Health system crisis: doctors are lacking and quality of care is declining

Health system crisis: doctors are lacking and quality of care is declining
Health system crisis: doctors are lacking and quality of care is declining

The increase in health insurance premiums triggered a crisis in the health system that not only affected the pockets of members, but also extended to the poor quality of medical care, in a timely and appropriate manner.

The Chamber of Medical Diagnostic Institutions (Cadime) requested that health be included as a State policy among the proposals of the “May Pact”, to which the national Government called, through the creation of a “Federal Health Agreement”, with the participation of all actors to promote the democratization of decisions, the formation of consensus, transparency and publicity of acts and procedures.

According to the entity’s analysis, the underlying reason is that “Argentina has not undertaken a State policy on health matters, which implements the construction of a system with continuous improvement in access, coverage and quality of care.”

The shortcomings in the shifts in both public and private medicine and in social medicine (unions) have been going on for a long time and, in any case, have been exacerbated in the context of a dispute between managers over increasingly scarce resources.

Beyond the financial difficulties cited by providers, specialist clinics and emergency rooms are overwhelmed with patient care.

The Medical Confederation of the Argentine Republic (Comra) had been warning about this before the increase in the prepaid health insurance rates at the beginning of the year: “Health is in ruins” and the availability of experienced professionals is suffering, as well as the fact that many prefer to look for job offers abroad, due to low salaries.

It was estimated that 15% of professionals gave up their jobs as providers due to the structural crisis of the health system. This discontent affects both the public and private sectors, as salaries have become very low and fees in the private sector have become the same.

Doctors were already seeking two objectives: better job offers and a better quality of life.

They feel very overworked, going from one job to another, from very early in the morning until late at night, and their shortage is noticeable without interruption.

Superstructures

The national health portfolio, headed by Mario Russo, has focused on defining the way in which it plans to decentralize health, for which it kicked off with the freedom of prices for prepaid health plans, the already established provision that members of social security schemes can redirect their contributions to where they choose, and a certain improvement in the efficiency of public health care.

The next step would be to redefine the responsibilities of the provinces, municipalities and the private sector, which would create the conditions that would lead to a National Health Agency, as is the case in other countries.

And what about the “workforce”? In the provinces they are already rethinking what has been done for several years in terms of health and with the training of health professionals, where fewer and fewer young people are choosing to study medicine in the country and in the world.

There are more and more specialties and subspecialties,

It is noted that in other health professions there is no such shortage. For example, careers such as kinesiology, dentistry or psychomotor skills have even more applicants.

The federal health councils have been addressing this issue for many years and are considering plans to reduce the number of years of study.

“Today, to have a trained doctor, we are talking about ten years of training. The new generations are different and choose other things,” observes the Ministry of Health.

In this context, the years of study and specialties are taken into consideration by the UBA, the Ministry of Education and the Ministry of Health.

When doctors specialize, they work between 80 and 90 hours a week, with 24-hour shifts, which overlap with their schedule the next day until they complete it.

“Young people today prioritize their schedule for sports, for being with their family, for traveling, for sports leave. We do not put anything into value judgment, we simply say that it has changed and that then we have to rethink from the training point of view,” added the ministerial source.

The least chosen by young people are basic specialties, that is, those carried out by a hospital: pediatrics, internal medicine, gynecology, pediatric intensive care, neonatology.

(N.A.)

 
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