Kick the can…
THE 179-page House committee report on the “health network” (medical referral) bill includes the following ominous phrase:
“Legislative reform is necessary to establish a new program.”
Recall that lawmakers once tried to give themselves a pay raise, and that they passed a pay-hike measure which resulted in a reduction of their salary. We’re talking about their own paychecks. They tried to improve their own finances, but made them worse.
Do you trust them to improve yours?
Now try to remember the many other grandiose and ambitious “reforms” and “new programs” that the Legislature has been passing and creating throughout the years — and then compare them with the actual results. (Among them, the “independent” and “financially sufficient” CHCC. The anti-litter law — the original and the “improved” version. The NMI Retirement Fund.)
As in the past, we hear talks about the need to “de-politicize” the medical referral program which was created by politicians and whose funding is supposed to be provided by politicians.
CHCC is an autonomous public corporation. But its board members are appointed and confirmed by politicians. And like CUC, which is another crucial government entity, CHCC is expected to provide essential services to members of the public, many of whom are voters who elect the politicians who, now and then, pass laws that directly affect the financial viability of CHCC (and CUC).
So let us, once again, get to the point of this most recent reiteration of a never-ending NMI dilemma:
NMI residents have been availing themselves of medical referral services provided by the government since the U.S. administration during the Trust Territory era — and quite possibly since the U.S. took over the islands at the end of World War II. NMI patients with serious medical conditions expect to be referred to off-island hospitals. Many such patients are voters related to other voters.
Medical referral costs, then and now, are enormous. More so for many Rota and Tinian patients.
The problem, then and now, is funding.
…down the road…
SOME of the “solutions” proposed and/or implemented then and now are, more or less, the same: transfer the program to the governor’s office; return it to the public health department (now CHCC); re-name the program; blame “politics” and/or “inefficiencies,” etc.; aim to “address” them.
And yet we would not be having any of these conversations if the medical referral program is adequately funded in the first place.
Recently, the House passed the latest “reform bill” that aims to “improve,” among other things, the medical referral program which would henceforth be known as the “Health Network Program.” The bill, H.B. 22-77, now goes to the Senate which, we hope, would hold public hearings, livestreamed. Many members of the public would surely want to hear a thorough discussion of the legislation’s key provision:
“Operate the Health Network Program in a manner that does not exceed the CNMI general fund appropriation for HNP. If appropriated funding for the Health Network Program is exhausted prior to the end of the fiscal year, the CHCC shall submit a request to the Governor and the Legislature for supplemental appropriations.”
CNMI residents would surely want to hear an answer to the following question:
What would likely happen to medical referral patients if the Legislature and the governor couldn’t agree on the specifics of the “supplemental appropriations” for the Health Network Program?
The retirees waited for over four months to get their Christmas holiday bonuses even though the administration and all lawmakers repeatedly expressed their “support” for the bonuses.
In the case of medical referrals, we’re usually talking about people who are very sick and are in dire need of medical care that can only be provided by an off-island hospital.
…again
AS we have earlier pointed out, bickering politicians (Democratic governor vs Republican Legislature), shut down the program in 1995. The then-governor said the Legislature should pass a funding measure, but lawmakers said he should just reprogram funds.
Why was it “hard” to pass a funding measure for medical referrals? Because they required a lot of money, and the government had other pressing obligations.
And that was in 1995 when the local economy was still vibrant and was about to boom (again).
Today, the NMI government’s pressing obligations include hefty, federal-court-mandated payments to the NMI Settlement Fund. The NMI, moreover, has fewer economic tools at its disposal since the federal government took over local immigration and minimum wage policies. And because of the Covid-19 restrictions, the NMI economy is at its lowest point since the TT era.
Do we truly believe that politicians in the executive and legislative branches of a cash-strapped government would readily and quickly agree on a supplemental funding source for the medical referral/Health Network Program?
NMI senior citizens, their families and other residents would want to hear an answer from their elected officials.
