Overhaul in health care program sought

With the spiraling cost of medical care, the Department of Public Health has urged the Senate to approve a health insurance system that would make employees partly responsible for their own health care.

Public Health Secretary Joseph Kevin Villagomez told the Senate Committee on Health Education and Welfare that there has to be a shift on the responsibility for the cost of health care delivery because the CNMI government can no longer afford to continue absorbing the cost of individuals who are not covered by any health care plan and yet continue to be employed.

The measure entitled Commonwealth Mandatory Health Care Act of 1999 was proposed by Sen. Morgen Tenorio. Patterned after Hawaii, the proposal requires employers to provide a prepaid health care plan which will include hospital benefits, out-patient care, surgical services, medical consultations, diagnostic laboratory services, maternity benefits and substance abuse treatment.

The Commonwealth Health Center cannot and do not deny service to anyone

Villagomez, however, warned that the $27 million operational cost, which does not cover the expenses on repair of medical equipment and purchase of supplies, would continue to increase if the government would continue shouldering health care expenses of those who are not insured.

Aside from this, medical referral cost ranges from $5m to $8 million per year.

CHC sees an average of 35,000 people a year in its outpatient Family Care Clinic and another 55,000 per year at the Women and Children’s Clinics. The Emergency Room sees an average of 20,000 patients per year. Over 5,000 of CNMI citizens are hospitalized every year.

The hospital collection system has improved. The collection average is placed at about $10 million each year. But still, Villagomez said, such amount is still below the hospital’s target.

As the population of the CNMI has risen dramatically for the past 10 to 15 years, demand on health care has also seen a corresponding increase. Amid this scenario, DPH has seen the need to shift its focus from curative to preventive.

“The rewards and benefits for this shift are long-term and might not be politically popular but it must be taken. It must be taken if we are to see not only financial savings but, more importantly, better quality of life for our citizens,” said Villagomez.

Since citizens from the Freely Associated States who are working in the private sector are not covered under the Non-Resident Workers Act, their health care expenses are not on the employer.

Several of them have been treated at CHC for injuries resulting from auto accident and they could not even pay their bill which is over $50,000 since they usually do not earn more than the minimum wage.

Villagomez said an employer has to realize that having a health insurance program for his/her employee is cheaper than not having an insurance at all when the employee gets into an accident. Bills of uninsured employees usually reach as high as $500,000.

Deputy Secretary for Public Health Administration Ned Arriola recommended a careful review of the proposed measure to make sure that all concerns are covered.

Arriola said a six-month contract with a health insurance firm may be negotiated through the Secretary of Health to give the department a better picture on how to address this proposed mandatory health insurance.