Prepaid medicine: co-payments, affidavits and the dilemma of health as a business
By Claudio Boada*
A few years ago, prepaid medicine was limited to a wealthier sector that could afford it. But today, with the transfer of funds from obras sociales to prepaid, the number of members of prepaid has increased and reaches many sectors. For this reason, this issue today is not for a wealthy sector, but for many workers with medium or low salaries.
Those associated with prepaid are captive consumers because whoever has a chronic illness or a certain disability needs prolonged treatment and continuity of the prepaid. It is not easy to enter another health system when you have a chronic disease. People, when going through a difficult economic situation, prioritize certain expenses and, within them, prepaid ones appear, which is not something dispensable because we are talking about health.
We’ve come up with well-above-inflation increases in prepaid medicine, and this year ended with about a 130 percent year-over-year increase. The last installment was subdivided into two and a new system of increases in prepaid payments was established. Thus, they will have different increases if the user has an income of less than six minimum wages, which, at this time, is about 392,000 pesos.
Those who have income less than this number, must make the affidavit before the 20th of this month, in which they declare their income, and, thus, they will pay 90 percent of the average increase. In February, the increase would be 4.95 percent, instead of 8.21. This affidavit must be filled out every month to maintain this quota, which is lower than that established by the Government. This proposal, initially, is for eight months.
Still, we have some doubts. One is if we talk about individual income or the family group. According to the prepaid, it refers to family income because, with higher income, more people would pay a higher fee. In addition, it was not specified whether gross or net salary is being discussed. And how will the system work if someone has fluctuating income, that varies. We believe that regulation should be more intense so that these types of increases are not present.
We have always been very critical of co-payments because it seems that, by paying a prepayment, you must also pay an additional one when you have a problem. Copayments restrict the use of health systems, which have to be comprehensive and accessible to all. During the macrismo, there was an expansion of this system. We question this because, at the time of need, you have to put a co-payment, with which one wonders what is the validity of paying something else every month.
*Holder of Union of Users and Consumers