Two related headlines on Thursday’s front page told a different story. St. Maarten Medical Center (SMMC) reported an 11.8 million Caribbean guilders surplus in 2025, but also lost Cg. 10.1 million in unpaid patient bills.
To start with the former, although making money should in principle not be the main motive behind a public hospital, financial stability is important. A profit of less than 10% seems fair enough, especially with so many challenges faced over the last decade.
Regarding unpaid bills, while people remain under- or uninsured this issue is likely to persist and even grow, as the total annual amounts increase by Cg. 0.6 million compared to 2024 also indicates. Refusing particularly urgent treatment to those in need of such remains an ethically unacceptable scenario.
People are quick to blame so-called “illegals” but there are several other reasons these situations exist. Besides, residency is not a requirement for workers’ coverage by Social and Health Insurance SZV, provided they are properly registered and premiums get paid on their behalf.
Introduction of the Sustainable Affordable Accessible Healthcare Act (SAAHA) may contribute to a solution by offering yet broader sickness coverage in the future. However, doubling the wage limit for SZV a few years ago didn’t exactly solve the problem either. Moreover, SZV already accounts for 74% of SMMC’s patient revenue.
What would certainly help is if employers of undocumented staff at least insured them even before their legal status can be regulated. Also from a social and humane point of view, it’s simply the right thing to do.
