The system of health voucher that the national government had announced since the electoral campaign was launched yesterday in the city of St nicolasprovince of Buenos Aires. Under the name of Municipal Medical Insurance, he GO Sanatorium San Nicolás It is the first center to launch the service with the objective of providing medical coverage to approximately 30% of the local population, that is, to almost 50,000 residents who do not have social work or prepaid medicine.
The Ministry of Health of the Nation highlighted that San Nicolás is the first city in the country in adopting this model, which will provide coverage through a digital credential which uses the user’s DNI as a member number. For its launch, an event was held yesterday chaired by the Minister of Health of the Nation, Mario Russo, the general secretary of the Presidency, Karina Milei, and the president of the Chamber of Deputies, Martin Menem.
According to the health authorities, the Municipal Medical Insurance seeks to guarantee that the medical benefits covered are based solely on the primary care of the patient, thus promoting a payment model by demand and not by supply. This system allows the municipality to subsidize only the needs of residents, while the private sector invests in the remaining medical supply.
Furthermore, according to the authorities, this health voucher model is already successfully implemented in countries such as Canada and Spain. With its introduction in San Nicolás, it is expected that other clinics and private offices in the city will soon join the system and thus expand the care options.
Regarding the operation of the new system, the director of the GO Sanatorio San Nicolás, Marisa Vicoexplained that, for the moment, the clinic he runs “is the only effector” attached to the system, but the objective is for it to be “replicated in the rest of the country.”
He pointed out—in statements to Radio With You— that to access patients must obtain an appointment through the municipal government website. “With this voucher you go to the sanatorium and require the care you need, whether it be gynecology, trauma, pediatrics, clinic or other specialties.” At the health center, “we take that voucher and then present it to the municipality to pay us attention what we have done in the private sector.”
Vico pointed out that the system “has limits”, since “it covers up to an amount and up to a certain type of complexity because otherwise the system is unsustainable. I understand that the municipality has an amount allocated to health and with that amount they are financing this part of primary care for all patients. The essentials are coveredbut in the event that the patient comes and requires a medical benefit High complexity, for example a tomography or an MRI, we have to ask for permissionlike any provider in the private health sector, to someone from the Municipality related to the Ministry of Health, and authorizes us or not the practice that we are requesting, which is outside what was agreed upon.”
Regarding the care that can be received with the voucher, the professional explained that it includes “everything that is pediatric on-call care, clinic, pediatric outpatient clinics, clinic, gynecology, traumatology, cardiology. All on-call and outpatient specialties. We also have covers mammograms and simple practices. What requires authorization are the most complex procedures, such as a tomography or an MRI.”
When asked what happens with complex practices that are not authorized by the Municipality, the doctor recalled that in the commune there is a public hospital, “but it has limitations in terms of equipment. If the hospital doesn’t have problems, it can take over. For example, if the patient needs a CT scan and we do not have it arranged, the same municipal management can refer him to the hospital to have the highly complex study performed. We do internal referral all the time,” she stressed.
For his part, the mayor of San Nicolás, Santiago Passaglia, clarified, in dialogue with Urban Playthat the local government has a “low complexity municipal hospital, without hospitalization because [como comuna] We are responsible for the first level of health care and at the same time we also have the voucher system, with which a neighbor can choose whether to go to the public health center or can go to a sanatorium that we have agreed upon and we cover the service.”
As Vico had pointed out, Passaglia stressed that the voucher system it is not unlimited, but rather it is “primary care, which is what corresponds to the municipalities. To understand the difference, except for what are hospitalizations, which already have another complexity”.
In the commune, “we give all those who do not have social work the possibility of choosing whether to go to the public system or be treated in a private sanatorium. In the latter case, the Municipality is responsible for the benefit used by that person,” he stressed.
Regarding the form of implementation, the authorities, he added, seek to “prevent any type of fraud or abuse” so “we give you a digital credential that we have a database with the DNI, we know who has social work and who doesn’t, and we authorize with a token each of these attentions to keep track and also prevent any type of fraud or abuse,” Passaglia closed.
