PHILIPSBURG: --- On Wednesday, Minister of Public Health, Social Development, and Labor (VSA), Richinel Brug, laid bare the financial instability plaguing Saint Maarten’s healthcare system. While the Minister’s statements highlighted ongoing efforts to address the crisis, they also exposed glaring failures in governance, enforcement, and accountability—failures that have left the Social Insurance Bank (SZV) and the people of St Maarten footing an ever-growing bill for systemic neglect.
A Healthcare System on the Brink
Minister Brug confirmed that the government owes SZV a staggering 69 million guilders for the OZR (healthcare costs for civil servants and pensioners) and an additional 49.6 million guilders for services rendered on behalf of the government. Despite structural payments and an additional one million guilders allocated this year, the debt continues to balloon.
The Minister attributed this to rising healthcare costs and the financial burden of undocumented individuals who are not contributing to the system.
The numbers are alarming. Over the past four years, SZV has spent an escalating amount on undocumented persons:
- 2021: 1.87 million guilders
- 2022: 2.6 million guilders
- 2023: 4.01 million guilders
- 2024: 5.6 million guilders
This represents a 200% increase in just four years, a trend that Minister Brug described as a “leak in the bucket” that must be plugged. Yet, despite these dire statistics, the government has no concrete payment plan to stabilize SZV’s finances, leaving the institution in a precarious position.
The Cost of Non-Compliance
Minister Brug’s remarks also shed light on a troubling issue: the widespread non-compliance of business owners with labor laws. Employers are legally obligated to register their employees—documented or undocumented—with SZV for medical coverage. However, many fail to do so, leaving workers uninsured and shifting the financial burden onto SZV and, by extension, the taxpayers of St Maarten.
The Minister acknowledged that approximately 5,000 undocumented individuals are currently contributing to SZV. However, this is a fraction of the undocumented population, many of whom remain uninsured. When uninsured individuals require medical care, SZV is often forced to cover the costs, particularly for emergency evacuations. Meanwhile, hospitals are left holding unpaid bills for uninsured patients, further straining the healthcare system.
Minister Brug’s admission that business owners’ “bad practices” are driving up healthcare costs is a damning indictment of his own ministry’s failure to enforce labor laws. As the official responsible for issuing labor permits and ensuring compliance, the Minister has a direct role in addressing these violations. Yet, his statements suggest a reactive approach rather than a proactive strategy to hold employers accountable.
Empty Promises and Shifting Blame
While the Minister emphasized ongoing efforts to restructure the healthcare system, including the drafting of a National Health Insurance (NHI) plan and a visitor’s tax, these measures remain in the planning stages. In the meantime, SZV’s financial instability continues to worsen, and the government’s debt grows unchecked.
Minister Brug’s attempts to shift blame onto business owners and undocumented individuals rings hollow. The government’s failure to enforce labor laws and ensure timely payments to SZV is a direct contributor to the current crisis. Moreover, the lack of a clear payment plan or timeline for repaying SZV undermines any claims of progress.
The people of St Maarten deserve better. They deserve a government that prioritizes the financial stability of its healthcare system and enforces labor laws to protect workers and taxpayers alike. Minister Brug’s statements, while candid, reveal a troubling lack of urgency and accountability. The time for excuses is over. It is time for action.
Minister Brug must take immediate steps to:
- Enforce Labor Laws: Crack down on non-compliant employers and ensure all workers are registered with SZV.
- Develop a Payment Plan: Commit to a clear timeline for repaying SZV and stabilizing its finances.
- Address Healthcare Costs: Implement measures to control rising healthcare expenses, including those related to undocumented individuals.
- Increase Transparency: Provide regular updates on the government’s progress in addressing SZV’s financial challenges.
Without decisive action, the healthcare system will continue to deteriorate, leaving the most vulnerable members of society to bear the brunt of the government’s failures. Minister Brug’s legacy will not be defined by his promises but by his ability—or inability—to deliver real solutions. The clock is ticking.
