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The social security in the DR is modeled after the US program, without all the benefits we receive. It has some good things and some bad things as far as the hospital is concerned.
I know you’re wondering, first understand that the program is only available to Dominican Employees. That leaves out all the people in the batey. At least that’s my understanding but I will stand corrected.
The first impact on the hospital is the employer portion that must be provided for each employee. When the program was first announced the funding was to come equally from the employee and the employer, just as the US funding for Social Security. When the program was rolled out the fees that were being paid to reimburse the doctors caused a threat of a general strike by doctors because the reimbursements were considered far less than what the doctors wanted. This caused a halt to the implementation until there was agreement with the doctors. The result was increasing payments to doctors. To cover the additional program costs the contribution to be made by the employer was increased.
The Dominican Republic wage laws require employers to pay all employees thirteen months pay for twelve months work. While this seems like something we in the US would enjoy it puts a heavy strain on the hospital’s ability to make their payroll in December. What makes it especially difficult is the fact that there are no groups in the DR from early December until late January. The extra burden of larger Social Security payments makes matters that much more difficult.
As mentioned earlier, only Dominican workers are eligible to receive benefits from this program. This has the possibility of providing significant benefits to the hospital as over 70% of the patients seen are Dominicans. However, the majority of patients that cannot afford to pay are either Haitian workers of Dominicans that are unemployed.
It will take six months to a year to understand how this new program will effect the financial operation of the hospital and we are watching these changes closely. The program is still being resisted by employers and they are warning they will pull out if their demands are not at least considered.
For right now, the hospital has signed contracts with at least one insurance provider and is positioning itself to take advantage of the program if and when it is implemented. For the hospital to stay competitive in the health industry in the DR requires our continued support through providing front line technologies such as ultrasound, dialysis, mammography, and soon, CT Scanning.
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