I was curious about what’s happening in the health sector of PR and so I had a conversation with a licensed doctor in PR. Like most Puerto Ricans, he remarks how everything is tied into the political condition. He emphasized how Puerto Rico’s commonwealth status limits the amount of funds Puerto Rico has to work with, rather it be FEMA, PAN, Social Security, etc. Of course, this reality of limited funds expands to what’s available for Medicare and Medicaid. He talked a bit about how some of this limitedness manifests in other areas which causes resource shortages, like how due to the Jones Act of 1920, for example, PR receives all its imports from the US from two ships coming from two ports, weekly, nothing else.

When thinking about the heightened difficulty PR experiences during events such as Hurricanes in making health services arrive towards where they need to be, the doctor pointed out how the federal bureaucratic systems in place make the moving of resources extremely complicated. How does this end up? While dealing with all these steps, resources are lost. Dealing with the problems of bureaucracy in a local sense, he described it as PR having a “macro-government”. What does that mean? The Puerto Rican government employs the majority of available people for the workforce. This creates a system where there’s more people for a position than what’s actually needed. He said he considered the local government as too large.

PR is currently experiencing a shortage of medical specialists and this is creating a critical situation right now for people in need of services. The doctor said that the two hurricanes pushed people away more than COVID. This coupled with billing companies refusing to provide adequate payment and services to both doctors and patients. The doctor states in regards to how all this combines when addressing recovery after disasters that, the system that’s been in place is not equipped to to tackle PR’s current situation for various reasons: social, economic, etc…

After leaving the office, I went into a store where I was talking to a cashier who has been acquainted to my family for many years. When asking on how things are going for me in the US, they began talking about the most recent labor law in PR. Many Puerto Ricans are working for $8.50 the hour while the cost of living is on a constant rise along with imports becoming increasingly more and more expensive. They talked about how new hires at the establishment have a slightly higher wage but they won’t leave the job to apply for another because then they’ll have to abide under the most recent labor law and conditions imposed upon Puerto Rican workers. They’ve been working in the establishment for 19 years.

They described the conditions of this law to me: 6 months probation, no benefits, no medical plan, you must work a specific amount of hours in order to be able to accumulate benefits. Many employers are finding ways to use this to their benefit. By the third month, they fire the person so they can’t reach enough hours to get benefits and then they go on to hire another for their position, most likely for another 3 months. I personally know people who have gone through this.

When I left the establishment, I went to the plaza in the municipality I’m staying in and sat at the plaza’s cafe to work (my favorite spot for project work) and prepare for the meeting I had to attend in the afternoon. I sat reflecting upon everything I had heard that morning. I couldn’t help but think back to the tax break available to mainland Americans, how they’re flocking to our coasts in mass, avoiding every possible obstacle in their finances, boosting their riches and standards of living. All this, while Puerto Ricans are being left with little options and many resorting to leaving for the mainland, uprooting their lives and starting from scratch in a strange place. As the cashier said at the establishment in regards to Puerto Ricans living in PR:

“Uno no vive, uno sobrevive.”