SBTNO: Higher income norm for medical specialists is risky

WILLEMSTAD - The Foundation Bureau for Oversight and Standardization of Government Entities (SBTNO) has warned about the risks associated with the proposed increase in the income norm for medical specialists in Curaçao. The government’s proposal to raise the income ceiling from 386,000 to 501,000 guilders per year could have negative implications for both the quality of healthcare and the country's financial situation. 

One of the main risks highlighted by SBTNO is the potential rise in overall healthcare costs. Although the government claims that the increase would not have direct consequences for the national budget, there is a risk of an indirect increase in healthcare expenditures. The salaries of medical specialists are financed through the Social Insurance Bank (SVB), but higher incomes may eventually raise healthcare costs. It remains uncertain whether these increases will lead to actual improvements in healthcare quality or simply exacerbate the financial pressure on the government. 

Additionally, SBTNO points to the possible inequality that could arise between medical specialists who fall under the increased norm and those who do not, such as specialists in other healthcare institutions like the Advent Hospital and the Curaçao International Clinic (CIC). This inequality could lead to dissatisfaction and staffing issues within the healthcare sector, where one group of specialists could earn significantly more than another. 

The competitive position of the healthcare sector in Curaçao compared to the region and the Netherlands could also be jeopardized by the higher income norm. The increase may result in salaries for specialists in Curaçao being higher than those at comparable institutions in the region, without guaranteeing an improvement in the quality of care. This could lead to rising healthcare costs without a corresponding increase in healthcare standards, potentially putting Curaçao at a disadvantage in maintaining its competitive position. 

Differentiation 

SBTNO further notes that the proposed increase applies to all medical specialists, regardless of their specialty or specific market conditions. This lack of differentiation means that the increased income norm may not be utilized effectively. Some specialists may benefit more from an increase than others, depending on the demand for their specific expertise. Uniformly raising the salary ceiling without considering these differences may lead to inefficient resource allocation. 

Another concern is the link between the salary increase and the reduction of waiting times in healthcare. While this may appear to be a positive measure on paper, SBTNO emphasizes that waiting times are not solely dependent on the efforts of medical specialists, but also on other factors such as the availability of nursing staff, medical equipment, and support services. Without improvements in these foundational conditions, the intended reduction in waiting times may not materialize, while healthcare costs continue to rise due to higher salaries. 

SBTNO urges the government to carefully reconsider the increase and provide a better justification for why a maximum increase of thirty percent is necessary. The government must clarify how this increase will actually contribute to improvements in healthcare and consider the broader implications for the country’s financial situation. There is a risk that the increase, without sufficient justification and differentiation, will lead to greater pressure on healthcare expenditures without achieving the desired improvements in care.




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