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Puerto Rico Health System Over the Time

  • Arbona Model

    Arbona Model
    Governor Luis Muñoz Marín began a regional and tiered public health system that would be considered cutting edge in the 1960s, the Arbona Model, in honor of Guillermo Arbona, then the Health Secretary.
  • Public Hospitals

    Public Hospitals
    Construction of public hospitals, health clinics and mental health centers began.
  • A functional system

    The health system worked, and the island had a better life expectancy when compared to the rest of the world. There was a regionalized and universal health care system, since practically all Puerto Ricans were covered.
  • Health Reform

    Health Reform
    Governor and pediatric surgeon, Pedro Rosselló González, began his so-called Health Reform to completely overhaul the system, selling public facilities and contracting services through insurers.
  • The pilot

    The pilot
    The Health Reform is rolled out in Fajardo. It was said to be a pilot project. In subsequent years, it was extended to the entire island.
  • Health System Evaluation Commission

     Health System Evaluation Commission
    Governor Aníbal Acevedo Vilá appoints the Health System Evaluation Commission to assess the performance and failures and propose changes. The group of 100 professionals concludes that Puerto Rico must change to a universal health care model.
  • Mi Salud

    Mi Salud
    The Luis Fortuño administration changes the name of the Government's medical plan to “Mi Salud,” making minor adjustments and leaving the model intact.
  • All insurers welcome

     All insurers welcome
    Governor Alejandro García Padilla opened participation in the public health insurance plan to all insurers, including advantage plans such as MMM, where his brother Luis “Gerry” García Padilla worked. He also tried to establish a pilot plan, as proposed by the 2005 commission, to change the health system’s model, but failed due to the conflict of interests among multiple components of the government and the health industry.
  • Multisectoral Council

    The Puerto Rico Health System Multisectoral Council is created by law, to study the existing models and make recommendations. In 2016, the Council presents its first report “The Health System has had enough patches,” which concludes that there must be an independent entity with effective presence or participation in all administrative, planning and supervisory processes. It also suggests that a study be done of the system’s components and how to finance health care services.
  • Vital

    Governor Ricardo Rosselló changes the name of the Government's health plan to “Vital,” consolidates all regions and allows patients to participate in the free selection of insurers, creating a greater disruption, with patients going to hospitals and non-contracted providers.
  • The first case of covid is identified

    The first case of covid is identified
    Italian tourist arrives in Puerto Rico aboard the Costa Luminosa cruise ship, the first case of COVID-19 identified by the Government of Puerto Rico.
  • The emergency

    The emergency
    Gov. Wanda Vázquez declares an emergency through an Executive Order when an Italian tourist shows a positive result. She asks Health Secretary Rafael Rodríguez Mercado to resign over the way he handled the COVID-19 situation.
  • The curfew

    The curfew
    Executive Order 2020-023 comes into effect to prevent the spread of COVID-19, and establishes a curfew.
  • The secretary resigns

    Interim Health Secretary Concepción Quiñones de Longo resigns, and the Governor designates a new Secretary, Lorenzo González Feliciano, who had been at the helm of the agency in 2012.
  • The peak is coming

    The peak is coming
    González Feliciano predicts that the peak of infections by COVID-19 will be between May 4-8.
  • The dashboard

    The dashboard
    The Department of Health presents a dashboard, which provides only some general data on COVID-19 infections and availability of hospital beds. Data for all tests performed and their breakdowns, or for patients in recovery, are not included.
  • Previous deaths

    The Department of Health confirmed that two men died of COVID-19 on the island, before the Italian tourist.
  • The reopening

     The reopening
    The Governor announces the start of the economic reopening on May 4 through Executive Order 2020-38, against recommendation of her medical Task force. Record number of COVID-19 hospitalizations, with 201 cases.
  • What about the peak?

    The Health Secretary says that the peak of infections has passed, although undetected.
  • confirmed v. probable

    The Department of Health changes the way it presents the data on its dashboard, separating the positive cases, which have been confirmed with a PCR test, and the probable ones, which have yielded positive through a serological test.
  • The spike

    The spike
    A spike in infections, hospitalizations and deaths from COVID-19 is recorded, and new daily records of COVID-19 hospitalizations are established.