Proceso de Cambio en el Sector Salud, una Mirada
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LPSRUWDQWHWDVDGHEHQHILFLR 'LYHUVRV *UXSRV 3UHYLVLRQDOHV \ FRPSDxtDV GH VHJXUR 3URYLQFLD 2PHJD &RQVROLGDU\)HFXQGDDQXQFLDURQRORHVWiQSRUKDFHUHOGHEXWGHVXVUDPDV HQVDOXG25 /DV SUHVHQFLDV GH RSHUDGRUHV LQWHUQDFLRQDOHV \ FRPSDxtDV GH VHJXUR SULYDGDV VH KDQ GDGR IXQGDPHQWDOPHQWH HQ HO iUHD GH DVHJXUDFLyQ FRQVLGHUDQGRTXHHQODPLVPDVHSODQWHDQLQQRYDFLRQHVPXFKRPiVIiFLOHVGH FRQFUHWDUTXHFXDQGRVHWUDWDGHFDPELDUODFXOWXUDRUJDQL]DWLYD\JHUHQFLDOGH /D QXHYD HVWUDWHJLD GH DOLDQ]DV GH ORV VLQGLFDWRV &RQVXOWRU GH 6DOXG GH PD\R SDJ Se encuentra presente en el sector salud mediante las empresas Sistema de Protección Médica SPM (Tim y Galeno), life y vesalio. Cuenta con servicios propios: Clinica del Sol-Arenales, Clinica del Sol-Coronel Diaz, Sanatorio Jockey Club, Sanatorio La Trinidad. Tiene un total de 160.000 adherentes titulares y en 1996 facturó 205 millones de pesos. SPM por su facturación integra el lote de las 10 empresas lideres de salud y es la mayor prepaga del país. (Clarin, El Cronista, Revista Mercado) 24 ASE, la obra social de los Ejecutivos se dispone a competir por el mercado privado de la salud en el interior del país. Con más de 4.600 empresas afiliadas y 20 años de vida institucional, ASE desarrolla su plan de expansión con la participación en Medlife (Mendoza), Medinea (Misiones) Boreal(Tucuman) y varios sanatorios en Rosario. Además participa junto con la Federación Agraria de Solidez, la única aseguradora para casos de alta complejidad. (El médico, octubre 1997) Swiss Medical luego de integrarse con el Banco Santander, adquiriendo Optar, la prepaga con la cuota más cara del mercado e incorpora de esta manera 13.000 afiliados. Swiss Medical Group esta entre los primeros entre cantidad de afiliados y alcanza una facturación de 240 millones al año, tiene prevista fortalecer su situación financiera con la participación en la Bolsa de Comercio.. El Banco Provincia de Buenos Aires esta lanzando una prepaga para competir en la provincia por las poblaciones que hoy se atienden en las empresas prepagas y obras sociales y tiene como meta llegar a una cobertura de 1.200.000 personas (FRQRPtD GH OD 6DOXG 8QD PLUDGD HFRQyPLFD LQVWLWXFLRQDO GHO SURFHVR GH FDPELR XQSUHVWDGRUGHVHUYLFLRVPpGLFRDVLVWHQFLDOHV$TXtHVGRQGHVHHQFXHQWUDQORV YHUGDGHURVDFWLYRVHVSHFtILFRVTXHVXUJHQGHORLQWULQFDGRGHODQHJRFLDFLyQ GHODVSDUWLFXODULGDGHVGHOJUXSRSURIHVLRQDO\GHODFXOWXUDRUJDQL]DWLYD ,GHQWLILFDFLyQGHHVFHQDULRVIXWXURV (OSUHVHQWHVHFDUDFWHUL]DSRUXQDJUDQKHWHURJHQHLGDGHQWUHORVGLIHUHQWHV PHUFDGRV GH VDOXG \ VXEVHFWRUHV DVHJXUDGRUHV \ SUHVWDGRUHV (O UDVJR VREUHVDOLHQWH GH HVWH HVFHQDULR GH PHUFDGR VDOYDMH HV OD FRQYLYHQFLD GH XQ SURFHVRGHFRPSHWHQFLDDFRWDGR\VLQJHVWLyQUHJXODGRUDSRUSDUWHGHOHVWDGR FRQ SURFHVRV GH UHDGHFXDFLyQ GH ODV RUJDQL]DFLRQHV GHO VHFWRU PHGLDQWH XQD EDWHULD GH LQQRYDFLRQHV GH FDUiFWHU ILQDQFLHUR \ HQ PHQRU PHGLGD RUJDQL]DWLYDV 8QRGHORVHVFHQDULRVSRVLEOHVGHOVHFWRUHVXQDYDQFHHQODFRQFHQWUDFLyQ GH OD GHPDQGD IXVLyQ GH REUDV VRFLDOHV DFXHUGRV GH REUDV VRFLDOHV FRQ SUHSDJDV HWF TXH XWLOL]DQGR OD HVWUDWHJLD GH GLIHUHQFLDFLyQ GH SURGXFWR LQWHQWDU ³HVFDSDU´ GHO HVTXHPD GH FREHUWXUD PLQLPD TXH OHV LPSRQH HO 302 PHGLDQWH HO ODQ]DPLHQWR GH SODQHV DGLFLRQDOHV TXH WLHQGHQ D LQFUHPHQWDU OD LQHTXLGDGIUDJPHQWDFLyQ\VHJPHQWDFLyQGHODSREODFLyQFXELHUWD 8Q PRGHOR LQVWLWXFLRQDO GHO HVWDGR VLPLODU DO SUHVHQWH HV GHFLU VLQ HMHUFLFLR GHODUHJXODFLyQVREUHHOSURFHVRGHFRPSHWHQFLD\OLEUHHOHFFLyQ (Q HVWH PDUFR VH SURIXQGL]DUtD OD UHFRPSRVLFLyQ GH OD FRQFHQWUDFLyQ \ RUJDQL]DFLyQ GH ORV SUHVWDGRUHV SULYDGRV TXH VH LQWHJUDQ YHUWLFDOPHQWH KDFLD DUULED DVXPLHQGR OD DGPLQLVWUDFLyQ GHO ILQDQFLDPLHQWR GH REUDV VRFLDOHV PHGLDQWH FRQWUDWRV FDSLWDGRV (Q HVWH PRGHOR VH FRQVROLGDQ ORV PRGHORV DVLVWHQFLDOHV LQWHJUDOHV GHVGH HO SULPHUQLYHOGHDWHQFLyQDPEXODWRULDKDVWDOD DOWDFRPSOHMLGDGGLDJQyVWLFD\TXLU~UJLFD(QHVWHFDVRODIXQFLyQGHFRPSUDGH VHUYLFLRVHVDVXPLGDSRUHOPLVPRJUXSRSUHVWDGRUFRPRHVWUDWHJLDGHSRGHU\ PHFDQLVPR GH DXWRUUHJXODFLyQ GHO PRGHOR DVLVWHQFLDO /D RUJDQL]DFLyQ GH OD RIHUWD WRPD QXHYDV IRUPDV LQVWLWXFLRQDOHV DOHMDGDV DO PRGHOR FRQIRUPDGR SRU ODVWUDGLFLRQDOHVLQVWLWXFLRQHVUHSUHVHQWDWLYDVGHODRIHUWD(OSURFHVRGHDMXVWH\ UHFRQYHUVLyQ HVWi GHWHUPLQDGR SRU OD SXMD GLVWULEXWLYD GH ORV PLVPRV 6X UHVXOWDGRHVSURGXFWRGHOSRGHUUHODWLYRGHORVDJHQWHVHFRQyPLFRVLQWHUQRVGHO JUXSRSUHVWDGRUSULYDGR (QWKRYHQ SODQWHD TXH OD HVWUDWHJLD GH OLEUH FRPSHWHQFLD HQ ORV PHUFDGRV GH VDOXG LQFOX\HQ VHOHFFLyQ GH ULHVJR OD VHJPHQWDFLyQ GHO PHUFDGR OD GLIHUHQFLDFLyQGHSURGXFWRVTXHHOHYDHOFRVWRGHSURGXFWRVFRPSDUDEOHVOD GLVFRQWLQXLGDG GH OD FREHUWXUD HO UHFKD]R GHO DVHJXUDPLHQWR GH FLHUWRV LQGLYLGXRV OD H[FOXVLyQ GH FREHUWXUD SDUD FRQGLFLRQHV SUHH[LVWHQWHV OD LQIRUPDFLyQVHVJDGDHQUHODFLyQFRQODFREHUWXUD\ODFDOLGDG\ODFRQVWUXFFLyQ GHEDUUHUDVGHHQWUDGDDOPHUFDGR /D LQWHQVLGDG \ OD YRFDFLyQ GH UHJXODFLyQ SRU SDUWH GH ORV JRELHUQRV FRQVWLWX\H XQ DVSHFWR IXQGDPHQWDO SDUD SHQVDU XQ HVFHQDULR DOWHUQDWLYR DO (FRQRPtD GH OD 6DOXG ,QVWLWXWR 8QLYHUVLWDULR ,6$/8' SUHVHQWH $OJXQDV GH ODV IXQFLRQHV FODYHV SDUD DVHJXUDU XQ PHFDQLVPR GH FRPSHWHQFLD UHJXODGD VHULDQ GHWHUPLQDFLyQ GH UHJODV GH HTXLGDG PDQHMDU OD VHOHFFLyQ GH ULHVJR DVHJXUDU SHULyGLFR SURFHVR GH DILOLDFLyQ YLJLODQFLD GH ORV DVHJXUDGRUHV FRQWUROHV GH FDOLGDG SURPRYHU OD HQWUDGD GH QXHYRV FRPSHWLGRUHV\PDQHMRGHORVVXEVLGLRV /DV HOHFFLRQHV SUHVLGHQFLDOHV SUHYLVWDV SDUD SHUPLWLUiQ FRQRFHU ODV SRVLFLRQHV GH OD VRFLHGDG H[SUHVDGDV D WUDYpV GH ODV GLIHUHQWHV H[SUHVLRQHV SROLWLFDV\HQHVWHGHEDWHHQFRQWUDUORVGHQRPLQDGRUHVFRPXQHVGHODDJHQGD HQVDOXGHQFRQVRQDQFLDFRQORVGHVDItRVGHFRPSHWLWLYLGDGHLQWHJUDFLyQVRFLDO TXHLPSRQHHOIXWXURGHOSDtV %LLEOLRJUDItD &DEDVHV +LWD -0 /D JHVWLyQ GH ORV VLVWHPDV QDFLRQDOHV GH VDOXG &DPELRV UHFLHQWHVHQ(VSDxD$(6$UJHQWLQDDEULO &RDVH5+/DHPSUHVDHOPHUFDGR\ODOH\$OLDQ]D(FRQRPtD0DGULG &RULDW%\'RVL*$SUHQGLHQGRDJREHUQDU\VROXFLRQDUSUREOHPDVVREUHODFR HYROXFLyQ GH FDSDFLGDGHV FRQIOLFWRV \ UXWLQDV RUJDQL]DFLRQDOHV %XHQRV $LUHV3HQVDPLHQWR(FRQyPLFR1UR2WRxR &XHUYR - 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