RMI Health Care Service System
The Marshall Islands has a well-developed/organized primary/preventive and public health system. There are two main hospitals located in the two urbanized islands in the Kwajalein (Ebeye Hospital) and Majuro (Majuro Hospital) Atolls. Including the two main hospitals, there are 60 health centers/health clinics located in the various islands that make up the Marshall Islands. The two main hospitals serve the urban areas including the surrounding islands through referrals and medical evacuation. The two hospitals provide primary/secondary and some tertiary care. However, most tertiary care patients are referred off-islands to hospitals in the Philippines and Hawaii (Tripler Army Medical Center). The health clinics in the Outer-Islands are staffed by Health Assistants who are locally trained and assigned to these clinics as primary care providers. The Marshall Islands MCH Title V program is one of the key programs in the Division of Public Health and provides the mandated services for the MCH population.
The 177 Health Care Program (Victims of Nuclear Fallout of Bikini, Rongelap, Enewetak, and Utrik) Clinics provide primary health care services to the four atolls affected by the nuclear testing. A primary health care physician manages the 177 Clinics. The Department of Energy has a DOE Clinic which provides medical services to the nuclear patients. The Diabetes Wellness Center which is managed by Canvasback Missions, in collaboration with MOHHS, demonstrates that natural foods and an active lifestyle can reduce or replace the need for diabetic medications and provides a higher quality of life for the participants. Taiwan Health Center concentrates on developing health education materials and training programs primarily used in Non-Communicable Diseases (NCDs) like diabetes and also helps with outreach activities, monthly missions on specialties to work at Majuro Hospital.
These health care services include, but are not limited to : a) clinical services in the hospitals and health center facilities and outreach activities; b) primary health care or preventive services in the hospital and health center settings, school and community compounds, house-to-house outreach; c) health promotions and educational activities, special projects with community groups; d) collection of data for the Health Information System to monitor health indicators, including monitoring and evaluation of health services and the health care systems.
In addition to the above-mentioned government sponsored health care services, there is one private health clinic, one private dental clinic, and two private optometry practices in Majuro. All of the doctors practicing in the government and private clinics are licensed under the MOHHS’ Medical Examining and Licensing Board to practice in the RMI.
Medical Referral is handled by the Medical Referral Office. MCH program coordinated the CSHCN referral with Medical Referral Office. RMI has a national health insurance offering basic and supplemental health insurance. For Basic insurance, patient pays a) $5 for full outpatient visit which includes laboratory, diagnostics and pharmacy b) $17 for Emergency visit and c) $10 for admission. For patient with no insurance, patient pays a) $20 for full outpatient visit which includes laboratory, diagnostics and pharmacy b) $35 for Emergency visit and c) $110 for admission. To be able to receive basic referral where patients are referred to tertiary hospitals in Hawaii, Manila, and Taiwan, patients’ needs to be enrolled in Basic Insurance. All Marshallese citizen are automatically under the Basic Insurance. For foreigners living, they need be an active member of Marshall Islands Social Security Administration with regular payment for 1 year and existing legal immigration papers.
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