At least 18 towns have no health centers or only partial medical services, according to an analysis of the Health Department ordered by the governor Peter Pierluisi to make viable his promise to locate a health facility in each municipality.
Secretary of Health, Carlos Melladoexplained yesterday, Sunday, that the analysis is still continuing to identify what needs each municipality has, for example, if they need to extend the hours of operation in an existing medical facility, create a health center, increase the contribution in the event that the services are provided by a group of primary health services (IPA) under the government health card or “require them to provide those services”.
He said that, among the elements that they take into consideration, is the distance to reach a health center.
However, Mellado estimated that they will need $10 million to $12 million to fulfill the governor’s commitment, announced last week during the State Situation Message. Currently, Health pays $10 million to subsidize the third shift or extended hours in some diagnosis and treatment centers (CDT).
“The principle is that there is no municipality that does not have access to health services”said the secretary.
to questions of The new daysaid the money for Pierluisi’s initiative would come from the General Fund.
“Another thing that I am proposing is that the Department of Health has the hospital (Dr. Ramón Ruiz Arnau University) in Bayamón, it has the Pediatric, UDH (University Hospital for Adults), it has the HIV-AIDS clinics, and they bill well. money. What happens is that the Board (of Fiscal Supervision), obviously, limits the ‘budget’ (budget). But I would say that, if one makes this well-supported approach, because of the money that the department develops, it could have access to those funds”he explained.
Reaching agreements with the municipalities and even subsidizing the third shift of medical services in more towns is not ruled out. But Mellado clarified that Salud will not bear all the costs to make the project viable.
He stressed that There is still no date to implement this initiative.
Mellado acknowledged that the governor’s proposal is to return to the so-called Arbona health system, under which medical care facilities were distributed throughout the island and there were three levels of medical services.
“Yes, in a certain way, we want to return that access, but the government is not going to take care of all that”he emphasized.
He added that the initiative did not arise as a result of the coronavirus pandemic. COVID-19but is contained in Pierluisi’s government plan.
Mellado recalled that as a doctor in Canóvanashad patients who could not get “even to the doctor’s office that is in town.”
“In other words, there are still many people within the same municipalities who do not have access to transportation to have to go to a hospital further away”he pointed.
The governor, for his part, reaffirmed his promise to expand access to health services for the population.
“The public policy of my administration established in the Government Plan proposes that, in every municipality, there must be a CDT or, in the alternative, a 330 Center that can provide medical attention and that, when justified by population, it is for 24 hours, seven days a week. I am taking care of that, because we have some municipalities that do not have medical facilities and others that have them with limited hours. Right now, we are addressing the lack of adequate medical services in municipalities such as Maunabo, Ceiba, and Vieques. In the latter, we already have the new hospital project underway”stated the president in writing, at the request of The new day.
Mellado specified that, As in Vieques, health centers will be built in Ceiba and Maunabo.
“We are preparing them for a hospital with limited services,” he said.
He argued that in line with the public policy of the Pierluisi administration, it is also sought that in the municipalities where there are IPAs, they offer extended hours, at least, until 11:00 pm and raise the fees for doctors.
Communication with the mayors, Mellado indicated, will be vital to establish whether the health services in a town will be offered 24 hours a day or only the offer or the hours will be increased.
Prior to the creation of the so-called health reform – whose implementation began in 1994 and in 2000 covered the entire island – all municipalities had a health center.
“In the Guillermo Arbona system there was at least one CDT for each municipality. They were the primary part. That CDT had a fairly comprehensive composition. It had doctors, social workers, x-rays, a pharmacy, a laboratory, an integrated team that gave support to the primary doctor. And the secondary level were the hospitals where patients who had some type of problem more complex than the primary level were referred”explained Dr. Ibrahim Pérez.
He added that some CDTs and hospitals were sold and others were privatized.
“That was not completely lost in Puerto Rico with the Rosselló reform because in 1970 the 330 centers began to be built, which already cover 67 municipalities in Puerto Rico”he claimed.
He stressed that the initiative proposed by Pierluisi “is a confession that we are returning -in concept- to the Arbona model, even at the primary level, which was the greatest success of the Arbona system.”
“They realized that there are places here where there are no medical services in their town and they have to go to another town to seek services”Perez said.