Overbilling and Abuse in the Hospital System: Minister Sinal's Cry of Alarm Against Existing Chaos

Port-au-Prince, November 11, 2025 — Recent statements by the Minister of Public Health, Dr. Bertrand Sinal, have reignited the debate on the alarming degradation of the Haitian health system. With this denunciation of serious irregularities at Saint-Michel Hospital in Jacmel, the minister faces a reality: that of a dilapidated health system, undermined by a lack of resources and a lack of trust between the population and the institutions meant to provide care.

During a recent inspection at Saint-Michel Hospital in Jacmel, Dr. Bertrand Sinal observed disturbing abuses: medical students were reportedly practicing in place of qualified doctors, while official care fees were largely exceeded.

According to the minister, a normal delivery, officially priced at 1,000 gourdes, would be billed at 3,000 gourdes, and a C-section, normally set at 12,000 gourdes, would reach up to 27,900 gourdes.

These revelations reflect a quasi-systemic practice in the Haitian public hospital network: overbilling, informal arrangements, and the substitution of qualified personnel by interns or students.

Regional hospitals, often in a state of quasi-administrative autonomy, operate like informal micro-enterprises, where users pay for everything: an IV drip, a syringe, a bed, sometimes even for a doctor to deign to examine a patient.

What is happening in Jacmel is not an isolated case. In many public hospitals across the country, from Les Cayes to Cap-Haïtien, passing through Port-de-Paix, and in the capital, Port-au-Prince, patients complain of mistreatment, insults, and even deliberate negligence.

Testimonies collected from patients, families, and human rights organizations report pregnant women left without assistance for hours, emergency patients abandoned in corridors, sometimes until death, due to lack of medical attention.

In some centers, underpaid, exhausted, and demotivated hospital staff are arrogant or indifferent, fostering a form of institutional violence that adds to the physical suffering of patients.

This loss of compassion and professionalism results from an unease within the system: lack of supervision, insufficient control by departmental directorates, degradation of medical training standards, and a massive exodus of competent professionals abroad.

The degradation of the health system is not solely due to poor hospital management: it reflects a broader political and budgetary failure.

The Ministry of Public Health and Population must act quickly and investigate the implementation of the latest measures taken to improve the living conditions of the most vulnerable, which, however, are not scrupulously respected by those very individuals who are supposed to implement them.

Under the Sinal administration, several praiseworthy actions have been taken to ensure a minimum nationwide. But as with the C-section, they are not implemented to the letter. It remains to be seen how many other measures are not being taken into account.