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ARGENTINA | 26-04-2023 13:49

Public v private: 1 in 4 only use state healthcare in Argentina

One out of every four solely uses the public healthcare system, though more use private schemes exclusively. The commercial system is more used by men and more women have had to adjust their choices due to inflation.

Public or private? How do Argentines choose their healthcare? There are various factors to evaluate – gender, city, education, infrastructure, distance, doctors and nurses, to name a few – and a new study by Fundación Colsecor has broken down the country’s relationship with healthcare. 

To start with, one in four people in Argentina only use the public system – i.e. 26 percent of those surveyed receive solely free healthcare. At the other end, 32 percent, just over three in 10, have private health insurance and only use the commercial system. 

Data from the Study on Access and Perception of Healthcare in Argentina ("Estudio sobre acceso y percepción de la salud en Argentina") reveals that more Argentines use the private system exclusively than those who only use the public system. However, most residents, i.e. 34 percent, have private health insurance and use either one system or the other.

Likewise, there are differences depending on the size of the city. In smaller locations, those under 10,000 inhabitants, 41 percent claim that, even if they have health insurance, they use either one system or the other. Yet in larger cities of over 100,000 inhabitants, only 29 percent use both systems.

In larger cities, even with a private healthcare scheme, 41 percent use the private system more frequently, as against 23 percent who use those schemes in smaller cities. In short, larger cities choose the private system more often than larger areas. 

Another difference lies in gender. “The private healthcare system is more popular among men (36 percent) than women (30 percent) … Women choose free healthcare more often since they use the public service more than men, 29 percent and 21 percent respectively,” the study concludes.

Free healthcare is also the most popular option for those aged between 25 and 39. Whereas in this age group 40 percent access free care, only 15 percent of those aged 60 and above choose it, while 40 percent of that age group uses the private system.

Regarding education, 44 percent of people with a university degree choose the private system, as against 17 percent of those who have not finished secondary school.

The kind of Argentines who use the private healthcare system are thus more often than not men aged 60 or above, in a major city and with a university degree. 

 

Health comes first

Costs and context can impact things, but the study shows not that much. “Seventy-eight percent of the population did not alter the way they access healthcare for financial reasons,” according to Colsecor, noting a question that enquired about the impact of rising costs and inflation, which topped 100 percent in Argentina over the last year.

Among those making changes, 14 percent said they switched to a cheaper health insurance (including five percent of young people and six percent aged 60 or above); six percent claimed they used to pay for private healthcare and now access the public system; and seven percent said they used to have private health insurance and now have started to use the public system.

The research concludes “women are more affected by cost and inflation than men.” Not only are same products more expensive for the former, such as a razor costing 500 pesos for men and 650 for women, but all feminine hygiene products, including pads, tampons and the like, are part of female shopping-baskets. Not to mention non-essentials like make-up, nail polish and waxing products, among many other things. 

According to the study, men have made fewer changes than women when it comes to healthcare:  84 percent of males did not make any adjustments due to economic circumstances as against 74 percent of females.

The exchange rate crisis and price hikes have also affected those most who are aged between 25 and 39, 65 percent of whom stated they have not changed, as opposed to 87 percent of youths between 15 and 24 who have made no changes, or 82 percent of those aged 60 or more.

The same goes for education. University graduates have made fewer changes than secondary school dropouts. 

 

Perceptions and ratings

“In the ‘overall’ perception of the healthcare service, private is barely better than public,” the study states. An average was collected from 12 different aspects of healthcare. The result was 66 percent approval rating for private, as against 61 percent for the public system. Nurses received a better rating than physicians while doctors in the private system have a higher rating than those in the public sector.

Keeping with state care, doctors have a 76 percent approval rating (23 percent very good and 53 percent good), and nurses 84 percent (28 percent very good and 56 percent good). In the private system, the approval rating of the former is 83 percent (20 percent very good and 63 percent good), while nurses have an 82 percent rating (24 percent very good and 58 percent good).

Private healthcare centres prevail in terms of digital access, equipment and specialists too, a 63 percent positive rating for digital access in the private system (12 percent very good and 51 percent good), as against a 45 percent approval rating in the public system, while in terms of equipment, the ratings are respectively 71 and 25 percent. 

Regarding access to specialised medical care, those surveyed rated it positively by 64 percent in the private system (14 percent very good and 50 percent good); as against 54 percent in the public system (12 percent very good and 42 percent good).

As for care, infrastructure and appointments, 72 percent of respondents have a favourable opinion of infrastructure in the private system (15 percent very good and 57 percent good), as opposed to a 65 percent positive rating in the public system (17 percent very good and 48 percent good). But when it comes to availability of appointments, both rate lower with five out of every 10 Argentines finding availability in private clinics to be good and four out of every 10 viewing the same factor in public hospitals positively (respectively 51 percent with seven very good and 39 percent with eight percent very good). 

The private system received a 71 percent approval rating for proper care (16 percent very good and 55 percent good) while the public system was rated positively by 68 percent (20 percent very good and 48 percent good).

Lastly, in terms of the overview of comprehensive coverage, just over five out of every 10 Argentines (55 percent, 10 percent very good and 45 percent good) believe the private system is good and just under five out of 10 (49 percent, nine percent very good and 40 percent good) believe the public system is good. 

 

Reasons for choice

However, despite all the pluses for the private system, the public sector is far superior when it comes to dispensing medication. In terms of free or more affordable medication, the approval rating was 59 percent (17 percent very good and 42 percent good) in the public system, as against 47 percent (nine percent very good and 38 percent good) in the private system.

The public system is also ahead in distance from private residences with a 73 percent approval rating (18 percent very good and 55 percent good), compared with 68 percent for the private system (12 percent very good and 56 percent good).

When Colsecor surveyed asked: “Which are the main reasons why you choose or use a particular healthcare centre?” nearly half (48 percent) of Argentines stated that they already had the insurance in question.

The following answers were also mentioned: 34 percent said the most important thing is the accessibility of a nearby centre; 31 percent stated the specialists they need are there; and 28 percent because it is free or affordable. There are also those who prioritised proper care (15 percent), good infrastructure and equipment (14 percent) and high quality (12 percent). 

Finally, one out of 10 Argentines choose their facility because it “has plenty of available appointments,” six percent because “it was recommended” and only two percent because it has “clear biosafety measures.”

 

About the report and the survey

The authors of the Study on access and perception of healthcare in Argentina by Fundación Colsecor, are Mario Riorda, director of the Master’s Degree in Political Communication at Universidad Austral; Griselda Ibaña, director of the Federal Government Institute at the Universidad Católica de Córdoba; and Mónica Cingolani, dean of the School of Political Science and International Relations, also at the Universidad Católica de Córdoba. 

People were surveyed between 11 and 27 November, 2022. Data was collected using the CAWI (Computer Assisted Web Interview) technology. Sampled cities were divided into four non-proportional brackets, by size: 350 per bracket, 1,480 in all. The margin of error is up to +/-2.55 percent. It was implemented by the consultancies Dicen and Proyección Consultores.

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