Today was very focused on the private healthcare sector in Argentina which includes both traditional insurance companies and prepaid plans that are negotiated with hospital networks. In the morning, we had a lecture with Dr. Florencia Ledesma who works for MEDIFE which is a large insurance provider/ executive union in Argentina. In the afternoon we toured ICBA (Institutio Cardiovascular de Buenos Aires) which is a part of Swiss Medical Group. Swiss Medical Group is one of the largest private medical providers in the nation and ICBA very much represents this profit orriented goal.

From the start several massive differences stood out between ICBA and the public hospitals we visited in La Mantanza and San Isidro. Firstly, the focus of ICBA was entirely cardiovascular focused while the other hospitals were all inclusive and offer a wider focused. Secondly, ICBA deals with more chronic issues such as heart conditions while San Isidro and La Mantanza have a drastically different scope of problems. San Isidro was more community oriented while La Mantanza was almost entirely trauma oriented. Physically the building was drastically different. ICBA resembled many top-quality American hospitals and had what can only be described as luxury accommodations while the public hospitals placed a premium on maximization of resources and space.

I think the biggest differences between the private and public hospitals is the way they are actually able to provide healthcare. ICBA is the cutting edge of cardiovascular care in Latin America. Every possible resource is available and there is never a concern about payment or lack of supplies or staff. ICBA runs like a business and when discussing the way, the hospital is run administrators often refer to data tracking, KPI’s, or cost efficiency. This is not the case in the public sector and if I have learned anything on this trip its that efficiency has many different meanings. In the private sector efficiency refers to business efficiency in a manner that maximizes profit while minimizing cost. In the public sector, especially La Mantanza, efficiecy also refers to minimizing cost but it more refers to maximizing available resources and staff. In the public sector the goal is to provide the best possible care in the quickest possible manner with the least number of resources because the resources simply don’t exist.

The public health care sector in Argentina is tasked with the nearly impossible job of providing healthcare to 44 million citizens depending solely on funding that comes from the government and resources that are in short supply with technology that is antiquated. While healthcare is equal in Argentina because everyone has access, it is not equitable because those who are able to pay have a sizable advantage both in quality, locations, and outcomes. In La Mantanza for example the primary patient is suffering from trauma such as gunshot wounds, stabbings, or assault. The hospital services 2 million citizens many of whom have no ability to pay and no type of insurance coverage and is constantly facing staffing and supply issues. This is not the case at ICBA where the staff are well paid, the facilities are luxurious in design and amenities, and the issues are chronic in nature. ICBA and La Mantanza represent two distinct Argentinas and two distinct approaches when it comes to medical care.

(ICBA procedure room)

(La Mantanza waiting room)