[Marxism] Random thoughts of a friend in Puerto Rico

Dennis Brasky dmozart1756 at gmail.com
Sun Jan 14 10:15:49 MST 2018


     The problem of visiting doctors here is twofold.  They are extremely
busy and they are poorly organized.  Their offices operate "on a first
come, first serve basis," and that leads some patients to get to the office
at ungodly hours in hopes of being first.  If the doctor happens to make
his hospital rounds in the early morning, that means he won't get to his
office until 9 a.m.  If there are four or five early risers ahead of you,
you won't be seen by the doctor until noon or 1 p.m., provided he does not
stop for lunch.



     The poor organization stems from the fact that the office staff does
not schedule patients according to the doctor's schedule.  Instead, they
ask everyone to come "early in the morning" and wait their turn. The fact
that thousands of doctors have left the island during the last few years
compounds the problem.  There is a medical shortage in most specialties and
that causes an overload of patients for those who remain.



     No one blames the ones who left for Florida, Texas, North Carolina and
other places because doctors here are less well compensated by Medicare and
other medical plans than their counterparts are in the United States.  Plus
they are not always fully appreciated by the patients forced to spend hours
waiting to be seen.



     This scenario is likely to be worsen as the population continues to
age.  The birth rate on this island has declined over the years and now the
increasing migration, mostly by the young, has left the island with a
disproportionate aged population to provide for. The young have gone in
search of jobs, which have gradually disappeared here since the
tax incentives to foreign capital were removed at the urging of the Clinton
administration, and the island's economy took a dive.  That situation has
grown worse since the island was devastated by two hurricanes in
September 2017. The young are not only going in search of jobs, they are
going in search of better schools for their children and a better quality
of life.  Some of the recent migrants leave dreaming of a place where
electric power and running water are the norm rather than the exception.



     Only a few of the older people are lucky enough to leave with their
adult children in hopes of finding faster medical attention. But in
exchange, they often spend their days alone in a foreign place where they
don't know anyone or even speak the language. In time they wish they were
back home.  For those who stay behind on the island, there are also
numerous challenges, including being stranded, if they do not know how to
drive since public transportation in many parts is non-existent.  They stay
at home waiting for the day their offspring can come for a visit, or better
yet, return home.



     For the young families who stay on the island daily life can be an
ordeal. At the moment, 40% of the population is struggling to survive
without electricity, reliable potable water, and good public schools for
their children. The brave men and women of this land, who get up every day
and go to work, if they have jobs, need to brave the traffic and take their
kids to school, if these have reopened.  Otherwise they have to take them
to a willing relative or leave them in private care while they go to work.
And after that day's struggle they are often surprised to learn that the
store or place of business where they earn their living is closing down and
they will no longer have a paycheck.  That was the case yesterday for 700
of Sam's Clubs employees who were told shortly after they reported to work
that three of the Clubs in different municipalities were closing down and
they no longer had jobs.



     The stores, according to the news account, had suffered damages during
the hurricanes.  Not said, of course, is the fact that the stores' profits
have shrunk to some undesirable level. But for the 700 workers these jobs,
though poorly paid, were a matter of survival.



     What will they do if they can't find another job?  Will they too be
forced to leave the island?  If they leave, what will happen to their
mortgaged homes?  What will become of their aging parents?  Who will take
care of them?  Will they too be abandoning their unpaid cars at the
airport?



      What is the government doing to mitigate these ills and save its
shrinking tax base as so many working-age people leave?  According to the
newspapers, it is trying to patch up the electric grid, grow the economy by
encouraging the nearly collapsed small and medium-size local business
sector.  A belated gesture, some would argue.  But mostly it is waiting for
a helping hand from the federal government in Washington.



     But most politicians in Washington are too preoccupied with their own
political survival to worry about a territory they blame for its economic
downfall.  They claim the island borrowed more than it could pay back, and
should not expect the feds to bail her out.  It is not that simple, of
course, but politicians try to simplify when the time comes to assign blame.



      These and other random thoughts are what keep me and many others
awake at night.



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