Medical Referral questions

The Torre administration, low on money and looking for options, has chosen to look at the CNMI Medical Referral annual expenditures of $15 million to find some savings. They also cite the overtime costs for law enforcement, (Department of Public Safety, Department of Fire and Emergency Medical Services, Department of Corrections, and Division of Customs), but obviously call for no cuts there. They cite these to try and make the Medical Referrals seem less important.

I’m all for finding ways to save money. I’m all for cutting less appropriate government programs and their associated costs. I am for axing some entire central government divisions. (fodder for a later column). We need to prioritize but we don’t need to be dumb about it.

CNMI Medical Referral sends patients from Saipan, Tinian and Rota off to first-rate facilities to have a wide variety of procedures performed by highly trained professional doctors, nurses and technical personnel in the newest hospital facilities with the very latest medical equipment. Often these patients are indigent, poor and have serious life-threatening illnesses. Even when they are not poor, they don’t send people off island for a hangnail. Potential patients are carefully screened by Medical Referral to meet stringent criteria before they qualify for so much as a discounted hotel room. So only the poorest of patients have their medical costs paid for by Medical Referral. Those actual medical costs for the poor account for the vast majority of total expenses (90-plus%). Those making too much to have their medical costs paid may still receive a small per diem allowance or a pre-contracted and discounted hotel room or maybe both, if their carefully checked income is low enough, paid by Medical Referral.

Our governor, in consultation with Aetna Insurance and our Legislative Health Committee, has negotiated a deal with that company, which the governor has implemented, for Aetna Insurance to handle all the appointments of each patient for their specific medical needs and to take care of insurance requirements, including all documentation.

“The administration assured us that we would see a significant 40% reduction in costs by allowing Aetna to provide this particular service for the medical referral office of the Commonwealth,” said Rep Lorenzo Deleon Guerrero.

The lawmaker also said that during the meeting, the governor insisted that the Health Committee chairs of both the House and Senate, Rep. Jose Itibus (R-Saipan) and Sen. Justo Quitugua (R-Saipan), respectively, meet with Medical Referral Services director Ronald Sablan to discuss all issues concerned.

So 40% of $15 million is $6 million buckaroos, which is a heck of a savings! If they can do that without cutting services to the poor who need those medical procedures to keep them alive and cant’ be helped on Saipan, I am a buyer. But is that level of savings really possible with just a change of paperwork providers? Seems doubtful to me but I will keep an eye on the details and be looking, as you should, at whether it really works to save that much or not.

I like my neighbor Vinnie’s (Sen. Vinnie Sablan) idea to spend $10 million reinvesting in our medical facility so fewer patients need to be sent to top-notch hospitals in expensive Hawaii or even not expensive Philippines. But let’s take a closer look. First, $10 million is a drop in the bucket for medical upgrades. Guam as an example has spent far more and still sends referral patients to the Philippines and Hawaii. Guam also brought in a major investor to build a modern new hospital, which doesn’t work because they can’t (and we on Saipan can’t either) staff whole hospitals with top professionals at the salaries offered. Hundreds of millions down the tubes? In Guam, a single test, a CT scan, costs $1,000 while it costs only $400 in the Philippines. An airplane ticket costs $600 and the payer has broken even. All the other tests, procedures, consultations etc. are gravy and large amounts are saved on each patient sent off island.

Here on Saipan, the example is even worse. A CT scan test costs $1,400 here and $400 in the Philippines using the latest 1152-slice Somatom scanner there versus Saipan with our 1937 model Volkswagen 180-slice scanner. Once completed with the scan, there is nobody who can read and interpret it here and hundreds of dollars more need to be paid out just to read it. I had one done here on Saipan and the guy who read it remarked that my spleen was in good shape (in fact my spleen was removed a long ago).

Let’s tread very lightly on trying to reduce this literally life-and-death expenditure carefully overseen by our experienced CNMI Medical Referral Office here on Saipan and their contracted official representative personnel in their office in the Philippines.

Bad things happen

Sometimes we get so involved in all that’s happening on Saipan we forget that bad things, and good, happen in other places too.

A friend of mine works as a chauffeur/driver in an Asian city. He, his wife, and three3 children live in a modest house in a poorer neighborhood with houses quite close together. The other evening, one of their neighbors, living with his parents, had a fight with his wife. Apparently, both he and his wife have an ice drug problem; the husband was drinking as well. At fight’s end, the wife stormed out and the husband, in a rage, set fire to his mom’s house and ran away. Six people died, including three children, and 20 nearby houses were destroyed. Several other people were injured, including the perpetrator’s own parents.

The hapless confessed arsonist has been charged with the arson and six murders, his life destroyed, and that of these innocent others for the fleeting pleasure of a stupid drug high.

Luckily, my friend’s house was spared the fire but had extensive damage from the smoke, water, and the firemen standing on his roof fighting the fire. His friends are now helping him rebuild and get back on his feet. That is the one bright spot here.

What we should learn here is—stay away from hard drugs. If you are already hooked, get some help and get off that dumb wagon—you are on the road to hell.
Thanks for reading Sour Grapes!

“Physicians mend or end us; but though in health we sneer, when sick we call them to attend us, without the least propensity to jeer.”
—Lord George Byron

“I got the bill for my surgery. Now I know what those doctors were wearing masks for.”
—James H. Baron

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Bruce A. Bateman resides on Saipan with a wife, a son, and an unknown number of boonie dogs. He has owned and operated a number of unusual businesses and most recently worked as the marketing manager for MVA. Bruce likes to read, travel, tinker with bicycles, hike, swim, and play a bit of golf. He is opinionated and writes when the moon is full and the mood strikes.