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Puerto Rico's government carries more than $70 billion in debt - debt it cannot pay. Congress is debating how and whether to help. And yesterday, Treasury Secretary Jack Lew called attention to Puerto Rico's crisis by going there. NPR's Greg Allen was with him.
GREG ALLEN, BYLINE: Centro Medico is the jewel of Puerto Rico's health care system, its largest hospital, with a trauma center and the only neonatal intensive care unit in the Caribbean. While Congress deliberates how to help Puerto Rico, Secretary Lew spent a day on the island assessing the human impact of the crisis. In Centro Medico trauma center, Dr. Juan Azaria was blunt.
JUAN AZARIA: We are hanging by a thread now. For us to provide services, we have to let other things not to be paid.
ALLEN: Puerto Rico is currently 70 to $80 million behind in Medicaid payments it owes to hospitals and doctors. The funding shortfall has forced hospitals to lay off staff and close entire floors. Nurses and doctors, more than one a day, are leaving the island for better-paying jobs on the mainland.
On a tour of Centro Medico, the head of Puerto Rico's health care financing agency, Ricardo Rivera told Lew the system is nearing collapse.
RICARDO RIVERA: There are people that ask, well, what's your plan B and plan C? But they are already on their plan W. Yeah, it comes down to funding.
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ALLEN: In the neonatal intensive care unit, about 15 tiny babies attached to wires and monitors lie in cribs and incubators. Dr. Marta Suarez, a pediatric specialist, says delays in payments to suppliers risk holding up dialysis treatments for newborns. Chemotherapy drugs now are only available to the hospital COD, she said, after it sends funds by wire transfer to the supplier.
MARTA SUAREZ: A kid needs chemotherapy. I can't - I mean, we have to jump through all these hoops and holes just to get that wire transfer while that kid, which may be anybody's daughter, waiting for their chemotherapy.
ALLEN: After touring going the hospital, Lew had a message for members of Congress who may have been waiting to help Puerto Rico until, in his words, it's a moment of crisis. The crisis, he said, is today.
JACK LEW: I don't think there's a member of Congress who would find it acceptable for a 5-week old baby to not have access to the medications they need for dialysis.
ALLEN: That's how Puerto Rico's debt crisis is playing out on the island. In Washington and the districts of some member of Congress though, a different is being aired.
(SOUNDBITE OF POLITICAL AD)
UNIDENTIFIED MAN: Tell Congress stop the Washington bailout for Puerto Rico.
ALLEN: The group that paid for this ad, the Center for Individual Freedom, doesn't disclose where its money comes from. But the ad is part of a campaign to block a bill under discussion in Congress that would set up a financial control board with the authority to restructure Puerto Rico's debt.
One of the campaign's most potent weapon is the use of that word, bailout. Treasury Secretary Lew.
LEW: It is not just incorrect. It's deceptive and plain wrong.
ALLEN: Lew says Congress has gone to great pains to make sure that not a penny of taxpayer dollars will be part of the bill. Opponents of the bill include an influential group of hedge funds and other creditors who don't like the idea of a control board, preferring to sue in court for repayment, even if it takes years. Lew says that's not in the public interest.
LEW: There may be some stakeholders who think the best solution here is for them to defend their interest to the very end. That will destroy Puerto Rico. It will produce worse outcomes for most stakeholders, and it will just destroy life for 3 and half million Americans.
ALLEN: After more than a year of struggling to pay its bills, last week, Puerto Rico went over a fiscal cliff, defaulting on a $400 million debt payment. That may encourage Congress to act before the next big deadline.
In July, Puerto Rico has a nearly 2 billion debt payment due, and the government says it doesn't have the money. Greg Allen, NPR News, San Juan, Puerto Rico. Transcript provided by NPR, Copyright NPR.