Today was filled with lectures and hospital visits. We started off the morning with a lecture from the past Minister of Health of Salta. She taught us about how the system is organized differently in that province because it is more rural. Salta is one of the poorest provinces of Argentina and that poses many challenges. Because of the geographical area Salta is in, access to health care is extremely difficult. She described how some people would have to travel 10 hours on horse to gain access to a hospital. In the public sector of rural provinces the largest goal is to find ways to bring resources to these areas.

Our next stop was the public hospital Fernandez. This is the most recognized public hospital in Buenos Aires.  Here we were taught about how a public hospital is managed and organized. This hospital was originally built as a Syphilis Asylum and was later modernized as a bargaining chip for the World Cup to be hosted in Buenos Aires. He further explained this idea of budget issues that are present all throughout the system. It proves to be rather challenging to make a budget for a broad amount of people. He showed graphs of how far people travel into the city to be seen there. This circle was far beyond the lines of the city. This is extremely hard to manage and predict how much allotted funds need to go where. Another major issue is they have no control over their total budget. The government sets the amount and they don’t get much say as to how much they get. After our meeting we met two fifth year medical students who were interested in our education. They even told us they just had a class on our healthcare system the other week. We then had a tour of the hospital. This was nothing like hospitals in the United States. The last time it had been renovated was the 90s and it is slowly being updated. It was cool to see all the advancements they were beginning to use. Our guide expressed that with the help of his private organization he was able to fund a new dialysis room.

After our tour we got in the vans and headed over to lunch. Once we all ate we walked to Swiss Medical to have a lecture and tour a small part of the hospital. The issues faced in the public sector and private were proven to be quite different. Instead of just allocating the funds like the public sector does, they had a focus on increasing value and improving care while cutting costs. He kept mentioning cutting down medical waste and increasing the quality of the care they give. This is under the payer vs. provider struggle. They have to try and make money while also not gauging prices. Part of this is maintaining occupancy. He said normally almost all of their 250 beds are allocated for, everyday. His model definitely was more business focused and not as much care focused. The lecture wrapped up and we went upstairs to tour a room. This hospital looked just like a nice hotel. It was nothing like I expected. Each room has an entire separate living room and bathroom, both of which looked like a fancy hotel. Other things included a large TV, pull out couch, and a room service menu. One major difference between a private hospital and a hospital in the US is that everything is included. Instead of being charged for every med and it being billed to your insurance, you pay a flat rate and unless the use of an expensive med or piece of technology is required you won’t be charged for anything else. He described this saying it is important to make going to the hospital easy, if it is expensive they will just push it off and say they aren’t that sick. Today was very interesting to see the very different management techniques and design of the hospitals. Tomorrow there is a general strike, so I am interested in seeing what the future holds.