Public health is "the science and art of Preventing disease, prolonging life and promoting health through the organized Efforts and informed choices of society, organizations,public and private, communities and individuals" (1920, CEAWinslow). Public health involves the health of a population and the factors influencing health status. These factors are also known determinants. Important determinants are prevention,health, lifestyle, social and physical environment and genetic and acquired characteristics. The state of health can be divided into:
• Diseases and disorders
• Functioning and quality of life
• Mortality and causes of death
• Life expectancy
Health care in Curacao reminds me of Dr. Mac Kibbelaar. He passed away in 2001 and was the architect of the health care policy in Curacao.
In Curacao it seems like it is not about health care but about finances.The last study "how healthy is Curacao?" dates from 1994. It is planned to be updated in 2013.
The philosophy of Primary Health Care, the best practice promoted by WHO, is not declared the national policy.
Health is a priority for humans it is a fundamental human right. The problem is that health care is big business and that is a contradiction with the human right.
In February 2013 health care is in the news. The pharmacy protest the new basic health care insurance policy. The new hospital construction site is again debated. Integration of two public insurance is also in the news.
After 1986 the problems in the healthcare begin. The high cost. The offshore suffered a sensitive blow when the tax treaty with the USA expired. The income of the government ecreased dramatically.
According to the government Budget 2013, 370 million of the 1.7billion of the total government. According to the Health Financial report 2008 – 201, Curacao spends900 million on health care. 500 million is spent by the government.
The health care system in Curacao is too complex and even experts do not understand it easily. As well as other systems. The system will involve three parties:
Government dictating the policy, regulations, inspection
Health care providers
Patients and consumer
After constitutional changes that went into effect on 10 October 2010 has brought simplification because the federal government was abolished.
A study of December 2012 states that the first line care is ok. This includes physiotherapy.
The second line is a problem. Specialists are independent one wants them to you in the hospital.
Hospitals
Pharmacy and importers are being addressed because the total cost of medicine is high.
Inspection, Dr. Jan Huurman is doing a great job. Quality has improved in the various institutions that are now in spected by the health care inspection.
Obesity is epidemic. There is not enough constant attention to this problem and it contributes to the high cost in health care. There is a good prevention program regarding HIV. But still AIDS patients are a heavy financial burden.
By implementing an ICT solution effectiveness and efficiency can be increased.
Permanent education physicians are well organized on the island
Capriles Clinic for mental health is very well managed. It has a regional function. What is missing is a department for children and youth.
Medical tourism is being developed but one must be careful, because it might conflict with the health care of the population.
Alternative medicine has developed. But it is still debated by orthodox medica lscience. The island offers dolphin therapy for autistic children.
Prevention programs should increase.
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