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Pros and cons of directing contributions directly to a prepaid plan without going through a social work

2024-02-20T09:21:18.236Z

Highlights: Draft regulation of DNU 70 on the deregulation of the social work system began to circulate last weekend. Patients will have the possibility of choosing whether they prefer to direct all their contributions to a prepaid plan or to a social work. The Government affirms that this new responsibility assigned to prepaid companies is nothing more than putting them on an equal footing with social works. The question is who will be able to choose at a time of unleashed inflation, when the pocketbook is tighter than ever, sources from the Superintendence of Health Services said.


It is the possibility of election that enables the regulations of DNU 70. It could mean a reduction in the cost of the fee, but that is not clear and there are benefits that would be lost. Both the unions and the prepaid companies are dissatisfied.


When the draft regulation of DNU 70 on the deregulation of the social work system

began to circulate last weekend

, both the Government and some prepaid companies highlighted that the elimination of the intermediation of social works to derive contributions directly to a prepaid one could mean an

economic benefit

for people.

This was reported by

Clarín

last Saturday.

But that argument, as the hours passed and the appearance of new elements contained in the regulations, entered a cone of shadow.

It was when another element of the rule was highlighted from the prepaid companies that would charge them

a new cost

: now they will have to deposit 20% of the total contribution received to the Solidarity Redistribution Fund, instead of the tax affecting only a part .

This Fund is the one that, in theory, is used for the

highest cost drug treatments and coverage

for the system.

But in recent years, the destination of that money, as explained by the private health system, was largely absorbed by the demand for

disability expenses

.

The owner of a medium-sized prepaid company told

Clarín

about the experience that Uruguay had in another era with this same problem, and the mantra that was later repeated: “Never put resources in an opaque fund that does not have protocols that say what they are going for.” to spend those funds.”

The same businessman added: “This Fund was always managed in

a political and discretionary manner

.”

The Government affirms that this new responsibility assigned to prepaid companies is nothing more than putting them on an

equal footing

with social works.

That is, they pay taxes to the Fund for the entire contribution they receive and not just part of it.

Anyway, the point is that now the prepaid are highlighting that instead of the beneficiary seeing his fee reduced by contributing directly to the private system,

the cost of the fee will probably rise

when the new disbursement arises.

Patients will have the possibility of choosing whether they prefer to direct all their contributions to a prepaid plan or to a social work.

Photo: Shutterstock

In this context,

what will be the motivation

that members will have to stop triangulating their contributions with a social work and send them directly to a prepaid one?

The DNU enables this possibility, which will have an

adaptation period

to start operating in a month.

“The prepaid plan will have a greater range of plans that will be made available to the beneficiary.

The idea is that, that there is more supply.

Lay the foundations to have a

more equitable, more supportive and better competitive

system,” sources from the Superintendence of Health Services (SSS)

told

Clarín .

The question is

who will be able to choose

at a time of unleashed inflation, when the pocketbook is tighter than ever.

The SSS source admitted that in the current economic context “there are going to be many people who

will drop out of prepaid

, that is a reality, but when the situation stabilizes Argentines will have more and better offers.”

The Government also emphasizes that the system “is today

completely unbalanced

” and asks: “How can it be that the most expensive prepaid is also the one with the largest number of affiliates?”

-in reference to OSDE- to add that "what is normal in a balanced market is that those who charge more have a minority portion of that market."

From the prepaid companies they cannot fully determine whether this regulation

benefits them or harms them

.

In fact, they tend to be more convinced of the latter, while those in the union sector believe the same due to the fact that Argentine employees

should no longer be captive

of the social work to which they currently belong due to their activity.

“If the criticism comes from both sides, the norm must not be so bad,” the Government ironically says.

"Rubber stamps" and real social works

On the other hand, we must distinguish between the so-called

“rubber stamps”

, which are social works that do not provide any service and only serve to triangulate contributions with a prepaid payment, and social works that

have members

and provide both health services and social.

The Government calculates that the DNU regulations will end with a business of "5 billion pesos per month", which is the money that - they claim - today those "rubber stamps" keep.

But the prepaid companies do not celebrate it as much: “Ending rubber stamps was a

historic demand of the union social works

,” they remember.

The unions, for their part, at least to the outside, consider that the initiative is

a political affront

by the Government and another chapter in a strained relationship from the beginning, the product of two antagonistic political paradigms.

The paradox is that the crisis, with 57.4% poverty and the unprecedented phenomenon of the growing mass of poor wage earners, may end up transferring

more ups than downs

to social works.

With 57.4% poverty and poor wage earners, the freedom to choose is reduced.

Photo: AP

Given this scenario, the only certainty from the publication of the DNU regulations in the Official Gazette is that the beneficiaries will have the

possibility of choosing

, depending on their personal finances and priorities, between continuing to triangulate their contributions or using them for the direct contracting of a prepaid.

It is likely that those who triangulate with social works that do not provide services will find it convenient for that money from the intermediation

to go directly

to the prepaid, to choose the plan that best suits their needs and pocket.

On the other hand, those who have a

social work with benefits

as an intermediary must consider whether they are useful: for example, coverage that prepaid companies sometimes refuse to provide and the social work provides, or certain social and tourist advantages that may Add.

The most pragmatic

beneficiaries will surely move within that margin

.

Then we will have to consider the most ideologized group of Argentines, on both sides of the rift.

From those who pay allegiance to unionism to those related to the now classic official brawl that cheers for freedom.

P.S.

Source: clarin

All life articles on 2024-02-20

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