Transforming Health: Proposals for an Equitable System

 

Leaders of the medical college, press, television, and renowned legislators agree on the existence of a problem in the provision of health services. They have even used the Sicilian nickname "mafia" to refer to medical insurers. According to articles published in this newspaper, five for-profit insurers dominate 95% of health services on the island.

 

Social and economic inequality between the working class, which pays for medical coverage, and those in poverty who receive the government’s insurance plan, is monumental. A third of the money allocated to health comes from the insured class, while two-thirds are funded by the United States government, totaling about twelve billion per year for a population of 3.2 million. Although it is estimated that the government can increase its contribution through CMS, there is skepticism about whether this will result in a more equitable distribution of funds to service providers and hospital institutions, as profit seeks profit, characteristic of capitalist societies. The proposed solution involves a radical and critical redesign of the health system, with key movements in service delivery:

1. Single Payer: Removing Financial Barriers Implementing a single payer would simplify financial administration, reducing costs and bureaucratic complexities.
2. Coverage for All: A Right, Not a Privilege In a universal system, everyone would have access to healthcare, eliminating disparities and promoting equity.
3. No Deductibles: Facilitating Access to Healthcare Eliminating deductibles would remove financial barriers, encouraging people to seek medical care without economic concerns.
4. Nonprofit: Prioritizing Health over Profits In a universal system, health would take precedence, without profit goals, allowing resources to focus on improving healthcare.
5. Efficient Administrative Expenses: Optimizing Resources Allocating a significant fraction of funds to administrative expenses aims to maintain efficient administration and optimal resource utilization.
6. Independent and Representative Leadership: A Diverse Board for Common Health An independent board, with diverse representatives from the healthcare sector, would ensure evidence-based decision-making free from political pressures.
7. Coverage for Visitors: Serving All Temporary Residents Offering coverage to temporary visitors through insurance premiums would contribute to the island's reputation as a friendly and caring destination.
8. Catastrophic Fund: Preparation for Complex Challenges Establishing a catastrophic fund would address complex medical conditions, providing resources for advanced treatments outside the island when necessary.

In summary, the implementation of a universal healthcare system with a single payer, total coverage, no deductibles and profits, along with efficient administration and diverse representation, promises to significantly transform healthcare on the island, prioritizing health as a universal right and providing equitable care to the entire population.

 

*Dr Humberto Lugo-Vicente is a professor and pediatric surgeon at RCM. Appointments - (787) 340-1868.