A number in recent years monotributistas The number has not stopped growing rapidly in the country to the point where it is close Three million. As is known, one who adheres to monoattribute must choose it social work And if it doesn’t it is assigned by default. The problem starts later, when these potential patients need medical benefits.
By consulting experts Clarion He agreed that these citizens find themselves in a quandary today bureaucratic inertia Which is difficult for them to remove. Thus, adequate access to health becomes a debt for them. The government’s mega DNU, which legislates on health issues, has not been involved in this financing problem, which is One of the main ones which is passing through the system in crisis.
The government admits that putting social works All kinds of obstacles To engage monotributistas, because input What these people do is menstruate Very little. On the other hand, if in the framework of this deficit they resort to the public system, they may also face obstacles for being – in theory – social work.
This New “No” -a term once popular to refer to young people without study or work, resigned to lack of access to health- are the involuntary protagonists of a contradictory scenario: the state wants to benefit the monotributista with the right to coverage, but the beneficiary remains. Caught up in the story, the virtual tug-of-war taking place in between took a toll Social Security and Public Health.
The conflict is reproduced year after year with no resolution. “Social works have about two million monotributist affiliates, who contribute an average 6 thousand pesos per monthWhile contributing around affiliates (more than 12 million people) in a dependency relationship 25 thousand“, explains Clarion Source of one of the largest social works in the country.
Enter a guard. Those who are supposed to belong to social functions are stuck in limbo.With these figures, the source tries to argue why social works They don’t want to be filled with monotributistas, in the sense that these people contribute very little based on the benefits they are entitled to claim. Opinions on the subject, indeed, reveal that Toxic stress between two of the three subsystems (the third is private) that make up Argentina’s health care contract.
“The state throws a party and social functions pay for champagne,” he writes in the dialogue. Clarion Ruben Torres, former Rector of Isalud University and one of the most important healthcare professionals in the country. “Social works, whenever a monotributista pays them, They are losing a lot of money. That is the reason for rejection. “
Torres adds: “The law says that once you become a monotributista you have the responsibility to choose social work and if you don’t, the Superintendence of Health Services (SSS) assigns it to you. Whether you use it or not, you have it on paper. So if you want to be treated in a public hospital, you will appear as such on the registry Associated with social workAnd so barriers to care begin in the public system.
Adolfo Rubinstein, former health minister during Mauricio Macri’s government, believes that “there is a Strong disappointment So that social functions involve monotributistas. The problem is that they collect contributions and They do not serve. They don’t admit it openly because legally they can’t, but they do it Bureaucratic obstacles“
The expert adds that “in theory the procedures are quite clear, but there are A framework that constrains and excludes. On the other hand, if the person goes to a public hospital, the provider must complete the procedure for recovery of benefits through the superintendence, so that the social work can reimburse the amount, which Very burdensome“
The public hospital that cares for the social work adjunct must request reimbursement later.For Rubinstein, the bottom line of the issue is the impracticality of the system due to its fragmentation: “There are 291 union social functions and two-thirds Less than 30 thousand members each. They are not viable and end up collecting additional funds and contributions from affiliates that do not serve them.”
disruptive effect
A research titled “Three studies for a new management model in social security” published by the Osdepym Social Works Research Institute in 2023 explains that “ Disruptive effect of monotax “It happens because those social functions break with the logic of creating and operating distributive justice.”
Analyzes that “affiliates in a dependency relationship and monotributist affiliates of social work contribute very unequally, as those in a dependency relationship do so. According to your financial capacityWhen monotributistas contribute the same amount Whatever category they belong to.
Rubinstein recalled that a correction was made in 2022 so that the highest categories of monotaxes “paid a little more”, but that still measured the problem. Exceeds the patch And the issue remains unresolved. The proof is that monotributists are seen as a “threat” whenever they approach social work to try to get a card.
In SSS they are not only aware of the situation, but this kind of conflict is between them Main demands Created by users, who also have a website available to file a complaint related to that organization.
According to official data, they transferred together in 2023, regarding the reimbursement of social functions to the state 23,215 million pesos, this is down from 24,340 million in 2022 and 30,880 thousand in 2021 (full covid stage). In 2020 it was 23,856 million pesos and in 2019, 12,189 million.
If the period of health crisis due to the epidemic is excluded – in which health services were obviously in greater demand – and 2019 is compared with 2023, it gives 90 percent increase In repayment of social works in five years, when more than the cumulative inflation of the period six times figure it out.
