Ensuring Medical Care Equality: The Case of Walter Matías Rosales and the Argentina-Bolivia Health Reciprocity Agreement

2023-09-15 21:46:00
Walter Matías Rosales, was a musician and traveled as a backpacker

Matías Rosales was a 30-year-old young man from Neuquén who died after being stabbed in Oruro, Bolivia. His family alleges that emergency teams discriminated against him and denied him the care that could have saved his life. The case is being investigated. According to an agreement signed by the governments of Argentina and Bolivia on July 4, 2023 – and to which Infobae agreed – Rosales and any Argentine citizen must be guaranteed medical care in the Bolivian health system.

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Furthermore, the government of Luis Arce committed in the aforementioned agreement to disseminate in a “constant and permanent” manner that the citizens of our country must be treated in Bolivian hospitals, receiving the same treatment that Bolivians receive in hospitals. of the Argentine public system. The understanding is in force, and was signed by Foreign Minister Santiago Cafiero and his Bolivian counterpart, Rogelio Mayta Mayta, during the recent meeting that the MERCOSUR countries had in the city of Puerto Iguazú, in the province of Misiones.

The agreement, in turn, is the ratification of a policy that the two countries committed to putting into practice in 2019. On that occasion, the former Argentine Secretary of Health, Adolfo Rubinstein, signed an understanding with the same content, together with the then minister Gabriela Montaño, former official and trusted leader of Evo Morales.

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In this way, both the management of Evo Morales and that of Luis Arce committed to the proposal of the Argentine government to eliminate any vestige of discrimination or reluctance to provide care to Argentines who need medical assistance in the neighboring country. “The parties will carry out a constant and permanent dissemination of the 2019 agreement and the present one, in order to ensure adequate knowledge of its provisions, scope and obligations to ensure its effective compliance,” indicates article 5 of the document.

Detail of the health reciprocity agreement signed by Argentina and Bolivia in July 2023

The provisions are nothing other than the demand for free care in the case of emergencies – which are defined as any clinical condition that requires urgent health care to alleviate suffering – and emergencies, understood as those conditions that involve risk of life. It is also highlighted that the medical response must be given regardless of the “immigration status”, that is, it does not matter if the person who needs care is a resident or is in the neighboring country for a circumstantial trip. In any case, it must be assisted.

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The reason why the governments of Argentina and Bolivia celebrated the reciprocity agreement had its recent origin in a proposal made by the government of Jujuy, when its governor, Gerardo Morales, made public his displeasure over the inequality of treatment in both systems of health. This position, which generated controversy in 2018, led to agreements first at the district level, and then between national states. However, there are precedents from 2015 and up to 1978 in which Argentina and Bolivia tried to agree on joint care policies for their populations.

However, both from the northern province and in the case of former and current national management officials acknowledged to Infobae that the application of the agreements is, at the very least, deficient on the part of Bolivia. “Since Evo Morales left, the government has no longer fulfilled itself, and I resumed my duties two months ago and I am going to demand that it be fulfilled again,” said the Minister of Health of Jujuy, Gustavo Bouhid. In addition, the official highlighted that the investment made by Jujuy, a border province, in the care of foreign citizens in the public health system is important in the area’s total budget.

The process, however, seems delayed. After the first signature in July 2019, the next meeting of officials to advance effective compliance with the reciprocity agreement took place on July 14, 2022, when a mixed commission was met with Argentine and Bolivian authorities to ensure that the system health system guarantees citizens mutual attention.

The former Minister of Health of Bolivia, Gabriela Montaño, and the former Secretary of Health, Adolfo Rubinstein, signing a reciprocity agreement in La Quiaca, in 2019

In parallel, cases are periodically known in which Argentine citizens suffer the consequences of the rigidity of the Bolivian health system. On July 11, 2022, Salta teacher Alejandro Benítez suffered an accident in Cochabamba, where he was on vacation. His family reported that emergency teams demanded money before providing assistance. He finally died. The governor of Salta, Gustavo Sáenz, repudiated the fact, which he described as unacceptable.

In December 2018, another Argentine, Manuel Vilca, a musician from Jujuy, was the victim of another accident, also in Cochabamba. In this case he managed to be assisted in a semi-private health center, but his family had to resort to a public opinion campaign since the hospital demanded a sum of more than 10 thousand dollars after his hospitalization. The government of Jujuy assisted him and then denounced “the inhuman treatment” that Argentine citizens receive in Bolivia in these cases.

An Argentinian was stabbed to death in Bolivia and his mother denounces abandonment of the person

The death of Matías Rosales revived the discussion. The Argentine ambassador in Bolivia, Ariel Basteiro, requested information from the Bolivian Ministry of Health about the possibility that the young man from Neuquén has been a victim of abandonment. “The Consul General contacted the Bolivian Foreign Ministry to inform that there would be new data that could indicate that Matías had not been assisted in a timely manner at the time of the incident,” says the statement from the consulate in La Paz, capital of Bolivia.

The police report maintains that Rosales died in public. However, both his girlfriend and his mother claim that he arrived with vital signs at a Health Center where they denied him care, and he died on the sidewalk.

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