7NEWS gave you the scoop on Monday, and now Cabinet has announced in its weekly brief that it will amalgamate the KHMH and Universal Health Services. As we reported, the government will take over two-thirds ownership in Universal. From there, KHMH will be, "reorganized to offer exclusively general care while acting as the gateway for referral to Universal which will offer exclusively critical care." According to government, it's all about "rationalizing" the delivery of healthcare, but critics say it's all about a public bailout of a private debt which has ballooned to $44 million. But for firsthand perspective on what's behind the amalgamation and how it will work, we spoke to the man who's been unofficially described as the architect of the plan,
Universal's Chairman Dr. Victor Lizarraga. He had a frank, often testy interview with Jules Vasquez today.
Dr. Victor Lizarraga, Universal's Chairman
"The amalgamation process should improve the quality of care at KHMH number one, and it is going to allow the poorer people of Belize to obtain service that they need at Universal free of cost. KHMH is designed mainly as a general care facility and they offer some tertiary care and specialized services but it is not as cost effective for them because of the fact that it was not a hospital that was built to offer that kind of service. Universal on the other hand is a hospital designed and built specifically for specialist care and critical care. It is most cost effective for them to do that level of service. The reverse is also true. It is not cost effective for Universal to do the general care service. It is more cost effective for KHMH to do that level of service."
Jules Vasquez Reporting,
So now there are existing areas of overlap, there are services that Universal offers and which are simultaneously at the KHMH. Those areas of overlap, under this plan, would be removed?
Dr. Victor Lizarraga,
"That is right."
Jules Vasquez,
And the operations of both will be streamlined?
Dr. Victor Lizarraga,
"Absolutely."
Jules Vasquez,
The motive behind this, as you said, is - and the release says - is the rationalizing health care. However there are critics who say it is not about rationalizing health care, it is about bailing out an investment which the government guaranteed without taking it to the House of Representatives and it is about bailing out that investment, which is now a wasting investment for which the government has made the commitment to the Belize Bank that it will pay.
Dr. Victor Lizarraga,
"Listen to me, Universal is here because of the policies of the PUP government, of this government, as it regards to health reform, National Health Insurance; that is why it is here. It was facilitated by the policies of the government. So it is only natural that this amalgamation process should happen and should be beneficial to the whole country but in particular to the poor people."
Jules Vasquez,
But appropriately so because the poor will have to pay.
Dr. Victor Lizarraga,
"How will the poor have to pay?"
Jules Vasquez,
Because the government without the public's approval, without any public disclosure, guaranteed the debt that you and your investors privately took on and now that the guarantee stands and you all are unable to service your debts, the taxpayers must stand and those are the poor.
Dr. Victor Lizarraga,
"No, that is not resolved. That is still owed to the government and will still be paid to the government."
Jules Vasquez,
You owe DFC $12 million.
Dr. Victor Lizarraga,
"That is also going to be paid."
Jules Vasquez,
You owe the Belize Bank $32 million.
Dr. Victor Lizarraga,
"That is also going to be paid."
Jules Vasquez,
Who is going to pay it?
Dr. Victor Lizarraga,
"Who is going to be paying? The details of that, you need to ask the government."
Jules Vasquez,
Well if I need to ask the government, that tells me the government will have to pay - and if the government will have to pay...
Dr. Victor Lizarraga,
"Listen to me, I can only talk for Universal and Universal will continue to have an obligation to the government to pay that amount of money."
Jules Vasquez,
But it's not paying it. It has not been current with the DFC debt first of all. It has not been servicing its Belize Bank principal debt of $17 million which has now expanded another $15 million.
Dr. Victor Lizarraga,
"I don't think I can agree with those figures but anyway..."
Jules Vasquez,
How wrong are they, you give me yours.
Dr. Victor Lizarraga,
"That is our private business. Why should we divulge that?"
Jules Vasquez,
But your private business is now becoming a public responsibility.
Dr. Victor Lizarraga,
"Well when it becomes that, then you deal with it."
Jules Vasquez,
But it is afoot, Cabinet has made a decision. I am saying to you Dr. Lizarraga that your wasting investment, your investment that you are unable to service, is now becoming a millstone around the public's neck.
Dr. Victor Lizarraga,
"Let's look at that, analyze that critically. I think the financial discussion you are having is unfair Jules. You know why? Because you don't even know the details of this and I don't think it is proper for me to discuss with you any details of my company."
Jules Vasquez,
But your company is now in the...
Dr. Victor Lizarraga,
"When it becomes that then..."
Jules Vasquez,
It is in the DFC hearings, $17 million that the government guaranteed.
Dr. Victor Lizarraga,
"That is a hearing, that is not..."
Jules Vasquez,
But that is in the public's domain. This is now a public responsibility. Your company is a millstone around the public's neck now; that is what it is.
Dr. Victor Lizarraga,
"Explain that to me, I don't know what you mean by 'millstone around the public's neck.'"
Jules Vasquez,
The government made a guarantee, did they not? The government gave a loan, two realities. The guarantee said that if this gentleman can't pay, because the government believes in improving healthcare, we the government will pay. You cannot pay, you cannot keep current with the loan. The people, who fund the government, have to pay."
Dr. Victor Lizarraga,
"We the people."
Jules Vasquez,
The taxpaying public.
Dr. Victor Lizarraga,
"You realize that I am a taxpayer just like you? You realize that I generate taxes just like you? I employ 165 people Jules."
Jules Vasquez,
But how are you the investor, we the people didn't stand to make a profit if it worked out. How are you as an investor entitled to a sovereign guarantee and how is it now that that has come flaming aground and we are responsible for it and now it is a private matter?
Dr. Victor Lizarraga,
"It has not become 'flaming aground,' what do you mean by that?"
Jules Vasquez,
It has become flaming aground, we are at this point not to rationalize healthcare, we are at this point because Universal Health Services can no longer amply service its debt and the Belize Bank reasonably wants to call in the money. That is why we are at this point.
Dr. Victor Lizarraga,
"So what would be your solution? Let me hear. You can say anything you want. We are where we are so what is your solution to that problem?"
Jules Vasquez,
My job isn't in finding solutions.
Dr. Victor Lizarraga,
"Your job is to criticize only and don't find any solutions. I will ask you Jules, find a solution to that problem."
Jules Vasquez,
I didn't create the problem. I didn't give a guarantee that was secret.
Dr. Victor Lizarraga,
"There is no secret, the guarantee is a DFC guarantee. So please man, I am not asking you how much money you owe. That is a damn shame Jules. You didn't make the mistake to go public because of the kind of business..."
Jules Vasquez,
I don't have a guarantee. The government never gave me a guarantee that if I can't pay it back. If they did that, I would be running on an overdraft of tens of millions of dollars.
Dr. Victor Lizarraga,
"You would do that?"
Jules Vasquez,
I would.
Dr. Victor Lizarraga,
"So you think we did that because there was a government guarantee? Don't you think that's because the level of investment that we had to put in to provide you, the kind of level of service that you use, because you use our facility too, you and your family. So please man, don't come with this foolishness. I am very pissed off, really and truly with kind of approach. You want to give good news then you give the proper news."
Jules Vasquez,
But I am pissed off with how this is unfolding. I feel that there is no way that the public should be made to pay what was built, I believe, around the illusion of the NHI. This was built all around the illusion of NHI when the government at all times lacked the political will, you know they did, to put a deductory tax to pay for NHI.
Dr. Victor Lizarraga,
"Let the government speak for themselves. I can only speak for our organization for our involvement."
Jules Vasquez,
How will you maintain the standings at Universal, it being a part of a public healthcare system?
Dr. Victor Lizarraga,
"I think that is the challenge, especially since I'll be very much under your scrutiny "
And while Universal's boss is clear on how it will all work, the KHMH bosses are in the dark. CEO Dr. Alvaro Rosado today told us he could not comment on the plan, because he hasn't been briefed about it. Chairman of the KHMH Israel "Pi" Marin similarly said he can't comment because he doesn't have all the details.
