Willemstad, September 11, 2022 – In response to several incorrect public statements, the Board of Directors of Curacao Medical Center (CMC) sent a letter to the Prime Minister, the Minister of Finance, the Minister of Health and the Minister of Justice on Friday, September 9th, 2022. The purpose of this letter was to clarify doubts and to reiterate that CMC has no objection for the government to receive the unedited Nederlandse Zorgauthoriteit (NZA) report. In this letter CMC also reiterates the current financial issues and asks for a dialogue to come to a solution for the current situation at the hospital.
Last week, a misleading statement was made that parts of the NZA report were made illegible at the request of CMC’s management. The correct information is that CMC reviewed the report in April, 2022, and identified a list of inaccuracies that needed to be corrected by NZA. Another alternative that CMC Management gave NZA was to publish the report with an overview of the responses from CMC, indicating the inaccuracies. This was stated in a letter to NZA on May 16th, 2022. However, NZA made the decision to make parts of the report unreadable.
The second incorrect statement is a text on the Minister of Finance’s personal Facebook page, stating that people in Curaçao are dying as a result of a waiting list of CMC. There is no data supporting this statement. Though it is important to draw attention to this social issue, it is also important to understand that elective care are related to only procedures on non-acute and non-life threatening conditions. CMC has strict procedures in place to monitor the individual circumstances of each patient in consultation with the main practitioner. Should the condition of the patient worsen or require urgent care, the patient is immediately prioritized to receive treatment. Acute and essential treatments were never placed on hold, not even during the Covid-19 waves in 2020, 2021 and 2022.
The third clarification, is that CMC’s 2019 financial statement has been audited and approved in CMC’s shareholders’ meeting. The 2020 and 2021 financial statements will be ready consecutively by September 30th and October 31st, 2022. The delay was mainly due to valuation problems with the new hospital’s building and layout. Furthermore, in the letter to the Minister they re-emphasizes the significant discrepancy between the actual costs of services to insured persons, compared to the amount received from SVB and stipulated in the healthcare budget. This has been the case since 2019, 2020, 2021, and now again in 2022.
Since the transition, a precondition for CMC’s balanced budget was a cost saving between ANG 70 and 80 million from medication, specialists, foreign patient transfers and laboratories costs. SVB received a task-setting assignment from the government, the Taskforce Market Regulation and Financing Healthcare Sector (TFMZ) led by Mr. Monte, calculated a saving of ANG 72.3 million starting in 2020 up to a maximum of ANG 99.5 in 2026. An internal analysis by SVB indicated that this amount should be approximately ANG 83 million. However, these savings have not been realized yet. Consequently, CMC has not received adequate funding from the government since its opening to cover the operational costs of the hospital services provided to BVZ insured persons. Based on a request of the Minister of Finance to SOAB in October 2021, SOAB preliminary advice was that there is a significant discrepancy between the healthcare budget provided to CMC stipulated by Ministerial degree compared to the hospital services provided to BVZ insured persons. The request of the Minister of Finance to SOAB was after the decision of CMC to postpone the elective care to BVZ insured persons in September of 2021.
The Ministry of GMN systematically allocates an inadequate (lower) healthcare budget to cover CMC’s hospital services provided to BVZ insured persons.. The 2019-2020 and 2021 healthcare budgets are the subject of appeal proceedings before court, but instead of litigation CMC prefers to come to a solution in consultation with the ministers GMN and Finance. CMC has tried to solve this matter on numerous occasions, has sent many letters to the governments of Curacao since 2019, but is yet to receive a response.
Next to the previously mentioned SVB budget challenge, CMC has repeatedly drawn attention with no response or complete relief on the issue of COVID-19 and the accumulating uninsured costs. Through July 2022, these costs total ANG 15 from COVID-19 treatments (of which 4.8 million was paid in March 2021), and ANG 16.7 million from the uninsured and undocumented. Under current laws, CMC is obliged to provide this care. Altogether, this lack of funds results into an accumulated loss of ANG 148.4 million as of July 2022 and an accumulated debt to creditors of ANG 104.5 million of which CMC Vastgoed has the highest outstanding amount. This poses a significant mid- and long-term risk to the preventive and corrective maintenance as well as the necessary accrued capital for medical equipment replacement program, which will be due in 7 to 12 years.
To add to the current dire situation, ADC credited CMC the amount of ANG 9.4 million for 2020 and 2021, but there is still a dispute of ANG 1.4 million from 2021 and the verification for 2022 is yet to be finalized. There were other discrepancies in 2020 and 2021 that ADC did not admit to initially, which lead to mistrust and consequently, the decision to terminate the service agreement between CMC and ADC as of 15 November 2024. In July 2022, CMC provided an evaluation of the service level agreement between CMC and ADC where CMC listed concrete areas of improvement to remedy the cooperation between ADC and CMC in the short term. Should these improve, CMC is willing to reconsider its current position on termination of the service level agreement.
CMC will remain pending for a dialogue with the government to resolve these matters.
