2023-06-18 03:30:00
The health situation in Río Negro and Neuquén was once again in the news, due to the increasing flight of medical professionals from the orbit of the obras sociales, due to delays and failure to update payments, which results in a drop in coverage and quality of care, a growing economic cost for patients and greater pressure on a public system that was already in clear deterioration.
The main reason for the current crisis has It is the inflationary acceleration in the country, where the values that social and prepaid works agree with health providers are quickly out of dateadded to the long payment terms (30, 60, 90 days) that in a context of average price increases of the order of 7% per month, this implies a reduction in what providers receive. Added to this are the periodic currency runs, which in a sector where inputs, devices and medicines have their prices in dollars, aggravating the distortions between costs and financing.
In this way, the payment of “coinsurance”, “plus” or attention in a particular way, with an uncertain promise of “reimbursement” in an imprecise future, has gradually become the norm. of the system, harming lower-income users more. Every time more professionals decide to leave the systems and attend in a private way, which leads to the de facto privatization of health, because patients continue to have discounts from their social work or prepaid, but in any case they must pay an extra or all the attention. On the other hand, as a form of response, several health entities went from agreements with professional associations to direct contracting of doctors, reducing the supply and often overexploiting human resources. The quality of patient care has been reduced, with 15-minute shifts, overshifts, long waits at receptions and the reduction or elimination of guards and emergency care in the main private clinics in the region.
On the other hand, the increase in the cost of care in the private sector has generated a migration of patients to hospitals and primary care wards, increasing the pressure on a public sector that was already saturated and with serious problems of lack of professionals and infrastructure. enough, even before the pandemic.
It is not an exclusive problem of Río Negro and Neuquén. Medical entities, social works and even private companies from all over the country have warned about the crisis in the health system. Added to the inflationary imbalance are structural conditions, such as the lack of professionals and medical residents in critical specialties such as pediatrics, general medicine, medical clinic, intensive therapy, gynecology, obstetrics and surgery. The extension of the races (up to 12 years of training) bad working conditions (extensive 24-hour guards, moonlighting, building deficiencies, assaults and mistreatment) low wages y the option for more profitable specialties and with better conditions for a life project, the supply of professionals for these critical areas has decreased, as well as the availability of residents, often the most visible face of medical institutions. Even populated and better-income provinces such as CABA, Buenos Aires, Santa Fe and Córdoba fail to cover charges. The situation also encourages the flight of professionals abroad, where better economic and working conditions tempt many.
Despite the fact that the problem is dramatic and affects almost the entire population, it occupies a marginal place on the agenda of politicians, without distinction. There are several proposals to reform the system: towards a national public health insurance, others with a greater incidence of the private sector, to improve the transparency and integration of management and financing, to reformulate university degrees, but they have all been boxed in by an inactive Congress. And while the political class debates lists and candidacies, the population suffers the collapse of a system that will have irreversible consequences for the future of our population, especially the most vulnerable.
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