Uruguay Info
Joined: 01 Dec 2006
Posts: 17
Home Country: uruguay
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 Posted: Tue Dec 05, 2006 4:28 am Post subject: HEALTHCARE IN URUGUAY / URUGUAY HOSPITAL GUIDE |
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HEALTHCARE IN URUGUAY
GENERAL
Uruguay is the smallest of the South American republics with an estimated population of 3.3mn and an annual growth of 0.7%. Nearly 50% of the population live in the capital Montevideo.
Unofficially the country is frequently referred to as "Little Switzerland", due to its political stability and favourable banking laws, which attract a considerable inflow of funds from wealthy individuals in neighbouring countries - notably Brazil and Argentina.
Uruguay's economy is characterised by an export-oriented agricultural sector, a well-educated workforce, relatively equal income distribution and high levels of social spending. Standards of living are among the highest in Latin America, with average per capita income of USD 6,348 in 1999.
Despite a strong domestic economy, its small size and geographic location make it susceptible to economic downturns in its larger Mercosur neighbours, Brazil and Argentina.
From 1992 to 1998, Uruguay's real gross domestic product (GDP) growth averaged 4.2% per year. In 1999 real GDP contracted by 3.2% and although a recovery was forecast for 2000, this did not occur and GDP fell by 1.5% due mainly to higher oil prices, higher interest rates, a drought, and an outbreak of foot-and-mouth disease.
IMF forecasts for 2001 and 2002 suggest growth rates of 2% and 2.7% although this was prior to the crisis in the Argentinian economy, which arose in March 2001.
Social Security
The social security programme in Uruguay is based on the principal of universality and as such embraces all the population. The underlying accepted cultural fact is the general understanding that the active members of the population should contribute towards and care for the inactive members of the population.
This programme encompasses family care, disability, unemployment, old age pensions and survivors. The two-tier system is made up of the underlying governmental social security programme with its universal reach managed by the BPS (Banco de Prevision Social), and a separate section consisting of individual pensions savings accounts held and managed by private entities known as AFAP (Administradoras de Fondos de Ahorro Previsional). This arrangement has worked extremely well in the five years that it has been operational.
The employee healthcare contribution of 3% per month will go towards his/her healthcare coverage provided by an approved provider or mutual referred to elsewhere in this report. By this mandatory payment the employee is strongly encouraged to enrol with one of the many mutual healthcare facilities or lose the 3% contribution. Additionally the employer has to pay an additional affiliation charge.
Contributions are made on a pay-as-you-go basis. In additions to retirement pensions, the basic social security contributions also finance sickness and maternity benefits, unemployment and family allowances. All payments are made to the social security system, which then channels payment to the private pension fund managers and healthcare providers.
The general public accept that the relatively high contributions levels are necessary in order to achieve the level of benefit desired.
Private Healthcare
Mutual associations and private medical schemes handle private healthcare in Uruguay. Over 50% of the population enjoy some form of privately managed healthcare.
Mutual associations, known locally as Instituciones de Asistencia Medica (IAMCs), had their origins in the diverse groups of immigrants that flocked to the country in the late 19th century and during the first 50 years of the 20th century. Initially the associations were formed to provide the immigrant population with a social and economic outlet, but as the need arose the associations commenced providing basic medical attention and developed into the current major private healthcare system.
There are three types of IAMCs, which are private non-profit organisations that provide services through prepaid health insurance.
* Mutual assistance associations, which are based on the principles of co-operation and use a system of mutual insurance to provide medical care to their members.
* Professional co-operatives providing medical care to their members and associates, in which the respective professionals contribute corporate capital.
* Health services created and financed by private companies or quasi-governmental entities to provide non-profit medical care to personnel and family members.
The institutions compete with each other and whilst the state exercises some legal and technical control over them, they have a high degree of autonomy. Some 35 IAMCs are physicians' co-operatives located in the country's interior and affiliated with each other through an association called the Medical Federation of the Interior.
Workers in private companies subscribe to a compulsory IAMC health plan through the Banco de Prevision Social (BPS). The BPS affiliates them with the IAMC of their choice and provides total health coverage. In the event of unemployment, the health insurance plan covers the period in which the worker is covered by unemployment insurance, up to six months.
Price adjustments to monthly contributions and other pricing issues need to be cleared by the health authorities before they can be implemented. Current monthly contributions average approximately USD 60 per person for broad medical/hospital treatment. This is financed by employer/ employee contributions to the BPS, currently 5% and 3% of salary respectively, which the BPS transfers to the appropriate IAMC, plus an affiliation charge levied on the employer.
It is estimated that the private health sector, consisting of the IAMCs and the private sanatoriums, has some 3,500 beds for the hospitalisation of acute patients throughout the country. The IAMCs administer a total of 2,800 beds, 1800 of which are in Montevideo. The private sanatoriums - 5 in Montevideo and 34 in the interior - have some 700 beds.
Out-patient services offered by the mutual associations normally require a small payment each time the person makes use of the service, in order to discourage unnecessary usage. However in recent years concerns have arisen as to the financial stability of some of the IAMCs and at least six were due to be wound up or merged with other companies at the time of writing.
At the moment the government is carrying out an in depth review of the IAMC system, with a view to completely reforming the sector. The government has negotiated a USD 75 m loan with the Interamerican Development Bank for this purpose. Notwithstanding the proposed reform, it seems unlikely that the insurance sector will be involved.
Individual Private Medical Insurance
There is a very small individual private medical insurance market in Uruguay, due to the predominant role played by the IAMC companies. In the circumstances private medical insurance has not prospered, although coverage is available for specific travel purposes and some insurers are offering daily hospital cash benefits as a complement to the IAMCx.
Group Private Medical Schemes
On the whole, individuals make their own arrangements for private medical cover, in many cases as a continuation of that which the individual enjoyed as a child through his/her family mutual association cover. Some employers are known to enrol their employees in such organisations.
Whilst medical inflation is evident, little co-operation would seem to take place in practice to control expenses amongst hospitals, doctors and pharmacists. The government nevertheless intervene to keep a close watch on the mutual associations and their pricing practices as a way of keeping related healthcare costs down.
Some companies, principally multinationals, provide group healthcare insurance to their employees, principally to supplement the coverage offered by IAMCs, e.g. covering overseas treatment.
The individual companies, unlike the mutual associations, which are closely supervised by the government, freely price insurance company-provided medical insurance.
The government owned Banco de Seguros del Estado (BSE) and Real Uruguaya de Seguros are believed to be the principal insurance company providers for cover when required. Other companies are developing complementary products, but their potential is limited.
In respect of reinsurance, there is negligible reinsurance needed at present.
Insurance company medical insurance is not sold to any great extent with the exception of travel related cover. Brokers as well as agents are involved in the sale of medical cover.
Expatriate cover
Expatriates legally resident in the country are entitled to the same benefits as a local national, although two years' residence is required to qualify for unemployment benefits. In addition to meeting the basic criteria of age, years of contribution and service, expatriates must prove they have a minimum 10 years continued residence in the country in order to be entitled to, for example, a disability pension. A minimum 15 years of continued residence is required to qualify for an old age pension benefit.
Foreign employees working in the free-trade zones are able to opt out of the social security system. Also, foreign employees from countries having social security treaties with Uruguay may be exempt from local contributions.
DIRECTORY OF HOSPITALS & CLINICS
Comero (Co-op Med Rocha)
Calle 33 Y Eliseo Marsol
Rocha
Uruguay
Tel: + 598 472 8785
Hospital Britanico
Avenida Italia 2420
Montevideo
Uruguay
Tel: + 598 2 47 10 20
Fax: + 598 2 47 40 80
Hospital Evangelico
Bvar Batlle y Ordonez 2759
Montevideo
11600
Uruguay
Tel: + 598 2 487 23 19
Fax: + 598 2 487 23 34
Hospital Italiano
Boulevard Artigas 1632
Montevideo
Uruguay
Tel: + 598 2 47 97 17
Fax: + 598 2 47 06 51
Sanatorio Americano
Isabelino Bosch 2466
Montevideo
Uruguay
Tel: + 598 2 708 6041
Fax: + 598 2 709 4231
Sanatorio Cantegril
Avada Roosevelt y Parade 13
Punta del Este
Maldonado
20000
Uruguay
Tel: + 598 42 489 151
Fax: + 598 42 487 998
Sanatorio Impasa
Av Luis Alberto de Herrera 2275
Montevideo
Uruguay
Tel: + 598 2 47 10 16
Fax: + 598 2 81 27 18
Sanatorio Larghero
Boulevard Artigas 2080
Montevideo
Uruguay
Tel: + 598 2 487 2875
Sanatorio Mautone
Avda. Roosevelt y Camacho
Punta del Este
Maldonado
20100
Uruguay
Tel: + 598 42 28 558/25 353
Fax: + 598 42 31 243
Sanatorio Orameco
Alberto Mendez 170
Colonia
Uruguay
Tel: + 598 522 2057 |
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