In addition to the obvious shipments of medicines for a myriad of conditions, large administrative changes will be needed to restore the Venezuelan health system.
The current situation involves an extremely “horizontal” system based on primary health clinics – Barrio Adentro. The Chavistas have also placed many political appointees in place of trained and educated specialists in the various health fields. Many specialists and other educated people have emigrated and are no longer in Venezuela.
How can Venezuela’s health system recover from this situation? The recovery will obviously be difficult, but a few measures for a new government to take are clear:
- In hiring new personnel, screen out loyal Chavistas and personnel from the Maduro administration.
- Hire based on actual qualifications.
- Chavismo has left an unfortunate unproductive and negative attitude among many people. In hiring, seek people who have positive and productive mindsets.
- Cooperate with international organizations that will probably be present in the recovery.
- Cooperate with business and industry, while also maintaining a regulatory regime to prevent the high health costs that are typical of the United States. Consider a model more similar to the health systems in other Latin American countries or similar to the pre-Chavismo system in Venezuela.
- Consider restoring some of the now-disbanded former structures that were successful in past years. I am thinking especially of the MSAS (Ministerio de Sanidad y Asistencia Social) that was once led by Arnoldo Gabaldón. The MSAS was fused with another ministry (Ministry of the Family) in 1999 and underwent a process of decentralization .
- The basic result of this administrative change was that the public health function of the MSAS was diluted and two things happened:
- Change in focus toward social programs and away from actual public health programs.
- Extreme decentralization and focus on primary health care (Barrio Adentro) and away from any vertical, nationwide efforts. As an example, vaccination programs have suffered greatly in the past 18 years.
- The disastrous result of these changes in Venezuela’s health administration is now visible. Epidemics of measles, diphtheria, malaria, and massive medicine shortages.