A couple of weeks ago, as I looked down at a gash on my foot and realized it was beginning to take on the characteristics of gangrene. The Sudocrem hadn’t managed to conquer the distasteful, and slightly greenish-mauve intruder on my foot, so I thought I’d better get it checked out by a doctor.
It was my first probe into the world of Argentine healthcare, and rather than conduct a thorough (or even vague) investigation into my available options, I let a quick googling do the work for me. The immediate options that I was given, were a list of hospitals named after European countries. Of course, I was tempted to let my ‘instinctive’ patriotism kick in, and opt for Hospital Británico, whilst dancing around my house draped in nothing but a Union Jack, but then, I noticed Hospital Alemán underneath. So, instead I let national stereotyping take control, I mean, who better to trust with your health than the Germans, right?
So, off I went to Hospital Alemán, expecting a host of friendly Germans to receive me with open arms whilst charming me with amusing anecdotes of architecture and engineering.
Upon arriving, signs were good. A crisp, clean hospital, with glass in place of walls, and a contented stream of happy patients. It was everything I had imagined, a competent operation of medical efficiency. My dream didn’t last.
Once through the doors, and at the reception, I wasn’t greeted by a friendly German at all, instead we were talking about money, a lot of it. I had just wanted a quick consultation, and maybe a few antibiotics, but we were talking about pesos: pesos in the thousands.
Now, being British, not only am I abhorred by the idea of paying for healthcare, I’m also inherently a tight-fisted mingebag. So, I gracefully declined. But, the receptionist duly informed me that there are a small number of public hospitals in the city. The closest; Hospital Rivadavia, on Avenida General Las Heras.
On this journey, I was slightly less enthusiastic, but if it was anything close to the sparkling facilities of the ‘German’ hospital, then I was sure to be all right. It wasn’t.
Arriving at Hospital Rivadavia was a curious affair. From the street, it appeared to be nothing more than a disused old colonial building, with discolored white bricks, and overcast old windows. There were no clues to the whereabouts of the entrance, or, in fact, that there was any activity taking place at all.
So, carefully sidestepping the overgrown foliage, I made my way into the hospital courtyard, hoping to find some evidence of medical practitioning. Unfortunately, that’s not what I found. Instead, it was more reminiscent of a scene from Shutter Island, than that of a functioning hospital. Lost looking patients aimlessly wondering, plants left rampant taking siege of the paving, and nothing but WordArt signs to indicate where I was.
After 10 minutes of walking freely amongst the deserted corridors, I found the reception for general patients. A cramped waiting room, filled with members of the Argentine public, all of whom looked like they had significantly more pressing medical problems than myself. A veritable array of medical emergencies that urgently needed treating. But, no help was in sight, and it remained that way for the best part of half an hour.
Eventually, an overworked nurse arrived to assist the growing crowd of temperamental health. Being at the wrong end of a sizable queue, I realized that I was there for the long haul, so I got comfortable and bedded in. An hour or two later, I was seen. The service was impersonal, and the surrounding were rustic, but I was given a shot of antibiotics up my ass and was on my way, feeling slightly perplexed, and maybe slightly aroused.
But, my musings were not of the semi-erotic manner in which my infection had seemingly been treated, but instead of the contrasts between the glistening arches of Hospital Alemán and the decaying facilities of its public cousin.
Of course, inequality is no secret, especially in Latin America. And, this is not the first time, nor will it be the last, that somebody casts a disapproving eye over public health care, in Argentina, or in any other country. But, the point is, that in a privatized, or insurance-based system of healthcare, the facilities that are left for those who cannot afford private health, or aren’t covered by insurance (often the people who need healthcare the most), are substandard, at best.
The system in Argentina is comprised of three sectors: the public sector, social care insurance, and the private sector.
The public sector, is, quite simply, the free healthcare, such as Hospital Rivadavia, funded by the government, and which, according to 2012 official statistics , accounts for 2.57% of Gross National Product. The social care system, or Obras Sociales, is a system in which social health insurance is funded by a compulsory payroll contribution from employees (3%) and employers (6%), and is administrated by trade unions.
But, it is important to note that this is not compulsory within all employment, and certainly not in the informal sector, within which many Argentine’s work. This sector accounts for 2.74% of Gross National Product . The private sector is private health insurance, funded through direct and voluntary pre-payments by insured members, and which account for 28% of total health expenditure .
To see who benefits (or in the case of the public sector: disadvantaged) from these different sectors, we can look at Daniel Maceira’s 2010 study, Inequidad en el acceso a la salud en la Argentina (Inequality in the Access to the Health System in Argentina). It shows that 56% of the population are covered under Obras Sociales, 10% have private health insurance, and 33.5% are solely reliant on the public facilities like those of the crumbling corridors of Hospital Rivadavia.
Interestingly, it also points out that of the poorest group of Argentines, 61% are covered only by the public sector, while only 12% of the richest group are without other options .
So, not that it comes as any great surprise, but the more affluent members of society can enjoy the welcoming, clean and decisive treatment of Hospital Alemán, while the less privileged get to wallow in the confusion of Hospital Rivadavia.
Now, I would like to stress, I’m not criticizing for a second the people who work at Hospital Rivadavia. I’m sure that they do the best they can for their patients, with, I imagine, very few resources. It’s not their fault that they work within a system of institutionalized inequality. Because that is what it is.
When public healthcare is determined by one’s means and their wealth, it just serves to reaffirm inequality, and fuel it from within. People at the bottom of the social ladder already have plenty of difficulties to overcome, making the importance of proper healthcare even more pronounced. And, in a country with an already extensive inequality gap, realigning the impartiality of the health care system is one of the first steps to making it smaller.
And, a quick shout of to my fellow British compatriots. We shouldn’t forget how privileged we are to have (relatively) well-functioning healthcare for all. Let’s not let David Cameron and his pesky band of Tory maniacs destroy one of the only valuable British institutions we have left.
3: Maceira, D. 2010, Inequidad en el acceso a la salud en la Argentina.