Francisco Zappone is 80 years old, lives in Avellaneda and has been a member of the ASE social work for 60 years.
He emigrated from Italy, at 18 he became a bus driver on Line 98 Expreso Quilmes SA and had 20 of his own buses, when it was a free activity for entrepreneurs in Argentina.
"He worked all his life, he never changed his social work and I refuse to discharge him because my grandmother and my brother died in a public hospital with very poor care. My father gave his life and health to this country. He does not deserve a quota that he cannot pay, the
last bill is $550,000
," his daughter, Laura, told
Clarín
, who has already contacted a lawyer to file an appeal to stop the increase.
There have already been at least five rulings in favor of prepaid members who cannot afford the weight of the updated fees of recent months, which exceeded a 100% increase.
Only in March they rose up to 23%.
At the same time that these days more and more filings are accumulating in the federal courts, among the retirees who have not yet acted, concern (or hope) arises as to whether a class action lawsuit would be possible that would lead to a general brake.
"There is no
class action
in Argentine Law, and since (prepaid contracts) are agreements between individuals,
that
individual is the only one who can feel aggrieved and through that grievance present an exceptional remedy that unfortunately in Argentina has become ordinary , which is protection,"
Eugenio Semino, the Defender of the Third Age, explains to
Clarín .
Semino receives between
300 and 400 calls and emails per day at the Ombudsman's Office
with cases of retired and pensioned members who cannot afford the increases in their prepaid payments.
The context of this cataract of protections is that
DNU 70
changed the operation of private health and did so for everyone equally.
The articles of the prepaid law that gave the Superintendence of Health Services the power to regulate the cost of the plans were repealed.
In addition to freeing the contributions of each member from having to go through union social works, it allowed prepaid medicine companies
to adjust their quotas without official mediation
: each one today can impose the increase percentages to suit itself, to compete freely. by clients.
The only requirement is that they must notify their members of the increase 30 days in advance.
"There are judges who have granted precautionary measures, which is what is important so that the latest increases are not collected, and many other judges who, in the case of retirees, have not accepted the precautionary measure, because they consider that these older people, such as "What happens in most cases, they may have an alternative health system to prepaid, such as their social insurance or PAMI," says the expert on the problems of this age group.
The problem, he indicates, is that the judges, although they give rise to the claim,
are not ruling on the substance of the matter
, "which is that this group cannot add the quotas to those values", but on an "immediate measure." , to stop collection and prevent members from being left without health benefits while the major problem is resolved.
The protection is an essentially precautionary tool, which must be resolved in a matter of days.
That makes it an extremely useful but, at the same time, temporary measure.
In general, when it is granted,
the brake on increases is for six months
.
The prepaid medicine company is ordered to re-invoice the fee through the Salary Variation Index, based on the amount it collected in December, prior to the DNU.
Semino, as he told
Clarín
, in the next few hours he will meet with the Secretary of Commerce about this issue.
"We have already spoken with Consumer Defense, to see how these increases could be arbitrated in the case of retirees, who often have a low-cost prepaid payment, which they pay themselves or are helped by relatives who can no longer do so. Because although they may have PAMI or a social work that does not charge them any extra, the benefits have not been provided in a timely manner for more than a year."
Prepaid in these groups, he explains, which operate in a
mix
of health care – for example, with greater discounts on medications via PAMI – works like "a spare wheel."
If they fall out of the private system, they go exclusively to a public system that is already stressed even for on-call care.
The
delays for appointments for specialties
, which continue to average 3 months, and for imaging studies, threaten the health of those who statistically need to attend consultations and reach diagnoses more frequently.
The Ministry of Health did not take a position at the moment on these issues.
Although it may seem like it, between affiliates and prepaid companies, Semino details, technically, there is no commercial contract.
"It's a matter of public health," he concludes.
MG