The Puerto Rico Healthcare Crisis
The Puerto Rico Healthcare Crisis
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DOI：
10.1513/annalsats.201508-531ps
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发表时间：
2015-12-01
影响因子：
8.3
通讯作者：
Roman, Jesse
中科院分区：
文献类型：
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作者：
Roman, Jesse
波多黎各联邦是美国的一个有组织的非建制领土，人口超过 350 万美国公民。由于最近的债务违约（估计超过 700 亿美元）、高贫困率和失业率上升，该岛最近成为人们关注的焦点。然而，人们对岛上医疗保健系统的关注较少，许多人认为该系统正处于崩溃的边缘。医疗保健占波多黎各经济的 20%，这场危机影响了医生的报销率，同时促进了该岛医疗保健基础设施的瓦解。一个主要贡献者涉及为支持该岛医疗保健系统而提供的联邦资金与向大陆各州和夏威夷提供的资金之间的差距。尽管波多黎各缴纳了自己应得的社会保障税和医疗保险税，但其获得的医疗保健联邦资金仍少于其他 50 个州和哥伦比亚特区。更糟糕的是，美国医疗补助和医疗保险服务中心计划很快将医疗优惠报销金额再削减 11%。这种对医疗保健支持的差异被认为是造成波多黎各总债务约 250 亿美元的原因。这些事件对岛上波多黎各人健康的影响无法完全预测，但医疗保健提供者的流失和获得护理的机会减少是肯定的，高质量的护理将受到影响，从而对患有呼吸道疾病等慢性疾病的人造成严重影响。
The Commonwealth of Puerto Rico is an organized nonincorporated territory of the United States with a population of more than 3.5million U.S. citizens. The island has been the focus of much recent attention due to the recent default on its debt (estimated atmore than $ 70 billion), high poverty rates, and increasing unemployment. Less attention, however, has been given to the island'shealthcare system, whichmanybelieve ison the verge of collapsing. Healthcare makes up 20% of the Puerto Rican economy, and this crisis affects reimbursement rates for physicians while promoting the disintegration of the island's healthcare infrastructure. A major contributor relates to a disparity in federal funding provided to support the island's healthcare system when compared with that provided to the states in the mainland and Hawaii. Puerto Rico receives less federal funding for healthcare than the other 50 states and the District of Columbia even though it pays its share of social security and Medicare taxes. To make matters worse, the U.S. Center for Medicaid and Medicare Services is planning soon to implement another 11% cut in Medical Advantage reimbursements. This disparity in support for healthcare is considered responsible for similar to$25 billion of Puerto Rico's total debt. The impact of these events on the health of Puerto Ricans in the island cannot be entirely predicted, but the loss of healthcare providers and diminished access to care are a certainty, and quality care will suffer, leading to serious implications for those with chronic medical disorders including respiratory disease.