January 27, 2012
The CNMI may just be the most dangerous place to live on U.S. soil. I am not talking about the crime, although there certainly is a proportionately large amount for such a small population. I am talking about
unstable utilities, a
retirement fund on the verge of collapse, an
inadequate health care system and incompetent and corrupted leaders that are apparently incapable of coming up with a plan to raise revenue.
Yesterday I drove by a billboard that announced that the lottery prize was $146 million. It struck me that the amount is more than the
entire annual budget of the CNMI, which is $102 million. Surely, even considering the small population, a property or sales tax could raise much needed revenue, but leaders stubbornly resist imposing any taxes. It seems that the leaders just wait for money to come from some illusive investment scheme or think that the federal taxpayers will provide a bail out so they act as if there were no emergency or need to come up with a revenue raising plan
now (or realistically, yesterday).
The media is constantly reporting the devastating financial condition of the CNMI agencies, departments and government in general and questioning the actions of the leaders. The most important question is what impact does and will the further economic collapse have on the people living in the CNMI? How long can or will people remain in such an unstable and dangerous place?
Living in the CNMI may be like playing Russian Roulette. If a person contracts a serious disease or has an accident he/she may not be able to get proper medical treatment. And since Saipan, Rota and Tinian are islands, it's not like a person could easily get to another city or state for treatment. There are serious risks in living in the CNMI today.
The island's only hospital is virtually bankrupt. The signs were evident for years. As it was continuously
reported on Unheard No More! and in the media over the last two years,
nurses were not being paid regularly and were not receiving their housing allowances on time. The number of nurses declined from 235 in 2010 to 175 in June 2011 resulting in
a nursing shortage. A
shortage of doctors was reported in July 2011. In November 2010 the
children's clinic was closed because there were no pediatricians.
In 2009 the hospital was placed under a "state of emergency." In July 2011, Lt. Governor Inos declared a
"state of emergency" again, as vendors refused to send supplies until past debts were paid. In July 2011 it was reported that the
hospital owed over $2.9 million to vendors who stopped supplying critical goods, including pharmaceutical, medical, and dialysis supplies. This week the
Marianas Variety reported that payroll for the 630 employees cannot be met, housing allowances are unpaid, and there are not even supplies to conduct lab tests. Aren't people taking their chances living in a place with no stable or functioning hospital?
It was also reported that the hospital has $24 million in uncollected bills. I would guess that many of the $24 million in unpaid bills are those of employers who failed to pay their foreign workers' medical expenses, as was required by CNMI law and contract. After all, hundreds of employer-crooks stole millions in wages from foreign workers and the CNMI government did nothing. Even with a collection agency, the CNMI government cannot expect that a significant amount of the past debts will be collected from a population of people that has never been held accountable for paying wages or bills.
How does a business get to the point that the collectables are $24 million? This did not happen in a year, or two years or even three years. Obviously, the hospital's administration that oversees operations, including the collection of bills and paying vendors, has been a complete failure for years. Where is the oversight?
The governor's solution to the hospital's woes seems to have been turning the hospital into a public corporation (October 2011) and appointing former Governor Juan Babauta to administer it. I am not sure how this can be seen as a solution. It is just taking a failed entity and slapping a new name on it since only $5 million was budgeted for the hospital for this fiscal year and the
Marianas Variety reports that inadequate sum will be spent by this summer.
Not surprisingly, the
Marianas Variety reported that a physician said that the staff feels "terrified and hopeless." Of course they do. They do not know how long they will be paid, if they will be paid, and even if there will be the needed supplies to perform their critical services. People who live in the CNMI are risking their lives and the lives of their children. After all there is only one hospital on each island and all three are operating at dangerously inadequate levels.
The CNMI government announced that
Medicaid money will be capped at $5.3 million for 2012, with $4 million going to the hospital and only $1.3 to be shared among over 20 Medicaid-approved private clinics of medical offices. The
2011 Medicaid spending far exceeded this amount. The
Marianas Variety reported:
Reductions to affect Saipan’s private providers will be even more horrific.
Total 2011 billings hovered around $9 million and their new cap was set at $1.3 million.
The loss of $7.7 million equals an 86 percent gutting of funding.
Considering one pharmacy alone billed Medicaid close to $2 million dollars in 2011, the impact to providers will be catastrophic.
While CHC will pick-up a majority of current Medicaid clients, the 57 percent overall program-funding reductions will result in fewer clients served or rationing of healthcare among the poor.
Either or both of these outcomes will devastate services for the approximately 6,400 people in the Medicaid program, over half of which are children.
The governor falsely claimed that the reason for the reduction in Medicaid funds was higher federal matching requirements, but the percentage of the match actually fell by 5%. Even more scary is the fact that the Ester Muna, past financial officer of the hospital (the hospital with $24 million in collectables), is now charged with
overseeing the Medicaid billing. She will be making decisions as to what spending is allowed and what is not allowed. Will she also be making decisions on who will be treated and who will not be treated under the program? We know how that worked in the NAP Office.
It was the U.S. citizen children of foreign workers who were singled out not to get food stamps.
It certainly looks like the weakest and poorest residents will again be the recipients of cruel decisions of the CNMI governor who has refused to support food stamp increases by rejecting applying the SNAP Program to the CNMI and has now slashed Medicaid funding.
Amazingly, this cash-strapped, near bankrupt government finds money for off-island trips, to fund indigenous affairs and other non-critical government offices, to hire numerous outside consultants, and to pay for lawsuits against the federal government.
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This is a story not just for Filipino children, but for all children in the world with a mom or dad living far away, who in one way or another have had the same experiences as my son."
