Today started off with a trip to IES for a presentation from Flor Ledesma. While she spoke a lot about aspects of the healthcare system that I felt I already understood such as the three sector system and the roles of each one. However, she went into greater detail about the unions that I hadn’t put together before. I learned about Medifé, which is one of the major national Obras Sociales in Argentina. Medifé is a private insurance company, but it also works directly with ASE, which is a union for the executives that provides them with private medical coverage such as Swiss Medical. Medifé is a complex company with over 60 branches that serves over 300,000 associates, and I found it interesting that some people get Medifé coverage on top of their union just to have more access and a wider range of healthcare facilities.

After Flor Ledesma’s presentation, we went to the hospital ICBA which is a private instituation that specializes in cardio. ICBA was founded by only 2 physicians in 1978, but now, they have over 250 physicians and 166 nurses. When the hospital first opened, it was composed of independent departments where physicians ran their own practices. Later, from 2001-2013, the departments became guided. However, there was a lot of financial pressure to keep the hospital from going into bankruptcy. Currently, the hospital system runs on a patient-centered model with disease-oriented programs. ICBA did seem to be more exclusive to patients with Medifé or Swiss Medical coverage because when asked if they would ever provide care to public patients in need of more care, the presenter said that it’s not customary for that to happen. During the COVID pandemic, however, they did agree to take a patient who needed higher care that the public hospital did not offer. After the management presentation, the nursing manager gave a presentation on nursing professional practice at ICBA. I really appreciated this presentation because I feel that it was the first of its kind on this trip. The nursing manager spoke about how nursing practice was based off of the Cleveland Clinic’s model which includes going on rounds, implementing an open-communication model, and the usage of a whiteboard in each room to maximize patient teaching. On top of these tasks, the nursing team also meets every Tuesday to go over and reflect about what can be improved on each unit. Learning about the nursing system was very intriguing to me, but it was clear that nurses in the United States have more rights and responsibilities in the healthcare system.