Unified Health System

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MINISTRY OF HEALTH

PLURINATIONAL STATE OF BOLIVIA

EVERYTHING YOU HAVE


WHAT TO KNOW ABOUT him
Unique System of

BOLIVIA 2018
Health
In 2019, all Bolivians will have
free health care. This way of
providing health care will be
called “single health system .”
IN WHICH PART OF THE Political Constitution of SeSALUD
State says there should be a Unified Health System?
• PLURINATIONAL STATE OF BOLIVIA

Article 18:

I. All people have the right to health.


II. The State guarantees the inclusion and access to
health of all people, without any exclusion or
discrimination.
III. The Unified Health System will be universal, free,
equitable, intercultural, intracultural, participatory,
with quality, warmth and social control. The system is
based on the principles of solidarity, efficiency and co-
responsibility and is developed through public policies
at all levels of government .
WHAT WE HAVE DONE ALL THESE
YEARS

The
Budget of
Health Sector 6.8
times SINCE 2005
THEY WERE BUILT AND EQUIPPED
1032 new Health establishments
HOSPITAL PROJECTS

MUNICIPALIT LEVEL TYPE


APARTMENT NUMBER OF
IES PROJECTS
SECOND
AND NOW I BENEFICIARIE THIRD ROOM
S
KNOW to 7 3 1 11
peac
BUILD
1.700
ochabamb 8 6
e 1 1 8
49 a
Santa Cruz 8 7 1 1 9
HOSPITALS
Tarij 9 1 2 1 4 MILLIONS OF
FURTHER a
Beni 3 3 1 0 4 DOLLARS
Oruro 4 1 1 0 2
Potosi 2 6 1 0 7
INVESTMENT
Pando 7 0 1 0 1
GUARANTEED
Chuquisaca 1 2
1 0 3
3
49
TOTAL 33 12 4
45
(-MINISTRY
X Ade HEALTH
In I 2 years we created I 6,686 items, (Public Subsector) —IN 2005 WE WERE 15,475... NOW PLURINATIONAL STATE OF BOLIVIA

WE ARE 32,161 HEALTH WORKERS


1938-2005 (68 years)
15,475 Items 32,161 Items (Public
subsector)
2006 - 2017 (12 years)

1938-2005 2006 - 2017


IN 2005 WE ONLY HAD 558 AMBULANCES...NOW WE HAVE
2072 AMBULANCES THROUGHOUT BOLIVIA
• FOR EASTERN BOLIVIA THERE NOW HAVE 5 AIR AMBULANCES - BEFORE
THERE WAS NO AMBULANCE AIRCRAFT IN
THE BOLIVIAN STATE.

BEFORE DOCTORS DID NOT GO HOUSE TO


HOUSE...NOW WITH THE PROGRAM
SAFCI MY HEALTH… 2768 DOCTORS GO THROUGH THE COMMUNITIES AND
NEIGHBORHOODS OF
310 MUNICIPALITIES

LIKE, NOTHING WAS DONE!!!


IMPORTANT FACTS FOR IMPLEMENTATION
OF THE SINGLE HEALTH SYSTEM
• State Constitution
• Framework Law of Autonomies
• Law No. 650 of January 19, 2015, which elevates the Patriotic Agenda of the Bicentennial 2025 to the rank
of Law.
• Law No. 786 of March 10, 2016 that approves the Economic and Social Development Plan, in which health
is expressed in Pillar 3, goal and result.
• Law No. 782 Economic and Social Development Plan
• Law No. 738 of September 21, 2015, Fourth Level Health Institutes
• Regulation No. 115 of the Ministry of Development Planning
• D.S. No. 29601 of June 11, 2008, which in its article 1, aims to establish the Care Model and the Health
Management Model within the framework of the SAFCI.
• D.S. No. 2497 of August 26, 2015, Construction, equipment and start-up of hospital health establishments.
• D.S. No. 2583 November 4, 2015, Construction and Equipment of Second Level Health Establishment
• D.S. No. 2677 of February 17, 2016, Construction and Equipment of Health Establishments.
IMPORTANT FACTS FOR THE
IMPLEMENTATION OF THE SINGLE HEALTH SYSTEM
• State Constitution
• Framework Law of Autonomies
• Law No. 650 of January 19, 2015, which elevates the Patriotic Agenda of the Bicentennial 2025 to the rank
of Law.
• Law No. 786 of March 10, 2016 that approves the Economic and Social Development Plan, in which health
is expressed in Pillar 3, goal and result.
• Law No. 782 Economic and Social Development Plan
• Law No. 738 of September 21, 2015, Fourth Level Health Institutes
• Regulation No. 115 of the Ministry of Development Planning
• D.S. No. 29601 of June 11, 2008, which in its article 1, aims to establish the Care Model and the Health
Management Model within the framework of the SAFCI.
• D.S. No. 2497 of August 26, 2015, Construction, equipment and start-up of hospital health establishments.
• D.S. No. 2583 November 4, 2015, Construction and Equipment of Second Level Health Establishment
• D.S. No. 2677 of February 17, 2016, Construction and Equipment of Health Establishments.
IMPORTANT FACTS FOR THE
IMPLEMENTATION OF THE SINGLE HEALTH SYSTEM
• D.S. No. 2719 6 of April of 2016, Construction and Implementation of the Institute
Fourth Level Cardiology.
• D.S. No. 3139 5 of April of 2017, Construction, Expansion and Equipment of
Second, Third and Fourth Level Hospital Health Establishments
• D.S. No. 3293 of August 24, 2017, creation of AISEM
• D.S. No. 3257 of July 19, 2017, which approves the Construction and implementation of the
Network of Nuclear Medicine and Radiotherapy Centers, in the cities of Santa Cruz, El Alto and La
Paz.
• D.S. No. 3631 of August 1, 2018, Hospital Infrastructure Equipment of Health Establishments.
• RM No. 908 of September 9, 2016, which determines the approval of the document called
Sectoral Comprehensive Development Plan to live well 2016-2020.
• RM No. 909 of September 9, 2016, which resolves in its first article, Approve the Institutional
Strategic Plan 2016-2020, which is the planning instrument that guides the actions of the Ministry
of Health within the framework of the mandates and development paradigms established in the
Political Constitution of the Plurinational State.
IMPORTANT FACTS FOR THE IMPLEMENTATION OF THE SINGLE
HEALTH SYSTEM
STAGE DESCRIPTION
S
FIRST Departmental Pre-Meetings
SECOND Departmental Meetings National
THIRD Meeting for Health and
Life
QUART Socialization Post-meetings
ER
FIFTH Implementation and Mobilization
in defense of the Unified Health
OBJECTIVES OFSystem
THE SUS
Achieve universal and equitable access of the population to free health services at the point of care .

Eliminate inequity and social exclusion from health care.

Reduce families' out-of-pocket health spending, avoiding impoverishment .


J.
Prioritize health promotion, disease prevention, and improve disease treatment and rehabilitation.

Improve the quality of health services.

Eliminate the current segmentation and fragmentation of the health system.


How do we register?
Ministry of
Health

Unified Health System

The person must go to the health facility closest to their


home presenting the following

documents:

Valid Identity Card.

Last invoice
light or water. for
determine where you
live (department,
municipality,
neighborhood, area or
community).
A Registration Point for
people will be enabled in the
Health Establishment
you would benefit
SUS.
• At this point it will be
verified if the person is
already a
beneficiary of some
insurance in a
Health Fund.
• If the data is tgm, correct he
health personnel. will proceed to fill out
the Form MS/SUS-O1 for the Single
Registration of Persons to the SUS
MS/SUS FORM - 001 Unified Health System

PLURINAGIONAL STATE OF BOLIVIA UNIQUE REGISTRATION OF PEOPLE AT


THEIR CI No.
MINISTRY OF HEALTH

Birth date:

Gender: M | F You are insured YES NO


Boliviano; Foreign:
Civil status :

Department Municipal Community/


ity Neighborhood/Area
Address Number/ Reference Telephone and/or Cell
Phone
Building
Health facility
Establishment Code Establishment

Health
Network

Registered by:

Signature of Registration Beneficiary Signature Establishment Seal


Personnel
ORIGINAL BENEFICIARY
HEALTH ESTABLISHMENT COPY Registration date:
/ What is a
Health Center?

It is the door of
entry to the system
Unique Health.

It is the first- level health facility in your


neighborhood or community, where you receive
basic and most frequent care.
If you need more attention
specialized will send
you or a
Second or third level HOSPITAL

Remember that we educate


in health it is everyone's problem
ASCRIPTION IN THE SNIS DATA
SYSTEM
WHICH THEY WILL
ATTEND YOU FOR FREE
CARE IN OFFICE WHEN YOU NEED OPERATION RX EXAMINATION, ULTRASOUND,
OTHERS.

BLOOD, URINE INTERNMENT FEEDING


EXAMINATION,

■■■■■■■■
lllllllll

ALL THIS WILL BE FREE AND FOR THE


WHO WILL RECEIVE THE ATTENTION OF
THEIR
I NSte38
PLURINATIONAL STATE OF BOLIVIA

• EVERYONE WHO DOESN'T HAVE INSURANCE


• I mean, those who work on their own... DO NOT WORK FOR ANYONE
• IT IS CLOSE TO 5,600,000 BOLIVIANOS
BENEFICIARY POPULATION

MEN AND WOMEN...BUT


WITHOUT INSURANCE...I mean,
those of us who RIGHT NOW HAVE
NO MONEY TO PAY THE DOCTOR
AND WHEN SOMETHING HAPPENS
TO US WE HAVE TO GET IT FROM
WHERE IT IS...IT IS
UNDERSTOOD
INTEGRAL HEALTH (WHOLE HEALTH)
ALL OVER THE WORLD…EXCEPT HERE

PROMOTION DISEASE
OF THE HEALTH ATTENTION OF REHABILITATIO
PREVENTION THE N
OF THE DISEASE
HOW will it be
VERY SPECIAL…
attended to??? FOURTH LEVEL
INVESTIGATION

IF IT IS MORE SERIOUS THEY SEND


YOU TO A THIRD LEVEL HOSPITAL - A
MORE SPECIALIZED HOSPITAL (EYES-
EARS-MORE DELICATE SURGERIES)

IF IT IS SERIOUS THEY SEND YOU TO HOSPITAL DE


SEGUNDO
LEVEL L
(GYNECO/SURGERIES/PEDIATRICS/INTERNAL MED)
WHEN YOU GET SICK YOU SHOULD GO TO
YOUR 1ST LEVEL CENTER (70% OF DISEASES
CAN BE CURE HERE)

THE WHEN YOU ARE HEALTH-HEALTH


FAMILY PROMOTION
( MINISTRY
X Ade HEALTH
PLURINATIONAL STATE OF BOLIVIA

THE INSURED'S MONEY WILL NOT BE


TOUCHED
I mean THEY
WILL NOT
TOUCH THE
NO WOMAN...THE SILVER IN
SUS WILL BE THE
PAID BY THE BOXES...
GOVERNMENT
WITH SILVER
FROM THE TGN
FARMERS

WHO BENEFITS FROM SUS?


ORIGINAL TOWNS
UNIONS
ARTISAN
DRIVERS
CANILLITAS
YOUTHS
SHOESHINE
BAKERS-BUTCHERS
PEDDLERS
WAYS
CONTRACTED WITHOUT INSURANCE
ONLINE CONSULTANTS
MASONS/PAINTERS
PLUMBERS
ARTISTS-CLOWNS
AYUCOS
CHARGERS
SEX WORKERS PEOPLE WITH CANCER
CASERITAS/MERCHANTS, ETC, ETC
FINANCING

Productive community social economic model


SECTORS INCOME AND
Surpluses
STRATEGIC: EMPLOYMENT
SURPLUS GENERATING
GENERATORS SECTORS

-Industry
•Hydrocarbons manufacturing and
•Mining crafts
-Electricity -Tourism
-Development
agricultural
REDISTRIBUTOR STATE -Living place
•Commerce,
transportation

INCOME REDISTRIBUTION
Unique services.
other services
SOCIAL PROGRAMS
system of
•Juancito Pinto Bonus
•Income Dignity
healt
•Juana Azurduy Bonus
FIGHT AGAINST POVERTY
h
Source: Luis A Arce Catacora • Professor of Economics and Finance - University of Chicgo - AM 201 $
• The SUS will have a budget of 200 million dollars
from the General Treasury of the Nation
• 215 million dollars from the nine governorates of
the country
• 80 million dollars for the acquisition of medicines

BUDGET
Evolution of the Executions of Municipal Health
Accounts
LAW 475 – MANAGEMENT 2017
CLASSIFICATION OF MUNICIPALITIES ACCORDING TO DEGREE
OF IMPLEMENTATIONNUMBER OF MUNICIPALITIES ACCORDING TO
DEPARTMENT Very bad LEVEL OF
BadIMPLEMENTATION
Regular Good
> 100%
TOTAL
0 to 25% 25.1 to 50% 50.1 to 75% 75.1 to 100% MUNICIPALITIES

CHUQUISACA
0 3 10 10 6 29
0.0% 10.3% 34.5% 34.5% 20.7%
PEACE 18 42 19 5 3 87
20.7% 48.3% 21.8% 5.7% 3.4%
COCHABAMBA 0 2 19 14 12 47
0.0% 4.3% 40.4% 29.8% 25.5%
ORURO 6 17 8 1 3 35
17.1% 48.6% 22.9% 2.9% 8.6%
5 18 11 4 2 40
POTOSI 12.5% 45.0% 27.5% 10.0% 5.0%

TARIJA 1 2 4 2 2 11
9.1% 18.2% 36.4% 18.2% 18.2%
SANTA CRUZ 0 6 22 18 10 56
0.0% 10.7% 39.3% 32.1% 17.9%
BENI 3 1 3 7 5 19
15.8% 5.3% 15.8% 36.8% 26.3%
PANDO
4 4 7 0 1 15
26.7% 20.0% 46.7% 0.0% 6.7%
37 94 103 61 44 339
BOLIVIA
10.9% 27.7% 30.4% 18.0% 13.0%
Source: General Directorate of Health Insurance. Ministry of
Health
TOTAL COST OF THE SINGLE HEALTH SYSTEM BY LEVELS OF
ATTENTION. (In Millions of Dollars)
HEALTH BENEFITS MANAGEMENTS
(Includes: Medications, supplies and
2019 2020 2021 2022 2023 2024 2025
reagents)
13 13 16
Total cost of universal benefits in 149 158 178 189
First Level of care 1 9 8
10 11 13
Total cost of universal benefits in 122 130 146 155
Second Level of care 8 5 8
15 16 19
Total cost of universal benefits in 175 185 208 221
Third Level of care 6 5 7
ESTIMATED TOTAL COST OF THE SUS 39 41 446 473 50 532 565
MUNICIPAL TAX CO-PARTICIPATION 5 20 9 22 3 31
15.5% 252 281 350 390
9 8 4
RESOURCES TO BE FINANCED 18 19 194 192 18 182 175
6 1 9
Source: Estimate based on the Study of Health Accounts and Unitary Costs of Law No. 475. Ministry of Health.
EVERYTHING
STARTS IN 2019
IT WILL BE FREE

BUT THERE ARE PEOPLE WHO DO NOT WANT THEIR


EXISTS

!!!!!THIS IS WHY WE MUST DEFEND IT


BY MOBILIZING OURSELVES IF
NECESSARY!!!!!
!TO VICTORY,
ALWAYS!

MOBILIZED, LET'S DEFEND THE SYSTEM


ONLY HEALTH!!!!!

FOR FREE HEALTH FOR ALL BOLIVIANS

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