“Excess Mortality:” Inside Puerto Rico’s Crumbling Healthcare System | Amanpour and Company 

Write your Senators AOC and Bernie Sanders, Vote Blue so Trump can never throw toilet paper at Puerto Ricans like he did after Maria and tell them to clean it up.

The thing is Puerto Rican corrupt goverment wanted to emulate USA bad healthcare system

Sick, poor and with bad healthcare it's all a problem on the Jones Act that drives up the cost of healthy foods. Small bag of green grapes $9

And Luma being federally subsidized has a monopoly and keeps prices high. AOC please abolish or have the Jones Act revised!!!

No comparison. PR is nothing like Colorado in any economic, demographic, or any other way. Fly there. It will be obvious to you.

Anyone on the island living or on vacation visiting wants and deserves safe health care.

Is the Fed going to pay and/incentivize candidates to sign of for more student debt and loose pay while attending these programs???? As an NP student, it's a lot of money and time, for a specialty that often pays the same as a bedside nurse. And loose your mind potentially because you don't have the right amount of resources with the gross demands they place on providers. And the Feds just cut back our school tuition grants for next semester BTW Yet, the Fed has millions to support global wars, apartheid, and genocide It's a sick country indeed Oh and about tele health, outside of behavioral health, it's inappropriate practice to solely depend on telehealth visits for complex, chronically ill patients. We need to see, touch and examine in-person to practice effectively.

@@susiq1121 Again, with respect, online research states that NPs receive, on average, a significantly higher salary rate than RNs in the states. I am left to wonder about the source(s) upon which your claims-- both about Medicare payments to Puerto Rican doctors and about the income of NPs--are founded. Cheers

​@@kesart8378You can search online all you want lol. I've worked as a RN for over a decade and will be a NP soon. This isn't a secret. This is the state of our healthcare system. Medicaid/Medicare does not reimburse as much as private insurance coverage. Therefore when you have a population that is elderly, sick and covered by Medicare, providers are easily over worked and underpaid. There is no incentive for any provider, MD/NP/PA to serve those communities long-term. Whether it's PR or inland.

No doctor gets paid more or less with Medicare/Medicaid. A large population in PR are elderly Medicare recipients and not privately insured. That's why Docs are leaving to practice with patients that have more private insurance for increase compensation

@@susiq1121 With respect, my online research indicates otherwise. Therefore, I must disagree with your assertion, unless you can furnish proof to substantiate your claim. Cheers

​@kesart8378 stay online and delusional while i continue to provide patient care here in the states i.e. real life Please stay across the pond, clearly you do not understand our healthcare system Meanwhile providers across all disciplines simply have the right to refuse Medicare and Medicaid recipients

@@susiq1121 With respect, my son is a neurologist in a major hospital in a state in the midwest. And my granddaughter's godmother has worked as a nurse for near two decades, and is now a supervisor of nurses in a large hospital system in the state of Florida. So I am not unfamiliar with working conditions and compensation for medical personnel in the states. That said, my disagreement with your position is not based on my anecdotal experience, but upon information gathered from highly reputable online sources, including United States government bureaus. Lastly, I do apologize if my comments caused any offence. I have the greatest respect for medical professionals and realize that the pandemic made a noble profession even more stressful, and that the salaries received do not approach being adequate when one considers the enormous value that such work has to society. Take care. Cheers

​@kesart8378 Your 'reputable' sources from US government sources are old. It is data collected from the past. No one who has boots on the ground here and now knows your suggestions on this broken system is not the answer. In fact your son is likely part if the problem. A major reason why there aren't more nurse practitioners, is because we cannot obtain enough preceptors because medical doctors are NOT willing to train us. Their elitist attitude towards the NP profession is comical to most MDs. Although 'reputable' government studies report the opposite. In addition, your granddaughter's godmother is also apart if the problem. I left being a nurse manager because as a RN, I would never go against my morals and oath to care for my patients for a company's bottom line. A company's botttom line is all these execs and admins serve: themselves. Your granddaughter's godmother is completely removed and out of touch with bedside RNs, and she is ok with that. The state of the bedside RNs and industry at large is because other RNs and MDs have went against their oaths to serve their careers, feed their egos and line their pockets. I've been in this sick industry for over 20 years, starting as a flight medic in the DoD. So please, keep your ill-informed stances about what's happening in this industry across the pond. And I'll keep working, live, boots on the ground serving my community with the limitations of this greed system.

It's still allowed to get buried on your land in Puerto Rico...

All that is left to you is complaining like a woman, or moving to the mainland and making something of yourself. From one Boricua to another of course, get out if you can. Vae Victis.

It comes down to the electoral college and Republicans fight it because they know AOC and a lot of people will vote Blue.

Same like DC District of Colombia

Does Puerto Rico actually have a medical school? Majority of students probably have to go to mainland to go to medical schools with the huge student debts. If they are paid enough to be able to live there and pay his debts and malpractice insurance...it's natural for ppl to leave places where they cant afford to live.

@@maryr7593 There are three nationally accredited medical schools in Puerto Rico. The pressing challenge is retaining graduates on the island after school because of the low pay compared to the mainland.

Sure...the fact that we are a colony, and treated as such has no bearing. U need more data.

@@diegoomar911 similar challenge that Portugal faces....all their college graduates left for higher paying European jobs. But also this similar thing happens on mainland US too..in the rural or less popular areas as wel as the native population reservations. Same with nursing programs. Some nursing schools have offered to pay the tuition for students who commit to stay for 10 yrs after graduation. Others clinics or city/county govt have offered to pay the loans for people who commit to stay the time. Does Puerto Rico also face a language challenge with older residents and drs who train in PR but do not speak Spanish? (Many young ppl from PR who I have encountered on mainland in GED adult ed programs had difficulty speaking English. They had dropped out of school in PR and for whatever reason come to mainland (Indiana) where there wasn't a large Spanish speaking population at the time. (Largest employer in the region was Wasbash Trailers who employed many ppl and many were enrolled in the ESL and GED programs in the area. Majority of Spanish speaking immigrants in that area were Mexican though...not PR. But the two brothers I had in a math class were pursuing GED in Spanish. One brother spoke better English than the other. My fluency in Portuguese and meager Spanish language background as well as the GED math meant I could teach these two with their assistance to teach me the proper Spanish math language vs English. It was like a tri-lingual math class...so everybody got to learn something. A bit slower than normal but nobody else at facility had any foreign language skills. Though the facility could give practice GED exams in Spanish...they lacked alot of the learning materials in Spanish. But this was years ago (like 2003-2006). Sorry for the digression, my overall question was if the drs who trained in the medical schools in PR actually spoke Spanish to attend to the limited English speaking PR population ? (And that was my question.. does.the majority of population speaks spanish still? Or was there a mandate to learn English in school (in school learning is vastly different from actual fluency...) but I was curious non the less. Thirty years ago Portugal, whose official language is Portuguese, mandated that every child in the country have an English class as they would have a Portuguese language class every year of their K-12 schooling. They used to only have English (as a foreign language) in high school and it was a choice...they could choose two languages to study...usually btw German, French, English. I would imagine Spanish was a possible choice BUT huge rivalry with Spain and in general the Portuguese HATE it if someone tries to speak Spanish to them....they would have rathered a butchered Portuguese to a Spanish. This was 30+ yrs ago when there was little foreign immigration interest and was only tourism.) Thus the reason for my question about a mandate in school or not? Unfortunately I have never been to PR nor know anything about the school system.

Most businesses go to where the people are actually located. That guarantees that they get the ppl traffic they need to keep the business open. I don't think that part of govt has anything to do with it. All clinics and hospitals nowadays are private businesses. Whereas 40+ yrs ago a county hospital was a County run business (it served the county's residents and thus called a County, the next county had a hospital, etc). But 20+ yrs ago that all changed to private business...presuming the costs for the county were too high. Just in the 15 yrs I have lived in this area, there are now health care clinics of the two major health insurers in every suburb located next to the city I live in. Before, that population just drove the 20-30 min drive into this city to see the providers. Now there is at least a clinic with primary care and a physical therapist. All other specialties they need to drive in for. But the major specialities have far flung clinics all over the city (far west side, central, far east side) so residents of the city can utilize them easier as well as those who need to drive a distance. Thus going to the where the ppl are located is a general business model for in person services that most businesses find profitable. No govt is involved with telling health clinics where to go...in fact like any business, they need county approval to purchase the land and build the clinic.