It’s an alarming economic indicator how the local government has amassed some $25 million in deficit, the bulk of which pertain to medical referral expenses.
This phenomenon tells us two things: 1). We have a very sick populace. 2). Both health and unfunded liabilities of the pension fund would saddle this government with more deficit than we’ve seen in our developmental history. At issue is how do we navigate the treacherous seas of revenue deceleration while obligations spike by leaps and bounds?
The only thing in mind is to individually return to the basic truth that health is a personal responsibility. Next, public health could promote healthy habits in schools via public education in personal hygiene. Please throw in healthy food and exercise too.
I recall at the opening of CHC in 1986 how young pupils in grammar school spoke of brushing their teeth twice or thrice daily. It’s a tale that the public health education program succeeded in conveying why personal hygiene is important to one’s health. Somehow, we dropped the ball as other politically attractive issues emerged. It’s unhealthy!
For all its travails (mostly political), our only local hospital deserves the accolades of the Northern Marianas community for the extra mile its professional staff take daily to ensure our health needs are met despite the odds. I mean, professionals and vital ancillary staff have to endure crippling cuts in operations fund from $40 million annually to $5 million in seed fund. And this administration expects miracles in the collection of receivables, fully aware of self-imposed underemployment (austerity), unemployment as businesses contract, which then concurrently contracts revenue generation.
The unintended consequence of this stealth denial of funds for hospital operations without sufficiency in transition didn’t absolve this administration of its financial obligations. It’s despicably ill-conceived, riddled with lack of due diligence to ensure that CHC doesn’t fall flat on its face in light of collateral issues falling short of expectations, i.e., revenue generation that has gone deep south. The heavy drain on revenues is a Herculean task to revive and not until hell freezes over.
Now, the growing number of long-term and catastrophic illnesses among locals make it even more important to revive public health education programs. Betel nut and tobacco chewing may not look disastrous on its face. But I have seen patients in off-island hospitals whose mouths have been deformed by oral cancer. They have been there for more than three months as medical experts treat the fatal illness, followed by reconstructive surgery.
Cardiovascular issues are equally troubling in the sense that one is self-inflicted, the other genetics. The former comes from woefully bad health habits that includes heavy smoking, heavy drinking, consuming too much fat and red meat, consuming too much sugar, coupled with a sedentary lifestyle-no exercise at all. The latter is inherited from your family. The only remedy is to be aware of it so you can commence healthy habits that would lessen the severity of the illness as you age.
Type II diabetes is the other genetically inherited long-term illness. Surprising the number of locals who have been afflicted by it as they reach 40-plus years. If one is wary and attends to healthy habits, chances of developing chronic illnesses from diabetes are lessened. If you’re careless, you may be rolling out the red carpet for kidney failure and a thrice-weekly session at a hemodialysis center.
I’ve seen other private hospitals between here and California. Private hospitals would turn you down if you don’t have health insurance, regardless of your condition. I’ve also seen a busy private hospital in San Francisco use the triage system to determine who among 30 people on gurneys at the entrance receives medical attention. It’s isn’t fun listening to the decision about who gets in and who’s left on the gurney as other catastrophic cases are wheeled-in by ambulance people.
The doctors and nurses at the ER and floor at CHC are real professionals who examine your condition, explain in simple English what they’ve found, recommend medication, hospitalization or medical referral, depending on the severity of illness. On the floor (wards) doctors come in to check on your condition regularly and work on what needs to be done to ensure your recovery. Too, they are the happiest people when they see you walk out of the hospital. If I may ingeminate, the hospital’s professional staff deserves the accolades of the NMI community. There’s no compromising the delivery of healthcare, despite its operations being crippled by funding issues.
Unsustainable pension fund
Now, the local pension program needs about $90 million annually to cover the paychecks of retirees. If I may note, the local government raked in some $102 million last fiscal year and it isn’t likely that this dismal figure would improve in the near term.
It is a huge financial obligation the NMI could no longer afford. What must be done to navigate this difficulty? It’s good the administration has decided to explore moving active employees to the U.S. social security system. It’s the only option to working on some benefits upon retirement to provide for basic needs. Beyond this option, I doubt that there’s another in the horizon to hitch a ride with.
The demise of the pension fund is caused by major indecisions since the outset some 32 years ago. These indecisions are mostly political in nature as to ignore that we were raising a huge elephant that eventually outgrew its own space in the room. It’s so huge in unfunded liability-$330 million over a 32-year period-as to inflict collateral damage to other basic services like healthcare, education, among other services. This is the net trophy of hysteresis-we ignored the steady crash of the program-that steadily reached the high decibels of bankruptcy.
It was a generous program, factoring accumulated overtime into the final pension amount when such calculation should have been premised solely on base salary. The program ventured into a failed housing program that had to be scrapped. It also loaned millions of dollars that can’t be paid on a timely basis by the agency when their revenues went south. It included members who never contributed to the fund.
Call these collateral damage "unintended consequences" of good intentions that have become a financial monstrosity. It must be one rude awakening of epic proportions and a reminder not to spend money you don’t have sitting pretty in your wallet.