Today was split into two very distinct parts. In the morning, we had a tango lesson and learned more about the culture of Buenos Aires. Then, in the afternoon we visited a public university and hospital in the neighborhood of La Matanza and discussed the role of federalism in the Argentine healthcare system. Like the United States Argentina has a federal system, and the system is broken into three levels. The national level, the provincial level, and the municipal level.
Within the public healthcare system in Argentina provinces receive money from the Ministry of Health. The provinces then distribute the funding as they see fit to the various municipalities and in some cases, they provide healthcare themselves in the form of a provincial hospital. The hospital we visited in La Matanza is one of these provincial hospitals as opposed to the hospital we visited in San Isidro which is a municipal hospital that is managed and run by the municipality of San Isidro. Both hospitals are public hospitals, and they provide healthcare to all citizens for free, but the hospitals are run by different levels of Argentinas federal government. The main difference between San Isidro and La Matanza is that San Isidro is a very wealthy neighborhood so the tax base from the citizens of San Isidro is able to pay for the hospital which is why it is a municipal hospital instead of a provincial one.
The tour of the hospital in La Matanza revealed several flaws in healthcare outcomes in Argentina. Firstly, with the neighborhood there are only 3 hospitals to service two million citizens. The neighborhood itself struggles with poverty, violence, and rising cancer rates along with deep economic issues stemming from the informal work that most citizens of La Matanza do for a living. Only twenty percent of the citizens have insurance coverage that is provided by their employers, so the rest of the population relies on three hospitals for all of their healthcare needs. The municipality cannot pay enough in taxes to pay for it own healthcare system like San Isidro so they rely on provincial funding for their healthcare but, the current national government which distributes funding to the provinces is drastically declining its healthcare expenditures so the hospitals in La Matanza are struggling to acquire resources that hospitals in wealthier neighborhoods like San Isidro have access too.
In summary the federalist system in Argentina reinforces the social determinates of healthcare by exposing poorer neighborhoods to the ebbs and flows of the national streams of funding while asking them to provide service to large portions of the population who don’t have any form of healthcare coverage yet rely solely on the provincial hospitals for all of their healthcare needs. The federalist system works great if you live in a neighborhood like San Isidro where the tax base can make up for the shortcomings in the provincial funding, but for poorer neighborhoods like La Matanza it leads to underfunding and shortages in communities that desperately need healthcare that is accessible, responsive, and ultimately preventative in design.
