If we are to believe Hugo Chávez, doctors have removed a cancerous tumor the size of a baseball from somewhere inside his body. The type of cancer he has and the stage of its advance remain a Venezuelan state secret, but it is likely that he is a very sick man.
This news, for a leader who is only 56 years old, might have elicited a wide sweep of public sympathy under different circumstances. Instead, Mr. Chávez's first-class treatment in a Cuban medical facility from a Spanish doctor has served to elevate the resentment many Venezuelans have about the declining quality of health care in their country.
The scarcity of basic goods in Venezuela is well documented. Just last week, the Venezuelan daily El Universal reported that its own survey of six supermarkets and government-owned food outlets found that out of 16 price-regulated staples, at least 10 were scarce.
Admittedly this was a narrow survey, but it garnered attention because it confirmed the daily experience of millions of Venezuelans. No cooking oil of any variety could be found in the six stores, and this included soy oil, which is not subject to price controls. Regulated cuts of meat were not available in the supermarkets; no price-controlled cheeses were found anywhere; processed corn flour was available in only one store.
Doctors, nurses and medical students demand higher wages in Caracas, June. 16.
Producers know why this is happening. In June, the food processor Polar asked the government to raise the price cap on corn oil because of the high cost of "the imported raw material." Other companies have made similar appeals. But the government has good reason to resist: The easy money policy of the Central Bank of Venezuela (BCV) has provoked the highest inflation in the region, even with price controls on many products. According to the Spanish-language news outlet Noticias Financieras, the BCV reported that the cost of personal-care products was up 30.5% in the 12 months ending June 30. Food and nonalcoholic beverages climbed 22.3% over the same period.
Yet it is in health care where Venezuelans are feeling the inflation pain most. Hospital services are up 39.7% year over year, doctor and paramedic services are up 21.5%, and the cost of medicines and medical equipment has risen 17.4%.
These cost increases refer, of course, to private clinics and goods that are not subject to price controls. Wherever prices can't be raised, both quality and supply are deteriorating rapidly.
One needn't be sick enough for a hospital to appreciate the problem. Venezuelans report shortages of everything from aspirin to cholesterol drugs, and it's likely this has triggered hoarding, which has exacerbated the situation.
Most medicines sold in Venezuela, prescription or over-the-counter, are imported or contain imported materials. This means that the distributor has to pay the market rate in dollars to suppliers abroad. Obviously if the government sets the retail price below the cost for the importer, the transaction will create a loss.
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Chávez-nomics has been even more devastating for doctors in the public hospitals. Dr. Douglas León Natera of the Venezuelan Medical Federation (FMV) told El Universal on June 16 that doctors earn a mere 2,600 bolivars (roughly $325 at the market exchange rate) monthly, and that even though hospitals have become targets of the country's rising crime, the government has failed to provide protection for health-care staff. Doctors also cite scarce and low-quality resources and long hours. On June 30 the FMV called a strike to protest low pay and arduous working conditions. Last week Mr. Chávez offered them a 30% raise. They refused to yield. They are, however, continuing to treat urgent cases.
Pharmaceutical importers have been reluctant to complain publicly about their difficulties; large companies that offend Mr. Chávez can become targets of nationalization. It's a bit more difficult to nationalize a doctor. A strike is just one option. Many of Venezuela's best doctors have fled the country, which explains how it is, according to the FMV, that in public hospitals there are 130,000 patients waiting for surgery.
In its 2010 annual report, the ministry of health acknowledged the shortage of doctors, particularly in specialties such as anesthesiology, neonatal care, cardiovascular surgery, neurosurgery and child cardiology. Private hospitals are also deteriorating now as the poor turn up for care with government medical insurance, but the insurer doesn't fulfill its obligation to pay.
The government has admitted that a large number of doctors have fled, but it says it's not worried. More than 25,000 Venezuelan students are now enrolled in Venezuela's new Bolivarian medical schools or in medical schools in Cuba. Unfortunately the curriculum is not public, and Venezuelans are worried that the students spend more time studying revolutionary politics than anatomy. Mr. Chávez seems to understand this, if nothing else. His surgeon hails from Spain.
(article published in the WSJ on July 18,2011)
Write to O'Grady@wsj.com
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