Apparently it is true that spending millions of suns EsSalud the insured to play in the Bolsa de Valores de Lima (BVL). No officer of the company has denied the Congressman Garcia Belaunde, besides this issue had already been talking about for quite some time.
EsSalud What could be argued to justify the use of money insured in this way?
The only argument would be visible on the LSE the money can be increased much more than otherwise and that would benefit the insured. But that view is untenable for several reasons:
These decisions have been taken almost in secret, without any assured knowing that their money was placed in the BVL (García Belaunde has been said that Essalud has lost 50 million soles);
stock games have huge risks, the money earmarked for social protection in health can be lost due to certain financial and stock market speculation;
Allocate million soles of social security to the BVL is itself nonsense, as opposed to the original purpose of EsSalud, because win or lose, which in the end it does is give money, even temporarily, speculators and financial investors (not an exaggeration to think that our money could be serving for reasons contrary to freedom and the right);
The issue is not that you can get more revenue in the LSE, but is unacceptable to risk the money that workers and employers give to an organization whose work is social security health and not the financial game. Consolidate
EsSalud early
On several occasions I have found evidence of people and families with EsSalud grateful for saving the lives of their families or provide treatments that would otherwise be unviable. It is true, despite all its limitations, there is an effort EsSalud reflected in a proportion of their workers, which makes comprehensive care to the insured is entitled to be effective for some (according to National Health Accounts in 35 only % of the insured does care when required). The question is why not all Peruvians have that same opportunity to obtain health care as a right and be more free in relation to contingencies?
means that the insured EsSalud have that right because they contribute to the solidarity fund, according to this reasoning, it is clear the labor formalization which discards a contribution to social security in health, not be possible in the country, nor in any country today that that is the foundation of the universality and comprehensiveness of health care or social security in general. Given this finding, trimmed to poor health grant from the logic of targeting scarce resources is a narrow, more appropriate would be to build a system to reduce the differences between Peru, seeking to raise funding and expand access to health, to that everyone at some point we have what we EsSalud in theory and in practice must provide: universality and comprehensiveness.
Those who are committed to maintaining the status quo in health create paranoia among the insured, in the sense of holding that if you choose to go towards the creation of a National Health System, will be an "invasion" of all poor not contribute to the financial apparatus / social benefits of EsSalud, or that there is a danger that the contributions will be diluted as the creation of a common fund for health would reduce their rights. First it is necessary to establish that it is inevitable the need to establish a National Health System, but not on the basis of the unification of the providers, but an approach to ordering medical chaos that exists today, where the various legitimate interests hidden and act according to their immediate convenience, which leads to the exclusion of most Peruvians the possibility of a right to health.
state responsibility and fiscal support
On the other hand it is necessary to overcome the view that only those that provide the return from work to have a formal job are the ones who build funds for their health care, all absolutely all Peruvians pay taxes direct or indirect depending on your activity or position, either because of income or indirectly by acquiring the majority of public goods or services from the VAT. That is, no less appropriate than the distinction among Peruvians with access to health and those without access to health, from a logic of immediate contribution.
In any case, there is a financial gap that prevents EsSalud uninsured access to all necessary services, to be responsible for closing is on the State at all levels, not the uninsured population, this leads to establish the need for a higher tax and substantial contribution to match the conditions of Peruvians from access to health, and also explore the possibility of contributions from organized groups that choose to do so, with the horizon to provide all the same regardless of its direct contribution.
EsSalud What makes money by placing all insured on the LSE, is a product of non-existence of a system capable of producing order and orientation of health actors. If we know that one of the key problems is access to health care financing, and one of the main administrators of health financing can escape all control and spend the game in the bag (and other businesses and potentially lose millions in it) huge amounts of money, it is obvious that something needs to be ordered and regulated. EsSalud, given its importance, can not behave like an island amid a sea of \u200b\u200bhealth needs, on the contrary, the issue is to seek an order from a systemic approach that would put at the service of all people what can be useful, with the corresponding state responsibility to address the financial gap and other gross today.
Understanding the need for a National Health System
The nature of a National Health System in Peru today, would not be based on the total unification of providers or the nationalization of these, what must be understood when speaking of a National Health System, is above all the establishment without restrictions of state responsibility versus the health needs of the population, since that responsibility for establishing consistent and concerted measures to unify the aspirations of people against their right to health.
This construction can explore the alternative set in the Unified Health System in Brazil, which despite the name, which has made the state is not nationalize or providers to unify, but to establish the rules and conditions for the state to cover the services people receive in public providers, private, mixed, NGOs or others, to achieve this was due to move from the logic of direct contribution as a source of law to the public logic of increased progressive tax contribution equal to everyone the right to receive health care. This can be useful in the country, as EsSalud enjoys constitutional protection that gives autonomy and seconded to the Ministry of Labour and not the health, that created a constitutional shield to protect the funds secured from misuse by the government in power does not apply if the logic is to build a health system universal and comprehensive. Just because
EsSalud principles must be preserved is necessary to correct the distortions that have been evolving as the money put on the LSE, or operations are producing lightning Public Private Partnerships (PPP) without which there is a debate respect, neither is taken into account the voice of the insured that there are millions in the country. EsSalud has not shown beyond unacceptable advertising spending that fills the print media and broadcast, that his supposed modernization, marked by some as privatization via PPP, is really appropriate now that the country needs to define the model logic and apply health to achieve universal and integrality health claims, and thus social development for the exercise of freedoms and capabilities.
persist in fragmentation, enhanced by the interest, in which each provider seeking their own benefits and people differ in their ability to pay or not, causes the state now only responsible for the health care of those who demonstrate their poverty from packages limited and never integral. Although the government and many political parties have promoted the universal health insurance, the resources needed to implement it are not allocated by the Ministry of Economy generating conflicts MINSA / MEF - Ministry of Health / DIRESAS. It is time then to not go to the accessory, but the substance, which exceeds the figures, statistics and the insured. Alexander Sack
June 28 2010
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