The Humanist Action deputy and president of the Chamber’s Health Commission, Ana María Gazmuri, addressed the progress of the processing of the short isapres law, which will begin its discussion in particular upon the return of this district week.
The parliamentarian assures that there are guarantees to dispatch the project before May 12, the deadline established by the last extension of the Supreme Court to comply with the ruling. Therefore, on Tuesday of the following week, the vote will be until fully dispatched, and then give way to a mixed commission.
In this sense, Gazmuri affirms that the priorities will be to analyze in depth complex indications such as the viability of the increase in health plans, the mandatory contribution of 7% without generating surpluses, in addition to clearing the cloak of “opacity” on real financial sustainability. of the insurers.
-What are the doubts that persist regarding the financial status of the Isapres and their viability of operation once the short law is passed? Taking into account that the financial information of the insurers is public.
We see that it is really a problem how the ISAPRES are being viewed as an isolated economic unit, without considering that many of them are part of a conglomerate, a holding company, and that there have also been transfers of money to the holding companies. There we have a certain opacity, we are not clear about this role of lender that some isapres have had towards the holding company they belong to. So, analyzing the numbers we see that the debts owed by the holding companies to the ISAPRES are sometimes more considerable than the other way around. Therein lies the first lack of transparency.
Second, since the amount of the debt has not been determined precisely, these different modulations have been made, but since this amount has not been exact, it has not been incorporated into the financial statements of the isapres. Therefore, we cannot really look at the financial health once we incorporate what they owe, which could probably show us a much more transparent picture of what the real situation of the isapres is today. Because different academic spaces, former authorities, also maintain that even with these measures that are super demanding, forced measures that are being proposed with the short law, and that mainly affect the members, it would not be possible to solve the underlying problem.
We have an unclear underlying situation, if we really do not know the final picture and we are promoting a bill that has measures that rather make the affiliate the one who ends up paying the debt, so that in the end this will not really contribute to economic sustainability of the system, we have to look at it. That is part of the concerns we have, and we have studied in great detail how this bill comes about and the observations we have.
-But has it been an opacity that has been maintained throughout the entire process?
I will stop here for a second, because this does not necessarily mean that isapres are bad business, for some reason new isapres are even emerging, which by not carrying this debt caused by bad practices, are viable. So, when one looks at all this comprehensiveness, we see that, in some way, what this short law became was a savage intention, and there we enter into how this was processed in the Senate.
At some points there was a lot of opacity in how this was processed. For example, if we go to article 8, which is super important, it was approved without even having delved into the scope of this article. What it allows is this first reduction from US$1.4 billion to US$1.1 billion. So we at least need to debate that point in more depth. Because that has to do with this idea that all contributions should be 7% so that they are the same as in public security. Which is totally reasonable, certainly yes, but reasonable if we think about it from one point forward, that is, the new contracts. What I think we have to look at carefully is what happens when we are talking about doing this retroactively, because there we are affecting the private property of each of the members in relation to their surpluses. And this proration would somehow affect that. So, that is a point that I think merits, at least that we look at it more closely.
-Are there modulations that are more accurate approximations of the financial panorama applying the short law?
The modulations that have been made have incorporated elements that are not natural. For example, the decreases in the amount of debt with mutualization, it is not that we naturally have doubts whether the debt is US$400 million or US$1,000 million. This decrease is the product of an artificial action that is entered into the system. These measures somehow even alter the financial order of how this was applied.
Beyond the Constitutional Court’s ruling on mutualization, we already had that decision made only because it altered the content of the Supreme Court’s ruling. And we have to observe the same thing in article 8, really see what happens there. If we are not also moving in a direction that has those same problems and that later could even bring us problems of judicialization, which is supposedly what we want to avoid.
-How has the work in the commission continued, what other elements are being evaluated to incorporate?
We are working together with the ruling parliamentarians to enter indications that go in the direction of making some exceptions. For example, in what has to do with this advisory body that is going to support the Superintendence of Health, in the demand that not only that its members have not worked in the isapres the last two years, but that they move forward in not have worked in the isapres directly, to ensure this transparency in a system that has more than shown us that it does not always act in the most correct way.
As well as in a series of other adjustments, for example, in the return deadlines, where we also have doubts. Ten years to pay back. What happens to the person who is 75, 78 years old? We are observing that. There are also other proposals such as that of Congresswoman Joanna Pérez, from the Democrats, who, although she is not in our conglomerate, but of course we are in talks and we also look with interest at what she has proposed, which we think could be a more alternative. in the return forms.
-The idea of restoring amounts through actions…
Of course through actions, but as long as the way in which these amounts are restored is the decision of the member, and it will not be the decision of the Isapres how to restore these amounts. That is another of the details that we want to put with the indications that we are preparing. We do not want to formally advance until the first session on Monday, where we will begin to know our instructions. But we have done a very good job in the commission.
As a reflection, I also want to say that regarding the committee of experts that was set up in the Senate, and that some have claimed that those inputs were inputs for us, well we do not participate in that committee of experts, neither in its composition, nor in the election of its members. So for those who want to show that this committee was super transversal and representative, the truth is that it has not been like that. The Chamber was not represented, the members were not represented, not all the entities that we have listened to, that we did invite, were represented. In the Senate they somehow stayed with that vision, a quite conservative position, very aligned with what the opposition is. Even surprisingly, it must be said, it has been a headache because the opposition constantly brings up that Mr. Cristóbal Cuadrado was on this committee of experts, and he agreed with the mutualization. They use it as a flag, but well, for us Mr. Cuadrado is an exception and he does not represent the thinking of our sector.
In that sense, my first commitment was to open the range of exhibitors so that we can make real decisions, knowing all the positions, because here we have had to face a brutal media lobby from the isapres.
– After the TC closed the door to mutualization, the opposition has transferred responsibility to the government in relation to proposing mechanisms for the financial balance of the system. What is your reading on that?
They ask the government to do magic. It also seems to me that it is not appropriate to transfer the responsibility to the government so that the isapres maintain their financial balance. And that is what has been discursively installed and that is what I mean when I talk about this media manipulation. How will it be the responsibility of the government? The responsibility lies with those who generated this problem. The government is responsibly trying to find ways to solve it, but those ways cannot go against the rules, against constitutional principles, for example.
-Should the government’s focus be on the members?
It is just that maintaining the financial balance of the Isapres by non-compliance with the ruling does not seem to us. And calling on the government to make that viable, or the parliament to make that viable, it seems to me that we are looking at this discussion in the wrong way, it is complex. Here there has been a passive position of the isapres, asking to solve the problem with measures that ultimately affect the members.
If the ISAPRES begin to go into insolvency, which will probably happen to some of them once this debt is assumed, I believe that the focus has to be on how private providers are supported and cared for. That is where the State, where the government has to go to affirm, look for mechanisms, that is the important support, more than the support for the insurers. It is the benefit that we have to ensure does not fall, because at no time are we thinking about a health system that can do without private providers. On the contrary, in this modality of complementary coverage that is proposed in the same project, it is thought that it will be done with private providers.
We have to change the focus in that sense and think about how we protect so that the clinics continue to function, and how we see again the way in which the isapres are capitalized so that they can pay at least the debts they have with private providers. So, today the Isapres have no way to return the amount indicated by the Supreme Court if we look at the Isapres in isolation. But we have to look at the volume of assets, of the entire holding company, the volume of assets managed by these groups, which is much higher, of course, than that managed by ISAPRES. And perhaps they are in a position to return the money.
We want this to be an opportunity for citizens to better understand the discussion. Because we feel that a couple of highlights They received all the media attention and prevented a more in-depth understanding of the different aspects contained in the bill. In that sense too, another of the things we are thinking about is opening it up a little, in the sense that it is not only the insurers, the insurance companies, that can participate in this type of complementary coverage, but also other types of entities. that provide this type of services, perhaps make them more flexible in that sense.
We are looking for adjustments, but above all we believe that by stopping point by point in each of the ten articles, plus the transitory articles, so that truly, when making the decision we make, we are fully aware that each one knows what they are deciding. , that there is no opacity.
-What are the most important indications for this particular upcoming discussion?
Basically there are three complex points. Mutualization, where incredibly the opposition continues to say that the Executive could have the power to incorporate it, but let us remember that the Executive said from day one that mutualization was not appropriate, therefore, ideologically it would be very serious to retract it.
We also have to open the debate on article 8 regarding the 7% contribution. In addition, there is the increase in the prices of the plans, with or without a ceiling, or an increase or no increase in short. I would say that these are the most sensitive points, to which is added this battery of indications to improve and refine other points.
But we need citizens to understand these three central indications, especially the issue of mutualization. We will say again that beyond what the Constitutional Court said, fundamentally we do not agree. Not only because it is the responsibility of the Executive, which is important to highlight, but because they have tried to cover up this discussion, as if the problem was only the form, and that is not the case.
