After a long and arduous debate, with 190 affirmative votes and 29 abstentions, the Civic Coalition, the PRO and Democratic Rep. of Santa Fe, Carlos Favario-the lower house approved the changes introduced by the Senate and became the controversial law that regulates prepaid medicine companies.
Thus, after a special meeting convened by Front for Victory (FPV), lawmakers endorsed the reform gathers currently about 4.5 million members in the private system.
The project was approved in August 2008 by Congress and in November 2010 by the Senate, but in that time changes were made to the original version so had to return to the House.
After the passage of the initiative opens a new scenario that puts providers on edge, who have already warned that the change can leave them on the brink of bankruptcy .
Among the key points and most controversial of the brand new rules, are:
- which states that accept prepaid shall patients with preexisting
- and referred to members may not refuse because of his age.
They joined that partners with more than 65 years old and 10 may not receive increases in their monthly fee.
law firms reached prepaid medical plans voluntary and marketing plans to overcome than the Health Insurance Agents (SSA). But excludes social work unions, cooperatives and mutuals, associations and foundations , which are covered by other regulations.
The new regulatory framework requires the private system have plans medical-care coverage and Mandatory Medical Program, as well as to provide basic services for people with disabilities .
also indicates that no waiting periods may be fixed or expected to provide such benefits.
After discussion, the president of the bloc of deputies of FPV, Agustín Rossi, said: "In the first half penalty, were not covered by insurance plans. The Senate clarified the proposal. This is a law that regulates the services of prepaid medicine companies . "
relevant changes
According to the text of the law recently enacted, the new regime poses the following scenario:
- will create a National Registry prepaid medicine companies, an entity that is regulated by the Ministry of Health, responsible for monitoring compliance with the law and regulations in coordination with health authorities around the country.
- The "minimum coverage" shall not be less than that established in the Compulsory Medical Plan (PMO) , which is one that provides essential basic services that Social Work should ensure the entire population.
- age can not be taken as a criterion for refusal of admission.
- For over 65 years, the Ministry of Health shall authorize and define the rate of increase in costs.
- Meanwhile, if people over 65 have more than 10 years old not be any increase may apply. At this point, the rule states that family group members are included to 21 years, while the newborn be automatically included, without prior arrangements.
- The prepaid plans may only offer partial coverage in exclusive dental services in emergencies, medical transfers and in localities that do not exceed 5,000.
addition, after switching to the current system until now, users may be terminated at any time contract with companies without restriction or penalty. To this end, states that, in the respective documents may not include waiting periods for benefits or waiting who are in the PMO.
Two spots
reform poses a highly contentious point, which brings alarm to the whole sector. It happens that after the passage of the new law " benefits are not limited in any pre-existing condition .
This means that a person is of a severe condition and presented to a prepaid even without having contributed in a previous enjoy full access to health coverage, since your order will be accepted without fail.
words, cover the respective treatment.
regard, President Swiss Medical Group and vice president of the Chamber of Medical Assistance Institutions (Cimara) Claudio Belocopitt, was blunt when it comes to illustrate this point with an example: "It's like a person who has no auto insurance, crash and the following day is presented to a company to cover your expenses."
He added: "This could even lead to choose not to employ a cover system and expect to have an ailment, and then move forward in this process."
In this complex scenario, is the fact that the Health portfolio " review and ensure the reasonableness of the fees " and who will be authorized by the increases, always These are "based on changes in cost structure."
Voices
He added: "This could even lead to choose not to employ a cover system and expect to have an ailment, and then move forward in this process."
In this complex scenario, is the fact that the Health portfolio " review and ensure the reasonableness of the fees " and who will be authorized by the increases, always These are "based on changes in cost structure."
Voices
Andrés Aznar, Swiss legal adviser and specialist in Medical Law ; elDial.com, challenged the norm.
In this regard, said that "no inhabitant is obliged to resort to private health. On the contrary, health is constitutionally protected by the State and only if such resident, freely and spontaneously resolved and the company hiring Private medical consent to this, incorporated into an additional system that already has , which does not exclude and even less, it replaces ".
" The concept of prepaid, from the most basic interpretation, there is nothing to pay before. But what is pre-pay? Just the protection of health, before it is damaged or diseased, a fact that inevitably happen in the course of time, "he said.
The standard, well written, according to the specialist," enables those who did not save when they were healthy or were young, attend to the system being sick or elderly. "
" The concept of prepaid, from the most basic interpretation, there is nothing to pay before. But what is pre-pay? Just the protection of health, before it is damaged or diseased, a fact that inevitably happen in the course of time, "he said.
The standard, well written, according to the specialist," enables those who did not save when they were healthy or were young, attend to the system being sick or elderly. "
"It's over savings, insurance ran out, ran the system," warned . Nancy
Celaya, specialist elDial.com Consumer Law, said that "beyond the deficiencies that you can find the standard, essentially no more than receptive long-standing demand from users of private services . "
"Regulation tends towards a balance between the parties, since, at present, is warns situations of real injustice suffered by users of the congenital weakness who have contracts of adhesion to own the system, "he said.
Celaya, specialist elDial.com Consumer Law, said that "beyond the deficiencies that you can find the standard, essentially no more than receptive long-standing demand from users of private services . "
"Regulation tends towards a balance between the parties, since, at present, is warns situations of real injustice suffered by users of the congenital weakness who have contracts of adhesion to own the system, "he said.
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