Convention: Study estimates the cost to the Treasury of eliminating Isapres at $580 billion annually | Digital medium The Northern Fox

The Commission on Fundamental Rights of the Convention is preparing to vote on a new article that would leave out two of the main fears of the clinics: that “for-profit” providers be excluded and the existence of the so-called “secondary insurance” be eliminated. floor” or “complementary”.

Why it is important: According to the study “Financial Cost of Modification of the Mixed Health System”, prepared by the Citizen Free Health Movement, the proposal made by the Convention will not only have more costs for the Treasury, but will also be “directly regressive ”, they say.

  • “The mandatory contributions of current Isapre contributors are not enough to finance the benefits included in the current Fonasa benefits package. Its inclusion in a Single Fund would generate an additional cost for the treasury of 584,000 million pesos per year, “says the report.
  • This extra cost for the State is generated from two problems: Isapre contributors will only contribute $2.3 billion pesos per year, equivalent to their mandatory 7%.
  • Today the contributors contribute to the Isapre $3.3 trillion, considering almost $900 billion of additional voluntary contributions, an amount that allows to improve the coverage of the plans. These $900 billion, because they are voluntary contributions, will not go to the single system.
  • “It should be noted that, in the case of unifying the health systems, it is only possible to have the mandatory contribution, that is, the 2,346,000 million, since the other resources are freely available to the contributors,” the study indicates.
  • A second factor that will cause debt, according to the citizen organization, is spending on medical licenses. Fonasa, indicates the study, rejects 15.3% of these permits, while the Isapre 27.3%. This gap would imply greater spending for the Fund, estimated at $207 billion. In addition, it is estimated that practically half of the contributions is used to pay for health permits.
  • Victoria Beaumont points out that, as it is proposed, the new system proposed by the convention will affect chronic patients, older adults and GES beneficiaries. “This is clearly a regressive proposal, because the people of Isapre will not only not finance the public system with their 7%, but, on the contrary, they will end up receiving a contribution from the Treasury for being in this system.”

Clinics and Isapres waiting for a vote: Between the two main actors in the private world of health there are two words that summarize their state of mind: concern and uncertainty. These are the main knots that today concern these sectors that will be attentive to the next debates in the Convention, which should dispatch the article between Tuesday and Wednesday.

What the clinics think: They are clear that eliminating the Isapre will affect private health providers. However, today 52% of those who attend clinics and private medical centers are beneficiaries of Fonasa. The estimate made in this sector is that, in the medium term (not beyond 5 years), 60 to 65% of its beneficiaries would be from Fonasa.

  • Gradual and temporality to develop the transfer process to a universal health plan. Although there is no detailed estimate, it is estimated that this process should not be ready before 3 to 4 years.
  • The waiting lists and postponements caused by the pandemic still weigh. More than 600,000 patients are waiting for surgery due to the pandemic, a contingency in which private clinics provided 40% of the beds.
  • Although the possibility of limiting private agreements with the universal fund only to those providers that are “not for profit” was returned to the commission, among the clinics they hope that this idea will finally be discarded this Tuesday.
  • The other article that complicates them is the one referring to the elimination of so-called “second floor” or complementary insurance. A source from the provider world maintains that “the idea is so bad that, for example, a collective insurance that a union or a company has, with this regulation would be eliminated, harming all those workers.”

What the Isapre think: For private insurers, the outlook is worse. They absolutely give up the battle and assume that yes or yes the end of these companies is imminent. For this reason, for now they are only waiting for the outcome of the plenary vote, although they take it for granted that the private health insurance model is close to extinction.

  • There are two key points for the Isapre. The most relevant, define the gradualness of the process. Sources in this sector suggest that rather than define a fixed number of years, strict conditions must be set so that the Isapre are eliminated once the new system is operational and a framework of action is defined that ensures people and the fund. that there will not be an effect like that of the start-up of Transantiago and its chaos in the first few months.
  • A second focus is given by the possible limitation of actors such as private insurance. Avoiding competition by eliminating insurance, they point out, will have a negative impact on people’s coverage and will leave captive groups out.

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Convention: Study estimates the cost to the Treasury of eliminating Isapres at $580 billion annually | Digital medium The Northern Fox


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