Last week I took the S.O. to his monthly chemotherapy. We were late by almost two weeks while he was dealing with side effects of the preceding cycle. Thus it had been nearly two months. The place is an ample room with about 15 comfy chaises for patients and an extra chair for accompanying people. Usually it is full and often we had to wait up to an hour for our turn.
What was my surprise to see that only two other chairs were taken and that the S.O. went straight to a chair of his choice!
I asked our regular nurse in a bit of dark humor whether everyone was cured or dead. She told me that there are two reasons for attendance to drop dramatically over the last two months. One, the treatments must keep apace with inflation which means that it is becoming quite a burden for many, even with insurance, as paychecks are not following inflation. But more dramatic, oncologie medicine stocks have been exhausted for many type of cancers, in particular the more common ones like breast cancers. I suppose that in a perverse irony of the Fates my S.O. is lucky to have a rarer cancer... por ahora.
We were told that for those who cannot find medicine there is only two options: suspend treatment in the hope that the regime will keep its promise of finding "generics" which are of dubious quality when triangulated with Cuba as past experience demonstrates; or shell out foreign currency.
So, what does it mean to pay your own way with foreign currency?
Let's look at some simple facts to begin. By law the regime/state has the monopoly of bringing into the country certain type of drugs: HIV, Cancer, Kidney failure, Organ Transplant and some other special cases. The reason was a good one (from the "4th republic" by the way, not Chavez): since those medicines tend to be expensive the state paid for them to allow for equal access. If you were poor you got treated at a public hospital; if you were rich or middle class with health insurance then you could pick up your practitioner and get less traumatic care than what you get as a general rule at Venezuelan public hospitals. Either way, you got treated.
But things went down under Chavez when, first, the regime decided to set up a parallel health care system that ended up in two equally deficient systems. With the crisis coming, an over saturated private system does not have the means, or vocation or the ability to replace the public system. The more so that the regime refuses to give it access to free convertible dollars to buy medicine and supplies. As it is the case of food and general drugs, treatment and analytical supplies are also dearly missing. And this is made graver for patients who depend on drugs under state monopoly, a monopoly that the state refuses to give up even though it cannot fulfill it.
Thus, if you have access to USD, and want to get your prescriptions from the US (or Colombia or even Mexico) you will need at least one trip to establish contact with a local physician that will write you that prescription (particularly in the US where M.D. are so afraid of malpractice suits that they refuse to write anything without seeing the patient). Be it Bogota or Miami we are talking here 1.000 for a round trip, between 200 and 1.000 on staying expenses depending on whether you have relatives there, plus the medical bill that can easily reach a multiple of 1.000 depending on your ailment. This for your first month; for the rest you may bring a supply for more than one cycle if drug stability is OK, or have someone else pick it up for you upon your local physician notice, or go back to pick the next lot. All of this, of course, if the sick person is able to travel because if it cannot, then...
We are looking here at a bottom line of 2.500 USD a trip. Since the minimal wage in Venezuela is at 11 USD, that trip, for a month supply, represents 227 MONTHLY MINIMUM WAGE. Think about that for a minute.
Clearly, only the super rich can afford treatment today. If you are middle to upper middle class you may be able to pay for a few months and quickly deplete whatever savings you have outside of the country, if you have them. And then, well, join the poor.
The catch here is who are the super rich that have easy access to dollars for themselves or the relatives they chose to help. There are two groups, those that were already rich in USD before Chavez and those that became obscenely rich under Chavez. Many in the group BEFORE are either long gone anyway, or got long ago a US health insurance. Their concern, if any, is for relatives left behind. And those that did not leave the country during Chavez first years do not have an endless supply of US dollars, amen of having actually to earn these while the chavista super rich simply steal the money they need, in dollars, straight.
At this point it is simply inconceivable, it is a crime against Human Rights not to allow free, if targeted, convertibility of currency so that sick people can at the very least avoid the trip part for getting the care they need. The regime is coldly erasing through death or financial failure the historical middle to upper middle class since the only rich folks that can deal with the current situation are the ones close to the regime.
At least in this particular case, at this time, we can use the term "genocidal class warfare". You either die, go bankrupt or leave the country. You have no other option.
Some pro Chavez/regime supporter may point out that it is mere justice that all Venezuelans have to go though this, rich or poor. After all, the poor do not get either the medicine, nor the health support. I will reply that totalitarian regimes do not care about what happens to their civilians. They are a mere casualty in the war for the just cause. It does not matter for the regime whether its supporters die in greater numbers, they are expendable. What matters in the end is that the opposition to the regime is broken. The end justifies the means. All methods are valid. Period.
Let me remind you historical precedents, such as Hitler not afraid to distract from its army and civilians resources for use in Jewish extermination carried out all the way to the last day of the war. Or how Stalin drive to liquidate Koulaks had no problem creating a general starvation, or how the Castros never lost a night of sleep over the balseros braving the straights of Florida or the Argentina's military sending unprepared soldiers to the Falklands, or....
The current holders of the Venezuelan regime have absolutely no qualms about letting people die of disease, and I mean not only cancer patients. Never mind those who will die soon of malnutrition and those who already die of violence in the barrios. What the regime wants is for denizens of El Cafetal, or Prados, or Altamira to stay terrified at home, looking at what next heirloom they will need to sell at low price to help buy medicine for cousin Juan. That chavista supporters suffer more, die in much greater numbers is really not an issue for Maduro.
Note: I already wrote in Spanish a note on why there is already enough evidence to instruct a dossier on chavista leadership to send them to the Hague tribunal. I suggest that the National Assembly starts officially the procedure. After all, if Dilma got impeached Sunday I do not see why we should not try to do so with Maduro.