MP Mercelina remains critical of hospital plan and general health insurance

PHILIPSBURG — United Democrats MP Luc Mercelina remains highly critical of the plan for the new hospital and of the intention to introduce a general health insurance scheme.

“It is a fundamental error to base decisions for the hospital on a business plan,” Mercelina said. “A general health insurance is only sustainable if you have huge numbers. This is not possible based on a population of 40,000.”

Mercelina said, not for the first time, that a large proportion of the population is illegal. He mentioned a number of 10,000 illegals. “They put pressure on an unsustainable social system, he warned.

Wynand van de Ven, a professor of health insurance at the Erasmus University in Rotterdam, said in an interview with the Today newspaper in January 2017 that financial sustainability is key for a national health insurance. “To achieve that, the NHI must behave like an active purchaser of care. It has to sign contracts, also for overseas care; otherwise the sky is the limit.”

Van de Ven also emphasized the importance of working together with surrounding small island nations to overcome the handicap of scale. In that sense he agrees with Mercelina: numbers do matter. “If you work together with others in the region that have similar problems your position becomes stronger. You are talking about a higher volume. This does not only apply to care, but also to medication. Against the monopoly of the pharmaceutical industry you have to create your own monopoly. Purchase medication together with other countries. The Netherlands has 17 million inhabitants, but it is doing the same, together with other European countries to get a better price for at times extremely expensive medication.”

Mercelina suggested during Monday’s parliament meeting that there are at least 600 and possibly 1,000 illegal Venezuelans on the island. “Who is going to pay for these people?” he wondered.

St. Maarten’s location inside a hurricane belt is another reason for concern, the MP said. He furthermore addressed the issue of premiums. “”Who is going to pay for them? Nobody is talking about the need to increase the premiums. How are we going to do that?”

Mercelina also wanted to know what guarantees are in place to ensure that INSO is able to provide maintenance services for the new hospital fifteen years from now.

MP Ardwell Irion expressed concerns about cost overruns. “Seven out of ten hospital projects have cost overruns and delays,” he noted.

MP Christophe Emmanuel wondered why INSO is looking for a buyer. “Without it they cannot survive. This means that INSO is in financial trouble,” he said.

MP Claude Peterson asked whether the contract would go to Vamed in case the SMMC does not continue with INSO. He also wanted to know if there are clauses in the contract to protect the hospital against cost overruns.

MP Rolando Brison accused Public Health Minister Emil Lee of tunnel vision. “Are your efforts focusing on building a new hospital or on giving a contract to INSO?” he said.

The meeting was adjourned to a later date around 5:30 p.m. to give Minister Lee and director Klarenbeek time to prepare answers to questions posed by MPs.

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