The NYSNA/1199 strike at Fresenius Dialysis Centers illustrates the global nature of what we are coming to know as International Corporate Health Care. The line between corporate healthcare interests (which are about profits, not patients) and healthcare legislation in the United States grows dimmer every day. It only speaks to the power of money and its influence over the laws of the land.
As we celebrate Independence Day — the end of our colonization by England, it’s significant to note that the US is one of the few countries that possesses colonies today, Puerto Rico being the most obvious one. Simply naming it a “commonwealth” doesn’t change that reality.
The relationship between Big Money’s control over healthcare internationally (and the banks and hedge funds that control so much more, leading to massive debt and forced austerity measures all over the world) and the colonial status of Puerto Rico were factors that generated a request for us to testify at the United Nations Special Committee on Decolonization in June. Excerpts of our testimony follows:
Good Afternoon, esteemed committee, speakers and guests.
It’s an honor — but a sad one — for us to speak about the drastic impact of colonization on Puerto Rico, particularly regarding its healthcare status.
As nurses, we’re acutely aware of health needs and conditions of patients, causative agents of disease and resources necessary to promote wellness.
Colonizing governments view the lives of the colonized as having lesser value. This facilitates the use of populations and environments as convenient testing grounds for activities and research.
Toxic testing ground
Poor Puerto Rican women served as unsuspecting guinea pigs in the 1950s and 60s as Pharmaceutical Corporations tested oral contraceptives to ensure their safety for US women in a chilling combination of eugenics and population control. In addition, one-third of Puerto Rican women between the ages of 20-49 were surgically sterilized without appropriate informed consent.
Today — no less horrifying — “Medical Tourism” speculators have explored the possibility of creating an organ transplant mecca in Puerto Rico, citing the availability of healthy organs due to high death rates of youths — a direct result of intense poverty and its ensuing violence.
The use of the country as a testing ground for weapons and military training has wreaked havoc on a variety of ecosystems resulting in disproportionate rates of cancers and other diseases.
Bombing runs and chemical weapons testing in Vieques, Puerto Rico over 60 years resulted in ongoing medical catastrophes. Viequenses suffer higher rates of cancer: 30%; hypertension: 380%; cirrhosis: 95%; diabetes: 41%; infant mortality: 25% higher than in other regions.
Why? Toxic metals accumulated in the biomass of plants, were eaten by grazing cows and fish, and traveled up the food chain to poison humans. Naval tests in surrounding waters devastated the fishing industry, which was an economic mainstay of locals.
Compromised food resources
Agriculture in Puerto Rico — and access to nutritious food — is seriously compromised. The “one crop economy” perpetrated by US corporations, and the absence of food processing and distribution systems, means that 90% of food — most of which could be grown on the very fertile island — is imported. The Jones Act — which enriches US companies but starves Puerto Ricans — fosters exorbitant prices for poor quality foodstuffs.
Growing financial concerns
The financial crisis — a direct effect of Congressional and Constitutional provisions — is dire. The “Promesa” Act negates any pretense of autonomy, increasing unemployment, lowering salaries and abrogating labor rights.
Schools and hospitals have closed, with massive cuts in health and human services. We see the largest migration in history — with a “deprofessionalization” of inhabitants. Doctors, nurses and other health professionals are leaving in droves — a doctor a day — reducing the already lowest rates of practitioner to patient in the US.
While Puerto Ricans pay identical Social Security and Medicare taxes as their US counterparts, reimbursement rates are only half as much! Thus, per capita health expenditures in Puerto Rico are $3,065 compared to $9,403 spent in the US.
This leads to hospital and clinic closures, provider migration, and the dismantling of life-saving programs. The country can’t comply with CDC best practice guidelines for Heart Attack and Stroke — key killers — because it cannot afford the resources. The debt must be repaid first.
Vaccination rates have declined — dramatically among the elderly, a growing population sector. ER waiting times are climbing to hazardous depths. Vector control — as seen with the Dengue, Chickungunya and Zika infections — is totally inadequate.
The crisis exacerbates diabetes, asthma, end-organ failure, chronic pulmonary disease with morbidity/mortality rates higher in nearly every major category than in the Colonizer nation.
As these conditions deteriorate, we ask: who cares about Puerto Rico? Evidence indicates the US government, banks and corporations that dominate don’t have the best interests of the people of Puerto Rico at heart. So: why is this immoral and oppressive situation permitted to continue?