Monetary Medicine: The Private Hospital Flat Line in Vallarta
On April 6, 2013, well-known Puerto Vallarta resident, Miguel Angel Santos Nolasco, age 35, tragically died from injuries sustained during a collision of his sea kayak and a small speedboat in the waters just off Los Muertos Beach.
In the days following the horrible event, many in Puerto Vallarta are asking troubling questions about the emergency care received by Santos Nolasco in the time preceding his death.
After receiving emergency triage on the Los Muertos Pier from paramedics, the victim was transferred by the B-38 Firefighters Unit to the Centro Médico Quirúrgico, or CMQ, a private care hospital on Basilio Badillo only minutes away from the scene of the accident. A formal account by hospital officials state that Santos Nolasco was stabilized prior to being redirected to the public regional hospital in the Hotel Zone for further treatment for his critical abdominal trauma.
However, sources close to the accident, including sister of the victim, Montserrat Álvarez Mendoza, claim that emergency medical care was not provided to the victim who was not able to make a $25,000 pesos deposit, approximately $2,070 USD, for service by credit card or in cash. Further sources claim that the boat captain responsible for the accident, Santiago Mercado Cervantes, attempted to make payment using a cheque from a Mexican national bank which was refused as a payment method by CMQ.
Questions arise about what more could have been done at the CMQ hospital to triage and stabilize Santos Nolasco prior to redirecting him to the public hospital as the victim died of shock and blood loss mere moments after arriving at the doors on the Regional Hospital.
Patients denied care due to their inability to pay for services is a sociological issue that extends far beyond the borders of Mexico. And there is no debate that private hospitals, particularly in Puerto Vallarta which benefits from a thriving medical tourism industry, serve an important function in the city. As corporate entities, private hospitals offer for-profit health care services for those who can afford them and have an economic right to conduct profitable business practices. But when protecting the bottom line interferes with protecting patients in need of dire emergency services, questions about the ethics of corporate health care are inescapable.
With eleven private care hospitals operating in Puerto Vallarta and only the Regional Hospital and the Red Cross offering public services, it seems logical that private medical facilities would have an ethical responsibility and policy for all patients ensuring that emergency triage services are provided in a timely, thorough and consistent manner to stabilize patients to the best ability of the facility and its staff. But low-income emergency cases are left to the discretion of medical staff that may or may not be willing to disregard corporate hospital admission policies and accept the consequences that may arise from their actions.
The right to triage is not a right of the rich, it is a human right. And until private hospitals are willing to create concrete policies that ensure that any patient in need of dire emergency care receives adequate medical attention, it is a tragic reality that death will continue to be a certainty for those who cannot afford a chance to live.
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