After another quick bus ride, most of the day consisted of meetings with extremely important people in the Argentinian healthcare system. To begin, we heard about the public healthcare system from Dr. Daniel Ferrante, the current Deputy Minister of Health of CABA. This was a huge honor to be able to listen as he explained the complexities of the public health system and its extensive history. This meeting took place in the Palacio del Gobierno, which was very beautifully decorated. Next, we met with Dr. Gabriel Leverstein, the current director of the Obra Social de Comercio, the largest union in Argentina. This was extremely informative on the role of unions in the Argentinian healthcare system.
In his presentation, Dr. Leverstein covered the ten most problematic topics within Argentina’s healthcare system. As he explained it, the role of the Obras Sociales (unions) is to represent workers and provide health insurance to those covered under the union. All other insurance coverage is grouped under HMOs (funded by 9% of individual salaries), which covers roughly 12 million people within the population of Argentina (out of roughly 45 million). Similar to the minimal essential coverage under the Affordable Care Act in the US, Argentina has a medical benefits program, PMOs, that list the legal services in which health insurance has to cover. This is regulated by the federal government. With the way the Argentinian healthcare system is structured, people are allowed to switch between various types of insurance to suit their needs. This issue, referred to as “adverse selection” occurs when people join higher funded plans when they are ill, and then switch back to a cheaper plan after they have received a higher quality treatment. This puts a strain on the system’s ability to be accessible for everyone; when one thing is made free, fees in another area of the system must increase to compensate. The PMO is only allocated a certain budget; when only the richer population can cover an increase in coverage costs for this reason, poorer populations fall behind and are left with lower quality and availability of care in areas that are not protected by the PMO. This was referred to as “increasing the social gradient.”
Currently, the president of Argentina, Javier Milei is attempting to cut what is deemed “nonessential funding” towards services that would normally be insured under Argentina’s healthcare system. This includes people using coverage for plastic surgery, nonessential drugs, and extensive disability care. As more people are funding these services, money is not allocated efficiently to public hospitals and primary care centers, causing lower salaries for physicians and staffing issues. Lastly, we spoke with Dr. Luis Gimenez, the past Deputy National Minister of Health (2017-2019), about policies he was attempting to enact during his term. His goals included implementing universal health coverage (UHC), reforming drug and medical device policies, and lowering childhood obesity within Argentina. Part of this plan worked to increase interoperable electronic health records. In other words, people from any area of the country have health records and any facility around the country they chose to receive care. It also worked on giving access to all people regardless of socioeconomic status and setting a fixed capita for services (base pay per patient). This was super interesting to talk about and I am so thankful to have been given this incredible educational opportunity. Hasta mañana amigos.
