A bureaucratic trap deprives thousands of people of access to social work or public hospital

number in recent years Monotributistas The rapid growth in the country has not stopped, the figures are so close three million, As it is known, the person who follows one-tribute must choose social work And if it doesn’t then it is assigned by default. The problem begins later, when these potential patients require medical care.

experts consulted bugle They agreed that these citizens today find themselves in a kind of crisis bureaucracy hanging in the balance Which is difficult for them to control. Thus, adequate access to health remains a debt for them. The government’s mega DNU, which made laws on health issues, did not get involved in this funding problem, which is most important He is going through a system in crisis.

The government believes that social work all kinds of obstacles To associate monotributistas, because Input monthly what these people do Very little, On the other hand, if within the framework of this deficit they resort to the public system, they may – in theory – also face obstacles due to the fact of it being a social function.

in New “neither” -The term was once coined to refer to young people without study or work, resigned due to lack of access to health -are the unwitting protagonists of a paradoxical scenario: the state is allegedly monotributista with the right to coverage. seeks to benefit, but the beneficiary remains trapped in the story, harmed by the virtual tug-of-war between Social Security and Public Health,

This struggle is repeated year after year but there is no solution in sight. “There are approximately two million monotributist associates in social work, who contribute on an average 6 thousand pesos per monthWhen collaborators (more than 12 million people) contribute in a dependency relationship 25 thousand“, explains to bugle Source of one of the largest social causes in the country.

A guard entry.  People involved in social work are reportedly stuck in limbo.A guard entry. People involved in social work are reportedly stuck in limbo.

With these data, the source tries to argue why social actions occur They don’t want to be full of monotributistas, in the sense that these people contribute very little in terms of the benefits they are entitled to claim. Thoughts on this subject, indeed, reveal a toxic stress Between two of the three subsystems (the third is private) that make up the Argentine Health Care Agreement.

“The state organizes a party and pays for champagne for social functions,” he writes in Dialogue bugle Rubén Torres, former rector of the University of Isolud and one of the most important health care professionals in the country. “Social work, every time a monotributista pays them, they are losing a lot of money, This is the reason for rejection.”

Torres says: “The law says that once you become a monotributista you have the obligation to choose a social function and if you don’t do it, the Superintendent of Health Services (SSS) assigns it to you. You have it on paper whether you use it or not. So if you want to be treated in a public hospital, you will see it on the registry as associated with a social causeAnd so barriers to care begin in the public system.

Adolfo Rubinstein, former health minister during the Mauricio Macri government, believes that “there is strong discouragement So that social work associates monotributistas. The problem is that they collect contributions and they do not provide service, They don’t admit it openly because legally they can’t, but they do. bureaucratic hurdles,

The expert says that “in principle the procedures are quite clear, but there is a framework that hinders and expels, On the other hand, if the person is going to go to a public hospital, the provider must complete a process for the recovery of benefits through the superintendent, so that social work can reimburse the amount that is very cumbersome,

A public hospital that provides care to a social work aide must subsequently request reimbursement.A public hospital that provides care to a social work aide must subsequently request reimbursement.

For Rubinstein, the bottom line of the issue is the unviability of the system due to its fragmentation: “291 unions are social functions and two-thirds Less than 30 thousand members each, They are not viable and are ultimately supported by surplus funds and contributions collected from associates who do not serve them.

disruptive effect

A research titled “Three Studies for a New Management Model in Social Security” published by Osdepim Social Works Research Institute in 2023 states that ” Disruptive effect of monotax “This happens because it breaks the logic of the construction and operation of distributive justice in social actions.”

Analyzes that “collaborators in a dependency relationship and monoattributist collaborators contribute very unequally to social work, as do those who are in a dependency relationship. according to your financial capacityWhile monotributistas contribute the same amount No matter which category they belong to.”

Rubinstein recalled that there was a reform in 2022 so that the highest categories of the monotax would “pay a little more”, but that the dimension of the problem still remained. more than patch And the issue remains unresolved. Evidence of this is that monotributistas are viewed as a “threat” whenever they approach a social function to attempt to obtain the card.

In SSS they are not only aware of the situation, but also this type of conflict main demands done by the users, who also have a website available to lodge the respective complaint with that body.

Regarding reimbursement of social functions to the state, according to official data in 2023 they moved together 23,215 million pesos, this is down from 24,340 million in 2022 and 30,880 thousand in 2021 (full Covid phase). In 2020 it was 23,856 million pesos and in 2019, 12,189 million,

If the period of health emergency caused by the pandemic is removed – in which health services were clearly in greater demand – and 2019 is compared with 2023, we get 90 percent increase In reimbursement of social functions over five years, when the cumulative inflation of that period exceeds six times That figure.

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