Since the beginning of the ’90s, many Latin American countries have implemented reforms hoping to improve health systems and reduce inequalities in access to health care. Yet, considering the disparity between what is medically achievable and economically viable, some form of rationing becomes unavoidable. In other instances, there is no efficient allocation of resources. As a result, the inability to expand coverage and the reduction of health inequalities remains a challenge in Latin America.

Argentina is one of the leaders in Latin America concerning health care expenditure per capita. When compared to other countries in the region, its health care system performs well on several key indicators, including life expectancy, child mortality rate and access to health services. However, like other countries in Latin America, Argentina struggles with challenges related to equity and efficiency.

Argentina’s Health Care System

Health services in Argentina are divided into three main parts: the public sector (national, provincial, and municipal), social insurance (Obras Sociales) and private health services. Approximately 35% of the population depends on public health care. This division helps manage and deliver health services to different groups of people. The public sector covers a significant portion of the population, ensuring access to healthcare services for those who rely on it. The rest have some form of health care coverage, either from the Obras Sociales (60% of the population) or the private health care system (13%). Approximately 10% of the population has access to more than one coverage system.

An administrator at the Secretary of Public Health of San Isidro, Buenos Aires, stated in an interview with The Borgen Project, “Due to the economic situation, many people are falling out of the private system, which is overwhelming the public system.” To combat this high influx of patients and ensure that everyone’s needs are met, the administrator stated the government set up a 35-day window for the maximum number of days that a patient can wait to receive an appointment. However, this wait is often greater in rural areas. This stems from the discrepancies between resources available between urban and rural areas. For example, the Hospital Central de San Isidro contains around 300 beds, while a hospital 500 miles away could have only 12 beds. The number of beds offered is calculated based on the size of the population.

Public Health Disparities

While public health care is accessible to everyone, significant disparities exist at the provincial level in terms of public health care expenditure, the availability of medical professionals and infant and maternal mortality rates. For instance, the mortality rate in colorectal and cervical cancer is 7 and 5.4 times higher, respectively, between the most affluent and the most economically disadvantaged provinces in the country.

These disparities in cancer mortality have been linked to variations in provincial capabilities for early detection, diagnosis and patient treatment. For instance, just 29% of women aged 50 to 70, who depend solely on public health services, have had a mammogram. One reason for this is the elevated transportation costs encountered by residents in rural communities when going to hospitals.

New Initiatives for Addressing Disparities

To enhance public health care access, the World Bank Board of Directors has sanctioned a $50 million investment for Argentina. This funding aims to assist 6.5 million vulnerable residents in Buenos Aires province. Under this initiative, the province will provide high-quality health care services to all citizens, regardless of their location, whether in rural or urban areas. This endeavor seeks to bridge health care gaps and ensure comprehensive coverage for the province’s diverse population.

In 2019, cardiovascular diseases and cancer accounted for 50% of deaths in the province. Treating these diseases requires constant attention and ongoing efforts. Noncommunicable diseases disproportionately affect the vulnerable population group due to lifestyle dynamics influenced by social and economic factors. In tackling these challenges, the investment will concentrate on strengthening electronic medical records and advancing the implementation of telemedicine.

Argentina’s Recent Successes Against Health Disparity

The Protecting Vulnerable People Against Noncommunicable Diseases Project Project (also known as PROTEGER) aims to strengthen the preparedness of Argentina’s public health facilities. This involves expanding and improving services for noncommunicable diseases (NCDs) specifically tailored to vulnerable population groups. The project’s overarching goal is to shield these vulnerable groups from prevalent risk factors associated with NCDs.

From 2015 to 2022, Argentina achieved several noteworthy outcomes through this project. For example:

• The percentage of participating public health clinics certified to provide quality health services for the detection and control of NCDs increased from 0% to 69.8%.
• The number of health institutions that provide new services for the early detection of colon cancer hit 877 by 2022, exceeding the goal of 850.
• The percentage of vulnerable patients regularly monitored for type-2 diabetes who had an HbA1c lower than 9% increased from 7.1% to 11.5%.
• The percentage of vulnerable patients regularly monitored for hypertension with an arterial pressure lower than 140/90 (i.e., the threshold between elevated and high blood pressure) increased from 6.1% to 8%.

Looking Ahead

Argentina still faces challenges related to public health, but substantial progress has been achieved. The nation remains steadfast in its commitment to enhancing the accessibility, equity and effectiveness of its health care system for the benefit of all citizens.

Speaking on the future of health care in Argentina, the administrator stated, “Public health care is a real thing that can be applied in every country of the world because it has been verified by many countries. I can say from my experience in Argentina that you can have the best equipment and resources you could [under any other system of health care].”

– Cameron Alcocer
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