>> Israel Gonzalez-Maldonado is 84. He's poor and battling terminal cancer. And to make matters worse, he lives in Puerto Rico. His house, like many others on the island, hasn't had power in the nine months since hurricanes Irma and Maria.
w as another hurricane season is about to descend, it's the elderly, like Gonzalez, who are most vulnerable, says Reuters correspondent Nick Brown, who has reported extensively from the region.
>> Puerto Rico has been in the biggest insolvency in US government history for a number of years, and a lot of the younger, healthier people on the island have been leaving. So the people that are left tend to be the poorest, the oldest, the least mobile. So you have a much greater population of elderly and also disabled people on the island than in most US states.
It's not just that there's a lot of elderly people in Puerto Rico, it's also their relative immobility. They're the most disabled elderly population in the country. They are the least educated elderly population in all of the United States.>> And there are not nearly enough resources to help, with only six government certified nursing homes on the entire island.
To fill the void, Puerto Ricans depend on the hundreds of private or nonprofit nursing homes, but these mom and pop operations are also hurting.>> They were barely making ends meet before the storm, trying to accommodate a mostly poor population, relying on payments, fees from their clients. A lot of those people couldn't pay, so they just let them come in for free, right, and then they rely on donations and federal subsidies or government subsidies.
So you can imagine now, with the storm, those places are in even worse shape.>> In the US, most senior citizens rely on Medicaid to pay for their skilled nursing care. But under a decades old US policy, Washington has limited federal spending on Medicaid in Puerto Rico. And pays less for services than it does in US states, despite nearly half the island living below the poverty rate.