Insurers are singled out as the ones who are killing the healthcare system
By Alejandra M. Jover Tovar
The General Workers Union (UGT, for its Spanish initials) was the only one that did not excuse itself from appearing before the public hearing of the Senate Health Committee to delve into Senate Resolution 146, which seeks to “conduct a comprehensive investigation on the provision of public and private health services in Puerto Rico, including municipalities, public government entities, private entities, for-profit or not-for-profit, not limited to organizations that the government contracts to provide health services,” according to the measure’s explanatory memorandum.
As part of the oversight of health facilities and programs, the president of the College of Medical Surgeons, Dr. Carlos Diaz, and the executive director of the Medical Services Administration (ASEM, for its Spanish initials), Jorge Matta, were also summoned, but neither appeared.
“I instruct the commission to meet again on Tuesday in conjunction with ASES. Any government agency that does not appear at this public hearing will be cited under penalty of contempt,” said Sen. Ruben Soto Rivera, chairman of the Senate Health Committee. “The situation in the country is critical; doctors are leaving day by day, employees are not in the best disposition, and they are not well paid. There is money, and plenty of it; what is happening is that it is not being taken to where it has to go, and (my) hand will not tremble in acting as I have to act so that finally, the Government and the entities that represent it can face the country with solutions,” he said.
In his speech, the president of the UGT, Gerson Guzmán López, indicated that the union represents more than 9,500 public and private sector employees. In his presentation, he highlighted the precariousness of health employees’ working conditions and salaries. “None of them currently earn the salary they deserve, nor do they have the ideal working conditions to work and feel fully satisfied,” he said.
Guzmán López insisted that “we consider that those who perform the fundamental work that sustains the health structure of the country deserve respect, the consideration and the living and working conditions necessary to build a solid system that provides the health services that our people urgently need.”
The unionist was emphatic that the insurance companies as the cause of the collapse of the current health system.
“Why are health professionals fleeing? Why are more health facilities closing? Because of problems with insurers,” Guzman Lopez said. “We want to call to the attention of this committee that (from the reading of the text of your resolution) there is no mention, directly and unequivocally, of the insurers and their abusive practices conducive to maintaining their millionaire revenues and profits, even if that means the economic crisis of providers and the illness, suffering, pain, and death of our people.”
“The privatization - or rather, the commercialization - of our health care system and the control that insurance companies have generated over that model has proven, just like LUMA Energy, to be a total failure. The same aggravating effects attributed to the electric energy’s privatizing entity are the same that, aggravated and with more visible effects, can be attributed to the so-called health insurance companies”, Guzmán López stated.
“Here we had a health system that was a world example, the Arbona system, which Pedro Rosselló’s ill-named Health Reform has destroyed,” said the union member. “We had eight regional hospitals; we had a CDT in each municipality. When you needed secondary medicine, you went to the Regional Hospital, and when you needed advanced care, you went to the Medical Center,” he recalled. “The number of people we have in the corridors at Centro Medico, and they still say that it is a bad service by the workers, is due to a lack of rooms, and that is due to a lack of personnel,” he stressed.
“When you take health services away from the people, that is to the detriment of the citizen,” Guzmán López said. “We had a system around the corner in every town, and they said it was not sustainable, but now we have a $1,300 million one that does not provide service to the people...”
He added that “restricting access to diagnostic tests, the intervention in the doctor-patient relationship, when they tell the person which medications they will approve and which they will not, with them being the ones who decide and not the doctor; the restrictions on specialized treatments... constitutes empirical evidence of the incorrect procedure of this business consortium and the failure of the privatizing model,” said Guzmán López, adding that the crisis is aggravated by the high deductibles, the delay in paying medical providers, pharmacies and service centers, and the control over drug coverage.
“We can be more rational in the management of available funds. We can do so if the Government properly assumes its responsibility and takes it out of the hands of the insurers, who so far only look through the prism of profits and the profitability of the big business of medicine,” insisted the unionist.
To reverse the crisis, the UGT proposes a Universal Health System that addresses all needs and a single-payer system that covers basic health needs and pays providers through a single system. “That is a single fund where all citizens contribute through taxes and employer contributions. From this fund, all health services are paid.”
Soto Rivera concluded the hearing by saying that “one sees in the face of each agency head that the single-payer issue is necessary, but there is a face higher up, call it the Executive, that does not see it the same way. If things are not done so that physicians can come back, there is not going to be a healthcare system. We have to start planning. Why the miserable payment that is given to the providers, to our doctors? This system is not working, and there is the money to make it work. There is no money problem here; the money is there. What we have to have here is the will,” the senator said.