Chapter 2

2.6 - Deficit in the Argentina national health
scheme and analysis of coverage tools
Levcovich M., San Martin M., Schweiger A.
2.6.1 Introduction
The objective of the present study is to point out the health insurance coverage inequalities
and the funding of distinct subsections of the Argentinean health scheme.
To this effect, the principal characteristics of each subsection are described (social insurance,
private and public sector) using per capita expenditure, insured citizens and the
body of guaranteed services as reference points.
Once the per capita expenditure of each subsection was determined, we carried out a
comparison between the expenses necessary for covering the entire basket of services
and the financial coverage possibilities for each subsection. Once a deficit arose, we
went on to analyze the instruments used to solve the problem.
2.6.2 Characteristics of the Argentinean health system
The Argentinean healthcare system is generally considered as a very fragmented, heterogeneous
and scarcely equitable one in its organizational and financial aspects and its accessibility
to healthcare services 1 . The consequences of these characteristics may be observed in
the differences presented by population health status indexes 2 .
Some studies 3 state that it is not fair to speak of a “healthcare scheme” considering the lack
of coordination between the parties that constitute its organization. But beyond semantics,
it is clear that the lack of coordination and organization hinders the efficient use of resources
and acceptable degrees of fairness. The lack of integration between the distinct subsections
(public, social welfare, private) is evident, but a high degree of fragmentation is also evident
within the same. The public sector contributes to this overall situation by a division according
to jurisdictions (national, provincial and municipal) that are not coordinated with each
other.
The present organization of the Health System is the result of a question that goes beyond
the dynamics of its own sector. Public subsections, Social Welfare and the private sector are
in charge of healthcare goods and services. The national point (Ministry of Health) are
responsible for administering the system on the whole, through regulations and programmes.
However, due to the federal structure of the country, provincial governments possess
a certain degree of independence on the matter of healthcare policies, which require definition
of agreements between the State and Regions. The outcome is that provincial govern-
1 Post-lauream in Salute Sociale e Comunitaria. Modulo 5. Politiche di Salute. Ministry of Health and Environment, 2005.
2 Basic indexes Ministry of Health – OPS/OMS (Year 2005). www.msal.gov.ar.
3 See Cetrángolo and Devoto 2002.
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