Dr. James U. Hofschneider secretary of public health for the Northern Mariana Islands said the CNMI is mandated to pay for all expenses relating to medical referrals. “It doesn’t matter if you are indigent or a millionaire the government will pay for your fare to go off-island.” Additionally he told symposium participants the government pays for the cost of accommodations an escort and a $20 daily stipend.

Hofschnieder based at the Commonwealth Health Center said the CNMI refers about 300 patients to Hawaii annually. “Maybe some of those can go to the Philippines in the future. Hawaii has become one of the most expensive places to send people for medical care.” The Philippines is known in the CNMI for its medical care he said. “The ones going to the Philippines are the ones who have private insurance.” The CNMI has a “Guam first” philosophy for referrals. “We send about 500 patients to Guam annually for diagnostic tests.”

The leading causes for referral for off-island medical care in the Northern Marianas are neurosurgical treatment cardiovascular conditions cancer and renal stones. MBJ