Medical service providers across the country say they are in crisis. The sector that brings together the social works of hierarchical personnel, mutuals, community hospitals and sanatoriums and clinics of civil associations across the country that covers around 70% of health coverage indicate that it is in intensive care and that in the last 10 years they disappeared “between 40% and 50% of the clinics and sanatoriums of the country”.
The health sector has been declared in emergency for 17 years, a situation that allowed some sanitariums not to make the contributions to be financed through this difference and to overcome the stretching of the payment terms of the national and provincial State every longer. This generated a virtual situation that, according to the president of the Association of Clinics, Sanatoriums and Private Hospitals of the Argentine Republic (Adecra), Jorge Cherro It means “a debt of around $ 10,000 million without counting interests and punitive claims that if Afip claims it means the closure of the private health sector.”
But not only the representatives of the clinics and sanatoriums were “distressed” by what they described as a terminal situation. Jorge Piva of prepaid Ase Conecta and Jose Sanchez Emergency director and of the Federation of Home Care Companies showed up in symphony. “In the last 5 years the number of companies has been reduced by half,” Sanchez said.
While they assure that they can no longer pay the “Macri bonus” of $ 5,000 and now they are added the salary increase and that they feel that the sector is in conditions of “abandonment” on the way to a “silent death”, next week they will meet with the minister of health Gines Gonzalez Garcia who will again take a document with measures they deem necessary.
“You cannot update the rates, the contribution that workers make through social works is not enough because wages lose against inflation, so we are going to ask that, since we function as subsidiaries of the State, we have some exemption tax”Said Cherro. So they will ask for the following:
– Provide free availability for the use of non-computable technical VAT balances, generated by the VAT exemption for social and prepaid works;
– Do not apply VAT on the direct import of capital goods, medical supplies and medicines since they accumulate as unrecovered credits,
– Exempt from income tax what is paid by families as a fee to prepaid medicine companies or additional contributions,
– Level the tax on the check to the rate of social works which would imply passing the rate from 1.2% to 0.5%;
– Adapt the moment of payment of the employer contributions with the moment of collection by the medical providers of the bills that are issued to the social and prepaid works,
– To tend towards the elimination of the provincial gross income tax and the rates of municipal commerce and industry for private health providers and lenders,
– Creation of a special employment contract for relations between the lending institutions and professionals in the liberal practice of medicine; Replace in the definition of SMEs the personal variable occupied by the number of beds in the medical provider sector;
– Establish a zero tariff on the importation of capital goods and specific supplies for medical care that are not produced in the country
– Exclusion of the credit invoice regime for companies in the health sector
– Advance the unification of the aliquot of employer contributions to 19.5 for all employers, which is scheduled for 2022
– Extension of the sanitary emergency and special moratorium with reduction of compensatory interests, extended terms and exemption of sanctions.
“We are going to ask Gines to ease our costs and to call a consultation table to find a solution to the system that does not come on the revenue side because people cannot pay more,” Piva added. If only the VAT measure is applied and the reduction of the tax on the check would have a fiscal cost of 52,000 million pesos.
A point that companies also want to discuss is what is within the Mandatory Medical Program (PMO). “Now they are pointing out that the prepaid would have to cover the sunscreens. We have to agree what will be inside the PMO and what not, because nobody knows the cost of the PMO, ”Piva explained.
At this point, employers will ask Gines that the Emergency Medical Program be left with “primary health care benefits of 1st, 2nd and 3rd level and specific funding fund for new high-cost technologies . The emergence of the health sector requires guaranteeing the financing of the most frequently demanded benefits and with proven cost-effectiveness from the population point of view, to meet the needs of the majority. The incorporation of new technology, which in general does not have robust evidence of effectiveness and is directed to the attention of particular cases, should be financed with a specific financing fund for very high cost innovations, plus the commissioning of the agency of evaluation of health technologies “.
Guillermo Lorenzo, Vice President of Adecra Cedim was lapidary: “We told the legislators and explained it to the officials of the previous management. They are just going to understand the state of the situation we are in when the crisis is so important that they don’t even have a place to attend. ”