A perspective from Ecuador #DAresists #Medicare4all

Yes we have universal health care here in Ecuador and even the poorest is received at either the public hospital and health care system. In addition there is the Ecuadorian Social Security System (IESS) for those who voluntarily subscribe or those subscribed through their employers. On paper it is great - until you have to use the system! Although there is some level of care for everyone there are serious problems too! There are shortages of doctors, nurses and administrative staff and since there is a parallel system of lucrative private hospitals and doctors operating private clinics, the good, well trained medical and laboratory personnel tend to migrate to these private institutions in the major cities like Quito, Guayaquil and Cuenca, leaving smaller and rural areas without good private care nor with decent government operated facilities. So while I applaud a government run health care system providing services for ALL, all the time, without a parallel private system, it needs to be universal, efficient, employing the best medical and administrative people. Will this be possible? Look at the Veterans Administration for an answer to this question! So if we can't run the veteran's administration correctly, how will we do it for the entire nation? So it is not so simple, requires a lot of planning, mammoth resources, a steady supply of well trained medical and administrative personnel and huge outlays for hospitals and related medical infrastructure, unless we simply nationalize existing private facilities and convert them into government institutions. The transition from what we have today to a public system will be a complicated and difficult task. Good luck. Robert Flick