More people dropping medical insurance

The CNMI government spent over $7 million for its medical referral program last fiscal year, the bulk of which was spent on the travel expenses of patients referred to off-island hospitals or clinics.

According to Public Health Secretary Joseph Kevin Villagomez yesterday, the department's medical referral cost in fiscal year 2010 was the highest incurred in the last several years.

Comparatively, the government spent just $6.9 million for this program in fiscal year 2009.

Villagomez said most of the expenses are split between airline costs for patients and escorts, hotel accommodations for patients and escorts, subsistence allowance for patients and escorts, and medical expenditures.

The amount covers all referrals to Manila, Guam, Honolulu and sometimes, to other parts of the United States.

“While the trend for 2011 is on the upswing, it will most likely not surpass 2010 because airlines are [currently] not processing tickets or hospital facilities are not accepting patients from the CNMI because of non-payments,” said Villagomez.

He attributed the surge in last year's referral costs to the fact that more and more people are dropping their health insurance, forcing the government to shoulder a bigger part of people's medical expenses.

Since health insurance is not mandated, Villagomez said the government shouldered the expenses in full for patients, majority of whom are not qualified for Medicaid assistance.

“What we're seeing now is that a lot of people that come to the medical program do not have Medicaid. They're dropping their health insurance because this is not among their top priorities. They said they have to deal with their mortgage, car loans, and other important expenses so when they get sick and they come to the hospital.We're spending more for their treatment,” explained Villagomez.

According to Villagomez, heart-related illnesses and cancer cases comprise the majority of medically referred patients. Although patients from Rota and Tinian are also considered medical referral cases, DPH said that many cases were sent to Guam and Manila hospitals.

Villagomez admitted that due to the government's financial constraints and the spotty payment history of the CNMI, some off-island hospitals such as in the Philippines now hesitate to accept the islands' medically referred patients.

“There are times when we don't have options when hospitals do not want to accept our patients because of payment issues. There are also times when airlines refuse them because of the same payment concern. It's really tough.and we're struggling,” he said, adding that DPH is just fortunate that there are still some providers and vendors who honor patients on a case-by-case basis.

On many occasions, Villagomez said, they just opt not to send follow-up cases to off-island providers, preferring to wait until airlines or hospitals could accommodate them.

Since October this year, travel agencies on Saipan have stopped processing the airline tickets of medically referred patients due to the government's non-payment of about $180,000 in arrears.

To date, Villagomez said only one travel firm is allowing the processing of off-island patients.

Saipan Tribune learned that DPH spent a total of $16.3 million to refer medical cases to facilities outside the Commonwealth from fiscal years 2006 through 2009.

Source  http://www.saipantribune.com/newsstory.aspx?newsID=105616&cat=1