In January 2013, the Federal Registry of Health Establishments (Registro Federal de Establecimientos de Salud - REFES) indicated there were 5,012 health establishments operating in Argentina, including hospitals, clinics, and hospices, amongst others. The majority of the establishments (70% or 3,494 establishments) pertain to the private sector.[5]
Social Security
The Social Security Sector is funded and managed by Obras Sociales (Insurance Plans), umbrella organizations for Argentine worker's unions. There are over 300 Obras Sociales in Argentina, each chapter being organized according to the occupation of the beneficiary. These organizations vary greatly in quality and effectiveness. The top 30 chapters hold 73% of the beneficiaries and 75% of resources Health Care in Latin America.[6] MSAS has established a Solidarity Redistribution Fund (FSR) to try to address these beneficiary inequities. Only workers employed in the formal sector are covered under Obras Sociales insurance schemes and after Argentina’s economic crisis of 2001, the number of people covered by these fell slightly (as unemployment increased and employment in the informal sector rose). In 1999, there were 8.9 million beneficiaries covered by Obras Sociales.[7][needs update]
There is a body within the social security sector in Argentina called "The Superintendence of Health Services" La Superintendencia de Servicios de Salud, which is in charge of setting the minimum coverage package that is included in the health insurance of every single health-care institution. This allows for a more transparent set of criteria for decision-making process within a sector of the Argentinean health-care system.[8]
Prior to 2000, workers did not have the freedom of choosing which Obra Social they contributed to and were covered by. This situation gave rise to some problems; e. g. a teacher living in a city where the gastronomy workers' Obra Social provided better care than the teachers union's Obra Social could not freely switch plans even when it would have been in their best interest. This was mended in the year 2000 when National Decree 446/2000 was signed into law which established changes to the regulation of Obras Sociales,[9] allowing for workers to choose freely between Obras Sociales administered by different workers unions (although they are still obligated to adhere to one of the Obras and make regular payments).
Private sector
The private health care sector in Argentina is characterized by great heterogeneity and is made up of a great number of fragmented entities and small networks; it consists of over 200 organizations and covers approximately 2 million Argentines.[10] Private insurance often overlaps with other forms of health care coverage, making it difficult to estimate the degree to which beneficiaries are dependent on the public and private sectors. According to a 2000 report by the IRBC, foreign competition has increased in Argentina’s private sector, with Swiss, American and other Latin American health care providers entering the market in recent years. This has been accompanied by little formal regulation.[10]
Public system
A system of public medical facilities is maintained by the government. The public system is highly decentralized, as it is administered at the provincial level; often primary care will be regulated autonomously by each city. Since 2001, the number of Argentines relying on public services has seen an increase. According to 2000 figures, 37.4% of Argentines had no health insurance, 48.8% were covered by Obras Sociales, 8.6% had private insurance plans, and 3.8% were covered by both Obras Sociales and private insurance schemes. Currently, about half of the population uses the public system.[11][7]