Monday, September 28, 2009

Emergency room

So the answer to years of mismanagement at the Commonwealth Health Center is... foreign doctors?

I'm not making this up --even for me that's too bizarre and breathtaking-- the Saipan Tribune says Governor Benigno R. Fitial wants to put CHC "under a state of emergency to allow the hiring of doctors from the Philippines and other countries".

You have to wonder whether he talked to Acting Public Health Secretary Pete Untalan, quoted in the article as saying "the CNMI cannot hire doctors from that country (the Philippines) due to the standards and requirements mandated by the federal government."

"The declaration is being drafted and may be issued this week," the Governor reportedly said. "I am meeting again with the attorney general on this." I'd love to be a fly on that wall.

Another Acting Public Health Secretary John Tagabuel just told the Marianas Variety last week that CHC is in trouble with the Centers for Medicare & Medicaid Services. I'm sure they'll love this development.

Two quick questions: why this flailing about when the Administration has had four years to make improvements and, why did the Legislature only start making noise two months before the election?

I've been hearing horror stories from (ex or soon-to-be ex) doctors for more years than I can count.


bandaid said...

You might as well close the doors when Medicaid finds out about this.

Anonymous said...

Let me fill you in on something that is going on in the Phil. with the US Govt. Through the VA office in the American Embassy in Manila. There are some hospitals that are taking Medicare and Vet medical claims.
I do not know about Medicaid.
The newly opened George Dewey Hospital and Wellness Center. (they also have a medical college on site) (Subic) is in communications and negotiations now with the US Govt. and the insurance companies to set up the "accounts" etc.
Their doctors are highly qualified specialists in their respective fields that work in Manila hospitals also, such as St Lukes, Asia Pacific, and The Doctors Clinic.
All the doctors are US or Canadian qualified.
The hospital can under go any type of operations, joint replacement, teeth implants, cardiology etc.
They are about 40 minutes from Clark airbase that will soon be the international airport as Manila will be turned into a domestic airlines terminal.

Anonymous said...

In the last few days, the CNMI Supreme Court held that the Executive Order abolishing the CUC Board of Directors and transferring its powers to the Office of the Governor was unconstitutional. Both Stanley Torres and Jack Angelo will have their CUC bills adjusted to reflect the rates prior to the rate increases which were made by Governor Fitial.Hopefully, others less fortunate will also be helped financially .What type of advice was the Governor receiving from his Special Legal Advisor and then AG?

One can only hope that the Governor will reconsider issuing an Executive Order to deal with CHC problems until all of the experts have had an opportunity to comment. We really don't need to do anything which could jeopardize Medicare and Medicaid funding!

KAP said...

I'm not necessarily putting down Philippine doctors, you can get world-class medical care there. It's a good option for referrals, though Dr. Khorram has suggested we look at Japan.

But this isn't like Aggreko, and a local state of emergency can't suspend U.S. requirements. Besides, there's a little thing called equal pay. The old ways won't fly any more.

(I suspect some attorney is licking his/her chops thinking about all of the rate increases that might be overturned.)

Saipan Writer said...

Glad you blogged about this. Saves me the job!

So Anon 7:40 PM-- the Philippines has US and Canada-qualified doctors? What does that mean?

I'm with Ken on this--I'm thinking Fitial isn't listening to Untalan.

And why is there a new / different acting secretary?

I loved the letter to the editor in today's Tribune from Dr. Edward Cornett.

We need hammers.


Anonymous said...

Saipan Writer, it means that these same doctors are qualified under the US Gov requirements and are taking and treating Medicare and VA medical applicants within the Phil.Through VA at the US Embassy.(VA handles the SS also in the Phil).
There are more than 3K retired and disabled vets in the Subic and surrounding areas alone, I believe the last number stats, was that there are more than 100K American residing in the Phil.The rest of the foreign nationalities are above 250K up for each nationality with Korea, China and Japan in that order.
If these type of qualified Phil doctors were recruited they would be qualified under the US Govt requirements for Medicaid, medicare, and also VA related treatments.

Bruce A. Bateman said...

With all the bitching and complaining about the horrid-state-of-affairs over at CHC I would like to remind all those who are incensed that we live in a remote location with a tiny, yes tiny, population.

Try moving to Ft. Smith in the NW Territories of Canada. See what happens when you need a heart transplant, or a splint applied to that compound fracture or a bit of brain surgery. Need a CAT scan as is so loosely bandied about as prerequisite here? Not bloody likely is the answer. You will be referred to somewhere where there is population big enough to pay for that kind of equipment and service. You’ll be taken to Yellow Knife where at least they have a hospital unless you need serious surgery in which case you’re shunted off to a sizable community hundreds of miles away. Sound familiar? Try Baltimore if you would like to live in a place with first rate medical services.

No need to extend this idea to the ridiculous but try finding that bypass surgeon in the Zimbabwe bush or the Australian outback.

While it may not be the greatest thing since sliced bread, it's better than what most small towns have.

Me? I'm cutting back to 3 bags of chicherones per day so as to stay in better health.

sameold said...

How much would the "recruiter" make?

KAP said...

I've seen both men quoted as Acting Secretary before, so it's probably no big deal: maybe they rotate in the position or the Acting who is not acting for the Acting is off-island or on leave.

Acting (!) Gov. Eloy Inos clears up a couple of things in today's Marianas Variety. Evidently they won't be U.S. certified, and will work under the supervision of a certified doctor. I dunno how the M&M feds would react, but it might be workable: the old Medical Officers provided good service.

The Variety notes that there are concerns about wage differences and questions about the use of an employment agency.

KAP said...

Oh, and it would probably only be a two-year fix anyway: I'm not sure it would work under federal immigration.

Bruce makes a good point, CHC is and will be a community hospital. We just don't have the population to support more. It seems to be a good use of resources to have specialists come in periodically. My problem is that, while money is always a factor, doctors usually talk more about lack of respect and lying from the hospital administration when they tell me they're leaving.

Everything in moderation, Bruce. (Everything). Oh, I canned one of your duplicate responses: you hiccuped on the submit key.