August 18, 2016

Dr. Emais Roberts


Medical Referral Committee

Ministry of Health

Koror, Republic of Palau 96940

Dear Chairman Dr. Roberts:

It is my understanding that the Medical Referral Program has a process that is followed for patients to receive medical treatment abroad.

[restrict]The basic process is that the patient’s doctor makes the diagnosis and if the treatment needed cannot be provided by our National Hospital then the doctor recommends to the Medical Referral Committee that the patient should be referred abroad for medical treatment.  Thereafter, the Medical Referral Committee deliberates and makes its decision to approve or deny the patient’s referral. If it is approved then the National Health Insurance makes the financial arrangements for the patient.

However, it has come to my attention that certain patients bypass the aforementioned process and receive treatment abroad and are still able to use their National Health Insurance to cover the cost after the treatment.  This means that the Medical Referral Committee somehow approved such action for the patient to be able to use the insurance to cover the treatment cost.

I believe that all patients should be treated equally under the system.  Therefore, I request that you provide statistics regarding the number of patients that have bypassed the medical referral process and the cost of their treatment in the past year.  Also, provide the statute or regulation or other authority that the Medical Referral Committee based their decision on regarding this matter.

Your prompt response and action regarding this matter will be greatly appreciated.


Toribiong, Joel

Senator, Ninth Olbiil Era Kelulau

Cc:       Medical Referral Committee Members; Social Security Administrator; and All Senators [/restrict]