Private takes cash too.If someone does not have insurance and no credit card don’t they go to public hospital.
But, you're right. For many Dominicans, public hospital is really their only and best option, but they don't pay for pharmaceuticals like insulin. People here die from easily treated but chronic conditions.
They do good work for cuts, scraps, etc. They definitely save lives and at least provide a basic level of care.
As for conditions, they are not the nicest facilities and I marveled at documents area which is a museum for paper records keeping. There equipment is used and probably donated. Deferred maintenance is everywhere.
However, they make due with what they have to work with which is not much.