Insurance Companies: Cause Of Exodus Of Doctors From Puerto Rico

During the last couple of years Puerto Rico has confronted an exodus from doctors and healthcare professionals from the country. According to the President of the House of Representatives, Carlos “Johnny” Méndez, insurance companies’ make doctors life impossible and believes that favorable conditions for doctors where insurance companies do not questioned the treatment, medication and procedures recommended by doctors. That is why the Representative indicated that he will be “focusing on healthcare plans”, according to the article “Letal las aseguradoras para la salud en Puerto Rico” by Yaritza Rivera Clemente, published by the newspaper El Nuevo Día on January 18, 2017.

The Representative also indicated that healthcare plans have not liberated the money already paid by the Government stating that they need to audit those institutions, during the public hearing celebrated regarding the “Proyecto de la Cámara 5 para promulgar la ‘Ley e Incentivos para la Retención y Retorno de Profesionales Médicos.’” The Representative suggests that it be the Government who pays and to not use insurance companies anymore.

On the other hand, Rafael Rodríguez Mercado, the Secretary of the Department of Health, believes that part of the exodus of doctors is due the payment of taxes and the high salaries offered to them in the United States.

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Puerto Rico And Its Healthcare Crisis

According to the article “Inminente crisis de salud” by Yaritza Rivera Clemente, published by the newspaper El Nuevo Día on January 19, 2017, during 2009 and 2014 there’s been a reduction of doctors in Puerto Rico of 13,452 to 11,088. Said numbers supports Rafael Rodríguez Mercado’s, Secretary of the Department of Health, statement that there is a lack of general and trauma surgeons, endocrinologists and neurosurgeons. Rodríguez also indicated that the patients of the Reform have been affected with the departure of so many specialists since these are affiliated with the Reform and these patients have been forced to seek treatment at Centro Médico, which in turn has caused that this hospital be visited by a large number of people. During the Public Hearing of the “Proyecto de la Cámara 5” which promulgates the “Ley de Incentivos para la Retención de Profesionales Médicos”, Rodríguez stated that Centro Médico has been receiving patients from Mayaguez and Vieques, which in turn has cause a $494 million dollars deficit. Said project proposes a reduction of the fixed tax rate of 4% of the generated income to doctors who provide services to “Mi Salud” plan or comply with the annual 180 hours of community service.

Meanwhile, Concepción Quiñones de Longo, subsecretary of the Department of Health, stated that there has been a reduction of 8,452 to 6,713 of specialized doctors. Victor Ramos, President of the College of Surgeons, indicated that there is a lack of specialized doctors in the pediatric area, since there are only 2 pediatric neurosurgeons, 3 radiologists and 2 pediatric vascular surgeons.

There isn’t only a problem with the departure of specialized doctors from the country, but doctors have also been affected by insurance companies. That’s why the Health Commission of the House of Representatives will be reviewing and regulating the services provided by insurance companies. Ángela Ávila Marrero, acting executive of the “Administradora de Seguros de Salud” (ASES), stated that insurance companies are the ones who contract the doctors and not the Government and that the actual model that is implemented is one “of coordinated care with the complete risk of the insurance company”.

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