time on cooking during the week. It assures that you are not scrambling to try and find a healthy meal last minute every day. By controlling your portions rather cooking too much while hungry, you get to set yourself up for a healthy week. Once you prepare your meals, all you have to do is store them and heat up your food when you’re ready to eat!

To begin meal prepping, start with a plan. 

Dedicate about one to two hours every weekend to plan and prepare healthy meals for the rest of the week. Many choose to meal prep on Sundays to plan for the week, but it can be done whenever works with your schedule. 

List the types of meals you are going for based on your goals. Keep your dietary needs in mind (veganism, allergies, etc.) as you plan meals with multiple components to fulfill your nutrient needs. 

Browse online for recipe ideas and meal prep templates and pick out the healthiest and tastiest choices for yourself. It is vital to plan out your meals for the week, or else this process, which is meant to help relieve stress, causes more stress. Many meal prep templates have circulated the internet, so you can choose the one that you feel best works for you. 

As you plan your meals, make a grocery list of everything you need for the week. You can prepare full meals for yourself, or meal components that you can mix and match to have variation in your diet. Some basic components you can prepare are grilled chicken, broccoli, beans, and endless other options. 

Not only does meal prep guarantee that you are keeping up with a healthy diet, but it reduces food waste, saves time during your busy week, and gets rid of stress over finding last-minute meals to prepare. A great way to start your new year is to implement meal prepping into your routine!

[thebttf]

The Contentious Issue of Health Care Reform

By Zadie Waletzko

The politics behind government-controlled health care reform have been contentious for a long time. Did you know that some hard-won health care reform acts date back to over 50 years ago? 

In 1946 the Hill-Burton Act enabled the building of hospitals throughout the nation. 

In 1965 Medicare and Medicaid programs were created providing insurance to millions of elderly, disabled, and poor Americans. 

In 1997 the enactment of smaller-scale programs expanded coverage for children of low-income families

In 2003 prescription drug aid was created for Medicare beneficiaries. 

Needless to say, federal healthcare has been a valued yet controversial topic in politics for a while. 

The conversation about health care today centers around who deserves a right to health care and what the government’s role in health care should be. While most Americans agree that the rising prices of prescription drugs and surprise bills are getting out of hand, there is no singular agreed-upon solution. Health care reform is challenging because the “perfect solution” must alleviate high costs while also addressing American’s different values. 

According to a telephone survey conducted by the Commonwealth Fund, most Americans believe that the government should play some role in health care. 

59% of those surveyed said they would support increasing taxes on higher-income people so that everyone could have health insurance.

53% would be personally willing to pay more in taxes for this.

However, Americans have little faith in the effectiveness and organization of a government-run healthcare program.

Only 44% said that they would prefer a government-run health insurance system.

The majority agree that “when something is run by the government today, it is generally run not too well or not well at all.” 

This dissonance among American’s values makes finding a perfect health care reform system difficult. However, people are becoming more comfortable with a health care system that is provided by a mix of both private business and government programs. For example, Medicare and Medicaid have grown in popularity over time, now covering more than 130 million Americans. 

Synthesizing the values of Americans to alleviate the cost of health care will be the most effective solution. However, the ambivalence of attitudes makes it a contentious issue. New policies that bring together the complementary qualities of public and private sectors may help to ease the concern of health care in America, by reducing the cost and aligning with the different opinions on the issue.

[thebttf]

A Bit of Mindfulness Per Day Keeps The Stress Away

By: Christina Klonis

Do you feel overly stressed with your busy work and life schedule? 

Perhaps a few simple changes can help fix this. 

Researchers say that 10-20 minutes of mindfulness daily can reap great benefits into short and long term aspects of your life. According to UC Berkeley1, studies have proven many tangible benefits of mindfulness, such as boosting your immune system and bettering your quality of sleep. In addition, it amplifies positive emotions and greatly reduces feelings of stress and depression. In the workplace, mindfulness is beneficial in improving leadership skills, memory, productivity, and creativity. 

Mindfulness is a state of presence and awareness, as well as acceptance of your thoughts, which can be reached by living a mindful lifestyle and practicing mindfulness meditation. Practicing mindfulness allows you to be fully present, and when it is integrated in your daily life you become more calm, focused, and aware. 

Simply begin to practice mindfulness meditation for 2 minutes daily, and as it is integrated into your routine add as much time as you can. Mindfulness meditation can be practiced in a few straightforward steps. Any time during the day, set aside a couple of minutes to close your eyes and cultivate your mindfulness by focusing on these things:

Concentrate on your breathing

Notice what you observe from your five senses that normally slip by you

Pay attention to small physical sensations such as your hands resting on your lap

Try to eliminate stressful thoughts and focus instead on your physical sensations (breathing, etc.)

Whether you are standing on the train or sitting in your office chair, take two minutes to close your eyes and focus on these simple tips to practice mindfulness.

There are other ways besides mindfulness meditation to transform your lifestyle into a mindful one. Practicing mindful eating can be done by being focused and present while you eat, rather than scoffing down your meal. Not only does this allow you to be more generally aware, but this also leaves you feeling more satisfied and nourished after your meal. In addition, be mindful when you are not meditating. For instance, as you walk your daily commute, be mindful of your surroundings. Recognize the physical sensation of your breathing, and all the other sensory details you encounter on your walk. Take small pauses in between every action, to keep your mind clear and bring you energy to move forwards.

The benefits of mindfulness are substantial. Overall, mindfulness will benefit you as a person, increasing self esteem, compassion, and endless other positive feelings.

1 https://greatergood.berkeley.edu/topic/mindfulness/definition#why-practice-mindfulness

[thebttf]

BTTF Fitness

By: Xiaoyu Huang

Regular sleep. Healthier life. Decreased risk of cancer.

We live our lives on the go, looking for the next task to fill our time. Sometimes it feels like we strive to be as health conscious with diet and exercise, but sleep often gets overlooked.

Why is sleep so important?

According to ATS Journals, sleep is important for neural development, memory, emotional regulation, cardiovascular and metabolic functions and cellular toxin removal. We need sleep as much as we need food to survive. Giving up just one hour of sleep could compromise our cardiovascular health, energy balance, and our ability to fight infections.

A sufficient amount of sleep is essential to human body functions, and makes us feel more energetic, alert, and overall happier. Lack of sleep causes an interference with our ability to function normally in school, work, and social environments. Sleep deprivation also proves to be linked to obesity because lack of sleep disrupts the body’s balance of key hormones that control appetite. Those who don’t get enough sleep may be hungrier than those who do.

How much sleep do I need?

18 - 25 years old           7 - 9 hours

26 - 64 years old           7 - 9 hours

65+                                7 - 8 hours

What is good quality sleep?  

It is not just getting the right amount of sleep, it about the quality of those hours. Deep sleep is critical because that is when the body repairs itself and rebuild energy the next day. REM sleep is equally as important so that the brain can regenerate. 

How do I improve the quality of my sleep?

Wake up and go to bed at the same time, every single day.

Try to have the same night routine during the weekends.

An hour before bed should be the time to slow down and put down the electronic device (read a book).

Avoid having a large meal within a couple hours of bedtime.