Ginés Mario González García had already ended the year. He believed that the signing of resolution 2987 of the Ministry of Health that authorized prepaid companies to increase rates by 7% as of February and had been published in the Official Gazette of December 31 would be his last act of Government of 2020. But Thursday at noon, when he was getting ready to prepare the New Year’s celebrations with his family, he received a phone call that altered his plans.
Resigned, the official activated his team and in record time signed another resolution -2988- to nullify what he had arranged a few hours ago. The argument to explain the reversal was made official in a special supplement to the Official Gazette published on December 31 in the afternoon and stated: “By express decision of the President of the Nation, the increases that were authorized to Prepaid Medicine entities and Health Insurance Agents are suspended.”. But as is usually the case with most acts of government, the foundation expressed in the rule has little to do with what actually happened.
The story began in the first days of December. The Government had enabled an adjustment in the quotas that was finally stand by. That setback enabled a negotiation of several weeks that had as protagonist not only González García, but also the superintendent of Health Services, Eugenio Daniel Zanarini. The dialogue had been complex, mainly because it is a sector of the economy whose income – regulated by the State – was far behind inflation in 2020, the year that Health was the protagonist of the coronavirus pandemic. Despite the differences, officials know that 70% of the country’s population is cared for in the private health system and that the decision to discontinue Assistance to Work and Production (ATP) and other subsidies linked to the pandemic caused a damage to the deficit finances of companies.
After those heated discussions, the leaders of the main companies had a promise that did not convince them, but that they believed would be fulfilled according to what the area officials had told them: that as of February they could increase their quotas by 7 % and then they would continue negotiating to find a point of understanding. President Alberto Fernández himself and the Chief of Staff, Santiago Cafiero, were aware of what would happen and had enabled the upload. However, after the first last resolution of the year of the Ministry of Health, something was broken in the dome of political power that prompted the head of state to suspend its effects.
Those who know the behind the scenes of the soap opera, They attribute the reversal to Vice President Cristina Kirchner, who put up uncompromising resistance in a telephone conversation with the President, who strictly speaking would have had little conversation. “It was almost a monologue that ended abruptly”, they recognize in their environment. Its position could have some kind of economic explanation in a difficult 2021 in terms of inflation for the Government: analysts revealed by Banco Nación predicted a price increase of more than 50 percent. But actually, the explanations are much closer to politics than economics.
The former President is targeting health companies and does not hide it. Recently, in an event organized by Axel Kicillof in La Plata in which Alberto Fernández also participated, CFK assured that one of the challenges of 2021 will be to “rethink” the entire system. “Our country must be the one in all of Latin America that has the most human, technological and investment resources in health. What happens is that we have it divided into three systems: public, private and social works. We are going to have to rethink an integrated health system“, he pointed. And I add: “We have to rethink not only the health system, but also a country design that forgets such an unfair and economically inefficient concentration”.
What does that mean in practical terms? Who surely has the answer is the Vice Minister of Health of the province of Buenos Aires, Nicolas Kreplak, who is working on a reform project whose draft has already toured the main offices of the Instituto Patria. Health businessmen are convinced that the initiative takes up the spirit of a decree of necessity and urgency that the Executive Branch had promoted at the beginning of the pandemic and was later rejected which declared all health resources in the country of public interest.
“Nobody has called us. We serve more than 30 million Argentines and we have not had a single meeting in which they explained to us what their reform project is. We believe that we have a good opportunity to contribute ideas and we hope that we will be summoned”, They assured this weekend from one of the cameras. Other businessmen are more skeptical: “When the Vice President talks about the reform of the health system, those affiliated with private medicine should be concerned”.
Market sources estimate that a business that moves $ 800 billion annually is at stake. Due to the magnitude of the figure, some compare the plan with the nationalization of the AFJPs ordered by Cristina Kirchner during her presidency as a result of an idea from Amado Boudou, today condemned for the Ciccone case.
The move could have a full impact on social works, the fund of many unions. For this reason, some are beginning to wonder what the reaction of the union leaders will be if the creation of a Single Health System advances. Héctor Daer, Secretary General of Health, for now watch silence.
The second last 2020 resolution of the Ministry of Health caused a crisis without precedent in the foundations of private health in Argentina. Some do not hesitate to call it “the 125th of health”, alluding to the rule that sparked the conflict with the countryside in 2008. Such was the tenor of the cimbronazo, that Superintendent Zanarini was unable to celebrate the New Year with his family because he ended up in intensive care with a serious health problem. This weekend he was still recovering in a well-known clinic in the Buenos Aires neighborhood of Flores.
Zanarini thus joined a tradition of Argentine officials, who usually choose the private system every time they have a health problem. For example, in May 2020, Ginés González García he was treated at the Otamendi Sanatorium in the city of Buenos Aires for a subdural hematoma. In July, Luis D’Elía Kirchner-reference and leader of the Federation of Land and Housing- tested positive for coronavirus and was admitted to the same sanatorium, located in the Buenos Aires neighborhood of Recoleta.
President Alberto Fernandez He also opted for the Otamendi Sanatorium when he was a candidate for president and had to be admitted for a medical check-up, where a picture of “pleural inflammation” was detected.
Mauricio Macri He resorted to the services of the private health system in 2017, when he served as president, for a knee operation that was performed at the Agote Sanatorium.
Cristina Fernández de Kirchner He chose the Austral de Pilar Hospital for his thyroid operation in January 2012 and the Favaloro Foundation University Hospital for an intervention for a chronic subdural hematoma in 2013. A year earlier, his son, the deputy Maximum Kirchner He also underwent surgery at the Austral Hospital for a problem in one of his knees.
In 2004, a year after taking office as president, Nestor Kirchner created the Presidential Care Unit (UAP) at the Dr. Cosme Argerich Acute General Hospital, the most complex public center in the country located in the La Boca neighborhood. However, the former president used it only once. Kirchner’s two cardiovascular interventions in February and September 2010 —for the obstruction of the right carotid first and for the placement of a stent later— they were held in the private Los Arcos sanatorium.
A complicated 2021
Based on the latest news, the meetings of the private health chambers, integrated into the Argentine Union of Health (UAS), intensified. In the last meeting, one of the directors complained about the lack of a valid interlocutor in the Government and ironically: “Perhaps from now on we will have to stop going to Government House and go directly to the Instituto Patria”.
Executives rely on assumptions: “On December 30, they gave us an absolutely insufficient increase of 7% with inflation close to 45 percent. Hours later, through another resolution and by “express instruction of President Alberto Fernández” the suspension of the increase was ordered. When it is necessary to clarify that it was by order of the President, one begins to doubt who the President is, ”they say angrily.
The concrete thing is that they are convinced that it will be very difficult to face a re-outbreak of coronavirus in Argentina under these circumstances. They say they are financially strapped and that rumors of a possible reform generate further uncertainty. “Not all of us are big companies. The smallest will fall first, then the medium ones and, finally, the big ones will also fall ”, they analyze quietly. The usual spokesmen for the Argentine Health Union for now avoided making public statements while waiting for the meetings that are scheduled for this week.
In some sectors of the Government, the situation is also observed with concern. Faced with the threat of a new wave of COVID and without room for maneuver due to the irruption of CFK in the management of one of the most sensitive issues for Argentines, the internal debate of the coalition begins to exacerbate.
I kept reading:
A Kicillof advisor acknowledged that it is being considered to implement a curfew to stop a second wave
Restrictions: the Government will seek to sustain the tourist season with the support of the governors