So Where Is Everybody?

So where is everybody?

That’s what a friend, José, wanted to know. He’s up on the news, he reads all the island’s newspapers every day; then he reads The New York Times for national and world news. Like me, he’s a news junkie; also like me, there are writers and journalists in his family.

And journalists, as I heard in exhausting detail—OK, I confess it. When the old man was lecturing on the importance of a free and objective press, I tuned him out, those many years ago. Look, does any 15-year old hang on his father’s lips?

Now, of course, it’s different. I see him, in my mind’s eye, listening on Tuesday nights to the City Council meetings, which were broadcast over the radio. Jack, my father, was probably the only guy who ever listened, but that was OK. If only one guy listens, but then goes and writes a blistering editorial in the newspaper the next day—well, the system works.    

There’s a real question, however, if the system works down here. The island is mesmerized by the capture of la viuda—the widow—who is in fact quite a merry widow. Here’s a pic….

Well, I confess it, I spent several hours of my life yesterday poking about and hanging with the widow as well. But today, la viuda is still splashing around on the front page of the New Day; I, however, am moving on.

“No, José, no. It can’t be….”

He swore it was. And then he told me the story.

In 1993, our governor, who was by the way a pediatric orthopedic surgeon, instituted a health plan. Essentially, he did away with the socialized health system and spent the money giving it to private insurers. The system continues to this day, said José, with 1.6 million patients.

“What,” I squawked at José, “are you telling me that half of the island is on the government’s health plan?”

Yes.

The island, for the purpose of the health plan, is divided into 8 regions, and various health providers are asked regularly to submit bids. Thus, it was no surprise when the new providers were announced last Thursday. What was the surprise?

For the first time, the entire island is going to be insured by one company—Triple-S.

Is that a big deal? Well, the doctors aren’t too happy. Here’s one:

“Tanto pacientes como médicos estamos a merced de esta organización, llámese como se llame. Le da un poder de casi $2,000 millones a una sola empresa, le da más que eso, le da una arrogancia sin límites. Va a disponer de pacientes, de clase médica, como le da la gana”, afirmó el doctor Eduardo Ibarra, presidente del Colegio de Médicos Cirujanos.

 (“Patients as well as doctors are at the mercy of this organization, call it what you will. It gives the power of almost 2 billion dollars to one enterprise, more than that, it gives unlimited arrogance. They can do whatever they want to patients and doctors,” stated Dr. Eduardo Ibarra, president of the College of Medical Surgeons.)

The politicians aren’t happy, either:

 “Preocupa grandemente que se conceda casi un monopolio de los servicios de Salud a Triple S. Sobre todo, se ha señalado constantemente que el secretario de Salud, Francisco Joglar Pesquera, ha tenido serios conflictos de intereses con dicha compañía y que esta contratación no abona a la confianza pública sobre dichos procesos de contratación”, afirmó el expresidente de la Comisión de Salud.

(“I worry greatly that this concedes almost a monopoly on the services of Health to Triple S. Above all, it’s been shown constantly that the secretary of health, Francisco Joglar Pesquera, has had serious conflicts of interest with this company and that this contract does not meet the public’s trust about the process of awarding contracts,” the former president of the Health Commission stated.)

Conflict of interest?

“What’s that all about?” I asked José.

Francisco Joglar Pesquera’s previous job?

Senior Vice President and Medical Director for Triple S.

“What?” I’ve gone beyond squawking, now I’m just squeaking.

“Yes,” said José.

I’m dumbfounded.

“This is blatant.”

“Don’t worry,” said José so seriously that I knew he was joking. “Joglar took himself out of the whole process. He recused himself, and gave it all to his sub-secretary. Then he went into his office, shut the door, closed his eyes and covered his ears. And when the sub-secretary knocked on the secretary’s door five minutes later, Joglar was just as surprised as the rest of us. So it was fair. See?”

Oddly enough, the essential health of the political system of the United States is that people are pissed off. We’re angry, frustrated, and—some of us—almost explosive. But that’s good—all that energy and foment can lead to change.

“Los pillos,” people say, with a shrug of the shoulders, a glance skyward.

The thieves.

Speaking of our elected officials as thieves is dangerous. It implies a cynicism, a consent to be stolen from, an apathy that nothing can change. And that means, of course, that nothing will change.

José was right….

Where is everybody?