Dear Editor,

The cost of health care in the United States has increased enormously over the past decade, resulting in huge profits for hospitals and drug companies. The profit which the University of Pittsburg Medical Center made recently was $769.7 billion and the compensation of its CEO was $5,975,462. Other well-known hospitals, which are also supposedly charitable organizations, had similar figures. It is estimated that in 2013 the cost of health care will be $2.8 trillion.

Hospitals are able to generate these huge profits because they are charging outrageously inflated amounts for every single item used in any way by a patient (e.g. $24 for one over-the-counter pain killer tablet).

One recent billing by a small hospital in Massachusetts charged $10,500 for just two blood transfusions. The average charge for an appendectomy in the US is $13,000, compared to $5,600 in Canada and $3,200 in France. The US spends more on health care than the next 10 biggest spenders in the world combined. From 1990 until 2010, the cost of medical care in the US increased 500 percent, five times the GDP.

But apart from these charges, we have in addition the costs of drugs in the US which are 50 percent higher than other developed countries. For example, there is a product manufactured in Spain as a solution for increasing the immune system, and the cost for processing by the Spanish firm and to test and ship this product is $300. It was sold to a US hospital for $1,500, and ultimately the patient who used this product to control his lymphoma was charged $7,346 by the hospital for the drug.

In another situation involving a cancer drug, it is estimated that it cost the manufacturer $300 to process, test and ship the product to a hospital, receiving $3,300 in payment, and the hospital charged its patient $13,700 for administration of the drug.

In 2003, George W. Bush pushed Congress to pass a bill which would provide the right to obtain drugs through Medicare. This sounded great, but unlike how Medicare can negotiate to set the charges of hospitals and doctors, Congress, under the persistent pressure of drug company lobbyists, refused to allow Medicare to negotiate with the drug companies to obtain reasonable prices for their drugs.

Other nations, including Canada, have negotiated for lower prices through arrangements with the US drug companies, but Congress held that Medicare must pay the average sales price, plus a six percent add-on, and of course, the drug companies set the sales prices at whatever they chose. As a consequence, cancer drug prices increased from $3 billion in 1997 to $11 billion in 2004, and analysts say annual cost will reach more than $20 billion, and keep in mind that this is only the cost of cancer drugs.

Members of Congress, particularly the right wing Tea Party types, focus entirely on the national debt (which incidentally has been significantly reduced in the past year under the Obama administration, something nobody talks about). They seek to do this by reducing or eliminating entitlement programs which benefit the elderly, the disadvantaged and those in poverty. Yet, they are perfectly willing to allow the drug companies to charge whatever they can get for drugs they sell in the US, twice the prices they receive from nations such as Canada. This, of course, imposes an even heavier burden on the disadvantaged in the nation.

Most of these right wing types profess to be avowed and committed Christians, but recognizing that Jesus Christ, first and foremost, sought to satisfy the needs of and to assist the poor and needy, it is amazing that these pious right wing types are willing to take programs from the poor and needy so that already wealthy companies can make even more profits.

For example, they pushed through a bill in the House providing for increased subsidies to large farming conglomerates while in the same bill at the same time, they cut back on food stamps for the poor which they desperately need merely to survive.

The drug companies and those members of Congress who support them all contend that a large portion of the prices charged for drugs are needed for the research and development of new drugs. Various analysis have shown, however, that this is a fabrication; that R&D is a small percentage of total revenue; that the costs spent by these companies for lobbying in Washington is as much, if not more than the cost of R&D; and that the primary goal is not altruistic but rather to raise profits of these drug companies even more.

Implementation of the Affordable Health Care program will have the effect of curtailing the runaway cost of health care while at the same time providing some 14 million or more Americans with medical coverage for the first time which they otherwise could not obtain.  

Under the system which has been in place for so many years, all with the blessing of members of Congress, hospitals, drug companies and doctors were free to charge whatever they could obtain, and those members of Congress who supported these health providers, were recognized through financial support from their benefactors at election time.

The Republicans in the House of Representatives, who are in the majority, have vehemently opposed what they have labelled as Obamacare, seeking to repeal it some 45 times and even shutting down the government for two weeks in protest to the program. One reason for this mindless opposition is the fact that, as they themselves have acknowledged, they cannot abide the idea that President Obama will be attaining this major undertaking after numerous earlier presidents could not do so. Indeed, these same Federal officials oppose every bill the President presents.

But another reason undoubtedly is that once the health care program is in place and functioning, health costs will be contained and these members of Congress will not have the same power to provide benefits to the drug companies, for example, thus no longer receiving from them a certain financial largess for their efforts. And again, in their blind opposition, they could care less about the fact that the runaway costs of health care will be curtailed and many millions of people will, for the first time, have medical coverage.

It will take time to fully implement the health care program, particularly since Republicans have done everything in their power to obstruct the program, including the fact that some 26 states under Republican control have refused to set up exchanges to facilitate the ability of people to obtain coverage and the Federal government will have to do this.

But once the program is up and running and the people begin to recognize the benefits it provides, the right wingers will be sorry that in the years ahead, long after Obama steps down, the program will popularly be known as Obamacare, the label they so callously applied to it in their effort to disparage the program.

Stephen A. Hopkins

Dear Editor,

Our budget will be debated in Parliament on the 29^th of February and I want to be amongst those to congratulate the Minister of Finance for having prepared the budget in such a short period of time. Also, the fact that Mr. Gibson choose to send the draft budget to CFT for its recommendations prior to handling it in the plenary session shows wisdom and maturity. For this, I praise Mr. Gibson. However, I have my reservations with regard to the finance minister’s decision on selection of budget cuts. In particular with the budget cut of more than five million guilders from the budget of the ministry of Tourism, Economic Affairs, Transport and Telecommunication.

I am the first to acknowledge that the most important task of a minister of TEATT is to research the possibility and exhaust all avenues for creating economic development. However, as it stands now, our single economic pillar is the tourism industry. Cutting the budget of this ministry will seriously hamper our opportunity for economic growth. I can understand that the minister does not agree with certain spending within the TEATT ministry, but with all due respect, the minister of TEATT must be given the tools to work with.

Although I recognize the importance of traveling in order to capitalize on expanding the tourism industry, I agree to limit the amount of traveling for now and invest in building and strengthening our product. The Inspection department for example, requires urgently needed funds in order to function properly. By investing in this department, additional funds will be generated for government. Whatever measures need to be taken in order to have a balanced budget must, as little as possible include the TEATT ministry.

Cutting the budget of TEATT ministry will prove detrimental. This is our lifeline. This is how we make money to cover government expenses. To quote the finance minister’s words, “the TEATT ministry brings in the bulk of income for government”. Don’t kill the goose that lays the golden egg. I would like nothing more than for St. Maarten to finally have a balanced budget. Having worked as the executive assistant of a former Minister of Finance for one year, gave me first-hand knowledge of our financial predicament and therefore, I agree that we have to cut our spending wherever possible, while we create new and structural income for government and in the process of balancing our budget, systematically reduce the budget deficit of some 60 million guilders.

Mr. Gibson says that the budget for 2016 will have a surplus of 20 million guilders. Again this is welcome news. This means that if this trend is followed, our deficit will be eliminated within three years. My question here is can we not eliminate the budget deficit in four years rather than in three? This will then leave us with an additional five million guilders for each of those four years to invest in urgent and or priority projects that will faster help to contribute to our development.

I can fully appreciate the concern of The Hague with regard to balancing of our budget. However, it is my opinion that the right of self-governing is unjustly withheld from us, without concern for our priorities. Fact is that St. Maarten never had a balanced budget since we became country within the Kingdom in October of 2010. Also a fact is that we never received the 120 million guilders needed to build our country, which by the way we were entitled to.

Now I am not one to cry over spilled milk, nor to focus too long on the past. I have learned from it and am ready to move on. However, The Hague’s unjustified insistence on a balanced budget within a short term hampers in my opinion, the best way for us to move forward with the development of our young nation, which include, but are not limited to: 1. Construction of our own weather station that will bring in additional funds. 2. Construction of the waste to energy plant that will provide cheaper electricity to our populace, which in return provides for more buying power and most importantly, 3. Strengthening of our economy.

A strong economy brings funds to the coffers of Government. Paying non-urgent debts depletes the coffers of our Government and seriously jeopardizes the stabilization of our country. And so, there are other urgent and viable investments for Government to make. With these and other new revenues for the coffers, Government can focus on, for example, housing development, which is desperately needed. This also includes the repairs and maintenance of the houses under management of the St. Maarten Housing Foundation.

When our hospital is built, service cost of SZV will drastically reduce, based on funds saved on overseas referrals, thus structurally regulating their income to meet their financial obligations. This will in all likelihood provide profit for SZV of which, dividends have to be paid to Government. This dividend can be used to service the debt that government has outstanding with this institution.

In the meantime, Government can focus on other necessary and urgent development projects. It is the job of our Parliamentarians and Government to make Holland understand that, with all due respect for the Dutch politicians and in the spirit of a harmonious kingdom working relationship we need to be given room to develop our country with the oars that we got. I also agree with the present Minister of TEATT that traveling for the purpose of marketing of our destination is imperative for the enhancement of our tourism industry.

However, it is my strong belief that we need to have an attractive product to market before we market it. Walt Disney built Disney Land and then fully focused on the marketing campaign and strategies. So did the people of Maduro Dam and so us too, when we decided to build a bigger and attractive port and airport. But what we see now is that the rest of the Caribbean is competing with us by doing the same. We were once one step ahead, but we have now lost this competitive edge.

We must now think creatively and out of the box to offer a better product so that we will remain one step ahead. This means that we have to think on something that will be unique to St. Maarten and impossible to copy by other destinations. First, let’s invest our financial resources in niche markets. Once this is done, we can focus harder on marketing our destination. The construction of a boardwalk and breakwater for the Maho beach is such a project.

This beach which offers a spectacular view of airplanes landing and taking off is an attraction that no other island or country in the world has to offer. However, it poses potential for serious accidents, which guaranteed will jeopardize our industry and therefore we must safeguard it from any and all incidents. Also, this is a project that Government with the input of the Harbour and Airport, in cooperation with the Police Force Traffic Department, must embark on and not leave it up to private investors that will most likely set unfavourable conditions. And so, other creative ideas must be brought to the table and realized. Let us take pride in what is ours and have the satisfaction that it was done by us and for us.

Louis R. Engel

Dear Editor,

In your Saturday edition you paid attention to the matter of the support provided by government for the annual St. Maarten Heineken Regatta .

In a small economy like ours the government has to be in close touch with economic potentials and niche markets if we are going to compete against the many competitive destinations. In larger and developed economies, larger well-funded institutions will play a role in advancing sectors, but these are not yet in existence here. Somehow our government will need to have an understanding of high potential niche markets to influence and mentor them favourably, and our citizens are going to suffer or enjoy the consequences of how they handle these niche markets .

The yachting sector of St. Maarten has been clearly shown by impartial researchers to drive 15 per cent of the St. Maarten economy, but it is a niche market with more niches within the general category of “yachting.”

The yachting sector should be looked at by government in terms of what benefits this sector can bring to the economy of St. Maarten. Various tourism reports, including the Master Plan, have pointed at the potential of this sector to contribute to the economy; in fact, it has been the most consistent advice that I have seen in the many reports. In spite of this, there has been little or no effort to develop a strategy and a knowledge base in government on this sector. In spite of the opinions of some MPs, the yachting sector provides significant high income employment and a solid tax return to the public sector.

The Heineken Regatta is one of the obvious strong points in this industry, creating clearly noticeable benefits and should enjoy some support, and the support must be consistent otherwise it is more damaging than positive in the long run. But, there are likely to be more initiatives in this industry besides this successful event that will provide a positive long term return to our economy.

The successive recent governments have chosen to pay relatively much more attention to areas of the economy that, in the overwhelming opinion of economists, provide much less potential for return and neglected this high potential but complex niche in the economy. Providing inconsistent support to the Heineken Regatta makes no sense whatsoever; the neglect of the rest of the sector is no better and in many cases there is no substantial cost involved.

Robbie Ferron

Founder St. Maarten Heineken Regatta

Dear Editor,

For everything that's in darkness shall come to light. It might take a few years, but light always wins darkness no matter how much they fight.

Numerous of us know what our responsibilities are in St. Maarten. What I don't really understand is why say the things we already know; why not come up with something different, say for instance: Where do you want to work, study or live when you're finished with your secondary education?

Why not say the different things you would like to study for when you're finished with school? It’s not acceptable in our country, because the older heads are not coming down from that position, or must I say we're overqualified. Is that really even true?

Your presentation stated this famous quote by John F. Kennedy, "Ask not what your country can do for you, ask what you can do for your country”. In my head I was brain storming all sorts of things you can think about, but I thought, why didn't you mention a few of the things you've accomplished for our country?

Or why the government keeps falling? Yes, you did mention that, but why not tell us the truth. On how really does the government fall, and politics is an amazing thing, but some people just get too greedy and try to develop the island/country when it's nearly time for an election, or when they see it's beneficial for the public to speak about them to gain more popularity. Yet again, a mother never tells all the secrets of their children to others, so I guess that's why not much truth and actions are taking place.

I was kind of disappointed on how the presentation went and what you really came to speak to us about. I was really expecting an eye opener on different things happening on St. Maarten. How can you develop the teaching skills and the parents acting as if the teachers don't really do their jobs? How can we as teenagers better ourselves and even try to become better and wiser; and which politician hears the cry of his people.

Also my ears were eager to hear different important things prior to Civic Responsibilities. Don't get me wrong, the different sectors that were mentioned were okay. Governor Eugene B. Holiday, it was a pleasure of you visiting and speaking to us about things that we may know a little too much about. But as we grow older and there aren't any blind folds on our eyes, we can see practically everything and we're brain storming about how things are being done in St. Maarten.

And how can we better understand, and solve different circumstances that arise in our country? For every glass house must have a crack and all the glass will be shattered, then we will really see what has been happening on the inside. Just an opinion of an average teen!

An MPC student

Name withheld at author's request.