THE alarming reports coming out of the CNMI yesterday all seemed to point to an imminent collapse of the Commonwealth’s ability to deliver health care to its residents.

We’ve written before about the serious implications from what is happening on our own hospital and healthcare system here on Guam. For if Saipan and the other islands of the CNMI cannot care for their injured or critically ill citizens, those who can afford to travel off-island will in many cases come here.

In fact that is already happening. Private clinics are faced with growing numbers of patients from the northern islands, and Guam Memorial Hospital’s emergency services and beds are under pressure to cope. Payment is also an issue. Some people from the CNMI are being turned away because they have no acceptable insurance and cannot afford the treatment.

What we face is nothing, though, compared with what they’re dealing with on Saipan. Following a lunchtime meeting yesterday, physicians decided to close the outpatient clinics at the Commonwealth Health Center (CHC). The action was described as a desperate, last-minute move after the government missed the Friday payroll for nurses and doctors.

Housing allowances for off-island nursing hires are said to be six months behind. The missed payroll is not the first, and staffers are becoming increasingly demoralized. As word spread through Saipan and the other islands about the closures, people began to realize the end may be near. One dazed nurse said, “How could the government let this happen in America?”

In a letter to CHC CEO Juan Babauta, Dr. Jeremy Richards, director of medical affairs, said the failure to make payroll was the “breaking point.” The medical staff has, in effect, drawn a line in the stand.

Whether the closure included CHC’s emergency services was a little uncertain last night. Apparently the emergency room remains open, although it was closed for a time on Monday because of what was described as the physical exhaustion of the two attending doctors.

“We came close to losing coverage in the ER,” Richards said in his letter, but “we were able to maintain emergency coverage.” He added, however, that the current staffing situation in the ER is “unsustainable.”

You can read more about this incredible situation elsewhere in today’s Variety, in a comprehensive report by Tammy Doty of our sister publication on Saipan.

But the bottom line is that complete closure of the CNMI’s only hospital is possible. That would be a catastrophe for the residents of the commonwealth. “CHC is on life-support and time is running out quickly,” said the Variety story, noting one staffer observed “CHC is Humpty-Dumpty and once it breaks there’s no putting it back together.”