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Editorial - Cost-effective

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Source: The Daily Herald 02 Feb 2015 06:27 AM

Friday's meeting of the Central Committee of Parliament on the non-payment of bills by Social and Health Insurance Fund SZV and government particularly to St. Maarten Medical Center (SMMC) ended soon after it started. Members agreed that a full picture of the situation in health care could not be gathered from the two ministers present alone and it was considered necessary to hear both SZV and SMMC as well.

Part of the concern that led to the National Alliance's request for such a meeting had also been addressed during the preceding debate on the 2015 budget. Some of the information provided by the Gumbs cabinet actually should be helpful in tackling issues surrounding the Dutch side's hospital.

Take the fact that there were 2,096 medical referrals abroad by SZV last year, up about 5.6 per cent from 1,982 in 2013. This may not seem like a huge increase, but the expense of sending patients elsewhere is considerable.

Of course, St. Maarten always will need to do so, because having every conceivable specialist on a relatively small island is hardly possible. At the same time, people should not make the mistake of calculating only the actual tariffs for certain treatments to determine what is feasible.

If, for example, a fee of 100 guilders is applied, one cannot simply multiply that amount by the number of times a specific service is expected to be used and evaluate whether that is enough to sustain such. Instead, the money spent on travel and accommodations for referrals abroad ought to be added, as former SMMC director George Scot always argued.

Based on that total, a more realistic, higher rate could be introduced then to make a certain specialty on the island achievable. After all, SZV and private insurers already are spending the same money now to send persons to other countries.

It should not be hard to figure out exactly how often each type of treatment is sought abroad to judge better which of these also could be offered locally in a cost-effective manner. If done correctly, this would open the door to being able to provide more health care locally, thereby helping the hospital to grow and improve its finances.


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