In August, the “health cost index” debuts, which from then on will define the percentage of bimonthly increases in prepaid medical plans. At its inauguration, the index showed a rise of 11.34% for August which, added to the previous adjustments, will generate a accumulated increase of 68.5% only in the first eight months of the year. In any case, the companies in the sector assure that they have not yet recovered what was lost in 2020 and 2021.
The index, prepared by the Superintendence of Health Services (SSS) contemplates the increase in wages in the sector, medical supplies and medicines and also includes a percentage of “general expenses”. Thus, it indirectly incorporates the results of the parity, the rise in the dollar via imported components and also the data on general inflation.
Although with the adjustment planned for August, prepaids will accumulate a rise of 68.5%, above the inflation that is projected today for that period, it will not be the last. Given the new system, there will be new uploads in October and December. A) Yes, 2022 will close with 9 increments in the year: January, March, April, May, June, July, August, October and December.
In the sector, they assure that prepaid medical plans had delays in recent years with respect to inflation, which would explain the strong attempt to recompose underway. In 2020, the Government – which has regulated the prices of the sector since 2011, the year in which the current “Regulatory Framework for Prepaid Medicine” was sanctioned – enabled a single increase of 10% at the end of the year, against an annual inflation of 36.1 %. Although less, in 2021 the prepaid fees fell behind the Consumer Price Index (CPI) again: they rose 47% against 50.9% of prices in general.
Santiago Manoukian, an economist at Ecolatina, points out that the members’ concern about a very “accelerated” recomposition of fees is reasonable. Between August 2021 and June of this year they rose 88% compared to inflation close to 57% for that period. “With the increase scheduled for August, the fees will double their value compared to a year ago,” he says.
However, Manoukian understands that this escalation is explained by the situation of delay. “When you look at the relative price between prepaid medicine and the general level of consumer prices, you see that eIn June, installments are 15% cheaper, in real terms, than they were in December 2019. Why? Inflation will have accumulated 175% in that period, compared to the 135% rise in prepaids.
Due to this delay, last year the providers denounced that the prepaid ones did not guarantee the adequate remuneration values for their benefits and threatened to institutionalize a “copayment” by the patients. Copayment is an illegal practice, but it currently exists in the form of an agreement between individuals. It is a “plus” of money that the professional sets for her care and that the patient can accept or not. The new bimonthly adjustment scheme defined by the index details that 90% of the price update level has to go to the providers.
A report by ElegíMejor.com.ar –a platform that brings together the offer of private providers– shows that in the first half of the year the contracting of cheaper coverage grew and the internal migration of affiliates towards cheaper plans.
Currently – before considering the August increase – a prepaid medical plan in one of the leading companies for a 30-year-old person costs approximately between $19,000 and $33,000, depending on whether the plan is the most basic or the most advanced. coverage. If the coverage is for a married couple with a minor child, for example, the price ranges between $48,000 and $82,000.
“Although it may seem incredible, it is estimated that this year we are going to be 10% below inflation, because it cannot be assumed that the previous delay does not exist”, argued a source in the sector. He also pointed out that a large part of the quotas of this year’s increase were destined to cover the salary increases of the 2021 joint ventures and to update the fees of the providers.
In the sector they point out that in addition to wages, because it is an “intensive work” sector, drugs explain much of the pressure on prices. During 2020 and 2021, some drugs linked to the treatment of Covid-19 rose to 1,000%, but this trend continued even after the most critical moment of the pandemic. “Not only did medicines increase in price, but the consumption of some of them, such as ibuprofen and psychotropics, increased a lot,” said a source from the medical sector.
According to Rubén Sajem, director of the Center for Argentine Pharmaceutical Professionals (Ceprofar), in the first four months of the year the basket of most used drugs increased 23%. Since January 2022, the National Ministry of Health has implemented reference prices for some essential drugs for chronic use, but Sajem considers that this measure was “of little application and usefulness for price regulation.” The concentration of the laboratory sector, added to its great political power, complicates the regulation of the sector.
According to Sajem, the prices indicated as reference were close to the price of the most expensive medicine in each therapeutic group and the surveys show that there remains a large price difference between different brands of drugs with the same generic active ingredient; differences that reach up to 500% in widely used drugs. “Nor was the health authority encouraged prescription by generic name, verifying that doctors and dentists continue to include commercial brands in prescriptions, which in general tend to be the most publicized and most expensive brands,” he added.
DT