WILLEMSTAD - The Board of Directors of the Curaçao Medical Center (CMC) wrote to the Second Chamber of the Dutch Parliament in July. The CMC management believes that Undersecretary of Kingdom Relations Raymond Knops has painted the wrong picture as if the hospital's precarious financial situation can be solved through cost control.
The letter of 12 July is addressed to Jan Paternotte, Member of Parliament for D66 and chairman of the Permanent Chamber Committee on Kingdom Relations and signed by Gilbert Martina as chairman of the Executive Board, medical director Ingemar Merkies and financial director Karina Lombardi. The CMC management responds to a letter dated 22 June in which the outgoing Undersecretary informs the Second Chamber about the liquidity support to Curaçao, Aruba and Sint Maarten for the third quarter of 2021.
Knops writes that a condition for the second sub-tranche concerns 'the establishment of the implementation agenda regarding (...) and cost control at the Curaçao Medical Center'. "This paints the picture that there must be cost control to solve the precarious financial situation of the CMC," the CMC management writes in the letter to Paternotte. That is 'too short sighted'.
In the letter, the situation in Curaçao is explained in detail in seven pages. For example, 85 percent of the population is insured with the Social Insurance Bank through the basic health insurance (BVZ). And that the BVZ fund is struggling with large deficits. That is "the main reason that the CMC has not been allocated an adequate healthcare budget to date", while this is the only hospital on the island that offers 24-hour care, including emergency care and intensive care.
According to the hospital management, a number of preconditions must be met for sustainable business operations in the short and long term. This largely concerns covering costs and increasing the healthcare budget: 17.5 million guilders for the start-up costs in 2019, 15.2 million for the consequences of Covid-19 in 2020 and another 11.8 million for the start-up costs. the covid impact in the first five months of 2021.
Then there is the item of 9.7 million guilders for care for the uninsured. But a cost-effective healthcare budget 'in accordance with the budget' (227.3 million guilders) is crucial. The advance of 4.8 million guilders that was received in April this year 'is a drop in the ocean'.
A sustainable solution goes further than the operational management of the hospital, according to the three-person management. Social funds and the health care system need to be overhauled. The latter was 'one of the most important principles' for the construction of the CMC.
“The new hospital should serve as a catalyst for restructuring the entire healthcare chain.” In addition to 'adequate financing', this also concerns an 'appropriate compensation system'.
The CMC management points out that 'recalibrating the method of funding and the rates in secondary care is described in the implementation agenda of the National Package as a necessary measure for the efficient organization of care and the realization of a robust and affordable health care system'.
"CMC endorses the importance of the measure and is of course willing to cooperate in this recalibration of the funding and tariff structure," said the management to the Second Chamber.
The hospital management is aware of the financial challenges of the country of Curaçao and has therefore identified 'four focus areas that can provide substantial savings on an annual basis'.
The costs of the laboratory can be reduced annually by 8.3 million guilders and the capital costs by 3.8 million guilders. A saving of 2.9 million guilders is possible on medical care products and another 2 million guilders on medicines 'due to favorable purchasing conditions via the Erasmus MC in the Netherlands'.