El colegio de Medicos Cirujanos propone una iniciativa tentadora y humanitaria ante el Congreso federal.
Estimados colegas:
Como les supongo informados a través de los medios de comunicación del país, el pasado jueves 9 de julio, este servidor fue citado a deponer ante miembros del Congreso de los Estados Unidos reunidos con relación a los cambios en el sistema de salud que están siendo evaluados, tanto por el propio Congreso como por el propio presidente Barack Obama. Estas fueron las opiniones y sugerencias al respecto propuestas a nombre del Colegio de Médicos Cirujanos de Puerto Rico:
“Thank you for your leadership on the issue of health care…the Puerto Rican College of Physicians and Surgeons strongly supports the Public Health Insurance Option your administration is proposing. Our organization…also agrees with President Obama on his assertion that the public option will give all citizens a wider range of choices, stimulate competition and will help to maintain honesty in the insurance industry.
It is our understanding and sincere hope that this will only be the first step toward much greater achievements of this administration in order to resolve the extremely serious health crisis in America.
Let us briefly examine some facts regarding health care in Puerto Rico:
1. Puerto Rico has a geographical area of only 9,104 km², with a population of nearly 4 million people. The population density of 438 people per square kilometer is the second highest in the US after New Jersey.
2. Puerto Rico has an unemployment rate of 14.7 %, which is rapidly growing.
3. Puerto Ricans had a median household income of $17,741 for 2007, making it the poorest jurisdiction of the Union.
4. Puerto Rico has an alarming 45.5% of the population living below the poverty line, compared to ± 12% in mainland USA.
5. Puerto Rico’s public debt has grown faster than its economy, reaching approximately $46.7 billion in 2008.
6. Approximately 500,000 Puerto Ricans have no health insurance at all.
7. When compared with the 50 states of the nation, Puerto Rico has the highest incidence of Diabetes mellitus (12.8 per 1,000 people versus 9.0 per 1,000 in the mainland USA).
8. Among persons younger than 45 years of age, the prevalence of hypertension in Puerto Rico is twice the rate observed in the United States (8.1% versus 4.2%).
9. AIDS cases per each 100,000 population are 21.5 versus a US National average of 12.4.
10. Notably, the Age-Adjusted Death Rate for HIV Disease in 2005 was 14.4 for 100,000 inhabitants for Puerto Rico versus an average of 4.2 for mainland USA.
11. The lifetime prevalence of bronchial asthma is the highest in the nation: ± 19.6 % in Puerto Rico versus ± 11.8 % in mainland USA.
12. The mortality due to bronchial asthma is 48.1 x 106 in Puerto Rico versus 14.0 x 106 for mainland USA
13. The Influenza vaccination rate for people older than 65 years is 32% in Puerto Rico versus 72% in mainland USA.
14. The dissatisfaction with the whole system by the general population, the media, the professionals and the providers of services is, to say the least, alarming.
It is extremely disturbing to notice, after considering such poor health indicators and general population dissatisfaction, that we expend 18.9% of our GDP on health care, the highest on planet earth!
On contemplating the history of the United States, there is a conspicuous coincidence when one compares the steps toward the achievement of Universal Education with that of Universal Health Care. Like most American rights, Universal Education was established after long years of a struggle begun by relatively few individuals, but pursued through broad education and eventually demanded by most Americans. It followed amazingly a path almost identical as Universal Health Care should follow. It was first established in one state, then a second one, followed by the rest until it becomes a law of the Nation. For that reason, as an immediate second step to the public insurance option, or ideally as a parallel first step to it, if so decided, the College of Physicians and Surgeons of Puerto Rico proposes that a pilot program of a Universal Health Plan with a single payer system be implemented on the island of Puerto Rico. Having no borders with other states, the function of the system can be well controlled avoiding situations like those of persons living in one state, being beneficiaries of the single payer insurance and at the same time working in adjacent states. Probably Hawaii and Alaska due to their similar characteristics could also benefit from such undertaking.
We are positive that after one year of implementation its predictable success will be notoriously projected not only to all the American people, but also to the rest of the world. It will represent a social justice achievement with the magnitude of the abolition of slavery or the implementation of civil rights.
Thank you very much again for this opportunity, not only in the name of the College of Physicians and Surgeons of Puerto Rico but in the name of all the people of Puerto Rico.
Terminada nuestra ponencia, varios de los Senadores presentes se nos acercaron para mostrarnos su respeto y respaldo hacia nuestra posición y simultáneamente nos participaron que la idea les parecía una forma muy elegante con la que el presidente Obama y el congreso demócrata podrían demostrar al pueblo americano su deseo de cumplir con una de sus más significativas y notorias promesas de campaña al iniciar en una o varias jurisdicciones el establecimiento de un auténtico plan de salud universal. Una observación muy significativa que uno de los senadores nos hizo persoalmente aparte al salir de la vista fue: “It sincerely is very hard to believe how such simple and obvious ideas of recognized humanitarian respect and transcendence arte taking us so much time and effort to comprehend and such a fight to implement”
..........estimados colegas, nosotros nos sentimos muy orgullosos por haber tenido la oportunidad de llevar la voz del Colegio hasta tan altos foros en cumplimiento de los más sagrados deberes institucionales. Estas circunstancias jamás se hubieran dado sin la marcha en Puerto Rico y la subsiguiente en Washington utilizando sus propios fondos y recursos de nuestros queridos colegas y amigos .........................
También tenemos que reconocer la presencia en nuestras marchas en Washington de familiares de algunos de nuestros colegas y amigos que residen en esa ciudad ...........así como muchas otras personas de la comunidad latina y de las organizaciones de Estados Unidos que han venido defendiendo y respaldando estos conceptos de impostergable justicia social, no solo para Puerto Rico sino para todos los pueblos del mundo.
Afectuosamente
Dr. Eduardo Ibarra
Presidente
Colegio de Médicos Cirujanos de Puerto Rico
Articulos importantes en Time Magazine hablan de los beneficios y los riesgos de una reforma de salud.
http://www.time.com/time/nation/article/0,8599,1909946,00.html
