Giving Thanks in Challenging Times

David Sandman
4 min readNov 21, 2022

It’s a tough time to be an optimist. The recent election affirms the country’s polarization; war rages abroad; and inflation is high.

In health care circles, the COVID-19 pandemic persists and take-up of the latest vaccines is sluggish. Flu and RSV are exacerbating the strain on the health care system. Polio has reemerged. New Yorkers who are food insecure are making impossible choices like skipping medicine and meals to make sure their kids can eat. Sky-high food prices are making it expensive to put Thanksgiving meals on the table. And when it comes to all of these challenges, we see stark racial and ethnic disparities, with Black and Hispanic New Yorkers faring worse than their white counterparts.

And yet, as we look ahead to Thanksgiving and the winter holiday season, I’m on the hunt for bright spots. Amidst the many challenges we’re facing in New York and as a nation, here are a few things I’m feeling thankful for:

The worst of COVID is behind us. The pandemic isn’t over and it’s likely that COVID will always be with us in some fashion. We still need to be vigilant about protecting ourselves and others from the virus: on average, 3,000 people each day are hospitalized with COVID across New York State, and about 15 people are dying each day (by comparison, that’s about 7% of the number we saw during the last COVID spike in January 2022). But with vaccines, testing, and treatments widely available, COVID looks and feels much different than it did two years ago and even one year ago, when both tests and treatment were in short supply. I’m thankful for the progress we’ve made.

The health care safety net has held. A rare silver lining of the pandemic is that health insurance coverage rates in New York State are now at record highs and the number of uninsured New Yorkers has declined. This progress is partly attributable to the 2020 federal public health emergency declaration, which included increased Medicaid funding to states and a continuous coverage requirement that prohibited states from terminating Medicaid enrollees’ coverage. Just last week, the public health emergency was extended and I’m thankful for it. It could have been devastating for those resources to dry up during a potential winter COVID spike. The extra time will also enable better preparation for the eventual transition.

Insurance coverage will remain more affordable. The 2021 American Rescue Plan included a temporary increase in subsidies for people purchasing health insurance through Affordable Care Act Marketplaces, including the New York State of Health Marketplace. It also expanded eligibility for subsidies to more middle-income people, for whom coverage might have previously been out of reach. This summer, federal legislation extended the enhanced subsidies for three years. As a result, more New Yorkers will have the protection and peace of mind that comes with stable health insurance coverage.

Seniors are poised to have more affordable prescriptions. This summer, we saw the passage of landmark legislation that will lower prescription costs in the Medicare program. It requires the U.S. Secretary for Health & Human Services to negotiate prices for some of the most common drugs covered by Medicare; mandates that pharmaceutical companies deliver rebates if the prices of drugs for Medicare beneficiaries rise faster than inflation; and caps out-of-pocket prescription spending for Medicare Part D beneficiaries at $2,000 annually. It will also end cost-sharing for vaccinations covered under Medicare Part D; that means seniors will no longer have to pay anything out of pocket for protection against shingles, for example.

Monkeypox hasn’t become the next COVID. Over the summer, I wrote an op-ed highlighting the parallels among HIV/AIDS, COVID, and the emerging monkeypox (MPV) outbreak in New York City. I feared that history was repeating itself again. We still haven’t fully learned from the experiences and mistakes of HIV or COVID. But we seem to have dodged the worst-case scenario when it comes to MPV: infection rates have declined significantly since the initial outbreak. Health centers and other trusted community-based organizations provided public education, vaccination outreach and administration, testing, and treatment, with a focus on the groups at highest risk for infection. I’m thankful for those efforts to curb an outbreak of infectious disease that could, once again, have devastated communities who have been historically marginalized.

I’m not a Pollyanna; I know there’s plenty in our health system that needs fixing. But there are also reasons for hope and encouragement. Embrace them and be inspired to keep working to make things better.

On a personal note: I’m thankful for my family and friends, my health, and rewarding work with great colleagues. I wish a happy holiday to you and your families and tables that overflow with laughter and love. Please comment and share what you are grateful for.