Ismael Bermúdez
01/06/2021 13:48
Clarín.com
Economy
Updated 01/06/2021 14:05
In the midst of the discussion between the government and prepaid companies over the increases and the future of the sector, a detailed X-ray of the coverage of the country's health system shows where the majority of the population is served.
The system has three sources: the public, social works and private medicine.
According to the latest INDEC survey, "
33.4% only have medical coverage through the public system
", which is equivalent to 15 million people.
Of the rest, according to private sources, it is estimated that more than 55% of the total - about 25 million people - corresponds to national or provincial social works, including PAMI;
another 7%, to the prepaid via transfer of social works and 4.6% - about 2.5 million- to the prepaid with the payment of the voluntary contribution.
The INDEC clarifies that of the 33.4% that is only served in the public system, it is made up of 32.2% in the case of women and 34.6% in the case of men.
By age group, children and adolescents (up to 17 years old) prevailed with 42.9%, while this percentage decreased to 2.9% in the group of older adults (65 years and over).
97% of the elderly population has a social, prepaid, mutual and / or emergency service.
In the City of Buenos Aires,
the voluntary coverage of prepaid covers 10.9% of the Buenos Aires population
- some 330,000 people - while another 16.1% also receives prepaid medical attention for having transferred from the social work.
With coverage only from social work, 47.7% of the Buenos Aires population appears, 18.7% through the public hospital and 6.6% has contracted partial plans.
According to the latest AFIP data, in September, for the distribution of the collection,
the social works received $ 31,322 million
, another $ 5,680 million from the Solidarity Fund for Redistribution of the system, and the PAMI $ 15,322 million.
In all three cases, aggravated by the pandemic and the fall in registered employment, in real terms income fell and the system was granting compensation in relation to the income of last March.
As it is a private system that collects directly from its affiliates, there is no official data on prepayments.
Private medicine advanced hand in hand with the agreements with the social works, which intensified with the deregulation process, which began in the 90s. Basically, these are high-income employees who can access with the mandatory contribution to greater coverage or they are willing to pay the difference to have a higher plan.
In these cases, prepaid payments are deductible up to 5% of the net profit for each year from the income tax base, which alleviates the impact of the fees on the affiliates with the consequent fiscal cost for the State.
The prepaid family plans (marriage and 2 children) are around $ 15,000 per month and more than $ 20,000 for the "better plans".
There are also “corporate” affiliates by agreements of the companies directly with the prepaid entities.
However, due to the loss of registered jobs and the fall in the income of salaried workers and independent workers, which has dragged on since the beginning of 2018,
there were many disaffiliations to the private system
and the switch to lower, cheaper plans.
During all of 2020, prepaid companies were only authorized to increase the value of their fees by 10% from last December.
But the Government says that, with the pandemic,
the Health sector received extraordinary aid.
In addition to the ATP program, by which the State pays a part of the salaries of the companies in the sector, last March through decree 300/2020
the employer contributions
of the companies in the sector destined for the System
were reduced by 95%
Argentine Social Security System (SIPA), while
a lower rate was set
for the payment of the tax on debits and credits.
Those benefits reached social works, health insurance services –prepaid and mutual medicine-, hospitals, ambulatory care services performed by doctors and dentists, diagnosis and treatment services, and emergency services and transfers, among others.
Until October 5, without the ATP program, the fiscal cost of the measures adopted by the pandemic for the Health sector, as a whole, is $ 64,106 million according to the Congressional Budget Office (OPC).
The most important item is the $ 5,000 bonus for health personnel from the Public Sector and the Private Sector.
"
These grants were important, but they did not compensate for the increase in health costs that reached 54%
", according to Hugo Magonza, President of ACAMI (Civil Association of Integrated Medical Entities) and director of the UAS (Argentine Union of Health), according to a report presented to the Superintendency of Health Services.
For their part, the social works received other substantial funds, not from the State, but from the system itself.
During 2020, a total of $ 23,909 million as an “advance of funds” of the Unified Refund System (SUR) “for the applications submitted pending cancellation and for those submitted in the future”.
They correspond "to benefits with a high economic impact and that demand prolonged coverage over time" and which are financed from the Redistribution Solidarity Fund that receives a part of the contributions and contributions of the system.
In addition, they received $ 5,282.5 million for the fall in collection compared to March through the Emergency Fund that was created with money from the Redistribution Solidarity Fund that receives a percentage of the contributions and contributions of the system every month.
These transfers are not from the State but from the system itself.
NE
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