As if things weren’t bad enough in Puerto Rico, the island is facing a new and deadly crisis: the loss of doctors. The Independent reports that on average one doctor leaves Puerto Rico for good each day.
The doctors are leaving the island for greener pastures in terms of money, but they are also leaving in a version of ‘Atlas Shrugged,’ refusing to no longer give their blood, sweat, tears and ideas to a failed government system. The exodus of doctors follows years of mid-level professionals leaving the island as well, draining the available high quality workforce for the island.
While much media coverage focuses on what is about to happen; a potential collapse, few have grasped the real issue: the collapse is already underway. Many of the professionals and their families left because they didn’t have jobs (300 thousand in just a few years). They stopped buying goods in the economy, paying rent and mortgages and using banks. They also stopped paying taxes.
The doctors face a situation where they too are not getting paid by the grossly inefficient government health care system. Doctors have to eat. They also have families to provide for and the face a mountain of potential liability whenever they see a patient. Why would they stay? With a growing Hispanic population in the United States, Spanish speaking doctors are in high demand.
This crisis is not new. Last year for a short time the only air ambulance service on the island closed due to non-payment from the government. Doctors have long warned these days were coming, but no one would listen; now the average Puerto Rican faces a true healthcare crisis.
The lack of doctors adds to the long waits already in place at many hospitals. It also means that if there is a major outbreak of disease or mass casualty event, Puerto Rico will no longer be able to respond effectively. That means, people will die.
They will die because there won’t be enough doctors or other medical professionals to treat them. People with communicable illnesses will languish in hospital waiting rooms (even longer than they do now) and spread their disease to others in the room. It means overall emergency response times will be much longer, leading to fewer saved lives during the moments after heart attacks, strokes, car accidents and on the job injuries.
It means even more shooting victims will die, leading to an overall increase in the homicide rate.
Puerto Rico’s health care system has been inefficient for as long as I can remember, now it is just deadly. The solutions however, are not simple.
First and foremost, government must get out of the way of treatment. Less regulation and greater freedom for doctors to perform needed tasks. Second, the payment system must be fixed. A streamlined system allowing doctors and service providers to get paid on time and in the right amounts. The system is so bad right now, that it gives on the impression that money earmarked for medical services is being purposely spent elsewhere.
Third, Puerto Rico must find a way to recruit doctors and keep the ones it already has. Why not contact those doctors who have left or who are planning to leave and ask them, “what would it take to get you to come back or stay?” You may be surprised at the answers you get.
Some of these doctors are leaving for cumulative reasons, in other words not just lack of payments. Many are also leaving because they no longer feel safe and are no longer willing to deal with graft, corruption and a myriad of contradictory regulations some of which could land them in jail or cost them their license.
Unfortunately for them, moving to the U.S. mainland is only a temporary fix. Thanks to ObamaCare, many U.S. doctors are retiring. U.S. doctors are also getting fed up with ‘the system’ even thought it is different than what is happening in Puerto Rico.
In the long run, the United States could join Puerto Rico in a massive health care crisis not caused by disease or disaster, but by government itself.
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