By Kylee Hendrie
The source of Puerto Rican pride resides in the resilience of the islanders despite the territory’s tumultuous history. In the most recent years, the island has suffered intense natural disasters–most notably hurricane Maria–causing only more economic instability in the territory. The greatest exodus in Puerto Rican history followed suit, resulting in 160,000 citizens migrating to the mainland. Though many residents eventually returned, the healthcare benefits and lower sales taxes enticed many Puerto Ricans to stay. Although, this isn’t the first instance of a great diaspora: the first occurred after World War II, when Puerto Rico’s economy shifted from primarily agrarian to manufacturing. Seeking higher wage jobs, migrants moved to the states, landing predominantly in the Northeast.
But now, another great exodus occurs in the wake of the pandemic. In the move for Puerto Rico gaining statehood, the comparisons between the mainland and the island reveal the great disparity between medical coverage and average income; and such differences have induced a phenomenon known as brainfreeze, in which young, educated Puerto Ricans are leaving the island for better economic opportunities in the states.
Brainfreeze is most notably seen in the medical industry, where young doctors are leaving to pursue higher paychecks in the states. Meanwhile, the island is left to face a pandemic with a crippling lack of medical workers. Though the federal government has sent relief funds, the total estimating around TK, the inconsistency of the government’s support has left the future of Puerto Rico uncertain.
“Uncertainty is the biggest challenge Puerto Rico has. It’s the uncertainty around funding. If we don’t have a budget, it’s hard to plan short, mid, or long term…Puerto Rico doesn’t have enough federal funds,” said Edna Marín, the executive director of medicaid for Puerto Rico.
While COVID relief funds alleviated economic stress temporarily, with 200 million reallocated to increase provider rates, it wasn’t durable.
“Non-reccuring money is used to fund recurring events; [Puerto Rico] hasn’t learned its lesson,” says Franco Carrasco, a financial advisor, economist, and native Puerto Rican.
The overall median household income in Puerto Rico is substantially different from the mainland. Averaging 31% lower overall, the migration of Puerto Ricans to the mainland is unsurprising. At 11.5%, Puerto Rico also has the highest sales tax in America, and yet, the disparity between income is stark. As a result, the economy has shifted in response to the uncertainty, and is now best summarized as an “informal economy,” by journalist, historian and director of the Harvard Puerto Rico Winter Institute, Pedro Reina-Pérez.
“Many business deals are made in cash. If you need any work done, the service is paid under the table so they aren’t taxed,” said Reina-Pérez.
Unfortunately the informal economy isn’t enough for medical workers to get paid sufficiently. In the wake of the pandemic, the crisis surrounding the lack of mental health resources is dire and yet, there’s no incentive for young doctors to come back to Puerto Rico.
“We’re losing about 500 [medical] providers a year; the shortness of mental health resources is huge. To prevent additional exodus and get [doctors] to come back is to increase fair rates…as long as we get [income] on a benchmark nationwide, we’re hoping for our medical providers to come back” said Marín.
In response to a dearth of providers, Puerto Rico has become innovative with solutions, outsourcing medical care to online companies.
“Puerto Rico is still innovating on telehealth. It was hard to implement it, [but] there’s been an increase in telehealth claims,” said Marín.
While telehealth is a good temporary solution, the culture of Puerto Rico is extraordinary interpersonal and results in a major adversity to online healthcare.
“Puerto Ricans love to go to our doctors. We like things in person,” said Marín.
The culture of Puerto Rico remains resilient. Despite the adaptations Puerto Ricans have been forced to make in response to the absence of health care workers, the people are as proud as ever. If the territory achieves statehood, a cause that’s been recently in the public eye, the exodus of educated Puerto Ricans might potentially halt. Federal funding would then be matched to the other states and result in recurring government aid for workers across the territory. There would be less likelihood of young Puerto Ricans leaving the island–and Puerto Rico could then begin to address its issues from the ground up. Unfortunately, with natural disasters and the pandemic causing extreme economic duress, Puerto Rico is still a long way from economic prosperity.
“It's very difficult to be Puerto Rican because even though we have a history, we have everything that's needed to be considered a nation. We don't have formal recognition as a nation…we don't have a seat at the United Nations. I mean, we are the oldest colony on the planet–and yet, it's great to be Puerto Rican,” said Carrasco.
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