he Access to health In Argentina it is conditioned by the economic and social realities of the patients, despite the fact that it is a universal right enjoyed by all persons within the territory. Consecutive increases in stakes Prepaid medical companiesThe presence of coinsurance and the lack of private clinic appointments are determinants and have a direct impact on access to various benefits, to the point that many choose to attend the public health system even though they have private coverage.
Among the parties to the economic and social crisis that our country is going through is a direct link in health, as there has been a movement between the public and private system due to the increase in contributions and the suspension of some benefits that were previously covered by social and prepaid works. Although they expressed from the Chamber of Private Medical Entities in Argentina that there were internal migrations between companies or changes in plans, they recorded an increase in demand from public influencers. Subsidiaries for the private system.
Significant increases recorded in upfront fees have led to a decrease in the number of associates moving into the general system, which has led to an increase in demand for outpatient shifts and guards which is reflected in the saturation of some hospitals.
Mendoza as a witness
Public hospitals in Mendoza County recorded an increase in demand for care by members social business And Prepaid medical companiesAlthough the services provided in these establishments have to be paid for, the reality is that the increase in demand affects the availability of appointments.
Another aspect to consider is the reductions in some benefits and medical studies that were originally covered by obras sociales or prepaid medical companies and that are suspended today. In these cases, patients turn to general medical providers even though they have coverage prepaid.
“The public system will always respond, although not always at the times the patient wants it to,” said an official associated with a hospital in Greater Mendoza.
Demand explosion in detail
Mendoza’s general hospitals recorded an increase in the demand for patients affiliated with them social business Or prepaid medical companies that come to receive medical care. Percentages vary but on average, in recent months the increase has continued to reach 45%.
“At Central Hospital, among the total number of patients admitted to emergency care, there is no difference from 2021 to 2022, bearing in mind that our hospital is the last link in the health chain, so all multiple injuries and severe neurological traumas, regardless of whether they are They have social work or not, they come in here The procedure is to be able to stabilize and if they can be transferred, ask to be transferred to their provider unit, this is what should happen, the truth is when patients enter here, said sources from the largest hospital in Mendoza They don’t want to leave.
“We’ve had an increase in consultations for joint patients on an outpatient basis. Bearing in mind that when you ask for an appointment that is made almost in almost all specialties, they ask you for a referral from a less complex health center or hospital and that you do not have work. Solidarity patients find there a candidate that the custodian does not have,” they explained and added, “The refusal to assign the outpatient clinic to patients who have social work is not a whim of the institution, but rather the requirement is so great that patients who have no other choice in their provider can be treated there, and that those who are not exchanged and who are not They have a choice other than public health, they also find an appropriate response.”
Hospital Teodoro Chistaco is a very complex institution that brings together medical services in the southern departments of Mendoza. According to the authorities, “for outpatient clinics, the demand by people who come for social work or paid medical companies has increased by 45% in recent months.”
A source from the south said: “The largest demand was registered in pediatrics, but the increase was in all specialties. During weekends and holidays, the situation becomes more complicated because the private system lacks guards and patients go exclusively to public responders for treatment.” Mendoza Hospital.
In the case of scheduled medical studies, the problem is growing because some prepaid medical companies have made cuts to their benefits, suspending some services, prompting members to head into the public system to do medical practices. “We suggest patients run the studies in their own particular effects because we prioritize patients who are not pooled because they have no other choice,” they highlight from Shestaco Hospital.
The Perrupato Hospital of San Martin brings together the care of departments in the Eastern Province. Based on a comparison of the 10 social business Which gets the most attention, Osip is noted to be in the lead followed by Pami in terms of outpatient care, custodial duty and hospitalization. The data could indicate a shortage of carers and care spaces for both social businesses leading to an increase in the number of patients attending the general hospital. In 2022, there was a 12% increase in outpatient care compared to 2021 and a 14% increase in phone calls.
In the case of Humberto Notti Children’s Hospital, pooled patient demand maintains a historical average of 40% in both hospitalization and outpatient care.
From Lagomaggiore Hospital, they report that 86% of people who almost completed shifts to get to clinics during March reported that they had no paid social work or medical company.
Despite the current economic crisis, many people continue to choose the private system for medical benefits or consultations. Nationwide, there are a total of 8 million members in the private order and there are about 17 million in the social opera. According to Ricardo Leloy, President of the Chamber of Private Medical Entities in Argentina: “70% of health care takes place through the private system and the choice of scheduled care within this system continues despite the decline registered by medical schemes.”
In this sense, they highlight from the private sector that “the demand in the private health system has increased above the natural growth of the population despite the impact of the incorporation of new coverage without financing, the increased participation in spending on medicines and the delay in updating quotas”.