General

In 2000 the total population in Argentina was estimated at 37 million. Argentina is divided into 23 provinces and a federal district, Buenos Aires, the Capital Federal.

Resources for health services in Argentina were US$ 22.700 million in 1999 of which US$ 5,400 million were for public hospitals, US$ 8,300 million for Obras Sociales and Pami, US$ 2,300 in Pre-paid services, US$ 6,700 direct payment for beneficiaries.

Health expenditures as percentage of GDP were 7.4% in 1997 and 9.7% in 1999.

The public sector has an annual budget of US$ 13.012 million, representing 1,9% of GDP. The GDP per capita is US$ 8,514. Health expenditures per capita amounted to US$ 675 in 1997 and US$ 826 in 1999.

The compulsory portion of healthcare has two components: the government-administered component is financed through tax revenue (on a pay-as-you-go basis) and guarantees a standard minimum benefit according to principles of redistribution and insurance; the private component is geared toward savings and security, and takes the form of individual member-capitalised savings plans or company-managed plans that are funded by joint employee and employer contributions, fully and individually capitalised and regulated by the government (i.e., fully funded plans).

The voluntary plans are identical in all respects to the fully funded plans with the exception that they are capitalised exclusively by the beneficiary.

The health services system is composed of four main sub sectors: the public hospital sub-sector (i.e., government-provided financing and services), the Obras Sociales (employee-benefit plans formerly run by unions and now organised by professional category), the private sub-sector (Pre-Paid voluntary insurance plans based on actuarial risk) and Insurance companies which cover a marginal sector of the economy. There is a strong bias toward curative care, with emphasis on hospital services. Although national, provincial, and municipal policies all define primary healthcare as their basic strategy, most of the jurisdictions that have adopted this strategy approach it in the form of "programme's" to be carried out at the primary care level.

The Obras Sociales plans are a system of compulsory social insurance that includes other benefits in addition to healthcare. Their financing comes from employer (5% monthly of salary) and employee (3% monthly) contributions. The Government is expediting deregulation of the sector in order to foster competition between the Obras Sociales plans and private (pre-paid) health insurance companies, encouraging beneficiaries to take an active role in choosing their Obras Sociales plan, and guaranteeing that all plans afford the basic benefits package of main services, diagnoses, and treatments for subscriber and dependants (PMO) as required by law. Benefits for primary and secondary care have a small co-payment (US$ 5 or US$10 for doctor's visits) but in-patient care and complex surgery/procedures are free of charge. There is a 50% cover for drugs.

These Obras Sociales used to be linked to economic activities. Therefore each industry had its own OS as they vary in their level of quality of service and their services depend on salary scales and contributions. Nowadays members can choose any OS if they deem it to provide better care. By law, OS are not allowed to impose waiting periods, pre-existing conditions or exclusions. There are approximately 260 Obras Sociales providing care to 16 million members.