Síguenos:




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

  Name  
  Email
  Comment  
Imagen CAPTCHA
Enter the code shown above

Well-informed and composed content. I got such astounding data from the post. I will likewise say that the plan of the site is overall quite stacked rapidly. Like this well researched blog, if you want to read about bank verification process you can read on diro.io DIRO bank verification

Adam mendas  30/sep./2023 09:35:

The BriansClub.com is a website online that has a distinctive look as well as products and services which are also distinctive. It is distinctive in the world of online since it provides members with an exclusive collection of content offers suggestions based on their interests and ensures their safety when they're online. This is a website that is suitable for various online activities and includes many features that improve the user experience. https://brianssclub.cm/

briansclub cm  27/sep./2023 11:55:

I've found this interesting! Check it out! Massage Riyadh |

riyadh massage nuru  27/sep./2023 02:21:

riyadh rerotic massage .! https://www.eroticmassageworld.com/erotic-massage-in-riyadh-saudi-arabia.html

riyadh massage  27/sep./2023 02:19:

https://www.incredibleforest.net/ [URL=https://www.incredibleforest.net/]Link[/URL] | https://www.incredibleforest.net/

ber ser  27/sep./2023 02:17:

Direct Macro is your dedicated technology partner, committed to providing innovative and reliable solutions to meet your diverse needs. With a strong focus on quality and performance, we offer a wide range of cutting-edge products designed to enhance your technological experience. The CLV620-0000 Barcode Scanner is a dependable and feature-rich solution that empowers businesses with efficient data capture capabilities.

Direct Macro CLV620-0000  27/sep./2023 10:10:

Dear immortals, I need some wow gold inspiration to create.

Linghc13  27/sep./2023 02:53:

Sharing My Faridabad Call Girls Experience With Escorts Service

Let me introduce myself. I am Smitarana Call Girls in Faridabad, and welcome to my very own, exclusive blog. I am a well-recognized Faridabad call girls with an extensive list of clients that includes actors, businessmen, politicians, and many more. Regardless of their occupation, all my clients seem to agree that I'm one of the most gorgeous, sexy, seductive, and passionate call girls Faridabad. I have just one simple yearning to have a huge list of clients who are dotted all through the length and breadth of Faridabad and may even extend across Faridabad's entire length and breadth.

As I am Smitarana, genuine call girls in Faridabad city, I naturally don't let anyone hire me out for the night. I have an extremely exclusive list, and not everyone gets the pleasure of enjoying a night with me. My eye-catching looks and spectacularly elegant figure are accustomed to wealth and the high life. This means that my personal services do not come cheap. That's the reason I exclusively deal with a high class of clients who are in a league of their own when money is taken into consideration. When you hire me, you may expect a night of company, romantic fulfillment, or, if you want it, both. If you hire my services as call girl Faridabad, you can be sure that you are in for a memorable night the likes of which you would never have experienced before and most probably won't experience again.

What Customers Look Into Me Being as Call Girls in Faridabad

Although my voluptuous figure, my stunning beauty, and my colorful personality are some of the biggest and most important reasons why my clients keep coming back to me for more and more of my Faridabad escort service, One of the major incentives that they have for coming back to me is my abilities in bed and my willingness to try new and daring things during the act. Let me assure you, I am quite experienced and have unique talents when it comes to lovemaking, and I, for my part, guarantee to give you sexual fulfillment during the time you will get to spend with me. Please not

Few Faridabad escorts are very high-profile and spend their time with VIP clients. Every independent Faridabad call girls has an ideal and most gorgeously fitted body, and we know that your heart will thump fast and more fast after looking at our hot call girls in Faridabad. Every escort girl from our escort agency shows off her positioning. You'll be able to have any Faridabad girls after your decision to us. Are you living in Faridabad and wish to experience a one-night stand with sexy model escort girls for real sexual needs? If so, you've found the proper site. In and around the region, we offer escorts service in Faridabad. We have the best females from around Faridabad to fulfill your needs. They will make sure that as soon as you enter the room, your life starts to mean something and you begin to experience it. Where there will be no tensions and bustle of the world, just you, your female, all set to hit it and have the time of your lives.

We Are Not Forced To Provide Faridabad Escorts Service

Our picture library, as you can see, is filled with all the pictures of sexy call girls Faridabad. Yes, all of the pictures on display are real, and the females are genuine. They are all high-profile and well-paid escorts. They have this obscene talent that makes them worth every penny spent. They are not forced into this business; instead, they work independently as escorts and call girls. There are you girls as college escorts and older horny females that are providing escort service in Faridabad known as housewives. We also have a variety of model escorts. You can see their pictures in the library. They are beautiful, young, and desirable.

Our college escorts in Faridabad are young and bold. Their sensuality has no comparison and is beyond beautiful. They are also excellent role players and make excellent slaves and puppets. They are young college escorts and are working very hard in this business. Then there are also housewives escorts available in our escort lot. We have old women who are working to fulfill the needs of other men because they have gotten tired of pleasing one man for so long.

They know you are just an anonymous client. Faridabad is a very crowded place full of hustle and bustle. We will provide you with the best of our service and the best of our independent call girls Faridabad.

Faridabad Escorts Service: Married Man Also Love It

Most people love their sex life with their own wives, but after a long time, a new feeling takes them to other married women. Do you know that some people just consider married women right for sex? Because Faridabad escorts service have very experienced women. She knows how to please a man. She is more attracted to any kind of sexual interaction. A married woman constantly keeps her body parts neat and tidy since she is aware of how much a man values this trait. Married ladies have excellent boob size development and are quite appealing. That is why it is so enjoyable to lick their breasts.

There is no shortage of married call girl in Faridabad. In Faridabad, there is no shortage of married escort girls. Even married ladies who are unhappy in their marriages choose to offer escort services in Faridabad in order to satisfy their sex needs. When it comes to their social lives, they are amiable in every manner. Married ladies go out of their way to satisfy their sex partners. In any case, if she has a request to fulfill, she will do so eagerly. Housewives are very much liked by gentlemen for breaking their mouths in cocks. Married women can have sex with men of any age. In general, she has more fun with young people. Young boys can also learn new sex art in the context of married women, which they can do with their girlfriends later. Escorts in Faridabad prefer to have very huge sex, and their batteries are always charged. Even though housewives' ladies are quickly inspired for sex, obtaining married women gradually gives one more pleasure.

People Book Us For Different Social Or Personal events

Our outstanding escorts are amazing, humorous, engaging, and trustworthy women who provide their clients with responsive and perfect services. Our Faridabad escort is unpretentious partner who help worldwide representatives and top-level VIP chiefs for business assignments and social events. These types of escort in Faridabad even cater to exceptional people who require unique services like accompanying them on dates, to clubs, and to opulent malls. You can communicate and make declarations with people anywhere in the world at any time; thus, for a man of honor, our administration includes a prominent name in the lives of people.

For the ones who aren’t free and need minute pride inside less term, our association offers tip zenith cheap call girls in Faridabad by method for which any man or lady can make their moment perfect and splendid. Your security is also a major concern for our organization, which keeps all of your information private and does not even remotely divulge it to anyone.

We Are Talented, Educated, Genuine Faridabad Call Girls

So our gathering bearer might be exceptionally secure and agreeable without paying additional coins. In-call and out-call advantages are additionally given by method for our Verified Faridabad call girls. Right here, there is no plausibility of pity in light of the truth that each associate is talented by the method of gifted education.

No young woman here creates the impression that every call girl here is exceedingly warm and recommendable. With regards to the administration, the estimation of intercourse circular is really substantially less, wherein you may choose up various prides and loosen up. Our Faridabad call girl additionally comprehends how to satisfy the individual so that each time you need to take any type of headache medication,

In essence, every one of you who is determined to have sex and fun can end here with a high-radiance Indian escort. Our Faridabad free name more youthful women have unprecedented clever inclination and record all together that they are acquainted with what the real arrangement clients need, so our hot call girls don’t dither to give clients their most sexual and provocative components. Each Faridabad escort service form is amazingly inconceivable and sexual, so don’t be confined on the off chance that you require an escort in Faridabad  for a party or private dating, we are here just to give you outstanding services.

priyaji  26/sep./2023 03:39:

Do you have sexual feelings and do not have the right partner with whom you can exempt all these lustful activities? Indore Call Girl Whatsapp Number

Rekha Mathur  26/sep./2023 02:49:
1 2 3 4 5 6 7 8 9 10 ...
Universo Centro