Reforming the CNMI healthcare system

Editor’s Note: The following is the testimony offered by orthopedic surgeon Dr. Grant E. Walker in reference to Senate Bill 19-04, which proposes to transform the Commonwealth Healthcare Corp. advisory board into a governing body. This testimony has been submitted to the Senate and House Health Care Committees.

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Senate Bill 19-04 could remove unnecessarily high master’s educational requirements for a CEO and others and accept a bachelor’s degree with a high amount of experience. This would open the door for equal or better candidates, judged by the people performing the interviewing. Choosing the candidate does not have to be outlined with such fervor in legislation.
In my recommendation for 19-04, physician insurance indemnification and lawsuit malpractice caps (malpractice tort reform) would apply to all doctors practicing in the CNMI, not just government officials. At present, the CEO uses a useless hospital bylaw requiring malpractice insurance for doctor who applies for privileges. Since there is no malpractice carrier who writes anywhere in the CNMI, how can a private practice doctor practice at the only CNMI hospital?
Why put all of the hospital eggs in one basket, a basket that likes to credential only doctors employed by the CEO? Why not create smaller, energy efficient and administratively efficient hospitals? I was thinking that with some simple revisions to Public Law 16-51, there would be room to attract more private doctors and to create these public-private surgical centers and mini-hospitals the size of small grocery marts.
Where would the money come from? It would come from partnering with the private doctors and the public sectors. It would come from grants such as the Bill Gates Foundation and Mallealuca. It would come from federal grants that already exist to pay for doctors in America’s rural and underserved areas. All experienced CEOs know about these things! Have you ever seen the mission-statement of CHC published anywhere?
But why stop there? Why not have additional checks-and-balances by way of a Surgeon General, serving the specific needs of the people and making recommendations with speed and accuracy, doing something about diabetes education in our schools, running blood checking finger sticks at malls, pamphlets to educate. It is cheaper than dealing with the high cost of the treatments. The SG could work to expand the role of the U.S. Peace Corps in the remote areas and expand the Peace Corps or military owned facilities?
So with my utmost respect to you and the people of the CNMI, I deliver to you my testimony on health care reform and 19-04. It is not whittled down to just putting the CHCC board of trustees in charge of a CEO. It is a comprehensive package that puts in place the tools necessary for a complete health care reform. It leads you to 2015. You can dismiss it if you like and accept the status quo. However, in two months’ time you will still have the same failing system, the same CMS Medicare woes, the same deteriorating energy-sucking hospital facility, the same enclaves of unchecked and unelected power, Tinian and Rota left in the wings, and people living in the greatest nation on earth, the United States of America, looking to travel to the developing nation of the Philippines for an up in the quality and services of medical care.
I respectfully give to you this set of recommendations for amendments, created with over 100 hours work, borne out of a bad thing that happened to me, former representative Ana Teregeyo and other patients, and doing something good with all of that experience. I see it as a challenge to create something with so few words (less than 20 pages), and so broad so encompassing that a simple piece of legislation can change lives one at a time. It has the capacity to change and adapt with the future, one neighbor and one American at a time, just as Madison envisioned the process. Who knows, tomorrow a bad thing may happen to you. This health care reform has the capacity to be something great.
With special thanks to Sen. Teresita Santos who has my full set of amendments rewritten into the PL 16-51 format, available for the asking.

Grant E. Walker, M.D.
Special to the Saipan Tribune

Grant E. Walker, MD, is a board certified and fellowship trained orthopedic surgeon and a 2014-2015 nationally certifying orthopedic board member.