Rummy’s Chum in Nicaragua Coaches Bush on Healthcare

Dear President Bush,

Last fall Sec. of Defense Donald Rumsfeld seemed concerned that the leadership of Nicaragua would change resulting in a dark force coming to power. He insinuated this could happen by surreptitious means but he failed to mention the method, the 2006 November elections! Don did meet with military leaders during his visit. Did Sec. Rumsfeld give them a wink and nod as to steps should the wrong leader get elected? Only he knows for sure.

Don’s chum is President Enrique Bolanos who has served in office since January 2002. Mr. Bolanos has many challenges as the government head of Nicaragua. His country is one of the poorest in Central America, underemployment is widespread, and the country carries a heavy debt burden. The CIA World Factbook states “Distribution of income is one of the most unequal on the globe”.

That Nicaragua is also the past playground for John Negroponte, your Director of National Intelligence, makes Rumsfeld’s moves all the more curious. I have a theory as to why your administration supports Bolanos. Is he advising you on your healthcare strategies?

President Bolanos is also interested in keeping down health care costs. Public health physicians struck in November of 2005 over wages. Doctors are demanding a 30% wage increase on their $500 a month pay. The government has said it cannot afford to pay, thus the strike continues.

In an effort to restart negotiations about 200 doctors occupied the Finance Ministry building. The police stormed the building firing tear gas and used batons to beat some resisting doctors before busing the protestors to police stations.

Nearly 2,000 doctors have not worked since the strike began impacting care for the average citizen living below poverty. Private hospitals and clinics remain open and core group of public health doctors continues to staff government hospitals and emergency rooms.

Both you and President Bolanos have said we cannot afford to pay more for healthcare. Both your plans have a greater impact on limiting the poor and middle income’s access to care. It is predictable that U.S. physicians will get more frustrated as your strategies are implemented. When their burden of no pay accounts receivable soars, how many will just throw up their hands and quit? My guess is a lot more than 2,000. How will you respond? Will you answer back with no negotiations, lockouts, batons and tear gas?

I can see why Sec. Rumsfeld wants to keep such a loyal leader in charge in Nicaragua. He pleases two bosses with one bone, you as his boss and the National Intelligence Director. We know it always pays to keep the boss happy…..