A version of this story appeared on State of the Territory News in August 2017. This story was revised and updated in 2021.
Charlotte Amalie — During a visit to Washington, DC, in 2017 former Governor Kenneth Mapp sat down with The Atlantic to discuss healthcare in the US Virgin Islands. The lengthy interview documented Mapp making false claims about universal health-care (UHC) in the territory. But access to UHC did not exist in the territory in 2017. And in 2021, UHC is not available in US Virgin Islands in any form.
The governor also discussed the social status of other U.S. territories and their relationship with the United States. Read Mapp’s transcribed interview with Vann R. Newkirk II, published by The Atlantic here.
Universal Care vs. Universal Access
When discussing health care in the Virgin Islands, Mapp discussed how residents receive care at local hospitals. “In the Virgin Islands, we’ve long had universal health-care,” he said. But that statement was false and misleading.
Universal care refers to a health care system that provides healthcare and financial protection to all citizens of a particular country. Universal health coverage does not exist anywhere in the 50 states or territories. The World Health Organization (WHO) classifies universal health coverage as a health care program that provides people with access to preventive and rehabilitative health services.
The WHO notes that UHC plans must be of sufficient quality and prove useful while ensuring that these services’ use does not expose the user to any financial hardship. Mapp’s Government House staff posted the transcribed interview on their official Facebook page, presumably to promote his comments as fact. A Government House representative said in a statement, “If you read the article in question, Governor Mapp uses the term to refer to the fact that our hospitals, by law must treat everyone regardless of ability to pay,” when asked for an explanation on the governor’s statements to The Atlantic.
At the time, several users pointed out that the Facebook page run by Government House in 2018 attempted to censor constituents’ responses by deleting comments that challenged the former governor’s statements to the publication.
“All residents, citizens, illegal immigrants, and visitors have unfettered access to health care services in the VI, notwithstanding their inability to pay for such care,” Mapp said. “These services are provided as a matter of law, and this mandate has existed since the late sixties.” The August 30, 2018 post received over 200 responses, mostly corrections about the territory’s health-care system.
“When both patients were discharged, the cost to this government in one particular case exceeded $750,000. We provide care to patients in our hospitals and in a number of facilities on the mainland to patients who have no means to pay for these services,” Mapp continued. “Yes, “WTF”; if this is not universal healthcare coverage; what is?”
To date, Mapp has not backtracked on his misleading statements but insisted that residents could receive universal care at medical facilities. Instead, he had an extraordinary public exchange with State of the Territory News in the comments section, where he attempted to change the definition of UHC, despite efforts by constituents who sought to inform him using official information published by the WHO.
According to the Virgin Islands law, public hospitals must administer care to anyone in need of emergency care, regardless of their inability to pay. However, Mapp and his aides at the time failed to reveal to The Atlantic that although hospitals must provide care to anyone in need of emergency care, patients receive bills later. In most circumstances, patients receive bills immediately after receiving lifesaving care.
Indeed, there are no states in the US or territories that offer UHC packages to taxpayers. From his Facebook page, the former governor elaborated on his comments and attacked his commenters that challenged what they viewed were misleading claims to The Atlantic.
Universal health care includes but does not exhaust itself to just emergency care. The local policy that Mapp referenced does not cover preventive care, like vaccinations and screening tests, all hallmarks of universal healthcare programs. It also does not fit the description of universal care that the WHO describes. In countries like Canada and Brazil, where universal health coverage exists, keeping people healthy and treating them when they’re sick are critical parts of the program.