That St. Maarten Medical Center (SMMC) has been left with 36.3 million Caribbean guilders in unpaid bills from uninsured patients between 2021 and 2024 (see related story) confirms that the local healthcare funding system remains problematic. Although people often point to illegal migrants, they are not the only ones involved.
The annual amounts were Cg. 8,628,000 in 2021, Cg. 9,463,000 in 2022, Cg. 8,729,000 in 2023 and Cg. 9,483,000 in 2024. Earlier released figures from Social and Health Insurance SZV on the cost of care for undocumented persons who are not contributing to the system showed amounts of respectively Cg. 1,876,983, Cg. 2,603,180, Cg. 4,012,156 and Cg. 5,603,742.
Minister of Public Health and Labor Richinel Brug is correct in urging businesses with undocumented workers to do the right thing by getting them medical coverage from SZV as allowed regardless of their legal status. However, the numbers indicate that a considerable number of uninsured cases reported by the hospital were patients with residence but no coverage.
The draft Sustainable Affordable Accessible Healthcare Act (SAAHA) is supposed to address that, but the question is at what cost. As pointed out during Wednesday’s press briefing, the proposal includes dental and eye care, which are not covered in the current package.
Getting more people living and working here to contribute would indeed help, but that alone might not be enough. Raising related premiums will probably increase the already high cost of both living and doing business during uncertain socioeconomic times.
The situation is complicated, but things could be worse. According to a story out of Willemstad in today’s edition, the amount Curaçao spent on healthcare in 2023 was approximately 14.7% of gross domestic product (GDP), compared to 8.7% in Aruba and 6.5% in St. Maarten.
Curaçao also spends 20 times as much on laboratory services per capita as the average in the Caribbean. An average of 20 prescriptions is written there per person, compared to 14 in Aruba and 12 in the Netherlands.
Nevertheless, St. Maarten is facing tough choices in this regard with huge financial implications. The prudent approach would have seemed to start SAAHA offering the same basic package and not get carried away.
