Dear Editor,
For several years now we have heard certain politicians talking about wanting to create medical tourism to generate more revenues for the island. Shouldn’t they focus instead on improving the health and prolonging the lives of our local people? Besides, they ought to know by now that medical tourism is already flourishing on the island; namely from the Dutch to the French side.
Every time I go to the eye specialist, where the state-of-the art equipment is impressive, the dentist or the Lab, or take someone to a general practitioner, I almost always meet people from the Dutch side in the waiting room. Practically all my acquaintances have told me they no longer go to doctors on the Dutch side. They are willing to pay their out-of-pocket money instead of making use of their health insurance, in order to get more reliable treatment.
I guess the medical savoir-faire in France was obtained from its population of almost 65 million, compared to Holland’s 17 million. They have always had a great deal more patients to experiment on and learn. Whatever the reason, French doctors seem to be more successful in their diagnoses and treatment of their patients.
Another valid reason for especially diabetics to cross the border is that medication is also way cheaper on the French side. I don’t know the reason for this, but I suppose that unlike the Dutch side, the cost of all medication is strictly controlled by the French authorities.
How did I find this out? One Friday afternoon, while my wife and I were shopping at Super U – another place patronized by lots of Dutch-side people – she reminded me that I was completely out of eye drops. Knowing I wouldn’t be able to get them on the Dutch side until after the weekend, I decided to buy a bottle in Marigot.
To my surprise, I paid US $ 9.37 for the bottle at a French pharmacy: the identical eye drops – same brand, same strength – on the Dutch side cost Fls. 58.50 (US $32.50), three and a half times more expensive.
The very next time I entered a Dutch pharmacy, I asked the druggist why the big difference in price. He smiled and said, “We buy local.” By the way, local means Curaçao, as most suppliers of medical products are branches of Curaçao-based businesses. Their profit margin must be tremendous; nothing less than a get-rich-quick scam at the expense of sick people. To say their branches on St. Maarten are blooming would be an understatement. And of course, pharmacies and the hospital add their mark-up to these already outrageously marked-up prices.
It gets worse! I understand these Curaçao-based businesses pay their taxes via their head office in Curaçao. They have been doing this since the time of Claude Wathey, when St. Maarten and the other islands were treated as colonies of Curaçao. They make their millions on St. Maarten, but their tax money ends up in the coffers of the government of Curaçao.
I once asked a former prime minister about this matter. Her reply was: “It depends on how the business is structured.” If they are making tons of money on St. Maarten, shouldn’t they be paying taxes here, regardless of how the business is structured? Why should consumers on St. Maarten support the government of Curaçao?
Being a diabetic myself, I decided to make some further inquiries about the cost of some must-have medical supplies for diabetics. I compared the prices at two Dutch- with those of two French pharmacies and found the following:
Lantus SoloStar insulin pens cost Fls. 48.00 (US $26.67) and Fls. 40, 00 (US $22.22) respectively at both Dutch-side pharmacies, compared to US $14.38 and US $ 14.96 at the French pharmacies.
NovoRapid insulin pens cost Fls. 32.88 (US $18.27) and Fls. 27.40 (US $15.22) at the Dutch pharmacies, compared to US $11.41 and US $11.31 at the French pharmacies.
Pen needles (90) cost Fls. 45.00 (US $25.00) and Fls. 63.25 (U$ 35.14) at the Dutch pharmacies, compared to US $20.99 and US $21.19 at the French pharmacies for 100. The Dutch pharmacies actually remove 10 needles from each box.
Galvus Met 50mg/850mg 60 pieces cost Fls. 92.40 (US $51.33) and Fls. 99.00 (US $55.00) at the Dutch pharmacies, compared to US $20.99 and US $21.19 at the French pharmacies.
As stated above, Lantanoprost eye drops, which are also used by non-diabetics, namely people with glaucoma, cost Fls. 58.50 (US $32.50) at both Dutch pharmacies, compared to US $9.46 and US $9.37 at the French pharmacies. As you can see, the difference in the prices is rather significant.
Depending on a diabetic’s daily dosage, he or she will need 5 to possibly 10 long-acting insulin and 5 or more fast-acting insulin pens per month. I have not included all crucial items for diabetics, such as strips used with a glucose metre, lancets and others. However, I don’t doubt that all of these other items are cheaper on the French side.
One Dutch druggist told me he could sell these medications a lot cheaper if he ordered them from Holland, but he is not allowed to do so. The Health Inspectorate restricts the countries from which medical supplies can be ordered. Are they doing so to protect the vendors of these unacceptably overpriced products, or could the reason for this be that the cheaper the imported medication, the less turnover tax is collected by government? Do they consider revenue from taxes more important than the health of our people?
Thank God for SZV!! I assume that most people are insured by SZV, but, it doesn’t take a mathematician to figure out that SZV and by extension the government, would save tens of thousands of guilders every month by making an arrangement with pharmacies on the French side to accept SZV-cards.
By doing so, they would most certainly make life affordable for uninsured diabetics and sick people in general. Supporting our local economy is without a doubt extremely important, but if our “local” businesses cannot provide reasonably-priced products, they oblige us to cross the border… or go online.
On behalf of all diabetics on the Dutch side and there are literally thousands of us, with more being diagnosed on a daily basis, I call on our Parliamentarians and especially the Minister of Health to make an in-depth inquiry into this matter without delay. Let’s wait and see if this new government will make a serious attempt to save lots and lots of money and make life for diabetics and other sick people affordable.
Clive Hodge
