Long story short

 THE medical referral program has always been a problem for the CNMI because quality healthcare is costly, and the government is expected to pay most if not all of it. Not surprisingly, the medical referral program has been discussed ad nauseam, but it seems that many politicians and voters are unable to remember anything that can’t be Googled easily. And so here we are, talking about it, again.

The mayor of Tinian knows it’s an old issue, so in his recent testimony he pointed out what has been repeatedly pointed out in the past and not-so recent past: the medical referral program needs more funding.

But as in previous discussions of this topic, many recommendations will be about other things such as managerial issues or what office should be responsible for the program — as if all that is needed to fix a perennial funding problem are “true leaders” with the “right vision,”  etc. Maybe.  Especially if they can also donate $20 million, each year, to the medical referral program.

Politicians, in any case, created this program.  Politicians also have to hire people who will hire the people to run it. And then politicians have to fund it. Every single year. Doctors may decide who should be medically referred, but politicians will have to pay the bills…with other people’s money. Unlike their federal counterparts, CNMI politicians don’t have a printing machine that can print real and legal U.S. dollars — or the world’s largest and most dynamic economy that could pay for trillion-dollar relief measures.

The medical referral programs and CHCC need more funding.

That’s not a state secret.

The real question is, what will politicians do about it besides talking about it, again and again?

Not so long ago

HERE’S what the medical referral program director said in Jan. 2020:

“We incur a deficit in the first month of the fiscal year. Normally, about 22% of our requested budget is appropriated. For example, if we requested $15 million, they will give us $2 million. So we are into deficit right away.”

Reminder: it is the Legislature that must act on the government’s budget bill each year.

In 2019, the program director said, his office referred 1,997 patients to off-island hospitals for a total cost of about $15 million. To provide funding for medical referrals, “the governor uses his reprogramming authority to transfer funds from other departments to cover medical referral costs.” If medical referrals were properly budgeted, the program director said, there would be no need to reprogram funds. But again, “we have always been underfunded.”

Appearing before the House for a budget hearing in the summer of 2020, a CHCC official provided an answer to one of the questions asked in a recent House committee hearing:

Moving back the medical referral program to CHCC would mean that the underfunded healthcare corporation would “inherit” the annual deficit (about $17 million at the time) of an underfunded program.

CHCC told lawmakers: please provide CHCC and the medical referral program adequate funding.

And what are the “major concerns” of many lawmakers today?

The deficit! The governor’s reprogramming powers!

Guess what will be their concerns next year, an election year.

It’s like the movie “Groundhog Day,” but with no entertainment value whatsoever.


Zaldy Dandan is the recipient of the Best Editorial Writer Award of the Society of Professional Journalists, and the CNMI Humanities Award for Outstanding Contributions to Journalism. His three books are available on amazon.com

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