Why the CNMI needs healthcare reform…now!

When the Commonwealth Health Center was in its infancy and planning stage in 1980, the people of the Northern Mariana Islands were proud that a 75-bed hospital, fully equipped with the state-of-the-art modern medical equipment will be built. It was envisioned to provide quality care and service to its population and reduce the need for off-island medical referral. It was highly supported by families from the islands of Rota, Tinian, Saipan and the islands north of Saipan. It was noteworthy in the entire region as it was the best, most up-to-date and technically advanced medical facility of its kind, capable of providing top-notch professional and highest quality healthcare to the people of the Northern Mariana Islands.

Thirty-five years later, we continue to experience reduced appropriation from the CNMI government, problems on billings and collections, lack of trained administrative personnel, lack of medical professionals in the area of specialized fields such as diabetes, cardiologist, pulmonologist, and a U.S. educated and trained orthopedic surgeon for bones, muscles and joints, to name a few. I have to ask myself, why? Why do we think of ourselves as only worthy of Third World medicine? Perhaps the acceptance of medical care noted to be that of a lesser standard than the Philippines, while CMS/Medicare pays and expects value for its payments, is the reason we are constantly in trouble with them. This is not rocket science. Do we need to do an inventory of what types of professional medical care and service the people need most or are we stuck in a loop, a kind of jigsaw puzzle, constantly reinventing what has already been invented before, trying to determine what we want to have and not making decisions based upon the needs of the general population, whose health is getting statistically worse? Do we have care based upon the ever aging, single hospital equipment facility and out-of-date supplies? What happened to us? What happened to that technically advanced medical facility that now seems as though it cannot even pay its electrical bill? Healthcare reform will provide the House/Senate committees with the tools to determine exactly what is needed and how to once again deliver quality healthcare. Once established, the House/Senate committees on health care will be in a better position to do an oversight of the hospital governing board of trustees and chief executive officer. They must appear before a joint committee of the House and Senate and submit to the presiding officers of the Legislature and the respective chairmen of the House/Senate health committees a quarterly progress report or an annual activity report not later than 30days after the end of a calendar year. The reports as submitted by the CHCC will assist the joint committees on healthcare with ideas to determine how we can best deliver a quality health care system that our islands and her people deserve!

Perhaps not many people knew of my sudden disappearance from the island, most specially my absence during the recently completed campaign season throughout the CNMI. I did not voluntarily choose to be away during an election year, but I had to go to the Las Vegas Trauma Center on June 20, 2014, to get the professional and quality medical care that CHC failed to provide when I was still an inpatient from Nov. 2, 2013, to Nov. 27, 2013. I was recovering from an operation on my left leg, a tibia bone shattered into more than nine pieces and a damaged kneecap. My former orthopedic surgeon, Dr. Grant E. Walker, was instrumental in securing my appointments for treatment at the Las Vegas Trauma Center, a faculty medical teaching center in Nevada. He discussed my case with two other orthopedic surgeons who joined to operate on what became six additional staged and sequenced surgeries. Dr. Walker never took a dime for any of this because that is his character. He did it because of the need to help someone whom he had once been responsible for and a person who had been mistreated and misdiagnosed by CHC and who would have had her leg amputated! The orthopedic p.a. just told me to “just go home.” Visit after visit I had no x-rays because it took so long to get an x-ray at CHC that the p.a. would just become frustrated and say, “Ah, we’ll do it next time.” When the next day came, there was yet another, “Well, we’ll just have to do it next time.”

I will be returning to my homeland, Saipan, hopefully in March of this year, and God willing, walking! It is painful, both physically and emotionally, to go through six surgeries in all, counting the one at CHC. It is noteworthy that having to go through surgeries for six times in a very short time in a matter of months is a very risky undertaking for any human being. The pre-operation procedure requires an administration of general sedation or regional anesthesia medication before surgery. Of the six surgeries, I was under a general anesthesia for the five, with one regional anesthesia of the spine for a knee reconstruction surgery. There are risks involved in any of the three forms of anesthesia medication, depending on the person’s health condition prior to surgery. Based on general understanding, anesthesia medication provides comfort and maintain vital life functions by putting a person into deep sleep during surgery so that a person may not feel pain. With a lot of physical therapy ahead and the help of some very talented surgeons, I hope to make a full recovery some day. Having gone through all the surgeries gave me a great deal of insight for what it is like to be a patient and helpless at the hands of CHC. I have read the CEO’s newspaper articles and I tried to reason with her while I was an inpatient. I now know that it is my destiny to use the gift of my political experience and challenge myself to help those who are and will be in the situation that I found myself as a patient. I feel determined, more than ever, pray that I will receive His grace and start walking again after more than one year in a wheelchair.

Personally, I cannot overemphasize the need for a quality, full time, U.S. trained, board certified orthopedic surgeon in the CNMI! I have never found any physician or patient that had anything other than excellent things to say about Dr. Grant E. Walker. Dr. LaVene, a senior surgeon at CHC, once commented that Dr. Walker perhaps is the best ortho surgeon he has seen in his career. Dr. LaVene assisted during my initial operation at CHC on Nov. 7, 2013. How did we do such a poor job of keeping him? Look, bad things can happen to good people. Any of us, at any time can get into orthopedic trouble regardless of the physical location of an individual. Accidents do not discriminate. I am aware of several individuals who are still inpatients at our lone, struggling public hospital and they are suffering for a long time with bone and joint related illnesses. As a family member, do you want them to recover and be active again? What is the usefulness of a life worth? An orthopedic doctor can certainly provide professional medical care to anyone who needs help in our time of need. It is time to reach out and correct the wrong caused. It is necessary to reach out to other specialists. It is time to bring quality healthcare back to the people. More than ever, it is time for health care reform!

Ana Sablan Teregeyo
San Vicente, Saipan