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Obamacare could spell disaster for Puerto Rico

By Catholic Online (NEWS CONSORTIUM)
December 15th, 2013
Catholic Online (www.catholic.org)

When it comes to Obamacare - one size definitely does not fit all. As the rest of the nation scrambles to sign up and make sense of health care reform, the people in the U.S. territory of Puerto Rico are at an impasse. The island is facing a financial crisis and members of the territory's medical community say that half the population there already is dependent on free health insurance.

LOS ANGELES, CA (Catholic Online) - Puerto Ricans, born as U.S. citizens, haven't enrolled on the healthcare.gov Web site. Their government has decided not to offer health-insurance exchanges, which offers private plans.

The Affordable Care Act has come to Puerto Rico in the form of a $6.3 billion social welfare check, which is allocated to the government to continue to pay for its Medicaid and for its separate, free state-run insurance program called "Mi Salud," between 2014 and 2019. This could be disastrous for the island.

An estimated 1.7 million Puerto Ricans already depend on free health insurance. Local doctors are concerned that the additional financial infusion to the program will make the territory even more dependent on welfare.

Medical experts say that the U.S. territory is already deemed as the "Next Detroit" and "America's Greece." The island's government is already over $70 billion in debt. About 45 percent of Puerto Ricans have incomes below the U.S. federal poverty line. Nearly 40 percent of all households receive food stamps.

In spite of this, Puerto Rico's surprisingly low 7.2 percent uninsured rate is actually second-lowest compared to all states, behind Massachusetts. "Our healthcare system is going to be entirely a welfare system," Dr. Guillermo Tirada, an internal medicine specialist says. "It's sad."

Due to Puerto Rico's U.S. territory status, health care reform gave Puerto Rico the choice to either allocate $925 million dollars toward establishing health care insurance exchanges - or to use the money to fund its Medicaid program until 2019.

Puerto Rico's government elected to take the second option. The nation is now channeling the funds through "Mi Salud," which some have decried as a wrong and desperate step in the government's desperate search for temporary financial relief.

The action, these critics argues, takes Puerto Rico further away from a free market privatized health care system. The doctors there will look elsewhere and leave the island,  already going to the U.S. mainland in search of higher salaries and better reimbursements from insurers.

The number of doctors in Puerto Rico dropped by 13 percent in the last five years, from 11,397 to 9,950. The biggest loss was among primary care physicians and specialists.

"The reimbursement from Medicaid and Mi Salud is abysmal and the public hospitals don't have the infrastructure to deal with an influx of patients and regulations," Dr. Jesus Alvarez, a "maternal fetal medicine specialist," who left the island in April. "For the physicians to survive, they can see 20 patients in one day in the U.S., but in Puerto Rico they have to see 50."



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