xml:lang="es-ES" lang="es-ES" xmlns="http://www.w3.org/1999/xhtml" Un país enfermo de SGSSS, Samuel Andrés Arias,Artículos completos, Universo, Centro, Medellín, autores

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Número 9 - Febrero de 2010  
(La edición N°9, está en proceso de montaje, por lo pronto  mostramos este artículo)  

Artículos
Un país enfermo de SGSSS
Samuel Andrés Arias
 

La emergencia social en salud en Colombia comenzó hace 17 años. En 1993, el Banco Mundial publicó su informe anual titulado Invertir en salud. El texto hacía un amplio recuento de la situación sanitaria del mundo y mostraba la imperiosa necesidad de inyectar dinero al sector; sin embargo, lo que parece una sensata y loable recomendación no se relacionaba con mayores recursos para hacer frente a las principales enfermedades y problemas de salud del mundo, sino a la necesidad urgente de generar un nuevo mercado, en convertir la salud, lo que alguna vez fue un derecho humano, en una mercancía.

Como siempre, nosotros los colombianos, tan obedientes como hemos sido con las directrices de los organismos financieros multilaterales, hicimos rápido la tarea. Ese mismo año el honorable senador de la república Álvaro Uribe Vélez fue ponente de un proyecto que revolucionaría el sector en Colombia y que luego todos conoceríamos como la Ley 100.

A partir de ese momento el país renunciaba a tener un sistema de salud y lo reemplazaba por un Sistema General de Seguridad Social en Salud –SGSSS– (hasta la sigla parece el nombre de algún terrible germen), donde la estrategia que prometía garantizar la salud de los colombianos era un seguro médico. Esto significa que por un porcentaje de su salario, usted se hacía acreedor a un limitado paquete de servicios (eso que llaman Plan Obligatorio de Salud –POS–) que cubrirían "todas" sus necesidades en salud. Pero, no todo el mundo tiene un trabajo estable y puede pagar el seguro. No se preocupe, una porción de su cuota sirve para que la gente pobre también sea asegurada, ah, eso sí, no con los mismos servicios, a gente de segunda, un plan de salud de segunda, o más elegante "POS subsidiado". Bueno, ¿esa platica y esos servicios quien los administra? ¡Ajá! Ahí está el secreto del éxito, ahí está el broche de oro de la tarea que pidió el Banco Mundial: una aseguradora con nombre falso y rimbombante: Empresa Promotora de Salud, una EPS. Ellas, al igual que cuando usted estrella el carro, son las encargadas de decidir qué, cómo, cuándo y bajo qué condiciones se prestan los servicios de salud. Bueno, en teoría eso debería ser estándar, pero por supuesto, entre menos servicios preste o entre más baratos sean, más ganancias tendrán como empresas. El problema es que en este caso no son autos averiados, son enfermedades de seres humanos, cuya salud no depende sólo de que lo vea un médico, sino de cómo se garantizan las condiciones políticas, sociales, ambientales, económicas, etc., que hacen que una persona o una comunidad goce de buena salud; eso que alguna vez se llamó salud pública, la salud de todos; que ya no existe y que no cabe dentro de un sistema de aseguramiento.

Siempre he insistido en que la Ley 100 es un esquizofrénico monstruo de Frankenstein. Al igual que la bestia creada por Mary Shelley, la atención de salud en Colombia es la suma de un montón de partes mutiladas que difícilmente pueden ser organizadas con coherencia. Por eso, es feo, ineficaz, se le ven las costuras, y aunque desee hacer el bien, le es imposible, porque la suma de sus partes lo hacen un engendro malévolo. Un buen amigo y salubristas cartagenero, Nelsón Albis, me lo dijo de una manera más elegante en diciembre pasado: "el sistema de salud nuestro segmenta las poblaciones y fragmenta las atenciones". ¿Cómo así? Lo voy a explicar contándoles cómo esa terrible enfermedad llamada SGSSS mató a mi tía Emma.

Mi tía Ema murió hace un quinquenio. Dos años antes se había trasladado de Ramiriquí, un pequeño pueblito boyacense, a Bogotá. Cuando llegó a la ciudad comenzó a perder rápidamente peso y a sufrir de unos terribles dolores de barriga. Siempre fue una mujer pobre, y esa condición la hizo merecedora en el pueblo de un bonito carné que le permitía acceder a los servicios del hospital que serían cubiertos por una aseguradora que recibiría un pago mensual de parte del Estado. En Ramiriquí nunca lo usó, pero cuando se mudó a Bogotá y se enfermó ya no le servía, tenía que volver a hacer los trámites y volver a demostrar que era pobre y vecina de la ciudad. Eso significó que, cada día, más débil, debía rodar por varias oficinas, hacer largas colas, hasta que al fin lo obtuvo y pudo pasar, luego de varios meses, a consulta médica para que le mandaran un tratamiento banal que no la mejoró en nada.

Un país enfermo de SGSSSEl sistema es insostenible financieramente desde su concepción, sobre todo por el inmenso gasto en la inútil e ineficiente intermediación de las EPS, algunas de las cuales han logrado multiplicar su capital en los últimos años

 

 

Consultó de nuevo, seguía mal, muy mal, hasta que un médico que trabajaba por la salud de sus pacientes y no por la salud financiera de su patrón, cometió el pecado por el que hoy –con los nuevos decretos de la emergencia social– podría ser sancionado, de mandarle las pruebas que requería. Tenía cáncer de colon y estaba jodida, tenían que operarla pronto o moriría. Ese resultado significaba que tenían que verla otros especialistas y hacerse otros exámenes. Para cada atención tuvo que solicitar (léase rogar) una autorización a la EPS y esperar otros tantos meses más para cada atención. Resultado final: Emma del Carmen Arias murió. El certificado de defunción dice que la mató el cáncer, pero a mí nadie me quita de la cabeza que la causa básica de la muerte fue el SGSSS.

Todos en este país tenemos una historia como esta que contar. Todos los colombianos estamos infectados desde hace 17 años con el SGSSS y hemos desarrollado una perversa inmunidad a la enfermedad. Hoy día somos incapaces de pensar un sistema que garantice la salud como derecho humano, creemos que el aseguramiento y sus profetas, las EPS, harán de Colombia un país saludable. ¡Qué gran mentira!

Por eso los recientes decretos expedidos bajo el amparo de la emergencia social son absurdos. Son nuevos parches para mostrar el monstruo renovado. Los justifican en que los recursos del sistema son insuficientes para garantizarle la salud a los colombianos, cuando realmente lo que hay detrás es que este sistema es insostenible financieramente desde su concepción, sobre todo por el inmenso gasto en la inútil e ineficiente intermediación de los aseguradores, algunos de los cuales han logrado multiplicar su capital en los últimos años. Seamos claros: árbol que nace torcido, jamás su tronco endereza.

Está bien, aceptémoslo por un momento. Los recursos del sistema de salud son escasos y se requiere una declaración de emergencia social. Sin embargo, la pregunta es: ¿acaso los de educación son abundantes, los de vivienda digna, los de saneamiento ambiental? No seamos ilusos. La emergencia social sólo tiene sentido para garantizar la sostenibilidad financiera de las EPS como intermediarias, no como estrategia para garantizar el derecho a la salud de los colombianos.

El monstruo está vivo, maquillado y renovado, pero ahora más que nunca, es peligroso.

 

Samuel Arias es médico epidemiólogo y narrador. Profesor de la Facultad Nacional de Salud Pública de la Universidad de Antioquia.

 

Un país enfermo de SGSSS

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The Delhi Escorts Offer A Luxurious And Unique Service In Delhi The Delhi escorts service is a new service that offers high-class escort services for women. The Delhi Escorts offer luxury and unique companionship from the most beautiful women in Delhi. They are available for outcalls, home visits, and hotel visits. The service is very professional, with private transport on hand to pick up guests, who are met with high-class escorts in a private car or luxurious van. Delhi has a thriving nightlife scene and is quite a party town. With so many bars and clubs in the area, it can be easy to get lost or forget your way home. If you are looking for a way to get back to your hotel or a local taxi stand without having to worry about how much money you've spent on drinks at the bar, consider hiring a local escort service! Delhi escorts Whether you are looking for a romantic escape or an exciting new experience, the Escorts at The Delhi offer a luxurious and unique service. From intimate dinners and passionate kisses to private massages and full body rubs, these ladies will provide everything you could want or need. Whether you are in the mood for something simple or something extravagant, the Escorts at The Delhi will make sure your experience is perfect. Delhi's Escorts offer a luxurious and unique service in the city that is sure to impress. From traditional massage services to intimate moments in private rooms, these ladies will make your time in Delhi a true pleasure. Whether you're looking for an afternoon delight or an indulgent evening adventure, these Escorts will make sure you get everything you desire. Why Delhi Escorts? Delhi Escorts offer a luxurious and unique service that is unmatched by any other type of escort. They can provide a level of service that is simply not available from any other type of escort. 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Whether you're in the mood for romance, or excitement or simply want to escape every day, these ladies will make sure your experience is nothing short of extraordinary. What You Get A Delhi Escorts Service If you're looking for something unique and luxurious in Delhi, then an Escorts service is the perfect option for you! These ladies offer a truly unique experience that is sure to leave you feeling satisfied and fulfilled. Here are just some of the highlights of what you can expect: The escort in Delhi service offers an intimate experience that is unlike anything else available in Delhi. You'll get to enjoy the company of beautiful women who will take care of everything for you. These ladies are experts at providing a sensual and romantic experience. They will make sure that all your needs are taken care of, from wine and snacks to massage and relaxation sessions. The escort service in Delhi is perfect if you're looking for an escape from everyday life. 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Piya Mehta  26/nov./2022 06:47:

Do you know what you are required to do before hiring Noida escorts? If not, it is fine. Allow us to inform you that we have got some points to follow. For instance, you should look to hire Noida escorts from the websites that are reputed and verified as well as genuine. It is important to find out the reliable websites through going their reviews because there are countless numbers of such websites where they self-proclaim that they are the best reliable ones but in fact they are not. Verification of the Noida Escort Service before finalizing of their service is extremely important. And some of you may be wondering how to do so, right? If yes, you can do so by going through and looking at the pictures, documents and explanation of the service details. You can also look out the reviews and feedbacks that most of the people used to provide to the agencies or escorts online. Therefore, carrying out research about the Noida Escort that you are going to book is equally significant. You may also love to explore each one of those things in the best way because having research done in advance will always put you at the right end or you can say at safer place. In order to enjoy your life, you must fill up it with juicy romance and sensual as well as erotic pleasure that can keep you well occupied and hence, you shouldn’t feel bothered at all. So, in the name of such romantic engagement and pleasurable service, you should truly look out to have amazing fun. Delhi escort near me has maintained its standard and quality steadily and people from all around the world have no issue in choosing it as their ultimate means of joys and happiness. If you are in need of such kind of romantic fun and erotic pleasure, do kindly let us through emails, contact number, whatsapp number or call. If you do call us, any of our relevant department will response your queries. Delhi Call girl in hotel Defence Colony Escorts

SaumyaGiri  23/nov./2022 05:03:
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