In an interview, the president of the Health Commission of the Lower House indicated that “the mutualization of the debt and the elimination of the paragraph that allowed setting a limit for the adaptation of the base prices of the Isapres plans, are relevant points in the discussion that we hope can be reversed in the Chamber of Deputies.” She emphasized that “with mutualization and the retrospective elimination of surpluses, we are left with a reduction of at least 700 million dollars in debt and those amounts must be returned to the affected users. “The Senate harmed members by reducing this figure and distorted the ruling of the Supreme Court.” Given the debate that will continue these months, the legislator pointed out that “we have seen an intense lobby communication and political of the Isapres to prevent them from being the ones who actually have to take charge of the debt generated.”
Hugo Guzman. Journalist. “The century”. Santiago. 1/3/2024. What is your opinion that the Senate has made it possible to reduce the Isapres debt from 1.4 billion dollars to 550 million? Is it an excuse?
This indication, which was proposed by the UDI, is not new. It was born in the middle of last year after being suggested by the “technical committee” or “experts” that made up the Senate. Let us remember that this table was made up mostly of representatives of insurance companies and others thinktank from the right. The Association of Isapres, Libertad y Desarrollo, and the Jaime Guzmán Foundation participated there, but the opinion of the members who were affected was not taken into account. They were not represented. It is evident that reducing a debt of 1,400 million dollars to 550 million is an excuse, there is no other way to look. For this reason, the possibility of mutualizing the debt is under discussion of constitutionality, although in any case, it is an indication that it will not see the green light in the Chamber of Deputies or in the Health Commission that I currently chair.
How is the discussion going regarding the base prices of the Isapres plans?
The Short Law project incorporated a rule that gave the possibility of regulating the modification of the base prices of health plans. The measure sought to adjust the final price of all Isapres pension health contracts that did not use the Single Table of Factors established by the Superintendency of Health and did so based on a table of factors established by themselves. Unfortunately, the Senate Chamber rejected the indication that allowed setting a limit or cap on the adaptations of health plans, which is very serious, because according to the Health Superintendence, insurers could increase the costs by up to 41%. prices of their plans. For this reason we hope that the indication will be restored in the Chamber of Deputies, because as the project stands, the possibility opens up that greater damage will be committed to the members and they themselves will be the ones to pay the debt.
In general, where will the central points of this discussion be when the legislative recess returns?
The mutualization of the debt and the elimination of the paragraph that allowed setting a limit for the adequacy of the base prices of the Isapres plans, are relevant points in the discussion that we hope can be reversed in the Chamber of Deputies. With mutualization and the retrospective elimination of surpluses, we are left with a reduction of at least 700 million dollars in debt and these amounts must be returned to the affected users. The Senate harmed members by reducing this figure and distorted the ruling of the Supreme Court. We await the response from the TC (Constitutional Court) but regardless of this resolution, we are not going to approve this indication in the Chamber nor in the Health Commission. Regarding the paragraph that was rejected and that allowed setting a limit for the adequacy of the base prices of the health plans, it is important that this be replaced because the increase in the amounts of the plans means that the affiliates themselves will finance the payment of the that they are owed, something inconceivable. This possibility of increasing the amount in the plans, which could be up to 41% according to calculations by the Superintendency, violates justice and opens the possibility of new judicializations – let us remember – which is what caused this situation.
What can we say about the argument that Isapres are at risk and that their members must be protected?
If there is something that the ruling party and the opposition agree on, it is that the focus has to be on protecting members and ensuring the continuity of health benefits. For this reason, the ruling party approved the advancement of the ICSA calculation, which allowed insurers to increase the price of their plans starting in March and thus give the system a break and ensure benefits. However, what the opposition proposes goes beyond giving continuity to the system. With the forgiveness of the debt, they go beyond the affected members and court rulings. Parliamentarians do not have the power to override a court ruling and that has been difficult for the opposition to understand. What mutualization implies is that the affiliates must socialize the risks and thus some users will have to pay excessively to resolve the debt that the Isapres carry with them, therefore, only the affiliates would be punished for the benefit of the Isapres. The repeated argument that the Isapres are at risk has been acquiring less and less relevance. We cannot be alarmed by a situation about which we do not have much information, as long as we do not know the real financial status of each Isapre. All this, considering that they have obtained million-dollar profits for decades, for example CIPER calculated that between 1990 and 2021, the Isapres obtained a gross profit of 8.6 billion pesos. We even learned that new Isapres are being created. So, I do not consider the argument of the Isapres insolvency crisis to be a valid argument as long as we do not have all the information on the table. Here too, we have to look deeper and understand that Isapres are not isolated entities, they are part of large holdings and that nature is not formally recognized.
Can it be said that we are witnessing collusion or support from right-wing legislators for the Isapres?
So far we have seen intense lobby communication and political of the Isapres to prevent them from being the ones who actually have to take charge of the debt generated. Part of the right has worked side by side with the Isapres and are seeking the same path: for Congress to allow debt forgiveness. In any case, I would make a nuance, since there are opposition parliamentarians who are uncomfortable voting in favor of a pardon. I do not want to think about collusion and I do want to think that the support of several opposition legislators is clouded by a false crisis alarm, not seeing that this project, in addition to strengthening FONASA and the Health Superintendency, could establish clearer limits and rules for an industry that has been exempt from regulation.
