Puerto Rico is imploding. Every major media outlet in the world has written about our government's failure to repay billions in loans to the United States and private investors who put their money into government bonds. Politicians are arguing over whether to send in a Federal Control Board to run the money that doesn't exist, and the government-owned water and electric companies cannot declare bankruptcy, but don't know how much longer they can keep our utilities on. Truly, it's a crisis of massive proportions for the almost four million residents of the commonwealth island that is, in fact, home to United States citizens.
I know exactly what is going on because I live in Puerto Rico and operate a wedding planning business here. And the young man I'm going to tell you about was featured on my TLC reality show "Wedding Island," filmed on Vieques, Puerto Rico. 
What we don't read about in the international news coverage - and we should - is that Puerto Rico's lack of medical care for its American citizens is literally killing them.
Occasionally, you hear about the atrocious health care system in Puerto Rico, but that's never the highlight of the stories. Everyone is worried about the money, not the people. As a resident and business owner in Puerto Rico for the past eight years, I have seen this dysfunctional system in action repeatedly. And now I'm going to tell you about a young, highly-decorated Puerto Rican cop who almost died because of neglect in a Puerto Rican hospital.
Agente Andy Ramos, a Brooklyn-born transplant to the island, has been a cop in one of the most dangerous places in the United States for 13 years. He consistently has the most arrests and convictions in his district (Vieques Island, located seven miles off the coast of Puerto Rico), and has received numerous awards for his service. He lives where he works, and is married to his high school sweetheart Angelica. They have two small children. Like all Puerto Ricans, they are dependent on the health care available on Vieques, or must travel to the main island of Puerto Rico.
Andy, age 34, developed a bad cough this spring. The Vieques hospital's X-ray machine was broken (more common than not), and so they diagnosed him with a bronchial infection and gave him antibiotics. When it didn't improve in a few weeks, they gave him another prescription. A month later, when he was coughing up blood, he took himself to a hospital on the big island with actual equipment. The small regional hospital took one look at his chest X-ray and sent him to Centro Medico, the biggest hospital in Puerto Rico, for care.
Chest X-rays and CT scans revealed a 6 ½ centimeter mass in his lung, so they did a biopsy. He had to wait for three weeks in the hospital for results, all of which came back "inconclusive." They did another biopsy and sent him home at the end of July, promising results by August 27th, a month later.
To give an average American real perspective, in Puerto Rico, you must bring your own blankets and pillows to the hospital. The nurse/patient ratio is ridiculously high. And IV poles don't even have monitors on them unless you are in the critical care unit so your IV bag runs dry and nobody even knows it. The entire time Andy was in Centro Medico, nobody ever had an oxygen saturation tab on his finger despite the fact he was struggling to breathe. So being released from the hospital was both a blessing and a curse. In Andy's case, it was a blessing.
Knowing something was terribly wrong and he might not be able to travel for a long time once the results came back, Andy flew to New York City to visit his family in Brooklyn. Shortly after his arrival in the city, he became very ill and unable to breathe due to the coughing. His family wisely took him to the emergency room at New York Presbyterian/Columbia University Medical Center. Within a few days, this young cop was diagnosed with Stage 3 lung cancer. He began chemotherapy almost immediately.
Because the Puerto Rican medical system failed him, the cancer has progressed to the point where the tumor cannot be operated on until its size has been reduced through chemo and radiation. The tumor has invaded his trachea, which is what caused the coughing that initially alerted them to the problem in May. It's been growing and eating him alive for four months that we know about, and we can all agree that is unacceptable. The vast majority of doctors in Puerto Rico receive some or all of their medical training at medical schools stateside. The fact that the island's healthcare is caught in the 1950s in unacceptable. Puerto Rico is not Cuba.
Furthermore, the doctors in New York have contacted the physicians who treated Andy at Centro Medico in Puerto Rico twice for information about his initial admission to the hospital and to get copies of the scans so they can measure growth, but Centro Medico has been completely unresponsive. It's as if they do not care what happens to their patients. In order to get medical records released, every doctor in the file must "sign off" on their individual records and then, the hospital requires 15 days to provide copies to an outside source. Again, Puerto Rico is at least 50 years behind the times.
The fact that Andy's cancer had been diagnosed now and he has begun treatment is a great thing, and he couldn't be in a better place. But in order to get a diagnosis and treatment for what is a fairly common cancer, he had to travel thousands of miles away and end up sick in a hospital in New York. His wife, children and family are still in Puerto Rico. He has family in Brooklyn to support him, but as anybody who has ever been through a major medical problem knows, you need your spouse with you for strength when the going gets tough. And for Andy, it's already tough and getting uglier.
What makes it worse is that, although Andy is a veteran police officer and his wife has a full-time job, there will never be enough money to cover the costs of dealing with this tragic situation. Nevermind the actual medical bills, it costs more than $100 one-way just to fly to San Juan to catch a flight to the states. Plus child care, accommodations, and basic expenses of trying to survive in Manhattan under these circumstances. 
Puerto Rico doesn't have the same sort of "Cop Family" structure that exists stateside. The "Thin Blue Line" isn't as solid as it is up north. Even if a police officer is killed in the line of duty, the death benefit to his family is tiny, and by law, must be split between his wife, parents and children. So obviously, there's nothing in place at all to support the very brave Policia de Puerto Rico when they are very sick, despite the fact they put their lives on the line every day on an island that has literally become the largest entry point into the United States for drug traffickers. In my opinion, as a cop wife, it's disgusting. His friends have set up a fundraising site to help his family, but as we all know, it will never be enough to offset what this medical nightmare will cost them to keep this husband, father and cop alive.
All Puerto Ricans are American citizens. And it doesn't matter what they do to extend additional health insurance coverage to citizens of the island if the health care offered is substandard. There are private hospitals with better reputations and who specialize in cancer, and maybe they could have helped Andy Ramos if Centro Medico had brought in consults or transferred him someplace else for care. But instead, they sent him home for a month to let the tumor continue to grow and take over his body. This isn't a man who neglected his health - he has never been a smoker or abused his body - he went for help and the Puerto Rican health care system failed him. Miserably.
The media isn't wrong about what a disaster the Puerto Rican government has become, it's just not taking a close enough look at the real people who are affected by its failure. We're reading about the unpaid debt by the island. Not the atrocities the island is committing against the legitimate tax paying citizens there.
Tens of thousands of skilled Puerto Ricans, many of them in the medical profession, are leaving the island in droves annually. They're headed stateside where they can practice REAL medicine with CURRENT equipment and SAVE lives. Puerto Rico can't force them to stay - they'll never be able to pay off their medical school loans if they do. But the consequences to the population are tragic, and getting worse every single day.
Agente Andy Ramos is a real person. He's a decorated police detective, and an excellent father and husband. The fact that he happened to relapse during a visit to his family in New York City is the only reason that he will survive this battle with cancer. And he will survive. Puerto Ricans are strong people used to fending for themselves when the government fails to provide basic things - such as adequate medical care - to its people. Andy has health insurance and a job. He wasn't a charity case who got ignored. He's a decorated cop who should have gotten the best possible care but the island he's dedicated his life to protecting has failed him.
It's time for Puerto Rico and the U.S. media who are covering its demise to take a closer look at the real, hard-working American citizens there who are suffering from the government's mismanagement of funds and general disregard for public welfare. How many good young men have to die before somebody stands up and says "THIS IS WRONG" and we must do something about it?
The United States sent more medical equipment, doctors and assets to Haiti after its earthquake, and to Japan after its tsunami, than they provide to Puerto Rico's American citizens. Puerto Ricans who can afford to leave the island to seek medical care do so immediately, those who can't are at the mercy of outdated equipment and overloaded, understaffed hospitals. Puerto Rico is broke and that's a huge problem, but before anybody can restructure the government to make it work, we have to help keep our American citizens alive on this island. And right now, the United States is failing its citizens. Because that's what all of the residents of Puerto Rico are - we are Americans. And our government should be ashamed of itself.