Life Without Medical Care: How the Public Health System Collapsed in Venezuela

Discussion in 'Preparedness' started by Harper, May 18, 2018.

  1. Harper

    Harper Guide

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    This is an article by Jose Martinez who has been reporting on the collapse of his country, Venezuela. I pay attention to people who live through such events.

    I'm posting it not because I think that our medical system will collapse under its own weight, but rather what things might be like after a SHTF scenario.


    [​IMG]


    Editor’s Note: People who have been through a collapse, like Jose and Selco, know for a fact what it is like to live in a place where there are no hospitals, little medicine, and few professionals. In this article, Jose gives us a glimpse of what life is like without medical care as he shares how the public health system in Venezuela collapsed. ~ Daisy

    by J. G. Martinez D
    The access to the public health system in Venezuela hasn’t been good since the middle 70s. In the bigger cities, things were more or less decent until the middle 80s. This system, based on mere profits as quotas or portions from the oil revenues, while the population was not very large, reached a critical mass level. The crumbs from such revenues (where most of this income was stolen or sent outside of the country) allowed us to avoid the total collapse of the health system. Despite being bigger every year, the infrastructure of the system could not hold up against the corruption.

    In such a fast-growing population as ours, this was the prelude to a total disaster. At first, people thought this was not important; money and work were enough. The major concern of the people was finding a place to live (buying a plot and building a house with their own effort was something that people did not do, except for some eccentric persons that earned the respect and admiration of their neighborhood). If the government built the house and you ended up paying an insignificant quota, much better. Usually, in 4 or 5 years the inflation would eat that debt, like it happened with our mortgage. Anyway, this was more or less the general status quo in the middle 80s.

    But the health system had already to feel the stress of the desperate migration mostly from Colombia, Ecuador, even Peru and Chile. Go figure. The corruption was so high that equipment and supplies were stolen by the doctors, and destined for their private hospitals. This is absolutely true. Never punished, this scheme went on for decades.

    You had to bring your own supplies to the hospital.
    Now, in the middle 90s, things were nasty enough. In the Central Hospital, one of the biggest and most prestigious hospitals in the country, the general situation of scarcity was starting to be felt. Usually, the patients had to take their own supplies and medication because there were not enough for everybody. If they could buy their supplies, the employees, nurses, and doctors could attend them for free. The few supplies they received from the government was just for the really poor who would die or face permanent damage if not properly attended.

    One time, I lost an encounter with a bee. Its poison made my ears, face, and hands get swollen. It was more or less funny (for my college friends) until I told them I had problems swallowing. So they decided to take me to the hospital. It was nearby, so in 4 minutes walking, we arrive at the gate. I never could see myself in a mirror but I don´t forget the face of the people and the gatekeeper when they looked at me. Once inside, we had to wait for a doctor. A chubby resident attended me in a hallway (there was no office available, much less a bed) and gave me a recipe. The antidote was inexpensive, and the kind pharmacist gave me the shot without charge. I went home and after a couple of hours, I was fine.

    If this would happen to me now, perhaps I would not be writing this. People have died because of much less harmful diseases. A few years ago, before the crisis, I went in a motorcycle ride with some good fellows. We went to a tourist town about a couple of hours from my city. Ate strawberries with whipped cream (yes, strawberries grown up in the middle of the tropics, could you believe it?) and another bee decided that I was not friendly. After half an hour, there I was again this time in a small town infirmary. One of the riding bros was a doctor, so he joked with the nurse that if something happened to me he just would take my bike after signing the death certificate. We Venezuelans have an indestructible sense of humor sometimes.

    Once my ear channel got unswollen and I was able to hear again, we hit the road and came back home. The next day, I bought two hydro-cortisone vials. One for me, and one for my kid, just in case. The probabilities of him being allergic too were way too big. When they were almost expired, we donate them to a public nearby infirmary in our location where we trusted the doctor in charge.

    You have to be ready to take care of yourself.
    This extremely long preamble is just to enhance this fact: anything can happen at any moment, and if you are not decently prepared you could suffer some degree of damage.

    I used to travel for years with a little plastic box, with everything needed to inject myself the hydro-cortisone, given the case. I know we could be able to locate someone able to give a shot to my kid, but the probabilities of getting a bee inside the car, with the air conditioning (weather is way to hot and we usually use it all the time) on and the windows closed, were almost zero. Almost.

    But I took the medicine with us wherever we went. I know this allergy can kill me or give us a hard time with the younger kid. Older son is tough as an old crocodile.

    The last 20 years in the Venezuelan public health system
    Anyway, allow me to explain how things have been going the last 20 years in the public health system in Venezuela.

    Given the general status of the health system, one of the flags that used Uncle Hugo was this, to bring voters to his side. Once he could sit on the chair, he started to use the vast resources of the country to try to improve the infrastructure.

    I have to be fair on this. Yes, there were some things that improved a lot. Compared to the disaster of a white elephant of our former public health system, many people could enjoy for the first time in their lives a decent medical attention (of course, that was the disguise for the Castro Bros getting inside my homeland his Cuban spies: doctors and nurses…all of them with military training, and well brainwashed).

    Kids with heavy facial deformation were able to get reconstructive surgery. Grannies and grandpas with eye problems got surgery too. Working in a state company, but with huge benefits like access to the private health system with a full coverage insurance, we were pretty much protected. Working in the oil fields we needed to know that our families were going to be OK.

    There has been a lot of rhetoric around the public system recently. It’s completely ineffective now, as the policies just remain in the air. The resources used came from the oil revenue. Instead of using that revenue and dumping it in the dark, bottomless pit that is the Venezuelan system of public health management, if just a portion, say one third of that income would have remained in a safe place, perhaps overseas, to generate passive income to hold some minimum expenses, and funding yearly that hedge, the health system could have been able to survive and provide some welfare for the children. But the currency control exchange was total and imposed with an iron fist.

    Back then, with the incredible amount of money incoming, no one saw any need to use it as a mean for securing a much smaller, but much safer income. That would have allowed a continuous stream of resources that, under an adequate management, would be enough for providing oxygen to a health infrastructure that day to day faces an increasing population.

    A chronic problem with the Venezuelan economy has been the lack of decent salaries. This is a very old problem. The health professionals stopped being well paid many years ago in the public sector. But the demand in the private sector was very very high, and this compensated the low salaries offered by the government. With the chronic scarcity taking its place in the medicines and supplies, the population increasing took to ridiculous levels the bedding availability in the hospitals. Traditionally, the assistance to people in regions far away the big cities was deficient.

    It was frequent to see people in small towns and villages trying to collect money to send a mother with her sick child or children to one of the big cities so she could take them to a big hospital.

    (Cont'd.)
     
  2. Harper

    Harper Guide

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    And now everyone is suffering.
    Is there any need to explain how poor people, MY poor people, are doing now? I don´t think it is necessary. The outrage I feel while typing this is something that can´t be healthy at all. A much wise writer than me wrote: “…once you have a child, you become the father of all the children in the world”. This was José Martí. And he was right.

    As I am writing, the last reports (Centro Gumilla, a social research center part of the Company of Jesus, part of the Catholic church of Venezuela, that has survived the official hostility since before the 90s) which began documenting in 2014, inform us that the emergency system is paralyzed.

    There is no blood availability for transfusions. How is someone going to be willing to donate any blood if they are malnourished? To make things worse, the collapse of the wastewater collection systems, the rainwater drainages, lack of water supply, and power are a complete disaster. The constant electrical failures have damaged very costly and essential medical equipment.

    It is unbelievable that this situation is present without even one missile or one shot, nor without the slightest threat of a war. The report mentions that, in the years 2007-2010 a significant amount of resources were “lost”. The official policies were completely erroneous because there was not an incentive to boost the internal medicine production. These are the results: 84% of our health products have to be imported.

    When we exported 2.4 millions of barrels a day with a price of 90$ the barrel, dang! Who cares?. Where do I sign? But now there is neither the crude nor the price. Just a deep sense of hopelessness.

    Another imbalance of the budget, is, and I am astonished to read this because it was new for me as well, is that the 21% of the health budget (that it was low even for Latin-American standards) was destined to 8 millions of public employees and families private insurance. This is a very high number in a country with roughly 36 millions of inhabitants I think. However, the private insurance is no longer functional, to be honest. One of my friends had an accident with his child, the kid broke one arm, and there was not even an specialist to attend him and put him a cast.

    The X-rays were insurance covered, thanks God. So my buddy had to go to another hospital, get borrowed money to buy the casting bandages, the painkillers, and the wait for a reimbursement that lasted 2 months. The money´s value was less than the half of the original amount, once he got it. For those of you that may not have access to some social networks, I have seen pictures of women giving birth on cardboards over the naked floor. I have seen pictures of newborns in cardboard boxes because there are no cradles. I have seen pictures of people getting a medical endovenose treatment laying on a cardboards and some sheets in the floor of the hospitals.

    I had to pay a lot of money in 2015 because of my wife needed four bottles of liquid serum for an antibiotic treatment, and the needles, plus tubing. This was something almost impossible to get, and without some extra income of my second job, it would have been pretty uphill. I have seen people younger than me dying because of a clogged brain blood vessel, with 37 years old because of the stress and God knows what else. An oil state company worker, subject to medical yearly exams. Some fellows still in the country have told me that people with nasty wounds, ulcerations or other diseases asking for money in the streets has increasing dramatically.

    This was a more or less common sight in the largest cities, especially in the public transport of the poorest areas of the cities, but now…you get the picture. If this is uncommon for them….go figure.

    I just logged in to one of my profiles of the social networks, and read that some medical personnel are protesting because of the lack of resources, and the entire medical staff of the Zulia state, once the largest oil producer of the country, has resigned. There is no medical attention in the entire state, leaving 5 million people unattended.

    Under these conditions, the best we can do is eat healthy (if such thing is even possible, but with an orchard and producing stealthy highly nutritional foods, it could be done for a while), to get out of the largest cities (which we did), and downsize our lifestyles, living much smaller lives, until things get settled.

    I hope you have enjoyed the reading. More certain facts in real time, in the next article.


    About the Author
    J.G. Martinez D
    Jose is an upper middle class professional. He is a former worker of the oil state company with a Bachelor’s degree from one of the best national Universities. He has a small 4 members family, plus two cats and a dog. An old but in good shape SUV, a good 150 square meters house in a nice neighborhood, in a small but (formerly) prosperous city with two middle size malls. Jose is a prepper and shares his eyewitness accounts and survival stories from the collapse of his beloved Venezuela. Thanks to your help Jose has gotten his family out of Venezuela. They are currently setting up a new life in another country. paypal.me/JoseM151

    Source: https://www.theorganicprepper.com/public-health-system-venezuela/
     
  3. atlastrekker

    atlastrekker Supporter Supporter Bushclass III Bushclass I Bushclass II

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    Great article. It looks he's turning out to be another FerFAL.
     
  4. fx77

    fx77 Scout

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    It will happen here eventually...Socialized Medicine
    Here is a stat..At my spouse's med school class of 2017---50% received MD and MBA ofr MPH..that tells U the $$$ is in administration and few plan to logng term care for patients...That will mean more para-professionals treating complex problems , often beyond their training levels or credentials, for cheaper employee costs to the Mega health corporations OR the socialized system which is coming...., and importing Foreign Doctors to pick up the slack..good luck America
     
  5. TrespassersWilliam

    TrespassersWilliam Supporter Supporter Bushcraft Friend

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    It is happening slowly. I am on the "don't get sick" plan. High deductible with HSA. The insurance company wasted no time after the "insurance mandate" to raise prices, reduce coverage, and started penalizing people who don't wear tracking devices that report heart rate and sleep habits.

    No insurance mandate penalty from the IRS for 2019 -- I am considering dropping health insurance altogether.

    There are naturopaths who don't deal with insurance companies and work for cash. If your kid gets a bad tick bite, you get a prescription for antibiotics immediately without hemming-and-hawing that the big hospital system doctors like to do. Those doctors seem more concerned with meeting institutional goals than treating individual patients.
     
    Last edited: May 19, 2018
  6. LostViking

    LostViking Supporter Supporter

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    I strongly recommend an advanced first aid course. Wilderness First Responder (Woofer)
    Wilderness First aid at least.

    And Buck Tilton's Book Wilderness Medicine.
    It ain't a doctor, or a hospital. But it sure beats a blank.

    They both also tie in well to Bushcrafting. Cuts, burns, broken bones, alergic reactions, all stuff we can encounter in the woods.
     
  7. Wasp

    Wasp We are GO for Sting! Supporter

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    Already when you go to the doc or even a specialist, many of your visits will be with a nurse practitioner, not the doctor. If you ask to see the doctor they get all huffy because you wanted and actual doc.

    My oncologist that manages my B12 defficiency just quit the hospital. They have more admins than doctors, all of which are making more than the doctors themselves and mismanaging the operating funds. He said he didn't want to be part of that because the hospital is not only bankrupt, but operating without a bond. This is a huge really nice Cancer centers, and they treat many hundreds of patients, all of which are outpatient.

    I had surgery end of last year. I had my presurgery exam, hospital room, nurse, IV, bed, anesthesiologist, four assistants in ER, my surgeon, meds, stitches, biopsy and testing, recovery, not to mention the hospital overhead including utilities, front staff, insurance and bond, etc, etc. My surgery was outpatient but I was there for three hours.
    The cost was only $5,800. My insurance came in and listed all costs and charges in line item form. They paid and everything (with no copay mind you) was $2,140 total.

    Now next time you go to the hospital and you wonder why they wont admit you unless youre dying in the floor, thats why, because in this current "medical economy" they cant sustain when trying to balance expenses and overhead.
    It could be argued that Doctors could make less money. But they work long hours and spent almost 25 years (from 5-30) in school, and their student loans exceed the average college student. Some make rediculous money but many do not. My physical therapist is 31 and still paying school loans and will be for years, and she doesn't make big money. My sister is an occupational therapist and still owes $150k and shes 45.

    With socialized medicine and expectations that most people on it will never get off, the medical sysyltem will faulter. If people would/could actually get healthy enough to pay for insurance again without government backing (tax dollars and low payout), then it would be much better. And what was high end insurance has now become minimal pay insurance companies, because why should they have to pay more thsn a low end government propped up insurance company, and youll still pay high co pays and high premiums and they will still pay the docs/facilities minimal payouts.

    Some people honestly need the help, but there are people that are too lazy to work and those are the ones that will help tear down the system.
     
  8. arleigh

    arleigh Guide

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    Do the incompetent have a right to tell the competent how to live ?
     
  9. Ron

    Ron Guide

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    I can already see the first stages of it in Sweden.
    Long cues in healthcare and people dying because of it, women giving birth in cars, due to the closure of clinics, poor elderly not being able to afford proper food or housing, let alone healthcare in any form. And we too have seen an explosive growth in population. A growth enforced upon locals from the outside.
    Another socialistic system on the verge of total collapse.
     
  10. central joe

    central joe Supporter Supporter Bushcraft Friend

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    Anything the government gets involved with go downhill FAST !! Just my opinion. joe
     
  11. backlasher

    backlasher Supporter Supporter Bushcraft Friend

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    If you think the VA system is great, you'll love socialized medicine.
     
  12. fx77

    fx77 Scout

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    Note above, if an ins carrier decides after the fact that an admission was not justified, they may not pay
    Also ER visits are al a carte...fee for everything, copay for everything, many consultants are not IN Network, and U get stuck with a huge bill.
    In patients are charged a global fee called a DRG based on your diagnosis.

    Hospitals often make more by keeping U in the ER.
     
  13. CaliforniaCanuck

    CaliforniaCanuck Guide

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    I dropped health insurance in Feb of 2016. I have a family of 4, me, wife and two kids.

    I should say I dropped "regular" health insurance, and instead got a health care cost sharing plan wth Christian Healthcare Ministries. It is a lot cheaper per month but there's a limit to the coverage. I think I had the silver plan and cost $230 per month. The limit is fairly low, I seem to remember something like $100k, plus there's a deductible.

    In that year (2016) the only significant medical expenses we had was that my wife got an ulcer and the treatment ended up costing approx about $1,500 going in as paying cash paying customer, not thru insurance. Healthcare Ministries ended up covering about $700 of that.

    When I calculated the monthly cost for my wife's portion of the coverage plus the deductible, we would have been better not having any insurance. So even the cheap cost sharing plan with Christian Healthcare ministries didn't really prove to be cheaper than not having any insurance.

    Today, we're covered under my wife's company policy and the cost is still fairly high, there's a high deductible, and in the event that someone gets really sick we'd likely lose everything.

    So, insurance or not, the cost of a major medical event will bankrupt the average american.
     
  14. Bridgetdaddy

    Bridgetdaddy Guide

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    The main hospital near me is hiring more management and vice presidents and getting rid of the basic staff that actually do the work .now they have consultants telling them how to cut costs. Even housekeeping and maintainence are being cut.
     
  15. atlastrekker

    atlastrekker Supporter Supporter Bushclass III Bushclass I Bushclass II

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    For anyone that doesn't have a copy of Survival and Austere Medicine:
    An Introduction, written and edited by The Remote, Austere, Wilderness and Third World Medicine please down load one. There's several places to download it, but this is the one I know of.

    http://nnpg.net/stuff.shtml

    Where there is no doctor is another good one, if you don't have that one either...

    http://hesperian.org/books-and-resources/
     
  16. DKR

    DKR Scout

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    Why is there any surprise? Once the FedGov demanded free healthcare at hospitals (anti-dumping laws) it was the true beginning of the end.
     

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