WILLEMSTAD - In a recent legal ruling, the Court upheld the government's position in a case brought by six medical specialists against the government of Curaçao. The Court agreed with the government's argument that medical specialists are not operating in a free market but within a public healthcare system that is financed by taxes and premiums collected from the public. As such, healthcare decisions, including the management of costs, are a matter of public and societal interest, the Court ruled.
According to the Court, it is up to the medical specialists to decide whether they want to work within this government-regulated healthcare system or pursue work elsewhere. The Court highlighted that the six specialists involved in the case are not in a unique professional situation. For instance, all medical specialists on the Dutch Caribbean islands of Bonaire and Sint Maarten are employed by the public sector, while Aruba has a mix of employment and private practice. In the Netherlands, most medical specialists work in salaried positions, either at university medical centers or peripheral hospitals.
The legal dispute revolves around the specialists’ desire to end their employment contracts with the Curaçao Medical Center (CMC) and operate independently. These specialists want to establish their own private practices on the island, with the aim of treating patients insured under the Social Insurance Bank’s (SVB) basic health insurance plan. However, the introduction of the Salary Norms for Top Incomes (LNT) law in December 2022 has played a significant role in their decision, as the law limits the salaries of specialists employed at CMC.
The specialists have expressed concerns about the financial instability at CMC, citing insufficient healthcare budgets from the SVB, which they fear may jeopardize their salary payments. They argue that moving to independent practice would allow them to avoid the salary caps imposed by the LNT law, and create partnerships with the hospital or insurance companies.
However, the Court emphasized that if the specialists sever their ties with CMC, they would lose their authorization to practice medicine in Curaçao, as well as the right to treat patients covered under the basic health insurance scheme, which constitutes about 85% of the island’s population.
The Court's ruling reinforces the government's policy of maintaining specialists as salaried employees within the public healthcare system, ensuring consistency and stability in the delivery of healthcare services. This legal outcome underscores the challenges and dilemmas faced by medical professionals in a publicly funded healthcare system.