Executive will enter indications to the short law in an inauspicious Congress climate

On Thursday, March 28, the Executive must enter indications to the short law of isapres, to be discussed in the House Health Commission. One of the knots in the process is in the formula for calculating the debt and mutualization emanated from the Senate as an alternative. However, the Constitutional Court (TC) declared the unconstitutionality of said formula – which reduced the debt by 780 million dollars with respect to what was established by the Government – ​​and now The Executive has less than a week to come up with an alternative that achieves consensus in Parliament, where it does not have a majority.

The outlook in Congress, to give way to the short isapres law, which aims to comply with the Supreme Court ruling that mandates insurers to return excess charges, is not very encouraging. Parliamentarians warn that the process in the Chamber will surely lead to a mixed commission to dispatch the law. This, however, is limited in time, since the deadline to comply with the ruling is at the end of April.

The mutualization of what is owed by the isapres appeared as an alternative after the Senate Health Commission convened a Technical Commission to offer some response to recalculate the debt that the Health Superintendence had preliminarily offered. This was around 1.4 billion dollars and with this formula the debt fell to 400 million dollars in US currency.

From there, the ruling party interpreted the mutualization as a “forgiveness” to the isapres, and the opposition, on the other hand, as an alternative that gave stability to the system, It put the insurers out of risk of bankruptcy and complied with the ruling, since what was owed was paid. Finally, during the process in the Senate, the opposition managed to dispatch the project with this mechanism included.

Pro-government senators filed arguments against said article before the TC and it ended up agreeing with them. However, the opposition did not interpret the ruling as an unconstitutionality of mutualization, but rather they attribute it to the fact that it was born as a result of a parliamentary motion. So, now they urge the Government to present this initiative.

RN Francisco Chahuán, who was part of the process in the Senate, maintained that “What the TC ruling does is transfer responsibility to the Government to achieve, as they have indicated, a financial balance for private health insurance.”

UDI Senator Sergio Gahona was more specific and indicated that, since the mutualization initiative corresponded to a social security issue, it is a specific attribution of the President. “What has to come now is for the Government to give in and present the indication in Congress, in such a way as to give viability and sponsorship to the mutualization initiative”said the senator.

Voices within the Ministry of Health affirm that The Executive is not going to agree to that. Rather, during this week he will look for an alternativebut preliminarily they are to maintain what has been said: ten years of term to pay the debt without withdrawal of profits, unless it is paid, advance in Fonasa with complementary coverage and maintain the amount of the debt at 1,180 million dollars.

The Minister of Justice, Luis Cordero, referred to the issue at the time and stated that what the TC resolved was a relatively technical aspect and marked a time: “What we learned yesterday was essentially the verdict. And to go deeper into what the court ultimately decided, one should see the basis of the ruling.”

Now, Cordero clarified that The Executive “has been very clear on this point (mutualization), a modality of these characteristics implies altering the content of the operative part of the Supreme Court ruling “which has an obligation of restitution for each member.”

Another payment alternative that has been proposed is that the Isapres also pay through bonds or shares and, regarding that, Minister Cordero assured that “Minister Aguilera raised it because it is one of the evaluations that the Executive has.”

The Christian Democrat deputy Eric Aedo is part of the Chamber’s Health Commission and assures that this indication will be entered from his bench. In any case, he anticipates that “it will finally be discussed in a mixed commission of senators and deputies. That’s the truth”.

From this perspective, Aedo believes that “nor there will be a concordance agreement between the Senate and the Chamber of Deputies and that will mean in reality that this mixed commission will have to have a political agreement.” In this agreement he believes that, probably, “I don’t know if mutualization but it does give financial stability to private health for the future and on the other hand, the isapres returning the money that they mischarged their users”.

The Broad Front deputy Patricio Rosas will also witness the process in the Health Commission and regarding the bonus proposal he believes that “it is not a fair mechanism for those who were overcharged, given that the price of the shares cannot be assured that is equivalent to what is owed.”

Firstly, he states that “isapres are a business that must be separated in the analysis from private health providers that generally have contracts with Fonasa and are expanding them.”

Regarding mutualization, Rosas believes that “It cannot be applied retroactively to offset the Isapres debt, because the excess collection existed and is not extinguished by those who were not overcharged (that was the reasoning behind the ‘mutualization’) and there is no space or neither technical nor political to insist on that path.”

The parliamentarian indicates that the indications must be precise, since “they must make it clear that the isapres nor their related companies can go bankrupt and create a new isapre, in order not to pay their obligations” and neither “can they imply a forgiveness of the debt and non-compliance of the Supreme Court ruling.”

For insurers, The most important thing is that the methodology determined allows for restoring balance in the system, complying with the rulings of the Supreme Court, in order to allow continuity in the coverage of people, who – they assure – are seriously threatened.

They assume that they will not receive the profits in 10 years and that the amount of 1.18 billion dollars to be paid, which the Executive proposes, is a threatening figure for some insurers. However, Another factor that also worries the Isapres is time, given that, if there is no clarity about the future as soon as possible, some could go bankrupt before having received a response from the political world.

After 4 p.m. yesterday, the Isapres Association shared a statement (Declaration Agich 220324 (1)) in which they referred to the ruling of the TC. “The Court has not indicated that it is unconstitutional to use mutualization, since none of the applicants requested an analysis of the matter. Therefore, this option remains valid, although its application depends on the Executive.”

The union pointed out that “while this is being debated, the private health sector is going through a serious crisis that has lasted 18 months, with an impact on patients and providers” and that “the crucial thing is that the solution allows for the restoration of financial balance, the only way to normalize the operation of the isapres, comply with the rulings and avoid harmful systemic effects.”