Prepaid medicine: Co-payments, affidavits, and the dilemma of health as a business

Written by Claudio Boada *

A few years ago, prepaid medicine was limited to a wealthier sector that could afford it. But today, with the transfer of money from obras sociales to prepaid, the number of prepaid members has increased and reached many sectors. For this reason, this issue today is not for a wealthy sector, but for many workers with middle or low salaries.

Those tied to prepayment are captive consumers because everyone with a chronic illness or disability needs prolonged treatment and continuity of prepayment. It’s not easy to get into another health system when you have a chronic illness. When people go through a difficult economic situation, they give priority to certain expenses and within them paid expenses appear, which is irreplaceable because we are talking about health.

We’ve had increases well above inflation rates for prepaid medications, and this year ended with an increase of 130 percent year-over-year. The last installment was divided into two parts and a new system of increases in payments made in advance was created. Thus, they will have different increases if the user has an income of less than six minimum wages, which at this time is about 392,000 pesos.

Those with incomes below this number must submit the statement before the 20th of this month, in which they declare their income and, accordingly, they will pay 90% of the average increase. In February, the increase will be 4.95 percent, instead of 8.21. This affidavit must be filled out every month to maintain this quota, which is less than that set by the government. This proposal is, initially, for a period of eight months.

Still, we have some doubts. One is if we talk about individual income or family group. According to prepayment, it refers to the household income because, as the income goes up, more people will pay higher fees. In addition, it is not specified whether gross or net salary is being discussed. And how the system will work if someone has a fluctuating income varies. We think regulation needs to be more intense for these kinds of increases not to be there.

We’ve always been very critical of co-payments because it seems that by making an upfront payment, you also have to make an additional payment when you have a problem. Co-payments restrict the use of health systems, which must be inclusive and accessible to all. During macrismo, there has been an expansion of this system. We question this because, in a time of need, you have to make a joint payment, with which one wonders what is the validity of paying something else every month.

* Holder of Users and Consumers Union