Aliens pose little pressure on public health facilities

Despite their overwhelming presence in the Northern Marianas, nonresidents continue to put too little pressure on public health facilities with United States citizens accounting for the highest percentage of hospital visits in the period covering 1994 to 1999, a federally-funded investigation of the CNMI disclosed.

The U.S. General Accounting Office revealed that nonresidents, who comprise about 58 percent of the total population of Saipan in 1999, accounted for only between 26 and 29 percent of the patient visits to Department of Public Health facilities each year from 1994 to 1999.

GAO, the investigative arm of the U.S. Congress, also bared U.S. citizens accounted for between 71 and 74 percent of all patient visits to public health facilities in the same period.

The CNMI government shouldered $24.9 million in total expenditures for the public health care of U.S. citizens on the islands, who made close to 100,000 visits to the Commonwealth Health Center last year.

During the same period, nonresidents made only about 32,158 medical consultations with the public hospital. The visits cost the CNMI government some $8.75 million, way lower than the U.S. citizens who comprise 42 percent of the total Saipan population.

In an interview with GAO investigators, CNMI Public Health Secretary Joseph Villagomez explained alien workers account for a comparatively low percentage of visits because majority of them are young and do not have chronic diseases.

The GAO report added, however, that the low volume of visits by the alien worker population at the lone government hospital may be attributed to the existence of other health care facilities that are not operated by the DPH.

Also, the influx of nonresidents into the Northern Marianas raise growing concerns on the presence of infectious diseases since the CNMI’s current health care system was developed to meet the demands of only about 20,000 people.

The CNMI is now home to approximately 70,000 people, including citizens, guest workers and residents of the Marshall Islands, Federated States of Micronesia and Palau, which comprise the Freely Associated States..

DPH attributed the growing concerns on infectious diseases to the rapid influx of poorly screened and monitored alien workers who have higher rates of Tuberculosis, Human Immunodeficiency Virus and syphilis than the indigenous CNMI population, the GAO report said.

However, DPH pointed out that although the majority of active TB cases involved alien workers, TB among the indigenous population continued to increase at a steady rate.

“Of the alien workers who have developed active TB, most of them were already living in the CNMI before they developed active TB, or it was inactive at the time of their arrival,” the GAO report added.

It also quoted reports from the CNMI-DPH which disclosed that 93 of the 110 diagnosed active TB cases in 1998 were from the CNMI’s alien population. Last year, 58 of the 66 diagnosed active TB cases were from the alien population.

GAO cited a regulation implemented by the CNMI government in order to effectively contain the spread of infectious diseases. The regulation requires the annual screening of all alien workers for TB, HIV and syphilis.

Economic contribution

A February 2000 report prepared by the U.S.-GAO said the presence of foreign workers in the islands has been directly and indirectly paving the way for the continued survival of the government and businesses in other sectors.

The GAO report questions findings by the Office of Insular Affairs that the garment and tourist industries and the workers they employ require government spending for services and infrastructure that exceeds what they contribute in revenue.

The local labor pool, including those already employed and U.S. citizens not born in the CNMI and non-U.S. citizens from the Freely Associated States who have the right of residency in the islands, is not sufficient to support the scope and size of the economy that exists in the Northern Marianas.

There are only about 12,800 resident workers on Saipan in 1999 while the island’s economy employed some 43,700, which explains the tourism and garment industries’ dependence on foreign manpower.

GAO validated the multiplier effect of garment and tourism industries to other business sectors, as well as to the growth of the local government which received over $50 million from the apparel manufacturing and $34 million from the travel sectors in 1998.

“These industries [garment and tourism] are linked to the rest of the economy through the purchases of goods and services from other industries, tax revenue paid to the government and workers’ spending,” the report pointed out.

The two sectors are responsible for about 85 percent of the total economic activity in the Northern Marianas, producing at least 96 percent of the Commonwealth’s exports.