The exodus of doctors is part of a larger wave of professionals who have left the US island territory in recent years, settling in states such as Florida and New York, where there is a big demand for bilingual workers, especially police and nurses.
Many Puerto Ricans also seek to escape a wave of violent crime and higher cost of living. Almost a million more Puerto Ricans now live on the mainland than on the island.
Plus, for the medical professions, living in the mainland also brings more immediate access to local seminars, symposia and conferences in their specialized fields, particularly for those in magnet areas like New York and Houston.
Obamacare is not a factor, though, since all regulations would be the same in the 50 states and Puerto Rico.
Officials say that when drug-resistant cases show up in the U.S., there is often a Mexico connection. Of San Diego’s 14 multidrug-resistant TB cases between 2007 and 2011, half were either from Mexico or had a Mexico link based on the particular strain of the disease, said Kathleen Moser of the county’s Health & Human Services Agency, which sees many patients who live and work on both sides of the border.
Part of the problem, of course, is that Mexico’s rate of TB infection is much higher—in some cases 10 times higher. The resistant strains begin to breed, experts say, when doctors there give patients similar drug regimens over and over. Other times, patients who aren’t supervised closely abandon treatment before they are cured.
It’s worse because of the Mexican drug violence:
Funding isn’t the only issue. As a key part of prevention efforts, U.S. experts have regularly crossed the border in California and Texas to keep tabs on and help patients directly. But drug-related violence along parts of the U.S.-Mexico border has shot up, forcing workers to consult only from the U.S. side. Among them is Barbara Seaworth, the medical director of a TB center in San Antonio, who stopped a few years ago after making the trips for nearly 20 years.
Compounding the problem: Mexico lacks enough health workers to offer directly observed therapy to every patient.
Health and Human Services Secretary Kathleen Sebelius cannot enforce the Obamacare contraception mandate as it is written, but must follow through on a promise to rewrite the rule to accommodate religious liberty,
They [the judges] ruled that the Obama administration must rewrite the regulation by August 2013 and provide updates to the court every 60 days. If the government fails to do so, the lawsuits may proceed.
Even then, it may not help.
The nuns employ people of many denominations, which makes them ineligible for the exemption being granted churches. They have 300 sisters who tend to the elderly in 30 U.S. cities.
That’s what you get when, in order to know what’s in it, you have to pass a mandate.
Health insurer Blue Shield of California wants to raise rates as much as 20% for some individual policyholders, prompting calls for the nonprofit to use some of its record-high reserve of $3.9 billion to hold down premiums.
In filings with state regulators, Blue Shield is seeking an average rate increase of 12% for more than 300,000 customers, effective in March, with a maximum increase of 20%.
Some consumer advocates and healthcare economists say Blue Shield shouldn’t be raising rates that high when it has stockpiled so much cash. The company’s surplus is nearly three times as much as the Blue Cross and Blue Shield Assn. requires its member insurers to hold to cover future claims.
The increase in reserves is due to an increase in uncertainty,
The company also expects higher costs from an influx of new customers under the federal healthcare law in 2014.
“It’s a once-in-a-lifetime change in the healthcare market that will bring a lot of volatility, and we need higher reserves for that,” Wagner said.
Even with these proposed rate increases, Blue Shield said, it expects to lose money in the individual insurance market in 2013.
The insurer said its medical costs for this segment of the business grew 10.6% and what it actually pays is rising 12.5% after adjusting for its portion after customer deductibles.
And Blue Shield is not alone,
The state’s largest for-profit health insurer, Anthem Blue Cross, cited a similar jump in medical costs in seeking rate hikes as high as 25% for some individual policyholders, effective in February.
Also in California, Kaiser Permanente is seeking to raise rates an average of 9% for 220,000 individual policyholders next month.
Nowhere near that 3,000% “premium fall” Obama had us expect.
So, let me get this straight. This is a long sentence. We’re going to be gifted with a healthcare plan that we’re forced to purchase and fined if we don’t, which purportedly covers at least 10 million more people without adding a single doctor but provides for 16,000 new IRS agents, written by a committee whose chairman says he doesn’t understand it, passed by a Congress that didn’t read it but exempted themselves from it, and signed by a President who smokes — [laughter] — same sentence! — with funding administered by a Treasury chief who didn’t pay his taxes, for which we will be taxed for four years before any benefits take effect, by a government that has already bankrupted Social Security and Medicare, all to be overseen by a Surgeon General who is obese — [laughter] — and finally, financed by a country that’s broke.
At the end, Dr. Bellar even channeled Allahpundit with this exit question:
Joe Arroyo, a Colombian songwriter, singer and bandleader whose pan-Caribbean salsa hybrids and historically conscious lyrics made him one of his country’s most respected musicians, died on Tuesday in Baranquilla, his adopted home city in Colombia. He was 55.
An academic study released over the weekend shows that nearly half of all Cubans that receive remittances from abroad have absolutely no interest in leasing a self-employment license (ownership remains prohibited) from the Castro regime, while another 34% would only “think” about it. That leaves few that actually have or would.
Chavez had been expected to host the summit on the 200th anniversary of Venezuela’s declaration of independence from Spain. He promoted it as an event to move ahead with the development of a 32-nation regional bloc, the Community of Latin American and Caribbean States, that excludes the United States and Canada.
The Venezuelan Foreign Ministry said it will work with other countries to schedule a new date for the summit in Venezuela later in the year. It remained unclear how soon Chavez might be able to return home.
Uruguayan President Jose Mujica, a Chavez ally, said before the announcement of the summit cancellation that he expected the Venezuelan leader to be home in time for the country’s independence anniversary July 5.
The summit, set for July 6-7 on Margarita Island, was to have followed a massive state celebration still scheduled for Tuesday to mark the nation’s 1811 independence. It is not known whether Chavez will return by Tuesday.