The governor of Chubut, Ignacio Torres, surprised this Wednesday by raising the possibility that the province could take over the administration of PAMI in its territory. The proposal, still without a formal document to support it, was advanced by the governor in the context of the difficulties that the national agency is going through in the provision of services in the region. Torres assured that the initiative seeks "to have greater closeness with affiliates, reduce bureaucracy and take advantage of the link that already exists with health providers."
The governor's proposal is not minor. PAMI is the largest social security organization in Argentina and one of the most important in the region, with an annual budget of around 10 trillion pesos. Torres' proposal would imply that the Nation transfers to Chubut the resources it currently allocates to the care of retirees residing in that province. Although the exact amounts are not known, one possibility would be to calculate the average spending per affiliate nationwide and, based on that data, establish the amount that the province should receive.
The initiative is based on the existing structure of the provincial social security organization, Seros, which already manages the health of public employees in Chubut. The idea is for the province, through Seros, to manage PAMI benefits, either through public hospitals or through private clinics and professionals. In this way, the aim would be to streamline care and prevent affiliates from ending up resorting to public hospitals due to the decline of PAMI providers, a situation that has already occurred in other provinces.
However, Torres' proposal raises more questions than certainties. First, it is not clear how the amount that the Nation should transfer for each retiree served would be calculated. PAMI is financed with contributions from active workers and their employers, discounts on retirees' incomes, transfers from the national State and resources from taxes with specific allocations. Determining what the "per capita" amount that would correspond to Chubut is a central point that has not yet been defined.
The initiative is also part of a broader debate on the decentralization of health in Argentina. As occurred with the transfer of education to the provinces, a possible provincialization of PAMI could set a precedent and spread to other districts. Governor Torres himself announced that he will present the proposal in detail to the national government to analyze its viability, although for now there are no deadlines or certainties about its implementation. Meanwhile, the debate is open and the retirees of Chubut are watching closely.
