Last week I took the S.O. to his monthly chemotherapy. We were late by almost two weeks while he was dealing with side effects of the preceding cycle. Thus it had been nearly two months. The place is an ample room with about 15 comfy chaises for patients and an extra chair for accompanying people. Usually it is full and often we had to wait up to an hour for our turn.
What was my surprise to see that only two other chairs were taken and that the S.O. went straight to a chair of his choice!
I asked our regular nurse in a bit of dark humor whether everyone was cured or dead. She told me that there are two reasons for attendance to drop dramatically over the last two months. One, the treatments must keep apace with inflation which means that it is becoming quite a burden for many, even with insurance, as paychecks are not following inflation. But more dramatic, oncologie medicine stocks have been exhausted for many type of cancers, in particular the more common ones like breast cancers. I suppose that in a perverse irony of the Fates my S.O. is lucky to have a rarer cancer... por ahora.
We were told that for those who cannot find medicine there is only two options: suspend treatment in the hope that the regime will keep its promise of finding "generics" which are of dubious quality when triangulated with Cuba as past experience demonstrates; or shell out foreign currency.
So, what does it mean to pay your own way with foreign currency?
Let's look at some simple facts to begin. By law the regime/state has the monopoly of bringing into the country certain type of drugs: HIV, Cancer, Kidney failure, Organ Transplant and some other special cases. The reason was a good one (from the "4th republic" by the way, not Chavez): since those medicines tend to be expensive the state paid for them to allow for equal access. If you were poor you got treated at a public hospital; if you were rich or middle class with health insurance then you could pick up your practitioner and get less traumatic care than what you get as a general rule at Venezuelan public hospitals. Either way, you got treated.
But things went down under Chavez when, first, the regime decided to set up a parallel health care system that ended up in two equally deficient systems. With the crisis coming, an over saturated private system does not have the means, or vocation or the ability to replace the public system. The more so that the regime refuses to give it access to free convertible dollars to buy medicine and supplies. As it is the case of food and general drugs, treatment and analytical supplies are also dearly missing. And this is made graver for patients who depend on drugs under state monopoly, a monopoly that the state refuses to give up even though it cannot fulfill it.
Thus, if you have access to USD, and want to get your prescriptions from the US (or Colombia or even Mexico) you will need at least one trip to establish contact with a local physician that will write you that prescription (particularly in the US where M.D. are so afraid of malpractice suits that they refuse to write anything without seeing the patient). Be it Bogota or Miami we are talking here 1.000 for a round trip, between 200 and 1.000 on staying expenses depending on whether you have relatives there, plus the medical bill that can easily reach a multiple of 1.000 depending on your ailment. This for your first month; for the rest you may bring a supply for more than one cycle if drug stability is OK, or have someone else pick it up for you upon your local physician notice, or go back to pick the next lot. All of this, of course, if the sick person is able to travel because if it cannot, then...
We are looking here at a bottom line of 2.500 USD a trip. Since the minimal wage in Venezuela is at 11 USD, that trip, for a month supply, represents 227 MONTHLY MINIMUM WAGE. Think about that for a minute.
Clearly, only the super rich can afford treatment today. If you are middle to upper middle class you may be able to pay for a few months and quickly deplete whatever savings you have outside of the country, if you have them. And then, well, join the poor.
The catch here is who are the super rich that have easy access to dollars for themselves or the relatives they chose to help. There are two groups, those that were already rich in USD before Chavez and those that became obscenely rich under Chavez. Many in the group BEFORE are either long gone anyway, or got long ago a US health insurance. Their concern, if any, is for relatives left behind. And those that did not leave the country during Chavez first years do not have an endless supply of US dollars, amen of having actually to earn these while the chavista super rich simply steal the money they need, in dollars, straight.
At this point it is simply inconceivable, it is a crime against Human Rights not to allow free, if targeted, convertibility of currency so that sick people can at the very least avoid the trip part for getting the care they need. The regime is coldly erasing through death or financial failure the historical middle to upper middle class since the only rich folks that can deal with the current situation are the ones close to the regime.
At least in this particular case, at this time, we can use the term "genocidal class warfare". You either die, go bankrupt or leave the country. You have no other option.
Some pro Chavez/regime supporter may point out that it is mere justice that all Venezuelans have to go though this, rich or poor. After all, the poor do not get either the medicine, nor the health support. I will reply that totalitarian regimes do not care about what happens to their civilians. They are a mere casualty in the war for the just cause. It does not matter for the regime whether its supporters die in greater numbers, they are expendable. What matters in the end is that the opposition to the regime is broken. The end justifies the means. All methods are valid. Period.
Let me remind you historical precedents, such as Hitler not afraid to distract from its army and civilians resources for use in Jewish extermination carried out all the way to the last day of the war. Or how Stalin drive to liquidate Koulaks had no problem creating a general starvation, or how the Castros never lost a night of sleep over the balseros braving the straights of Florida or the Argentina's military sending unprepared soldiers to the Falklands, or....
The current holders of the Venezuelan regime have absolutely no qualms about letting people die of disease, and I mean not only cancer patients. Never mind those who will die soon of malnutrition and those who already die of violence in the barrios. What the regime wants is for denizens of El Cafetal, or Prados, or Altamira to stay terrified at home, looking at what next heirloom they will need to sell at low price to help buy medicine for cousin Juan. That chavista supporters suffer more, die in much greater numbers is really not an issue for Maduro.
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Note: I already wrote in Spanish a note on why there is already enough evidence to instruct a dossier on chavista leadership to send them to the Hague tribunal. I suggest that the National Assembly starts officially the procedure. After all, if Dilma got impeached Sunday I do not see why we should not try to do so with Maduro.
Showing posts with label medical crisis. Show all posts
Showing posts with label medical crisis. Show all posts
Sunday, 17 April 2016
Thursday, 18 February 2016
Musings on the pharmaceutical genocidal debacle
Thinking about what I wrote last night, giving Maduro a D-. I realized that I was too generous, that my Scientific objectivity took above my best judgement. These measures mean nothing, at best it is a way for him to gain a few more weeks until he finds a way to save his ass. Nothing basic will change in the system. That is all.
A brutal slap drove that point a couple of hours ago. In yet another cadena Maduro sat in front of him representatives of the pharmaceutical sector to "restart" production which apparently to him has unaccountably stopped. Basically he rediscovered the wheel and medicines will churned soon for the great contentment of the people. Unfortunately I wok in the sector and things are not as rosy as he would like el pueblo to believe.
Well, a note first: I do not work in the human medical sector but part of my activities are related to animal husbandry medications and the story is exactly the same. There we see much lower yields because animals cannot be treated adequately. And thus less protein for el pueblo.
I am not going to discuss how medicine is paid or costs in Venezuela: every country has its own very complex system. What I am going to address is how come there is today a criminal, yes, criminal, shortages of medicine in Venezuela.
Before Chavez Venezuela did not produce active principles of a large majority of most medicines. Like most countries in the world, it had a wide representation of diverse major pharmaceuticals companies that would or would not produce on site a given principle, pill it or bottle it for Venezuela and export it to neighboring countries. And vice versa. There were also several local pharmaceutical that would get licenses to manufacture all sorts of generics with raw material imported from wherever. In short, a wide variety of pharmaceuticals were available and we were the envy of Latin America. The only problem was cost. Admittedly a significant one but not an insoluble one if a serious government had set its mind to make public hospitals work efficiently and dispense directly medicine to the neediest sectors of the population. And yet costs were not astronomical and at least the middle class managed quite well.
When chavismo set its currency exchange controls, its importations barriers, its refusal to accept that foreign companies recover their investments, the whole system unraveled. Add to this sub par quality imports from Cuba to satisfy Barrio Adentro Mision and other unfair competition and ridiculous price controls and you get the picture.
The mystery is not that pharmacy shelves are empty today, the mystery is how come they have not been empty 2 years ago already.
What happened took place in different phases, First, major foreign laboratories closed one by one, moving their production facilities to Colombia or elsewhere. Quite often the products they manufactured here disappeared, not even coming back imported from the new place. Simply, they left the country, having enough of its problems. Then, as currency crunch happened, suppliers of raw material became more and more reluctant to provide what the local generics needed to make their pills, packagings and the like. The debt ballooned and suppliers simply stopped sending stuff. Hence the current situation. As for what could not be assembled here, well, they stopped coming even before generics stopped production.
The criminal role of the regime CANNOT be understated: the medical emergency has already been denounced since early last year, people have died, and keep falling and we had to wait until today to finally hear about a new plan that will not resolve anything. At best, the regime announced that it will decide which deseases you can survive and which, well, will be too bad for you if you get them.
The regime guilt comes from its stubborn refusal to create a free exchange rate where people could at least import medicine at international cost. But no, we all have to die the same, and only the very reach, those with hefty accounts over seas can bring whatever they need to bring in. This is XXI century socialism for you.
What is terrible here is that the solution is simple and fast, at least to restock the shelves of the basics. Remove price controls. Free the currency for import of raw material, packaging needs, etc. In three months top you will get again 90% of the generics produced 2 years ago. The production lines exist, the people to make them are trained. You do not even need to pay back debt to suppliers yet, you can wait a little bit longer for that and start paying it AFTER production restarts. They will understand (I know what I am talking about, direct experience with providers). Many of the raw materials can actually be brought in airborne as they are needed in small amounts. The rest can come in a couple of dozen containers just to restart the basics like acetaminophen for dengue and zika or high blood pressure drugs.
That it will be too expensive? What is worse: cheap inexistant pills or expensive available pills? For the poor the regime just needs to organize large scale discounted purchases for public hospitals and provide the prescription for free for those that go there for treatment. Or charge them a nominal fee. Corruption is easily control: one package for hospitals and one for pharmacies so you will know if what you buy has been subtracted from an hospital.
It is really quite simple and the dollars for that exist. You just need to stop the corruption around it.
But since the regime is unwilling to do that, then I have the regret to insist on that: the regime is guilty of genocidal practices against the Venezuelan people for deliberately depriving it from on time access to necessary medication.
Period.
A brutal slap drove that point a couple of hours ago. In yet another cadena Maduro sat in front of him representatives of the pharmaceutical sector to "restart" production which apparently to him has unaccountably stopped. Basically he rediscovered the wheel and medicines will churned soon for the great contentment of the people. Unfortunately I wok in the sector and things are not as rosy as he would like el pueblo to believe.
Well, a note first: I do not work in the human medical sector but part of my activities are related to animal husbandry medications and the story is exactly the same. There we see much lower yields because animals cannot be treated adequately. And thus less protein for el pueblo.
I am not going to discuss how medicine is paid or costs in Venezuela: every country has its own very complex system. What I am going to address is how come there is today a criminal, yes, criminal, shortages of medicine in Venezuela.
Before Chavez Venezuela did not produce active principles of a large majority of most medicines. Like most countries in the world, it had a wide representation of diverse major pharmaceuticals companies that would or would not produce on site a given principle, pill it or bottle it for Venezuela and export it to neighboring countries. And vice versa. There were also several local pharmaceutical that would get licenses to manufacture all sorts of generics with raw material imported from wherever. In short, a wide variety of pharmaceuticals were available and we were the envy of Latin America. The only problem was cost. Admittedly a significant one but not an insoluble one if a serious government had set its mind to make public hospitals work efficiently and dispense directly medicine to the neediest sectors of the population. And yet costs were not astronomical and at least the middle class managed quite well.
When chavismo set its currency exchange controls, its importations barriers, its refusal to accept that foreign companies recover their investments, the whole system unraveled. Add to this sub par quality imports from Cuba to satisfy Barrio Adentro Mision and other unfair competition and ridiculous price controls and you get the picture.
The mystery is not that pharmacy shelves are empty today, the mystery is how come they have not been empty 2 years ago already.
What happened took place in different phases, First, major foreign laboratories closed one by one, moving their production facilities to Colombia or elsewhere. Quite often the products they manufactured here disappeared, not even coming back imported from the new place. Simply, they left the country, having enough of its problems. Then, as currency crunch happened, suppliers of raw material became more and more reluctant to provide what the local generics needed to make their pills, packagings and the like. The debt ballooned and suppliers simply stopped sending stuff. Hence the current situation. As for what could not be assembled here, well, they stopped coming even before generics stopped production.
The criminal role of the regime CANNOT be understated: the medical emergency has already been denounced since early last year, people have died, and keep falling and we had to wait until today to finally hear about a new plan that will not resolve anything. At best, the regime announced that it will decide which deseases you can survive and which, well, will be too bad for you if you get them.
The regime guilt comes from its stubborn refusal to create a free exchange rate where people could at least import medicine at international cost. But no, we all have to die the same, and only the very reach, those with hefty accounts over seas can bring whatever they need to bring in. This is XXI century socialism for you.
What is terrible here is that the solution is simple and fast, at least to restock the shelves of the basics. Remove price controls. Free the currency for import of raw material, packaging needs, etc. In three months top you will get again 90% of the generics produced 2 years ago. The production lines exist, the people to make them are trained. You do not even need to pay back debt to suppliers yet, you can wait a little bit longer for that and start paying it AFTER production restarts. They will understand (I know what I am talking about, direct experience with providers). Many of the raw materials can actually be brought in airborne as they are needed in small amounts. The rest can come in a couple of dozen containers just to restart the basics like acetaminophen for dengue and zika or high blood pressure drugs.
That it will be too expensive? What is worse: cheap inexistant pills or expensive available pills? For the poor the regime just needs to organize large scale discounted purchases for public hospitals and provide the prescription for free for those that go there for treatment. Or charge them a nominal fee. Corruption is easily control: one package for hospitals and one for pharmacies so you will know if what you buy has been subtracted from an hospital.
It is really quite simple and the dollars for that exist. You just need to stop the corruption around it.
But since the regime is unwilling to do that, then I have the regret to insist on that: the regime is guilty of genocidal practices against the Venezuelan people for deliberately depriving it from on time access to necessary medication.
Period.
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