Day 10 in Buenos Aires! Today we had a meeting with Dr. Josefina Medrano, who was the former minister of health in the province of Salta during Covid-19. She was the first female minister of health in Salta. During this meeting at Austral, we learned about the healthcare system in more rural areas outside of Buenos Aires, such as Salta. It is difficult for the people in Salta to access healthcare because of the rough terrains like mountains and rainforests. Physicians in Salta often have to travel by horse to reach their patients/hospitals, which takes hours. Dr. Medrano also told us about her experience working as the minister of health right when Covid-19 started, and the decisions she had to make. After our first meeting, we then had a tour of Hospital Fernandez, which is a public hospital. We spoke with Dr. Previgliano, the former director of the hospital. It was named after Juan A. Fernandez, the first medical doctor in Argentina. This hospital has around 400 beds, and has 2229 staff (529 nursing staff). During the pandemic, the hospital had all beds under internal medicine doctors, and medical staff was increased from 28 to 49. We learned that this hospital has very low mortality rates, and their services are much cheaper than most average hospitals. We toured the ICU and the Covid-19 departments. We then visited our very last hospital, Swiss Medical, which is a private hospital. Swiss Medical is one of Argentina’s leading prestigious private healthcare providers, offering prepaid health insurance plans and operating a network of modern hospitals and clinics. Known for its high-quality care and advanced facilities, it mainly serves middle- and upper-income patients who can afford private coverage. Inside, we got to see an active operating room, an ER patient room, and several private patient hospital rooms. After finishing up all of our tours, we did some shopping on Florida Ave. and had empanadas for dinner!

The social gradient in health can be seen in both the United States and Argentina. The social gradient in healthcare refers to the concept that health outcomes improve as social and economic status increases, which means the lower a person is on the social ladder (in terms of income, education, or occupation), the worse their health tends to be. In United States and Argentina, people with higher income and education, often have better access to healthcare. Private healthcare systems offer higher and faster quality service. This systems favors those who can pay. Additionally, in both countries, urban residents typically have better access to healthcare than rural populations. Despite these many similarities, there are also many differences. In Argentina. access usually depends on employment status due to workers getting coverage through Obras sociales. Informal workers rely on underfunded public hospitals. Provincial differences can also dramatically affect the quality of care that patients can receive. In the United States, we do not have universal healthcare system like Argentina has, so citizens do not have the choice of free healthcare. Lack of insurance in the U.S., often leads to limited access and delayed care. Lastly, healthcare is largely commodified, with extremely high costs for services and medications. In short: The poorer you are, the more likely you are to experience illness, have shorter life expectancy, and receive lower-quality healthcare.