Puerto Rico needs healthy people to achieve sustainability. Having hundreds of thousands without medical coverage or dignified access to quality healthcare services, threatens an essential right that undermines productivity on the island while eroding the Treasury´s capacity.

We recognize the Health Insurance Administration (PRHIA) efforts in seeking alternatives to ensure healthcare services for those who need medical treatment. But the island also needs will to undertake a project that places citizens´well-being at the core of a fair healthcare system, which understands health as a right, instead of as a commodity.

Generating healthcare policy means ensuring that the funds budgeted return as service to the people. It is essential to ensure that every citizen has a fair medical coverage with access to the services they require and when they need them. It does not seem right that people who work do not have a healthcare coverage that allows them and their families to receive care, treatments and medicines. This situation undermines the culture of work. The lower the income, the greater the chances to have a  government healthcare plan.

Prevention is an essential factor for a population in good physical and mental condition. It reduces costs and generates wealth for citizens and for the island.

However, according to official data, Puerto Rico is between the countries with the highest rate of diabetes-related deaths, for example. The data show the relationship between the prevalence of diseases and people´s low socioeconomic level.

Such indicators show that although the public healthcare system has a multi-million dollar budget, that allocation does not translate into better healthcare services for the population.

Contradictions increase if we consider that, while the government's healthcare budget increased another $ 100 million – to a total of $ 2,7 billion this year – the system has lost 200,000 beneficiaries in five years. This increase has neither produced more nor better services for the participants, as revealed in documents on the prevalence of chronic diseases on the island.

Before new data on the decline of participants in the government healthcare system, the authorities resort to the same move: turn to the federal government for more benefits. However, it is clear that we need something beyond the repetitive funds-dependence exercise or asking Washington for changes in regulations. 

In order to control healthcare spending, it is necessary to generate clear healthcare policy and  use the available resources efficiently. Recently we noted that the Department of Health´s action plan until 2020 indicates that chronic diseases, one of the most expensive problems and with the highest impact on the quality of life, are preventable.

Intensifying efforts to prevent rather than cure, improving the quality of disease controlservices and promoting access to the right to good health to more people will reduce the cost of medical complications and emergency room visits which, in the long run, is also paid by taxpayers.

Healthcare should be a pillar in the plans to boost the economy. The better the health, the better the productivity. That is why ensuring a healthy life and promoting well-being for all at all ages is one of the UN´s sustainable development goals for 2030. And the proposal includes, among other goals, achieving universal health coverage, access to quality essential services and safe, effective and affordable medicines for all.

This goal should also frame the island's development strategies.

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