Running Head: Healthcare in Argentina 1

Healthcare in Argentina
Gina Loiacono
HLTH 101 Overview of Healthcare & Delivery – Gutierrez
13 April 2020
 Running Head: Healthcare in Argentina 2

Argentina

Argentina is a country located in the southern half of South America. As of 2019, it has a

total population of about 45 million. Its national language is Spanish and about 96.7% of its

population is of European or Mestizo descent. Its healthcare system is fragmented and made of

three sectors that include the social (or obras social), private and public sector. It considers

healthcare a constitutional right and aims to make healthcare accessible and affordable for all

those in Argentina, whether a permanent citizen, or an international visitor.

Type of Healthcare

Argentina’s healthcare system is comprised of both a universal healthcare system and a

private sector. Currently, about 63% of the total population is covered under a social health

insurance sector, which is under a worker’s union, or as they are called in Argentina “Obra

Social”. There are about 300 worker’s unions in Argentina and they are each divided and

associated with a specific trade or industry. Additionally, this includes 24 provincial unions

which represent each province in Argentina. This social health insurance sector is covers about 5

million public sector workers, and this includes 16% of which are covered under private

insurance, 5% which is funded by monthly premiums, co-payments, and out of pocket

expenditures and 11% via a worker’s union.

This leaves roughly, 36% of the total population that does not have formal coverage and

is covered through the public system. This would be considered the universal health system that

comprises part of the healthcare in Argentina. This can be troublesome as individuals who

cannot afford and work for private insurance, must apply though institutions for free care under

the public system. Celia Iriart writes in her article, Managed Care in Latin America: the new
 Running Head: Healthcare in Argentina 3

common sense in health policy reform, that these patients must undergo lengthy and difficult

testing which often results in 30-40% of applicants being rejected. (2001 pg.7)

Financing

Over the last decade, Argentina reported that 8.5% of the gross domestic product was that

of healthcare expenditures. The World Health Organization reports that 34% of the health

expenditure cost came from the Obras Sociales, which covers formal workers. These unions are

funded through compulsory payroll contributions from employers and employees.

Another 44% of the GDP healthcare expenditure came from private insurance through the

means of premiums, co-payments, and out of pocket fees; this is a way that private coverage is

subsidized and is seen as inefficient and inequal. Additionally, there is no reimbursement system

for services rendered, implemented in Argentina. In his article, Health Care Organization and

Delivery in Argentina: A Case of Fragmentation, Inefficiency and Inequality, Gabriel Novick

states that “an individual with formal coverage can receive health care from a public facility at

no cost and its insurance company may never receive a bill for it.” (2017, pg.94)

Finally, about 21% of the total healthcare expenditures in Argentina are in form of

general taxation to fund the public sector without formal insurance such as private or through the

means of a union.

Scope of Services.

It’s important to note that in 1995, Argentina established what is known as the Plan

Medico Obligatorio, or PMO. This is a catalogue of coverage benefits and with every passing

year, the number and range of covered services and procedures is expanded and today, the PMO

is considered the most inclusive plan in the world. However, there is no official nomenclature or
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diagnosis codes established in Argentina, therefore most providers use their own terminology

and coding in their offices.

Obras sociales, are funded by its beneficiaries, but its health services are outsourced to

private providers. Each year, the unions contract providers which are chosen by the employers

and employees, and with the option of re-selecting a provider every year, beneficiaries can

choose providers that best fit their needs. Unions provide the minimum essential healthcare and

do not allow providers to deny a patient care based on pre-existing conditions.

Those covered under the public sector have access to free healthcare and this includes

hospital, medical, dental, palliative, pre-natal, maternity rehab services, transportation to and

from these appointments, and prosthetics.

Private Health Insurance can be localized, meaning they are only valid in certain areas of

the countries. However, it’s found that those under private health insurance rarely receive service

that is any less than excellent. In addition to the services covered by public insurance, mental

health care is also provided through access to psychiatric professionals.

Just as in the United States, and regardless of whether you are covered by the public,

private, or social (union) sector, general medicine and specialty providers are easy to access and

are affordable. However, these resources are typically more prevalent in major cities such as

Buenos Aires, Rosario, or La Plata, than they are in rural areas.

Consumer Cost.

The cost of health insurance for the consumer is far less than compared to what we are

used to in the United States. It is reported that a visit to see a general practitioner can cost about

$17-20 USD, and a specialist is about $40-50. Interestingly enough, these prices also apply to

visiting foreigners. Healthcare in Argentina is considered a constitutional right and therefore

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healthcare is made available to anyone, even non-citizen visitors to the country. For those

covered under the public sector, health services are covered and free, with the exception of

contributions made for prescriptions and chronic conditions.

Providers.

Becoming a physician in Argentina parallels becoming one in the United States. There

are currently, 29,000 medical schools in Argentina, a number which has increased dramatically

in the last decade. Students typically have to go through a six-year program, which includes 2

year of basic science, 3 years of clinic science, and 1 year of residency. Not all schools require

pre-requisites, but if they do, it’s typically a course based on mathematics, biology or physics.

While an estimated 5,000 students graduate every year as physicians, in his article, The

Programs and Context of Medical Education in Argentina, Dr. Angel Centeno states that “Each

year, there are approximately 12,000 first-year medical students attending the 29 schools, which

suffer a high dropout rate during the first years because of vocational problems or inability to

adapt to university life.” (2006, pg.1081) If a student makes it through medical school and

graduates a physician, Salary Explorer reports that they earn an average of 210,000 Argentine

pesos or about 3,247 USD monthly, with specialists earning a small amount more.

Similar to the United States, students wanting to become the equivalent of a nurse in

Argentina, must earn an undergraduate degree and a certification to treat patients. On average,

Salary Explorer reports that registered nurses in Argentina make an average of 73100 Argentine

Pesos, or $1,129 USD per month. Additionally, like in most countries, nurses in Argentina face

long shifts and hard work, and in his article, Burnout prevalence in intensive care nurses in

Argentina, M. Torre reports that about 89.2% of male ICU nurses, and 82.9% of female ICU

nurses experience burnout after about 10 years of formal experience.

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Argentina vs The United States

Unlike Argentina, the United States does not in a way have universal health system, but

the two countries share similarities in their healthcare system. In Argentina, healthcare is

considered a constitutional right, while here in the states, it isn’t. While Argentina has private

insurance, it also has public and social insurance that is funded through taxes and payroll

contributions from employers and employees, the United States has a heavily fragmented system.

In their book, Delivering Health Care in America: A Systems Approach, Leiyu Shi and Douglas

Singh describe the U.S. Health system as a “…market-oriented economy in the United states that

attracted a variety of private entrepreneurs that pursue profits by facilitating the key functions of

healthcare delivery.”; and healthcare in the US is just that, a business. Employers purchase health

insurance that they offer to eligible employees through private sources, and they are able to use

these services as they pay a monthly premium, at times in conjunction with their employer. The

U.S. Government does finance public insurance for those who are socio-economically

disadvantaged populations such as the elderly, low-income, and disabled. This insurance is

typically in conjunction with state organizations and are managed via a Health Maintenance

Organization (HMO). Just like Argentina, the US has a blend of both private and public health

insurance which leads to a confusing, and frustrating system.

Special Populations.

While healthcare is easy to access to Argentina’s major cities, much of the country is

comprised of rural areas in both the north and the south. The north includes provinces of

Formosa, Chaco, and Santiago Del Estero, all provinces that lay close to the Paraguayan border;

while the most socio-economically impacted areas in the south are Tierra de Fuego. Argentina

controls the northern portion of Tierra del Fuego, while Chile holds the southern portion. Tierra
 Running Head: Healthcare in Argentina 7

de Fuego is secluded and can have frigid weather, but while it may seem far from the country’s

capital, it provides a huge economic boost with the harvesting of oil. Non-communicable disease

are high in these rural areas, where 40% of Argentina’s poorest populations reside.

Healthcare is not easily accessible in these areas and these communities are often stricken

with conditions such as cardiovascular diseases, diabetes, and cancers that go undetected. In a

collaboration with the government of Argentina, World Bank has recently started an initiative to

prevent chronic non-communicative disease in these rural areas. In the article, WB/Argentina:

Promoting Better Health and More Opportunities in Rural Development among the Most

Vulnerable, it states that “approximately 1.5 million rural dwellers live in poverty. These include

small-scale farmers, indigenous people and rural workers, normally living in isolated

communities with limited access to markets and services and facing a precarious land ownership

situation.” (2015) The initiative aims to build more resources for access to primary care in order

to provide early detection and control for diseases like obesity, hypertension, chronic obstructive

pulmonary disorder, and diabetes.

Major Health Concerns.

Argentina, like most countries, has major health concerns despite most individuals having

access to health insurance and care. PAHO, of the Pan American Health Organization, reports

that in additional to the prevalence of cardiovascular diseases and diabetes, there also exists

critical health issues in Argentina that include transmission of infectious viruses such as Zika,

Dengue, Chikungunya and Chagas in areas of neglect and poverty. It also reports that as of 2015,

maternal mortality measured at 3.9-5.9 deaths per 10,000 live births and that these numbers

fluctuated between provinces, bringing to light the inequalities of socio-economic status,

education, and access to basic healthcare. PAHO also reported that between 2009 to 2013,
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overweight prevalence rose from 35.4% to 37.1%, and obesity went from 18% to 20%. It

response to this, Argentina implemented public policies that regulated the type of food aimed at

children such as empty-calorie foods, and sugary drinks by additional taxation added to these

foods.

Reflection.

In reflection, I found this research assignment to be incredibly difficult. It was not easy to

find reliable information of the healthcare system in Argentina; and it made it frustrating when

trying to understand how the healthcare system really works in Argentina. I find it to be a

complicated system, with typical fragmentation, but I also found it to be functional and I believe

that the United States would strongly benefit from learning from systems like this where private

and universal health care can be coexist. Upon my research, I found that Argentina didn’t have as

many decrepit, and undistributed health issues as they exist here in the states. I didn’t find that

much of a social divide in healthcare like we obviously have here. The United States is run like a

business and those with more money live healthier lives, with easier access to medicine and

better resources than those of lower social class. Typically, that isn’t a problem, if you have

worked hard for your financial stability, it makes sense to enjoy the fruits of your labor –

however, this shouldn’t be the case with healthcare. Healthcare should be universal and

everyone, regardless of their social or economic status, should have access to free and accessible

healthcare. I believe that Argentina is setting the standards with their ideology that healthcare is a

constitutional right, and it’d be beneficial for any country that still hasn’t implemented that view

into their healthcare system, to do that sooner rather than later.

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References

Argentina. (n.d.). Retrieved April 13, 2020, from https://www.paho.org/salud-en-las-americas-

2017/?p=2706

Casey, K. (n.d.). Healthcare in Argentina: Public & Private Hospital Information. Retrieved

April 13, 2020, from https://internationalliving.com/countries/argentina/health-care-in-

argentina/

Cavagnero, E. (2008). Health sector reforms in Argentina and the performance of the health

financing system. Health Policy, 88(1), 88–99. doi: 10.1016/j.healthpol.2008.02.009

Centeno, A. M. (2006). The Programs and context of medical education in Argentina. Academic

Medicine, 81(21), 1081–1084. doi: 10.1097/01.ACM.0000246700.88093.6b

General Medical Practitioner Average Salary in Argentina 2020. (n.d.). Retrieved April 13, 2020,

fromhttp://www.salaryexplorer.com/salarysurvey.php?loc=10&loctype=1&job=919&jobt

ype=3

Iriart, C., Merhy, E., & Waitzkin, H. (2001). Managed Care in Latin America: the new common

sense in health policy reform. Social Science & Medicine, 52(8), 1243–1253. doi:

https://doi.org/10.1016/S0277-9536(00)00243-4.

Novick, G. E. (2017). Health Care Organization and Delivery in Argentina: A Case of

Fragmentation, Inefficiency and Inequality. Global Policy, 8, 93–96. doi: 10.1111/1758

5899.12267

Nurse Average Salary in Argentina 2020. (n.d.). Retrieved from

http://www.salaryexplorer.com/salarysurvey.php?loc=10&loctype=1&job=865&jobtype

=3
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Shi, L., & Singh, D. (2019). Delivering Health Care in America: A systems approach (7th ed.).

Burlington, MA: Jones & Bartlett Learning.

Torres, M., Popper, S., & Bergesio, A. (2019). Burnout prevalence in intensive care nurses in

Argentina. Enfermeria Intensiva, 30(3), 108–115. doi:

https://doi.org/10.1016/j.enfie.2018.04.005.

WB/Argentina: Promoting Better Health and More Opportunities in Rural Development among

the Most Vulnerable. (2015, June 11). Retrieved from

https://www.worldbank.org/en/news/press-release/2015/06/11/promoting-better-health-

and-more-opportunities-in-rural-development-among-the-most-vulnerable