Carmen Torruella Thillet
September 21, 2010
Prof. RoMay Sitze
The Truth behind Puerto Rico's Health Care Reform
Puerto Rico is a territory of the United States of America with a unique form of government called a Commonwealth. Under provisions of the Commonwealth, Puerto Ricans enjoy American citizenship, homeland security, minimum wage, Pell grants, and other funding programs and amenities offered by the Federal Government in exchange for the Island’s strategic “key to the new world” position in the Caribbean. As a Commonwealth, that can be translated into something like “restricted freedom state”, Puerto Rico has limited sovereignty over much of its local laws and issues, including public health care management. For long years, the public health care system rested on Medicaid and Medicare funds. These funds were directed to the poor population, and were not enough to cover the cost of basic health care for the middle class workers who earned too much to qualify for Medicaid, but could not afford to pay for private health insurance. For an island with very high rates of mortality due to heart disease, diabetes and cancer (www.salud.gov.pr), it soon became an important political campaign debate point. In 1993, former Governor Dr. Pedro Rosselló proposed an unprecedented and dramatic change to the Puerto Rican health care system. He proposed a health reform, a system of equal health care treatment for all citizens, trying to emulate examples of countries around the world that successfully offer this privilege to their inhabitants. In the beginning, the “Reforma” (reform in Spanish, as it is known) was thought to be the end of health care disparity. Everyone would have the precious plastic blue card that would put an end to their miseries. Little the people knew at what cost that equality would come, in monetary and health terms. The Puerto Rico Health Reform drained the public...