HEALTHCARE IN ARGENTINA

In 2000 the total population in Argentina was estimated at 37 million. Argentina is divided into 23 provinces and a federal district, Buenos Aires, the Capital Federal.

Resources for Health services in Argentina were US$ 22.700 million in 1999 of which US$ 5,400 million were for public hospitals, US$ 8,300 million for Obras Sociales and Pami, US$ 2,300 in Pre-paid services, US$ 6,700 direct payment for beneficiaries.

Health expenditures as percentage of GDP were 7.4% in 1997 and 9.7% in 1999.

The public sector has an annual budget of US$ 13.012 million, representing 1,9% of GDP. The GDP per capita is US$ 8,514. Health expenditures per capita amounted to US$ 675 in 1997 and US$ 826 in 1999.

The compulsory portion of health care has two components: the government-administered component is financed through tax revenue (on a pay-as-you-go basis) and guarantees a standard minimum benefit according to principles of redistribution and insurance; the private component is geared toward savings and security, and takes the form of individual member-capitalized savings plans or company-managed plans that are funded by joint employee and employer contributions, fully and individually capitalised and regulated by the government (i.e., fully funded plans).

The voluntary plans are identical in all respects to the fully funded plans with the exception that they are capitalised exclusively by the beneficiary.

The health services system is composed of four main sub sectors: the public Hospital sub-sector (i.e., government-provided financing and services), the Obras Sociales (employee-benefit plans formerly run by unions and now organized by professional category), the private sub-sector (Pre-Paid voluntary insurance plans based on actuarial risk) and Insurance companies which cover a marginal sector of the economy. There is a strong bias toward curative care, with emphasis on hospital services. Although national, provincial, and municipal policies all define primary health care as their basic strategy, most of the jurisdictions that have adopted this strategy approach it in the form of "programme's" to be carried out at the primary care level.

The Obras Sociales plans are a system of compulsory social insurance that includes other benefits in addition to health care. Their financing comes from employer (5% monthly of salary) and employee (3% monthly) contributions. The Government is expediting deregulation of the sector in order to foster competition between the Obras Sociales plans and private (pre-paid) health insurance companies, encouraging beneficiaries to take an active role in choosing their Obras Sociales plan, and guaranteeing that all plans afford the basic benefits package of main services, diagnoses, and treatments for subscriber and dependants (PMO) as required by law. Benefits for primary and secondary care have a small co-payment (US$ 5 or US$10 for doctor's visits) but in-patient care and complex surgery/ procedures are free of charge. There is a 50% cover for drugs.

These Obras Sociales used to be linked to economic activities. Therefore each industry had its own OS as they vary in their level of quality of service and their services depend on salary scales and contributions. Nowadays members can choose any OS if they deem it to provide better care. By law, OS are not allowed to impose waiting periods, pre-existing conditions or exclusions. There are approximately 260 Obras Sociales providing care to 16 million members.

There are also Obras Sociales not associated to trade unions which offer care to middle and senior management who earn over US$2,000 monthly. These OS are financed like regular OS. The difference lies in the quality of service due to higher revenues. There are 24 institutions of this type in Argentina covering approximately 950,000 members. They have the same obligations as the trade union OS.

Except for those included under special programmes, the public sub-sector does not cover drugs for out-patient care. The public sub-sector of Obras Sociales plans defray a percentage of members' drug costs and fully subsidise all the uncommon, high-cost drugs included in the PMO (Plan Medico Obligatorio).

Pre-paid medicine companies also cover 50% of beneficiaries' drug costs. It is estimated that 8% of the population covered by the OS would also contribute to Pre-paid (PP) medicine. Pre-paid companies amount to 2,200.000 beneficiaries and operate very much any company providing private health insurance.

The only institution, which provides health care for the retired/elderly, is PAMIs, which are privately owned but managed by the government. The level of care and financing is inadequate. Pamis cover approximately 4,500.000 people.
In 1992 there was an average of only one physician for every 367 residents, and a ratio of 1 nurse for every 4 physicians and 5.4 nurses per 10,000 of the population, levels in this category were also considered insufficient. In 1999 there were 24.9 physicians for 10,000 of the population.

The number of available beds was 1,55.749 in 1995, with 54% in the public sub-sector, 2.8% in the Obras Sociales sub-sector, 43% in the private sub-sector. In 1996 there were 824 self'- managing public hospitals, offering a total of 62,402 beds (almost 75.3% of the country's public beds). In 1999 there were 44.8 hospital beds per 1,000 of the population.

In the private sub-sector, the two main subgroups are: professionals who provide independent care services to members of Obras Sociales or private, pre-paid plans; and health care facilities that are contracted by Obras Sociales plans.

Argentina health is not administered as insurance, as is the case with most foreign countries.

Pre-paid medical insurance originated as cover for independent workers. The popular perception is that pre-paid medicine rates very highly, as everybody would like to afford a particular plan. Pre-paid cover has a higher rate of usage than Obras Sociales and the Pre-paid client demands good service and is not willing to pay co-payments. PPs do not need sanction from any government body to operate; they exist to satisfy supply and demand.

Regarding outside cover, there is an international network only for emergencies providing free-of- charge care for accidents and for not pre-existing conditions for up to 180 days abroad. It includes repatriation of mortal remains due to accidental death. There are various plans on offer.

Expatriates are not covered unless they choose one of the pre-paid institutions. The level of care and quality is similar to that in their home countries.

DIRECTORY OF HOSPITALS & CLINICS

Clinica Bessone
Paunero 1648/86
San Miguel
Argentina
Tel: + 54 381 4667 2040

Clinica Del Sol
Av Coronel Diaz 2211
Buenos Aires
Argentina
Tel: + 54 11 4821 1000

Hospital Aleman
Av. Pueyrredon 1640
Buenos Aires
1118
Argentina
Tel: + 54 11 4821 1700
Fax: + 54 11 4805 6087
Email: mterrera@hospitalaleman.com
Website: www.hospitalaleman.com

Read the whole list of hospitals on Allo' Expat Argentina.