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COUNTRY PROFILE: ARGENTINA
to the decrease and delay in the payments of the public
insurance. By 2004, this national structure of small and
medium-sized health companies, is facing the biggest
economic crisis in its history and the real danger of
collapse.
➜ Both sectors (state and private) have serious problems
caused by tremendous demand on the one hand and
low performance of the available resources on the other.
Also, the elevated cost of medical supplies (medicine,
disposable material, prosthesis, equipment, etc) affects
the possibility of offering health care services at its
historical level of quality.
➜ Both sectors (state and private), face the challenge of
re-emerging pathologies that we believed were
extinguished and forgotten and that today are now
increasing (infantile malnutrition, perinatologic diseases,
maternal mortality, tuberculosis, leprosy, parasitosis,
AIDS, Dengue Fever, etc), together with the traditional
illnesses of the ‘developed world’ (cardiovascular
diseases, cancer, accidents, etc) that nevertheless
continue being the main cause of morbimortality in
Argentina).
➜ The high cost that families have to bear, reflects the
inequity and inefficiency of the health system, since it
punishes the less protected and vulnerable.
Trends
To combat the situation outlined above, the national
government has called a round table conference that
involves all sectors of society including our Association.
The national health department organised the creation of
a crisis committee whose duty was to directly advise the
Minister of Health about the essential issues related to the
improvement of the crisis. This committee was formed by
representatives from all sectors of health and was
instrumental in developing the measures that were being
taken, and together with the work of the provinces through
the Health Federal Council (COFESA), they provided
materials and information for the creation of the Health
Federal Plan.
As its principles set out, the Health Federal Plan,
establishes a programme or project that is to be carried out
over the course of the next few years; specifically, it is
planned for the four-year period from 2004 to 2007.
To achieve its goals, some reforms are going to happen
over time, avoiding the easy or urgent solutions. The plan
mainly involves a cultural change: integrating the subsectors
where the health system is fragmented; creating one
health system that could improve the equity, accessibility
and financing; putting emphasis on primary care and on
prevention and promotion.
All the indivuduals that belong to these sectors know
that, in the way, they are traditionally answering to
Argentine’s geographical and social characteristics and to
the people’s idiosyncrasy that says it cannot think of a
system that excludes some of its parts. Specifically, the
Health Federal Plan recognises and includes the private
sub-sector, with its technical capacity in physical resources,
structure and human resources, to complement the actions
of the state sub-sector.
Health service suppliers, always based on the Primary
Assistance Strategy, will create mixed assistance ‘Sanitary
Networks’, formed by human and material resources
(laboratories, assistance centres, surgeries, clinics and
hospitals) coming from the state sub-sector and the private
sub-sector. These networks will be in charge of different
populations; people will have access to medical assistance
with an organised transit through the different levels of
complexity, organised by primary assistance doctors (head
doctors).
For a long time, our associations – the Argentine
Confederation of Clinics, Sanatoriums and Hospitals
(CONFECLISA), the Argentine Chamber of Health
Enterprises (CAES) and the Latin-American Federation of
Hospitals (FLH) – have worked to make people aware of the
strange structure of the health system (it is not an only one
system, it is formed by both the state and private subsectors,
both in its organisation and in its financing system).
A sectorial or isolated solution is not possible, all the
resources and efforts of both parts must be united to face the
crisis. In this way, we have been working intensively with the
Health Department to create emergency plans based on
mutual cooperation and the fundamental concepts of the
Health Federal Plan.
This fragmentation of the Health System works against the
quick response that people need, that is why it is necessary
to urgently unite the goals between the sub-sectors that
form it.
Challenges and proposals
We want this Health Federal Plan to become a Health
Federal Law so that it can really turn into a state policy. We
know, that as a health private sector, health care is a public
service which requires the convergence of all the existent
resources, whether state or private. This means that all the
resources created by civil society must be rationally used to
create sector equity and to assure the accessibility of all the
population to health care.
The specific offer of our organizations is to help articulate
the thoughts of both sub-sectors, under the modern forms
of the health management, and not under the simple figure
of contribution or complement to the services.
The concept of the ‘health citizen’ must go beyond the
‘treatment of the disease’, and be based on the prevention
strategy and giving precedence to the primary care organised
in integrated networks.
The way of financing the health assistance must also be
reconsidered, since the current one, mainly based on
deductions for health at work has proved to be inadequate
to assist all the population.
In short, the answer to the crisis is, as far as our sector is
concerned, a proactive attitude: the organisation, the
training of human resources, the management of
improvement, the quality programmes, the health services
accreditation, and the struggle to make the health assistance
a state policy, firmly articulating the components of all the
health system, since a country without health, education
and security is ungovernable. ❑
Vol. 40 No. 4 | World Hospitals and Health Services | 11