Puerto Rico has been working to become a major destination for medical tourism — the practice of traveling to a less expensive location for medical care. A knee replacement can cost nearly $70,000 in New York. In Puerto Rico, it can be as low as $12,000. With up-to-date facilities and a U.S.-trained orthopedic surgeon, that’s a bargain.
The cost difference amply covers travel costs and a very nice vacation in Puerto Rico for the family while the patient recuperates.
It’s a different story for people who live in Puerto Rico. Medical care in Puerto Rico at this point is in a state of crisis.
For one thing, although Puerto Ricans pay into the federal healthcare system, they don’t get equal benefits, and millions of dollars in additional cuts are scheduled to take place over the next year.
Most Puerto Ricans don’t pay federal income taxes, so they are not eligible for the subsidies that go along with the Affordable Care Act in the States, even though Puerto Rico opted into many parts of the ACA.
There is also a shortage of doctors in Puerto Rico, as doctors stream to the mainland in search of better compensation. Rep. Raul Ruiz, in the recent hearing on Puerto Rico’s status, reported that there had been a loss of 13% in the total number of doctors on the Island over the past five years. Compared to the states, Puerto Rico has less than half as many emergency care physicians.
Since Medicare, which funds about half of all the medical care in the territory, pays less to doctors in Puerto Rico, it is more profitable for physicians to head for the States. Since so many Puerto Rican doctors were educated on the mainland, it’s an easy move to make.
“Our territories are part of our nation,” Dr. Ruiz said, “The people of Puerto Rico deserve to have access to the health care services that they have paid for.” He asked Rep. Pierluisi whether this situation was related to the status of Puerto Rico.
“We do not get equal treatment in federal programs,” said Pierluisi. “We afford health insurance to people up to roughly 80% of the poverty level [compared with] 134% of the poverty level in the States… To me it is unacceptable.” He explained further that there is a bill which would improve the situation, but reminded the speakers that he has no vote in Congress. “I represent 3.7 million Americans, but I have no vote. That is not democracy. That is embarrassing.”
The problems of health care in Puerto Rico reflect the status of Puerto Rico, and statehood will provide a solution.