To understand why health in Peru is almost a privilege, it is useful to outline the logical drive to certain types of viable or not to exercise the right to health. In order to facilitate analysis puts us in the field of health services and health care organization, leaving for another time as related to social determinants of health.
The country has a tendency to recognize that everyone would have the right to access health services. But this trend, among other reasons, is limited by a constitutional contradiction. While Article 11 stipulates that the state only guarantees free access to health services, Article 10 does recognize the universal and progressive right everyone to social security. Social security to undoubtedly includes health as one of its scope.
The 1993 Constitution thus facilitating the implementation of competition in the market is that access to health care distributed on the basis of purchasing power, but in turn holds a different perspective on social security covered, which according to its principles driving the full realization of the right to health. It is precisely this discussion that the country and public health professionals have not resolved. But what is verifiable is that the state, since the scheme began in 1992, has opted to strengthen the first perspective.
If the state only guarantees access to benefits health, in practice abdicate their responsibility to the right to health and focuses on providing care to the extreme poor and poor luck. To make effective its limited resources, requires the beneficiaries of their health care, to demonstrate and extend their poverty and identification. This leads to implement the subsidy claim through payment mechanisms euphemistically called public insurance. And obviously, this insurance will never be comprehensive because they do not have sufficient resources to do so. Deepens and the distinction between citizens should have equal rights, and establish care packages that create situations that reach limits that violate human dignity.
On the other hand, the universal and comprehensive perspective, argues that access to health services is not dependent on purchasing power and poverty status of individuals but of their status as human beings. This makes it promotes the enforceability of health care, against which the State should organize and promote the reforms necessary to provide progressively. While this means more funding, it also makes clear the need to move towards real health reform precisely to facilitate such access universal and comprehensive. This reform will become necessary if placed before the right to health, whereas if placed in front of targeting and the always useful excuse for the lack of resources, that leads to governmental efforts to be satisfied with half health to the poorest.
In Peru the first perspective is being developed, ie the state is primarily focused on bringing care packages to the poor. Thus, all other health workers in practice do what requires immediate interest. It is no accident and the expansion franchise in health and Hospitals Solidarity EsSalud screen advertising, the growth of pharmacy chains, the growth of private insurance restrictive in their attentions, and many other phenomena that have been some to argue that Peru would be a failed state in the toilet.
Others believe that no, this quest for a universal real face of targeting can be reversed. This requires encouraging and demonstrate the ideological debate with facts and ideas to leading this trend. Colombia, which has been and is the experimental field of health insurance, health care is collapsing. Proponents of this model indicated that 90% of Colombians have health insurance, that's true, but reality is that insurance does not guarantee that citizens care and access given only minimal care plan, also The government faces blackmail for insurers private end of every year insist that they increase funding.
's own framework law enacted universal health insurance a year ago, acknowledged in its article one, the right to full and progressive social health insurance. Thus the current state of expansion of access to health should be seen as a transition, as short as possible, to achieve a real globalization, which is not the property or goods which define access to health, but the human condition.
it is necessary to extend the framework to discuss and overcome the narrowness that poses health insurance, leading to substantive issues, which are those having to do with vesting for the exercise of freedoms and capabilities. In health, it can be built only from a public logic, this logic implies that the State assumes its responsibility and allow public and private competition in the health field, but with conditions under which the right premium and not the interest. Alexander Sack
March 10 2010
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