“Dengue, malaria, cancer, AIDS, Zika, Parkinson, diabetes…you name it, we can’t treat it.”

Hector’s crestfallen demeanor after a long day’s work tells the story of the worries eating at him. As the director of a private clinic in the Altos Mirandinos, he’s in a position to know.

“Patients simply can’t find the medicines they need to treat their conditions, we’re not able to find enough medicines as well or to provide a full medical service with the same quality for them, and they’re dying because of it”.

 
What keeps me up at night is to figure out how to keep the clinic working on the brink of bankruptcy and under constant harassment from public agencies such as the tax administration.

At his clinic, he runs the show in terms of supplying the clinic: everything from buying medicines and equipment to dealing with bully governmental agencies such as SENIAT.

“Nationwide, they are dying by the hundreds, every day,” Hector says.

The problem is not a mosquito carrying a highly contagious disease. The problem is a crazy foreign exchange control regime that has created the most rampant incentive for corruption in Venezuela’s modern history. The one-two punch of regulatory control over the import of basic goods and medicines, and the ever increasing differential between the preferential and parallel rates create enormous incentives to fake the import of medical supplies.

“Over-invoicing” is the usual euphemism.

And as fake imports grow, real imports decline. The Cadivi mafia flourishes, and the ones suffering the consequences are (as usual) the most vulnerable ones: the patients.

Local pharmaceutical firms have been taken over by the government one after another, bringing local production to a record low.

The “Humanitarian Crisis” declaration by the National Assembly is about more than just semantics. It is not something created in a Doñas del Cafetal lab. It is a heartbreaking reality; one with deep roots in the failed economic model implemented by the government and its record setting corruption.

A Three Year Price Freeze

Let’s go back to the beginning. On June 26th 2013, the Superintendency of Fair Prices (SUNDECOP) enacted the “Providencia Nº294”. The document sets price controls for all the main medical services provided by private clinics.

This was the beginning of the current catastrophe. The regulation was enacted without even a semblance of consultation with the service providers it regulates. Even by 2013 standards, its assessment of the cost structure of medical services wasn’t realistic. According to Héctor, “it’s like it was drafted by people without a single clue about how the private health sector works.”

Three years on, controlled prices have not been revised at all. Not once. Prices for private medical services remain locked at 2013 levels even as accumulated inflation since then hits 740%.

Think about that, It’s virtually impossible to keep the clinic solvent given those numbers.

“What keeps me up at night is to figure out how to keep the clinic working on the brink of bankruptcy and under constant harassment from public agencies such as the tax administration,” Héctor murmurs.

 
We used to import critical medicines from Cúcuta, when we were not able to get them from our regular suppliers. Since the border was closed, we’ve had to stop.

Then, with his eyes wide open, he says “we’re not able to revise our prices, but we adjust wages when the minimum wage is raised. Do the math: almost three years with the highest inflation on the planet, with increasing variable and fixed costs, but with no changes on earnings. Los números no dan”.

How on earth are private clinics supposed to survive and provide proper medical services in those conditions?This instrument is a clinic-killer, a service-killer…and in this field, a clinic-killer is a patient-killer.

Clinics have had to shut down Intensive Cares Units and other key services or to come up with services outside the regulated ones in order to survive. Or at least, this is how Héctor says he’s managing to keep the boat afloat.

“We used to import critical medicines from Cúcuta, when we were not able to get them from our regular suppliers. Despite the cost (as Cadivi took too long to approve our dollars requests if we luckily got one, we had to go to the parallel market), it was worth it. Either you operate, or you close,” Héctor continues.

“Since the border was closed, alongside the crazy price in the parallel market, we’ve had to stop. Now, we often trade with other clinics. What some have in stock, others may need, and so on and so forth. But it is very far from being enough”.

If you thought that getting spare parts for your car or motorcycle was hard, imagine having to hunt for medical equipment spare parts.

 
The system is teetering towards outright collapse. Hanging in the balance, thousands of people’s lives.

“Around 70% of the medical equipment in the clinic I run is out of service due to a lack of spare parts”, Héctor clarifies. “These are all imported machines and technicians dedicated to provide maintenance services have fled the country, or their companies closed operations. The equipment doesn’t get regular maintenance, so it fails. We can’t get the spare parts – buying it on the parallel market would bankrupt us in a second – so the patient doesn’t get proper treatment. And you see, the clinic I run is in ‘good’ shape compared to many others. The situation outside Caracas in general is very depressing”.

To add some numbers to the equation, according to the Federación Farmacéutica de Venezuela (Fefarven), the government owes 3.5bn US dollars to the Health Sector as a whole. In effect, private clinics have run up huge debts with foreign suppliers, who’ve largely run out of patience. They’re now dealing in a Cash Up-Front world.

“And it’s worse in public hospitals. Venezuela’s public health system is so threadbare now that it’s common for clinics to get patients referred from public hospitals, who just can’t treat them. But clinics are between a rock and a hard place too”, Héctor concludes. Many times, clinics need to refer patients to other clinics.

The system is teetering towards outright collapse. Hanging in the balance, thousands of people’s lives.

Genocide is a tough word. But it is what comes out of Hector’s mouth when he speaks about the mismanagement of Venezuela’s health care system, and the fatalities it’s causing.

“A silent genocide” is what he calls it. He sees it every day.

15 COMMENTS

  1. My wifes (Venezuela expat living in the States) uncle died of kidney failure about 1 month ago. He was unable to get dialysis in Venezuela and was unable to get to any other country for treatments before he was too frail for any travel.
    More will die, I fear before Maduro is gone. They care more about remaining in power and symbolism than the people.

  2. Its a question of simple arithmetic : If we have an oil export income of 18 billion $ (2.5 mbd production as per EIA in 2015 – 750 mbd local oil consumption x 30 $ per bl x 365 days a year) and have to spend in 2016 : 10.1 billion $ servicing the international debt + 6.3 billion paying the Chinese indebtedness (in oil) + 4.3 Billion $ in cost of imports needed to keep oil industry going (adding to 20.7 billion $) then you have a surfeit of 2.7 billion $ to cover the above costs and have yet to spend a penny in imports needed to cover the essential living needs of 30 million venezuelans (at least 25 to 30 billion $ a year) then how much forex have you got available to import medicines and medical supplies needed to protect the health of all ill and sick people.?? the answer is of course zilch …cero …nothing.

    We Venezuelans have to pay with our lives and hunger and hardship for the megalomaniacal ‘revolutionary’ conceits of one man and the corruption, gross incompetence, utopian rethorical delusions and power madness of his succcesors.

    • That’s an excellent point. For the most part it appears that the pueblo of Venezuela have little understanding of the fact that the Bolivarian Revolution has purposely chosen to pay Wall Street brokers billions of dollars in interest fee’s, all the while neglecting the importation of basic medical supplies with their now limited foreign reserves. People are dying quietly, with little or no publicity, by the hundreds every week. It’s a fantastic situation, and the utter hypocrisy behind it all, beyond belief. Do they really understand what is happening? Education indeed.

    • No education is how they managed to seize power in the first place.

      30 years of brain-rotting courtesy of castro-cuban agents seeded in the guerrilla times to sow ignorance and complexes among the population, all to pave the way for communism’s ascension in the end of 90s.

      All these criminals deserve 30 straight years locked in a 2×2 cell for the atrocities they’ve done.

  3. @ Bill Bass – that’s a good rough calculation. When you look at the numbers you can see how bad the situation is. Unless they borrow even more money from the Chinese, there will soon not be any money left to steal, and things will grind to a complete halt. I hope Venezuela can change course before the money runs out completely.

  4. I know that this is the result of gross incompetence, simple greed, and misguided policies. But, a conspiracy theorist might conclude that this is the regime’s way of thinning out the herd…

  5. In the US in the 1950s health related mortality per 100K (including infant, TB, cancer, cardio & pneumo/influ) in the US was 1297. In 2011 it was 680. That was an improvement of 552.
    Let us for the moment imagine that Venezuela experienced a similar improvement between 1950 and 2011.
    And now, let us imagine that this improvement disappears all of a sudden for lack of medicines etc.
    How many people die in one year given a population of 32M? 176,896
    The current death rate in Venezuela is 531 per 100K, equivalent to 169,920 per year.
    The death rate could double.
    That’s genocide.
    http://www.infoplease.com/ipa/A0922292.html
    https://en.wikipedia.org/wiki/Infant_mortality

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