PHILIPSBURG:--- For years, Sint Maarten has been facing structural deficits in the healthcare funds. If no action is taken, the situation becomes unsustainable. It is of great importance that Sint Maarten implements the general healthcare insurance as soon as possible.
For some time now, the Cft has been expressing its concern about the deficits in the healthcare funds, which cause losses for the Executive Organization for Social and Healthcare Insurances (Uitvoeringsorgaan Sociale en Ziektekosten Verzekeringen – SZV). The cumulative deficit in the healthcare funds over the 2010 to 2023 period amounts to approximately XCG 500 million. The coming years, the SZV anticipates deficits of XCG 30 to 35 million each year. At current, these deficits are being compensated by surpluses, particularly of the old-age pension (AOV). Consequently, the fund's reserves are rapidly decreasing. The International Monetary Fund even predicts that the liquid reserves will be exhausted as early as in 2029.
Take measures
It is important that the income and expenses are balanced. In Sint Maarten's case, the expenses for healthcare structurally exceed the income, which causes a deficit. This poses a major risk to government finance. Sint Maarten's population will continue to age over the coming years. For a sustainable system, each person must contribute their fair share. For some time now, the Cft has insisted that measures must be taken to reduce the deficits. Sint Maarten is working on a general health insurance (GHI/SAAHA) which is expected to lead to higher premium income and manageable expenses. The legislative process, however, has been ongoing for over ten years. The Cft urges all involved stakeholders, including the Minister of Public Health, Social Development and Labor, the Minister of Finance, the SZV and the hospital (SMMC/SMGH), to work together in addressing these issues.
The Cft also stresses the importance of the other measures that Sint Maarten is working on, such as an increased use of generic medication, a more important role for primary healthcare (family medicine clinics) and more conscious choices regarding medical referrals abroad. These plans have already been made some time ago. Now it’s important to implement them.
Budget for 2025 and 2026
The budget for 2025 was approved by Parliament in January of 2025, and was not adopted until much later, on July 10th of this year. This exceeds the statutory deadline set to December 15th, 2024 by more than six months. Sint Maarten is currently working on the budget for 2026. The Cft urges the country to make the utmost effort to adopt the budget before the start of the new year. In doing so, the country can take an important step towards improvement of financial management.