Federalism is the dispersion of political power among various levels within the state. In Argentina, power is divided between the National, Provincial, and Municipal levels. This goes further in the public health system with sanitary zones.
Today, we visited a provincial hospital in La Matanza, the largest public hospital in the province of Buenos Aires, adding to our knowledge of the public sector from our visit to a public municipal hospital a few days ago. The Hospital in La Mantaza has 2 million people that rely on it, within a very low-income and violent neighborhood where car accidents, stabbings, and other attacks are common. They become very overwhelmed by trauma in their emergency department and specialize in highly complex patients.
However, we also learned a key difference between municipal, provincial, and national levels of health care delivery. There are municipal hospitals that get most of their funding from local taxes, so the wealthier neighborhoods, such as San Isidro, have very nice hospitals, while a municipal hospital in La Matanza would look a lot different. The municipal hospitals/ services are then additionally subsidized by funds from the provincial level and from some national programs, such as relief for patients with diabetes.
On the other hand, provincial services are paid solely by the provincial ministry of health, so there is more equity throughout each province, but it differs between provinces based on politics. Although another factor in each hospital’s income is whether the patients have additional insurance, it also depends if the hospital has the ability to bill their insurance to get paid for the services they perform.
Due to the differences in funding, we noticed that the municipal hospital of San Isidro was much nicer than the provincial hospital of La Mantaza. San Isidro was noticeably cleaner/ nicer and had more up to date technology than the provincial hospital.
