Today a former employer of the Ministry of Health, Guillermo Williams, came to speak to us about what the Ministry of Health does and more about how the government works. Much like the United States, Argentina is also a federation of provinces, or states. However, their provinces have a much stronger autonomy than our states.
Dr. Williams explained that while in the U.S. the federal government could create and apply laws to all states, this is not how the Argentinian central government functions. Here, the central government can create a law that is then suggested to each province. It is up to the province to then implement that law or not. This creates a much stronger challenge in regard to health care because there is no unity to the way things are run. As we have learned in the past week, the Argentinian healthcare system is extremely fractured, and this had shed a lot of light as to why. When the government has virtually no power over the provinces, of course there is no unification of one healthcare system. The country is to an extent, just several smaller countries with the same name. This also can be an issue in regard to the quality of care between provinces. While the Ministry of Health can build hospitals, as soon as they are done, ownership is given to the province or municipality. Funding is also mixed between the central government and the province, so richer provinces will have more money to put into the public hospitals and may therefore have more care.
On the other hand, however, the federation can be useful because each person will have more say over how the laws affect them. Rather than a few representatives voting a law in for all people, each province gets to decide what’s best for its citizens, which are far fewer than in the country as a whole. It also allows each province to specialize its healthcare to its citizens and their wants and needs.