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As Venezuela’s Healthcare Collapses, Women and Girls Dying Needlessly

The surgeon is one of only three left at the Concepcion Palacios hospital in the Venezuelan capital

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Venezuela, Healthcare, Pregnant Women
Venezuelan girls beg for change where Venezuelans cross illegally into Colombia near the Simon Bolivar International Bridge, April 14, 2019. VOA

In Caracas’s main maternity hospital the blood banks and medicine cabinets are empty, the power and water regularly cut out — and women and girls are dying needlessly, according to one of the few remaining doctors, Luisangela Correa.

The surgeon is one of only three left at the Concepcion Palacios hospital in the Venezuelan capital, where the lifts and most toilets are closed and there are no bandages, sterilizers or X-ray services.

“We are like trapped, kept hostage by this situation … hope is what keeps us here,” Correa, 45, told the Thomson Reuters Foundation.

“If we haven’t left the hospital, it’s because we hope that things will improve.”

Venezuela, Healthcare, Pregnant Women
A Venezuelan migrant woman holds a baby outside an immigration processing office on the Rumichaca bridge after crossing the border from Colombia to Rumichaca, Ecuador, June 12, 2019. VOA

One in four have left

Millions of Venezuelans have fled the country to escape an economic and political crisis that has left about seven million — one in four — in need of humanitarian aid, according to the United Nations.

Its human rights chief Michelle Bachelet said last week after a three-day mission in March to the troubled South American country that Venezuela’s healthcare sector was in “critical condition.”

A lack of basic medicine and equipment was “causing preventable deaths,” she said — something Correa is witnessing at first hand.

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Infection rates at the maternity hospital are high because cleaners do not have disinfectants to wash away bacteria and there are no sterilizers for doctors to clean their equipment, she said.

“Currently, maternity is a risk for Venezuelan women, as it is for babies … many give birth at home, in the street,” Correa said.

“And there are no blood banks. Any complications from heavy bleeding is a very big risk of death for a patient.”

Correa, the U.N. and women’s rights groups all said unsanitary hospital conditions along with food and medical shortages had led to a rise in maternal mortality rates.

Venezuela, Healthcare, Pregnant Women
In Caracas’s main maternity hospital the blood banks and medicine cabinets are empty. VOA

U.N. findings disputed

The Venezuelan government disputed the findings of the U.N. report and said in a written response that maternal mortality rates had decreased by nearly 14% between 2016 and 2018.

Venezuela’s national healthcare system, once considered a model for Latin America, is now plagued by shortages of imported drugs and thousands of doctors and nurses no longer show up for work, their salaries ravaged by inflation.

Venezuelan President Nicolas Maduro has said there is little need for humanitarian aid, blaming U.S. sanctions for the oil-rich country’s economic problems.

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The United States imposed tough sanctions on Venezuela’s oil industry in January in an effort to oust Maduro in favor of opposition leader Juan Guaido, who is recognized as Venezuela’s rightful leader by more than 50 governments.

‘100% shortage’

CEPAZ, a coalition of women’s rights groups, has said Venezuela’s maternal mortality rates have increased by 65% from 2013 to 2016, with nearly 800 women dying.

Bachelet’s report cited a national survey that showed 1,557 people died due to lack of supplies in hospitals between November 2018 and February 2019.

Correa said she was seeing more pregnant teenage girls seeking care because they cannot find or afford contraception and do not receive sex education in schools.

According to the U.N. report, teenage pregnancies have risen by 65% since 2015, and several cities in Venezuela face a “100% shortage” of all types of contraception.

Strict abortion law

Due to Venezuela’s strict abortion law, which only allows the procedure under limited circumstances, some women and girls resort to unsafe abortions.

This has contributed to a rise in preventable maternal mortality, with about 20% of maternal deaths reportedly linked to unsafe abortions, the U.N. said in its report.

Correa says she is determined to continue to speak out about the dire conditions in public hospitals and help women in need. “The only thing we have are the outcries and hope that this will change,” she said. “My people, my country need me at this moment.” (VOA)

Next Story

Over One Third of Healthcare Costs in the U.S. Goes to Bureaucracy: Study

U.S. insurers and providers spent more than $800 billion in 2017 on administration, or nearly $2,500 per person

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Healthcare
The reason why administrative costs in U.S.A are so high are because the insurance companies and healthcare providers are engaged in a tug of war. Pixabay

U.S. insurers and providers spent more than $800 billion in 2017 on administration, or nearly $2,500 per person — more than four times the per-capita administrative costs in Canada’s single-payer system, a new study finds.

Over one third of all healthcare costs in the U.S. were due to insurance company overhead and provider time spent on billing, versus about 17% spent on administration in Canada, researchers reported in Annals of Internal Medicine.

Cutting U.S. administrative costs to the $550 per capita (in 2017 U.S. dollars) level in Canada could save more than $600 billion, the researchers say.

“The average American is paying more than $2,000 a year for useless bureaucracy,” said lead author Dr. David Himmelstein, a distinguished professor of public health at the City University of New York at Hunter College in New York City and a lecturer at Harvard Medical School in Boston.

Healthcare costs
Over one third of all healthcare costs in the U.S. were due to insurance company overhead and provider time spent on billing. Pixabay

“That money could be spent for care if we had a ‘Medicare for all program’,” Himmelstein said.

To calculate the difference in administrative costs between the U.S. and Canadian systems, Himmelstein and colleagues examined Medicare filings made by hospitals and nursing homes.

For physicians, the researchers used information from surveys and census data on employment and wages to estimate costs. The Canadian data came from the Canadian Institute for Health Information and an insurance trade association.

United States vs. Canada

When the researchers broke down the 2017 per-capita health administration costs in both countries, they found that insurer overhead accounted for $844 in the U.S. versus $146 in Canada; hospital administration was $933 versus $196; nursing home, home care and hospice administration was $255 versus $123; and physicians’ insurance-related costs were $465 versus $87 They also found there had been a 3.2% increase in U.S. administrative costs since 1999, most of which was ascribed to the expansion of Medicare and Medicaid managed-care plans.

Overhead of private Medicare Advantage plans, which now cover about a third of Medicare enrollees, is six-fold higher than traditional Medicare (12.3% versus 2%), they report. That 2% is comparable to the overhead in the Canadian system.

Why are administrative costs so high in the U.S.?

It’s because the insurance companies and health care providers are engaged in a tug of war, each trying in its own way to game the system, Himmelstein said. How a patient’s treatment is coded can make a huge difference in the amount insurance companies pay. For example, Hammerstein said, if a patient comes in because of heart failure and the visit is coded as an acute exacerbation of the condition, the payment is significantly higher than if the visit is simply coded as heart failure.

More and more paperwork required

“It’s clear that healthcare costs in the U.S. have soared,” said Dr. Albert Wu, an internist and professor of health policy and management. VOA

This upcoding of patient visits has led insurance companies to require more and more paperwork backing up each diagnosis, Himmelstein said. The result is more hours that healthcare providers need to put in to deal with billing.

“(One study) looked at how many characters were included in an average physician’s note in the U.S. and in other countries,” Himmelstein pointed out. “Notes from U.S. physicians were four times longer to meet the bureaucratic requirements of the payment system.”

The new study is “the first analysis of administrative costs in the U.S. and Canada in almost 20 years,” said Dr. Albert Wu, an internist and professor of health policy and management at the Johns Hopkins School of Public Health in Baltimore. “It’s an important paper.”

‘Inefficient and wasteful’  system

“It’s clear that health costs in the U.S. have soared,” Wu said. “We’re paying for an inefficient and wasteful fee-for-services system.”

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“Some folks estimate that the U.S. would save $628 billion if administrative costs were as low as they are in Canada,” said Jamie Daw, an assistant professor of health policy and management at Columbia University’s Mailman School of Public Health in New York City.

“That’s a staggering amount,” Daw said in an email. “It’s more than enough to pay for all of Medicaid spending or nearly enough to cover all out-of-pocket and prescription drug spending by Americans.” (VOA)