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A sanatorium in San Nicolás de los Arroyos, in the north of Buenos Aires, is the first in the country to offer the system of health vouchers for the care of the population with public coverage. The system, which appeared in the national government’s campaign platform, has been operating in that municipality since last January and users choose if they want to be served. in centers of the public system or the private sector, which have an agreement with the municipality.
For this, people without social security or prepaid insurance access by DNI – which becomes the Municipal Medical Insurance affiliate number – a digital credential with a token which is used in the center to access the benefit just like other coverage. With this credential they can be treated in hospitals, as until last year, or in the GO Sanatorium San Nicoláswhich belongs to Oroño Group, which participates in this system as a provider. The municipality pays that center for each service.
To define the values of each service, the Municipal Health Secretariat uses the list of tariffs from the Provincial Autárquico Institute of Social Work (Iapos) of Santa Fe.
“We want patients without coverage to also be able to choose where they receive care because the public system competes with the private system and not because they have no other option,” he said. Santiago Passaglia, mayor of San Nicolás de los Arroyos. In dialogue with THE NATIONconsidered this modification of the health service provided by the State “positive” because “it encourages competition and raises the bar in care.”
The official considered that one of Argentina’s problems in a fragmented system is its organization and use. “In this way we use the idle infrastructure of the private system, which is very important especially when the public system is overloaded,” he said.
There are 50,000 residents of San Nicolás who have no coverage other than what the municipal state can provide. That among a population of 175,000 inhabitants, according to the mayor. Through this voucher system, since last January, more than 5,000 consultations for services provided at the first level of care have been administered. “Patients go from having the experience of receiving care in the public center to doing so, if they wish, in a center just like a patient with coverage,” added Passaglia.
Mirna BottazziSecretary of Health of San Nicolás, explained to THE NATION that the voucher covers those benefits that promote and prevent health, from clinical and pediatric care to tocogynecology and vaccination, when you choose to make the consultation at the provider sanatorium. If it is at the hospital, just present your ID.
“If a boy comes to the ward or to an outpatient clinic of the sanatorium due to bronchospasm, he is assisted, an x-ray is done, which is a practice that is included in first-level care, and he is given treatment,” explained the official–. He may need a brief hospitalization, of three or four hours, temporarily or, if he improves, he continues treatment in the outpatient clinic with the indicated controls. If he requires more complex care, he is referred to a second level of care, which is hospital, and can be public or private. This hospitalization is not covered by the voucher, but by the public system through the patient’s ID.”
This change is for administrative purposes, for financing, and the user is not required to complete any procedure. At GO San Nicolás, at the moment it is prepared for hospitalizations of up to 12 hours. “The voucher – said Bottazzi – is to be able to receive care in the private system if the patient wants. If you choose to continue serving in the public, you only show up with your DNI. “What we seek is to build an integrated public-private system and improve accessibility and equity.”
In San Nicolás, there is the San Felipe Hospital, which depends on the Ministry of Health of the province of Buenos Aires and has complex services with hospitalization, and the municipal hospital in the northern area, which is 100% publicly managed. The local government is building another hospital in the southern area of the municipality and, in the western area, is where the GO San Nicolás sanatorium operates, managed by the Grupo Oroño, from Santa Fe, and which is where since last January patients can be treated. beneficiaries of the voucher system. In the sanatorium, that firm hired the professional staff and provided the equipment for care.
“This system has been working well and is absolutely sustainable because it is not more expensive than supporting the public system when comparing the cost of benefits throughout the year,” said the mayor.
Bottazzi mentioned that with this system “attention was greatly decompressed” with the increase 15 days ago in respiratory infections with the arrival of the cold. “Demand is decentralized,” he said.
There are more private institutions that are interested in providing care to patients with voucher coverage, according to Bottazzi. Meanwhile, there are mayors from other towns who visited San Nicolás to learn how the system works, according to Passaglia.
The municipality had been one of those that had withdrawn public employees from the coverage of IOMA, the main social work in Buenos Aires, which had also signed an agreement with the Oroño Group to provide services locally, as was learned after the presentation of this Insurance. Municipal Doctor, as this mixed system of public-private coverage and care was called, carried out today in San Nicolás.
They participated Mario RussoMinister of Health of the Nation, and Karina Milei, general secretary of the Presidency, for the national government. She was also present Martin Menem (LLA), president of the Chamber of Deputies of the Nation.
From the national health portfolio, through a statement, they emphasized on this health insurance that “it subsidizes demand, not supply,” which was what appeared in the platform of La Libertad Avanza during the presidential campaign last year. promoted by Eduardo Filgueira Lima, then health reference for the Javier Milei-Victoria Villarruel formula.
There are more private institutions that are interested in providing care to patients with voucher coverage, according to the Secretary of Health of San Nicolás. Meanwhile, there are mayors from other towns who visited San Nicolás to learn how the system works, according to Passaglia. In the national Ministry of Health, they consider it, meanwhile, “a management model that can be replicated in other municipalities”, while sources from that portfolio indicated to this medium that “it will be encouraged by the Nation.”
