My twitter brought me though Decifrado this link from America Economia which lists the 20 bests health centers in Latin America, from private clinics to public hospitals and teaching universities. Venezuela has only one clinic ranked, Clinica Metropolitana, which readers should remember from the travails that yours truly endured there. In a way I am happy because this conforms to me that my appreciation of Clinica Metropolitana as a top institution in spite of all the miseries faced to operate in a country ruled by incompetence. But look at the table some more and you will start wondering....
- For example Colombia has 5 institutions, Venezuela only one.
- Clinica Metropolitana is one of the smallest in bed numbers: 136, while just in Chile, with 3 ranked institutes, counts more than 1100 beds.
- Two public hospitals do make it tot he ranking, one in Medellin and one in San Jose, Costa Rica. Tiny Costa Rica also gets the number 5 slot with a private clinic....
It is to be noted that Clinica Metropoliana ranked dead last that the item "patient security" which is an index that deals with ethics, to confidentiality and transparency, from reception at the ER to information. I can understand that personally since the clinic is simply overwhelmed by the amount of people who try to check in and as such personalized patient following cannot be good. Unfortunately for Metropolitana, it was one of the biggest index to establish the general ranking.
How can we explain that Venezuela with so much oil energy and such vaunted health plans can only manage to have a small private hospital to make it to the top 20? And an hospital already built in 1970.
The date is the secret: Clinica Metropolitana is in fact one of the last major health center built in Caracas (I think that only the complex at La Trinidad follows, though several smaller clinics have opened). Under Chavez no major private health center has been opened, or even public ones for that matter as the only thing to note is the Children Cardio Center which is not very big to begin with.
People are not going to invest in private heath center, even though the market exists as can be seen by the overcrowding of the places that make them look like public hospitals! Why that lack of investment?
- The chavista government has not helped private institutions to invest to try to compensate at least in part the deficit of the public sector. It is not for the state to build these of course, but at least to give tax credits, credits, prepared medical personnel t staff these centers, etc, etc... All what chavismo has done is to graduate under par medics in Cuba that none of these centers would hire even for bed pan duty.
- The government has instead relied on private health insurance for many of its employees who do not attend the public sector. The concentration of government investment in primary care exclusively for electoral purposes has for result the crowding of private facilities, killing competition and need to invest since they are minting as it is.
- The constant threats of Chavez to nationalize everything, coupled to the real time observation of the continuous overall degradation of the public health sector makes the owners of private clinics and hospitals know full well that when the situation of the public sector becomes catastrophic Chavez will simply nationalize the private sector facilities to replace the ruined hospitals he is unable to fix adequately. Why invest for Chavez to enjoy the results?
Ad that my friends is the reality of the Venezuelan heath care system, confirmed strangely through this page of America Economia where only one relatively small Venezuelan institution manages to figure... True, some public hospitals have newer equipments, have been restored, etc... but what matters the most, access, seems not to have improved since 1998 while access to private health care has degraded.