Chile/Latam: Otro post (no es) sobre Isapres y Seguros Privados

Today I want to share a post that I have published in a venture that I maintain with two more friends. This venture is called Matasanos, and it is a blog which is meant to be a platform for debate and ideas regarding healthcare in Chile and Latin America. The blog has been quite succesful, and we of course are very proud of it.

This is a post written in Spanish about the current changes and discussion that are being conducted mainly in Chile, but also incorporating examples from Argentina and Colombia, about the private insurance sector.  The lack of regulation, coupled with the constant abuses of the system, focused on prices increase, lack of coverage and discrimination by gender and sex, are fuelling concerns and calling for changes in those countries, where private insurances companies do not have an important share in the market, but, they maintain strong presence in terms of influence and lobby, driven by their economic power.

Al menos, es la intención. Durante la semana pasada – y lo que llevamos de ésta – hemos sido bombardeados por editoriales, columnas (incluido el conspicuo El Post), expertos por aquí, expertos por allá, reportajes y análisis sobre el famoso y tan esperado proyecto llamado Ley Corta de ISAPRES II  que el gobierno se decidió a presentar para su discusión en el congreso.

En Matasanos, en Junio del 2010 publicamos un post sobre la decisión del Tribunal Constitucional (TC) sobre la famosa tabla de factores de las Isapres (Click Aquí), donde en vez de derogarla por completo, el TC declaro inconstitucional algunos elementos de ella…..

You can read the post in www.matasanos.org clicking here

Colombia: Basic Insurance Plan is not enough..do you hear Chile??

Amid the discussion which is been carried out in Chile, regarding the likely changes of the private insurances model, it is worth to check what is happening in one of the paradigm models of private health in Latinamerica, which is Colombia.

This week the High Court (Corte Constitucional) in Colombia has ruled in favour of a mother and her son, who were rejected to receive the Pneumococcal vaccine because it is not included in the Compulsory Health Program (Programa Obligatorio de Salud – POS), which is used by Private Health Insurance Companies (EPS) to provide a minimum nest of health services, according to the story publish in the local El Tiempo. Moreover, the High Court officially stated that Pneumococcal vaccine must be extended to the entire population, as many other neighbour countries do. Pneumococcal vaccine is included in POS just for certain conditions, such as low weight at birth or pre term deliveries. Families with children’s without such conditions must assume extra cost if they want to obtain the vaccine.

Financing in the Colombian Health System is based on private insurance companies (Entidades Promocion de Salud). Even though the government has tried to diminish the risk of adverse selection and price discrimination through the implementation of the compulsory health program, still there are a great number of complaints and allegations from consumers against these organisations, which has given rise to legal disputes. This factor adds extra cost to the system, along with the adverse consequences in terms of the health of the population. It is worth noting that in this case the judicial power, the Corte Constitucional in Colombia, is recommending to the government the extension of the coverage of a vaccine highlighting the important prevalence of pneumococcal disease in the country. It will be important to see the reaction of the health authorities in an aspect that they must consider as part of their scope of decision.

However, despite of evidence published and practical examples such as this situation in Colombia, authorities in different countries, especially Chile, still aspirate to consolidate the subsistence of the private health insurance model. The case of the discrimination regarding the pneumococcal vaccine in Colombia, and the subsequent decision of the High Court, highlights that the Basic Health Plan, one of the flagships of the Health Minister in Chile,  even though is a good proposal, is not enough when we talk about eliminate the discrimination that is part of the private insurance business model.