Little by little, but without pause, the doctors abandon the social work and prepaid bills and decide to attend in a private way, charging their patients for consultations. The cause of the sustained flight of professionals, justified by the delays in payments and a delayed updating of values, despite the sustained increases for affiliates, has a direct impact on the restrictions on private care and a consequent shock on the demand in public health.
The outpatient medical attention to patients with prepaid and social works had been the subject of a tironeo between professionals and medical companies. However, with the unstoppable rise of inflation of the country, the situation finally broke down and both in Río Negro and in Neuquén the neighbors wander around trying to get turns or refuse to pay for the consultations on their own.
“Personally, after the pandemic I chose to work privately. The reality of doctors is increasingly difficult. Although we are independent professionals, in this inflationary reality above 100% per year, we lose a lot“, synthesized the neurologist Sergio Lindembaum, member of the board of directors of the Medical College of Bariloche.
Warned that the query value is low and every update –“slow”– remains below annual inflation. The last recomposition granted by the social and prepaid works in Bariloche was around 70 or 80% average.
The president ofl Neuquén Medical CollegeDaniel Castro, He also referred to what happens in the city. «When -the doctors- go looking for Your payment is not keeping up with inflation.exposed in dialogue with Diario BLACK RIVER.
«So far this year the social works have increased by more than 50% and we receive 4%, 3% per month,” he explained, adding that it is half of what the social work receives charging their associates, “that obviously makes the consultation does not follow the inflationary rhythm».
In cipolletti, where the main medical specialties of the Alto Valle are concentrated, the situation is no different. “With the level of inflation that we have and the delay in payments makes it unfeasible maintain the provision”, indicated a manager of one of the main health centers in the city.
The sources consulted from the cipoleño private service indicated that some obras sociales and prepaid take more than 30 days to make payments. There are also cases where payments to doctors are settled in 60 days after submitting the invoice.
Flight of prepaid doctors: the spring of the plus in Neuquén
Daniel Castro, president of the Neuquén Medical Association, commented that until before the pandemic it was charged in a timely mannerbut then the delays appeared, «more than the delay is loss of value due to delay“, he indicated.
To solve the problem, he stated that “there should be a recomposition of values”, but until then doctors are still in the same situation, so they must look for alternatives.
The most chosen is collection of the bonus «Today already we have no way for doctors to work without charging patients because the query is generally 50% or more below what a query would be,” Castro said.
However, he guaranteed “from the medical school We do not endorse the collection of the plus because the current agreement says that it cannot be collected, but it is known by all the patients that they end up charging an extra”.
There has been talk of other alternatives to equalize income, How to transfer the cost of some materials to patients. Despite thisfrom the association they were unaware of this activity.
Prepaid and social works, the case in Bariloche
Sergio Lindembaum could not specify how many doctors have already chosen to cut the care of social works. But The percentage of professionals who reduce -or extinguish- the universe of social works is increasing.
“Many times, They come to consult the Medical College for the value that consultations should have. And they decide to unsubscribe from the social works that are below those values. Suddenly, many have been discharged from Ipross, Iosfa and Unión Personal which, in general, have the lowest values,” Lindembaum described.
In certain cases, professionals who decide to continue working with obras sociales that pay low values opt for an offer of few shifts per month.
recognized that not all doctors can get out of the system. Those who require an operating room, for example, are somehow forced to continue care. In any case, in these cases, the forte of their income does not come from the consultations.
When he decided to limit care in a particular way, Lindembaum considered how he would like to care and decided that the shifts be extended by 30 minutes. «For a low fee to be useful, you have to generate quantity. So, many take turns every 10 minutes, 15 minutes. In 10 minutes you can’t ask anyone anything. In my specialty, neurology, 20 minutes is a fair amount of time. In 30 minutes, one attends calmly. I feel like I’m doing the best I can,” she concluded.
Cipolletti’s doctors are leaving the prepaid and social works, the pressure reaches the public sector
The exodus of doctors from prepaid and obras sociales envisions a complex scenario for the private health system in Cipolletti.
A long time ago many professionals decided to cut the provision of services, but in recent months the crisis deepened and many specialists they only attend privately.
“Con the level of inflation we have and the delay in payments make it unfeasible maintain the benefit”, indicated a manager of one of the main health centers in Cipolletti. The first measure that was taken, and still persists, is to apply coinsurance.
However, the gap is increasing and users of the private system complain about the continuous increases. Many cannot pay them. “The thing is people also do not have, in general, the ability to pay”, recounted another manager and doctor from the town of Alto Valle.
both professionals They agreed that the “leakage” of prepaid and social works occurs mainly in doctors with experience. “There are recognized specialists who do not attend directly with any social work, only private consultation. Of course not everyone can do it. But the majority of doctors with experience work like this, ”they say. They understand that it is a precariousness of the system with health professionals.
“A recognized doctor. By name. With many patients you can say, I only work privately, but how many are there? The rest of us are slaves to a rather dysfunctional system.”, assured a clinical doctor.
the scene of crisis adds to the growing demand of the public health system which in turn has less and less supply. Many people they go to the hospital because they cannot pay for a consultation and that creates a bottleneck in the response to the health service. Shifts, except emergencies, are achieved in 2 or 3 weeks. In some specialties take more than a month to get an appointment with a doctor.
