barriomulas.com - The Health Reform

Yesterday El Vocero reported on the Health Reform program's projected $394 million deficit. The article also reported that for every 1,000 additional participants the program enrolls it needs an extra $1 million. Currently the program covers 1.4 million persons (out of a total population of 4 million) and at once served as much as 1.5 million in 2005-2006. For those of you unfamiliar with Puerto Rico's Health Reform project, it is simply nothing more than the government paying citizen's private health coverage. Allegedly as a fusion of socially-conscious public health and quality-conscious private health, the program has generated an operations deficit since it began in 1993.

The Health Reform is wack. Using the above numbers I am estimating that the program costs about $1.4 billion to run each year (out of a total budget of approximately $12 billion). This means that since the program was initiated, the state has invested a total of $21 billion in simply subsidizing the purchase of private health insurance coverage! The thought that $21 billion dollars was handed over to private health insurers is simply disappointing. If the program were to be cut tomorrow than the island would be back to square one, considering that fact that none of this money is spent on infrastructure, training, preventive health care, and other things that can have long-term effect. Do you know many hospitals, ambulances, and potential doctors can be built and trained with $1.4 billion a year?

The health industry is one of the local issues that most agitates me. Those of the medical profession are members of a sort of privileged class, protected by government regulations and even subsidized by public funds. Private companies pull in billions a year while riding on the back of government spending. Our population is pumped with drugs, put to bed with pills, and tranquilized with sedatives. Doctors offices and hospitals resemble factories, where clients are treated as produce - in and out - in the quickest amount of time possible. I'm sure I don't have to mention much more, for I'm positive that the vast majority of you have seen the movie Sicko.

My concept of an ideal health system is one where a citizen can simply walk into a hospital without having to worry about insurance papers and receive top quality service. As much as the country is criticized, Cuba has succeeded in mounting such a system. Though bureaucracy and economic hardships have brought about a lack of equipment and supplies, Cubans enjoy a health coverage unimaginable in the rest of the Third World. The concept of call-in doctors or medical personal assigned to specific neighborhoods (preferably the one they reside in) is an idea that I think very highly of.

Personally, I feel that all should be done to saturate the market with as many doctors as possible. Students expressing an interest in the health profession should be scooped up from a young age and streamlined through semesters, providing them free education in exchange for a guarantee to work (with pay, of course) in the public health sector for a set amount of years. The military does this, why can't the state? I really don't see why health officials cannot go to a high school, ask how many students want to be doctors, and as their hands go up scoop 'em away into some sort of military-style health academy.

Even if the "quality" of our doctors were to "go down", I'd see no problem with this considering the fact that the vast majority of doctors use very little of what they were taught in school and often limit their work to referring citizens to specialists, writing prescriptions, and referring to medical encyclopedias. (You wonder what they do when they disappear behind the door, they are simply referring to the same health catalogs that you can buy off ebay.)

I hold strong regards for the private market, the invisible hand of capitalism, and supply and demand mechanisms, but the health of the populace is something that I don't feel should be in the hands of the private sector. The private sector is one driven by profit and not by humanitarian needs. Health is one of the few "industries" that I believe need to be jealously guarded under the protection of the public sector. I doubt that a lack of incentive for people to study medicine would occur, for this incentive in the first place used to be limited to people who could afford the $120,000 student loan needed to study it.