El Sistema de Salud LECCIÓN 10

México  In México the IMSS (Instituto Mexicano del Seguro Social) operates the social security system, providing everyone who has a stable job with health care and medicine at almost no cost.  The IMSS operates under the Mexican Social Security Law and provides the following  Medical assistance  Protection of basic necessities  Social services necessary for individual and collective well-being  Giving out a pension

Argentina  In Argentina there are public and private hospitals but health care is most accessible in Buenos Aires, the capital than any where else in the country.  Public hospitals provide basic care but the staff are very well trained. If a patient does not have health insurance or their insurance will not cover the treatment, patients are typically required to pay in cash before leaving or within a month.

Argentina  Private hospitals also expect immediate cash for health services and a visit to a doctor can cost from $17 to $50 for a specialist.  Many of the private hospitals offer their own health plans which the public can join. These plans usually offer more flexible payment terms, discounts and improved accessibility to health care.

España  Spain has nearly 40 million people and is comprised of 17 autonomous communities (Much like American states)

Overview of Spanish health care system  Spain has universal coverage with free access to health care for almost all citizens.  Public financing, mainly through general taxation.  Each autonomous community is in charge of their own residents but federally mandated to provide services.  They are developing a new model of primary health care emphasizing on prevention.

Overview of Spanish health care system  Spain has a generally good reputation with some 800 hospitals and 2,700 medical centers (Centros de Salud)throughout the country.  Almost every village will have a doctor (medico) who will attend his medical center daily (even if its just for a few hours before he goes to the next village or district).  Normally a nurse, (enfermera) will be in attendance and sometimes as a patient you can see your doctor the same day.

Sus Derechos  Under the Carta de Derechos y Deberes you may choose your own doctor– it is not necessary to be living in a particular area.

El Centro de Salud  You may also choose to go to a Centro de Salud (healthcare center), which usually has half a dozen doctors. You may not always get the doctor you first went to, but they try to give you a sense of regularity.  As a Centro de Salud you must make an appointment, whereas many doctors with their own practices take patients in the order they arrive.

El dentista  Unless you have private health insurance which covers dental work, you must pay for treatment at the dentist.  This is not overly expensive though and as with many businesses and services in Spain, if you need time to pay, dentists will allow this rather than making you pay on the day of your visit.

La farmacia  You can buy many medicines over the counter in Spain that you may not be able to get in the United States without a prescription.  Pharmacies are usually open from 9:30 a.m. until 2 p.m. and from 5 p.m. until 9:30 p.m. Mondays to Fridays and from 9:30 a.m. to 2:30 p.m. on Saturdays.

Las emergencias  Throughout Spain the numbers to call for a medical emergency is 061.  In each province it is wise to familiarize yourself with the address of the nearest hospital and its own emergency number.

¡No hablo español!  The main downside to use the Spanish state healthcare system is the problem of being understood.  The doctors, nurses and staff work in Spanish and translators are not provided within hospitals or medical centers.

Healthcare in the United States  Healthcare is not usually provided by the government.  Most people pay for healthcare through their employer and the insurance is through a private company.  Dental and vision insurance are usually extra as well.  There are 2 government systems: Medicare and Medicaid for the elderly, poor and disabled.  Health care companies previously could raise rates for individuals due to age, medical conditions or sex or decline to cover individuals for the same reasons.

Hospitals  Most hospitals are owned and operated by private businesses and many are non profit.  Hospitals provide some outpatient care in the emergency room and specialty clinics; but primarily provide in patient care.  If you do not have health insurance; hospital costs can be $10,000 or higher.  With health insurance you still have to pay a portion of money for your services.  Hospitals usually provide translators for people who do not speak English.

Affordable Care Act  Signed in 2010 and effective until  Insurance companies can not deny coverage to people based on pre-existing medical conditions. The same price must be offered to all people of the same age and in the same geographic location no matter gender or pre-existing conditions.  Any person without health insurance through an employer, not on Medicaid or Medicare is REQUIRED to carry health insurance or pay a fine.  Health insurance exchanges allow people to compare prices of plans and purchase insurance of their choice through the government.  Low income individuals who meet certain criteria and purchase through the exchange will receive a tax credit.